Objective. To evaluate the effectiveness of a 12-month multicomponent obesity prevention intervention. Setting. 9 elementary schools in Santiago, Chile. Subjects. 6-8?y old low-income children (N = 1474). Design. Randomized controlled study; 5 intervention/4 control schools. We trained teachers to deliver nutrition contents and improve the quality of PE classes. We determined % healthy snacks brought from home, children's nutrition knowledge, nutritional status, duration of PE classes, and % time in moderate/vigorous activity (MVA). Effectiveness was determined by comparing ? BMI Z between intervention and control children using PROCMIXED. Results. % obesity increased in boys from both types of schools and in girls from control schools, while decreasing in girls from intervention schools (all nonsignificant). % class time in MVA declined (24.5-16.2) while remaining unchanged (24.8-23.7%) in classes conducted by untrained and trained teachers, respectively. In boys, BMI Z declined (1.33-1.24) and increased (1.22-1.35) in intervention and control schools, respectively. In girls, BMI Z remained unchanged in intervention schools, while increasing significantly in control schools (0.91-1.06, P = 0.024). Interaction group ? time was significant for boys (P < 0.0001) and girls (P = 0.004). Conclusions. This intervention was effective in controlling obesity, but not preventing it. Even though impact was small, results showed that when no intervention is implemented, obesity increases. PMID:24872892
Kain, Juliana; Concha, Fernando; Moreno, Lorena; Leyton, Bárbara
Objective. To evaluate the effectiveness of a 12-month multicomponent obesity prevention intervention. Setting. 9 elementary schools in Santiago, Chile. Subjects. 68?y old low-income children (N = 1474). Design. Randomized controlled study; 5 intervention/4 control schools. We trained teachers to deliver nutrition contents and improve the quality of PE classes. We determined % healthy snacks brought from home, children's nutrition knowledge, nutritional status, duration of PE classes, and % time in moderate/vigorous activity (MVA). Effectiveness was determined by comparing ? BMI Z between intervention and control children using PROCMIXED. Results. % obesity increased in boys from both types of schools and in girls from control schools, while decreasing in girls from intervention schools (all nonsignificant). % class time in MVA declined (24.516.2) while remaining unchanged (24.823.7%) in classes conducted by untrained and trained teachers, respectively. In boys, BMI Z declined (1.331.24) and increased (1.221.35) in intervention and control schools, respectively. In girls, BMI Z remained unchanged in intervention schools, while increasing significantly in control schools (0.911.06, P = 0.024). Interaction group ? time was significant for boys (P < 0.0001) and girls (P = 0.004). Conclusions. This intervention was effective in controlling obesity, but not preventing it. Even though impact was small, results showed that when no intervention is implemented, obesity increases.
Kain, Juliana; Concha, Fernando; Moreno, Lorena; Leyton, Barbara
Full Text Available In 1998 the World Health Organization declared childhood obesity as a global epidemic. It has also been observed that the health problems of adult obesity can be prevented, if obesity is controlled in childhood. This study aims to assess the effectiveness of structured teaching programme on knowledge and attitude regarding prevention of obesity and Correlate the knowledge and attitude regarding prevention of obesity among adolescents in a selected pre-university college. A pre-experimental one group pre-test post-test design was adopted. Convenience sampling technique used for selecting the adolescents. A structured knowledge questionnaire on prevention of obesity and a five-point Likert scale to assess the attitude regarding prevention of obesity were developed as the tools for data collection. The data obtained were analyzed based on the objectives and hypotheses, using descriptive and inferential statistics. The result showed that the mean post-test knowledge and attitude score of adolescents on prevention of obesity was higher than the mean pretest knowledge and attitude score. There was no correlation between knowledge and the attitude. The present study concludes that the teaching programme improved the knowledge and attitude of adolescents regarding prevention of obesity.
Prashanth K and Umarani J
Childhood obesity is a complex disease with different genetic, metabolic, environmental and behavioural components that are interrelated and potentially confounding, thus making causal pathways difficult to define. Given the tracking of obesity and the associated risk factors, childhood is an important period for prevention. To date, evidence would support preventative interventions that encourage physical activity and a healthy diet, restrict sedentary activities and offer behavioural suppor...
Obesity prevention is a major public health priority. It is important that all groups benefit from measures to prevent obesity, but we know little about the differential effectiveness of such interventions within particular population subgroups. This review aimed to identify interventions for obesity prevention that evaluated a change in adiposity according to socioeconomic position (SEP) and to determine the effectiveness of these interventions across different socioeconomic groups. A systematic search of published and grey literature was conducted. Studies that described an obesity prevention intervention and reported anthropometric outcomes according to a measure of SEP were included. Evidence was synthesized using narrative analysis. A total of 14 studies were analysed, representing a range of study designs and settings. All studies were from developed countries, with eight conducted among children. Three studies were shown to have no effect on anthropometric outcomes and were not further analysed. Interventions shown to be ineffective in lower SEP participants were primarily based on information provision directed at individual behaviour change. Studies that were shown to be effective in lower SEP participants primarily included community-based strategies or policies aimed at structural changes to the environment. Interventions targeting individual-level behaviour change may be less successful in lower SEP populations. It is essential that our efforts to prevent obesity do not leave behind the most disadvantaged members of society. PMID:24629126
Beauchamp, A; Backholer, K; Magliano, D; Peeters, A
A balanced and energy-restricted diet, exercise and behavior modification are the usual approaches used for obesity. Islamic fasting, which has the components of energy restriction and behavior modification, could be a safe nutritional approach for the prevention and treatment of obesity. For this reason, the effect of Islamic Fasting, an abstention from Foods, fluids and sex from dawn to sunset, on food intake, body weight and blood chemistry was studied in ten healthy adult male human subje...
Alam Khan; Muzaffar Ali Khan Khattak, M.
Full Text Available Elizabeth TeixeiraDrexel University College of Nursing and Health Professions, Philadelphia, PA, USAAbstract: Obesity is a major public health concern worldwide. The increasing prevalence of obesity in all ages, especially children and adolescents, has gained global attention and it is widely known that obesity increases the risk of many chronic conditions and illnesses, such as Type 2 Diabetes Mellitus (T2DM and cardiovascular disease (CVD. Obesity is a complex metabolic disorder, however, that is difficult to treat and manage. Therefore, despite the increased awareness about obesity-related health risks, obesity prevention and control has been a major challenge for health professionals. Lifestyle modification is easily prescribed, however, multiple barriers to implementation exist. Barriers include but are not limited to: behavioral and motivational factors, anti-fat bias, access to and reimbursement of educational programs, availability of healthy affordable foods, ongoing support systems that are culturally and community attuned, and comorbidities that limit physical activity and quality of life. Further, the current health care systems are not all designed to focus on health promotion and wellness. These contributing factors complicate weight management and control. Community-based programs are one potentially feasible approach that can assist individuals, families, and communities in developing healthy behaviors that promote and maintain weight loss. This review reports on nine worldwide current studies on the effectiveness of community-based programs in diverse populations targeting obesity. The purpose of this review is to examine evidenced-based interventions that can assist in the development of standard practices in the battle against obesity.Keywords: obesity, community, prevention, physical activity, nutrition
Full Text Available Abstract Childhood obesity has reached epidemic levels in developed countries. Twenty five percent of children in the US are overweight and 11% are obese. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising prevalence of obesity worldwide. In general, overweight and obesity are assumed to be the results of an increase in caloric and fat intake. On the other hand, there are supporting evidence that excessive sugar intake by soft drink, increased portion size, and steady decline in physical activity have been playing major roles in the rising rates of obesity all around the world. Consequently, both over-consumption of calories and reduced physical activity are involved in childhood obesity. Almost all researchers agree that prevention could be the key strategy for controlling the current epidemic of obesity. Prevention may include primary prevention of overweight or obesity, secondary prevention or prevention of weight regains following weight loss, and avoidance of more weight increase in obese persons unable to lose weight. Until now, most approaches have focused on changing the behaviour of individuals in diet and exercise. It seems, however, that these strategies have had little impact on the growing increase of the obesity epidemic. While about 50% of the adults are overweight and obese in many countries, it is difficult to reduce excessive weight once it becomes established. Children should therefore be considered the priority population for intervention strategies. Prevention may be achieved through a variety of interventions targeting built environment, physical activity, and diet. Some of these potential strategies for intervention in children can be implemented by targeting preschool institutions, schools or after-school care services as natural setting for influencing the diet and physical activity. All in all, there is an urgent need to initiate prevention and treatment of obesity in children.
Merchant Anwar T
The rising prevalence of overweight and obesity in children represents a major public health challenge, since excess weight is associated with many chronic diseases. These conditions also place a considerable economic burden on the society through increased healthcare costs and a morbidity-related decrease in productivity. Australia ranks amongst the countries with the highest prevalence for unhealthy weight and policy-makers are seeking for solutions in order to prevent the early onset of un...
Obesity is a public health problem that has become epidemic worldwide. Substantial literature has emerged to show that overweight and obesity are major causes of co-morbidities, including type II diabetes, cardiovascular diseases, various cancers and other health problems, which can lead to further morbidity and mortality. The related health care costs are also substantial. Therefore, a public health approach to develop population-based strategies for the prevention of excess weight gain is o...
Chan, Ruth S. M.; Jean Woo
Programs to prevent overweight and obesity are needed in order to improve individual and public health, to support informed choice and to diminish the societal costs associated with overweight. However, lifestyle interventions frequently evoke ethical debate. The potential ethical pitfalls that arise with respect to the prevention of overweight regard consequences for physical health, psychosocial well-being, equality, informed choice, social and cultural values, privacy, the attributions of responsibilities and liberty. For doctors in gastroenterology, it is important to be aware of these ethical pitfalls, either because they apply directly to questions in the consulting-room, or because they help to create awareness of the societal context a patient lives in. An ethical framework is being presented to show which ethical issues play a role in obesity prevention and how they can be prevented, followed by reflection on the ethical issues in interventions and in policy and media debate. PMID:24810191
Ten Have, Marieke
As the emphasis on preventing obesity has grown, so have calls for interventions that extend beyond individual behaviors and address changes in environments and policies. Despite the need for policy action, little is known about policy approaches that are most effective at preventing obesity. The Centers for Disease Control and Prevention (CDC) and others are funding the implementation and evaluation of new obesity prevention policies, presenting a distinct opportunity to learn from these pra...
Leeman, Jennifer; Sommers, Janice; Vu, Maihan; Jernigan, Jan; Payne, Gayle; Thompson, Diane; Heiser, Claire; Farris, Rosanne; Ammerman, Alice
In response to the growing burden of obesity, public primary prevention programs against obesity have been widely recommended. Several studies estimated the cost effects of diabetes prevention trials for different countries and found that diabetes prevention can be costeffective. Nevertheless, it is still controversial if prevention conducted in more real-world settings and among people with increased risk but not yet exhibiting Increased Glucose Tolerance can really be a cost-effective strat...
Ha?ußler, Jan; Breyer, Friedrich
In response to the growing burden of obesity, public primary prevention programs against obesity have been widely recommended. Several studies estimated the cost effects of diabetes prevention trials for different countries and found that diabetes prevention can be costeffective. Nevertheless, it is still controversial if prevention conducted in more real-world settings and among people with increased risk but not yet exhibiting Increased Glucose Tolerance can really be a cost-effective strat...
Ha?ußler, Jan; Breyer, Friedrich
Low-income youth are at increased risk for excess weight gain. Although evidence-based prevention programs exist, successful adaptation to provide wide dissemination presents a challenge. Hip-Hop to Health (HH) is a school-based obesity prevention intervention that targets primarily preschool children of low-income families. In a large randomized controlled trial, HH was found to be efficacious for prevention of excessive weight gain. The Expanded Food and Nutrition Education Program (EFNEP) and the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) are USDA-funded nutrition education programs offered to low-income families, and may provide an ideal platform for the wide dissemination of evidence-based obesity prevention programs. A research-practice partnership was established in order to conduct formative research to guide the adaptation and implementation of HH through EFNEP and SNAP-Ed. We present the design and method of a comparative effectiveness trial that will determine the efficacy of HH when delivered by peer educators through these programs compared to the standard EFNEP and SNAP-Ed nutrition education (NE) curriculum. Results from this trial will inform larger scale dissemination. The dissemination of HH through government programs has the potential to increase the reach of efficacious obesity prevention programs that target low-income children and families. PMID:24952282
Buscemi, Joanna; Odoms-Young, Angela; Stolley, Melinda L; Blumstein, Lara; Schiffer, Linda; Berbaum, Michael L; McCaffrey, Jennifer; Montoya, Anastasia McGee; Braunschweig, Carol; Fitzgibbon, Marian L
Child obesity is becoming a serious public health concern, and major research effort is being devoted both to understand its aetiology and to improve the effectiveness of prevention strategies. Early growth patterns, both prenatally and postnatally, are emerging as important markers of later obesity risk, with rapid neonatal weight gain a clear risk factor for later obesity and metabolic syndrome. Thus, in two distinct senses child obesity is a growing problem. The paper summarises current ev...
Cole, T. J.
Childhood obesity can cause social, psychological and health problems, and is linked to obesity later in life and poor health outcomes as an adult. Obesity development is related to physical activity and nutrition. To prevent obesity, 55 studies conducted internationally have looked at programmes aiming to improve either or both of these behaviours. Although many studies were able to improve childrens nutrition or physical activity to some extent, only some studies were able to see an ef...
Elizabeth TeixeiraDrexel University College of Nursing and Health Professions, Philadelphia, PA, USAAbstract: Obesity is a major public health concern worldwide. The increasing prevalence of obesity in all ages, especially children and adolescents, has gained global attention and it is widely known that obesity increases the risk of many chronic conditions and illnesses, such as Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease (CVD). Obesity is a complex metabolic disorder, however,...
Abstract Childhood obesity has reached epidemic levels in developed countries. Twenty five percent of children in the US are overweight and 11% are obese. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the ...
Childhood obesity has reached epidemic levels in developed countries. Twenty five percent of children in the US are overweight and 11% are obese. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising prevalence o...
Objective: Evaluate the effects of a prevention program targeting both eating disorders and obesity at 1- and 2-year follow-ups. Method: Female college students at risk for these outcomes because of body image concerns (N = 398) were randomized to the "Healthy Weight 2" group-based 4-hr prevention program, which promotes lasting healthy
Stice, Eric; Rohde, Paul; Shaw, Heather; Marti, C. Nathan
Full Text Available Global increases in obesity have led public health experts to declare this disease a pandemic. Although prevalent in all ages, the dire consequences associated with maternal obesity have a pronounced impact on the long-term health of their children as a result of the intergenerational effects of developmental programming. Previously, fetal under-nutrition has been linked to the predisposition to pediatric obesity explained by the adiposity rebound and catch-up growth that occurs when a child born to a nutrient deprived mother is exposed to the obesogenic environment of present day. Given the recent increase in maternal overweight/obesity (OW/OB our attention has shifted from nutrient restriction to overabundance and excess during pregnancy. Consideration must now be given to interventions that could mitigate pregravid body mass index (BMI, attenuate gestational weight gain (GWG and reduce postpartum weight retention (PPWR in an attempt to prevent the downstream signaling of pediatric obesity and halt the intergenerational cycle of weight related disease currently plaguing our world. Thus, this paper will briefly review current research that best highlights the proposed mechanisms responsible for the development of child OW/OB and related sequalae (e.g. type II diabetes (T2D and cardiovascular disease (CVD resulting from maternal obesity.
Sleep may affect energy balance. Sleep may not be the only answer to the obesity pandemic, but its effect should be considered seriously, as even small changes in the energy balance are beneficial. Good sleep could be part of the obesity prevention approach.
This podcast is based on the August, 2011 CDC Vital Signs report. Childhood obesity is an epidemic in the US. Breastfeeding can help prevent obesity, but one in three moms stop without hospital support. About 95% of hospitals lack policies that fully support breastfeeding moms. Hospitals need to do more to help moms start and continue breastfeeding. Created: 8/2/2011 by Centers for Disease Control and Prevention (CDC). Date Released: 8/2/2011.
By 2002, Chinas prevalence of overweight and obesity among adults was 18.9 percent and 2.9 percent, respectively. The Chinese traditional diet has been replaced by the Western diet and major declines in all phases of activity and increased sedentary activity as the main reasons explaining the rapid increase in overweight and obesity, bring major economic and health costs. The Nutrition Improvement Work Management Approach was released in 2010. Overweight and obesity prevention-related policies were added to national planning for disease prevention and control. The Guidelines for Prevention and Control of Overweight and Obesity of Chinese Adults and the School-age Children and Teenagers Overweight and Obesity Prevention and Control Guidelines in China were promulgated in 2003 and 2007, respectively. Few education programs have been implemented. Selected academic intervention research projects dominate with a focus on reducing child obesity and promoting healthier diets; increasing physical activity and reducing sedentary time; and facilitating changes in family, school, social, and cultural environments. Intervention samples are small and have not addressed the increasing rates of obesity throughout the entire population. Government provision of effective policy measures, multisectoral cooperation and increasing corporate social responsibility are keys to curb the trend toward overweight and obesity in China.
Huijun, Wang; Fengying, Zhai
By 2002, China's prevalence of overweight and obesity among adults was 18.9 and 2.9%, respectively. The replacement of traditional Chinese diet with 'Western diet', major declines in all phases of activity and increased sedentary activity are cited as the main reasons explaining the rapid increase in overweight and obesity, which bring major economic and health costs. The Nutrition Improvement Work Management Approach was released in 2010. Overweight and obesity prevention-related policies were added to national planning for disease prevention and control. The Guidelines for Prevention and Control of Overweight and Obesity of Chinese Adults and the School-age Children and Teenagers Overweight and Obesity Prevention and Control Guidelines in China were promulgated in 2003 and 2007, respectively. Few education programmes have been implemented. Selected academic intervention research projects dominate with a focus on reducing child obesity and promoting healthier diets; increasing physical activity and reducing sedentary time; and facilitating changes in family, school, social and cultural environments. Intervention samples are small and have not addressed the increasing rates of obesity throughout the entire population. Government provision of effective policy measures, multisectoral cooperation and increasing corporate social responsibility are keys to curbing the trend towards overweight and obesity in China. PMID:24102781
Wang, H; Zhai, F
Effective school-based obesity prevention programs are needed to prevent and reduce the growing obesity risk among youth. Utilizing the evidence-rich areas of violence and substance use prevention, translation science may provide an efficient means for developing curricula across multiple health behaviors. This paper introduces Pathways to Health, a school-based obesity prevention program that was developed by translating from evidence-based violence and drug use prevention programs, Promotin...
Sakuma, Kari-lyn K.; Riggs, Nathaniel R.; Pentz, Mary Ann
Obesity is a medical condition in which excess body fat that it may have an adverse effect on health, leading to life expectancy and increased health problems. In keeping with the general international trend of rising prevalence of obesity, maternal obesity prevalence is rising. According to WHO, the prevalence of obesity in pregnancy ranges from 1.8 to 25.3%. Maternal obesity has been identified to be a risk factor for maternal and perinatal mortality. The aim of this article was reviewed in...
Emre Yanikkerem; Selviye Mutlu
Abstract The rates of paediatric obesity have risen dramatically. Given the challenge of successful weight loss and maintenance, preventive interventions are sorely needed. Furthermore, since a substantial proportion of individuals do not respond to traditional behavioural weight loss therapy, alternative approaches are required. Psychological treatments for binge eating disorder have been generally effective at reducing binge episodes and producing weight maintenance or modest weight loss in obese adults. Given the strong link between loss of control eating and obesity in youths, binge eating disorder treatment may serve as a viable form of excess weight gain prevention. An adapted version of interpersonal psychotherapy for binge eating disorder is one such intervention that we have considered. A description of the theoretical basis and proposed mechanism is described. Adaptations of interpersonal psychotherapy and other established therapies for binge eating disorder may serve as platforms from which to develop and disseminate obesity and eating disorder prevention programs in children and adolescents. PMID:22724648
Childhood obesity is a complex issue and needs multistakeholder involvement at all levels to foster healthier lifestyles in a sustainable way. Ensemble Prévenons lObésité Des Enfants (EPODE, Together Lets Prevent Childhood Obesity) is a large-scale, coordinated, capacity-building approach for communities to implement effective and sustainable strategies to prevent childhood obesity. This paper describes EPODE methodology and its objective of preventing childhood obesity. At a c...
Borys, Jean-michel; Le Bodo, Y.; Jebb, Sa; Seidell, Jc; Summerbell, C.; Richard, D.; Henauw, Stefaan; Moreno, La; Romon, M.; Visscher, Tls; Raffin, S.; Swinburn, B.; Een Study Group, The; Assche, Joke
Childhood obesity is a complex issue and needs multistakeholder involvement at all levels to foster healthier lifestyles in a sustainable way. Ensemble Prévenons l'ObésitéDes Enfants (EPODE, Together Let's Prevent Childhood Obesity) is a large-scale, coordinated, capacity-building approach for communities to implement effective and sustainable strategies to prevent childhood obesity. This paper describes EPODE methodology and its objective of preventing childhood obesity.
Borys, J-m; Le Bodo, Y.; Jebb, S. A.; Seidell, J. C.; Summerbell, C.; Richard, D.; Henauw, S.; Moreno, L. A.; Romon, M.; Visscher, T. L. S.; Raffin, S.; Swinburn, B.
Childhood overweight and obesity is a major health concern in the United States. It is recommended that every well-child examination include body mass index measurements and obesity prevention discussions that encourage healthy eating habits, regular physical exercise, and limited television and computer screen time. Providers can make a difference through strategic intervention. J Contin Educ Nursing. 2014;45(5):199-200. PMID:24801582
Tyler, Jennifer M; Fruh, Sharon M; Mulekar, Madhuri S
Abstract Background Overweight and obesity have a dramatic negative impact on children's health not only during the childhood but also throughout the adult life. Preventing the development of obesity in children is therefore a world-wide health priority. There is an obvious urge for sustainable and evidenced-based interventions that are suitable for families with young children, especially for families with overweight or obese parents. We have developed a prevention program, ...
Sobko Tanja; Svensson Viktoria; Ek Anna; Ekstedt Mirjam; Karlsson Håkan; Johansson Elin; Cao Yingting; Hagströmer Maria; Marcus Claude
Full Text Available SciELO Brazil | Language: English Abstract in english BACKGROUND: Prevention of childhood obesity is an international public health priority given the significant impact of obesity on acute and chronic diseases, general health, development and well-being. The international evidence base for strategies that governments, communities and families can im [...] plement to prevent obesity, and promote health, has been accumulating but remains unclear. OBJECTIVE: This review primarily aims to update the previous Cochrane review of childhood obesity prevention research and determine the effectiveness of evaluated interventions intended to prevent obesity in children, assessed by change in Body Mass Index (BMI). Secondary aims were to examine the characteristics of the programs and strategies to answer the questions "What works for whom, why and for what cost?" METHODS: Search methods: The searches were re-run in CENTRAL, MEDLINE, EMBASE, PsychINFO and CINAHL in March 2010 and searched relevant websites. Non-English language papers were included and experts were contacted. Selection criteria: The review includes data from childhood obesity prevention studies that used a controlled study design (with or without randomisation). Studies were included if they evaluated interventions, policies or programs in place for twelve weeks or more. If studies were randomized at a cluster level, six clusters were required. Data collection and analysis: Two review authors independently extracted data and assessed the risk of bias of included studies. Data was extracted on intervention implementation, cost, equity and outcomes. Outcome measures were grouped according to whether they measured adiposity, physical activity (PA)-related behaviours or diet-related behaviours. Adverse outcomes were recorded. A meta-analysis was conducted using available BMI or standardized BMI (zBMI) score data with subgroup analysis by age group (0-5, 6-12, 13-18 years, corresponding to stages of developmental and childhood settings). MAIN RESULTS: This review includes 55 studies (an additional 36 studies found for this update). The majority of studies targeted children aged v 6-12 years. The meta-analysis included 37 studies of 27,946 children and demonstrated that programmes were effective at reducing adiposity, although not all individual interventions were effective, and there was a high level of observed heterogeneity (I2 = 82%). Overall, children in the intervention group had a standardised mean difference in adiposity (measured as BMI or zBMI) of -0.15kg/m2 (95% confidence interval (CI): -0.21 to -0.09). Intervention effects by age subgroups were -0.26kg/m2 (95% CI -0.53 to 0.00) (0- 5 years), - 0.15 kg/m2 (95% CI -0.23 to -0.08) (6-12 years), and -0.09 kg/m2 (95% CI -0.20 to 0.03) (13-18 years). Heterogeneity was apparent in all three age groups and could not explained by randomisation status or the type, duration or setting of the intervention. Only eight studies reported on adverse effects and no evidence of adverse outcomes such as unhealthy dieting practices, increased prevalence of underweight or body image sensitivities was found. Interventions did not appear to increase health inequalities although this was examined in fewer studies. AUTHORS' CONCLUSIONS: We found strong evidence to support beneficial effects of child obesity prevention programmes on BMI, particularly for programmes targeted to children aged six to 12 years. However, given the unexplained heterogeneity and the likelihood of small study bias, these findings must be interpreted cautiously. A broad range of programme components were used in these studies and whilst it is not possible to distinguish which of these components contributed most to the beneficial effects observed, our synthesis indicates the following to be promising policies and strategies: school curriculum that includes healthy eating, physical activity and body image; increased sessions for physical activity and the development of fundamental movement skills throughout the school week; improvements in nu
Waters, Elizabeth; Silva-Sanigorski, Andrea de; Burford, Belinda J.; Brown, Tamara; Campbell, Karen J.; Gao, Yang; Armstrong, Rebecca; Prosser, Lauren; Summerbell, Carolyn D..
Obesity is a global epidemic and children are affected in increasing numbers. Overweight children are at increased risk of becoming overweight adults with associated chronic diseases. In this update, we present key findings from a review of the current literature focused on potential causes and strategies for preventing childhood obesity. We highlight recent evidence regarding the role of genetics, maternal body mass index, postnatal influences, and environmental effects throughout childhood ...
Vos, Miriam B.; Welsh, Jean
Full Text Available Marcio C Mancini, Alfredo HalpernObesity and Metabolic Syndrome Group, Endocrinology and Metabolism Department, Faculty of Medicine, University of São Paulo, São Paulo, SP, BrazilAbstract: There has been an increase in the concern about preventing type 2 diabetes mellitus (T2DM, a disease with great and increasing prevalence. The prevalence of obesity, physical inactivity, Western processed diet, important risk factors for the development of T2DM, are also rising. Free fatty acids are increased in obesity and reduce insulin clearance and increase hepatic glucose production. Implementation of a healthy lifestyle has been show to slow the progression of impaired glucose tolerance to T2DM. Orlistat is an inhibitor of lipase activity, with proved efficacy in body weight reduction and long-term management of obesity and more favorable effects on carbohydrate metabolism and it was prospectively shown in XENDOS study that orlistat promoted long-term weight loss and prevented T2DM onset in obese individuals with normal and impaired glucose tolerance at baseline over four years. This benefit could be associated to the weight loss itself, to the limited absorption of lipids and reduction of plasma free fatty acids, to increased production of incretins or to modulation of secretion of cytokines by adipocytes, all effects secondary to orlistat treatment. A proposed strategy is to identify subjects at highest risk to receive a drug intervention, using lifestyle interventions alone at the community level.Keywords: type 2 diabetes mellitus, prevention, diabesity, obesity, metabolic syndrome, orlistat
Marcio C Mancini
Childhood and adolescent obesity has been increasing in most middle- and high-income countries, and, as with adult obesity, this has been driven by increasingly obesogenic environments, especially the food environment. This constitutes a "market failure," signaling the need for government interventions with policies, programs, and social marketing. Population prevention strategies are critical, and children and adolescents should be the priority populations. Food marketing to children is a central policy issue for governments to address, and comprehensive regulations are needed to provide substantive protection for children. Community-based intervention programs show some real promise in reducing childhood obesity, but the 2 big challenges ahead are to ensure that there is substantial ongoing funding so that the community capacity to promote healthy weights can be scaled up to a national level and to ensure that policies are in place to support these efforts. The social and cultural shifts that support healthy eating and physical activity occur differentially, and special efforts are needed to reduce the socioeconomic gradients associated with childhood obesity. A positive public health approach encompassing environmental, regulatory, sociocultural, and educational strategies offer the best chance of reducing obesity without increasing disordered eating patterns. PMID:19014868
OBJECTIVES: (1) To evaluate the evidence relating to the effectiveness of methods to prevent and treat obesity, and (2) to provide recommendations for the prevention and treatment of obesity in adults aged 18 to 65 years and for the measurement of the body mass index (BMI) as part of a periodic health examination. OPTIONS: In adults with obesity (BMI greater than 27) management options include weight reduction, prevention of further weight gain or no intervention. OUTCOMES: The long-term (mor...
Douketis, J. D.; Feightner, J. W.; Attia, J.; Feldman, W. F.
Prevention of childhood obesity is an international public health priority given the significant impact of obesity on short- and long-term functioning, health and wellbeing. Although recommended in several recent reviews, school-based obesity prevention interventions targeting physical activity and diet have been tested with mixed results. The overall aim of the HEalth in Adolescents (HEIA) study was to design, implement and evaluate a comprehensive intervention program to promote a healthy w...
There is mounting evidence that current food production, transport, land use and urban design negatively impact both climate change and obesity outcomes. Recommendations to prevent climate change provide an opportunity to improve environmental outcomes and alter our food and physical activity environments in favour of a 'healthier' energy balance. Hence, setting goals to achieve a more sustainable society offers a unique opportunity to reduce levels of obesity. In the case of children, this approach is supported with evidence that even from a young age they show emerging understandings of complex environmental issues and are capable of both internalizing positive environmental values and influencing their own environmental outcomes. Given young children's high levels of environmental awareness, it is easy to see how environmental sustainability messages may help educate and motivate children to make 'healthier' choices. The purpose of this paper is to highlight a new approach to tackling childhood obesity by tapping into existing social movements, such as environmental sustainability, in order to increase children's motivation for healthy eating and physical activity behaviours and thus foster more wholesome communities. We contend that a social marketing framework may be a particularly useful tool to foster behaviour change beneficial to both personal and environmental health by increasing perceived benefits and reducing perceived costs of behaviour change. Consequently, we propose a new framework which highlights suggested pathways for helping children initiate and sustain 'healthier' behaviours in order to inform future research and potentially childhood obesity intervention strategies. PMID:23392756
Skouteris, Helen; Cox, Rachael; Huang, Terry; Rutherford, Leonie; Edwards, Susan; Cutter-Mackenzie, Amy
Obesity prevalence in the Brazilian adult population is 12.5% among men and 16.9% among women. Obesity control has been a subject of concern in Brazilian health policies since the publication of the National Food and Nutrition Policy in 1999. The initiatives include a comprehensive national intersectorial plan for obesity prevention and control focused on confronting its social and environmental causes, development of a food and nutrition education framework aimed at intersectorial public policies in the food and nutritional security field, promotion and provision of healthy food in school environments (linked to family farming), structuring nutrition actions in primary healthcare in the national healthcare system, promoting community physical activity, food regulation and control, and encouragement of public participation and food control. We conclude that several initiatives have been developed in Brazil to deal with the challenge of implementing an intergovernmental, intersectorial response to reverse the rising overweight and obesity rates. The success of this response will depend on a governance model that promotes joint and integrated action by different sectors and active participation of society to consolidate the actions, places and laws that protect health and promote healthy lifestyles. PMID:24102701
Jaime, P C; da Silva, A C F; Gentil, P C; Claro, R M; Monteiro, C A
Preventing Childhood Obesity: Tips for Parents and Caretakers Updated:Feb 5,2014 Balance is key in helping your child maintain ... way to change weight is gradually. Learn more: Childhood Obesity BMI in Children Making a Healthy Home Healthier ...
A high-fat diet (HFD) results in hyperlipidemia and an increase in oxidative stress. The purpose of this study was to investigate the preventive effect of embelin against hyperlipidemia and oxidative stress in HFD-induced obesity in rats. Male Wistar rats aged 12 weeks (150-200 g) were fed with an HFD for a period of 28 days to induce experimental obesity. HFD-induced obese rats were treated with embelin (50 mg/kg) or orlistat (10 mg/kg) for 21 days. A range of parameters were tested including body weight gain, body mass index (BMI), blood pressure, visceral fat pad weights, serum levels of glucose, insulin, leptin, apolipoprotein B (ApoB), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), hepatic thiobarbituric acid-reactive substances (TBARS), superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH). Twenty-one days of embelin (50 mg/kg) treatment produced effects similar to orlistat in reducing body weight gain, blood pressure, visceral fat pad weight, serum lipid levels, as well as coronary artery risk and atherogenic indices of HFD-fed rats. Embelin treatment also lowered the serum levels of glucose by 24.77 %, insulin by 35.03 %, and leptin by 43.39 %. Furthermore, embelin treatment significantly (p embelin in HFD-induced obesity and its related complications. Embelin could be valuable in the development of new drug therapies to prevent obesity, hyperlipidemia, and oxidative stress. PMID:22450777
Chaudhari, Hemantkumar Somabhai; Bhandari, Uma; Khanna, Geetika
In recent decades, obesity has become a major public health problem in developed societies and economies in transition. Rapid social changes that have occurred since the mid 20th century prompted major changes in eating habits and lifestyles, with the gradual abandonment of traditional dietary patterns and culinary techniques, significant decrease in physical activity and increased sedentary time, giving as result in an imbalance in the energy balance. Obesity is a risk factor for many chronic diseases. There is evidence that childhood obesity influences adult health condition. Additionally, obesity in children affects their physical, emotional and social wellbeing. According to some estimates the cost of obesity may represent up to 12% of health cost in some countries. Many actions have been developed since around the year 2000 WHO alerted about the problem. The analysis of the factors involved in the origin of the problem have led to recognize the importance of creating supportive environments for healthier food choices and physical activity to be the easiest and accessible options in common everyday environments, such as schools, workplace or community environment. Evidence is long available that the most effective interventions to prevent childhood obesity should consider multiple strategies and last longer. Today it is also recognized the importance of implementing policies that encourage supportive friendly environments for physical activity and help decisions to opt for healthy eating habits. PMID:24010753
Aranceta Bartrina, Javier
Abstract Background Overweight and obesity in children in Mexico was among the countries with the highest prevalence's in the world. Mexico currently has few innovative and comprehensive experiences to help curb the growth of this serious public health problem. Therefore, the aim of this study is to assess the effectiveness of a nutrition and physical activity strategy, called "Nutrition on the Go" ("nutrición en movimiento") in maintaining the BMI values of school ...
Shamah Levy Teresa; Morales Ruán Carmen; Amaya Castellanos Claudia; Salazar Coronel Araceli; Jiménez Aguilar Alejandra; Méndez Gómez Humarán Ignacio
Prevention of childhood obesity is a national priority. Parents influence young childrens healthy lifestyles, so it is paradoxical that obesity interventions focus primarily on children. Evidence and theory suggest that including parents in interventions offers promise for effective childhood obesity prevention. This case study engaged parents as co-researchers in the design, implementation and evaluation of an intervention for low-income families with a child enrolled in Head Start. Pa...
Jurkowski, Janine M.; Green Mills, Lisa L.; Lawson, Hal A.; Bovenzi, Mary C.; Quartimon, Ronald; Davison, Kirsten K.
Full Text Available IntroductionBecause of the publics growing awareness of the childhood obesity epidemic, health policies that address obesogenic environments by encouraging healthy eating and increased physical activity are gaining more attention. However, there has been little systematic examination of state policy efforts. This study identified and described state-level childhood obesity prevention legislation introduced and adopted from 2003 through 2005 and attempted to identify regional geographic patterns of introduced legislation.MethodsA scan of legislation from all 50 states identified 717 bills and 134 resolutions that met study inclusion criteria. Analyses examined patterns in the introduction and adoption of legislation by time, topic area, and geography.ResultsOverall, 17% of bills and 53% of resolutions were adopted. The amount of legislation introduced and adopted increased from 2003 through 2005. The topic areas with the most introduced legislation were school nutrition standards and vending machines (n = 238; physical education and physical activity (n = 191; and studies, councils, or task forces (n = 110. Community-related topic areas of walking and biking paths (37%, farmers markets (36%, and statewide initiatives (30% had the highest proportion of bills adopted, followed by model school policies (29% and safe routes to school (28%. Some regional geographic patterns in the introduction of legislation were observed. There was no statistical association between state-level adult obesity prevalence and introduction of legislation.ConclusionPublic health and health policy practitioners can use this information to improve advocacy efforts and strengthen the political climate for establishing childhood obesity prevention legislation within state governments. Expanded surveillance (including standardized identification and cataloging of introduced and adopted legislation will enhance the ability to assess progress and identify effective approaches. Future policy research should examine determinants, implementation, and effectiveness of legislation to prevent childhood obesity.
Tegan K. Boehmer, PhD, MPH
Full Text Available Abstract Background Overweight and obesity in children in Mexico was among the countries with the highest prevalence's in the world. Mexico currently has few innovative and comprehensive experiences to help curb the growth of this serious public health problem. Therefore, the aim of this study is to assess the effectiveness of a nutrition and physical activity strategy, called "Nutrition on the Go" ("nutrición en movimiento" in maintaining the BMI values of school children in the State of Mexico. Methods A two-stage cluster trial was carried out. Sixty schools were selected in the State of Mexico, of which 30 were randomly assigned to the intervention group (IG and 30 to the control group (CG. A total of 1020 fifth grade school children participated. The intervention strategy aimed to decrease the energy content of school breakfasts and include fruits and vegetables, as well as increase physical activity and the consumption of water during the time spent at school. The strategy was implemented over a 6-month period. Results The estimated probability (EP of obesity between baseline and the final stage for the IG decreased 1% (Initial EP = 11.8%, 95%CI 9.0, 15.2, final EP = 10.8, 95%CI 8.4, 13. For the CG, the probability increased 0.9% (baseline EP = 10.6%; 95%CI 8.1, 13.7; final EP = 11.5, 95%CI 9.0, 14.6. The interaction between the intervention and the stage is the average odd time corrected treatment effect, which is statistically significant (p = 0.01 (OR = 0.68, 95%CI 0.52, 091. This represents the interaction between intervention and stage, which is highly significant (p = 0.01 (OR = 0.68; 95%CI 0.52, 091. In addition, girls had a protective effect on obesity (OR = 0.56; 95%CI 0.39, 0.80. Conclusions The intervention strategy is effective in maintaining the BMI of school children.
Shamah Levy Teresa
Full Text Available Obesity and its related metabolic abnormalities, including insulin resistance, alterations in the insulin-like growth factor-1 (IGF-1/IGF-1 receptor (IGF-1R axis, and the state of chronic inflammation, increase the risk of colorectal cancer (CRC and hepatocellular carcinoma (HCC. However, these findings also indicate that the metabolic disorders caused by obesity might be effective targets to prevent the development of CRC and HCC in obese individuals. Green tea catechins (GTCs possess anticancer and chemopreventive properties against cancer in various organs, including the colorectum and liver. GTCs have also been known to exert anti-obesity, antidiabetic, and anti-inflammatory effects, indicating that GTCs might be useful for the prevention of obesity-associated colorectal and liver carcinogenesis. Further, branched-chain amino acids (BCAA, which improve protein malnutrition and prevent progressive hepatic failure in patients with chronic liver diseases, might be also effective for the suppression of obesity-related carcinogenesis because oral supplementation with BCAA reduces the risk of HCC in obese cirrhotic patients. BCAA shows these beneficial effects because they can improve insulin resistance. Here, we review the detailed relationship between metabolic abnormalities and the development of CRC and HCC. We also review evidence, especially that based on our basic and clinical research using GTCs and BCAA, which indicates that targeting metabolic abnormalities by either pharmaceutical or nutritional intervention may be an effective strategy to prevent the development of CRC and HCC in obese individuals.
Background: United States pediatric guidelines recommend that childhood obesity counseling be conducted in the primary care setting. Primary care-based interventions can be effective in improving health behaviors, but also costly. The purpose of this study was to evaluate the cost of a primary care-based obesity prevention intervention targeting children between the ages of two and six years who are at elevated risk for obesity, measured against usual care. Methods: High Five for Kids was a c...
Wright, Davene R.; Taveras, Elsie M.; Gillman, Matthew W.; Horan, Christine M.; Hohman, Katherine H.; Gortmaker, Steven L.; Prosser, Lisa A.
Obesity and its related metabolic abnormalities, including insulin resistance, alterations in the insulin-like growth factor-1 (IGF-1)/IGF-1 receptor (IGF-1R) axis, and the state of chronic inflammation, increase the risk of colorectal cancer (CRC) and hepatocellular carcinoma (HCC). However, these findings also indicate that the metabolic disorders caused by obesity might be effective targets to prevent the development of CRC and HCC in obese individuals. Green tea catechins (GTCs) possess a...
Masahito Shimizu; Masaya Kubota; Takuji Tanaka; Hisataka Moriwaki
Full Text Available The purpose of this study was to reveal the various strategies for preventing and managing overweight and obesity in relation to reducing morbidity and mortality due to overweight and obesity. Thus, overweight and obesity are defined as Body Mass Index (BMI of 25.0-29.9 kg/m2 and > 30.0 kg/m2 respectively. Overweight and obesity are complex multifactorial chronic diseases that develop from an interaction of genotype and the environment. It was therefore concluded that overweight and obesity involve the interaction of social, behavioural, cultural, physiological, metabolic and genetic factors. Thus, it was recommended that multi-component intervention which include nutrition and physical activities and strategies such as providing nutrition education or dietary prescription, physical activity, pharmacological and behavioural skills development and training could help to prevent and manage overweight and obesity.
Elvis I. Agbonlahor
Research has identified pregnancy as a trigger to obesity among women; therefore, childbirth educators are encouraged to include the topic of weight gain in their classes. The Centers for Disease Control and Prevention recently published a guide on obesity that may serve as an excellent resource for both educators and their clients.
Montgomery, Kristen S.
Partial Contents: Introduction; Legal approaches in other areas; Actions by federal agencies: a focus on foods and beverages; Perspectives from the food industry; Using regulations and taxes to prevent obesity; Using the law to increase physical activity;...
The aim of this study was to investigate the Danish publics support for publicly funded obesity treatment and prevention. It was also examined whether levels of support could be explained by dislike of obese people and / or the belief that those who are obese are personally responsible for their condition. A representative survey of members of the Danish public (N=1,141) was conducted using a web-based questionnaire. The survey was designed to assess attitudes to public funding for obesity...
Lund, Thomas Bøker; Sandøe, Peter; Lassen, Jesper
This report summarizes the National Heart, Lung, and Blood Institute Working Groups recommendations on future research directions in childhood obesity prevention and treatment. The Working Group consisted of leaders and representatives from public and private academic and medical institutions with expertise in a variety of health specialties. They reviewed the literature and discussed the findings as well as their own experiences in the prevention and treatment of childhood obesity. The Wo...
Pratt, Charlotte A.; Stevens, June; Daniels, Stephen
The objectives of the present thesis were to investigate self-efficacy and motivational interviewing as motivational frameworks for health behavior change in the prevention of childhood obesity, and to explore child health services as a setting for childhood obesity prevention. Specifically, the thesis aimed to (a) develop a measure of parental self-efficacy for promoting healthy physical activity and dietary behaviors in children and assess its psychometric properties, (b) evaluate the effec...
This 60 second Public Service Announcement (PSA) is based on the August, 2011 CDC Vital Signs report. Childhood obesity is an epidemic in the US. Breastfeeding can help prevent obesity, but one in three moms stop without hospital support. About 95% of hospitals lack policies that fully support breastfeeding moms. Hospitals need to do more to help moms start and continue breastfeeding. Created: 8/2/2011 by Centers for Disease Control and Prevention (CDC). Date Released: 8/2/2011.
When people look back 50 years from now, childhood obesity may well stand out as the most important public health issue of our time. The prevalence of childhood obesity has tripled in just three decades, contributing to the ever more frequent appearance i...
A. C. Burns E. Sanchez L. Parker
Childhood obesity is a grave issue, which needs to be addressed urgently because it leads to several medical and psychosocial problems in children. High prevalence is being increasingly reported in children from developing countries as well. The combination of our genetic propensity to store fat, the ready availability of calorie dense foods, and sedentary lifestyle promotes overweight. The child's food environment at home and parental obesity are strong determinants. Urban poor in developed ...
Raychaudhuri, Moutusi; Sanyal, Debmalya
Abstract: Obesity, diabetes and oral diseases (dental cariesand periodontal diseases), largely preventable chronic diseases, are described as global pandemic due their distribution and severe consequences. WHO has called for a global action for prevention and promotion of these diseases as a vital investment in urgent need. Diabetes and obesity, showing an increasing trend, lead to disabilities and negatively impacts on the quality of life through life course along with oral diseases. WHO projects that the prevalence of diabetes and deaths/year attrituble to diabetes complications will double worldwide by 2030. Globally, more than 1 billion adults are overweight; almost 300 million of them are clinically obese. Being obese/overweight raises steeply the likelihood of developing DM2. Approximately 85% of people with diabetes are DM2, and of these 90% are obese or overweight. Obesity increases the likelihood of periodontitis which is one of the most common chronic diseases worldwide, described as pandemic, and closely related to DM2. Promoting good oral health is significantly essential for prevention and reducing the negative consequences of periodontal diseases, DM2 and obesity, and to maintain good health, as proposed by European health goals by WHO.
Cinar, Ayse Basak
Childhood overweight is one of the most serious problems currently affecting individual and public health. Schools represent a logical site for prevention because children spend 6-8 hours a day there during most of the year. Although reports of school-based overweight or obesity prevention programs exist, there are no summaries specifying which
Budd, Geraldine M.; Volpe, Stella L.
Abstract Background Prevention is considered effective in combating the obesity epidemic. Prenatal environment may increase offspring's risk for obesity. A child starts to adopt food preferences and other behavioral habits affecting weight gain during preschool years. We report the study protocol of a pragmatic lifestyle intervention aiming at primary prevention of childhood obesity. Methods/Design A non-randomized controlled pragmatic trial in maternity and chi...
Mustila Taina; Keskinen Päivi; Luoto Riitta
IntroductionBecause of the publics growing awareness of the childhood obesity epidemic, health policies that address obesogenic environments by encouraging healthy eating and increased physical activity are gaining more attention. However, there has been little systematic examination of state policy efforts. This study identified and described state-level childhood obesity prevention legislation introduced and adopted from 2003 through 2005 and attempted to identify regional geographic pat...
Tegan K Boehmer, Phd; Ross C Brownson, Phd; Debra Haire-joshu, Phd; Dreisinger, Mariah L.
Childhood obesity is a recognized public health crisis. This paper reviews the lessons learned from a voluntary initiative to expand insurance coverage for childhood obesity prevention and treatment services in the United States. In-depth telephone interviews were conducted with key informants from 16 participating health plans and employers in 2010-11. Key informants reported difficulty ensuring that both providers and families were aware of the available services. Participating health plans...
Rask, Kimberly J.; Gazmararian, Julie A.; Kohler, Susan S.; Hawley, Jonathan N.; Bogard, Jenny; Brown, Victoria A.
Full Text Available Abstract Obesity is traditionally viewed to be beneficial to bone health because of well-established positive effect of mechanical loading conferred by body weight on bone formation, despite being a risk factor for many other chronic health disorders. Although body mass has a positive effect on bone formation, whether the mass derived from an obesity condition or excessive fat accumulation is beneficial to bone remains controversial. The underline pathophysiological relationship between obesity and bone is complex and continues to be an active research area. Recent data from epidemiological and animal studies strongly support that fat accumulation is detrimental to bone mass. To our knowledge, obesity possibly affects bone metabolism through several mechanisms. Because both adipocytes and osteoblasts are derived from a common multipotential mesenchymal stem cell, obesity may increase adipocyte differentiation and fat accumulation while decrease osteoblast differentiation and bone formation. Obesity is associated with chronic inflammation. The increased circulating and tissue proinflammatory cytokines in obesity may promote osteoclast activity and bone resorption through modifying the receptor activator of NF-?B (RANK/RANK ligand/osteoprotegerin pathway. Furthermore, the excessive secretion of leptin and/or decreased production of adiponectin by adipocytes in obesity may either directly affect bone formation or indirectly affect bone resorption through up-regulated proinflammatory cytokine production. Finally, high-fat intake may interfere with intestinal calcium absorption and therefore decrease calcium availability for bone formation. Unraveling the relationship between fat and bone metabolism at molecular level may help us to develop therapeutic agents to prevent or treat both obesity and osteoporosis. Obesity, defined as having a body mass index ? 30 kg/m2, is a condition in which excessive body fat accumulates to a degree that adversely affects health 1. The rates of obesity rates have doubled since 1980 2 and as of 2007, 33% of men and 35% of women in the US are obese 3. Obesity is positively associated to many chronic disorders such as hypertension, dyslipidemia, type 2 diabetes mellitus, coronary heart disease, and certain cancers 456. It is estimated that the direct medical cost associated with obesity in the United States is ~$100 billion per year 7. Bone mass and strength decrease during adulthood, especially in women after menopause 8. These changes can culminate in osteoporosis, a disease characterized by low bone mass and microarchitectural deterioration resulting in increased bone fracture risk. It is estimated that there are about 10 million Americans over the age of 50 who have osteoporosis while another 34 million people are at risk of developing the disease 9. In 2001, osteoporosis alone accounted for some $17 billion in direct annual healthcare expenditure. Several lines of evidence suggest that obesity and bone metabolism are interrelated. First, both osteoblasts (bone forming cells and adipocytes (energy storing cells are derived from a common mesenchymal stem cell 10 and agents inhibiting adipogenesis stimulated osteoblast differentiation 111213 and vice versa, those inhibiting osteoblastogenesis increased adipogenesis 14. Second, decreased bone marrow osteoblastogenesis with aging is usually accompanied with increased marrow adipogenesis 1516. Third, chronic use of steroid hormone, such as glucocorticoid, results in obesity accompanied by rapid bone loss 1718. Fourth, both obesity and osteoporosis are associated with elevated oxidative stress and increased production of proinflammatory cytokines 1920. At present, the mechanisms for the effects of obesity on bone metabolism are not well defined and will be the focus of this review.
Cao Jay J
Obesity is a global problem. Sugar-sweetened beverages (SSB) are a leading contributor of added sugars in individual diets and thus to obesity. Governments have considered taxing SSBs to prevent obesity and generate revenue, but no 'one-size-fits-all' taxation approach exists. We describes three key considerations for governments interested in exploring beverage taxation: (i) what type of tax to apply plus how and where the tax is collected and presented to consumers; (ii) what types of beverages to tax; and (iii) the amount of tax needed to affect consumption and/or obesity prevention-related revenue generation. We offer examples of existing beverage taxes in the United States and internationally. The information will be useful to policymakers at all levels of government, as they continue to consider beverage taxation policies. PMID:23698157
Chriqui, Jamie F; Chaloupka, Frank J; Powell, Lisa M; Eidson, Shelby S
Numerous investigations documented that there is a significant correlation between obesity and the onset of malignant neoplasms. It has been known for decades that Vojvodina is an area characterized by frequent occurrence of obesity with adult population, which starts much earlier in childhood. Good knowledge of incidence in child obesity is a first step in the prevention of malignant diseases. The study encompassed the anthropometric measurements (body height and body weight) of 3298 boys an...
Mirilov Jelena M.; Bjelica Artur L.
The aim of this comprehensive systematic review was to identify the most effective behavioural models and behaviour change strategies, underpinning preschool- and school-based interventions aimed at preventing obesity in 4-6-year-olds. Searching was conducted from April 1995 to April 2010 using MEDLINE, EMBASE, CINAHL, PsycINFO and The Cochrane Library. Epidemiological studies relevant to the research question with controlled assignment of participants were included in the review, if they had follow-up periods of 6 months or longer. Outcomes included markers of weight gain; markers of body composition; physical activity behaviour changes and dietary behaviour changes. Twelve studies were included in the review. The most commonly used model was social cognitive theory (SCT)/social learning theory (SLT) either as a single model or in combination with other behavioural models. Studies that used SCT/SLT in the development of the intervention had significant favourable changes in one, or more, outcome measures. In addition, interventions that (i) combined high levels of parental involvement and interactive school-based learning; (ii) targeted physical activity and dietary change; and (iii) included long-term follow-up, appeared most effective. It is suggested that interventions should also be focused on developing children's (and parents') perceived competence at making dietary and physical changes. PMID:22309069
Nixon, C A; Moore, H J; Douthwaite, W; Gibson, E L; Vogele, C; Kreichauf, S; Wildgruber, A; Manios, Y; Summerbell, C D
Full Text Available Five major approaches namely dietary, exercise, behavior, combination and pharmacy therapies are used for treatment and control of obesity. In dietary therapy, low-calorie diet (LCD, which provides 800 to 1500 kcal of energy daily; a very-low-calorie diet (VLCD, which provides 250-800 kcal of energy daily and an energy-restricted or hypo caloric diet (HCD, which is based on a person`s estimated daily energy requirement. LCDs can reduce total body weight by an average of 8 percent and help reduce abdominal fat content over a period of approximately 6 months. VLCDs are not recommended for weight loss therapy because the deficits are too great, and nutritional inadequacies will occur unless VLCDs are supplemented with vitamins and minerals. Regular exercise/physical activity should be an integral part of weight loss therapy and weight maintenance. A daily regimen of 30-45 minutes of walking, bicycling or working around the house conveys physical activity`s positive effects on the muscolo-skeletal, cardiovascular, respiratory and endocrine systems, reduces risk of premature mortality, coronary heart disease, hypertension, colon cancer and diabetes. Exercise should be initiated slowly, and the intensity should be increased gradually; starting from small tasks of daily living such as taking the stairs or walking or swimming at a slow pace leading to the more strenuous activities like brisk walking, cycling, exercise, rope jumping and Jogging. Behavior therapy provides methods for overcoming barriers to compliance with dietary and exercise therapies. Combined intervention of an LCD, increased physical activity, and behavior therapy provides the most successful therapy for weight loss and weight maintenance. Islamic way of life (directional eating and lifestyle (worship schedule is the most efficient method for prevention and control of obesity and is one of the best example of combination of diet and exercise therapies. Pharmacotherapy or medication should be the last approach for obesity control.
Aien Khan Afridi
The commercial drivers of the obesity epidemic are so influential that obesity can be considered a robust sign of commercial success - consumers are buying more food, more cars and more energy-saving machines. It is unlikely that these powerful economic forces will change sufficiently in response to consumer desires to eat less and move more or corporate desires to be more socially responsible. When the free market creates substantial population detriments and health inequalities, government policies are needed to change the ground rules in favour of population benefits.Concerted action is needed from governments in four broad areas: provide leadership to set the agenda and show the way; advocate for a multi-sector response and establish the mechanisms for all sectors to engage and enhance action; develop and implement policies (including laws and regulations) to create healthier food and activity environments, and; secure increased and continued funding to reduce obesogenic environments and promote healthy eating and physical activity.Policies, laws and regulations are often needed to drive the environmental and social changes that, eventually, will have a sustainable impact on reducing obesity. An 'obesity impact assessment' on legislation such as public liability, urban planning, transport, food safety, agriculture, and trade may identify 'rules' which contribute to obesogenic environments. In other areas, such as marketing to children, school food, and taxes/levies, there may be opportunities for regulations to actively support obesity prevention. Legislation in other areas such as to reduce climate change may also contribute to obesity prevention ('stealth interventions'). A political willingness to use policy instruments to drive change will probably be an early hallmark of successful obesity prevention. PMID:18534000
Swinburn, Boyd A
Maternal obesity is a global epidemic affecting both developed and developing countries. Human and animal studies indicate that maternal obesity adversely programs the development of offspring, predisposing them to chronic diseases later in life. Several mechanisms act together to produce these adverse health effects. There is a consequent need for effective interventions that can be used in the management of human pregnancy to prevent these outcomes. The present review analyzes the dietary and exercise intervention studies performed to date in both altricial and precocial animals, rats and sheep, with the aim of preventing adverse offspring outcomes. The results of these interventions present exciting opportunities to prevent, at least in part, adverse metabolic and other outcomes in obese mothers and their offspring. PMID:24147928
Nathanielsz, Peter W; Ford, Stephen P; Long, Nathan M; Vega, Claudia C; Reyes-Castro, Luis A; Zambrano, Elena
We examined the long-term metabolic effects of glipizide gastrointestinal therapeutic system (GITS), a potent sulfonylurea (SU), in impaired glucose-tolerant (IGT), first-degree relatives of African American patients with type 2 diabetes. To this end, we assessed glucose homeostasis, beta-cell function, insulin sensitivity (Si), and glucose effectiveness (Sg) in patients with IGT before and at yearly intervals for 24 months of GITS or an identical placebo in a randomized, double-blind manner. Eighteen IGT patients were randomized to receive either glipizide GITS (GITS, 5 mg/d, n = 9; mean age, 43.3 +/- 8.7 years; mean body mass index [BMI], 32.9 +/- 6.3 kg/m(2)) or identical placebo (PLAC, n = 9; mean age, 41.5 +/- 5.7 years; mean BMI, 39 +/- 4.2 kg/m(2)) for 24 months. Each of the subjects underwent oral glucose tolerance test (OGTT) and frequently sampled intravenous glucose tolerance test (FSIGT) at baseline and yearly intervals for 2 years. Si and Sg were determined by Bergman's minimal model method. The ability of beta cell to compensate for peripheral insulin resistance was calculated as the disposition index (DI). Chronic administration of glipizide GITS attenuated serum glucose responses to oral glucose challenge at 12 and 24 months when compared to baseline (0 months). In contrast, serum glucose levels at fasting and during OGTT tended to increase in the IGT/PLAC group at 12 and 24 months when compared to baseline. Serum insulin (P glipizide GITS administration improved glucose homeostasis by increasing beta-cell responsiveness to glucose, improving Si, as well as significantly improved DI, but not Sg, in high-risk, obese African Americans with IGT. Our study demonstrated that GITS appears to prime beta cells to intravenous glucose stimulation resulting in restoration of physiologic acute first- and second-phase insulin secretion in African Americans with IGT. We conclude that GITS might be considered as a useful agent in the primary prevention of type 2 diabetes in high-risk, obese African American patients with IGT. PMID:15045685
Osei, Kwame; Rhinesmith, Scott; Gaillard, Trudy; Schuster, Dara
This paper presents a community-school-higher education partnership approach to the prevention of childhood obesity. Public elementary school personnel, primarily teachers, participated in the design and delivery of a curriculum targeting primary caregivers of 8-9-year-old children. Theoretical framework and methodological approaches guided the
Bruss, Mozhdeh B.; Dannison, Linda; Morris, Joseph R.; Quitugua, Jackie; Palacios, Rosa T.; McGowan, Judy; Michael, Timothy
As researchers continue to analyze the role of parenting both in the development of childhood overweight and in obesity prevention, studies of child nutrition and growth are detailing the ways in which parents affect their children's development of food- and activity-related behaviors. Ana Lindsay, Katarina Sussner, Juhee Kim, and Steven Gortmaker
Lindsay, Ana C.; Sussner, Katarina M.; Kim, Juhee; Gortmaker, Steven
Given the disproportionately high rates of obesity-related morbidity among low-income, ethnic minority youth, obesity prevention in this population is critical. Prior efforts to curb childhood obesity have had limited public health impact. The present study evaluates an innovative approach to obesity prevention by promoting foundational parenting and child behavioral regulation. This pre-post intervention study evaluated an enhanced version of ParentCorps with 91 families of pre-Kindergarten students in low-income, urban communities. Assessments included tests of knowledge and parent report. Consistent with findings from two randomized controlled trials of ParentCorps, parent knowledge and use of foundational parenting practices increased and child behavior problems decreased. Child nutrition knowledge and physical activity increased and television watching decreased; for boys, sleep problems decreased. Comparable benefits occurred for children at high risk for obesity based on child dysregulation, child overweight, and parent overweight. Results support a "whole child," family-centered approach to health promotion in early childhood. PMID:24702665
Dawson-McClure, Spring; Brotman, Laurie Miller; Theise, Rachelle; Palamar, Joseph J; Kamboukos, Dimitra; Barajas, R Gabriela; Calzada, Esther J
Research evidence indicates that obesity has spread through social networks, but lever points for interventions based on overlapping networks are not well studied. The objective of our research was to construct and parameterize a system dynamics model of the social transmission of behaviors through adult and youth influence in order to explore hypotheses and identify plausible lever points for future childhood obesity intervention research. Our objectives were: (1) to assess the sensitivity of childhood overweight and obesity prevalence to peer and adult social transmission rates, and (2) to test the effect of combinations of prevention and treatment interventions on the prevalence of childhood overweight and obesity. To address the first objective, we conducted two-way sensitivity analyses of adult-to-child and child-to-child social transmission in relation to childhood overweight and obesity prevalence. For the second objective, alternative combinations of prevention and treatment interventions were tested by varying model parameters of social transmission and weight loss behavior rates. Our results indicated child overweight and obesity prevalence might be slightly more sensitive to the same relative change in the adult-to-child compared to the child-to-child social transmission rate. In our simulations, alternatives with treatment alone, compared to prevention alone, reduced the prevalence of childhood overweight and obesity more after 10 years (1.21.8% and 0.21.0% greater reduction when targeted at children and adults respectively). Also, as the impact of adult interventions on children was increased, the rank of six alternatives that included adults became better (i.e., resulting in lower 10 year childhood overweight and obesity prevalence) than alternatives that only involved children. The findings imply that social transmission dynamics should be considered when designing both prevention and treatment intervention approaches. Finally, targeting adults may be more efficient, and research should strengthen and expand adult-focused interventions that have a high residual impact on children.
Frerichs, Leah M.; Araz, Ozgur M.; Huang, Terry T. - K.
Childhood obesity is a complex issue and needs multi-stakeholder involvement at all levels to foster healthier lifestyles in a sustainable way. 'Ensemble Prévenons l'Obésité Des Enfants' (EPODE, Together Let's Prevent Childhood Obesity) is a large-scale, coordinated, capacity-building approach for communities to implement effective and sustainable strategies to prevent childhood obesity. This paper describes EPODE methodology and its objective of preventing childhood obesity. At a central level, a coordination team, using social marketing and organizational techniques, trains and coaches a local project manager nominated in each EPODE community by the local authorities. The local project manager is also provided with tools to mobilize local stakeholders through a local steering committee and local networks. The added value of the methodology is to mobilize stakeholders at all levels across the public and the private sectors. Its critical components include political commitment, sustainable resources, support services and a strong scientific input--drawing on the evidence-base--together with evaluation of the programme. Since 2004, EPODE methodology has been implemented in more than 500 communities in six countries. Community-based interventions are integral to childhood obesity prevention. EPODE provides a valuable model to address this challenge. PMID:22106871
Borys, J-M; Le Bodo, Y; Jebb, S A; Seidell, J C; Summerbell, C; Richard, D; De Henauw, S; Moreno, L A; Romon, M; Visscher, T L S; Raffin, S; Swinburn, B
Obesity is currently a global public health problem. Obesity in early life increases the risk of long-term energy imbalance and adult obesity and its comorbidities, type 2 diabetes, and cardiovascular disease. Since infancy and childhood are critical periods for the adoption of food preferences and physical activity, prevention strategies must intervene in these early periods to promote healthy habits and reduce risk behaviors. Trends in the prevalence of childhood obesity and overweight in Spain have continuously increased in the last three decades. Obesity and overweight currently affect 15 and 20% of Spanish children, respectively, and these percentages are among the highest in Europe. Childhood obesity is determined by social and economic factors pertaining to sectors other than the health system, such as advertising, the built environment, education and the school environment, transportation and the food environment. Following the Health in All Policies (HiAP) approach, the authors identified a series of multisector policy changes that may help to prevent and control the current rising trend of childhood obesity in Spain. The HiAP approach acknowledges that social factors including socioeconomic status, gender differences and the work-life balance are important to develop effective policy changes in the prevention of childhood obesity. A key to success in the prevention of childhood obesity in Spain through policy changes will depend on the ability to establish a policy with the explicit and primary goal of improving health outcomes, despite the anticipated resistance from various sectors and stakeholders. PMID:21074906
Franco, Manuel; Sanz, Belén; Otero, Laura; Domínguez-Vila, Adrián; Caballero, Benjamín
Abstract Background Error in self-reported measures of obesity has been frequently described, but the effect of self-reported error on recruitment into diabetes prevention programs is not well established. The aim of this study was to examine the effect of using self-reported obesity data from the Finnish diabetes risk score (FINDRISC) on recruitment into the Greater Green Triangle Diabetes Prevention Project (GGT DPP). Methods The GGT DPP was a structured group...
Hernan Andrea; Philpot Benjamin; Janus Edward D; Dunbar James A
In this study, the anti-obesity effect of 1-deoxynojirimycin (DNJ) was examined in the diet-induced obese mouse model. Mulberry DNJ was administered to the obese mice for 12 weeks. As a result, DNJ decreased both the visceral fat weight and adipocyte size. To determine the influence of DNJ on lipid metabolism, lipid parameters of the plasma and the liver and the activities of several molecules related to lipid metabolism in the liver were measured. DNJ activated the ?-oxidation system, suppressed lipid accumulation in the liver and reduced plasma triacylglycerol. Since it was thought that the factor activated in the ?-oxidation system was adiponectin, plasma adiponectin levels were measured and it was shown that plasma adiponectin was increased with DNJ. Therefore, it was suggested that DNJ promoted an increase in plasma adiponectin and activated the ?-oxidation system. Overall, it was shown that DNJ prevents diet-induced obesity through an increase in adiponectin. PMID:23561072
Tsuduki, Tsuyoshi; Kikuchi, Ikuko; Kimura, Toshiyuki; Nakagawa, Kiyotaka; Miyazawa, Teruo
Full Text Available AbstractAmong children ages 719, about 1 in 3 are overweight and obese (BMI-for-age at or above the 85th percentile of the 2000 CDC growth charts.; 32.1% of all boys and 31.3% of all girls are overweight and obese. Because of the dramatic and alarming increase in childhood obesity and its associated health risks, obesity prevention programs targeting children can and should be developed to promote the health of the public. This study is an overview of different interventions conducted, to guide efforts for an effective management of childhood obesity. The aim of this review was to assess the literature regarding the prevention of childhood obesity. Databases that were accessed for current literature included Medline, Cochrane and CINAHL. A total of 26 articles were found based on the inclusion criteria for this study. Only 38% of studies required parents' participation, the sample sizes of the studies varied considerably from 201 to 3135 children. 92% of studies used randomized controlled trials and the range of intervention duration ranged from eight weeks to four years. Implications for future research and practice are presented.
Hanan Mohamed Tork
Full Text Available Numerous investigations documented that there is a significant correlation between obesity and the onset of malignant neoplasms. It has been known for decades that Vojvodina is an area characterized by frequent occurrence of obesity with adult population, which starts much earlier in childhood. Good knowledge of incidence in child obesity is a first step in the prevention of malignant diseases. The study encompassed the anthropometric measurements (body height and body weight of 3298 boys and 3146 girls aged from 6 to 15 years, from 10 primary schools of the wider area of the city of Novi Sad. The measurement data served as the basis to calculate the body mass index (BMI. On the basis of BMI the incidence of the overall obesity (³P85 among the examined boys on the territory of Novi Sad community was found to be 16.59%. Overweight (P85 - P95 was observed in 10.28%, and obesity (³P95 in 6.31% boys. The analysis of the nutrition status among the examined schoolgirls on the territory of Novi Sad community, on the basis of BMI, showed that overall obesity (³P85 was present in 14.69% of schoolgirls; overweight (P85 - P95 was found in 9.38%, and obesity (³P95 in 5.31% of the examined schoolgirls. The high percentage of obese schoolchildren cannot be considered as desirable, especially if it is taken into account that there has been a significant increase compared with the previous examination.
Mirilov Jelena M.
The increasing childhood obesity epidemic calls for appropriate measures and effective policies to be applied early in life. Large-scale socioecological frameworks providing a holistic multifactorial and cost-effective approach necessary to support obesity prevention initiatives in this age are however currently missing. To address this missing link, ToyBox-study aims to build and evaluate a cost-effective kindergarten-based, family-involved intervention scheme to prevent obesity in early chi...
Manios, Y.; Grammatikaki, E.; Androutsos, O.; Chin A Paw, M. J. M.; Gibson, E. L.; Buijs, G.; Iotova, V.; Socha, P.; Annemans, L.; Wildgruber, A.; Mouratidou, T.; Yngve, A.; Duvinage, K.; Bourdeaudhuij, I.
Approximately two thirds of U.S. adults and one fifth of U.S. children are obese or overweight. During 1980--2004, obesity prevalence among U.S. adults doubled, and recent data indicate an estimated 33% of U.S. adults are overweight (body mass index [BMI] 25.0-29.9), 34% are obese (BMI >or=30.0), including nearly 6% who are extremely obese (BMI >or=40.0). The prevalence of being overweight among children and adolescents increased substantially during 1999-2004, and approximately 17% of U.S. children and adolescents are overweight (defined as at or above the 95% percentile of the sex-specific BMI for age growth charts). Being either obese or overweight increases the risk for many chronic diseases (e.g., heart disease, type 2 diabetes, certain cancers, and stroke). Reversing the U.S. obesity epidemic requires a comprehensive and coordinated approach that uses policy and environmental change to transform communities into places that support and promote healthy lifestyle choices for all U.S. residents. Environmental factors (including lack of access to full-service grocery stores, increasing costs of healthy foods and the lower cost of unhealthy foods, and lack of access to safe places to play and exercise) all contribute to the increase in obesity rates by inhibiting or preventing healthy eating and active living behaviors. Recommended strategies and appropriate measurements are needed to assess the effectiveness of community initiatives to create environments that promote good nutrition and physical activity. To help communities in this effort, CDC initiated the Common Community Measures for Obesity Prevention Project (the Measures Project). The objective of the Measures Project was to identify and recommend a set of strategies and associated measurements that communities and local governments can use to plan and monitor environmental and policy-level changes for obesity prevention. This report describes the expert panel process that was used to identify 24 recommended strategies for obesity prevention and a suggested measurement for each strategy that communities can use to assess performance and track progress over time. The 24 strategies are divided into six categories: 1) strategies to promote the availability of affordable healthy food and beverages), 2) strategies to support healthy food and beverage choices, 3) a strategy to encourage breastfeeding, 4) strategies to encourage physical activity or limit sedentary activity among children and youth, 5) strategies to create safe communities that support physical activity, and 6) a strategy to encourage communities to organize for change. PMID:19629029
Khan, Laura Kettel; Sobush, Kathleen; Keener, Dana; Goodman, Kenneth; Lowry, Amy; Kakietek, Jakub; Zaro, Susan
Full Text Available Abstract Background Many unhealthy dietary and physical activity habits that foster the development of obesity are established by the age of five. Presently, approximately 70 percent of children in the United States are currently enrolled in early childcare facilities, making this an ideal setting to implement and evaluate childhood obesity prevention efforts. We describe here the methods for conducting an obesity prevention randomized trial in the child care setting. Methods/design A randomized, controlled obesity prevention trial is currently being conducted over a three year period (2010-present. The sample consists of 28 low-income, ethnically diverse child care centers with 1105 children (sample is 60% Hispanic, 15% Haitian, 12% Black, 2% non-Hispanic White and 71% of caregivers were born outside of the US. The purpose is to test the efficacy of a parent and teacher role-modeling intervention on childrens nutrition and physical activity behaviors. . The Healthy Caregivers-Healthy Children (HC2 intervention arm schools received a combination of (1 implementing a daily curricula for teachers/parents (the nutritional gatekeepers; (2 implementing a daily curricula for children; (3 technical assistance with meal and snack menu modifications such as including more fresh and less canned produce; and (4 creation of a center policy for dietary requirements for meals and snacks, physical activity and screen time. Control arm schools received an attention control safety curriculum. Major outcome measures include pre-post changes in child body mass index percentile and z score, fruit and vegetable and other nutritious food intake, amount of physical activity, and parental nutrition and physical activity knowledge, attitudes, and beliefs, defined by intentions and behaviors. All measures were administered at the beginning and end of the school year for year one and year two of the study for a total of 4 longitudinal time points for assessment. Discussion Although few attempts have been made to prevent obesity during the first years of life, this period may represent the best opportunity for obesity prevention. Findings from this investigation will inform both the fields of childhood obesity prevention and early childhood research about the effects of an obesity prevention program housed in the childcare setting. Trial registration Trial registration number: NCT01722032
Prevention of obesity in childhood and adolescence remains a worthwhile and realistic goal, but preventive efforts have been beset by a number of problems, which are the subject of this review. The review draws on recent systematic reviews and evidence appraisals and has a United Kingdom (UK) perspective because there is a rich evidence base in the United Kingdom that may be helpful to obesity prevention researchers elsewhere. Recent evidence of a leveling off in child and adolescent obesity ...
Reilly, John J.
Full Text Available A systematic review of the literature was conducted to identify the barriers that prevent practitioners from identifying and counseling parents and caregivers of overweight or obese children. Once identified, barriers were organized into thematic categories (parental, provider, and professional barriers and recommendations were generated to facilitate discussion about childhood obesity between professionals and parents. Childhood obesity is a significant public health problem. Healthcare providers must be able to effectively communicate with caregivers and put childhood obesity at the front of healthcare discussions. This article provides a synthesis of the relevant literature and makes recommendations for healthcare providers to overcome the barriers allowing healthier outcomes for children.
Full Text Available Abstract Background Nearly one in five 4-year-old children in the United States are obese, with low-income children almost twice as likely to be obese as their middle/upper-income peers. Few obesity prevention programs for low-income preschoolers and their parents have been rigorously tested, and effects are modest. We are testing a novel obesity prevention program for low-income preschoolers built on the premise that children who are better able to self-regulate in the face of psychosocial stressors may be less likely to eat impulsively in response to stress. Enhancing behavioral self-regulation skills in low-income children may be a unique and important intervention approach to prevent childhood obesity. Methods/design The Growing Healthy study is a randomized controlled trial evaluating two obesity prevention interventions in 600 low-income preschoolers attending Head Start, a federally-funded preschool program for low-income children. Interventions are delivered by community-based, nutrition-education staff partnering with Head Start. The first intervention (n?=?200, Preschool Obesity Prevention Series (POPS, addresses evidence-based obesity prevention behaviors for preschool-aged children and their parents. The second intervention (n?=?200 comprises POPS in combination with the Incredible Years Series (IYS, an evidence-based approach to improving self-regulation among preschool-aged children. The comparison condition (n?=?200 is Usual Head Start Exposure. We hypothesize that POPS will yield positive effects compared to Usual Head Start, and that the combined intervention (POPS?+?IYS addressing behaviors well-known to be associated with obesity risk, as well as self-regulatory capacity, will be most effective in preventing excessive increases in child adiposity indices (body mass index, skinfold thickness. We will evaluate additional child outcomes using parent and teacher reports and direct assessments of food-related self-regulation. We will also gather process data on intervention implementation, including fidelity, attendance, engagement, and satisfaction. Discussion The Growing Healthy study will shed light on associations between self-regulation skills and obesity risk in low-income preschoolers. If the project is effective in preventing obesity, results can also provide critical insights into how best to deliver obesity prevention programming to parents and children in a community-based setting like Head Start in order to promote better health among at-risk children. Trial registration number Clinicaltrials.gov Identifier: NCT01398358
Miller Alison L
Federally funded, community-based participatory research initiatives encourage the development and implementation of obesity prevention policies. In 2009, the Centers for Disease Control and Prevention (CDC) published the Common Community Measures for Obesity Prevention (COCOMO), which include recommended strategies and measures to guide communities in identifying and evaluating environmental and policy strategies to prevent obesity. Agreeing on "winnable" policy issues can be challenging for...
Jilcott Pitts, Stephanie B.; Whetstone, Lauren M.; Wilkerson, Jean R.; Smith, Tosha W.; Ammerman, Alice S.
Efectividad de una intervención en educación alimentaria y actividad física para prevenir obesidad en escolares de la ciudad de Casablanca, Chile (2003-2004 Effectiveness of a dietary and physical activity intervention to prevent obesity in school age children
Full Text Available Background: With the aim of contributing to he Healthy Goal 2010 of reducing significantly the prevalence of childhood obestiy we developed and implemented during 2003 and 2004, a school-based obesity prevention intervention which included nutrition education and the promotion of physical activity. Aim To report the results of the intervention. Material and methods: The sample included 1760 children (1st to 7th grade from 3 elementary public schools in Casablanca (experimental group and 671 from a similar school located in Quillota, a neighboring city (control. Primary outcomes were body mass index (BMI Zscore, the mile and shuttle-run tests and obesity prevalence. We also compared changes in waist circumference and triceps skinfold between both groups. Effectiveness of the intervention was assessed by analyzing separately the group *age* time interaction for the first 3 outcomes (follow-up-baseline, using a mixed model of covariance and by comparing variations in obesity prevalence between both groups. Results: There was a significant decline in BMI Z scores in experimental schools for both genders, but greater in boys (p <0.001 versus p =0.0034 in girls, while in controls, BMI Z scores increased. Obesity prevalence declined significantly in experimental schools; from 17 to 12.3% and from 14.1 to 10.3% in boys and girls respectively, while in the control group, it remained unchanged. Also, triceps skinfold in girls from Casablanca increased significantly ¡ess than that of control girls. Conclusion: This intervention proved that it is possible to reduce significantly the prevalence of obesity in Chilean schoolchildren attending public elementary schools (Rev Méd Chile 2008, 136:22-30
Juliana Kain B
We tested the hypothesis that activation of transient receptor potential vanilloid type-1 (TRPV1) by capsaicin prevents adipogenesis. TRPV1 channels in 3T3-L1-preadipocytes and visceral adipose tissue from mice and humans were detected by immunoblotting and quantitative real-time RT-PCR. The effect of TRPV1 on cytosolic calcium was determined fluorometrically in 3T3-L1-preadipocytes and in human visceral fat tissue. Adipogenesis in stimulated 3T3-L1-preadipocytes was determined by oil red O-staining of intracellular lipid droplets, triglyceride levels, expression of peroxisome proliferator-activated receptor-gamma, and expression of fatty acid synthase. Long-term feeding experiments were undertaken in wild-type mice and TRPV1 knockout mice. We detected TRPV1 channels in 3T3-L1-preadipocytes and visceral adipose tissue from mice and humans. In vitro, the TRPV1 agonist capsaicin dose-dependently induced calcium influx and prevented the adipogenesis in stimulated 3T3-L1-preadipocytes. RNA interference knockdown of TRPV1 in 3T3-L1-preadipocytes attenuated capsaicin-induced calcium influx, and adipogenesis in stimulated 3T3-L1-preadipocytes was no longer prevented. During regular adipogenesis TRPV1 channels were downregulated which was accompanied by a significant and time-dependent reduction of calcium influx. Compared with lean counterparts in visceral adipose tissue from obese db/db and ob/ob mice, and from obese human male subjects we observed a reduced TRVP1 expression. The reduced TRPV1 expression in visceral adipose tissue from obese humans was accompanied by reduced capsaicin-induced calcium influx. The oral administration of capsaicin for 120 days prevented obesity in male wild type mice but not in TRPV1 knockout mice assigned to high fat diet. We conclude that the activation of TRPV1 channels by capsaicin prevented adipogenesis and obesity.
Zhang, Li Li; Yan Liu, Dao
Full Text Available In this article the authors provide a background for the discussion of childhood obesity, examine factors contributing to overweight and obesity in children, review the literature describing interventions and prevention strategies for childhood overweight, and describe nursing skills to prevent childhood obesity. The literature supports a family-focused approach to influencing dietary habits of very young children, prevention interventions that start early in childhood prior to established poor dietary patterns, and the need for community support and involvement. Given these findings, nurses are encouraged to develop skills, such as advocacy, collaborative leadership, and social marketing skills, that will contribute to the prevention of childhood obesity.
Abstract Background Schools are the most frequent target for intervention programs aimed at preventing child obesity; however, the overall effectiveness of these programs has been limited. It has therefore been recommended that interventions target multiple ecological levels (community, family, school and individual) to have greater success in changing risk behaviors for obesity. This study examined the immediate and short-term, sustained effects of the Switch program, which ...
Efectividad de una intervención en educación alimentaria y actividad física para prevenir obesidad en escolares de la ciudad de Casablanca, Chile (2003-2004) / Effectiveness of a dietary and physical activity intervention to prevent obesity in school age children
Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] Abstract in english Background: With the aim of contributing to he Healthy Goal 2010 of reducing significantly the prevalence of childhood obestiy we developed and implemented during 2003 and 2004, a school-based obesity prevention intervention which included nutrition education and the promotion of physical activity. [...] Aim To report the results of the intervention. Material and methods: The sample included 1760 children (1st to 7th grade) from 3 elementary public schools in Casablanca (experimental group) and 671 from a similar school located in Quillota, a neighboring city (control). Primary outcomes were body mass index (BMI) Zscore, the mile and shuttle-run tests and obesity prevalence. We also compared changes in waist circumference and triceps skinfold between both groups. Effectiveness of the intervention was assessed by analyzing separately the group *age* time interaction for the first 3 outcomes (follow-up-baseline), using a mixed model of covariance and by comparing variations in obesity prevalence between both groups. Results: There was a significant decline in BMI Z scores in experimental schools for both genders, but greater in boys (p
Juliana, Kain B; Ricardo, Uauy D; Bárbara, Leyton D; Ricardo, Cerda R; Sonia, Olivares C; Fernando, Vio D.
Using a simulation model, Pieter van Baal and colleagues conclude that obesity prevention leads to a decrease in costs of obesity-related diseases, but this is offset by cost increases due to diseases unrelated to obesity in life-years gained.
Baal, Pieter H. M.; Polder, Johan J.; Wit, G. Ardine; Hoogenveen, Rudolf T.; Feenstra, Talitha L.; Boshuizen, Hendriek C.; Engelfriet, Peter M.; Brouwer, Werner B. F.
Background Social marketing integrates communication campaigns with behavioural and environmental change strategies. Childhood obesity programs could benefit significantly from social marketing but communication campaigns on this issue tend to be stand-alone. Methods A large-scale multi-setting child obesity prevention program was implemented in the Hunter New England (HNE) region of New South Wales (NSW), Australia from 20052010. The program included a series of communication campaigns promoting the program and its key messages: drinking water; getting physically active and; eating more vegetables and fruit. Pre-post telephone surveys (n?=?9) were undertaken to evaluate awareness of the campaigns among parents of children aged 215 years using repeat cross-sections of randomly selected cohorts. A total of 1,367 parents (HNE?=?748, NSW?=?619) participated. Results At each survey post baseline, HNE parents were significantly more likely to have seen, read or heard about the program and its messages in the media than parents in the remainder of the state (p?0.001). Further, there was a significant increase in awareness of the program and each of its messages over time in HNE compared to no change over time in NSW (p?0.001). Awareness was significantly higher (p?0.05) in HNE compared to NSW after each specific campaign (except the vegetable one) and significantly higher awareness levels were sustained for each campaign until the end of the program. At the end of the program participants without a tertiary education were significantly more likely (p?=?0.04) to be aware of the brand campaign (31%) than those with (20%) but there were no other statistically significant socio-demographic differences in awareness. Conclusions The Good for Kids communication campaigns increased and maintained awareness of childhood obesity prevention messages. Moreover, messages were delivered equitably to diverse socio-demographic groups within the region.
Full Text Available This paper presents a community-school-higher education partnership approach to the prevention of childhood obesity. Public elementary school personnel, primarily teachers, participated in the design and delivery of a curriculum targeting primary caregivers of 8-9-year-old children. Theoretical framework and methodological approaches guided the development of a cognitive behavioral lifestyle intervention targeting childhood obesity prevention in the Commonwealth of the Northern Mariana Islands (CNMI, a U.S. commonwealth. This project demonstrated that in populations with health disparity, teachers can be a valuable and accessible resource for identifying key health issues of concern to communities and a vital partner in the development of parent and child interventions. Teachers also benefited by gaining knowledge and skills to facilitate student and parent learning and impact on personal and familial health. Successful community-school-higher education partnerships require consideration of local culture and community needs and resources. Moreover, within any community-schoolhigher education partnership it is essential that a time sensitive and culturally appropriate feedback loop be designed to ensure that programs are responsive to the needs and resources of all stakeholders, and that leaders and policymakers are highly engaged so they can make informed policy decisions.
Mozhdeh B Bruss
Mitochondrial function declines with aging and obesity, and has been implicated in the development of many age-related diseases. Caloric restriction (CR) prevents aging and has been shown to induce mitochondrial biogenesis and improve mitochondrial function. These effects may involve increased activity of the \\(NAD^+\\)-dependent deacetylase SIRT1. Indeed, overexpression of SIRT1 reproduces many of the health benefits of CR including induction of mitochondrial biogenesis by deacetylation...
Price, Nathan Loftus
Obesity, mainly childhood obesity, is a worldwide concern. Childhood obesity continues to adulthood, and it is associated with multiple noncommunicable diseases. One important aspect in the fight against obesity is prevention, the earlier, the better. Social marketing is a novel concept being increasingly used as an approach to address social problems and more and more included in the community-based interventions aiming to change unhealthy behaviors. Although there is limited evidence of its...
Gracia-marco, Luis; Moreno, Luis A.; Vicente-rodri?guez, Germa?n
Full Text Available Abstract Background Policies targeting obesogenic environments and behaviours are critical to counter rising obesity rates and lifestyle-related non-communicable diseases (NCDs. Policies are likely to be most effective and enduring when they are based on the best available evidence. Evidence-informed policy making is especially challenging in countries with limited resources. The Pacific TROPIC (Translational Research for Obesity Prevention in Communities project aims to implement and evaluate a tailored knowledge-brokering approach to evidence-informed policy making to address obesity in Fiji, a Pacific nation challenged by increasingly high rates of obesity and concomitant NCDs. Methods The TROPIC project draws on the concept of knowledge exchange between policy developers (individuals; organisations and researchers to deliver a knowledge broking programme that maps policy environments, conducts workshops on evidence-informed policy making, supports the development of evidence-informed policy briefs, and embeds evidence-informed policy making into organisational culture. Recruitment of government and nongovernment organisational representatives will be based on potential to: develop policies relevant to obesity, reach broad audiences, and commit to resourcing staff and building a culture that supports evidence-informed policy development. Workshops will increase awareness of both obesity and policy cycles, as well as develop participants skills in accessing, assessing and applying relevant evidence to policy briefs. The knowledge-broking team will then support participants to: 1 develop evidence-informed policy briefs that are both commensurate with national and organisational plans and also informed by evidence from the Pacific Obesity Prevention in Communities project and elsewhere; and 2 collaborate with participating organisations to embed evidence-informed policy making structures and processes. This knowledge broking initiative will be evaluated via data from semi-structured interviews, a validated self-assessment tool, process diaries and outputs. Discussion Public health interventions have rarely targeted evidence-informed policy making structures and processes to reduce obesity and NCDs. This study will empirically advance understanding of knowledge broking processes to extend evidence-informed policy making skills and develop a suite of national obesity-related policies that can potentially improve population health outcomes.
Background Policies targeting obesogenic environments and behaviours are critical to counter rising obesity rates and lifestyle-related non-communicable diseases (NCDs). Policies are likely to be most effective and enduring when they are based on the best available evidence. Evidence-informed policy making is especially challenging in countries with limited resources. The Pacific TROPIC (Translational Research for Obesity Prevention in Communities) project aims to implement and evaluate a tailored knowledge-brokering approach to evidence-informed policy making to address obesity in Fiji, a Pacific nation challenged by increasingly high rates of obesity and concomitant NCDs. Methods The TROPIC project draws on the concept of knowledge exchange between policy developers (individuals; organisations) and researchers to deliver a knowledge broking programme that maps policy environments, conducts workshops on evidence-informed policy making, supports the development of evidence-informed policy briefs, and embeds evidence-informed policy making into organisational culture. Recruitment of government and nongovernment organisational representatives will be based on potential to: develop policies relevant to obesity, reach broad audiences, and commit to resourcing staff and building a culture that supports evidence-informed policy development. Workshops will increase awareness of both obesity and policy cycles, as well as develop participants skills in accessing, assessing and applying relevant evidence to policy briefs. The knowledge-broking team will then support participants to: 1) develop evidence-informed policy briefs that are both commensurate with national and organisational plans and also informed by evidence from the Pacific Obesity Prevention in Communities project and elsewhere; and 2) collaborate with participating organisations to embed evidence-informed policy making structures and processes. This knowledge broking initiative will be evaluated via data from semi-structured interviews, a validated self-assessment tool, process diaries and outputs. Discussion Public health interventions have rarely targeted evidence-informed policy making structures and processes to reduce obesity and NCDs. This study will empirically advance understanding of knowledge broking processes to extend evidence-informed policy making skills and develop a suite of national obesity-related policies that can potentially improve population health outcomes.
Children who become overweight by age 2 years have significantly greater risks of long-term health problems, and children in low-income communities, where rates of low adult literacy are highest, are at increased risk of developing obesity. The objective of the Greenlight Intervention Study is to assess the effectiveness of a low-literacy, primary-care intervention on the reduction of early childhood obesity. At 4 primary-care pediatric residency training sites across the US, 865 infant-parent dyads were enrolled at the 2-month well-child checkup and are being followed through the 24-month well-child checkup. Two sites were randomly assigned to the intervention, and the other sites were assigned to an attention-control arm, implementing the American Academy of Pediatrics' The Injury Prevention Program. The intervention consists of an interactive educational toolkit, including low-literacy materials designed for use during well-child visits, and a clinician-centered curriculum for providing low-literacy guidance on obesity prevention. The study is powered to detect a 10% difference in the number of children overweight (BMI > 85%) at 24 months. Other outcome measures include observed physician-parent communication, as well as parent-reported information on child dietary intake, physical activity, and injury-prevention behaviors. The study is designed to inform evidence-based standards for early childhood obesity prevention, and more generally to inform optimal approaches for low-literacy messages and health literacy training in primary preventive care. This article describes the conceptual model, study design, intervention content, and baseline characteristics of the study population. PMID:24819570
Sanders, Lee M; Perrin, Eliana M; Yin, H Shonna; Bronaugh, Andrea; Rothman, Russell L
Background. The period surrounding pregnancy has been identified as a risk period for overweight/obesity in both mother and child because of excessive gestational weight gain (GWG). The promotion of a healthy GWG is therefore of paramount importance in the context of the prevention of obesity in the current and next generations. Objective. To provide a comprehensive overview of the effect of prenatal physical activity interventions, alone or in combination with nutritional counselling, on GWG...
Ruchat, Stephanie-may; Mottola, Michelle F.
Valid and reliable measures of energy balance-related behaviours are required when evaluating the effectiveness of public health interventions aiming at prevention of childhood obesity. A structured descriptive review was performed to appraise food intake, physical activity and sedentary behaviour assessment tools used in obesity intervention strategies targeting mainly preschool children across Europe. In total, 25 papers are described, addressing energy balance-related behaviours as study o...
Mouratidou, T.; Mesana, M. I.; Manios, Y.; Koletzko, B.; Chin A Paw, M. J. M.; Bourdeaudhuij, I.; Socha, P.; Iotova, V.; Moreno, L. A.
This pilot study examined the feasibility of an interactive obesity prevention program delivered to a class of fourth-grade students utilizing daily e-mail messages sent to the students' home computers. The study involved a single intact class of 22 students, 17 (77%) of whom submitted parental permission documentation and received e-mail messages each school day over the course of one month. Concerns regarding Internet safety and children's use of e-mail were addressed fairly easily. Cost/benefit issues for the school did not seem prohibitive. Providing e-mail access to students without a home computer was accomplished by loaning them personal digital assistant (PDA) devices. In larger interventions, loaning PDAs is probably not feasible economically, although cell phones may be an acceptable alternative. It was concluded that this type of interactive obesity prevention program is feasible from most perspectives. Data from a larger scale effectiveness study is still needed. PMID:19827452
Owens, Scott; Lambert, Laurel; McDonough, Suzanne; Green, Kenneth; Loftin, Mark
Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Introducción: La elevada prevalencia de la obesidad en escolares chilenos (23,1%), hace necesario la aplicación de intervenciones que incorporen el ejercicio físico de fuerza muscular, pues éste muestra gran eficacia en niños obesos. Objetivo: Evaluar el efecto residual del ejercicio físico de fuerz [...] a muscular sobre la grasa corporal, el síndrome metabólico y la condición física en escolares obesos. Métodos: La muestra incluyó 111 escolares obesos, entre 8 y 13 años, de 3 colegios de la ciudad de Santiago. La intervención temprana (n = 60) ejecutó en paralelo ejercicio físico de fuerza muscular, educación alimentaria y apoyo psicológico durante 3 meses. La intervención tardía (n = 51), incorporó los primeros 3 meses, sólo la intervención educativa y el apoyo psicológico, y el ejercicio se agregó entre los 3 y 6 meses. A los 9 meses post-intervención, se evaluó el efecto residual del ejercicio físico. La grasa corporal se determinó por ecuaciones antropométricas. El síndrome metabólico se diagnóstico por el criterio de Cook. La condición física se evaluó por la distancia recorrida en el test de seis minutos. Resultados: El porcentaje grasa corporal disminuyó al final de la intervención y aumentó post-intervención, con la excepción de los hombres de la intervención temprana. La distancia recorrida se incrementó al final de la intervención, pero se redujo en la post-intervención. El síndrome metabólico, disminuyó al término de la intervención incrementando post-intervención (p Abstract in english Introduction: The high prevalence of the obesity in Chilean students (23,1%), necessitates the application of interventions that incorporate muscle strength exercise, as this shows great efficacy in obese children. Objective: To evaluate the residual effect of muscle strength exercise on body fat, m [...] etabolic syndrome and physical fitness in obese schoolchildren. Methods: The sample included 111 obese schoolchildren, between 8 and 13 years, of 3 schools in the city of Santiago. Early intervention (n = 60) participated in parallel intervention that included muscle strength exercise, nutrition education and psychological support for 3 months. The late intervention (n = 51) incorporated the first 3 months, only the educational intervention and psychological support, and exercise was added between 3 and 6 months. At 9 months post intervention, we evaluated the residual effect of exercise. Body fat was determined by anthropometric equations. The metabolic syndrome was diagnosed by the criteria of Cook. Physical fitness was assessed by the distance walked in six minutes test. Results: The body fat percentage decreased at the end of the intervention and post intervention increased with the exception of the men of early intervention. The distance traveled increased at the end of the intervention but declined in the post intervention. Metabolic syndrome, decreased at the end of the intervention increased post intervention (p
Vásquez, Fabián; Díaz, Erik; Lera, Lydia; Meza, Jorge; Salas, Isabel; Rojas, Pamela; Atalah, Eduardo; Burrows, Raquel.
Full Text Available This paper aims to review the current worrying situation in terms of physical activity in our country and the problem that leads us to be below the European average, with the attendant problems of obesity, particularly among children, which follow from this. We analyzed the intervention programs that are being used as PIOBIN plan (The Andalusian Plan for Childhood Obesity, effective from 2007-12, based on a national strategy called Naos Strategy and how different studies support that some intrinsic motivation toward physical activity helps to create lasting habits to the practice. We also carry out an analysis of the different Motivation theories and we base our study on the Self-determination Theory of Deci and Ryan (1985, 2000
Carrillo Aguilera, Sonia
Abstract Background Many unhealthy dietary and physical activity habits that foster the development of obesity are established by the age of five. Presently, approximately 70 percent of children in the United States are currently enrolled in early childcare facilities, making this an ideal setting to implement and evaluate childhood obesity prevention efforts. We describe here the methods for conducting an obesity prevention randomized trial in the child care setting. ...
Natale Ruby; Scott Stephanie Hapeman; Messiah Sarah E; Schrack Maria Mesa; Uhlhorn Susan B; Delamater Alan
To build on a growing interest in community-based obesity prevention programs, methods are needed for matching intervention strategies to local needs and assets. We used the Community Readiness Model (CRM), a structured interview guide and scoring system, to assess community readiness to act on childhood obesity prevention, furthering a replication study of a successful intervention.
Sliwa, Sarah; Goldberg, Jeanne P.; Clark, Valerie; Junot, Bridgid; Nahar, Elizabeth; Nelson, Miriam E.; Tovar, Alison; Economos, Christina D.; Collins, Jessica; Edwards, Ruth; Hyatt, Raymond R.
Past research has identified social and environmental causes and correlates of behaviors thought to be associated with obesity and weight gain among children and adolescents. Much less research has documented the efficacy of interventions designed to manipulate those presumed causes and correlates. These latter efforts have been inhibited by the predominant biomedical and social science problem-oriented research paradigm, emphasizing reductionist approaches to understanding etiologic mechanisms of diseases and risk factors. The implications of this problem-oriented approach are responsible for leaving many of the most important applied research questions unanswered, and for slowing efforts to prevent obesity and improve individual and population health. An alternative, and complementary, solution-oriented research paradigm is proposed, emphasizing experimental research to identify the causes of improved health. This subtle conceptual shift has significant implications for phrasing research questions, generating hypotheses, designing research studies, and making research results more relevant to policy and practice. The solution-oriented research paradigm encourages research with more immediate relevance to human health and a shortened cycle of discovery from the laboratory to the patient and population. Finally, a "litmus test" for evaluating research studies is proposed, to maximize the efficiency of the research enterprise and contributions to the promotion of health and the prevention and treatment of disease. A research study should only be performed if (1) you know what you will conclude from each possible result (whether positive, negative, or null); and (2) the result may change how you would intervene to address a clinical, policy, or public health problem. PMID:15694528
Robinson, Thomas N; Sirard, John R
Introduction The extent of obesity prevention activities conducted by local health departments (LHDs) varies widely. The purpose of this qualitative study was to characterize how state obesity prevention program directors perceived the role of LHDs in obesity prevention and factors that impact LHDs success in obesity prevention. Methods From June 2011 through August 2011, we conducted 28 semistructured interviews with directors of federally funded obesity prevention programs at 22 state and regional health departments. Interviews were transcribed verbatim, coded, and analyzed to identify recurring themes and key quotations. Results Main themes focused on the roles of LHDs in local policy and environmental change and on the barriers and facilitators to LHD success. The role LHDs play in obesity prevention varied across states but generally reflected governance structure (decentralized vs centralized). Barriers to local prevention efforts included competing priorities, lack of local capacity, siloed public health structures, and a lack of local engagement in policy and environmental change. Structures and processes that facilitated prevention were having state support (eg, resources, technical assistance), dedicated staff, strong communication networks, and a robust community health assessment and planning process. Conclusions These findings provide insight into successful strategies state and local practitioners are using to implement innovative (and evidence-informed) community-based interventions. The change in the nature of obesity prevention requires a rethinking of the statelocal relationship, especially in centralized states.
Lewis, Moira; Khoong, Elaine C.; LaSee, Claire
Full Text Available Abstract Background In 2005, we reported on the success of Comprehensive School Health (CSH in improving diets, activity levels, and body weights. The successful program was recognized as a "best practice" and has inspired the development of the Alberta Project Promoting active Living and healthy Eating (APPLE Schools. The project includes 10 schools, most of which are located in socioeconomically disadvantaged areas. The present study examines the effectiveness of a CSH program adopted from a "best practice" example in another setting by evaluating temporal changes in diets, activity levels and body weight. Methods In 2008 and 2010, we surveyed grade 5 students from approximately 150 randomly selected schools from the Canadian province of Alberta and students from 10 APPLE Schools. Students completed the Harvard Youth/Adolescent Food Frequency Questionnaire, questions on physical activity, and had their height and weight measured. Multilevel regression methods were used to analyze changes in diets, activity levels, and body weight between 2008 and 2010. Results In 2010 relative to 2008, students attending APPLE Schools were eating more fruits and vegetables, consuming fewer calories, were more physically active and were less likely obese. These changes contrasted changes observed among students elsewhere in the province. Conclusions These findings provide evidence on the effectiveness of CSH in improving health behaviors. They show that an example of "best practice" may lead to success in another setting. Herewith the study provides the evidence that investments for broader program implementation based on "best practice" are justified.
Background: Due to increasing problems with childhood and adolescent obesity in Austria PRESTO (PrEvention STudy of Obesity) created a school based intervention program for promoting a healthy lifestyle in Austrian youth.
Methods: PRESTO was carried out by a multi-disciplinary team including a physician, a psychologist, a nutritionist and an exercise physiologist. The study was carried out in 12 first grade s...
Sabine Dietrich; Angelo Pietrobelli; Sabine Dämon; Kurt Widhalm
Abstract Background The diets, physical activity and sedentary behavior levels of both children and adults in Australia are suboptimal. The family environment, as the first ecological niche of children, exerts an important influence on the onset of childrens habits. Parent modeling is one part of this environment and a logical focus for child obesity prevention initiatives. The focus on parents own behaviors provides a potential opportunity to decrease obesity risk beha...
Full Text Available Abstract Background Prevention is considered effective in combating the obesity epidemic. Prenatal environment may increase offspring's risk for obesity. A child starts to adopt food preferences and other behavioral habits affecting weight gain during preschool years. We report the study protocol of a pragmatic lifestyle intervention aiming at primary prevention of childhood obesity. Methods/Design A non-randomized controlled pragmatic trial in maternity and child health care clinics. The control group was recruited among families who visited the same clinics one year earlier. Eligibility criteria was mother at risk for gestational diabetes: body mass index???25?kg/m2, macrosomic newborn in any previous pregnancy, immediate family history of diabetes and/or age???40?years. All maternity clinics in town involved in recruitment. The gestational intervention consisted of individual counseling on diet and physical activity by a public health nurse, and of two group counseling sessions. Intervention continues until offsprings age of five years. An option to participate a group counseling at childs age 1 to 2?years was offered. The intervention includes advice on healthy diet, physical activity, sedentary behavior and sleeping pattern. The main outcome measure is offspring BMI z-score and its changes by the age of six years. Discussion Early childhood is a critical time period for prevention of obesity. Pragmatic trials targeting this period are necessary in order to find effective obesity prevention programs feasible in normal health care practice. Trial registration Clinical Trials gov NCT00970710
Childhood obesity has become an alarming problem in this country. Risk factors associated with childhood obesity include having obese parents, a history of low or high birth weight, Black or Hispanic ethnicity, and low socioeconomic background. Although most healthy American infants and toddlers have adequate diets, many parents and health
Childhood obesity continues to be a significant public health issue. mHealth systems offer state-of-the-art approaches to intervention design, delivery, and diffusion of treatment and prevention efforts. Benefits include cost effectiveness, potential for real-time data collection, feedback capability, minimized participant burden, relevance to multiple types of populations, and increased dissemination capability. However, these advantages are coupled with unique challenges. This commentary discusses challenges with using mHealth strategies for child obesity prevention, such as lack of scientific evidence base describing effectiveness of commercially available applications; relatively slower speed of technology development in academic research settings as compared with industry; data security, and patient privacy; potentially adverse consequences of increased sedentary screen time, and decreased focused attention due to technology use. Implications for researchers include development of more nuanced measures of screen time and other technology-related activities, and partnering with industry for developing healthier technologies. Implications for health practitioners include monitoring, assessing, and providing feedback to child obesity program designers about users' data transfer issues, perceived security and privacy, sedentary behavior, focused attention, and maintenance of behavior change. Implications for policy makers include regulation of claims and quality of apps (especially those aimed at children), supporting standardized data encryption and secure open architecture, and resources for research-industry partnerships that improve the look and feel of technology. Partnerships between academia and industry may promote solutions, as discussed in this commentary. PMID:24294329
Tate, Eleanor B; Spruijt-Metz, Donna; O'Reilly, Gillian; Jordan-Marsh, Maryalice; Gotsis, Marientina; Pentz, Mary Ann; Dunton, Genevieve F
Background Early and rapid growth in Infants is strongly associated with early development and persistence of obesity in young children. Substantial research has linked child obesity/overweight to increased risks for serious health outcomes, which include adverse physical, psychological, behavioral, or social consequences. Methods/design The goal of this study is to compare the effectiveness of structured Community Health Worker (CHW)- provided home visits, using an intervention created through community-based participatory research, to standard care received through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) office visits in preventing the development of overweight (weight/length ?85th percentile) and obesity (weight/length ?95th percentile) in infants during their first 3 years of life. One hundred forty pregnant women in their third trimester (3036 weeks) will be recruited and randomly assigned to the intervention or control group. Discussion This study will provide prospective data on the effects of an intervention to prevent childhood obesity in children at high risk for obesity due to ethnicity, income, and maternal body mass index (BMI). It will have wide-ranging applicability and the potential for rapid dissemination through the WIC program, and will demonstrate the effectiveness of a community approach though employing CHWs in preventing obesity during the first 3 years of life. This easy-to-implement obesity prevention intervention can be adapted for many locales and diverse communities and can provide evidence for policy change to influence health throughout life. Trial registration Clinical Trials Number: NCT01905072
There is a worldwide epidemic of obesity with far-reaching consequences for the health of our nation. Prevention of obesity, especially in children, has been deemed by public health policy makers to be one of the most important objectives for our country. This prevention project, called Louisiana (LA) Health, will test whether modification of environmental and behavioral factors can prevent inappropriate weight gain in children from rural parishes of Louisiana who are enrolled in the fourth t...
Williamson, Donald A.; Champagne, Catherine M.; Harsha, David; Han, Hongmei; Martin, Corby K.; Newton, Robert; Stewart, Tiffany M.; Ryan, Donna H.
Abstract Objective Up to now, no guideline has been set up that provides criteria for good practice in universal and selective childhood obesity prevention projects for children aged 3 to 6 in the kindergarten setting. Hence, based on guidelines for targeted prevention, the present study not only aims at assessing the current state of German universal and selective childhood obesity prevention projects in kindergartens, but also at deriving criteria of go...
Obesity in both adults and children is a critical issue in Hawaii, as well as nationally and internationally. Today in Hawaii, 57 percent of adults are overweight or obese as are almost 1 in 3 children entering kindergarten. Each year, obesity costs Hawaii more than $470 million in medical expenditures alone.1 These staggering human and economic costs underscore the serious need for Hawaii to address obesity now.
Richards, Katie; Fuddy, Loretta J.; Greenwood, Mrc; Pressler, Virginia; Rajan, Ranjani; St John, Tonya Lowery; Sinclair, Bronwyn M.; Irvin, Lola
The obesity epidemic requires the development of prevention policy targeting individuals most likely to benefit. We used self-reported prepregnancy body weight of all women giving birth in Nova Scotia between 1988 and 2006 to define obesity and evaluated socioeconomic, demographic, and temporal trends in obesity using linear regression. There were 172,373 deliveries in this cohort of 110,743 women. Maternal body weight increased significantly by 0.5?kg per year from 1988, and lower income a...
Dummer, Trevor J. B.; Kirk, Sara F. L.; Penney, Tarra L.; Dodds, Linda; Parker, Louise
Community-based interventions are an important component of obesity prevention efforts. The literature provides little guidance on priority-setting for obesity prevention in communities, especially for socially and culturally diverse populations. This paper reports on the process of developing prioritized, community-participatory action plans for obesity prevention projects in children and adolescents using the ANGELO (Analysis Grid for Elements Linked to Obesity) Framework. We combined stakeholder engagement processes, the ANGELO Framework (scans for environmental barriers, targeted behaviours, gaps in skills and knowledge) and workshops with key stakeholders to create action plans for six diverse obesity prevention projects in Australia (n = 3), New Zealand, Fiji and Tonga from 2002 to 2005. Some sites included sociocultural contextual analyses in the environmental scans. Target groups were under-5-year-olds (Australia), 4-12-year-olds (Australia) and 13-18-year-olds (all four countries). Over 120 potentialbehavioural, knowledge, skill and environmental elements were identified for prioritization leading into each 2-day workshop. Many elements were common across the diverse cultural communities; however, several unique sociocultural elements emerged in some cultural groups which informed their action plans. Youth were actively engaged in adolescent projects, allowing their needs to be incorporated into the action plans initiating the process of ownership. A common structure for the action plan promoted efficiencies in the process while allowing for community creativity and innovation. The ANGELO is a flexible and efficient way of achieving an agreed plan for obesity prevention with diverse communities. It is responsive to community needs, combines local and international knowledge and creates stakeholder ownership of the action plan.
Simmons, A; Mavoa, H M
Full Text Available Abstract Background The first years of life are crucial to start preventive interventions that can have an impact on lifestyle and later overweight and obesity. Under the Italian National Health System (INHS, children are cared for by family pediatricians who perform health balances at regular intervals. The Italian Society of Preventive and Social Pediatrics (SIPPS has designed a randomized controlled trial (RCT to evaluate the effectiveness of family pediatricians for the prevention of childhood obesity in preschool children. We report the rationale and protocol of such trial, named the "Mi voglio bene" ("I love myself" study. Methods "Mi voglio bene" is a parallel-arm RCT. Family pediatricians willing to participate to the trial will be randomly assigned to a control group and to an experimental group. The control group will provide the usual standard of care while the experimental group will implement 10 preventive actions (promotion of breastfeeding, avoidance of solid foods, control of protein intake, avoidance of sugar-sweetened beverages, avoidance of bottle, active means of transportation, identification of early adiposity rebound, limitation of television viewing, promotion of movement, and teaching portion size at 10 time points during a 6-yr follow-up. The main outcome measures is the prevalence of overweight and obesity at 6 years of age. The experimental intervention is expected to reduce the prevalence of overweight and obesity from 25% to 20% and the study requires a total of 3610 children. Each pediatrician will enroll 30 consecutive newborns into the study so that a total of 120 pediatricians will participate to the study. Discussion "Mi voglio bene" is expected to provide important information for the INHS and possibly other institutional child care settings about the effectiveness of a pediatrician-based approach to the prevention of childhood obesity. We published this study protocol with the aim of opening a discussion with all people interested in fighting childhood obesity and to receive useful criticisms.
University faculty and community agencies collaborated to design and implement Healthy Weigh/El camino saludable, a family-focused obesity prevention and intervention program in a low-income, urban community at high risk for obesity and related chronic disease. Hispanic and African American families participated in 12 weekly sessions. Offered in
Dart, Lyn; Frable, Pamela Jean; Bradley, Patricia J.; Bae, Sejong; Singh, Karan
Background: Obesity is a major concern among American Indians and Hispanics. The Child Health Initiative for Lifelong Eating and Exercise (CHILE) is an evidence-based intervention to prevent obesity in children enrolled in 16 Head Start (HS) Centers in rural communities. The design and implementation of CHILE are described. Methods: CHILE uses a
Davis, Sally M.; Sanders, Sarah G.; FitzGerald, Courtney A.; Keane, Patricia C.; Canaca, Glenda F.; Volker-Rector, Renee
The prevalence of juvenile obesity is increasing worldwide. Throughout Europe, ca. 20% are affected, in Germany 15%. Many modifiable and nonmodifiable causes have been determined and included, but are not limited to genetic, familiar, and lifestyle factors. In addition, obesity disproportionately affects minority and low socioeconomic status groups. Juvenile obesity increases the risk of having multiple cardiovascular and metabolic diseases, psycho-social problems, and a variety of other co-m...
Abstract Obesity is traditionally viewed to be beneficial to bone health because of well-established positive effect of mechanical loading conferred by body weight on bone formation, despite being a risk factor for many other chronic health disorders. Although body mass has a positive effect on bone formation, whether the mass derived from an obesity condition or excessive fat accumulation is beneficial to bone remains controversial. The underline pathophysiological relationship bet...
Cao Jay J
Full Text Available Abstract Background Developing effective prevention and intervention programs for the formative preschool years is seen as an essential step in combating the obesity epidemic across the lifespan. The overall goal of the current project is to measure the effectiveness of a healthy eating and childhood obesity prevention intervention, the MEND (Mind Exercise Nutrition Do It! program that is delivered to parents of children aged 2-4 years. Methods/Design This randomised controlled trial will be conducted with 200 parents and their 2-4 year old children who attend the MEND 2-4 program in metropolitan and regional Victoria. Parent-child dyads will attend ten 90-minute group workshops. These workshops focus on general nutrition, as well as physical activity and behaviours. They are typically held at community or maternal and child health centres and run by a MEND 2-4 trained program leader. Child eating habits, physical activity levels and parental behaviours and cognitions pertaining to nutrition and physical activity will be assessed at baseline, the end of the intervention, and at 6 and 12 months post the intervention. Informed consent will be obtained from all parents, who will then be randomly allocated to the intervention or wait-list control group. Discussion Our study is the first RCT of a healthy eating and childhood obesity prevention intervention targeted specifically to Australian parents and their preschool children aged 2-4 years. It responds to the call by experts in the area of childhood obesity and child health that prevention of overweight in the formative preschool years should focus on parents, given that parental beliefs, attitudes, perceptions and behaviours appear to impact significantly on the development of early overweight. This is 'solution-oriented' rather than 'problem-oriented' research, with its focus being on prevention rather than intervention. If this is a positive trial, the MEND2-4 program can be implemented as a national program. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12610000200088
Nutrition and health educators work in community settings implementing lifestyle programs focused on obesity prevention and chronic disease risk reduction. These programs typically focus on improving diet and physical activity (PA) behaviors. Many nutrition educators may not be confident in their ability to select, administer, and interpret PA assessments to effectively evaluate their PA or lifestyle programs. This report will assist educators in identifying and selecting appropriate field-based assessments for measurement of PA, physical fitness, and body composition for children and adults. Specific guidelines, references, and resources are given for selecting assessment methods and test within these 3 areas. PMID:23850013
Lindsay, Anne R; Hongu, Nobuko; Spears, Karen; Idris, Rafida; Dyrek, Anthony; Manore, Melinda M
Full Text Available An active area of public health policy in the United States is policy meant to promote healthy eating, reduce overconsumption of food, and prevent overweight/obesity. Public discussion of such obesity prevention policies includes intense ethical disagreement. We suggest that some ethical disagreements about obesity prevention policies can be seen as rooted in a common concern with equality or with autonomy, but there are disagreements about which dimensions of equality or autonomy have priority, and about whether it is justifiable for policies to diminish equality or autonomy along one dimension in order to increase it along another dimension. We illustrate this point by discussing ethical disagreements about two obesity prevention policies.
Full Text Available Abstract Background The diets, physical activity and sedentary behavior levels of both children and adults in Australia are suboptimal. The family environment, as the first ecological niche of children, exerts an important influence on the onset of childrens habits. Parent modeling is one part of this environment and a logical focus for child obesity prevention initiatives. The focus on parents own behaviors provides a potential opportunity to decrease obesity risk behaviors in parents as well. Objective To assess the effect of a parent-focused early childhood obesity prevention intervention on first-time mothers diets, physical activity and TV viewing time. Methods The Melbourne InFANT Program is a cluster-randomized controlled trial which involved 542 mothers over their newborns first 18?months of life. The intervention focused on parenting skills and strategies, including parental modeling, and aimed to promote development of healthy child and parent behaviors from birth, including healthy diet, increased physical activity and reduced TV viewing time. Data regarding mothers diet (food frequency questionnaire, physical activity and TV viewing times (self-reported questionnaire were collected using validated tools at both baseline and post-intervention. Four dietary patterns were derived at baseline using principal components analyses including frequencies of 55 food groups. Analysis of covariance was used to measure the impact of the intervention. Results The scores of both the "High-energy snack and processed foods" and the "High-fat foods" dietary patterns decreased more in the intervention group: -0.22 (?0.42;-0.02 and ?0.25 (?0.50;-0.01, respectively. No other significant intervention vs. control effects were observed regarding total physical activity, TV viewing time, and the two other dietary patterns, i.e. Fruits and vegetables and Cereals and sweet foods. Conclusions These findings suggest that supporting first-time mothers to promote healthy lifestyle behaviors in their infants impacts maternal dietary intakes positively. Further research needs to assess ways in which we might further enhance those lifestyle behaviors not impacted by the InFANT intervention.
AbstractAmong children ages 719, about 1 in 3 are overweight and obese (BMI-for-age at or above the 85th percentile of the 2000 CDC growth charts.); 32.1% of all boys and 31.3% of all girls are overweight and obese. Because of the dramatic and alarming increase in childhood obesity and its associated health risks, obesity prevention programs targeting children can and should be developed to promote the health of the public. This study is an overview of different ...
Hanan Mohamed Tork; Thomas Boggatz
OBJECTIVE: To investigate lay perceptions of the causes and prevention of obesity among primary school children. DESIGN: A cross-sectional survey of randomly selected sample of adults in a shopping centre. SUBJECTS: 315 adults in Melbourne, Australia. MEASUREMENTS: Subjects completed a self-completion questionnaire, in which they rated the importance of 25 possible causes of obesity and the importance of 13 preventive measures on four-point scales: not important; quite important; very importa...
Hardus, P. M.; Vuuren, C. L.; Crawford, D.; Worsley, A
There is a great need for empirical evidence to inform clinical prevention and management of overweight and obesity. Application of virtual reality (VR) methods to this research agenda could present considerable advantages. Use of VR methods in basic and applied obesity prevention and treatment research is currently extremely limited. However, VR has been employed for social and behavioral research in many other domains where it has demonstrated validity and utility. Advantages of VR technolo...
As obesity prevention becomes an increasing health priority in many countries, including Australia and New Zealand, the challenge that governments are now facing is how to adopt a systematic policy approach to increase healthy eating and regular physical activity. This article sets out a structure for systematically identifying areas for obesity prevention policy action across the food system and full range of physical activity environments. Areas amenable to policy intervention can be system...
Sacks, Gary; Swinburn, Boyd A.; Lawrence, Mark A.
Full Text Available Abstract Background The prevalence of overweight and obesity in Europe is high. It is a major cause of the overall rates of many of the main chronic (or non communicable diseases in this region and is characterized by an unequal socio-economic distribution within the population. Obesity is largely determined by modifiable lifestyle behaviours such as low physical activity levels, sedentary behaviour and consumption of energy dense diets. It is increasingly being recognised that effective responses must go beyond interventions that only focus on a specific individual, social or environmental level and instead embrace system-based multi-level intervention approaches that address both the individual and environment. The EU-funded project sustainable prevention of obesity through integrated strategies (SPOTLIGHT aims to increase and combine knowledge on the wide range of determinants of obesity in a systematic way, and to identify multi-level intervention approaches that are strong in terms of Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM. Methods/Design SPOTLIGHT comprises a series of systematic reviews on: individual-level predictors of success in behaviour change obesity interventions; social and physical environmental determinants of obesity; and on the RE-AIM of multi-level interventions. An interactive web-atlas of currently running multi-level interventions will be developed, and enhancing and impeding factors for implementation will be described. At the neighbourhood level, these elements will inform the development of methods to assess obesogenicity of diverse environments, using remote imaging techniques linked to geographic information systems. The validity of these methods will be evaluated using data from surveys of health and lifestyles of adults residing in the neighbourhoods surveyed. At both the micro- and macro-levels (national and international the different physical, economical, political and socio-cultural elements will be assessed. Discussion SPOTLIGHT offers the potential to develop approaches that combine an understanding of the obesogenicity of environments in Europe, and thus how they can be improved, with an appreciation of the individual factors that explain why people respond differently to such environments. Its findings will inform governmental authorities and professionals, academics, NGOs and private sector stakeholders engaged in the development and implementation of policies to tackle the obesity epidemic in Europe.
Purpose: The aim of this literature review is to summarise and synthesise the research base concerning childhood obesity and physical activity, particularly in relation to teachers and schools and within a policy context of the UK. The review investigates childhood obesity, physical activity, physical education, the role of teachers, the role of
Background: Over the last 3 decades, US obesity rates have increased dramatically as more children and more adults become obese. This study explores an innovative program, Active Generations, an intergenerational nutrition education and activity program implemented in out-of-school environments (after school and summer camps). It utilizes older
Werner, Danilea; Teufel, James; Holtgrave, Peter L.; Brown, Stephen L.
The atherosclerotic process begins in childhood and advances rapidly triggered by multiple genetic and environmental factors, including obesity. Obesity has reach epidemic proportions mainly by the consumption of junk food and a sedentary lifestyle. Our children spend long time inactive in front of the television and video games, further aggravated by the consumption of excessive calories of unhealthy food bombardment from TV commercials. The health related expenses of the obese is in average $1,500 annually higher than for persons with normal weight. The annual cost of diseases associated to obesity is estimated on $147 billion in the United States, a 10% of the national medical expenses. We must uncover strategies conducting to healthier lifestyles. School and home initiatives together with community and governmental efforts are necessary to stimulate our youngsters to live healthy lifestyles. The commitment of the food industry is critical to achieve the difficult goal of reducing childhood obesity to the prevalent 5% of the 1970's. PMID:22737835
Full Text Available High-protein diets have been shown to prevent the development of diet-induced obesity and can improve associated metabolic disorders in mice. Dietary leucine supplementation can partially mimic this effect. However, the molecular mechanisms triggering these preventive effects remain to be satisfactorily explained. Here we review studies showing a connection between high protein or total amino nitrogen intake and obligatory water intake. High amino nitrogen intake may possibly lower lipid storage, and prevent insulin resistance. Suggestions are made for further systematical studies to explore the relationship between water consumption, satiety, and energy expenditure. Moreover, these examinations should better distinguish between leucine-specific and unspecific effects. Research in this field can provide important information to justify dietary recommendations and strategies in promoting long-term weight loss and may help to reduce health problems associated with the comorbidities of obesity.
Klaus J. Petzke
Effective interventions to prevent obesity in children have never been more necessary. There have been over 30 published reviews and meta-analyses on such interventions (randomized and controlled trials) since 2008. In summary, interventions which involve the whole community (community-based) in complex interventions (promoting healthy eating, reduction in sedentary behaviours and increase in physical activity) that target environments and upstream determinants appear to be more effective. In this article the strengths and weaknesses of community-based complex interventions which aim to prevent obesity in children will be discussed and a selection of recent and ongoing interventions that are shaping the evidence-base in this field will be highlighted (beyond those reported in other papers in this supplement: KOPS, CHILT, TigerKids, IDEFICS and TrinkFit). This paper reviews the challenges and opportunities associated with designing and evaluating community-based complex interventions and initiatives. These include a) design issues (strengths and weaknesses of different types of evidence), b) measurement of (effectiveness) outcomes, c) development of interventions (pilot work, planning frameworks and underpinning theories), d) partnership working and community engagement and e) health inequalities. PMID:21347757
Hillier, F; Pedley, C; Summerbell, C
Full Text Available The purpose of this article was to review primary prevention interventions targeting childhood obesity implemented in the after school environment from 2006 and 2011. A total of 20 interventions were found from 25 studies. Children in the interventions ranged from kindergarten to middle schoolers, however a majority was in the 4th and 5th grades. Most of the interventions targeted both physical activity and dietary behaviors. Among those that focused on only one dimension, physical activity was targeted more than diet. The duration of the interventions greatly varied, but many were short-term or brief. Many interventions were also based on some behavioral theory, with social cognitive theory as the most widely used. Most of the interventions focused on short-term changes, and rarely did any perform a follow-up evaluation. A major limitation among after school interventions was an inadequate use of process evaluations. Overall, interventions resulted in modest changes in behaviors and behavioral antecedents, and results were mixed and generally unfavorable with regards to indicators of obesity. Recommendations for enhancing the effectiveness of after school based childhood obesity interventions are presented.
Ling Zhi-8 (LZ-8), a novel and recently discovered immunomodulatory protein having in vivo immuno-suppressive activity, was tested for in vivo effect against Type 1 (insulin-dependent) diabetes mellitus in the nonobese diabetic mouse, the disease having immunologically mediated aetiology in this animal. LZ-8 had mitogenic activity in vitro towards spleen cells of the non-obese diabetic mice as previously shown towards those of DBA/2 mice. Intraperitoneal administration of LZ-8 twice weekly into the mice (10.3-12.6 mg/kg body weight) from 4 weeks of age prevented insulitis and an almost normal number of insulin producing cells were observed. Extreme insulitis and reduction of the number of insulin producing cells were observed in the pancreata of the untreated non-obese diabetic mouse. No cumulative incidence of diabetes mellitus was observed in the LZ-8 treated group, while cumulative incidences of 70% and 60% were observed in an untreated group followed up to 42 weeks of age when the incidence of diabetes was defined as a plasma glucose level of greater than 11 mmol/l and as a urine glucose level of greater than 2+, respectively. T cell subset population analysis was performed to further investigate the action of LZ-8 on the non-obese diabetic mouse which revealed that LZ-8 treatment increased in L3T4'/Lyt-2+ ratio. PMID:2073984
Kino, K; Mizumoto, K; Sone, T; Yamaji, T; Watanabe, J; Yamashita, A; Yamaoka, K; Shimizu, K; Ko, K; Tsunoo, H
Background: Parents are integral to the implementation of obesity prevention and management recommendations for children. Exploration of barriers to and facilitators of parental decisions to adopt obesity prevention recommendations will inform future efforts to reduce childhood obesity.Methods We conducted 4 focus groups (2 English, 2 Spanish) among a total of 19 parents of overweight (BMI ? 85th percentile) children aged 5-17 years. The main discussion focused on 7 common obesity preventio...
La Pelle, Nancy; Sonneville, Kendrin Rae; Taveras, Elsie Mireya; Gillman, Matthew William; Prosser, Lisa Alison
Nearly two thirds of the US population is overweight or obese and those numbers are climbing. Many organizations are beginning to recognize overweight and obesity as severe health threats and to acknowledge that treatment can serve as an important first step in addressing this epidemic. Through its Obesity with Co-morbidities Initiative, the Disease Management Association of America (DMAA) seeks to raise awareness and improve understanding of the role disease management (DM) can play in the treatment and management of obesity with comorbidities. Among the objectives of the Obesity with Co-morbidities Initiative was to develop standard definitions of obesity and obesity with comorbidities and to conduct qualitative research among key DM stakeholders. The first project undertaken and completed by the Obesity with Associated Co-morbidities Steering Committee and work group was to define the term "obesity" for consistent usage within the DM community for the purposes of population-based interventions. As part of this initiative, DMAA partnered with Synovate, a global market research firm, to conduct focus groups and in-depth interviews in order to collect qualitative data on attitudes and practices related to obesity treatment and coverage among key industry stakeholders, including health plans, disease management organizations, employers, and the business community. The findings indicated that obesity was widely recognized as a serious issue, but there remained varying opinions regarding responsibility, health and productivity costs, coverage, and best treatment methods among the participants. DMAA will continue this initiative through 2007 and will continue to develop a knowledge base of obesity guidelines and management practices, create valuable tools and resources including an online resource center, and facilitate partnerships with other organizations involved in the management and prevention of obesity. PMID:17590146
May, Jeanette; Buckman, Ellen
Full Text Available
Background: Due to increasing problems with childhood and adolescent obesity in Austria PRESTO (PrEvention STudy of Obesity created a school based intervention program for promoting a healthy lifestyle in Austrian youth.
Methods: PRESTO was carried out by a multi-disciplinary team including a physician, a psychologist, a nutritionist and an exercise physiologist. The study was carried out in 12 first grade school classes in Austria (2002-2004, mainly in Vienna (N=260. The control group consisted of 231 subjects. Medical examinations were performed and the participantsf knowledge on good nutrition and dietary habits were collected. Twelve nutrition sessions, one hour per week in each class, were conducted. Teachers were advised to discuss health issues in their classes and specific exercise physiologists were informed about how to integrate appropriate exercises into their lessons.
Results: In comparison with control group, classes who performed PRESTO showed a significant knowledge of nutrition, consuming less unhealthy foods. These effects could be observed in the short term (14 weeks and at follow up (10 months. 24% subjects could be classified as being overweight (BMI .90.Perc..
Conclusions: School-oriented intervention programs/studies, like PRESTO, are a potential way to demonstrate positive effect on nutrition, physical activity and healthy behaviours in youth, especially if carried out on a long-term basis. Ultimately PRESTO has proven to be a suitable programme to be disseminated onto schools throughout Austria.
Abstract Background New Zealand rates of obesity and overweight have increased since the 1980s, particularly among indigenous M?ori people, Pacific people and those living in areas of high deprivation. New Zealand's response to the obesity epidemic has been The Healthy Eating-Healthy Action: Oranga Kai - Oranga Pumau (HEHA) Strategy ('the Strategy'), launched in 2003. Because the HEHA Strategy explicitly recognises the importance of evaluation and the need to create...
McLean Rachael M; Hoek Janet A; Buckley Sue; Croxson Bronwyn; Cumming Jacqueline; Ehau Terry H; Tanuvasa Ausaga; Johnston Margaret; Mann Jim I; Schofield Grant
Background and objectives: The European Unionâ??as well as other parts of the worldâ??faces a major challenge of increasing incidence of overweight/obesity. In particular, the increase in childhood obesity gives rise to a strong imperative for immediate action. Yet, little is known about the effectiveness of community interventions, and further research in this field is needed. There is, however, a growing consensus that such research should start from the paradigm that the current living environments tend to counteract healthy lifestyles. Questioning these environments thoroughly can help to develop new pathways for sustainable health-promoting communities. Against this background, the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study developed and implemented innovative community-oriented intervention programmes for obesity prevention and healthy lifestyle primarily in children aged 2â??10 years in eight European countries: Sweden, Estonia, Germany, Belgium, Hungary, Italy, Spain and Cyprus. Materials and methods: The IDEFICS community-oriented intervention study mobilised an integrated set of interventional efforts at different levels of society, with the aim of facilitating the adoption of a healthy obesity-preventing lifestyle. The overall programme has been composed of 10 modules: three at community level, six at school level and one for parents. The main focus was on diet, physical activity and stress-coping capacity. The sphere of action encompassed both children and their (grand) parents, schools, local public authorities and influential stakeholders in the community. All materials for the interventions were centrally developed and culturally adapted. Results: So far, the following has been achieved: focus group research, literature review and expert consultations were done in an early phase as a basis for the development of the intervention modules. The intervention mapping protocol was followed as guide for structuring the intervention research. The overall intervention programme's duration was 2 years, but a longer-term follow-up programme is under development. Conclusions: This large-scale European effort is expected to contribute significantly to the understanding of this major public health challenge.
De Henauw, Stefaan; Verbestel, V.
Full Text Available This research is made to define damages of the obesity, cure processes with body exercises and effects of the leptin on the obesity. In this research, scientific researches about the subject were analyzed carefully and it was handled on these literatures. As a result, it is presented that an inactive life and fatty diets cause the obesity and the leptin influences the anti-obesity. Besides, it is shown that some body exercises reduce the obesity by wasting calories.
Obesity in Chilean children has increased markedly over the past decades. School-based obesity prevention interventions have been launched by the Ministry of Health and academic groups to tackle this condition. We summarize the main characteristics of the interventions that we have conducted and reflect on the lessons learned. Since 2002, we conducted 1 pilot study, a 2-y controlled intervention including 6- to 12y-old children (Casablanca), another pilot study, and a 2-y controlled interv...
Kain, Juliana; Uauy, Ricardo; Concha, Fernando; Leyton, Ba?rbara; Bustos, Nelly; Salazar, Gabriela; Lobos, Luz; Vio, Fernando
From the screening of literature on public health policy we have learned that public intervention is necessary in order to deal with childhood overweight and obesity and that the local administrative level constitutes the tailpiece of any public intervention in this field. The key task of the (local) government in obesity prevention consists of supporting the target groups (such as children, adolescents, etc.) and the first-level actors (such as parents, schools, sports organisations, associa...
Assche, Joke; Henauw, Stefaan; Reynaert, Herwig
This paper is written as a briefing document with the aim of providing support to policy-makers and government officials tackling obesity and related non-communicable diseases. It is based on a symposium Obesity and non-communicable diseases: Learning from international experiences convened by the International Association for the Study of Obesity (now the World Obesity Federation) and its policy section, the International Obesity TaskForce (now World Obesity - Policy and Prevention). The symposium discussed a wide range of proposals to tackle the consumption of unhealthy food products, including interventions in the market through fiscal policies and marketing restrictions, measures to strengthen public health legislation and measures to limit agri-food company lobbying activities. It recognized the need for government leadership and action in order to reduce preventable deaths while improving economic performance and identified a need for governments to take a systems wide approach to tackling obesity and to work with civil society, especially to monitor the drivers of disease and to hold all stakeholders accountable for progress. PMID:24888259
Lobstein, Tim; Brinsden, Hannah
A systematic review of the literature was conducted to identify the barriers that prevent practitioners from identifying and counseling parents and caregivers of overweight or obese children. Once identified, barriers were organized into thematic categories (parental, provider, and professional barriers) and recommendations were generated to facilitate discussion about childhood obesity between professionals and parents. Childhood obesity is a significant public health problem. Healthcare pro...
The benefits of regular physical activity have been known since ancient Greek. But in the last Century the scientific knowledge around this topic has progressed enormously, starting with the early studies of JN Morris and RS Paffenberger, who demonstrated that physical activity at work reduced incidence of cardiovascular disease and mortality. In the Harvard alumni study, the lowest risk was associated with a weekly output of 1000 to 2000 kcal performing vigorous activities. Further studies in all age groups have supported these findings and have added that even moderate levels of physical activity provide considerable benefits to health, including lower prevalence of overweight and obesity at all ages. Metabolic fat oxidation rate is highest at exercise intensities between 45 and 65% of VO2max. This means that people must be active regularly and force physiological mechanisms at certain intensities. All this body of evidence has contributed to current WHO physical activity recommendations of 150 min/week of moderate to vigorous physical activity (MVPA) in adults and elderly, and 60 min/day of MVPA in children and adolescents, with additional strength training, apart from adopting an active lifestyle. In the last 50 years, occupational physical activity has been reduced for about 120 kcal/day, and sedentarism has emerged as an additional risk factor to physical inactivity. Even if less than 60 min of TV time in adults have been related to lower average BMI, there is still a need for research to determine the appropriate dose of exercise in combination with sedentary behaviours and other activities in the context of our modern lifestyle in order to prevent obesity at all ages. As public health measures have failed to stop the obesity epidemic in the last 3 decades, there is clearly a need to change the paradigm. The inclusion of sport scientists, physical education teachers and other professionals in the multidisciplinary team which should be responsible for drawing the road map to prevent the increase of the obesity epidemic effectively is a "must" from our point of view. PMID:24010748
González-Gross, Marcela; Meléndez, Agustín
This review is focused on the effects of obesity on function and expression of potassium (K) channels in the vasculature. Five families of K channels have been identified in the vascular wall, calcium-activated K (KCa) channels, inward-rectifier K (KIR) channels, ATP-sensitive K (KATP) channels, voltage-gated K (KV) channels and two-pore domain K (K2P) channels. In endothelial cells (EC) and vascular smooth muscle cells (VSMC) opening of K channels leads to hyperpolarisation followed by vasodilatation. In some vascular beds of animal models of obesity, vasodilatation mediated by KCa3.1 and KCa2.3 channels has been reported to remain unaltered or even increased, whereas vasodilatation involving KCa1.1 channel has consistently been reported to be impaired. Changes in expression and function of KIR and KATP channels have also been associated with impaired vasodilatation in animal models of obesity, and therefore activation of these channels may improve endothelial function and reduce the risk of major cardiovascular events. Expression of KV7.x channels is downregulated in small arteries from hypertensive animals and it would be interesting to assess whether these channels contribute to development of hypertension in obese patients. However, the role of KV7.x and K2P channels in regulation of blood pressure remains unexplored compared to other K channels. In conclusion, obesity and metabolic syndrome alter expression, function and sensitivity of vascular K channel subtypes causing smooth muscle dysfunction and probably endothelial dysfunction which makes these patients particularly prone to premature cardiovascular disease. Modulation of K channel activity by use of openers of e.g. KCa and KATP channels may also be attractive to counteract vascular dysfunction observed in obesity.
Climent, Belen; Simonsen, Ulf
This review is focused on the effects of obesity on function and expression of potassium (K) channels in the vasculature. Five families of K channels have been identified in the vascular wall, calcium-activated K (KCa) channels, inward-rectifier K (KIR) channels, ATP-sensitive K (KATP) channels, voltage-gated K (KV) channels and two-pore domain K (K2P) channels. In endothelial cells (EC) and vascular smooth muscle cells (VSMC) opening of K channels leads to hyperpolarisation followed by vasodilatation. In some vascular beds of animal models of obesity, vasodilatation mediated by KCa3.1 and KCa2.3 channels has been reported to remain unaltered or even increased, whereas vasodilatation involving KCa1.1 channel has consistently been reported to be impaired. Changes in expression and function of KIR and KATP channels have also been associated with impaired vasodilatation in animal models of obesity, and therefore activation of these channels may improve endothelial function and reduce the risk of major cardiovascular events. Expression of KV7.x channels is downregulated in small arteries from hypertensive animals and it would be interesting to assess whether these channels contribute to development of hypertension in obese patients. However, the role of KV7.x and K2P channels in regulation of blood pressure remains unexplored compared to other K channels. In conclusion, obesity and metabolic syndrome alter expression, function and sensitivity of vascular K channel subtypes causing smooth muscle dysfunction and probably endothelial dysfunction which makes these patients particularly prone to premature cardiovascular disease. Modulation of K channel activity by use of openers of e.g. KCa and KATP channels may also be attractive to counteract vascular dysfunction observed in obesity. PMID:24846233
Climent, Belen; Simonsen, Ulf; Rivera, Luis
Full Text Available In this study there are two main aims. The first one is to model and predict the incidence of obesity in the 3-5 years old population in the coming years in the region of Valencia, Spain. The second aim of this research is to use the constructed model to analyze the possible strategies in order to prevent the spread of obesity. At first a logistic regression statistical analysis of sociocultural variables of children with weight problems is performed. The result of this logistic regression statistical analysis suggests that sociocultural factors in the region of Valencia where the child grows up influence the development of overweight or obesity. Thus, this result permit to consider the hypothesis that the obesity is a health concern that depends on sociocultural factors and it is transmitted by the spread of unhealthy eating habits. In this way the hypothesis permits to construct a mathematical epidemiological type model in order to forecast obesity prevalence and to understand the mechanisms of the obesity spread. Using the constructed epidemiological mathematical model it is predicted that in the coming years, an increasing trend in the overweight and obese 3-5 years old children in the region of Valencia is predicted if the actual parameters of the mathematical model stay invariant. In addition, the different numerical simulations performed with the constructed epidemiological mathematical model indicate that the most likely successful strategy to tackle the obesity is through educational campaigns about the risk of unhealthy eating habits. This study shows how an epidemiological type mathematical model is an interesting tool to study the obesity transmissions dynamics in the population. It is useful to predict the prevalence of the obesity and study strategies to tackle it.
Overweight and obesity are major public health problems in the European Union (EU). Providing nutrition information on foods and menus is considered a relevant means to guide consumers toward more healthful food choices, in part characterized by adequate energy intakes to achieve and maintain a healthy body weight. Various formats of back-of-pack and front-of-pack nutrition labeling can currently be found across the EU, with varying levels of penetration. Experimental studies show that consum...
Storcksdieck Genannt Bonsmann, Stefan; Wills, Josephine M.
Objective To assess recent trends in obesity, health beliefs, and lifestyles in Swedish schoolchildren, with focus on socioeconomic disparities. Method The study was conducted in two areas with high and low socioeconomic status (SES). 340 1112 year olds participated in three cross-sectional surveys assessing food-related behaviours, physical activity and health beliefs, together with anthropometric examinations. Comparisons were made before and after a community-based intervention (2003 ve...
The lessons learned from over 20 years of obesity prevention efforts in Australia and New Zealand are presented. The obesity epidemic started in the 1980s but poor monitoring systems meant the rise in obesity prevalence initially went undetected. In the 1990 s, experts started advocating for government action; however, it was the rapid increase in media reports on obesity in the early 2000s which created the pressure for action. Several, comprehensive reports produced some programme investment but no regulatory policies were implemented. The powerful food industry lobby ensured this lack of policies on front-of-pack food labelling, restrictions on unhealthy food marketing to children, or taxes on unhealthy foods. The New Zealand government even backpedalled by rescinding healthy school food guidelines and withdrawing funding for the comprehensive national obesity strategy. In 2007, Australian Governments started a major long term-investment in preventive health in order to improve economic productivity. Other positive initiatives, especially in Australia, were: the establishment of several advocacy organizations; successful, long-term, whole-of-community projects reducing childhood obesity; a national knowledge exchange system for practitioners; and some innovative programmes and social marketing. However, despite multiple reports and strong advocacy, key recommended regulatory policies remain unimplemented, largely due to the private sector interests dominating public policy development. PMID:24102746
Swinburn, B; Wood, A
Childhood obesity is a prevalent subject of research currently, and many researchers have studied the effectiveness of school programs in battling obesity among students. This case study, utilizing ethnographic tools of observation, interviews, and investigation of artifacts, examines educators' perceptions of the role of the school in the
Johnson, Sharon Kay Harris
While many women with polycystic ovary syndrome (PCOS) are overweight, obese or centrally obese, the effect of excess weight on the outcomes of PCOS is inconsistent. The review aimed to assess the effects of overweight, obesity and central obesity on the reproductive, metabolic and psychological features of PCOS. MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL) and PSYCINFO were searched for studies reporting outcomes according to body mass index categories or body fat distribution. Data were presented as mean difference or risk ratio (95% confidence interval). This review included 30 eligible studies. Overweight or obese women with PCOS had decreased sex hormone-binding globulin (SHBG), increased total testosterone, free androgen index, hirsutism, fasting glucose, fasting insulin, homeostatic model assessment-insulin resistance index and worsened lipid profile. Obesity significantly worsened all metabolic and reproductive outcomes measured except for hirsutism when compared to normal weight women with PCOS. Overweight women had no differences in total testosterone, hirsutism, total-cholesterol and low-density lipoprotein-cholesterol compared to normal weight women and no differences in SHBG and total testosterone compared to obese women. Central obesity was associated with higher fasting insulin levels. These results suggest that prevention and treatment of obesity is important for the management of PCOS. PMID:23114091
Lim, S S; Norman, R J; Davies, M J; Moran, L J
Abstract Background Obesity is often associated with low back pain (LBP). Despite empirical evidence that LBP induces gait abnormalities, there is a lack of quantitative analysis of the combined effect of obesity and LBP on gait. The aim of our study was to quantify the gait pattern of obese subjects with and without LBP and normal-mass controls by using Gait Analysis (GA), in order to investigate the cumulative effects of obesity and LBP on gait. Methods Eight ...
Cimolin Veronica; Vismara Luca; Galli Manuela; Zaina Fabio; Negrini Stefano; Capodaglio Paolo
Tea (Camellia sinensis, Theaceae) and tea polyphenols have been studied for the prevention of chronic diseases, including obesity. Obesity currently affects >20% of adults in the United States and is a risk factor for chronic diseases such as type II diabetes, cardiovascular disease, and cancer. Given this increasing public health concern, the use of dietary agents for the prevention of obesity would be of tremendous benefit. Whereas many laboratory studies have demonstrated the potential eff...
Grove, Kimberly A.; Lambert, Joshua D.
Five major approaches namely dietary, exercise, behavior, combination and pharmacy therapies are used for treatment and control of obesity. In dietary therapy, low-calorie diet (LCD), which provides 800 to 1500 kcal of energy daily; a very-low-calorie diet (VLCD), which provides 250-800 kcal of energy daily and an energy-restricted or hypo caloric diet (HCD), which is based on a person`s estimated daily energy requirement. LCDs can reduce total body weight by an average of 8 percent and help ...
Aien Khan Afridi; Mohammad Siddique; Mahpara Safdar; Alam Khan
Abstract Background In 2005, we reported on the success of Comprehensive School Health (CSH) in improving diets, activity levels, and body weights. The successful program was recognized as a "best practice" and has inspired the development of the Alberta Project Promoting active Living and healthy Eating (APPLE) Schools. The project includes 10 schools, most of which are located in socioeconomically disadvantaged areas. The present study examines the effectiveness of a CSH pr...
Fung Christina; Kuhle Stefan; Lu Connie; Purcell Megan; Schwartz Marg; Storey Kate; Veugelers Paul J
Full Text Available Background: Excessive increases in weight bearing forces caused by obesity may negatively affect the lower limbs and feet but minimal research has examined the long-term loading effects of obesity on the musculoskeletal system, particularly in reference to the feet. Objectives: The purpose of the study was to investigate the effect of obesity on medial longitudinal arch of foot in young adults. Method: 60 subjects, 30 obese & 30 non obese were assessed for height & weight using standard technique. Radiographic images under static condition were used for calculating the arch index. Result: The arch index of obese subjects was significantly lower than the non obese subjects & there is a negative correlation between the BMI & the arch index. Conclusion: These results suggests that obesity lowers the medial longitudinal arch of foot.
Sneha Sameer Ganu
Background Childhood overweight and obesity have increased during the past decades and there is a need for effective intervention programs both for treatment and prevention to interrupt the increased trend. Overweight and obesity result from a combination of genetic predisposition and lifestyle where an imbalance in energy intake (EI) and total energy expenditure (TEE) is the key factor. The objective of this thesis is to evaluate the impact of a 2-year lifestyle intervention on food habits, ...
INTRODUCTION: QT prolongation and obesity are associated with ventricular arrhythmia and sudden cardiac death. The relationship between uncomplicated obesity and QT interval prolongation is not clear. OBJECTIVES: The aim of the study was to investigate the effects of uncomplicated obesity on QT interval in young men. PATIENTS AND METHODS: A total of 122 men, including 59 obese patients and 63 controls, were recruited into the study. Patients with hypertension, diabetes mellitus, and ischemic ...
Full Text Available Abstract Background Error in self-reported measures of obesity has been frequently described, but the effect of self-reported error on recruitment into diabetes prevention programs is not well established. The aim of this study was to examine the effect of using self-reported obesity data from the Finnish diabetes risk score (FINDRISC on recruitment into the Greater Green Triangle Diabetes Prevention Project (GGT DPP. Methods The GGT DPP was a structured group-based lifestyle modification program delivered in primary health care settings in South-Eastern Australia. Between 200405, 850 FINDRISC forms were collected during recruitment for the GGT DPP. Eligible individuals, at moderate to high risk of developing diabetes, were invited to undertake baseline tests, including anthropometric measurements performed by specially trained nurses. In addition to errors in calculating total risk scores, accuracy of self-reported data (height, weight, waist circumference (WC and Body Mass Index (BMI from FINDRISCs was compared with baseline data, with impact on participation eligibility presented. Results Overall, calculation errors impacted on eligibility in 18 cases (2.1%. Of n?=?279 GGT DPP participants with measured data, errors (total score calculation, BMI or WC in self-report were found in n?=?90 (32.3%. These errors were equally likely to result in under- or over-reported risk. Under-reporting was more common in those reporting lower risk scores (Spearman-rho?=??0.226, p-value? Conclusions Overall FINDRISC was found to be an effective tool to screen and recruit participants at moderate to high risk of diabetes, accurately categorising levels of overweight and obesity using self-report data. The results could be generalisable to other diabetes prevention programs using screening tools which include self-reported levels of obesity.
BACKGROUND: Obese individuals who smoke have a 14 year reduction in life expectancy. Both obesity and smoking are independently associated with increased risk of malignancy. Natural killer cells (NK) are critical mediators of anti-tumour immunity and are compromised in obese patients and smokers. We examined whether NK cell function was differentially affected by cigarette smoke in obese and lean subjects. METHODOLOGY AND PRINCIPAL FINDINGS: Clinical data and blood were collected from 40 severely obese subjects (BMI>40 kg\\/m(2)) and 20 lean healthy subjects. NK cell levels and function were assessed using flow cytometry and cytotoxicity assays. The effect of cigarette smoke on NK cell ability to kill K562 tumour cells was assessed in the presence or absence of the adipokines leptin and adiponectin. NK cell levels were significantly decreased in obese subjects compared to lean controls (7.6 vs 16.6%, p = 0.0008). NK function was also significantly compromised in obese patients (30% +\\/- 13% vs 42% +\\/-12%, p = 0.04). Cigarette smoke inhibited NK cell ability to kill tumour cell lines (p<0.0001). NK cells from obese subjects were even more susceptible to the inhibitory effects of smoke compared to lean subjects (33% vs 28%, p = 0.01). Cigarette smoke prevented NK cell activation, as well as perforin and interferon-gamma secretion upon tumour challenge. Adiponectin but not leptin partially reversed the effects of smoke on NK cell function in both obese (p = 0.002) and lean controls (p = 0.01). CONCLUSIONS\\/SIGNIFICANCE: Obese subjects have impaired NK cell activity that is more susceptible to the detrimental effects of cigarette smoke compared to lean subjects. This may play a role in the increase of cancer and infection seen in this population. Adiponectin is capable of restoring NK cell activity and may have therapeutic potential for immunity in obese subjects and smokers.
BACKGROUND: Obese individuals who smoke have a 14 year reduction in life expectancy. Both obesity and smoking are independently associated with increased risk of malignancy. Natural killer cells (NK) are critical mediators of anti-tumour immunity and are compromised in obese patients and smokers. We examined whether NK cell function was differentially affected by cigarette smoke in obese and lean subjects. METHODOLOGY AND PRINCIPAL FINDINGS: Clinical data and blood were collected from 40 severely obese subjects (BMI>40 kg\\/m(2)) and 20 lean healthy subjects. NK cell levels and function were assessed using flow cytometry and cytotoxicity assays. The effect of cigarette smoke on NK cell ability to kill K562 tumour cells was assessed in the presence or absence of the adipokines leptin and adiponectin. NK cell levels were significantly decreased in obese subjects compared to lean controls (7.6 vs 16.6%, p = 0.0008). NK function was also significantly compromised in obese patients (30% +\\/- 13% vs 42% +\\/-12%, p = 0.04). Cigarette smoke inhibited NK cell ability to kill tumour cell lines (p<0.0001). NK cells from obese subjects were even more susceptible to the inhibitory effects of smoke compared to lean subjects (33% vs 28%, p = 0.01). Cigarette smoke prevented NK cell activation, as well as perforin and interferon-gamma secretion upon tumour challenge. Adiponectin but not leptin partially reversed the effects of smoke on NK cell function in both obese (p = 0.002) and lean controls (p = 0.01). CONCLUSIONS\\/SIGNIFICANCE: Obese subjects have impaired NK cell activity that is more susceptible to the detrimental effects of cigarette smoke compared to lean subjects. This may play a role in the increase of cancer and infection seen in this population. Adiponectin is capable of restoring NK cell activity and may have therapeutic potential for immunity in obese subjects and smokers.
Over the last decades, the prevalence of obesity and related diseases has increased rapidly in the Western world. Obesity is a disorder of energy balance and is associated with hyper-insulinemia, insulin resistance, and abnormalities in lipid metabolism, and it is one of the most important risk factors in the development of Type II diabetes, cardiovascular disease, atherosclerosis, and certain cancers. Because of the lower frequency of these diseases in Asian countries, attention has been turned toward the Asian diet, which consists highly of soy and soy-based products. The health benefits associated with soy consumption have been linked to the content of isoflavones, the main class of the phytoestrogens. As a result of their structural similarities to endogenous estrogens, isoflavones elicit weak estrogenic effects by competing with 17beta-estradiol (E2) for binding to the intranuclear estrogen receptors (ERs) and exert estrogenic or antiestrogenic effects in various tissues. The estrogenic activities of soyisoflavones are thought to play an important role in their health-enhancing properties. Additionally, the isoflavones have been proved to exert non-ER-mediated effects through numerous other pathways. Genistein, daidzein, and glycitein are the principal isoflavones in soy. Genistein is the most thoroughly examined of these, because it is the most prevalent isoflavone in soy and the most active of these compounds, because of its higher binding affinity for the ER. Genistein and daidzein can be obtained in high levels in humans under certain nutritional conditions, and epidemiologic and laboratory data suggest that these compounds could have health benefits in human obesity. This review will focus on the latest results of research on isoflavones and their effect on obesity in cell cultures, rodents, and humans.
Ã?rgaard, Anne; Jensen, Lotte
Full Text Available Abstract Background New Zealand rates of obesity and overweight have increased since the 1980s, particularly among indigenous M?ori people, Pacific people and those living in areas of high deprivation. New Zealand's response to the obesity epidemic has been The Healthy Eating-Healthy Action: Oranga Kai - Oranga Pumau (HEHA Strategy ('the Strategy', launched in 2003. Because the HEHA Strategy explicitly recognises the importance of evaluation and the need to create an evidence base to support future initiatives, the Ministry of Health has commissioned a Consortium of researchers to evaluate the Strategy as a whole. Methods This paper discusses the Consortium's approach to evaluating the HEHA Strategy. It includes an outline of the conceptual framework underpinning the evaluation, and describes the critical components of the evaluation which are: judging to what extent stakeholders were engaged in the process of the strategy implementation and to what extent their feedback was incorporated in to future iterations of the Strategy (continuous improvement, to what extent the programmes, policies, and initiatives implemented span the target populations and priority areas, whether there have been any population changes in nutrition and/or physical activity outcomes or behaviours relating to those outcomes, and to what extent HEHA Strategy and spending can be considered value for money. Discussion This paper outlines our approach to evaluating a complex national health promotion strategy. Not only does the Evaluation have the potential to identify interventions that could be adopted internationally, but also the development of the Evaluation design can inform other complex evaluations.
Full Text Available Abstract Background The aim of the ACE-Obesity study was to determine the economic credentials of interventions which aim to prevent unhealthy weight gain in children and adolescents. We have reported elsewhere on the modelled effectiveness of 13 obesity prevention interventions in children. In this paper, we report on the cost results and associated methods together with the innovative approach to priority setting that underpins the ACE-Obesity study. Methods The Assessing Cost Effectiveness (ACE approach combines technical rigour with 'due process' to facilitate evidence-based policy analysis. Technical rigour was achieved through use of standardised evaluation methods, a research team that assembles best available evidence and extensive uncertainty analysis. Cost estimates were based on pathway analysis, with resource usage estimated for the interventions and their 'current practice' comparator, as well as associated cost offsets. Due process was achieved through involvement of stakeholders, consensus decisions informed by briefing papers and 2nd stage filter analysis that captures broader factors that influence policy judgements in addition to cost-effectiveness results. The 2nd stage filters agreed by stakeholders were 'equity', 'strength of the evidence', 'feasibility of implementation', 'acceptability to stakeholders', 'sustainability' and 'potential for side-effects'. Results The intervention costs varied considerably, both in absolute terms (from cost saving [6 interventions] to in excess of AUD50m per annum and when expressed as a 'cost per child' estimate (from Conclusion The use of consistent methods enables valid comparison of potential intervention costs and cost-offsets for each of the interventions. ACE-Obesity informs policy-makers about cost-effectiveness, health impact, affordability and 2nd stage filters for important options for preventing unhealthy weight gain in children. In related articles cost-effectiveness results and second stage filter considerations for each intervention assessed will be presented and analysed.
Performed was a clinical open trial to examine the anti-obesity effect of Bofutsushosan, a Japanese OTC, oriental herbal medicine (ROHTO Pharma. Co., Ltd.) used for constipation release. Subjects were 40-65 years old, 20 females with the body mass index 25-35, who t.i.d. ingested 3 tablets of the medicine, which corresponding to 3.0 g of dried extract of the Bofutsusho material per day, for 6 months (Sep. 2006-Feb. 2007). Before, 3 and 6 months after the beginning of the study, CT imaging was done to measure the fat areas on umbilical cross section for efficacy evaluation, with Siemens SOMATOM Sensation 16. Total, subcutaneous and inter-visceral fat areas were found to be significantly reduced by medication as well as improvement in other body-measure, hematological and biochemical parameters related with obesity and metabolism. No significant adverse effects were found. The medicine can be useful for improvement of the so-called metabolic syndrome not only for obesity and constipation. (R.T.)
In this study there are two main aims. The first one is to model and predict the incidence of obesity in the 3-5 years old population in the coming years in the region of Valencia, Spain. The second aim of this research is to use the constructed model to analyze the possible strategies in order to prevent the spread of obesity. At first a logistic regression statistical analysis of sociocultural variables of children with weight problems is performed. The result of this logistic regress...
Morales, A.; Jodar, L.; Gonzalez, G.; Santonja, F. J.; Villanueva, R. J.; Rubio, C.
We hypothesized that resveratrol, a natural phytoalexin found in grapes, can prevent oxidative stress, obesity and its related disturbances in obese rats programmed by early weaning. Lactating Wistar rats were separated into two groups: early weaning (EW) - dams who were wrapped with a bandage to interrupt the lactation in the last 3 days of lactation; control - dams whose pups had free access to milk during all lactation. At the 150th day, EW offspring were randomly subdivided into EW+resveratrol (EW+Res) - resveratrol (30 mg/kg/day); EW+vehicle (EW) - rats that received 0.5% (w/v) aqueous methylcellulose. The control group received vehicle. Rats were treated by gavage daily for 30 days. EW offspring developed hyperphagia, higher body weight, visceral obesity, higher systolic (SBP) and diastolic blood pressure (DBP) (+15% and +20%, respectively; Pglutathione peroxidase activities (+51%, +18%, -58%, -31%, respectively; P<.05), and resveratrol normalized both plasma and liver TBARS and increased the activity of SOD and catalase in plasma. EW rats presented liver steatosis and higher liver TG, and resveratrol prevented these hepatic alterations. In conclusion, this study demonstrated a potential therapeutic use of resveratrol in preventing obesity and oxidative stress and reducing the risk of hypertension, dyslipidemia and steatosis in adult rats programmed by early weaning. PMID:22959054
Franco, Juliana G; Lisboa, Patrícia C; Lima, Natália S; Amaral, Taline A S; Peixoto-Silva, Nayara; Resende, Angela C; Oliveira, Elaine; Passos, Magna C F; Moura, Egberto G
The environment of children has drastically changed in Europe during the last decades as reflected in unhealthy dietary habits and sedentary lifestyle. Nutrition obviously plays a part in the development of overweight in childhood. However, dietary factors and physical activity are also involved in the development of metabolic syndrome, type II diabetes, cardiovascular diseases, osteoporosis, and postural deformities like scoliosis, effects related in part to excessive weight gain. To stop the resulting epidemic of diet- and lifestyle-induced morbidity, efficient evidence-based approaches are needed. These issues are the focus of IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants), a five-year project proposed under the sixth EU framework. The IDEFICS consortium comprises 25 research centres and SMEs across Europe. The planned prospective study will identify risk profile inventories for children susceptible to any of these disorders with emphasis on obesity and its co-morbid conditions. Genetic and non-genetic factors, psychosocial factors and social settings will be considered. The project will devise tailored prevention strategies that are effective, easy to implement and that account for the needs of different social groups. Population-based studies will investigate the impact of sensory perception and provide results concerning internal and external triggers of food choices and children's consumer behaviour. The ethical implications of a "right not to know" of genetic factors will be addressed. We will propose knowledge-based guidelines on dietary and lifestyle activities for health promotion and disease prevention in children for health professionals, stakeholders and consumers. PMID:16679223
Ahrens, W; Bammann, K; de Henauw, S; Halford, J; Palou, A; Pigeot, I; Siani, A; Sjöström, M
Despite its benefits, conjugated linoleic acid (CLA) may cause side effects after long-term administration. Because of this and the controversial efficacy of CLA in humans, alternative biomolecules that may be used as functional ingredients have been studied in recent years. Thus, conjugated linolenic acid (CLNA) has been reported to be a potential anti-obesity molecule which may have additional positive effects related to obesity. According to the results reported in obesity, CLNA needs to be given at higher doses than CLA to be effective. However, because of the few studies conducted so far, it is still difficult to reach clear conclusions about the potential use of these CLNAs in obesity and its related changes (insulin resistance, dyslipidemia, or inflammation). PMID:24029409
Miranda, Jonatan; Arias, Noemi; Fernández-Quintela, Alfredo; del Puy Portillo, María
Full Text Available Abstract Background This paper reports the primary outcomes of the Healthy Opportunities for Physical Activity and Nutrition (HOP'N after-school project, which was an effectiveness trial designed to evaluate the prevention of childhood obesity through building the capacity of after-school staff to increase physical activity (PA and fruit and vegetable (FV opportunities. Methods We conducted a three-year, nested cross-sectional group randomized controlled effectiveness trial. After a baseline assessment year (2005-2006, schools and their after-school programs were randomized to the HOP'N after-school program (n = 4 or control (n = 3, and assessed for two subsequent years (intervention year 1, 2006-2007; intervention year 2, 2007-2008. Across the three years, 715 fourth grade students, and 246 third and fourth grade after-school program participants were included in the study. HOP'N included community government human service agency (Cooperative Extension led community development efforts, a three-time yearly training of after-school staff, daily PA for 30 minutes following CATCH guidelines, a daily healthful snack, and a weekly nutrition and PA curriculum (HOP'N Club. Child outcomes included change in age- and gender-specific body mass index z-scores (BMIz across the school year and PA during after-school time measured by accelerometers. The success of HOP'N in changing after-school program opportunities was evaluated by observations over the school year of after-school program physical activity sessions and snack FV offerings. Data were analyzed in 2009. Results The intervention had no impact on changes in BMIz. Overweight/obese children attending HOP'N after-school programs performed 5.92 minutes more moderate-to-vigorous PA per day after intervention, which eliminated a baseline year deficit of 9.65 minutes per day (p Conclusions The HOP'N program had a positive impact on overweight/obese children's PA and after-school active recreation time. Trial registration NCT01015599.
Coleman Karen J
This thesis presents studies on the prevention of childhood overweight. In this general introduction public health issues of childhood overweight will be addressed and a model of planned health education and health promotion will be introduced. Following the different steps of this model, the research questions that are addressed in this thesis are described. The chapter finishes with a summary of the research questions, an overview of the study designs and study populations th...
Exercise is a mechanism for maintenance of body weight in humans. Morbidly obese human patients have been shown to possess single nucleotide polymorphisms in the melanocortin-4 receptor (MC4R). MC4R knockout mice have been well characterized as a genetic model that possesses phenotypic metabolic disorders, including obesity, hyperphagia, hyperinsulinemia, and hyperleptinemia, similar to those observed in humans possessing dysfunctional hMC4Rs. Using this model, we examined the effect of volun...
Haskell-luevano, Carrie; Schaub, Jay W.; Andreasen, Amy; Haskell, Kim R.; Moore, Marcus C.; Koerper, Lorraine M.; Rouzaud, Francois; Baker, Henry V.; Millard, William J.; Walter, Glenn; Litherland, S. A.; Xiang, Zhimin
Background: The prevalence of overweight and obesity in Europe is high. It is a major cause of the overall rates of many of the main chronic (or non communicable) diseases in this region and is characterized by an unequal socio-economic distribution within the population. Obesity is largely determined by modifiable lifestyle behaviours such as low physical activity levels, sedentary behaviour and consumption of energy dense diets. It is increasingly being recognised that effective responses m...
Lakerveld, Jeroen; Brug, Johannes; Bot, Sandra; Teixeira, Pedro J.; Rutter, Harry; Woodward, Euan; Samdal, Oddrun; Stockley, Lynn; Bourdeaudhuij, Ilse; Assema, Patricia; Robertson, Aileen; Lobstein, Tim; Oppert, Jean-michel; Ada?ny, Ro?za; Nijpels, Giel
Objective To assess feasibility and acceptability of a multifaceted, culturally appropriate intervention for preventing obesity in South Asian children, and to obtain data to inform sample size for a definitive trial. Design Phase II feasibility study of a complex intervention. Setting 8 primary schools in inner city Birmingham, UK, within populations that are predominantly South Asian. Participants 1090 children aged 68?years took part in the intervention. 571 (85.9% from South Asian background) underwent baseline measures. 85.5% (n=488) were followed up 2?years later. Interventions The 1-year intervention consisted of school-based and family-based activities, targeting dietary and physical activity behaviours. The intervention was modified and refined throughout the period of delivery. Main outcome measures Acceptability and feasibility of the intervention and of measurements required to assess outcomes in a definitive trial. The difference in body mass index (BMI) z-score between arms was used to inform sample size calculations for a definitive trial. Results Some intervention components (increasing school physical activity opportunities, family cooking skills workshops, signposting of local leisure facilities and attending day event at a football club) were feasible and acceptable. Other components were acceptable, but not feasible. Promoting walking groups was neither acceptable nor feasible. At follow-up, children in the intervention compared with the control group were less likely to be obese (OR 0.41; 0.19 to 0.89), and had lower adjusted BMI z-score (?0.15 kg/m2; 95% CI ?0.27 to ?0.03). Conclusions The feasibility study informed components for an intervention programme. The favourable direction of outcome for weight status in the intervention group supports the need for a definitive trial. A cluster randomised controlled trial is now underway to assess the clinical and cost-effectiveness of the intervention. Trial registration number ISRCTN51016370.
Adab, Peymane; Pallan, Miranda J; Cade, Janet; Ekelund, Ulf; Barrett, Timothy; Daley, Amanda; Deeks, Jonathan; Duda, Joan; Gill, Paramjit; Parry, Jayne; Bhopal, Raj; Cheng, K K
Full Text Available New societies, specially those that are transitioning towesternized lifestyles, are experiencing substantial increases inprevalence of obesity that is showing epidemic characteristicsin several communities. Besides it is well accepted that geneticfactors have an important role in weight control, the observedexplosion of obesity seen in the last century can not be explainedexclusively by alterations in genes that occurred in this shortperiod of time but it is much more suitable to be the result ofenvironmental changes related to the contemporaryindustrialization and technological advances. The primaryenvironmental determinants of obesity are those related to theincrease in caloric intake and low levels of activity thatgenetically susceptible subjects to the weight gain are exposedby the modern style of living. Stimulated by the cheaper andgreater availability of food, the increase in automation andmechanization facilitating the physical inactivity and thecontinuous psychological stress the modern man is actually moreexposed to behavior changes favoring the weight gain. Sinceobesity is widely recognized to be an important cardiovascularand diabetes risk factor, prevention of obesity must be recognizedby policy-makers as an important public health actions to protecthealth. To combat the epidemic of obesity we must cure thetoxic environmental changing our behavior and promoting newfood technologies.
Simão Augusto Lottenberg
The incidence of obesity, increased weight gain and the popularity of high-fat \\/ high-sugar diets are seriously impacting upon the global population. Billions of individuals are affected, and although diet and lifestyle are of paramount importance to the development of adult obesity, compelling evidence is emerging which suggests that maternal obesity and related disorders may be passed on to the next generation by non-genetic means. The processes acting within the uteri of obese mothers may permanently predispose offspring to a diverse plethora of diseases ranging from obesity and diabetes to psychiatric disorders. This review aims to summarise some of the molecular mechanisms and active processes currently known about maternal obesity and its effect on foetal and neonatal physiology and metabolism. Complex and multifactorial networks of molecules are intertwined and culminate in a pathologically synergistic manner to cause disruption and disorganisation of foetal physiology. This altered phenotype may potentiate the cycle of intergenerational transmission of obesity and related disorders.
Full Text Available Obesity is a growing issue for all children. Many experts say that preventing obesity is largely a matter of eating the right foods and getting enough physical activity. This advice doesnt recognize the fact that First Nations, Inuit, and Métis children face unique barriers to growing up healthy and strong simply because of theiridentity. This paper discusses how the social determinants of health impact the ability of Aboriginal children to grow up free of obesity. The paper highlights results from a community-based research project conducted amongst Aboriginal parents and service providers in Ontario who wish to prevent obesity amongst their ownyoung children and clients. Research was carried out over two years to help develop a toolkit and training program to help service provides increase efforts to prevent obesity amongst First Nations, Inuit, and Métis children from the ages of 2 to 6 in Ontario.
Melanie A. Ferris
Full Text Available Obesity has emerged as a global health issue that is associated with wide spectrum of disorders, including coronary artery disease, diabetes mellitus, hypertension, stroke, and venous thromboembolism (VTE. VTE is one of the most common vascular disorders in the United States and Europe and is associated with significant mortality. Although the association between obesity and VTE appears to be moderate, obesity can interact with other environmental or genetic factors and pose a significantly greater risk of VTE among individuals who are obese and who are exposed simultaneously to several other risk factors for VTE. Therefore, identification of potential interactions between obesity and certain VTE risk factors might offer some critical points for VTE interventions and thus minimize VTE morbidity and mortality among patients who are obese. However, current obesity measurements have limitations and can introduce contradictory results in the outcome of obesity. To overcome these limitations, this review proposes several future directions and suggests some avenues for prevention of VTE associated with obesity as well.
Full Text Available Abstract Background Community-based interventions are a promising approach and an important component of a comprehensive response to obesity. In this paper we describe the Collaboration of COmmunity-based Obesity Prevention Sites (CO-OPS Collaboration in Australia as an example of a collaborative network to enhance the quality and quantity of obesity prevention action at the community level. The core aims of the CO-OPS Collaboration are to: identify and analyse the lessons learned from a range of community-based initiatives aimed at tackling obesity, and; to identify the elements that make community-based obesity prevention initiatives successful and share the knowledge gained with other communities. Methods Key activities of the collaboration to date have included the development of a set of Best Practice Principles and knowledge translation and exchange activities to promote the application (or use of evidence, evaluation and analysis in practice. Results The establishment of the CO-OPS Collaboration is a significant step toward strengthening action in this area, by bringing together research, practice and policy expertise to promote best practice, high quality evaluation and knowledge translation and exchange. Future development of the network should include facilitation of further evidence generation and translation drawing from process, impact and outcome evaluation of existing community-based interventions. Conclusions The lessons presented in this paper may help other networks like CO-OPS as they emerge around the globe. It is important that networks integrate with each other and share the experience of creating these networks.
Objective: To gain opinions from low-income, limited-English-speaking Hispanic and Asian immigrants for formative research in a social marketing campaign. Design: Nineteen questions on obesity prevention-related topics were embedded into a larger random digit-dial survey investigating the effects of language and cultural barriers on health care
Sugerman, Sharon; Backman, Desiree; Foerster, Susan B.; Ghirardelli, Alyssa; Linares, Amanda; Fong, Amy
Abstract Background: Pediatric obesity is a serious and prevalent problem. Smartphone technology, which is becoming increasingly available to children of diverse backgrounds, presents a unique opportunity to instill healthy behaviors before the onset of obesity. Past studies have examined the use of smartphone applications as tools of health behavior modification for adults. The present study examines the content of children's exercise and nutrition smartphone apps. Method: Sixty-two iPhone apps were identified and coded by two independent raters for adherence to expert-recommended behaviors (e.g., five fruits/vegetables per day) and strategies (e.g., self-monitoring diet/physical activity) for the prevention of pediatric obesity. Results: App behavioral and strategy index scores were uniformly low. Apps were more likely to address expert-recommended behaviors for the prevention of pediatric obesity (93.5%), whereas few apps addressed recommended strategies (20.9%). The most common behaviors addressed included physical activity (53.2%) and fruit/vegetable consumption (48.3%). Other important behaviors (e.g., screen time [1.6%] and family meals together [1.6%]) were rarely addressed. Conclusions: Current children's diet and exercise apps could be improved with increased adherence to expert-recommended guidelines, especially expert-recommended strategies. PMID:24655230
Wearing, Jessica R; Nollen, Nikki; Befort, Christie; Davis, Ann M; Agemy, Carolina K
Obesity and dental caries in childhood are among the major public health concerns described as a global pandemic because of their global distribution and severe consequences. A consensus has developed as to a recently emerging and alarming common risk factor that leads to the double burden of dental caries and obesity; energy-dense foods (sugar-coated cereals, high-sugar yogurt, soft drinks) are becoming very popular among children because of their dense marketing, cheaper price, increased supply and variety. Implementation of health-promoting and -supporting marketing strategies for healthy food can be one initial cornerstone for successful application of the common risk factor approach in prevention of obesity and dental caries, as also suggested by World Health Organization. Labelling healthy food with a 'health-friendly' logo, illustrating that the teeth and the heart are both parts of the whole body (standing side by side supporting each other as close friends), both happy and protected because of consumption of healthy food for the whole body, can promote the foods that are friendly to health of the whole body, implementing the common risk factor approach under a single theme. Labelling healthy food as 'health-friendly' based on an international consensus will provide a clear and uniform picture of what is healthy to eat and result in an international integrated programme for prevention of obesity and caries.
Cinar, A B; Murtomaa, H
Obesity and dental caries in childhood are among the major public health concerns described as a global pandemic because of their global distribution and severe consequences. A consensus has developed as to a recently emerging and alarming common risk factor that leads to the double burden of dental caries and obesity; energy-dense foods (sugar-coated cereals, high-sugar yogurt, soft drinks) are becoming very popular among children because of their dense marketing, cheaper price, increased supply and variety. Implementation of health-promoting and -supporting marketing strategies for healthy food can be one initial cornerstone for successful application of the common risk factor approach in prevention of obesity and dental caries, as also suggested by World Health Organization. Labelling healthy food with a 'health-friendly' logo, illustrating that the teeth and the heart are both parts of the whole body (standing side by side supporting each other as close friends), both happy and protected because of consumption of healthy food for the whole body, can promote the foods that are friendly to health of the whole body, implementing the common risk factor approach under a single theme. Labelling healthy food as 'health-friendly' based on an international consensus will provide a clear and uniform picture of what is healthy to eat and result in an international integrated programme for prevention of obesity and caries. PMID:19207877
Cinar, A B; Murtomaa, H
This study investigated the mechanism of processed tomato vinegar beverage (TVB)-mediated anti-obesity and anti-insulin resistance effects in high-fat diet (HF)-induced obese mice. Oral administration of TVB (14 mL kg(-1) body weight) to HF-fed mice for 6 weeks effectively reduced the body and visceral fat weight and significantly lowered plasma free fatty acid, triglyceride and hepatic triglyceride levels. TVB significantly increased fecal triglyceride excretion, both phosphorylated AMP-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC) and peroxisome proliferator-activated receptor (PPAR)? protein levels in the liver, which were associated with increased fatty acid ?-oxidation and carnitine palmitoyltransferase activities in HF-fed mice. TVB improved glucose tolerance, hyperinsulinemia and HOMA-IR levels in the HF + TVB group compared to the HF group. Additionally, TVB significantly increased glucokinase activity and decreased glucose-6-phosphatase activity in the liver, which enhanced glucose metabolism in obese mice. These results suggest that TVB prevents visceral obesity and insulin resistance via AMPK/PPAR?-mediated fatty acid and glucose oxidation. PMID:24867606
Seo, Kwon-Il; Lee, Jin; Choi, Ra-Yeong; Lee, Hae-In; Lee, Ju-Hye; Jeong, Yong-Ki; Kim, Myung-Joo; Lee, Mi-Kyung
With American children on course to grow into the most obese generation of adults in history, Sonia Caprio argues that it is critical to develop more effective strategies for preventing childhood obesity and treating serious obesity-related health complications. She notes that although pediatricians are concerned about the obesity problem, most
Full Text Available Abstract Background Obesity is increasing in the child-bearing population as are the rates of gestational diabetes. Gestational diabetes is associated with higher rates of Cesarean Section for the mother and increased risks of macrosomia, higher body fat mass, respiratory distress and hypoglycemia for the infant. Prevention of gestational diabetes through life style intervention has proven to be difficult. A Finnish study showed that ingestion of specific probiotics altered the composition of the gut microbiome and thereby metabolism from early gestation and decreased rates of gestational diabetes in normal weight women. In SPRING (the Study of Probiotics IN the prevention of Gestational diabetes, the effectiveness of probiotics ingestion for the prevention of gestational diabetes will be assessed in overweight and obese women. Methods/design SPRING is a multi-center, prospective, double-blind randomized controlled trial run at two tertiary maternity hospitals in Brisbane, Australia. Five hundred and forty (540 women with a BMI > 25.0 kg/m2 will be recruited over 2 years and receive either probiotics or placebo capsules from 16 weeks gestation until delivery. The probiotics capsules contain > 1x109 cfu each of Lactobacillus rhamnosus GG and Bifidobacterium lactis BB-12 per capsule. The primary outcome is diagnosis of gestational diabetes at 28 weeks gestation. Secondary outcomes include rates of other pregnancy complications, gestational weight gain, mode of delivery, change in gut microbiome, preterm birth, macrosomia, and infant body composition. The trial has 80% power at a 5% 2-sided significance level to detect a >50% change in the rates of gestational diabetes in this high-risk group of pregnant women. Discussion SPRING will show if probiotics can be used as an easily implementable method of preventing gestational diabetes in the high-risk group of overweight and obese pregnant women.
Nitert Marloes Dekker
To build on a growing interest in community-based obesity prevention programs, methods are needed for matching intervention strategies to local needs and assets. We used the Community Readiness Model (CRM), a structured interview guide and scoring system, to assess community readiness to act on childhood obesity prevention, furthering a replication study of a successful intervention. Using the CRM protocol, we conducted interviews with 4 stakeholders in each of 10 communities of similar size, socioeconomic status, and perceived readiness to implement a community-wide obesity prevention intervention. Communities were in California, Florida, Illinois, Massachusetts, New York, North Carolina, Pennsylvania, and Tennessee. The 4 stakeholders were the mayor or city manager, the school superintendent, the school food service director, and a community coalition representative. Interviews were recorded and professionally transcribed. Pairs of trained reviewers scored the transcriptions according to CRM protocol. The CRM assesses 9 stages of readiness for 6 dimensions: existing community efforts to prevent childhood obesity, community knowledge about the efforts, leadership, community climate, knowledge about the issue, and resources. We calculated an overall readiness score for each community from the dimension scores. Overall readiness scores ranged from 2.97 to 5.36 on the 9-point scale. The mean readiness score, 4.28 (SD, 0.68), corresponds with a "preplanning" level of readiness. Of the 6 dimensions, community climate varied the least (mean score, 3.11; SD, 0.64); leadership varied the most (mean score, 4.79; SD, 1.13). The CRM quantified a subjective concept, allowing for comparison among 10 communities. Dimension scores and qualitative data from interviews helped in the selection of 6 communities for a replication study. PMID:22005643
Sliwa, Sarah; Goldberg, Jeanne P; Clark, Valerie; Collins, Jessica; Edwards, Ruth; Hyatt, Raymond R; Junot, Bridgid; Nahar, Elizabeth; Nelson, Miriam E; Tovar, Alison; Economos, Christina D
The purpose of this article was to review school based interventions designed to prevent childhood and adolescent obesity that focused on modifying dietary behavior and were published between 2000 and May 2009. A total of 25 interventions met the criteria. The grade range of these interventions was from K to 12; 13 studies exclusively targeted elementary school, 2 targeted both elementary and middle school, 9 exclusively targeted middle school, and 1 targeted high school. The majority of the ...
The purpose of this article was to review primary prevention interventions targeting childhood obesity implemented in the after school environment from 2006 and 2011. A total of 20 interventions were found from 25 studies. Children in the interventions ranged from kindergarten to middle schoolers, however a majority was in the 4th and 5th grades. Most of the interventions targeted both physical activity and dietary behaviors. Among those that focused on only one dimension, physical activity w...
Paul Branscum; Manoj Sharma
Abstract Background The home and neighborhood environments may be important in obesity prevention by virtue of food availability, food preparation, cues and opportunities for physical activity, and family support. To date, little research has examined how home and neighborhood environments in rural communities may support or hinder healthy eating and physical activity. This paper reports characteristics of rural homes and neighborhoods related to physical activity environment...
Kegler Michelle C; Escoffery Cam; Alcantara Iris; Ballard Denise; Glanz Karen
Full Text Available Background: Increase in the prevalence of childhood and adolescence obesity in recent years caused many investigations to be held on effective factors on childhood obesity. Environmental factors have a strong impact and are investigated in many studies worldwide. The objective of this study was to determine the effective factors in Neishabur primary school children.Materials and Method: Using two stage cluster sampling from 60 Neishbur primary schools, all students who had body mass index(BMI ?95 percentile, were identified as obese (n=114 and 102 students of the same age and gender were indicated as non-obese pupils. Data were collected by questionnaires. Results: Our analyzed data showed that the mean birth weight in obese cases was significantly more than the others. The ratio of first and second born children in obese group was higher than of the non-obese. The ratio of pupils starting complementary feeding earlier than 6 month of age was significantly higher in obese (80.7% than non-obese children (46.1%. Conclusion: High birth weight, birth order and early treatment with complementary foods were associated with obesity among Neishabur primary school children. This should be noted in interventional planning
Full Text Available A comparative study of age matched 50 obese and 50 lean adults was undertaken. The blood samples were collected after overnight fast. The diet sampling was done on the spot without prior information over a period of three months. The results showed that mean serum cholesterol level of obese persons was higher than leans. The frequency of its occurrence was high in case of sedentary people. More than 70% adults were not involved in enough physical activity where as 10% were benefited from moderate activity. The physical activity is more pronounced in young persons, decreases with age and is less common among the obeses. The average diet of obeses contained higher percentage of nutrients and calories. Except for fat contents of leans, the other nutrients were present in adequate amounts over RDA in both groups. The data revealed that both the parameters under study, significantly control the serum cholesterol elevation and obesity. The other factors and sources which may cause rise in serum cholesterol level and obesity have been indicated. The adverse effects of physical inactivity and imbalanced nutrition are briefly discussed in perspective of human health.
Abdul Rehman Khan
Context: Research consistently shows that the majority of American children do not consume diets that meet the recommendations of the Dietary Guidelines for Americans, nor do they achieve adequate levels of daily physical activity. As a result, more children are overweight today than at any other time in U.S. history. Schools offer many opportunities to develop strategies to prevent obesity by creating environments in which children eat healthfully and engage regularly in physical activity. Methods: This article discusses the role of schools in obesity prevention efforts. Current issues in schools' food and physical activity environments are examined, as well as federal, state, and local policies related to food and physical activity standards in schools. The article is organized around four key areas: (1) school food environments and policies, (2) school physical activity environments and policies, (3) school body mass index measurements, and (4) school wellness policies. Recommendations for accelerating change also are addressed. Findings: The article found that (1) competitive foods (foods sold outside of federally reimbursed school meals) are widely available in schools, especially secondary schools. Studies have related the availability of snacks and drinks sold in schools to students' high intake of total calories, soft drinks, total fat and saturated fat, and lower intake of fruits and vegetables; (2) physical activity can be added to the school curriculum without academic consequences and also can offer physical, emotional, and social benefits. Policy leadership has come predominantly from the districts, then the states, and, to a much lesser extent, the federal government; (3) few studies have examined the effectiveness or impact of school-based BMI measurement programs; and (4) early comparative analyses of local school wellness policies suggest that the strongest policies are found in larger school districts and districts with a greater number of students eligible for a free or reduced-price lunch. Conclusions: Studies show that schools have been making some progress in improving the school food and physical activity environments but that much more work is needed. Stronger policies are needed to provide healthier meals to students at schools; limit their access to low-nutrient, energy-dense foods during the school day; and increase the frequency, intensity, and duration of physical activity at school.
Story, Mary; Nanney, Marilyn S; Schwartz, Marlene B
This article is the second in a two-part review of law's possible role in a regulatory approach to healthier nutrition and obesity prevention in Australia. As discussed in Part 1, law can intervene in support of obesity prevention at a variety of levels: by engaging with the health care system, by targeting individual behaviours, and by seeking to influence the broader, socio-economic and environmental factors that influence patterns of behaviour across the population. Part 1 argued that the ...
Magnusson, Roger S.
Cancer prevention is rapidly emerging as a major strategy to reduce cancer mortality. In the field of breast cancer, significant strides have recently been made in the understanding of underlying preventive mechanisms. Currently, three major strategies have been linked to an increase in breast cancer risk: obesity, lack of physical exercise, and high levels of saturated dietary fat. As a result, prevention strategies for breast cancer are usually centered on these lifestyle factors. Unfortunately, there remains controversy regarding epidemiological studies that seek to determine the benefit of these lifestyle changes. We have identified crucial mechanisms that may help clarify these conflicting studies. For example, recent reports with olive oil have demonstrated that it may influence crucial transcription factors and reduce breast tumor aggressiveness by targeting HER2. Similarly, physical exercise reduces sex hormone levels, which may help protect against breast cancer. Obesity promotes tumor cell growth and cell survival through upregulation of leptin and insulin-like growth factors. This review seeks to discuss these underlying mechanisms, and more behind the three major prevention strategies, as a means of understanding how breast cancer can be prevented. PMID:23725113
Alegre, Melissa Marie; Knowles, McKay Hovis; Robison, Richard A; O'Neill, Kim Leslie
Interventions in Canada to address obesity have largely been limited to individual-level change through education rather than a population-level public policy approach. Little is known about obesity policy support in Canada, and substantial national variation in obesity policy support prevents direct transferability of these policies among nations. Our study recruited 521 young adults for an online survey through leaflets and flyers. We investigated how respondents demographics, health cha...
Ryan Lange; Guy Faulkner
Full Text Available Abstract Background Multiple factors combine to support a compelling case for interventions that target the development of obesity-promoting behaviours (poor diet, low physical activity and high sedentary behaviour from their inception. These factors include the rapidly increasing prevalence of fatness throughout childhood, the instigation of obesity-promoting behaviours in infancy, and the tracking of these behaviours from childhood through to adolescence and adulthood. The Infant Feeding Activity and Nutrition Trial (INFANT aims to determine the effectiveness of an early childhood obesity prevention intervention delivered to first-time parents. The intervention, conducted with parents over the infant's first 18 months of life, will use existing social networks (first-time parent's groups and an anticipatory guidance framework focusing on parenting skills which support the development of positive diet and physical activity behaviours, and reduced sedentary behaviours in infancy. Methods/Design This cluster-randomised controlled trial, with first-time parent groups as the unit of randomisation, will be conducted with a sample of 600 first-time parents and their newborn children who attend the first-time parents' group at Maternal and Child Health Centres. Using a two-stage sampling process, local government areas in Victoria, Australia will be randomly selected at the first stage. At the second stage, a proportional sample of first-time parent groups within selected local government areas will be randomly selected and invited to participate. Informed consent will be obtained and groups will then be randomly allocated to the intervention or control group. Discussion The early years hold promise as a time in which obesity prevention may be most effective. To our knowledge this will be the first randomised trial internationally to demonstrate whether an early health promotion program delivered to first-time parents in their existing social groups promotes healthy eating, physical activity and reduced sedentary behaviours. If proven to be effective, INFANT may protect children from the development of obesity and its associated social and economic costs. Trial registration Current Controlled Trials ISRCTN81847050
Prevenção primária de doenças cardiovasculares na obesidade infantojuvenil: efeito anti-inflamatório do exercício físico Early prevention of cardiovascular diseases in juvenile obesity: the anti-inflammatory effect of physical exercise
Full Text Available A pandemia da obesidade juvenil e do sedentarismo está relacionada com o maior risco de doenças cardiovasculares no futuro. Ambas com fisiopatologia inflamatória, essas condições têm atraído significativa atenção científica. O início dos eventos que agridem o endotélio vascular pode ocorrer na infância, porém, sinais clínicos da aterosclerose geralmente só aparecem na fase adulta. O tecido adiposo é hoje reconhecido por seu papel ativo, induzindo a produção de citocinas pró e anti-inflamatórias, como o fator de necrose tumoral-alfa, as interleucinas 1, 6 e 10, a proteína C-reativa e outras. Há várias evidências de que os níveis sanguíneos dessas citocinas se encontram mais altos em indivíduos com excesso de peso, inclusive crianças e adolescentes. A prevenção precoce, desde a infância, apresenta-se como a melhor maneira de evitar os danos da obesidade na fase adulta, enquanto o potencial da prática regular de exercícios físicos tem se mostrado surpreendente. Sua ação anti-inflamatória se manifesta através de menores concentrações séricas de interleucina 6, de proteína C-reativa e leptina, além de aumentos na adiponectina. Observa-se escassez de estudos randomizados e controlados avaliando as relações entre obesidade, inflamação e exercícios para a população jovem. Com resultados às vezes controversos, a maioria das conclusões é procedentede estudos com adultos. O objetivo desta revisão é avaliar o papel anti-inflamatório, e assim cardioprotetor, da atividade física regular na obesidade infantojuvenil.Nowadays, juvenile obesity and physical inactivity are pandemic conditions which relate to a greater future risk of cardiovascular diseases. From an inflammatory point of view, they have attracted massive scientific attention. The beginning of the events related to atherosclerosis may occur in childhood, generating endothelial and metabolic dysfunction; however, the symptoms usually only appear later on, in adulthood. The fat tissue is recognized as being metabolically active, stimulating the production of inflammatory cytokines, such as the tumoral necrosis factor, interleukines 1, 6 and 10, C-reactive protein, among others. There is plenty of evidence that the serum levels of these citokines are higher in overweight individuals, including children and adolescents. Early prevention as young as possible is the best way to avoid future consequences of obesity. In this context, the potential benefits of regular physical exercise have been surprising. Researchers have shown evidence of anti-inflammatory responses, including lower levels of interleukine 6, C-reactive protein, leptin, besides higher levels of adiponectins after engagement in regular physical activity. However, we still have few controlled randomized studies addressing the relations between obesity, inflammation and exercise for the pediatric population. There are controversial findings in this field, and many of them come from adult studies. Thus, the purpose of the present review is to evaluate the metabolic role of physical exercise in juvenile obesity, aiming at heart protection.
Márcia Braz Rossetti
Ghrelin regulates homeostatic food intake, hedonic eating, and is a mediator in the stress response. In addition, ghrelin has metabolic, cardiovascular, and anti-aging effects. This cross-sectional study examined associations between total plasma ghrelin, caloric intake based on 3day diet diaries, hedonic eating attitudes, stress-related and metabolic factors, and leukocyte telomere length in overweight (n=25) and obese women (n=22). We hypothesized associations between total plasma ghrelin and eating behaviors, stress, metabolic, cardiovascular, and cell aging factors among overweight women, but not among obese women due to lower circulating ghrelin levels and/or central resistance to ghrelin. Confirming previous studies demonstrating lowered plasma ghrelin in obesity, ghrelin levels were lower in the obese compared with overweight women. Among the overweight, ghrelin was positively correlated with caloric intake, giving in to cravings for highly palatable foods, and a flatter diurnal cortisol slope across 3days. These relationships were non-significant among the obese group. Among overweight women, ghrelin was negatively correlated with insulin resistance, systolic blood pressure, and heart rate, and positively correlated with telomere length. Among the obese subjects, plasma ghrelin concentrations were negatively correlated with insulin resistance, but were not significantly correlated with blood pressure, heart rate or telomere length. Total plasma ghrelin and its associations with food intake, hedonic eating, and stress are decreased in obesity, providing evidence consistent with the theory that central resistance to ghrelin develops in obesity and ghrelin's function in appetite regulation may have evolved to prevent starvation in food scarcity rather than cope with modern food excess. Furthermore, ghrelin is associated with metabolic and cardiovascular health, and may have anti-aging effects, but these effects may be attenuated in obesity. PMID:24462487
Buss, Julia; Havel, Peter J; Epel, Elissa; Lin, Jue; Blackburn, Elizabeth; Daubenmier, Jennifer
Chronic low grade inflammation is closely linked to obesity-associated insulin resistance. To examine how administration of the anti-inflammatory compound indomethacin, a general cyclooxygenase inhibitor, affected obesity development and insulin sensitivity, we fed obesity-prone male C57BL/6J mice a high fat/high sucrose (HF/HS) diet or a regular diet supplemented or not with indomethacin (Â±INDO) for 7 weeks. Development of obesity, insulin resistance, and glucose intolerance was monitored, and the effect of indomethacin on glucose-stimulated insulin secretion (GSIS) was measured in vivo and in vitro using MIN6 Î²-cells. We found that supplementation with indomethacin prevented HF/HS-induced obesity and diet-induced changes in systemic insulin sensitivity. Thus, HF/HS+INDO-fed mice remained insulin-sensitive. However, mice fed HF/HS+INDO exhibited pronounced glucose intolerance. Hepatic glucose output was significantly increased. Indomethacin had no effect on adipose tissue mass, glucose tolerance, or GSIS when included in a regular diet. Indomethacin administration to obese mice did not reduce adipose tissue mass, and the compensatory increase in GSIS observed in obese mice was not affected by treatment with indomethacin. We demonstrate that indomethacin did not inhibit GSIS per se, but activation of GPR40 in the presence of indomethacin inhibited glucose-dependent insulin secretion in MIN6 cells. We conclude that constitutive high hepatic glucose output combined with impaired GSIS in response to activation of GPR40-dependent signaling in the HF/HS+INDO-fed mice contributed to the impaired glucose clearance during a glucose challenge and that the resulting lower levels of plasma insulin prevented the obesogenic action of the HF/HS diet.
FjÃ¦re, Even; Aune, Ulrike L
Introduction Overweight and obesity remain significant public health risks for youth in the United States, particularly among racial/ethnic minority groups. Efforts at obesity prevention and control have targeted youth and family members in diverse settings. Although involving parents in obesity prevention programs for youth may improve the potential of these programs, less is known about parents preferred methods of engagement, especially among racial/ethnic minority parents and parents whose primary language is not English. In this qualitative study, parents of middle-schoolaged children were asked how best to engage their children in obesity prevention and control efforts. Methods We recruited 38 parents whose children attended Los Angeles middle schools to participate in focus groups. Two English-language focus groups with 14 parents of different racial/ethnic backgrounds and 2 Spanish language groups with 24 Latino parents were conducted from 2010 through 2011. We analyzed focus group transcripts by using content analysis using inductive and deductive techniques. Results Findings from focus groups confirmed that parents want to help their children avoid obesity but feel constrained in their ability to take action. Participants identified an overarching desire to become better parents as a potential incentive to engage in obesity prevention efforts. Parents advocated for family-focused approaches in obesity prevention programs, including family sports leagues and cooking classes. Most findings were consistent between language groups, but parents in the Spanish language groups cited language-related barriers. Conclusion The development and testing of simple programs that are sustainable, community-based, and family-focused may empower families to address obesity prevention and control.
Chung, Paul. J.; Thompson, Lindsey R.; Elijah, Jacinta; Lamb, Sheila; Garcia, Vanessa P.; Bastani, Roshan
Full Text Available This study evaluated the anti-obesity effects of Artemisia capillaris extracts in high-fat diet (HFD-induced obese rats. After six weeks feeding with HFD, Wistar male rats (12-weeks-old were divided into three groups: HFD-control group and HFD mixed with 0.4% and 0.8% Artemisia capillaris extracts treated groups. After seven weeks of treatments, the body weight gain of the 0.4% and 0.8% A. capillaris extracts treated groups were significantly less than that of the HFD-control group by 11.8% and 15.4%, respectively. Also, A. capillaris extracts treated groups showed significantly lower serum TG, TC and LDL-c levels in a dose-related manner, while causing the reverse effect in serum HDL-c, and exhibited a hepatoprotective effects in vivo, indicated by reduced hepatic lipid contents, and serum ALT and AST levels. These results show that A. capillaris extracts may prevent body weight increases and improve dyslipidemia in HFD-induced obese rats by enhancing their lipid metabolism.
Full Text Available Purpose:This study was designed to determine the effects of a school-based obesity-management program on obese primary school children. Methods:A total of 995 children (6–12 years old in a primary school were screened in March 2008, and of those, 101 obese students (44 boys and 57 girls, body mass index (BMI ?#249;5 percentile were enrolled for a study group. The school- based, obesity management program, which includes physical exercise and nutritional education, was conducted as part of an extracurricular program for 12 weeks. The measurement of height, weight, waist circumference, blood pressure (BP, and bioelectrical impedance analysis (BIA was performed before and after the program. Results:Height and weight increased significantly (P<0.05. The BMI and obesity index decreased significantly (P<0.01. Systolic and diastolic BP decreased significantly (P<0.01. BMI decreased in 61.4% of boys and 66.7% of girls. Protein and basal metabolic rate (BMR increased significantly on the BIA (P<0.01. Fat decreased significantly (P<0.05. The total body water (TBW and percent body fat (PBF decreased significantly (P<0.01. The changes in protein, fat, TBW, PBF, and BMR significantly correlated to the change in BMI (P<0.05. In a multiple logistic regression analysis, BMI change was significantly correlated to the changes in protein and fat content (P<0.01. Conclusion:The school-based obesity management program is a very effective way to manage obesity for obese primary school children.
Han Gyu Kim
Therapies to prevent renal injury in obese hypertensive individuals are being actively sought due to the obesity epidemic arising from the Western diet (WD), which is high in fructose and fat. Recently, activation of the immune system and hyperuricemia, observed with high fructose intake, have been linked to the pathophysiology of hypertension and renal injury. Because dipeptidyl peptidase 4 (DPP4) is a driver of maladaptive T-cell/macrophage responses, renal-protective benefits of DPP4 inhibition in the WD-fed mice were examined. Mice fed a WD for 16 weeks were given the DPP4 inhibitor MK0626 in their diet beginning at 4 weeks of age. WD-fed mice were obese, hypertensive, and insulin-resistant and manifested proteinuria and increased plasma DPP4 activity and uric acid levels. WD-fed mice also had elevated kidney DPP4 activity and monocyte chemoattractant protein-1 and IL-12 levels and suppressed IL-10 levels in the kidney, suggesting macrophage-driven inflammation, glomerular and tubulointerstitial injury. WD-induced increases in DPP4 activation in the plasma and kidney and proteinuria in WD mice were abrogated by MK0626, although blood pressure and systemic insulin sensitivity were not improved. Contemporaneously, MK0626 reduced serum uric acid levels, renal oxidative stress, and IL-12 levels and increased IL-10 levels, suggesting that suppression of DPP4 activity leads to suppression of renal immune/inflammatory injury responses to a WD. Taken together, these results demonstrate that DPP4 inhibition prevents high-fructose/high-fat diet-induced glomerular and tubular injury independent of blood pressure/insulin sensitivity and offers a potentially novel therapy for diabetic and obesity-related kidney disease. PMID:24712875
Nistala, Ravi; Habibi, Javad; Lastra, Guido; Manrique, Camila; Aroor, Annayya R; Hayden, Melvin R; Garro, Mona; Meuth, Alex; Johnson, Megan; Whaley-Connell, Adam; Sowers, James R
This research was conducted to assess the effect of a weight management program in Turkish school children with overweight and obesity. Forty one students formed the intervention group while 40 students formed the control group in two elementary schools. Students in intervention group were given seven training sessions in a period of 2.5 months.
Toruner, Ebru Kilicarslan; Savaser, Sevim
Full Text Available Abstract Background Efforts to prevent the development of overweight and obesity have increasingly focused early in the life course as we recognise that both metabolic and behavioural patterns are often established within the first few years of life. Randomised controlled trials (RCTs of interventions are even more powerful when, with forethought, they are synthesised into an individual patient data (IPD prospective meta-analysis (PMA. An IPD PMA is a unique research design where several trials are identified for inclusion in an analysis before any of the individual trial results become known and the data are provided for each randomised patient. This methodology minimises the publication and selection bias often associated with a retrospective meta-analysis by allowing hypotheses, analysis methods and selection criteria to be specified a priori. Methods/Design The Early Prevention of Obesity in CHildren (EPOCH Collaboration was formed in 2009. The main objective of the EPOCH Collaboration is to determine if early intervention for childhood obesity impacts on body mass index (BMI z scores at age 18-24 months. Additional research questions will focus on whether early intervention has an impact on children's dietary quality, TV viewing time, duration of breastfeeding and parenting styles. This protocol includes the hypotheses, inclusion criteria and outcome measures to be used in the IPD PMA. The sample size of the combined dataset at final outcome assessment (approximately 1800 infants will allow greater precision when exploring differences in the effect of early intervention with respect to pre-specified participant- and intervention-level characteristics. Discussion Finalisation of the data collection procedures and analysis plans will be complete by the end of 2010. Data collection and analysis will occur during 2011-2012 and results should be available by 2013. Trial registration number ACTRN12610000789066
Berberine, a major pharmacological component of the Chinese herb Coptis chinensis, which was originally used to treat bacterial diarrhea, has recently been demonstrated to be clinically effective in alleviating type 2 diabetes. In this study, we revealed that berberine effectively prevented the development of obesity and insulin resistance in high-fat diet (HFD)-fed rats, which showed decreased food intake. Increases in the levels of serum lipopolysaccharide-binding protein, monocyte chemoatt...
Zhang, Xu; Zhao, Yufeng; Zhang, Menghui; Pang, Xiaoyan; Xu, Jia; Kang, Chaoying; Li, Meng; Zhang, Chenhong; Zhang, Zhiguo; Zhang, Yifei; Li, Xiaoying; Ning, Guang; Zhao, Liping
Diet high in dairy products is inversely associated with body mass index, risk of metabolic syndrome and prevalence of type 2 diabetes in several populations. Also a number of intervention studies support the role of increased dairy intake in the prevention and treatment of obesity. Dairy calcium has been suggested to account for the effect of dairy on body weight, but it has been repeatedly shown that the effect of dairy is superior to the effect of supplemental calcium. Dairy proteins are p...
In this paper, we used a randomized experiment, the Moving to Opportunity for Fair Housing Demonstration (MTO) study, to assess whether several environmental attributes are causes of obesity. To accomplish our objective, we linked the MTO data with several external data sources that provide information on potential determinants of obesity including food prices, restaurant and food store availability, physical activity facility availability, the prevalence of crime and population density. We find that the environmental factors we examined are unable to explain the observed decrease in obesity associated with the MTO experiment among low-income minority women. PMID:24447507
Zhao, Zhenxiang; Kaestner, Robert; Xu, Xin
Obesity is a major public health problem and is often associated with type 2 diabetes mellitus, cardiovascular disease, and metabolic syndrome. Leptin is the crucial adipostatic hormone that controls food intake and body weight through the activation of specific leptin receptors (OB-R) in the hypothalamic arcuate nucleus (ARC). However, in most obese patients, high circulating levels of leptin fail to bring about weight loss. The prevention of this leptin resistance is a major goal for ...
Couturier, Cyril; Sarkis, Chamsy; Se?ron, Karin; Belouzard, Sandrine; Chen, Patty; Lenain, Aude; Corset, Laetitia; Dam, Julie; Vauthier, Virginie; Dubart, Anne; Mallet, Jacques; Froguel, Philippe; Rouille?, Yves; Jockers, Ralf
Full Text Available Abstract Background Dietary 1(3-behenoyl-2,3(1-dioleoyl-rac-glycerol (BOO has been reported to inhibit pancreatic lipase activity in vitro and suppress postprandial hypertriacylglycerolemia in humans. In the present study, the anti-obesity activities of BOO and its inhibitory effects on lymphatic triacylglycerol (TAG absorption were investigated in rats. Methods In Experiment 1, rats were fed either BOO or soybean oil (SO diet for 6 weeks. In the BOO diet, 20% of SO was replaced with an experimental oil rich in BOO. In Experiments 2 and 3, rats cannulated in the thoracic duct were administered an emulsions containing trioleoylglycerol (OOO or an oil mixture (OOO:BOO, 9:1. Tri[1-14C]oleoylglycerol (14C-OOO was added to the emulsions administered in Experiment 3. Results No observable differences were detected in food intake or body weight gain between the BOO and SO groups in Experiment 1. Plasma and liver TAG concentrations and visceral fat weights were significantly lower in the BOO group than in the SO group. The apparent absorption rate of fat was significantly lower in the BOO group than in the SO group. In Experiment 2, the lymphatic recovery of oleic and behenic acids was significantly lower at 5 and 6 h after BOO administration than after OOO administration. In Experiment 3, the lymphatic recovery of 14C-OOO was significantly lower at 5 and 6 h after BOO administration than after OOO administration. Conclusions These results suggest that BOO prevents deposition of visceral fat and hepatic TAG by lowering and delaying intestinal absorption of TAG.
Full Text Available Abstract Background Obesity is a major public health issue; however, only limited evidence is available about effective ways to prevent obesity, particularly in early childhood. Romp & Chomp was a community-wide obesity prevention intervention conducted in Geelong Australia with a target group of 12,000 children aged 0-5 years. The intervention had an environmental and capacity building focus and we have recently demonstrated that the prevalence of overweight/obesity was lower in intervention children, post-intervention. Capacity building is defined as the development of knowledge, skills, commitment, structures, systems and leadership to enable effective health promotion and the aim of this study was to determine if the capacity of the Geelong community, represented by key stakeholder organisations, to support healthy eating and physical activity for young children was increased after Romp & Chomp. Methods A mixed methods evaluation with three data sources was utilised. 1 Document analysis comprised assessment of the documented formative and intervention activities against a capacity building framework (five domains: Partnerships, Leadership, Resource Allocation, Workforce Development, and Organisational Development; 2 Thematic analysis of key informant interviews (n = 16; and 3 the quantitative Community Capacity Index Survey. Results Document analysis showed that the majority of the capacity building activities addressed the Partnerships, Resource Allocation and Organisational Development domains of capacity building, with a lack of activity in the Leadership and Workforce Development domains. The thematic analysis revealed the establishment of sustainable partnerships, use of specialist advice, and integration of activities into ongoing formal training for early childhood workers. Complex issues also emerged from the key informant interviews regarding the challenges of limited funding, high staff turnover, changing governance structures, lack of high level leadership and unclear communication strategies. The Community Capacity Index provided further evidence that the project implementation network achieved a moderate level of capacity. Conclusions Romp & Chomp increased the capacity of organisations, settings and services in the Geelong community to support healthy eating and physical activity for young children. Despite this success there are important learnings from this mixed methods evaluation that should inform current and future community-based public health and health promotion initiatives. Trial Registration Number ANZCTRN12607000374460
de Groot Florentine P
Over the last decades, the prevalence of obesity and related diseases has increased rapidly in the Western world. Obesity is a disorder of energy balance and is associated with hyper-insulinemia, insulin resistance, and abnormalities in lipid metabolism, and it is one of the most important risk factors in the development of Type II diabetes, cardiovascular disease, atherosclerosis, and certain cancers. Because of the lower frequency of these diseases in Asian countries, attention has been tur...
Ørgaard, Anne; Jensen, Lotte
Abstract Background Childhood obesity in rural communities is a serious but understudied problem. The current experiment aims to assess a wide range of obesity risk factors among rural youth and to offer an 8-month intervention program for parents to reduce obesity risk in their preteen child. Methods/Design A two-group, repeated measures design is used to assess the effectiveness of the 4-Health intervention program. Assessments include anthropometric measures,...
Lynch Wesley C; Martz Jill; Eldridge Galen; Bailey Sandra J; Benke Carrie; Paul Lynn
During the Bicentennial summer of 1976, American Legion Conventioneers in Philadelphia suffered a dramatic epidemic that left 34 dead. Near the end of 1976, scientists at the Centers for Disease Control (CDC) in Atlanta discovered the bacterium that caused Legionnaires` disease and named it Legionella. Nearly two decades later, a wealth of scientific information exists about the organism, its health effects, epidemiology, microbiology, aquatic ecology, molecular biology, immunology, pathophysiology, etc. Fortunately, for the engineer seeking to prevent Legionnaires` disease, it is unnecessary to master this complexity; the practice of prevention requires understanding a few, straightforward facts. The purpose of this paper is to present four messages about Legionnaires` disease that provide a conceptual framework to guide the crucial role of practical prevention. Those messages are: Legionnaires` disease is important; Legionnaires` disease is an environmental disease; Legionnaires` disease is preventable; and Legionnaires` disease prevention requires the right strategy.
Millar, J.D.; Morris, G.K.; Shelton, B.G. [PathCon Labs., Norcross, GA (United States)
The prevention of childhood obesity is a global priority. However, a range of complex social and environmental influences is implicated in the development of obesity and chronic disease that goes beyond the notion of individual choice. A population-level approach recognises the importance of access to and availability of healthy foods outside the home. These external food environments, in restaurants, supermarkets, and in school, or recreation and sports settings, are often characterised by energy dense, nutrient-poor food items that do not reflect the current nutritional guidelines for health. In addition, our understanding of these broader influences on nutritional intake is still limited. Particularly, lacking is a clear understanding of what constitutes the food environment, as well as robust measures of components of the food environment across different contexts. Therefore, this review summarises the literature on food environments of relevance to childhood obesity prevention, with a focus on places where children live, learn and play. Specifically, the paper highlights the approaches and challenges related to defining and measuring the food environment, discusses the aspects of the food environment unique to children and reports on environmental characteristics that are being modified within community, school and recreational settings. Results of the review show the need for a continued focus on understanding the intersection between individual behaviour and external factors; improved instrument development, especially regarding validity and reliability; clearer reported methodology including protocols for instrument use and data management; and considering novel study design approaches that are targeted at measuring the relationship between the individual and their food environment. PMID:24423112
Penney, Tarra L; Almiron-Roig, Eva; Shearer, Cindy; McIsaac, Jessie-Lee; Kirk, Sara F L
The development of insulin resistance in the liver is a key event that drives dyslipidemia and predicts diabetes and cardiovascular risk with obesity. Clinical data show that estrogen signaling in males helps prevent adiposity and insulin resistance, which may be mediated through estrogen receptor-? (ER?). The tissues and pathways that mediate the benefits of estrogen signaling in males with obesity are not well defined. In female mice, ER? signaling in the liver helps to correct pathway-selective insulin resistance with estrogen treatment after ovariectomy. We assessed the importance of liver estrogen signaling in males using liver ER?-knockout (LKO) mice fed a high-fat diet (HFD). We found that the LKO male mice had decreased insulin sensitivity compared with their wild-type floxed (fl/fl) littermates during hyperinsulinemic euglycemic clamps. Insulin failed to suppress endogenous glucose production in LKO mice, indicating liver insulin resistance. Insulin promoted glucose disappearance in LKO and fl/fl mice similarly. In the liver, insulin failed to induce phosphorylation of Akt-Ser(473) and exclude FOXO1 from the nucleus in LKO mice, a pathway important for liver glucose and lipid metabolism. Liver triglycerides and diacylglycerides were also increased in LKO mice, which corresponded with dysregulation of insulin-stimulated ACC phosphorylation and DGAT1/2 protein levels. Our studies demonstrate that estrogen signaling through ER? in the liver helps prevent whole body and hepatic insulin resistance associated with HFD feeding in males. Augmenting hepatic estrogen signaling through ER? may lessen the impact of obesity on diabetes and cardiovascular risk in males. PMID:24691030
Zhu, Lin; Martinez, Melissa N; Emfinger, Christopher H; Palmisano, Brian T; Stafford, John M
Full Text Available Abstract Background Schools are the most frequent target for intervention programs aimed at preventing child obesity; however, the overall effectiveness of these programs has been limited. It has therefore been recommended that interventions target multiple ecological levels (community, family, school and individual to have greater success in changing risk behaviors for obesity. This study examined the immediate and short-term, sustained effects of the Switch program, which targeted three behaviors (decreasing children's screen time, increasing fruit and vegetable consumption, and increasing physical activity at three ecological levels (the family, school, and community. Methods Participants were 1,323 children and their parents from 10 schools in two states. Schools were matched and randomly assigned to treatment and control. Measures of the key behaviors and body mass index were collected at baseline, immediately post-intervention, and 6 months post-intervention. Results The effect sizes of the differences between treatment and control groups ranged between small (Cohen's d = 0.15 for body mass index at 6 months post-intervention to large (1.38; parent report of screen time at 6 months post-intervention, controlling for baseline levels. There was a significant difference in parent-reported screen time at post-intervention in the experimental group, and this effect was maintained at 6 months post-intervention (a difference of about 2 hours/week. The experimental group also showed a significant increase in parent-reported fruit and vegetable consumption while child-reported fruit and vegetable consumption was marginally significant. At the 6-month follow-up, parent-reported screen time was significantly lower, and parent and child-reported fruit and vegetable consumption was significantly increased. There were no significant effects on pedometer measures of physical activity or body mass index in the experimental group. The intervention effects were moderated by child sex (for fruit and vegetable consumption, physical activity, and weight status, family involvement (for fruit and vegetable consumption, and child body mass index (for screen time. The perception of change among the experimental group was generally positive with 23% to 62% indicating positive changes in behaviors. Conclusion The results indicate that the Switch program yielded small-to-modest treatment effects for promoting children's fruit and vegetable consumption and minimizing screen time. The Switch program offers promise for use in youth obesity prevention.
Abstract Background Screening for obesity and providing appropriate obesity-related counseling in the clinical setting are important strategies to prevent and control childhood obesity. The purpose of this study is to document pediatricians (PEDs) and general practitioners (GPs) with pediatric patients use of BMI-for-age to screen for obesity, confidence in explaining BMI, access to referral clinics, and characteristics associated with screening and counseling to children and...
Wethington Holly R; Sherry Bettylou; Polhamus Barbara
Dipeptidyl peptidase-4 (DPP-4)-deficient mice exhibit prevention of obesity with increased energy expenditure, whereas currently available DPP-4 inhibitors do not induce similar changes. We investigated the impact of the novel DPP-4 inhibitor teneligliptin on body weight, energy expenditure, and obesity-related manifestations in diet-induced obese mice. Six-weeks-old C57BL/6N mice were fed a high-fat diet (60%kcal fat) ad libitum and administered teneligliptin (30 or 60mg/kg) via drinking water for 10 weeks. Mice fed a high-fat diet showed accelerated body weight gain. In contrast, compared with the vehicle group, the administration of teneligliptin reduced body weight to 88% and 71% at dose of 30mg/kg/day and 60mg/kg/day, respectively. Although there was no change in locomotor activity, indirect calorimetry studies showed that teneligliptin (60mg/kg) increased oxygen consumption by 22%. Adipocyte hypertrophy and hepatic steatosis induced by a high-fat diet were suppressed by teneligliptin. The mean adipocyte size in the 60-mg/kg treatment group was 44% and hepatic triglyceride levels were 34% of the levels in the vehicle group. Furthermore, treatment with teneligliptin (60mg/kg) reduced plasma levels of insulin to 40% and increased the glucose infusion rate to 39%, as measured in the euglycemic clamp study, indicating its beneficial effect on insulin resistance. We showed for the first time that the DPP-4 inhibitor prevents obesity and obesity-related manifestations with increased energy expenditure. Our findings suggest the potential utility of teneligliptin for the treatment of a broad spectrum of metabolic disorders related to obesity beyond glycemic control. PMID:24309217
Fukuda-Tsuru, Sayaka; Kakimoto, Tetsuhiro; Utsumi, Hiroyuki; Kiuchi, Satoko; Ishii, Shinichi
Effective therapies for the treatment of obesity, a key element of metabolic syndrome, are urgently needed but currently lacking. Stearoyl-CoA desaturase1 (SCD1) is the rate-limiting enzyme catalyzing the conversion of saturated long-chain fatty acids into monounsaturated fatty acids, which are major components of triglycerides. In the current study, we tested the efficacy of pharmacological inhibition of SCD1 in controlling lipogenesis and body weight in mice. SCD1-specific antisense olig...
Jiang, Guoqiang; Li, Zhihua; Liu, Franklin; Ellsworth, Kenneth; Dallas-yang, Qing; Wu, Margaret; Ronan, John; Esau, Christine; Murphy, Cain; Szalkowski, Deborah; Bergeron, Raynald; Doebber, Thomas; Zhang, Bei B.
Effective therapies for the treatment of obesity, a key element of metabolic syndrome, are urgently needed but currently lacking. Stearoyl-CoA desaturase1 (SCD1) is the rate-limiting enzyme catalyzing the conversion of saturated long-chain fatty acids into monounsaturated fatty acids, which are major components of triglycerides. In the current study, we tested the efficacy of pharmacological inhibition of SCD1 in controlling lipogenesis and body weight in mice. SCD1-specific antisense olig...
Jiang, Guoqiang; Li, Zhihua; Liu, Franklin; Ellsworth, Kenneth; Dallas-yang, Qing; Wu, Margaret; Ronan, John; Esau, Christine; Murphy, Cain; Szalkowski, Deborah; Bergeron, Raynald; Doebber, Thomas; Zhang, Bei B.
Obesity prevention should remain a priority, even if there is some suggestion that the epidemic may presently have reached a stable level. However, previous interventions have not been effective in preventing overweight and obesity, and at the same time studies suggest that some subgroups are more predisposed to future obesity. The purpose of this paper is to review interventions on obesity prevention published during the past year, and to examine if interventions targeting predisposed groups...
Olsen, Nanna Julie; Mortensen, Erik Lykke; Heitmann, Berit Lilienthal
Abstract Background: Improving nutrition and physical activity behaviors associated with childhood obesity are significant national public health goals. Energy Balance for Kids with Play (EB4K with Play), developed through a partnership between the Academy of Nutrition and Dietetics Foundation and Playworks, is a multi-component school-based intervention designed to address youth's nutrition and physical activity behaviors. This article describes the EB4K with Play intervention and evaluation study and presents the baseline data. Methods: The evaluation is a 2-year cluster-randomized design targeting third- to fifth-grade students enrolled in a low-income, urban school district in northern California. Six schools were recruited to participate. Four were randomized to the intervention group and two into a control group. Baseline student-level data pertaining to nutrition, physical activity, fitness, and BMI were collected in the fall of 2011. The EB4K with Play program, which includes direct-to-student nutrition and physical activity interventions, a school wellness component, and parent/community partner outreach components, began immediately after baseline data collection. Results: An ethnically diverse sample of students (n=844) was recruited to participate in the study. Baseline data showed a higher percent of eligibility for free and reduced-price school lunch and higher rates of obesity/overweight than the California state averages. Fitness levels and levels of moderate-to-vigorous physical activity were comparable to state averages. Conclusions: End-point data will be collected after 2 years of the intervention. The findings from this study should help guide future efforts to design effective intervention programs to support the prevention of pediatric obesity. PMID:24783961
Myers, Esther F; Gerstein, Dana E; Foster, Jan; Ross, Michelle; Brown, Katie; Kennedy, Evan; Linchey, Jennifer; Madsen, Kristine A; Crawford, Patricia B
An increase in adiposity is associated with altered levels of biologically active proteins. These include the hormones adiponectin and leptin. The marked change in circulating concentrations of these hormones in obesity has been associated with the development of insulin resistance and metabolic syndrome. Variations in dietary lipid consumption have also been shown to impact obesity. Specifically, omega-3 fatty acids have been correlated with the prevention of obesity and subsequent development of chronic disease sequalae. This review explores animal and human data relating to the effects of omega-3 fatty acids (marine lipids) on adiponectin and leptin, considering plausible mechanisms and potential implications for obesity management. Current evidence suggests a positive, dose-dependent relationship between omega-3 fatty acid intake and circulating levels of adiponectin. In obese subjects, this may translate into a reduced risk of developing cardiovascular disease, metabolic syndrome and diabetes. In non-obese subjects, omega-3 is observed to decrease circulating levels of leptin; however, omega-3-associated increases in leptin levels have been observed in obese subjects. This may pose benefits in the prevention of weight regain in these subjects following calorie restriction. PMID:24129365
Gray, B; Steyn, F; Davies, P S W; Vitetta, L
Full Text Available Abstract Background Parents are integral to the implementation of obesity prevention and management recommendations for children. Exploration of barriers to and facilitators of parental decisions to adopt obesity prevention recommendations will inform future efforts to reduce childhood obesity. Methods We conducted 4 focus groups (2 English, 2 Spanish among a total of 19 parents of overweight (BMI ? 85th percentile children aged 5-17 years. The main discussion focused on 7 common obesity prevention recommendations: reducing television (TV watching, removing TV from child's bedroom, increasing physically active games, participating in community or school-based athletics, walking to school, walking more in general, and eating less fast food. Parents were asked to discuss what factors would make each recommendation more difficult (barriers or easier (facilitators to follow. Participants were also asked about the relative importance of economic (time and dollar costs/savings barriers and facilitators if these were not brought into the discussion unprompted. Results Parents identified many barriers but few facilitators to adopting obesity prevention recommendations for their children. Members of all groups identified economic barriers (time and dollar costs among a variety of pertinent barriers, although the discussion of dollar costs often required prompting. Parents cited other barriers including child preference, difficulty with changing habits, lack of information, lack of transportation, difficulty with monitoring child behavior, need for assistance from family members, parity with other family members, and neighborhood walking safety. Facilitators identified included access to physical activity programs, availability of alternatives to fast food and TV which are acceptable to the child, enlisting outside support, dietary information, involving the child, setting limits, making behavior changes gradually, and parental change in shopping behaviors and own eating behaviors. Conclusions Parents identify numerous barriers to adopting obesity prevention recommendations, most notably child and family preferences and resistance to change, but also economic barriers. Intervention programs should consider the context of family priorities and how to overcome barriers and make use of relevant facilitators during program development.
Taveras Elsie M
Background: The prevalence of childhood obesity has increased during the past decades and is now considered an urgent public health problem. Although stabilizing trends in obesity prevalence have been identified in parts of Europe, preventive efforts in children are still needed. Using the socio-ecological approach as the underlying theoretical perspective, the IDEFICS project aimed to develop, implement and evaluate a community-based intervention for the prevention of childhood obesity in ei...
Verbestel, Vera; Henauw, Stefaan; Maes, Lea; Haerens, Leen; Ma?rild, Staffan; Eiben, Gabriele; Lissner, Lauren; Moreno, Luis A.; Frauca, Natalia Lascorz; Barba, Gianvincenzo; Kova?cs, E?va; Konstabel, Kenn; Tornaritis, Michael; Gallois, Katharina; Hassel, Holger
Obesity is a major public health issue in Canada that is reaching historically high levels in spite of efforts, targeted primarily at individual behaviour, to promote changes in diet and physical activity. Urgency for change at the population level compels moving "upstream" toward multilevel, societal approaches for obesity prevention. Public health researchers, advocates and policy makers are increasingly recognizing the current food environment, including availability, pricing, and marketing of foods and beverages, promotes overconsumption of unhealthy food and beverage choices and have identified the food environment as a point for intervention for obesity prevention. In April 2011, a consensus conference with invited experts from research, policy and practice fields was held. The conference aimed to build consensus around policy levers to address environmental determinants of obesity, including next logical steps toward further policy action. Using economic policies, such as taxation of sugar-sweetened beverages (SSB), was discussed as one opportunity to promote healthy eating. This article reports on the consensus discussion that led to recommendations to tax sugar-sweetened beverages as one step in a multipronged comprehensive approach to obesity prevention. This recommendation is based on a synthesis of available evidence, including evidence regarding political feasibility, and potential impacts of a tax. In addition, we present additional primary research using current SSB consumption data to model the economic and behavioural impact of such a tax in Canada. PMID:24070799
Buhler, Susan; Raine, Kim D; Arango, Manuel; Pellerin, Suzie; Neary, Neil E
Obesity prevalences are increasing in Sweden and the US. Obesity has many health consequences and health risks are associated with small increases in weight and marked obesity. Cross-sectional and panel surveys from northern Sweden and upstate NY provide the basis for furthering understanding of body mass index (BMI) development. BMI and weight change (+/-3%) were used to evaluate obesity and weight loss, maintenance, or gain. The 1989 prevalences of obesity were 9.6% and 21.3% in Sweden and ...
Physical activity helps to decrease the effect of genetic predisposition on obesity Genetic differences explain an essential part of individual obesity differences, but physical activity also appears to be associated with obesity. Twin studies have revealed that genetic variation associated with obesity is less common in those with a high than low level. There are also indications that the FTO gene, a candidate gene predisposing to obesity, has an effect on obesity only in those with a low level of physical activity but not in those with a high level. The effect of obesity-predisposing genetic heritage can thus possibly be suppressed by physical activity. PMID:20593626
Karri, Silventoinen; Jaakko, Kaprio
Sedentary lifestyles and increased pollution brought about by industrialization pose major challenges to the prevention of both obesity and chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD), asthma, obstructive sleep apnea and obesity hypoventilation syndrome. Obesity has emerged as an important risk factor for these respiratory diseases, and in many instances weight loss is associated with important symptomatic improvement. Moreover, obesity may influence the ...
Poulain, Magali; Doucet, Marie?ve; Major, Genevie?ve C.; Drapeau, Vicky; Se?rie?s, Fre?de?ric; Boulet, Louis-philippe; Tremblay, Angelo; Maltais, Franc?ois
About 30% of Americans are currently obese, which is roughly a 100% increase from 25 years ago. Public health officials have consequently become alarmed because recent research indicates that societal costs of obesity now exceed those of cigarette smoking and alcoholism. Cigarette taxes may have exacerbated the prevalence of obesity. In 1964, the US Surgeon General issued its first report relating smoking and health, and since that time, federal and state governments have increased cigarette taxes in a successful effort to reduce cigarette smoking. However, because cigarette smoking and obesity seem inversely related, cigarette taxes may have simultaneously increased obesity. This paper examines the effects of cigarette costs on BMI and obesity and finds that they have significant positive effects. This paper attempts to reconcile conflicting evidence in the literature by controlling more carefully for correlation with state-specific time trends using panel data. Results indicate that the net benefit to society of increasing cigarette taxes may not be as large as previously thought, though this research in no way concludes that they should be decreased to prompt weight loss. PMID:18241088
Baum, Charles L
Obesity is now one of the public health concerns in China. Many factors are contributing to obesity. However, the underlying mechanism is not clear. As it is hard to cure it once obesity occurs, the most effective and encouraging strategies is prevention. Risk factors should be identified in order to develop prevention strategies
Full Text Available OBJETIVO: Revisar a abordagem terapêutica da obesidade infantil, bem como aspectos de seu diagnóstico e prevenção. FONTES DOS DADOS: Foi realizada busca de artigos científicos através das bases de dados MEDLINE, Ovid, Highwire e Scielo. As palavras-chave utilizadas foram: "childhood obesity" e também combinações junto a "treatment", "prevention" e "consequence". Dentre os artigos provenientes da busca incluíam-se artigos de revisão, estudos observacionais, ensaios clínicos e posições de consenso. Percebida a relevância, também se buscou diretamente referências indicadas. O período de coleta de dados foi de 1998 a 2003. SÍNTESE DOS DADOS: Foram encontrados vários trabalhos de prevalência no Brasil. No entanto, poucos trazem resultados de programas educativos aplicáveis em nosso meio. CONCLUSÕES: Deve-se prevenir a obesidade infantil com medidas adequadas de prescrição de dieta na infância desde o nascimento, além de se estudar mais sobre programas de educação que possam ser aplicados no nível primário de saúde e nas escolas.OBJECTIVE: To review therapeutic approaches to childhood obesity and also its diagnosis and prevention. SOURCES OF DATA: Searches were performed of scientific papers held on the MEDLINE, Ovid, Highwire and Scielo databases. Keywords utilized were: "childhood obesity" and a variety of combinations of this term with "treatment", "prevention" and "consequence". The search returned papers including review articles, observational studies, clinical trials and consensus statements. Bibliographical references in these articles were also investigated if it was perceived that they were relevant. Data was collected from 1998 to 2003. SUMMARY OF THE FINDINGS: While a number of different Brazilian prevalence studies were found, few gave details of the results of educational programs in our country. CONCLUSIONS: Childhood obesity must be prevented through prescriptive diets from birth throughout childhood. Educational programs that might be applicable to primary health care or schools should receive further study.
Elza D. de Mello
Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Revisar a abordagem terapêutica da obesidade infantil, bem como aspectos de seu diagnóstico e prevenção. FONTES DOS DADOS: Foi realizada busca de artigos científicos através das bases de dados MEDLINE, Ovid, Highwire e Scielo. As palavras-chave utilizadas foram: "childhood obesity" e també [...] m combinações junto a "treatment", "prevention" e "consequence". Dentre os artigos provenientes da busca incluíam-se artigos de revisão, estudos observacionais, ensaios clínicos e posições de consenso. Percebida a relevância, também se buscou diretamente referências indicadas. O período de coleta de dados foi de 1998 a 2003. SÍNTESE DOS DADOS: Foram encontrados vários trabalhos de prevalência no Brasil. No entanto, poucos trazem resultados de programas educativos aplicáveis em nosso meio. CONCLUSÕES: Deve-se prevenir a obesidade infantil com medidas adequadas de prescrição de dieta na infância desde o nascimento, além de se estudar mais sobre programas de educação que possam ser aplicados no nível primário de saúde e nas escolas. Abstract in english OBJECTIVE: To review therapeutic approaches to childhood obesity and also its diagnosis and prevention. SOURCES OF DATA: Searches were performed of scientific papers held on the MEDLINE, Ovid, Highwire and Scielo databases. Keywords utilized were: "childhood obesity" and a variety of combinations of [...] this term with "treatment", "prevention" and "consequence". The search returned papers including review articles, observational studies, clinical trials and consensus statements. Bibliographical references in these articles were also investigated if it was perceived that they were relevant. Data was collected from 1998 to 2003. SUMMARY OF THE FINDINGS: While a number of different Brazilian prevalence studies were found, few gave details of the results of educational programs in our country. CONCLUSIONS: Childhood obesity must be prevented through prescriptive diets from birth throughout childhood. Educational programs that might be applicable to primary health care or schools should receive further study.
Mello, Elza D. de; Luft, Vivian C.; Meyer, Flavia.
Full Text Available Abstract Background Interest in community-based interventions (CBIs for health promotion is increasing, with a lot of recent activity in the field. This paper aims, from a state government perspective, to examine the experience of funding and managing six obesity prevention CBIs, to identify lessons learned and to consider the implications for future investment. Specifically, we focus on the planning, government support, evaluation, research and workforce development required. Methods The lessons presented in this paper come from analysis of key project documents, the experience of the authors in managing the projects and from feedback obtained from key program stakeholders. Results CBIs require careful management, including sufficient planning time and clear governance structures. Selection of interventions should be based on evidence and tailored to local needs to ensure adequate penetration in the community. Workforce and community capacity must be assessed and addressed when selecting communities. Supporting the health promotion workforce to become adequately skilled and experienced in evaluation and research is also necessary before implementation. Comprehensive evaluation of future projects is challenging on both technical and affordability grounds. Greater emphasis may be needed on process evaluation complemented by organisation-level measures of impact and monitoring of nutrition and physical activity behaviours. Conclusions CBIs offer potential as one of a mix of approaches to obesity prevention. If successful approaches are to be expanded, care must be taken to incorporate lessons from existing and past projects. To do this, government must show strong leadership and work in partnership with the research community and local practitioners.
Haby Michelle M
Objective: To assess the impact of an online continuing education course on the knowledge, skills, and self-efficacy of nutrition professionals to use an ecological approach to prevent childhood obesity. Design: Quasi-experimental design using intervention and delayed intervention comparison groups with pre/post-course assessments. Setting: Online
Stark, Christina M.; Graham-Kiefer, Meredith L.; Devine, Carol M.; Dollahite, Jamie S.; Olson, Christine M.
Obesity is a rapidly-growing public health problem that is related in part to the foods available in the eating environment. Properties of foods such as portion size and energy density (kJ/g) have robust effects on energy intake; large portions of energy-dense foods promote excess consumption and this effect starts in early childhood. Studies show, however, that in both adults and children these food characteristics can also be used strategically to moderate energy intake, as well as to impro...
Rolls, Barbara J.
The main objective of this study was to assess the effectiveness of an obesity prevention intervention which included nutrition education and physical activity applied to low income Chilean children in a longitudinal three-year follow-up study. Participants included all 4-7 year old children from 7 public schools located in a low socioeconomic district of Santiago. The main aspects of the intervention were: training of teachers so they could apply an educational program on healthy eating, increase in physical education classes from 3 to 4 per week, and improvement of their quality. Weight, height, waist circumference (WC) and the 6-minute walk distance (6MWD) were assessed yearly in 597 children. We calculated BMI, BMI Z, % normal (N), overweight (OW) and obesity (OB), WC > 90th percentile (NHANES III) and fitness (6MWD/height). Annual changes in BMI Z, WC, 6MWD and fitness were assessed, using repeated measures ANOVA and the test of proportions. Knowledge in healthy eating was assessed during 2 of the 3 years. Results showed that % OB remained unchanged for 2 years (17%) but increased to 19.3% at follow-up. BMI Z increased from 0.3 to 0.38 (p = 0.052) in the N, remained unchanged in the OW, while decreasing significantly in the OB (2.73 to 2.41 p 90 th percentile decreased in the OW and OB; 6 MWD was higher in the OW, but the increase in distance overtime was greater among the N. Overall fitness improved, however it was only significant among the N (p = 0.0002). There was a significant increase in food knowledge. We conclude that in spite of a decrease in BMI Z of the OB, an improvement in fitness in the N and food knowledge in all the children, obesity increased at follow-up. This study shows that in school-based obesity programs it is necessary to apply more intense interventions with another type of methodology; otherwise this condition will continue to rise. PMID:23477209
Kain, Juliana; Leyton, Bárbara; Concha, Fernando; Weisstaub, Gerardo; Lobos, Luz; Bustos, Nelly; Vio, Fernando
Full Text Available SciELO Brazil | Language: English Abstract in english The aim of the present study was to evaluate the effect of a 12 week program of physical exercise (PE) on butyrylcholinesterase (BChE) in obese adolescents. This study compared obese adolescents (N = 54) before and after PE, regarding the relative intensity (RI) and activity of different molecular f [...] orms (G1, G2, G4 and G1-ALB) of BChE found in plasma. Waist circumference (WC) and lipid profile were also assessed before and after PE. It was shown that before PE, mean plasma BChE activity was significantly higher in obese than in non-obese adolescents and that it was significantly reduced after PE, becoming similar to that found in non-obese adolescents. Lipid profile and WC also changed in response to PE. These results are consistent with studies that found a correlation between BChE and lipid metabolism and suggest that PE may have led to a physiological regularization of plasma BChE activity. Although mean BChE activity of each isoform was significantly reduced by PE, their RI did not change. This is in accordance with a previous suggestion that this proportion is maintained under factors such as obesity, and may therefore be important for BChE functions.
Isabela M.W., Silva; Neiva, Leite; Dellyana, Boberg; Thais J., Chaves; Gerusa M., Eisfeld; Gisele M., Eisfeld; Gleyse F., Bono; Ricardo L.R., Souza; Lupe, Furtado-Alle.
The goal of nutrigenomics is to develop nutritional interventions targeted to individual genetic make-up. Obesity is a prime candidate for nutrigenomics research. Personalized approaches to prevention of diseases associated with obesity may be available in the near future. Nevertheless, in the context of limited resources, access to a nutrigenomics personalized health service raises questions around equity. Using focus groups, the present qualitative research study provides empirical data on ethical concerns and values surrounding the nutrigenomics-guided personalized nutrition for obesity prevention. Eight focus groups were convened including 27 healthy individuals and 21 individuals who self-identified as obese or at risk of obesity. The transcripts of the focus group were analyzed according to the qualitative method of grounded theory. Responsibility, reciprocity, and solidarity emerged as the key ethical criteria perceived by the respondents to be significant in terms of how health professionals should determine access to personalized nutrition services. Still, exclusion of individuals from specific nutrigenomic services is likely to conflict with the imperatives of medical deontology and contemporary social consensus. The representation of equity in this paper is novel: it considers the intersection of nutrigenomics and personalized nutritional interventions specifically in the context of limited public resources for health services. PMID:19040373
Lévesque, Lise; Ozdemir, Vural; Godard, Béatrice
Obesity is a chronic metabolic disorder caused by imbalance between energy intake and expenditure, and is one of the principal causative factors in the development of metabolic syndrome, diabetes and cancer. COH-SR4 ("SR4") is a novel investigational compound that has anti-cancer and anti-adipogenic properties. In this study, the effects of SR4 on metabolic alterations in high fat diet (HFD)-induced obese C57BL/J6 mice were investigated. Oral feeding of SR4 (5 mg/kg body weight.) in HFD mice for 6 weeks significantly reduced body weight, prevented hyperlipidemia and improved glycemic control without affecting food intake. These changes were associated with marked decreases in epididymal fat mass, adipocyte hypertrophy, increased plasma adiponectin and reduced leptin levels. SR4 treatment also decreased liver triglycerides, prevented hepatic steatosis, and normalized liver enzymes. Western blots demonstrated increased AMPK activation in liver and adipose tissues of SR4-treated HFD obese mice, while gene analyses by real time PCR showed COH-SR4 significantly suppressed the mRNA expression of lipogenic genes such as sterol regulatory element binding protein-1c (Srebf1), acetyl-Coenzyme A carboxylase (Acaca), peroxisome proliferator-activated receptor gamma (Pparg), fatty acid synthase (Fasn), stearoyl-Coenzyme A desaturase 1 (Scd1), carnitine palmitoyltransferase 1a (Cpt1a) and 3-hydroxy-3-methyl-glutaryl-CoA reductase (Hmgcr), as well as gluconeogenic genes phosphoenolpyruvate carboxykinase 1 (Pck1) and glucose-6-phosphatase (G6pc) in the liver of obese mice. In vitro, SR4 activates AMPK independent of upstream kinases liver kinase B1 (LKB1) and Ca2+/calmodulin-dependent protein kinase kinase ? (CaMKK?). Together, these data suggest that SR4, a novel AMPK activator, may be a promising therapeutic compound for treatment of obesity, fatty liver disease, and related metabolic disorders. PMID:24376752
Figarola, James Lester; Singhal, Preeti; Rahbar, Samuel; Gugiu, Bogdan Gabriel; Awasthi, Sanjay; Singhal, Sharad S
Obesity is a chronic metabolic disorder caused by imbalance between energy intake and expenditure, and is one of the principal causative factors in the development of metabolic syndrome, diabetes and cancer. COH-SR4 (SR4) is a novel investigational compound that has anti-cancer and anti-adipogenic properties. In this study, the effects of SR4 on metabolic alterations in high fat diet (HFD)-induced obese C57BL/J6 mice were investigated. Oral feeding of SR4 (5 mg/kg body weight.) in HFD mice for 6 weeks significantly reduced body weight, prevented hyperlipidemia and improved glycemic control without affecting food intake. These changes were associated with marked decreases in epididymal fat mass, adipocyte hypertrophy, increased plasma adiponectin and reduced leptin levels. SR4 treatment also decreased liver triglycerides, prevented hepatic steatosis, and normalized liver enzymes. Western blots demonstrated increased AMPK activation in liver and adipose tissues of SR4-treated HFD obese mice, while gene analyses by real time PCR showed COH-SR4 significantly suppressed the mRNA expression of lipogenic genes such as sterol regulatory element binding protein-1c (Srebf1), acetyl-Coenzyme A carboxylase (Acaca), peroxisome proliferator-activated receptor gamma (Pparg), fatty acid synthase (Fasn), stearoyl-Coenzyme A desaturase 1 (Scd1), carnitine palmitoyltransferase 1a (Cpt1a) and 3-hydroxy-3-methyl-glutaryl-CoA reductase (Hmgcr), as well as gluconeogenic genes phosphoenolpyruvate carboxykinase 1 (Pck1) and glucose-6-phosphatase (G6pc) in the liver of obese mice. In vitro, SR4 activates AMPK independent of upstream kinases liver kinase B1 (LKB1) and Ca2+/calmodulin-dependent protein kinase kinase ? (CaMKK?). Together, these data suggest that SR4, a novel AMPK activator, may be a promising therapeutic compound for treatment of obesity, fatty liver disease, and related metabolic disorders.
Figarola, James Lester; Singhal, Preeti; Rahbar, Samuel; Gugiu, Bogdan Gabriel; Awasthi, Sanjay; Singhal, Sharad S.
Pregnancy is now considered to be an important risk factor for new or persistent obesity among women during the childbearing years. High gestational weight gain is the strongest predictor of maternal overweight or obesity following pregnancy. A growing body of evidence also suggests that both high and low gestational weight gains are independently associated with an increased risk of childhood obesity, suggesting that influences occurring very early in life are contributing to obesity onset. ...
Herring, Sharon J.; Rose, Marisa Z.; Skouteris, Helen; Oken, Emily
Childhood obesity has become an epidemic on a worldwide scale. This article gives an overview of the progress made in childhood and adolescent obesity research in the last decade, with a particular emphasis on the transdisciplinary and complex nature of the problem. The following topics are addressed: 1) current definitions of childhood and adolescent overweight and obesity; 2) demography of childhood and adolescent obesity both in the US and globally; 3) current topics in the physiology of f...
A vast body of research exists to demonstrate that obesity is a complex disorder with a strong genetic basis and a multifactorial etiology. Yet despite the overwhelming evidence that genes play an important role in the development of obesity, many people argue that the increasing prevalence of obesity is simply due to an abundance of palatable food and a dearth of opportunities for physical exercise. While activity and eating behaviors contribute substantially to the development of obesity, c...
Bray, Molly S.
Studies show that childhood obesity has reached epidemic proportions in the United States. Today, more than 23 million American children--or nearly one in every three--are overweight or obese. If childhood obesity is left unaddressed, a generation of individuals could face health, social, and economic challenges that promise to stress government
Mulheron, Joyal; Vonasek, Kara
The aim of the study was to explore the associations between obesity, weight perceptions and gender, ethnicity, culture and social class in a large national study of Australian school children. Primary and high schools (N = 47) were recruited from every state and territory of Australia and included 7889 children from government, private and Catholic schools (82% response rate) in August-November, 2006. The socioeconomic status (SES) of schools was based on a government survey of total family income. A questionnaire completed by students, measured demographic details of gender, age, weight perceptions and ethnic/cultural background. Height and weight were measured by trained research assistants. Outcome measures included body mass index (BMI), prevalence of obesity, overweight, weight perceptions. Prevalence of obesity was 6.4% of males and 5.6% of females in primary school students (P = 0.34). More high school males were obese than females (7.7% vs. 5.7%, P = 0.001). Obesity was more prevalent among students from Pacific Islander backgrounds. Adolescents who were most likely to be obese were boys and girls of low SES or Pacific Islander or Middle Eastern/Arabic background. The least likely to be obese were Anglo/Caucasian or Asian students and in particular, the girls. Obese female adolescents from Aboriginal, Middle Eastern/Arabic and Pacific Islander backgrounds were less likely than their Caucasian or Asian peers to perceive themselves as 'too fat'.Those working in clinical, community or educational settings with young people and in particular, obese young people, should be aware that obesity is likely to be more prevalent, more culturally acceptable and perhaps more desirable among children and teens from low SES communities and/or Middle Eastern and Pacific Islander backgrounds. Health and social work professionals should be careful not to exaggerate the risks of overweight or obesity or inadvertently create weight concerns among young people. The different body image perceptions identified in this study should be taken into account when planning clinical, community or preventive initiatives among children or adolescents from varying ethnic groups. PMID:18328051
O'Dea, Jennifer A
In this issue of the International Journal of Obesity, Katz et al. report on a meta-analysis of school-based interventions (SBIs) for lessening overweight and obesity in children. A hard look at SBIs is certainly warranted and we applaud Katz et al. for undertaking the task. SBIs have been and remain among the most advocated of anti-obesity approaches and, at least as research projects, they have tended to be large expensive projects. Not surprisingly, evidence of the efficacy/ effectiveness ...
Durant, N.; Baskin, Ml; Thomas, O.; Allison, Db
Neighborhood environment is consistently associated with obesity; changes to modifiable aspects of the neighborhood environment may curb the growth of obesity in the US and other developed nations. However, currently the majority of studies are cross-sectional and thus not appropriate for evaluating causality. The goal of this study was to evaluate the effect of a neighborhood-changing intervention on changes in obesity among older women. Over the past 30 years the Portland, Oregon metropolitan region has made significant investments in plans, regulatory structures, and public facilities to reduce sprawl and increase compact growth centers, transit-oriented development approaches, and green space. We used geocoded residential addresses to link data on land-use mix, public transit access, street connectivity, and access to green space from four time points between 1986 and 2004, with longitudinal data on body mass index (BMI) from a cohort of 2003 community-dwelling women aged 66 years and older. Height and weight were measured at clinic visits. Women self-reported demographics, health habits, and chronic conditions, and self-rated their health. Neighborhood socioeconomic status was assessed from census data. Neighborhood walkability and access to green space improved over the 18-year study period. On average there was a non-significant mean weight loss in the cohort between baseline (mean age 72.6 years) and the study's end (mean age 85.0 years). We observed no association between neighborhood built environment or change in built environment and BMI. Greater neighborhood socioeconomic status at baseline was independently associated with a healthier BMI at baseline, and protected against an age-related decline in BMI over time. BMI decreases with age reflect increased frailty, especially among older adults with complex morbidities. Future research should consider the influence of the neighborhood environment on additional relevant health outcomes and should include measures of the social environment in conjunction with built environment measures. PMID:24565150
Michael, Yvonne L; Nagel, Corey L; Gold, Rachel; Hillier, Teresa A
Non-fasting triglyceridemia is much closer associated to cardiovascular risk compared to fasting triglyceridemia. We hypothesized that there would be acute differential effects of four common dietary proteins (cod protein, whey isolate, gluten, and casein) on postprandial lipemia in obese non-diabetic subjects. To test the hypothesis we conducted a randomized, acute clinical intervention study with crossover design. We supplemented a fat rich mixed meal with one of four dietary proteins i.e. cod protein, whey protein, gluten or casein. Eleven obese non-diabetic subjects (age: 40-68, body mass index: 30.3-42.0 kg/m(2)) participated and blood samples were drawn in the 8-h postprandial period. Supplementation of a fat rich mixed meal with whey protein caused lower postprandial lipemia (P = .048) compared to supplementation with cod protein and gluten. This was primarily due to lower triglyceride concentration in the chylomicron rich fraction (P = .0293). Thus, we have demonstrated acute differential effects on postprandial metabolism of four dietary proteins supplemented to a fat rich mixed meal in obese non-diabetic subjects. Supplementation with whey protein caused lower postprandial lipemia compared to supplementation with cod and gluten. As postprandial lipemia is closely correlated to cardiovascular disease, long-term dietary supplementation with whey protein may prove beneficial in preventing cardiovascular disease in obese non-diabetic subjects.
Holmer-Jensen, Jens; Mortensen, Lene Sundahl
Childhood obesity is increasing in prevalence in the United States. Comorbid diseases once thought of as adult issues such as hypertension, diabetes, and dyslipidemia, are now being encountered in the pediatric population as a result of obesity. Primary prevention is still the most cost-effective approach to this growing problem. In terms of management, the treatment of obesity in children is not identical to that in adults. Thus far, the only accepted weight loss therapy for children are die...
Salazar, Maria L.; Eiland, Lea S.
There is conflicting evidence on the duration of action of atracurium in obese patients. Cisatracurium is one of the stereoisomers of atracurium. We investigated the neuromuscular effects of cisatracurium in morbidly obese patients. Twenty obese female patients (body mass index >40) were randomized in two groups. Group I (n = 10) received 0.2 mg/kg of cisatracurium on the basis of real body weight (RBW), whereas in Group II (n = 10) the dose was calculated on ideal body weight (IBW). In a control group of 10 normal weight female patients (body mass index 20-24), the dose of cisatracurium was based on RBW. Neuromuscular transmission was monitored using acceleromyography of the adductor pollicis, and anesthesia was induced and maintained with remifentanil and propofol. Onset time was comparable between Group I and the control group (132 s versus 135 s; P = ns). The duration 25% was longer in Group I than in the control group (74.6 min versus 59.1 min; P = 0.01) and in the control group compared with Group II (45.0 min; P = 0.016). In conclusion, the duration of action of cisatracurium was prolonged in morbidly obese patients when dosed according to RBW compared with a control group of normal weight patients. Duration was also prolonged in the control group patients compared with morbidly obese patients to whom the drug was administered on the basis of IBW. PMID:15385356
Leykin, Yigal; Pellis, Tommaso; Lucca, Mariella; Lomangino, Giacomina; Marzano, Bernardo; Gullo, Antonino
Full Text Available Abstract Background In the Netherlands, the first adolescents with diabetes mellitus type 2 as a result of obesity have recently been diagnosed. Therefore, it is very important that programs aiming at the prevention of type 2 diabetes of obese adolescents are developed and evaluated. Methods Go4it is a multidisciplinary group treatment that focuses on: 1 increasing awareness of the current dietary and physical activity behaviour (i.e. energy balance behaviour, 2 improving diet, 3 decreasing sedentary behaviour, 4 increasing levels of physical activity, and 5 coping with difficult situations. Go4it consists of 7 sessions with an interval of 23 weeks. The effectiveness of the multidisciplinary group treatment compared with usual care (i.e. referral to a dietician was evaluated in a randomised controlled trial. We examined effects on BMI(sds, body composition, energy expenditure, glucose tolerance and insulin resistance (primary outcome measure, as well as dietary and physical activity behaviour and quality of life. An economic evaluation from a societal perspective was conducted alongside the randomised trial to evaluate the cost-effectiveness of the multidisciplinary treatment program vs. usual care. Discussion In this paper we described a multidisciplinary treatment program (Go4it for obese adolescents and the design of a randomised controlled trial and economic evaluation to evaluate its effectiveness and cost-effectiveness. Trial registration Netherlands Trial Register (ISRCTN27626398.
Weijs Peter JM
Background The increasing prevalence of obesity in pregnant women is associated with adverse maternal and neonatal outcomes, and increased costs to healthcare, the economy and broader society. Objectives To assess the efficacy of behavioural interventions for managing gestational weight gain (GWG) in the pre-conceptual and pregnancy period in overweight, obese and morbidly obese women. Search Methods A search was performed for published studies in the English language, from date? 200031 December 2012 in five electronic databases; PubMed, Scopus, Cochrane Library, CINAHL and PsycINFO. Selection criteria Studies were included if they compared the efficacy or effectiveness of a particular behavioural intervention in pregnant or pre-conceptual women with standard maternity care. Studies that included women with co-morbid conditions such as diabetes mellitus and polycystic ovarian syndrome were excluded to help isolate the effect of the intervention. Results Fifteen studies involving 3,426 participants were included. One study (n?=?692) focused on the pre-conceptual period and the remaining 14 (n?=?2,734) in the pregnancy period. Pooled mean difference for GWG indicated a lower GWG in the intervention groups when compared to standard maternity care groups (n?=?1771, mean difference (MD) ?1.66 kg, 95% CI ?3.12 to ?0.21 kg). With respect to the types of participants, considerable heterogeneity between studies was shown in the obese subgroup [Tau2?=?15.61; Chi2?=?40.80, df?=?3 (P<0.00001); I2?=?93%]. Conclusions Behavioural interventions in pregnancy may be effective in reducing GWG in obese women without comorbid conditions, but not overweight or morbidly obese women. Behavioural interventions had no effect on postpartum weight loss or retention, gestation week of delivery and infant birth weight in overweight, obese and morbidly obese women.
Agha, Maliha; Agha, Riaz A.; Sandell, Jane
"Background: The prevalence of overweight and obesity in Europe is high. It is a major cause of the overall rates of many of the main chronic (or non communicable) diseases in this region and is characterized by an unequal socio-economic distribution within the population. Obesity is largely determined by modifiable lifestyle behaviours such as low physical activity levels, sedentary behaviour and consumption of energy dense diets. It is increasingly being recognised that effective respo...
Lakerveld, Jeroen; Brug, Johannes; Bot, Sandra; Teixeira, Pedro J.; Rutter, Harry; Woodward, Euan; Samdal, Oddrun; Stockley, Lynn; Bourdeaudhuij, Ilse; Assema, Patricia; Robertson, Aileen; Lobstein, Tim; Oppert, Jean-michel; Adany, Roza; Nijpels, Giel
Abstract Background Childhood obesity is a major public health concern with serious implications for the sustainability of healthcare systems. Studies in the US and UK have shown that ethnicity is consistently associated with childhood obesity, with Black African origin girls in particular being more vulnerable to overweight and obesity than their White peers. Little is known, however, about what promotes or hinders engagement with prevention programmes among ethnic minority ...
The prevalence of obesity increases and is associated with increases in co-morbidities e.g. type 2 diabetes, hyperlipidemia, hypertension, obstructive sleep apnea, heart disease, stroke, asthma, several forms of cancer, depression, and may result in reduction of expected remaining lifespan. We have reviewed the adverse effects on the cardiovascular system of anti-obesity drugs now retracted from the market as well as the cardiovascular profile of current drugs and potential pathways which are considered for treatment of obesity. Fenfluramine, and sibutramine were withdrawn due to increased cardiovascular risk, while an inverse agonist at cannabinoid type 1 (CB1) receptors, rimonobant was withdrawn due to serious psychiatric problems. At present there are only few treatments available including orlistat and, phentermine alone or in combination with topiramate and lorcaserin, although cardiovascular side effects need to be clarified regarding phentermine and lorcaserin. Drugs approved for type 2 diabetes including glucagon like peptide (GLP-1) analogues and metformin also cause moderate weight losses and have a favourable cardiovascular profile, while the anti-obesity potential of nebivolol remains unexplored. Pathways with anti-obesity potential include sirtuin activation, blockade of transient receptor potential (TRPV1) channels, acetyl-CoA carboxylase 1 and 2 inhibitors, uncoupling protein activators, bile acids, crotonins, CB1 antagonists, but the cardiovascular profile remains to be investigated. For type 2 diabetes, new drug classes with possible advantageous cardiovascular profiles, e.g. GLP-1 analogues and sodium-glucose co-transport type 2 inhibitors, are associated with weight loss and are currently being evaluated as anti-obesity drugs.
Comerma-Steffensen, Simon; Grann, Martin
The prevalence of obesity increases and is associated with increases in co-morbidities e.g. type 2 diabetes, hyperlipidemia, hypertension, obstructive sleep apnea, heart disease, stroke, asthma, several forms of cancer, depression, and may result in reduction of expected remaining lifespan. We have reviewed the adverse effects on the cardiovascular system of anti-obesity drugs now retracted from the market as well as the cardiovascular profile of current drugs and potential pathways which are considered for treatment of obesity. Fenfluramine, and sibutramine were withdrawn due to increased cardiovascular risk, while an inverse agonist at cannabinoid type 1 (CB1) receptors, rimonobant was withdrawn due to serious psychiatric problems. At present there are only few treatments available including orlistat and, phentermine alone or in combination with topiramate and lorcaserin, although cardiovascular side effects need to be clarified regarding phentermine and lorcaserin. Drugs approved for type 2 diabetes including glucagon like peptide (GLP-1) analogues and metformin also cause moderate weight losses and have a favourable cardiovascular profile, while the anti-obesity potential of nebivolol remains unexplored. Pathways with anti-obesity potential include sirtuin activation, blockade of transient receptor potential (TRPV1) channels, acetyl-CoA carboxylase 1 and 2 inhibitors, uncoupling protein activators, bile acids, crotonins, CB1 antagonists, but the cardiovascular profile remains to be investigated. For type 2 diabetes, new drug classes with possible advantageous cardiovascular profiles, e.g. GLP-1 analogues and sodium-glucose co-transport type 2 inhibitors, are associated with weight loss and are currently being evaluated as anti-obesity drugs. PMID:24846238
Comerma-Steffensen, Simon; Grann, Martin; Andersen, Charlotte U; Rungby, Jorgen; Simonsen, Ulf
Recent literature indicates the potential of community-based obesity prevention programmes in the endeavour to reduce the prevalence of obesity in developed nations. Considerable suggestion and advocacy come from theoretical standpoints and little is known on actual practical application of this type of multi-component health promotion programme. This article explores the experiences of 'implementation' by stakeholders of a large community-based obesity prevention programme, facilitated by a National Health Service Care Trust in the north-east of England, UK. Three stakeholder groups (senior health officials, public health workers and community members) who had administrated and experienced the programme since its conception in 2006 provide perspectives on the aspects of local delivery and receipt. Semi-structured interviews and focus groups were conducted with stakeholders (28 participants in total). The participants felt there were three broad aspects which shaped and constrained the delivery and receipt of the programme, namely partnership working, integration of services and quality issues. Data indicated that it had taken time to establish working partnerships between the multi-agencies involved in the community-based obesity programme. Strategic management would aid the processes of communication and collaboration between agencies and also the local community involved in the administration, delivery and participation of interventions in the programme. Secondly, the way in which the programme is justified and sustained will have to be reviewed, with the intention of using a suitable evaluative framework or tool for monitoring purposes. PMID:23297339
Middleton, G; Henderson, H; Evans, D
Understanding the early factors affecting obesity development in males and females may help to prevent obesity and may lead to the discovery of more effective treatments for those already obese. The Otsuka Long-Evans Tokushima Fatty (OLETF) rat model of obesity is characterized by hyperphagia-induced obesity, due to a spontaneous lack of CCK1 receptors. In the present study, we focused on the behavioral and physiological aspects of obesity development from weaning to adulthood. We examined bo...
Schroeder, Mariana; Zagoory-sharon, Orna; Shbiro, Liat; Marco, Asaf; Hyun, Jayson; Moran, Timothy H.; Bi, Sheng; Weller, Aron
Weight loss can reduce the increased cardiovascular risk associated with obesity. Pharmacotherapy is a recognized weight loss treatment option; however, cardiovascular safety issues with some previous weight loss drugs raise concerns for newly approved pharmacotherapies. Phentermine is approved for short-term obesity treatment in conjunction with lifestyle modifications, but is commonly used chronically. Topiramate, approved for treating epilepsy and preventing migraines, also induces weight loss. A single-dose combination of low-dose phentermine and topiramate extended-release was recently approved by the United States Food and Drug Administration as an adjunct to lifestyle intervention for the chronic treatment of overweight/obese adults. This review summarizes and evaluates the cardiovascular risk/benefit profile associated with phentermine and topiramate, individually and in combination. Cardiovascular data associated with long-term use of phentermine and topiramate extended-release indicate that this combination may be a safe and effective option for reducing weight in overweight/obese patients at low-to-intermediate cardiovascular risk. PMID:24621808
Jordan, Jens; Astrup, Arne; Engeli, Stefan; Narkiewicz, Krzysztof; Day, Wesley W; Finer, Nick
Weight loss can reduce the increased cardiovascular risk associated with obesity. Pharmacotherapy is a recognized weight loss treatment option; however, cardiovascular safety issues with some previous weight loss drugs raise concerns for newly approved pharmacotherapies. Phentermine is approved for short-term obesity treatment in conjunction with lifestyle modifications, but is commonly used chronically. Topiramate, approved for treating epilepsy and preventing migraines, also induces weight loss. A single-dose combination of low-dose phentermine and topiramate extended-release was recently approved by the United States Food and Drug Administration as an adjunct to lifestyle intervention for the chronic treatment of overweight/obese adults. This review summarizes and evaluates the cardiovascular risk/benefit profile associated with phentermine and topiramate, individually and in combination. Cardiovascular data associated with long-term use of phentermine and topiramate extended-release indicate that this combination may be a safe and effective option for reducing weight in overweight/obese patients at low-to-intermediate cardiovascular risk.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0.
Jordan, Jens; Astrup, Arne
Telmisartan shows antihypertensive and several pleiotropic effects that interact with metabolic pathways. In the present study we tested the hypothesis that telmisartan prevents adipogenesis in vitro and weight gain in vivo through activation of peroxisome proliferator-activated receptor (PPAR)-delta-dependent pathways in several tissues. In vitro, telmisartan significantly upregulated PPAR-delta expression in 3T3-L1 preadipocytes in a time- and dose-dependent manner. Other than enhancing PPAR-delta expression by 68.2+/-17.3% and PPAR-delta activity by 102.0+/-9.0%, telmisartan also upregulated PPAR-gamma expression, whereas neither candesartan nor losartan affected PPAR-delta expression. In vivo, long-term administration of telmisartan significantly reduced visceral fat and prevented high-fat diet-induced obesity in wild-type mice and hypertensive rats but not in PPAR-delta knockout mice. Administration of telmisartan did not influence food intake in mice. Telmisartan influenced several lipolytic and energy uncoupling related proteins (UCPs) and enhanced phosphorylated protein kinase A and hormone sensitive lipase but reduced perilipin expression and finally inhibited adipogenesis in 3T3-L1 preadipocytes. Telmisartan-associated reduction of adipogenesis in preadipocytes was significantly blocked after PPAR-delta gene knockout. Chronic telmisartan treatment upregulated the expressions of protein kinase A, hormone-sensitive lipase, and uncoupling protein 1 but reduced perilipin expression in adipose tissue and increased uncoupling protein 2 and 3 expression in skeletal muscle in wild-type mice but not in PPAR-delta knockout mice. We conclude that telmisartan prevents adipogenesis and weight gain through activation of PPAR-delta-dependent lipolytic pathways and energy uncoupling in several tissues.
He, Hongbo; Yang, Dachun
Full Text Available Abstract Background The prevalence of childhood obesity has increased during the past decades and is now considered an urgent public health problem. Although stabilizing trends in obesity prevalence have been identified in parts of Europe, preventive efforts in children are still needed. Using the socio-ecological approach as the underlying theoretical perspective, the IDEFICS project aimed to develop, implement and evaluate a community-based intervention for the prevention of childhood obesity in eight European countries. The aim of the present manuscript was to describe the content and developmental process of the IDEFICS intervention. Methods The intervention mapping protocol (IMP was used to develop the community-based intervention for the prevention of childhood obesity in 3 to 10 years old children. It is a theory- and evidence-based tool for the structured planning and development of health promotion programs that requires the completion of six different steps. These steps were elaborated by two coordinating centers and discussed with the other participating centers until agreement was reached. Focus group research was performed in all participating centers to provide an informed basis for intervention development. Results The application of the IMP resulted in an overall intervention framework with ten intervention modules targeting environmental and personal factors through the family, the school and the community. The summary results of the focus group research were used to inform the development of the overall intervention. The cultural adaptation of the overall intervention was realised by using country specific focus group results. The need for cultural adaptation was considered during the entire process to improve program adoption and implementation. A plan was developed to evaluate program effectiveness and quality of implementation. Conclusions The IDEFICS project developed a community-based intervention for the prevention of childhood obesity by using to the intervention mapping heuristic. The IDEFICS intervention consists of a general and standardized intervention framework that allows for cultural adaptation to make the intervention feasible and to enhance deliverability in all participating countries. The present manuscript demonstrates that the development of an intervention is a long process that needs to be done systematically. Time, human resources and finances need to be planned beforehand to make interventions evidence-based and culturally relevant.
This article describes the creation of a faith-based, community action research intervention aimed at reducing childhood obesity among a vulnerable population. Of particular concern to the community was the prevalence of obesity among its minority children. Engaging parents in a childhood obesity initiative through faith-based organizations (churches, community organizations with a common religious focus) was a method to provide a research intervention. It is important for researchers to be c...
Reifsnider, Elizabeth; Hargraves, Martha; Williams, Karen Jaynes; Cooks, John; Hall, Valerie
The discovery of a form of chronic, low-grade systemic inflammation (metaflammation) linked with obesity, but also associated with several lifestyle-related behaviours not necessarily causing obesity, suggests a re-consideration of obesity as a direct cause of chronic disease and a search for the main driversor cause of causes. Factors contributing to this are considered here within an environmental context, leading to the conclusion that humans have an immune reaction to aspects of ...
Overweight and obesity have now reached historical, maximal peak values, with nearly one-third of world population suffering from these conditions. We are now witnessing the impact of this epidemic upon the global health status, with non-communicable diseases on the rise. We have also witnessed the shortcomings and failures of past actions taken when obesity is already present. In this essay the author reviews efforts made in the past regarding identification and treatment of obesity, and pro...
Full Text Available Se describen los cambios epidemiológicos y nutricionales que ha tenido Chile en las últimas décadas, especialmente relacionados con la dieta y sedentarismo, lo que ha llevado a un aumento explosivo de la obesidad a niveles semejantes a los Estados Unidos. Frente a esta situación, se plantea la necesidad de desarrollar una Política de Estado en Promoción de Salud a través de VIDA CHILE, y en el caso específico de la alimentación y nutrición, seguir los lineamientos que ha dado la OMS y la FAO frente al tema Dieta, Nutrición y la Prevención de las Enfermedades Crónicas no TransmisiblesThe epidemiologic and nutritional changes that have occurred in Chile in the last decades are described, in particular related to diet and sedentarism, with the consequence of an explosive increase in obesity, similar to United States levels. To cope with this situation it is necessary a State Policy in Health Promotion through VIDA CHILE. In the case of diet and nutrition it is recommended to follow the WHO and FAO guidelines related to Diet, Nutrition and the Prevention of Chronic Diseases
Fernando Vio D
Full Text Available It is estimated that about half of the population in developed countries are either overweight or obese. In some developing nations obesity rates have increased to surpass those seen in Western countries. This rate increase in obesity has many implications as obesity has been associated with numerous negative health effects including increased risks of hypertension, diabetes, cardiovascular disease, stroke, liver disease, apnea, and some cancer types. Obesity is now considered to be one of the major public health concerns facing the society. Cholangiocarcinomas (bile duct cancers are malignant tumors arising from cholangiocytes inside or outside of the liver. Although cholangiocarcinomas are relatively rare, they are highly lethal. The low survival rate associated with cholangiocarcinoma is due to the advanced stage of the disease at the time of diagnosis. Prevention is therefore especially important in this cancer type. Some data suggest that the incidence of cholangiocarcinoma in the western world is on the rise. Increasing rate of obesity may be one of the factors responsible for this increase. Determining whether obesity is a risk factor for cholangiocarcinoma has significant clinical and societal implications as obesity is both prevalent and modifiable. This paper seeks to provide a summary of the current knowledge linking obesity and cholangiocarcinoma, and encourage further research on this topic.
Mansour A Parsi
OBJECTIVES: "Pause-2-Play" is an obesity prevention program targeting screen-related sedentary behaviours and increasing physical activity among elementary school students. The program consisted of a Behavioural Modification Curriculum and a Health Promoting Afterschool Program. This pilot study reports program feasibility, practicability, and impact. METHODS: the 12-week pilot program was implemented with 32 grade five and six students. Program feasibility and practicability were assessed us...
Gregory Killough; Danielle Battram; Joanne Kurtz; Gillian Mandich; Laura Francis; Meizi He
This paper presents details the Healthy Foods Hawaii (HFH) intervention trial, aimed to improve children's dietary behavior to prevent child obesity, by modifying the food environment with community-selected foods. Four communities were selected by ethnic composition, income level, two on Oahu and one neighbor island. On each island one community was randomly assigned to intervention and one to control. The intervention was implemented through food stores in the intervention communities...
OBJECTIVE: To use epidemiological data and a standardized economic model to compare projected costs for obesity prevention in late adolescence accrued using a cross-sectional weight classification for selecting adolescents at age 15 years compared with a longitudinal classification. less thanbrgreater than less thanbrgreater thanMETHODS: All children born in a Swedish county (population 440 000) in 1991 who participated in all regular measurements of height and weight at ages 5, 10 and 15 yea...
Ekberg, Joakim; Angbratt, Marianne; Valter, L.; Nordwall, Maria; Timpka, Toomas
Service evaluation of a community-based healthy lifestyle programme, designed for families aimed at preventing obesity. Physiological and behaviour measures were recorded at the beginning and end of the programme. Out of a total of 454 participants, 358 (79%) completed. From these completers 293 (64%) were analysed as there was sufficient data. The use of high visibility recruitment led to 77% of completers being from Coventry's two most deprived population quintiles. Ethnic minorities ...
Towey, Marsha; Harrell, Ruth; Lee, Berni
Over the past decade, motivational interviewing has been used by health professionals to promote health behavior changes and help individuals increase their motivation or readiness to change. This paper describes a preliminary study used to evaluate the feasibility of motivational interviewing as a component in a school-based obesity prevention program, New Moves. New Moves is a program for inactive adolescent high school girls who are overweight or at risk for becoming overweight due t...
Flattum, Colleen; Friend, Sarah; Neumark-sztainer, Dianne; Story, Mary
Full Text Available INTRODUCTION: QT prolongation and obesity are associated with ventricular arrhythmia and sudden cardiac death. The relationship between uncomplicated obesity and QT interval prolongation is not clear. OBJECTIVES: The aim of the study was to investigate the effects of uncomplicated obesity on QT interval in young men. PATIENTS AND METHODS: A total of 122 men, including 59 obese patients and 63 controls, were recruited into the study. Patients with hypertension, diabetes mellitus, and ischemic heart disease were ineligible. Body mass index (BMI of all patients was calculated. QT interval was measured from the precordial lead V5, and corrected QT (QTC was calculated using the Bazetts formula. RESULTS: Mean age, BMI, and waist circumference (WC of obese patients and controls were as follows: 22.0 ±3.0 years, 36.2 ±2.2 kg/m², and 114 ±8.1 cm; 22.6 ±2.9 years, 24.7 ±2.5 kg/m², and 81.6 ±7.5 cm, respectively. There was a statistically significant difference between the obese and control groups with regard to BMI and WC (P <0.001. Furthermore, statistically significant differences were observed between the 2 groups in terms of QTC (407.9 ±17.1 ms vs. 397.7 ±14.0 ms, respectively, P <0.001, systolic (126.9 ±8.2 mmHg vs. 114.2 ±11.1 mmHg, respectively, P <0.001 and diastolic blood pressure (78.3 ±4.5 mmHg vs. 66.9 ±10 mmHg, respectively, P <0.001. There was a positive correlation between QTC interval and both WC (r = 0.357, P <0.001 and BMI (r = 0.424, P <0.001. There was no association between QTC and blood pressure. CONCLUSIONS: Uncomplicated obesity in young men is associated with QT interval prolongation. Weight gain may inversely affect cardiac repolarization in uncomplicated obesity.
Full Text Available Abstract Background Studies have shown that a proportion of children as young as two years are already overweight. This indicates that obesity prevention programs that commence as early as possible and are family-focused are needed. This Healthy Beginnings Trial aims to determine the efficacy of a community-based randomized controlled trial (RCT of a home visiting intervention in preventing the early onset of childhood overweight and obesity. The intervention will be conducted over the first two years of life to increase healthy feeding behaviours and physical activity, decrease physical inactivity, enhance parent-child interaction, and hence reduce overweight and obesity among children at 2 and 5 years of age in the most socially and economically disadvantaged areas of Sydney, Australia. Methods/design This RCT will be conducted with a consecutive sample of 782 first time mothers with their newborn children. Pregnant women who are expecting their first child, and who are between weeks 24 and 34 of their pregnancy, will be invited to participate in the trial at the antenatal clinic. Informed consent will be obtained and participants will then be randomly allocated to the intervention or the control group. The allocation will be concealed by sequentially numbered, sealed opaque envelopes containing a computer generated random number. The intervention comprises eight home visits from a specially trained community nurse over two years and pro-active telephone support between the visits. Main outcomes include a duration of breastfeeding measured at 6 and 12 months, b introduction of solids measured at 4 and 6 months, c nutrition, physical activity and television viewing measured at 24 months, and d overweight/obesity status at age 2 and 5 years. Discussion The results of this trial will ascertain whether the home based early intervention is effective in preventing the early onset of childhood overweight and obesity. If proved to be effective, it will result in a series of recommendations for policy and practical methods for promoting healthy feeding and physical activity of children in the first two years of life with particular application to families who are socially and economically disadvantaged.
In recent years, obesity is the most common metabolic disease emerging as a global problem especially in developed nations. The discovery of bioactive compounds from natural plant extracts is one possible way to control obesity and prevent or reduce the risks of getting various obesity-related diseases. In this study, we elucidated that Nepetae spica extract significantly reduced the body weight gain induced through feeding a high-fat diet to C57BL/6 mice. The treatment of Nepetae spica extra...
Changhyun Roh; Min-Kyoung Park; Hee-June Shin; Insub Kim; Jin Kyu Kim; Uhee Jung
This dissertation examines methods used to evaluate the cost-effectiveness of childhood obesity interventions in order to help decision-makers prioritize among competing health programs using standardized outcomes. Chapter 1 generates inputs for use in cost-effectiveness analyses (CEAs) of childhood obesity interventions. In Chapter 1.1, I use data from the Medical Expenditure Panel Survey to predict expenditures associated with obesity in childhood and adolescence. I found that obese childre...
Full Text Available Abstract Background Kids - 'Go for your life' (K-GFYL is an award-based health promotion program being implemented across Victoria, Australia. The program aims to reduce the risk of childhood obesity by improving the socio-cultural, policy and physical environments in children's care and educational settings. Membership of the K-GFYL program is open to all primary and pre-schools and early childhood services across the State. Once in the program, member schools and services are centrally supported to undertake the health promotion (intervention activities. Once the K-GFYL program 'criteria' are reached the school/service is assessed and 'awarded'. This paper describes the design of the evaluation of the statewide K-GFYL intervention program. Methods/Design The evaluation is mixed method and cross sectional and aims to: 1 Determine if K-GFYL award status is associated with more health promoting environments in schools/services compared to those who are members only; 2 Determine if children attending K-GFYL award schools/services have higher levels of healthy eating and physical activity-related behaviors compared to those who are members only; 3 Examine the barriers to implementing and achieving the K-GFYL award; and 4 Determine the economic cost of implementing K-GFYL in primary schools Parent surveys will capture information about the home environment and child dietary and physical activity-related behaviors. Environmental questionnaires in early childhood settings and schools will capture information on the physical activity and nutrition environment and current health promotion activities. Lunchbox surveys and a set of open-ended questions for kindergarten parents will provide additional data. Resource use associated with the intervention activities will be collected from primary schools for cost analysis. Discussion The K-GFYL award program is a community-wide intervention that requires a comprehensive, multi-level evaluation. The evaluation design is constrained by the lack of a non-K-GFYL control group, short time frames and delayed funding of this large scale evaluation across all intervention settings. However, despite this, the evaluation will generate valuable evidence about the utility of a community-wide environmental approach to preventing childhood obesity which will inform future public health policies and health promotion programs internationally. Trial Registration ACTRN12609001075279
This study evaluated the anti-obesity effects of HT048, a combination of C. pinnatifida fruit and C. unshiu peel extracts, in high-fat diet (HFD)-induced obese rats. 4-Week-old male Sprague Dawley (SD) rats were divided into normal and high fat diet (HFD) groups. The HFD groups were further divided into five groups treated with distilled water, orlistat (40 mg/kg, twice daily, p.o) and HT048 (30, 100 and 300 mg/kg, twice daily, p.o.) for 12 weeks. Orlistat, an anti-obesity drug, was used as p...
Dong Wook Lim; MiKyung Song; Juyeon Park; Sang Woug Park; Nak Hoon Kim; Bhakta Prasad Gaire; Ho-Young Choi; Hocheol Kim
Obesity is a major international problem related to many reproductive health problems including polycystic ovary syndrome (PCOS). This article reviews the evidence of being overweight and its effect on female reproduction. The fecundity of obese women is lower than normal weight women, but there is no absolute consensus about the effect of obesity on infertility treatment. The obese patient might have oocyte, hormone, metabolic and endometrial dysfunction affecting reproduction. Insulin and leptin may be some of the answers explaining anovulation during obesity leading to infertility. Moreover, the follicular glucose and lipids which are important for oocyte development also increase in the obese patient and these might have an effect on oocyte quality because studies in mice have revealed that the obesity affects follicular cell stress and oocyte lipids. Overall, obesity affects female reproduction by disturbing the general body metabolism, hormone metabolism and the follicular environment. PMID:24188449
Pantasri, Tawiwan; Norman, Robert John
Abstract Background The prevalence of childhood obesity has increased during the past decades and is now considered an urgent public health problem. Although stabilizing trends in obesity prevalence have been identified in parts of Europe, preventive efforts in children are still needed. Using the socio-ecological approach as the underlying theoretical perspective, the IDEFICS project aimed to develop, implement and evaluate a community-based intervention for the prevention o...
Verbestel Vera; De Henauw Stefaan; Maes Lea; Haerens Leen; Mårild Staffan; Eiben Gabriele; Lissner Lauren; Moreno Luis A; Frauca Natalia; Barba Gianvincenzo; Kovács Éva; Konstabel Kenn; Tornaritis Michael; Gallois Katharina; Hassel Holger
The nation faces an obesity crisis, especially among low-income children and children of color. Today, nearly one-third of children and adolescents are overweight or obese, and physical inactivity is a leading cause of this epidemic. Equitable transportation policy that fosters healthy, opportunity-rich communities has a critical role to play in
Robert Wood Johnson Foundation, 2012
Childhood obesity has become an epidemic on a worldwide scale. This article gives an overview of the progress made in childhood and adolescent obesity research in the last decade, with a particular emphasis on the transdisciplinary and complex nature of the problem. The following topics are addressed: (1) current definitions of childhood and
A systemic reappraisal of the thermic effect of food was done in lean and obese males randomly fed mixed meals containing 0, 8, 16, 24, and 32 kcal/kg fat-free mass. Densitometric analysis was used to measure body composition. Preprandial and postprandial energy expenditures were measured by indirect calorimetry. The data show that the thermic effect of food was linearly correlated with caloric intake, and that the magnitude and duration of augmented postprandial thermogenesis increased linea...
Full Text Available Purpose:Obesity has been identified as a risk factor for the development of bulimia nervosa (BN in those who try to lose weight. The purpose of the present study was to examine the effect of walking exercise in order to provide a method for overcoming bulimia nervosa in obese young women suffering from bulimia nervosa.Methods: Twenty obese women with bulimia nervosa (body mass index [BMI]>30 and a mean age of 22.00 ± 1.50 years volunteered to participate in this study. They were randomly assigned to exercise (n=10 and control (n=10 groups. Both groups underwent anthropometric measurements and blood analysis before and after the training program. Exercise program included 30-minute walking sessions at 50-75% of maximal heart rate,3 days per week and for 2 months.Results: After 2 months significant changes were observed in all anthropometric variables (P<0.001.Percent body fat, fat mass, BMI, body weight and lean mass changes in response to training were significant in the exercise group (P<0.001.Conclusion:This study demonstrated that moderate aerobic exercises such as moderate walking are suitable behavior therapies for overcoming bulimia nervosa in obese young women.
Obesity during childhood is a dominant risk factor for noncommunicable diseases (NCDs), and is itself considered a disease that needs to be treated. Recently, the growth in childhood obesity in Korea has become stagnant; however, two in every ten children are still overweight. In addition, 60% or more of overweight children have at least one metabolic syndrome risk factor. Thus, childhood obesity should be controlled through lifestyle modification. This paper reviews studies of the modifiable risk factors of obesity in Korean children. According to the life-course approach, preschool-aged children (skipping meals, eating out, and high fat intake, along with low physical activity, facilitate increased obesity among adolescents (12 to 18 years). Notably, adolescent girls show high rates of both underweight and obesity, which may lead to the development of NCDs in their offspring. Therefore, the problem of NCDs is no longer limited to adults, but is also prevalent among children. In addition, early intervention offers cost-effective opportunities for preventing NCDs. Thus, children need primary consideration, adequate monitoring, diagnosis, and treatment to reduce the burden of NCDs later in adulthood. PMID:23946875
Lee, Hye Ah; Park, Hyesook
Since the 1970s, the proportion of overweight and obese people in the United States has grown at an alarming rate. An awareness of the consequences of obesity on the health and well-being of individuals is evident in the plethora of strategic plans at the local and national levels, most of which have largely fallen short of their goals. If interventions continue to be unsuccessful, it is estimated that approximately three of four Americans will be overweight or obese by 2020. Prevention of excess weight gain can be accomplished with relatively small changes in lifestyle behaviours to control body weight. Small sustainable changes are perhaps better than efforts to achieve larger changes that cannot be sustained. Legumes can be a valuable food by which the needs of the undernourished or under-served populations could be met. They can be incorporated into meat products, such as sausages and burgers, to lower the energy density of these foods while providing important nutrients. Replacing energy-dense foods with legumes has been shown to have beneficial effects on the prevention and management of obesity and related disorders, such as cardiovascular disease, diabetes and the metabolic syndrome. This review explores the nutritional value and obesity-related health benefits of legume consumption while focusing on pulses. PMID:24433379
Rebello, C J; Greenway, F L; Finley, J W
Abstract Aim Obesity is generally linked to complications in lipid metabolism and oxidative stress. The aim of this study was to compare the effect of a proprietary extract of Cissus quadrangularis (CQR-300) to that of a proprietary formulation containing CQR-300 (CORE) on weight, blood lipids, and oxidative stress in overweight and obese people. Methods The first part of the study investigated the in vitro antioxidant properties of CQR-300 and...
The prevalence of obesity and its associated health problems have increased sharply in the past 2 decades. New revisions to Medicare policy will allow funding for obesity treatments of proven efficacy. The authors review studies of the long-term outcomes of calorie-restricting diets to assess whether dieting is an effective treatment for obesity.
Mann, Traci; Tomiyama, A. Janet; Westling, Erika; Lew, Ann-Marie; Samuels, Barbra; Chatman, Jason
Full Text Available Abstract Background In Australia, the food industry and public health groups are locked in serious struggle for regulatory influence over the terms of front-of-pack food labelling. Clear, unambiguous labelling of the nutritional content of pre-packaged foods and of standardized food items sold in chain restaurants is consistent with the prevailing philosophy of 'personal responsibility'. An interpretive, front-of-pack labelling scheme has the capacity to encourage healthier patterns of eating, and to be a catalyst for improvements in the nutritional quality of food products through re-formulation. On the other hand, the strength of opposition of the Australian Food and Grocery Council to 'Traffic Light Labelling', and its efforts to promote a non-interpretive, voluntary scheme, invite the interpretation that the food industry is resistant to any reforms that could destabilise current (unhealthy purchasing patterns and the revenues they represent. Discussion This article argues that although policies that aim to educate consumers about the nutritional content of food are welcome, they are only one part of a broader basket of policies that are needed to make progress on obesity prevention and public health nutrition. However, to the extent that food labelling has the capacity to inform and empower consumers to make healthier choices - and to be a catalyst for improving the nutritional quality of commercial recipes - it has an important role to play. Furthermore, given the dietary impact of meals eaten in fast food and franchise restaurants, interpretive labelling requirements should not be restricted to pre-packaged foods. Summary Food industry resistance to an interpretive food labelling scheme is an important test for government, and a case study of how self-interest prompts industry to promote weaker, voluntary schemes that pre-empt and undermine progressive public health regulation.
Magnusson Roger S
Few interventions have focused on very young children for obesity prevention. This study evaluated a pilot intervention to improve the nutrition and physical activity environments of child care centers serving infants and toddlers. This randomized controlled trial took place in 32 centers in Boston, Massachusetts. The intervention aimed to improve policies and practices related to nutrition and physical activity within the center. For the outcome, observers assessed center environments using the Environment and Policy Assessment and Observation (EPAO) instrument (range 0-320 points) at baseline and the 6-month follow-up. We fit linear regression models with change in EPAO score from baseline to follow-up, controlling for potential confounders for total score, nutrition sub-score, and physical activity sub-score. Intervention centers had a mean (SD) of 98.2 (144.8) children enrolled, while control centers had 59.2 (34.5). In intervention centers, 47.5 % of children were white, compared to 46.2 % in controls. Fewer intervention centers had outdoor play areas on site (75 vs. 100 %) but more had indoor play space (67 vs. 25 %). At baseline, intervention centers had a mean (SD) EPAO score of 134.5 (7.0) points and controls had 146.8 (4.8) points. Compared with controls, intervention centers improved their EPAO scores at follow-up by 18.5 points (95 % CI 0.1, 37.0; p = 0.049), chiefly through greater improvement in physical activity (12.2; 95 % CI -1.6, 26.0; p = 0.075) and not nutrition (6.4; 95 % CI -7.1, 19.8; p = 0.385). The pilot showed promise as an intervention to improve center environments, but future studies should include child-level outcomes. PMID:24065371
Benjamin Neelon, Sara E; Taveras, Elsie M; Ostbye, Truls; Gillman, Matthew W
Full Text Available This study aimed to analyse the impact of obesity in type 2 diabetes (T2D on adipocytokines (adiponectin, leptin and resistin and inflammatory markers (TNF-?, IL-6 and hsCRP as cardiovascular risk factors. A cross-sectional study comparing the basal levels of adipocytokines and inflammatory markers was done in 18 obese (BMI ? 30 kg/m2 (group A, 21 overweight (25 kg/m2 ? BMI < 30 kg/m2 (group B, 25 non-obese T2D patients (group C and 15 non-obese controls (group D. The lowest levels of adiponectin and the highest levels of leptin, resistin, TNF-?, IL-6 and hsCRP were found in group A. Adiponectin levels were significantly lower, and resistin, TNF-?, and hsCRP levels were elevated in group C vs. D. However, leptin and IL-6 levels differed significantly between groups A and B, but not between groups C and D. Moreover, we found a significant negative correlation between adiponectin and TNF-?, but not with other markers, which was independent of the presence of obesity. In contrast, leptin and resistin correlated with the inflammatory markers, and this correlation was obesity-dependent. Our results suggest that obesity influences cardiovascular risk primarily through changes in leptin and resistin and less efficiently at the level of adiponectin.
Full Text Available Abstract Recent studies demonstrated that obesity is associated with prostate cancer aggressiveness and prognosis. However, the mechanisms underlying this relationship are poorly understood. Tumor microenvironment has been increasingly considered as an important determinant of cancer growth and progression. In the light of this growing evidence, Ribeiro et al., in a BMC Medicine research article, investigated the gene expression profiles of periprostatic adipose tissue of obese patients with and without prostate cancer and compared them to those of lean patients. Their findings provide the first evidence of a differential gene expression in the periprostatic adipose tissue of obese individuals. Differences were also observed when comparing the periprostatic adipose tissue of patients with and without prostate cancer. Differentially expressed genes are related to cell proliferation and immunological responses. Besides suggesting the genetic bases for the observed relationship between obesity and prostate cancer aggressiveness, these findings provide new insights on the important link between local microenvironment and cancer progression.
Full Text Available Obesity and its concomitant health risks are among the most common conditions managed by health care practitioners. The limited long-term effectiveness of conventional weight management has led to researching alternative medicine and one which is widely accepted is the herbal products by virtue of its safety in long term use. The study was conducted to evaluate effect of caplet of Garcinia extract with reference to reduction in BMI and skin fold thickness in obese individuals. This study was performed according to a double-blind, randomized, placebo-controlled, design. Subjects aged 18 to 60 years with Obesity as decided by BMI > 25 Kg/m2 to 35 Kg/m2 falling in the category of overweight and class I obesity were included in the study. A total of 110 individuals participated in the study. Subjects were randomly assigned into two groups of 55 each to receive treatment for 4 months with Garcinia or matching placebo at a dose of 1 caplet twice daily. All the subjects completed the study as stipulated. At the end of 4 months, Garcinia group had significant reduction in BMI and skin fold thickness when compared to the placebo group and baseline values respectively. No severe adverse effect was observed at any time in the study period. Compliance to treatment was good. It is therefore expected that Garcinia may be useful for the prevention and reduction of obesity.
...Healthcare cuts may have lasting effect on obesity: Think tank | EurActiv Despite the steady rise in obesity in the EU, ... health,diabetes,obesity EU news & policy debates- across languages - en fr Click here for EU news »x Search this ...VIDEOS Home Health & Consumers News Healthcare cuts may have lasting effect on obesity: Think tank -A + A Published 11 April 2013 ...comment Tags diabetes, Health, obesity Cuts in healthcare budgets today might reduce public expenses in the short-run but lead to higher costs in the ...
Objective: To describe and contrast individual state nutrition and physical activity regulations related to childhood obesity for child care centers and family child care homes in the United States. Methods: We conducted a review of regulations for child care facilities for all 50 states and the District of Columbia. We examined state regulations and recorded key nutrition and physical activity items that may contribute to childhood obesity. Items included in this review were: 1) Water is fre...
Benjamin, Sara E.; Slining, Meghan; Walker, Elizabeth M.; Cradock, Angie Lynn; Gillman, Matthew William
ABSTRACT Objective To describe and contrast individual state nutrition and physical activity regulations related to childhood obesity for child care centers and family child care homes in the United States. Methods We conducted a review of regulations for child care facilities for all 50 states and the District of Columbia. We examined state regulations and recorded key nutrition and physical activity items that may contribute to childhood obesity. Items include...
Benjamin Sara E; Cradock Angie; Walker Elizabeth M; Slining Meghan; Gillman Matthew W
Full Text Available Obesity is a chronic, multifactorial, increasing prevalence, which along with being overweight affects more than half the population in developed countries. The aim of this paper is to set basic guidelines regarding the training load, frequency, duration, intensity, etc. in physical activity programs aimed at obese people, propose three concrete guidelines for action. The aim is to contribute to a better understanding of physical activity programs in this population.
Gema Torres Luque
Abstract Background The prevalence of overweight and obesity in Europe is high. It is a major cause of the overall rates of many of the main chronic (or non communicable) diseases in this region and is characterized by an unequal socio-economic distribution within the population. Obesity is largely determined by modifiable lifestyle behaviours such as low physical activity levels, sedentary behaviour and consumption of energy dense diets. It is increasingly being recognised t...
Lakerveld Jeroen; Brug Johannes; Bot Sandra; Teixeira Pedro J; Rutter Harry; Woodward Euan; Samdal Oddrun; Stockley Lynn; De Bourdeaudhuij Ilse; van Assema Patricia; Robertson Aileen; Lobstein Tim; Oppert Jean-Michel; Ádány Róza (1952-) (orvos); Nijpels Giel
Obesity has emerged as one of the principle worldwide health concerns of the modern era, and there exists a tremendous unmet clinical need for safe and effective therapies to combat this global pandemic. The prevalence of obesity and its associated co-morbidities, including cardiovascular and metabolic diseases, has focused drug discovery and development on generating effective modalities for the treatment and prevention of obesity. Early efforts in the field of obesity pharmacotherapy center...
Valentino, Michael A.; Lin, Jieru E.; Waldman, Scott A.
Full Text Available This study evaluated the anti-obesity effects of HT048, a combination of C. pinnatifida fruit and C. unshiu peel extracts, in high-fat diet (HFD-induced obese rats. 4-Week-old male Sprague Dawley (SD rats were divided into normal and high fat diet (HFD groups. The HFD groups were further divided into five groups treated with distilled water, orlistat (40 mg/kg, twice daily, p.o and HT048 (30, 100 and 300 mg/kg, twice daily, p.o. for 12 weeks. Orlistat, an anti-obesity drug, was used as positive control in the HFD-induced obese rats. We measured the food intake, body weight, epididymal adipose tissue and liver weights, and serum total cholesterol (TC, triglyceride (TG, alanine transaminase (ALT, and aspartate aminotransferase (AST levels. The body weight and epididymal adipose tissue and liver weights of the HT048 100 and 300 mg/kg treated groups were significantly lower than that of the HFD control group. Also, serum TC, TG, ALT, and AST levels in the HT048 100 and 300 mg/kg treated groups were significantly decreased. Moreover, the orlistat treated group showed significantly reduced body weight and improved serum lipoprotein, compared with the HFD control group. These results show that HT048 supplements improved obesity-related body weight and serum lipoprotein parameters in a HFD-induced obese rat model.
Obesity prevention should remain a priority, even if there is some suggestion that the epidemic may presently have reached a stable level. However, previous interventions have not been effective in preventing overweight and obesity, and at the same time studies suggest that some subgroups are more predisposed to future obesity. The purpose of this paper is to review interventions on obesity prevention published during the past year, and to examine if interventions targeting predisposed groups or individuals seem more efficient in preventing obesity than studies targeting general populations. Among 15 identified studies, 7 targeted predisposed children or adolescents. More of the studies targeting predisposed individuals were able to show significant effects than the studies targeting general populations. Most studies targeting predisposed defined the predisposition based on ethnicity or socioeconomic status. Thus, we may be more successful in preventing obesity when targeting predisposed individuals, but morestudies are needed before a firm conclusion can be drawn.
Olsen, Nanna Julie; Mortensen, Erik Lykke
Bariatric surgery is a component of the multimodal treatment of obesity, which consists of multidisciplinary evaluation and diagnosis, conservative and surgical treatments, and lifelong follow-up care. The current guideline extends the BMI-based spectrum of indications that was previously proposed (BMI greater than 40 kg/m(2), or greater than 35 kg/m(2) with secondary diseases) by eliminating age limits, as well as most of the contraindications. A prerequisite for surgery is that a structur...
Dimitrov, Dimiter V.; Ivanov, Valkan; Atanasova, Maria
Full Text Available The objective of this study was to analyze the effects of aquatic exercise and nutritionalguidance on the body composition of obese children and adolescents. Thirty obese childrenaged 10 to 16 years, with a body mass index (BMI above the 95th percentile according to theclassification proposed by the Centers for Disease Control and Prevention (CDC, 2000, weredivided into two groups: the first group started learning to swim (GSwim, n = 10 and the secondgroup underwent a deep water running program (GDeep, n = 20. Weight, height, BMI, BMIZ-scores, relative and absolute fat, and relative and absolute lean body mass were evaluated atbaseline and after 12 weeks. The program consisted of 12 meetings for nutritional guidance (oncea week and 36 sessions of exercise (three times per week. MANOVA and Fishers exact testwere used for statistical analysis, with the level of significance set at p < 0.05. After 12 weeks,GDeep showed a significant reduction in BMI, BMI Z-scores and relative and absolute fat,and an increase in relative and absolute lean body mass. Significant differences were observedbetween GDeep and GSwim in terms of the reduction in body fat (p = 0.014 and the increasein lean mass (p = 0.006. A program of deep water running together with nutritional guidancemay promote significant changes in the body composition of obese children and adolescents dueto the cyclic characteristic of this physical activity.
Gerusa Eisfeld Milano
Capsaicinoids show several pharmacological effects including weight loss. However, their pungency limits the long-term use through the gastrointestinal tract. In that sense, the goal of this study was to prepare capsaicinoids-loaded poly(?-caprolactone) microparticles as an oral carrier in order to improve their gastric tolerability and to make feasible the long-term treatment of obesity. Formulations containing 3, 5 and 10% capsaicinoids were successfully obtained by simple emulsion/solvent evaporation method. Values of encapsulation efficiency above 90% were achieved. Microparticles showed spherical shape and smooth surface. The particle size was suitable for oral use in order to provide an extended release through the gastrointestinal tract. No chemical bond was observed between drug and polymer. Microencapsulation led to drug amorphization. Formulations prolonged the release of capsaicinoids without changing the release kinetic (biexponential model). Microencapsulation increased the gastric tolerability of capsaicinoids because it prevented inflammatory processes in the stomach of rats. Microparticles containing 5% capsaicinoids demonstrated a statistically significant reduction of Lee index, mesenteric and retroperitoneal fat pads of rats with obesity induced by hypothalamic lesion using monosodium l-glutamate. In summary, capsaicinoids-loaded poly(?-caprolactone) microparticles are low-irritative oral controlled-release carriers for a long-term use in obesity. PMID:24857502
Almeida, Martinha A; Nadal, Jessica M; Grassiolli, Sabrina; Paludo, Katia S; Zawadzki, Sônia F; Cruz, Letícia; Paula, Josiane P; Farago, Paulo V
Full Text Available Abstract Background Childhood obesity in rural communities is a serious but understudied problem. The current experiment aims to assess a wide range of obesity risk factors among rural youth and to offer an 8-month intervention program for parents to reduce obesity risk in their preteen child. Methods/Design A two-group, repeated measures design is used to assess the effectiveness of the 4-Health intervention program. Assessments include anthropometric measures, child self-evaluations, parent self-evaluations, and parent evaluations of child. County Extension agents from 21 rural Montana counties recruit approximately 150 parentchild dyads and counties are semi-randomly assigned to the active intervention group (4-Health Educational Program or a best-practices (Healthy Living Information control group. Discussion This study will shed light on the effectiveness of this parent-only intervention strategy in reducing obesity risk factors among rural preteens. The 4-Health program is designed to provide information and skills development for busy rural parents that will increase healthy lifestyles of their preteen children and improve the parents ability to intervene effectively in the lives of their families during this critical developmental period. Trial registration ClinicalTrials.gov ID: NCT01510587
Lynch Wesley C
Full Text Available The prevalence of overweight and obesity and their associated metabolic disorders are considered a major threat to the publics health. While several diet and exercise programs are available for weight loss and prevention of weight regain, progress is often slow and disappointing. Recently, natural bioactive phytochemicals present in foods have been discovered for their potential health benefit effects on the prevention of chronic disorders such as cancer, cardiovascular disease, inflammatory and metabolic diseases including obesity.Polyphenols are a class of naturally-occurring phytochemicals, of which some such as catechins, anthocynines, resveratrol and curcumin have been shown to modulate physiological and molecular pathways that are involved in energy metabolism, adiposity, and obesity. The potential in vivo, beneficial effects of these polyphenols on adiposity and obesity as complementary agents in the up-regulation of energy expenditure have emerged by investigating these compounds in cell cultures, animal models of obesity and in some human clinical and epidemiological studies. In this brief review, the efficacy of the above-named polyphenols and their potential efficacy to modulate obesity and some associated disorders are discussed.
The Bellagio 'Conference on Program and Policy Options for Preventing Obesity in the Low- and Middle-Income Countries' (LMICs) was organized to pull together the current. We need not reiterate the importance of this topic or the speed of change in eating, drinking and moving facing us across the globe. The conference emerges from need to significantly step up the policies and programs to reduce obesity by learning from some current examples of best practice and strengthening the role of the academic and civil society players in translating global evidence and experience into action at the national level. There is also a need to empower the younger generation of scholars and activists in these countries to carry on this effort. The meeting was also timely because a number of funding agencies in the United States, Canada and the UK, at least, are beginning to focus attention on this topic. This set of papers provides not only examples of existing best practice but also a road map ahead for LMICs in the various areas of action needed to reduce obesity across LMICs. The meeting highlighted critical barriers to implementation that have blocked many initiatives. PMID:24102826
Popkin, B; Monteiro, C; Swinburn, B
Full Text Available ABSTRACT Objective To describe and contrast individual state nutrition and physical activity regulations related to childhood obesity for child care centers and family child care homes in the United States. Methods We conducted a review of regulations for child care facilities for all 50 states and the District of Columbia. We examined state regulations and recorded key nutrition and physical activity items that may contribute to childhood obesity. Items included in this review were: 1 Water is freely available; 2 Sugar-sweetened beverages are limited; 3 Foods of low nutritional value are limited; 4 Children are not forced to eat; 5 Food is not used as a reward; 6 Support is provided for breastfeeding and provision of breast milk; 7 Screen time is limited; and 8 Physical activity is required daily. Results Considerable variation exists among state nutrition and physical activity regulations related to obesity. Tennessee had six of the eight regulations for child care centers, and Delaware, Georgia, Indiana, and Nevada had five of the eight regulations. Conversely, the District of Columbia, Idaho, Nebraska and Washington had none of the eight regulations. For family child care homes, Georgia and Nevada had five of the eight regulations; Arizona, Mississippi, North Carolina, Oregon, Tennessee, Texas, Vermont, and West Virginia had four of the eight regulations. California, the District of Columbia, Idaho, Iowa, Kansas, and Nebraska did not have any of the regulations related to obesity for family child care homes. Conclusion Many states lack specific nutrition and physical activity regulations related to childhood obesity for child care facilities. If widely implemented, enhancing state regulations could help address the obesity epidemic in young children in the United States.
Full Text Available Primary paediatric health care is the foundation for preventative child health. In light of the recent obesity epidemic, paediatricians find themselves at the frontline of identification and management of childhood obesity. However, it is well recognized that evidence based approaches to obesity prevention and subsequent translation of this evidence into practice are critically needed. This paper explores the role of primary care in obesity prevention and introduces a novel application and development of a primary care research network in CanadaTARGet Kids!to develop and translate an evidence-base on effective screening and prevention of childhood obesity.
Catherine S. Birken
Background: South Africa is experiencing a unique double burden of disease due to the nutrition transition, facing diseases related to both under and over nutrition. Childhood obesity is associated with a poor childhood diet, physical inactivity and sedentary lifestyle. Promoting healthy eating and physical activity is important. Promoting healthy eating patterns and regular activity are essential components of lifestyle modification of children. An obesity prevention programme with elements ...
Although pediatric providers have traditionally assessed and treated childhood obesity and associated health-related conditions in the clinic setting, there is a recognized need to expand the provider role. We reviewed the literature published from 2005 to 2012 to (1) provide examples of the spectrum of roles that primary care providers can play in the successful treatment and prevention of childhood obesity in both clinic and community settings and (2) synthesize the evidence of important ch...
Vine, Michaela; Hargreaves, Margaret B.; Briefel, Ronette R.; Orfield, Cara
Osteopontin (OPN) is a multifunctional extracellular matrix (ECM) protein involved in multiple physiological processes. OPN expression is dramatically increased in visceral adipose tissue in obesity and the lack of OPN protects against the development of insulin resistance and inflammation in mice. We sought to unravel the potential mechanisms involved in the beneficial effects of the absence of OPN. We analyzed the effect of the lack of OPN in the development of obesity and hepatic steatosis induced by a high-fat diet (HFD) using OPN-KO mice. OPN expression was upregulated in epididymal white adipose tissue (EWAT) and liver in wild type (WT) mice with HFD. OPN-KO mice had higher insulin sensitivity, lower body weight and fat mass with reduced adipose tissue ECM remodeling and reduced adipocyte size than WT mice under a HFD. Reduced MMP2 and MMP9 activity was involved in the decreased ECM remodeling. Crown-like structure number in EWAT as well as F4/80-positive cells and Emr1 expression in EWAT and liver increased with HFD, while OPN-deficiency blunted the increase. Moreover, our data show for the first time that OPN-KO under a HFD mice display reduced fibrosis in adipose tissue and liver, as well as reduced oxidative stress in adipose tissue. Gene expression of collagens Col1a1, Col6a1 and Col6a3 in EWAT and liver, as well as the profibrotic cytokine Tgfb1 in EWAT were increased with HFD, while OPN-deficiency prevented this increase. OPN deficiency prevented hepatic steatosis via reduction in the expression of molecules involved in the onset of fat accumulation such as Pparg, Srebf1, Fasn, Mogat1, Dgat2 and Cidec. Furthermore, OPN-KO mice exhibited higher body temperature and improved BAT function. The present data reveal novel mechanisms of OPN in the development of obesity, pointing out the inhibition of OPN as a promising target for the treatment of obesity and fatty liver.
Lancha, Andoni; Rodriguez, Amaia; Catalan, Victoria; Becerril, Sara; Sainz, Neira; Ramirez, Beatriz; Burrell, Maria A.; Salvador, Javier; Fruhbeck, Gema; Gomez-Ambrosi, Javier
Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Poucos estudos obtiveram resultados favoráveis na prevenção da obesidade. Teoricamente, crianças e adolescentes, se comparados aos adultos, poderiam mais facilmente prevenir o ganho excessivo de peso, pois estão crescendo e têm maior possibilidade de gastar energia em atividades de lazer. Entretanto [...] , não se consegue superar os muitos fatores que concorrem para a crescente epidemia de obesidade e as intervenções na sua maioria abordam uma fração muito pequena dos fatores que geram a obesidade. Aspectos importantes, como o papel da indústria de alimentos, das cadeias de fast food, das propagandas, de um estilo de vida que mantêm as crianças cada vez mais sedentárias e submetidas a um hiperconsumo calórico, não têm espaço nos desenhos de estudos tradicionais. Das intervenções publicadas, as que integram a família no tratamento têm obtido melhores resultados. Estudos com elementos isolados da dieta como cálcio, proteína, fibras e índice glicêmico não têm mostrado eficácia, e embora não conclusivos, os resultados referentes à redução de bebidas com alto teor de açúcar e redução do sedentarismo são promissores. Abstract in english Few studies on treatment or prevention of obesity have shown significant results. Theoretically, in children and adolescents as compared to adults, prevention of excessive weight gain should be easy due to the energy expended during growth, associated with more time spent in leisure-time activities. [...] However, numerous factors that stimulate overeating and sedentary behaviors are difficult to overcome. Additionally, most intervention studies have focused on a minor portion of the many factors associated with obesity. Important aspects of the obesity epidemic such as the role of the food industry, fast food chains, advertising, and a lifestyle that limits children to sedentary activities and overeating cannot be explored by a traditional clinical trial design. At any rate, among the published interventions, those including the family in weight-reduction strategies have shown the best results, as compared to children-centered approaches. Meanwhile, studies on specific nutrient or dietary composition (such as calcium, protein, or glycemic index) related to prevention or treatment of obesity have failed to yield good results. Reducing the intake of high-sugar carbonated drinks and juices has shown promising but still inconclusive results.
Rosely, Sichieri; Rita Adriana de, Souza.
Full Text Available SciELO Public Health | Language: Portuguese Abstract in portuguese Poucos estudos obtiveram resultados favoráveis na prevenção da obesidade. Teoricamente, crianças e adolescentes, se comparados aos adultos, poderiam mais facilmente prevenir o ganho excessivo de peso, pois estão crescendo e têm maior possibilidade de gastar energia em atividades de lazer. Entretanto [...] , não se consegue superar os muitos fatores que concorrem para a crescente epidemia de obesidade e as intervenções na sua maioria abordam uma fração muito pequena dos fatores que geram a obesidade. Aspectos importantes, como o papel da indústria de alimentos, das cadeias de fast food, das propagandas, de um estilo de vida que mantêm as crianças cada vez mais sedentárias e submetidas a um hiperconsumo calórico, não têm espaço nos desenhos de estudos tradicionais. Das intervenções publicadas, as que integram a família no tratamento têm obtido melhores resultados. Estudos com elementos isolados da dieta como cálcio, proteína, fibras e índice glicêmico não têm mostrado eficácia, e embora não conclusivos, os resultados referentes à redução de bebidas com alto teor de açúcar e redução do sedentarismo são promissores. Abstract in english Few studies on treatment or prevention of obesity have shown significant results. Theoretically, in children and adolescents as compared to adults, prevention of excessive weight gain should be easy due to the energy expended during growth, associated with more time spent in leisure-time activities. [...] However, numerous factors that stimulate overeating and sedentary behaviors are difficult to overcome. Additionally, most intervention studies have focused on a minor portion of the many factors associated with obesity. Important aspects of the obesity epidemic such as the role of the food industry, fast food chains, advertising, and a lifestyle that limits children to sedentary activities and overeating cannot be explored by a traditional clinical trial design. At any rate, among the published interventions, those including the family in weight-reduction strategies have shown the best results, as compared to children-centered approaches. Meanwhile, studies on specific nutrient or dietary composition (such as calcium, protein, or glycemic index) related to prevention or treatment of obesity have failed to yield good results. Reducing the intake of high-sugar carbonated drinks and juices has shown promising but still inconclusive results.
Rosely, Sichieri; Rita Adriana de, Souza.
Full Text Available Poucos estudos obtiveram resultados favoráveis na prevenção da obesidade. Teoricamente, crianças e adolescentes, se comparados aos adultos, poderiam mais facilmente prevenir o ganho excessivo de peso, pois estão crescendo e têm maior possibilidade de gastar energia em atividades de lazer. Entretanto, não se consegue superar os muitos fatores que concorrem para a crescente epidemia de obesidade e as intervenções na sua maioria abordam uma fração muito pequena dos fatores que geram a obesidade. Aspectos importantes, como o papel da indústria de alimentos, das cadeias de fast food, das propagandas, de um estilo de vida que mantêm as crianças cada vez mais sedentárias e submetidas a um hiperconsumo calórico, não têm espaço nos desenhos de estudos tradicionais. Das intervenções publicadas, as que integram a família no tratamento têm obtido melhores resultados. Estudos com elementos isolados da dieta como cálcio, proteína, fibras e índice glicêmico não têm mostrado eficácia, e embora não conclusivos, os resultados referentes à redução de bebidas com alto teor de açúcar e redução do sedentarismo são promissores.Few studies on treatment or prevention of obesity have shown significant results. Theoretically, in children and adolescents as compared to adults, prevention of excessive weight gain should be easy due to the energy expended during growth, associated with more time spent in leisure-time activities. However, numerous factors that stimulate overeating and sedentary behaviors are difficult to overcome. Additionally, most intervention studies have focused on a minor portion of the many factors associated with obesity. Important aspects of the obesity epidemic such as the role of the food industry, fast food chains, advertising, and a lifestyle that limits children to sedentary activities and overeating cannot be explored by a traditional clinical trial design. At any rate, among the published interventions, those including the family in weight-reduction strategies have shown the best results, as compared to children-centered approaches. Meanwhile, studies on specific nutrient or dietary composition (such as calcium, protein, or glycemic index related to prevention or treatment of obesity have failed to yield good results. Reducing the intake of high-sugar carbonated drinks and juices has shown promising but still inconclusive results.
Childhood obesity is likely to persist into adult life and puts individuals at risk for stroke, hypertension, diabetes and other chronic diseases. It is also in childhood where eating habits are formed for a lifetime. Now as never before, the nutrition an...
The obesity crisis in America is ubiquitous and irrefutable, and it's hitting youth so hard that health experts warn that this generation of children will be the first to have a shorter life expectancy than their parents. Tackling and reversing this epidemic will require a comprehensive and sustained effort in every community in America. The
Afterschool Alliance, 2006
Full Text Available Abstract Background Excessive weight gain during pregnancy and subsequent postpartum weight retention may contribute to the epidemic of obesity among women of childbearing age. Preventing excessive gestational weight gain (GWG to optimize maternal, fetal and infant wellbeing is therefore of great importance. A number of dietary interventions in this area has been conducted with inconsistent results, which has made it difficult to identify effective strategies to prevent excessive weight gain during pregnancy among normal weight, overweight and obese women. The primary objective of this review was to evaluate the effect of dietary interventions for reducing GWG. The secondary objective was to examine the impact of these interventions on different child and maternal health outcomes. Method The PUBMED, the Cochrane Central Register of Controlled Trials (CENTRAL and the LILACS databases were searched for relevant articles. All published randomized controlled trials (RCT and quasi-randomized controlled trials (QCT, with concurrent controls, on dietary interventions during pregnancy were considered. Results were presented using relative risk (RR for categorical data and weighted mean difference (WMD for continuous data. Data were primarily analyzed with a fixed-effect model and a random-effects model was used in the presence of heterogeneity. No date and language restrictions were applied. Results In total, 13 studies were included in this review and 10 trials contributed data on total GWG. Dietary intervention significantly reduced total GWG (n = 1434; WMD = -1.92 kg; 95% CI = -3.65/-0.19; p = 0.03, weight retention at six months postpartum (n = 443; WMD = -1.90 kg; 95% CI = -2.69/-1.12; p Conclusion Dietary advice during pregnancy appears effective in decreasing total GWG and long-term postpartum weight retention, but so far there is limited evidence for further benefits on infant and maternal health.
Adegboye Amanda RA
Overweight and obesity have adverse metabolic effects on blood pressure, blood lipids and insulin resistance, consequently increasing the risk of chronic diseases such as type 2 diabetes, cardiovascular diseases, and even certain forms of cancer. Together with abdominal obesity, insulin resistance plays a principal role in initiating and perpetuating the pathological manifestations of the metabolic syndrome. Obesity results from the combined effects of genes, environment and lifestyle. In thi...
Abstract Introduction The effects of obesity on pulmonary functions have not been addressed previously among Saudi population. We aim to study the effects of obesity on spirometry tests among healthy non-smoking adults. Methods A cross sectional study conducted among volunteers healthy non-smoking adults Subjects. We divided the subjects into two groups according to their BMI. The first group consisted of non-obese subjects with BMI of 18 to 24.9 kg/m2 and the s...
Al Ghobain Mohammed
The prevalence of overweight and obesity and their associated metabolic disorders are considered a major threat to the publics health. While several diet and exercise programs are available for weight loss and prevention of weight regain, progress is often slow and disappointing. Recently, natural bioactive phytochemicals present in foods have been discovered for their potential health benefit effects on the prevention of chronic disorders such as cancer, cardiovascular disease, inflammato...
Mohsen Meydani; Hasan, Syeda T.
Full Text Available Abstract Background The recruitment of participants for childhood overweight and obesity prevention interventions can be challenging. The goal of this study was to identify barriers that Dutch youth health care (YHC professionals perceive when referring parents of overweight children to an obesity prevention intervention. Methods Sixteen YHC professionals (nurses, physicians and management staff from eleven child health clinics participated in semi-structured interviews. An intervention implementation model was used as the framework for conducting, analyzing and interpreting the interviews. Results All YHC professionals were concerned about childhood obesity and perceived prevention of overweight and obesity as an important task of the YHC organization. In terms of frequency and perceived impact, the most important impeding factors for referring parents of overweight children to an intervention were denial of the overweight problem by parents and their resistance towards discussing weight issues. A few YHC professionals indicated that their communication skills in discussing weight issues could be improved, and some professionals mentioned that they had low self-efficacy in raising this topic. Conclusions We consider it important that YHC professionals receive more training to increase their self-efficacy and skills in motivating parents of overweight children to participate in obesity prevention interventions. Furthermore, parental awareness towards their childs overweight should be addressed in future studies.
Gerards Sanne MPL
Obesity is reaching epidemic proportions all over the world yet it lacks adequate treatment. Most of the drugs have failed either due to ineffectiveness or adverse effects. Complementary and alternative system of medicine is being used since ancient times. However, many of them have not been tested for efficacy and safety using modern scientific methods. Therefore, the antiobesity effect of Safoof Mohazzil, a polyherbal formulation, was evaluated in cafeteria diet induced obesity in female Sprague Dawley rats. Animals weighing 100-150 g were divided into four groups (n = 8) i.e. standard pellet diet, cafeteria diet control, cafeteria diet + Safoof Mohazzil and standard pellet diet plus Safoof Mohazzil. The formulation was administered orally at a dose of 1 g/kg/day for 14 weeks. At the end of study, cafeteria diet significantly increased body weight, Lee's index, lipid profile (cholesterol and triglycerides), insulin and leptin levels as compared to standard pellet diet control group. Fourteen week treatment with Safoof Mohazzil significantly prevented the increase in body weight, Lee's index, lipid profile, insulin and leptin levels as compared to cafeteria diet control group without affecting food and water intake. Safoof Mohazzil had no adverse effect on hepatic transaminases, locomotor activity and motor coordination. The study provides evidence for antiobesity effect of Safoof Mohazzil. PMID:23305028
Gupta, Pooja; Mehla, Jogender; Gupta, Yogendra Kumar
Although obesity screening and treatment are recommended by the US Preventive Services Task Force, 1 in 5 women are obese when they conceive. Women are at risk for complications of untreated obesity particularly during the reproductive years and may benefit from targeted screening. Risks of obesity and potential benefits of intervention in this population are well characterized. Rates of adverse pregnancy outcomes including gestational diabetes, preeclampsia, cesarean delivery, and stillbirth increase as maternal body mass index increases. Offspring risks include higher rates of congenital anomalies, abnormal intrauterine growth, and childhood obesity. Observational data suggest that weight loss may reduce risks of obesity-related pregnancy complications. Although obesity screening has not been studied in women of reproductive age, the effect of obesity and the potential for significant maternal and fetal benefits make screening of women during the childbearing years an essential part of the effort to reduce the impact of the obesity epidemic. PMID:22005618
Zera, Chloe; McGirr, Susan; Oken, Emily
Recent epidemic increases in the U.S. prevalence of obesity and diabetes are a consequence of widespread environmental changes affecting energy balance and its regulation. These environmental changes range from exposure to endocrine disrupting pollutants to shortened sleep duration to physical inactivity to excess caloric intake. Overall, we need a better understanding of the factors affecting individual susceptibility and resistance to adverse exposures and behaviors and of determinants of i...
Ershow, Abby G.
Abstract Background Kids - 'Go for your life' (K-GFYL) is an award-based health promotion program being implemented across Victoria, Australia. The program aims to reduce the risk of childhood obesity by improving the socio-cultural, policy and physical environments in children's care and educational settings. Membership of the K-GFYL program is open to all primary and pre-schools and early childhood services across the State. Once in the program, member schools and services ...
de Silva-Sanigorski Andrea; Prosser Lauren; Carpenter Lauren; Honisett Suzy; Gibbs Lisa; Moodie Marj; Sheppard Lauren; Swinburn Boyd; Waters Elizabeth
Abstract Background The rising burden of obesity in Tonga is alarming. The promotion of healthy behaviours and environments requires immediate urgent action and a multi-sectoral approach. A three-year community based study titled the Ma'alahi Youth Project (MYP) conducted in Tonga from 2005-2008 aimed to increase the capacity of the whole community (schools, churches, parents and adolescents) to promote healthy eating and regular physical activity and to reduce the prevalence...
Fotu Kalesita F; Moodie Marj M; Mavoa Helen M; Pomana Siosifa; Schultz Jimaima T; Swinburn Boyd A
Full Text Available Catherine Rolland, Michelle Hession, Iain BroomCentre for Obesity Research and Epidemiology, Robert Gordon University, Aberdeen, Scotland, UKBackground: Adipose tissue functions as an endocrine organ by releasing adipokines which have important roles in the regulation of inflammation and insulin sensitivity. Although there is evidence of improvement in circulating levels of adipokines with weight loss, few studies relate such changes to specific diets. We investigated the effects of weight loss achieved by two different diets on circulating adipokine levels in obese individuals.Methods: A total of 120 obese patients (body mass index ? 35 kg/m2 underwent a three-month screening period on a low-fat, reduced-calorie diet. Patients failing to achieve a 5% weight loss using this approach were randomly allocated to either a low carbohydrate/high protein diet (n = 17 or to a commercial very low calorie diet (LighterLife®, n = 14 for a period of nine months.Results: At nine months, a significant weight loss was only maintained for LighterLife® (?32.3 ± 22.7 kg, P < 0.0001 but not on the low carbohydrate/high protein diet. Changes in adiponectin (15.8 ± 17.1 ng/mL versus ?0.8 ± 6.2 ng/mL, P = 0.003 and leptin (?17.6 ± 24.3 ng/mL versus ?3.0 ± 9.2 ng/mL, P = 0.049 at nine months were significantly greater for LighterLife® than for the low carbohydrate/high protein diet, which may reflect greater weight loss and decrease in fat mass. Changes in tumor necrosis factor-alpha, interleukin-6, and plasminogen activator inhibitor type 1 did not differ significantly between the dietary interventions at nine months.Conclusion: A significant weight loss of 23.8% from baseline weight was observed using a very low calorie diet and resulted in significant improvements in circulating levels of leptin, plasminogen activator inhibitor type 1, and adiponectin, which are likely to be due to weight loss and not macronutrient intake.Keywords: weight loss, adipokine, obesity
Abstract Background Obesity-associated type 2 diabetes is rapidly increasing throughout the world. It is generally recognized that natural products with a long history of safety can modulate obesity. Aim To investigate the development of obesity in response to a high fat diet (HFD) and to estimate the effect of L-carnitine and an Egyptian Herbal mixture formulation (HMF) (consisting of T. chebula, Senae, rhubarb, black cumin, aniseed, fennel and licorice) on bod...
Anti-obesity effects of onion extract were determined in obesity and diabetes-prone Zucker diabetic fatty rats by measuring the efficacy of markers concerned with diabetes and obesity. Body and adipose tissue weights in 5% of onion extract-fed group were found to be significantly lower than the control group without onion extract. Fasting blood glucose and HOMA-IR levels were also improved, although the serum insulin and leptin levels did not show any remarkable difference. Serum triglyceride...
Yoshinari, Orie; Shiojima, Yoshiaki; Igarashi, Kiharu
Berberine, a major pharmacological component of the Chinese herb Coptis chinensis, which was originally used to treat bacterial diarrhea, has recently been demonstrated to be clinically effective in alleviating type 2 diabetes. In this study, we revealed that berberine effectively prevented the development of obesity and insulin resistance in high-fat diet (HFD)-fed rats, which showed decreased food intake. Increases in the levels of serum lipopolysaccharide-binding protein, monocyte chemoattractant protein-1, and leptin and decrease in the serum level of adiponectin corrected for body fat in HFD-fed rats were also significantly retarded by the co-administration of berberine at 100 mg/kg body weight. Bar-coded pyrosequencing of the V3 region of 16S rRNA genes revealed a significant reduction in the gut microbiota diversity of berberine-treated rats. UniFrac principal coordinates analysis revealed a marked shift of the gut microbiota structure in berberine-treated rats away from that of the controls. Redundancy analysis identified 268 berberine-responding operational taxonomic units (OTUs), most of which were essentially eliminated, whereas a few putative short-chain fatty acid (SCFA)-producing bacteria, including Blautia and Allobaculum, were selectively enriched, along with elevations of fecal SCFA concentrations. Partial least square regression models based on these 268 OTUs were established (Q(2)>0.6) for predicting the adiposity index, body weight, leptin and adiponectin corrected for body fat, indicating that these discrete phylotypes might have a close association with the host metabolic phenotypes. Taken together, our findings suggest that the prevention of obesity and insulin resistance by berberine in HFD-fed rats is at least partially mediated by structural modulation of the gut microbiota, which may help to alleviate inflammation by reducing the exogenous antigen load in the host and elevating SCFA levels in the intestine. PMID:22880019
Zhang, Xu; Zhao, Yufeng; Zhang, Menghui; Pang, Xiaoyan; Xu, Jia; Kang, Chaoying; Li, Meng; Zhang, Chenhong; Zhang, Zhiguo; Zhang, Yifei; Li, Xiaoying; Ning, Guang; Zhao, Liping
Periprosthetic joint infection (PJI) following total knee arthroplasty is a major burden for patients and health systems. Prevention of this challenging complication through implementation of effective strategies should be a priority. These strategies should encompass various levels of patient care. Multiple modifiable risk factors such as uncontrolled hyperglycemia, obesity, smoking, substance abuse, and nasal colonization with Staphylococcus aureus have been described for PJI. Preoperative recognition and mitigation of these risk factors along with optimization of nonmodifiable risk factors such as kidney, liver, or immune system insufficiency can considerably decrease the risk of PJI. A comprehensive perioperative protocol should involve optimization of the operative environment to reduce the number of bacteria and particulates in the air. Several surgical and nonsurgical details of intraoperative care such as maintenance of normothermia, skin preparation, surgical field irrigation, wound closure, and duration of surgical and anesthetic procedure can influence the occurrence of PJI. Prophylactic perioperative antibiotic administration is probably one of the most important strategies in preventing PJI. Implementation of surgical safety checklist can diminish the risk of perioperative complications, particularly surgical site infection. Controversy regarding efficacy, efficiency, and optimization of some preventive measures continues to exist due to inconsistency or inadequacy of available evidence. Novel research has focused on designing PJI-resistant implants and developing vaccines that target molecule components with major role in the process of bacterial adhesion to the implant or periprosthetic tissues. PMID:24792971
Alijanipour, Pouya; Heller, Snir; Parvizi, Javad
Childhood obesity is prevalent, is of consequence, and disproportionately affects racial/ethnic minority populations. By the preschool years, racial/ethnic disparities in obesity prevalence and substantial differences in many risk factors for obesity are already present, suggesting that disparities in obesity prevalence have their origins in the earliest stages of life. The reasons for racial/ethnic variation in obesity are complex and may include differences in cultural beliefs and practices...
Pen?a, Michelle-marie; Dixon, Brittany; Taveras, Elsie M.
In humans, obesity is closely associated with insulin resistance (IR) and dyslipidaemia. The purpose of this study was to explore the effect of age on metabolic disturbances related to obesity in dogs (n = 25). Three age-groups of dogs (puppies, young adults and mature adults) were overfed to induce obesity, and body composition, insulin sensitivity index (I(IS)) (euglycaemic-hyperinsulinaemic glucose clamp) and plasma lipids were measured. Fat mass was similar in the three obese groups (30 +/- 1% in puppies, 34 +/- 1% in young adults and 39 +/- 1% in mature adults). In mature adults, body weight (BW) increased (+45%, p balance energy needs with energy consumption. PMID:18662350
Serisier, S; Gayet, C; Leray, V; Le Bloc'h, J; Ouguerram, K; Magot, T; Nguyen, P
This report summarizes a meeting, Obesity Prevention from Conception, held in Ottawa in 2012. This planning workshop was funded by the Canadian Institutes of Health Research (CIHR) to bring together researchers with expertise in the area of maternal obesity (OB) and weight gain in pregnancy and pregnancy-related disease to attend a one-day workshop and symposium to discuss the development of a cross-Canada lifestyle intervention trial for targeting pregnant women. This future intervention will aim to reduce downstream OB in children through encouraging appropriate weight gain during the mothers pregnancy. The workshop served to (i) inform the development of a lifestyle intervention for women with a high pre-pregnancy body mass index (BMI), (ii) identify site investigators across Canada, and (iii) guide the development of a grant proposal focusing on the health of mom and baby. A brief summary of the presentations as well as the focus groups is presented for use in planning future research.
Adamo, Kristi B; Shen, Garry X; Mottola, Michelle; Nascimento, Simony; Jean-Philippe, Sonia; Ferraro, Zachary M; Nerenberg, Kara; Smith, Graeme; Chari, Radha; Gaudet, Laura; Piccinini-Vallis, Helena; McDonald, Sarah; Atkinson, Stephanie; Godbout, Ariane; Robitaille, Julie; Davidge, Sandra T; Gruslin, Andree; Prud'homme, Denis; Stacey, Dawn; Rossiter, Melissa; Goldfield, Gary S; Dodd, Jodie
Actinidia polygama has been used as a herbal folk medicine for treating pain, gout, rheumatoid arthritis and inflammation. In the present study, the anti?obesity properties of Actinidia polygama extract (APE) were investigated in mice with high?fat diet?induced obesity. APE treatment of high?fat diet (HFD)?fed obese mice significantly reduced body weight, adipose tissue mass and serum triglyceride and leptin levels relative to the HFD?fed mice. Food intake did not differ between the HFD and HFD+APE groups, although the food efficiency ratio (FER) was significantly decreased in the HFD+APE group compared with the HFD group. Histological examination showed that the sizes of the adipocytes were significantly smaller in the HFD+APE group compared with the HFD group. Serum levels of aspartate transaminase were significantly decreased in the HFD+APE mice compared with the HFD?fed mice, but serum levels of alanine transaminase (ALT), blood urea nitrogen and creatinine were not significantly changed in the HFD+APE mice compared with the levels in the normal diet (ND)?fed and HFD?fed mice. These results suggest that APE may be useful for treating metabolic diseases, including obesity and hyperlipidemia, without toxic side?effects. PMID:23255063
Sung, Yoon-Young; Yoon, Taesook; Yang, Won-Kyung; Moon, Byeong-Cheol; Kim, Ho Kyoung
As obesity rates increase, the protection of obese occupants will become increasingly important in vehicle and restraint design. As a first step in this effort, this study seeks to compare the kinematics, dynamics, and injuries of obese post mortem human surrogates (PMHS) to (approximately) 50th percentile adult male PMHS in frontal impact sled tests with a force-limiting, pre-tensioning restraint system. Forty-eight km/h, frontal impact sled tests were performed with a sled buck representing...
Forman, Jason; Lopez-valdes, Francisco J.; Lessley, David; Kindig, Matthew; Kent, Richard; Bostrom, Ola
Economic development in developing societies characterized by industrialization, urbanization and globalization has seen the emergence of an epidemic of diet and life-style related chronic degenerative diseases. A research project has been initiated under the aegis of the International Atomic Energy Agency (IAEA), Vienna, Austria, under its Co-ordinated Research Programme (CRP) to promote the use of stable isotopic techniques to document the extent of the problem and to understand the determinants of this epidemic. The principal objectives of this CRP involving countries both in the North and the South are to define the magnitude of the problem of obesity and non-insulin Dependent diabetes mellitus (NIDDM) in developing countries, to identify the vulnerable groups at increased risk and to attempt to describe the metabolic and physiological mechanisms underlying this phenomenon. These comparative international studies of obesity and NIDDM are looking at the effects of childhood malnutrition (Brazil and socio-economic differentials (Mexico) on adult risk factors; the composition of the daily diet on obesity (Chile); levels of patterns of physical activity of older adults (China) as well as their influence on weight gain and obesity (Cuba, Nigeria); the impact of body composition and energy expenditure on the evolution frank diabetes from impaired glucose tolerance (Jamaica), and of body compositional changes and the role of inflammatory cytokines on impaired glucose tolerance (India). The last study conducted in New Zealand was aimed at comparing the energy expenditures of Maori (Pacific Island) with New Zealanders of European descent. The findings of the CRP of the MEA in this area carried out in several countries are presented in this article. (author)
Full Text Available Presently life style modification at the transitionof menopause will go long way in preventing weight gainduring this metabolically vulnerable period which will helpin primary and secondary prevention of several chronicdiseases (e.g., cardiovascular disease, diabetes, cancer,hypertension, obesity, depression and osteoporosis andpremature death beside keeping women physically andmentally fit in her menopause.
Obesity is one of the most important health problems, which many people suffer from it. As a chronic disease, it is a precipitating factor for many medical conditions like hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, sleep apnea syndrome and some malignancies (breast, uterus, prostate and colon carcinoma). With attention to this fact that obesity is an independent risk factor associated with significant increase in morbidity and mortality, treatment of overweight individuals is very important. One of the medications for short-term weight loss is fluoxetin. In this clinical trial study, fluoxetin effect on weight loss induction during 8 weeks was investigated. 201 cases with BMI between 25-42 were selected randomly (113 female and 88 male) and all received fluoxetine (40 mg daily) for 8 weeks. Measurement was carried out after the 4(th) and 8(th) week of administration and 4 weeks after end of treatment. Management of 9 cases (4 due to weight gain and 5 due to headache) were discontinued after 4 weeks of treatment. Data assessments were performed using t-test and SPSS program. Mean body weight at first visit was 89.32±13.30kg. At the 4(th), 8(th) week of treatment and 4 weeks after study, the mean body weight of cases reached 86.09±13.27 (p=0.00), 82.69±11.31 (p=0.00) and 81.97±13.26 (p=0.00) respectively. Mean BMI at first visit was 34.90±5.20kg/m(2). At 4(th), 8(th) weeks of treatment it was 33.72±5.20kg/m(2) and 32.40±5.18kg/m(2) respectively. Mean weight loss at 4(th) and 8(th) weeks of treatment was 3.24kg and 6.67kg respectively without any weight gain at the end of the 4(th) week after discontinuation of the drug. Fluoxetine is an effective, well-tolerated and relatively safe drug for short-term treatment of obesity. PMID:23105511
Afkhami-Ardekani, M; Sedghi, H
In this study, to evaluate the anti-obesity effects of fermented red ginseng (FG), levan (L), and their combination (FGL), we investigated their effects on the weights of body, liver and white adipose tissue, lipid profiles, and biomarkers for insulin resistance in high fat diet (HFD)-induced obese C57BL/6J male mice. Furthermore, the levels of leptin in the serum were measured. FG (150 mg/kg/d), L (100 mg/kg/d), and FGL (150 mg/kg/d of FG plus 100 mg/kg/d of L) were administered orally to mice daily for 11 weeks. After 11 weeks feeding, FGL showed significantly lower body weight and fat mass with decreasing food efficiency ratio than the HFD control mice. In addition, the FGL group was significantly lower in the levels of total cholesterol and fasting blood glucose and score of the homeostatic model assessment of insulin resistance. Furthermore, FGL decreased serum leptin levels compared to the HFD control group. Taken together, FGL showed a significant anti-obesity effect in HFD-induced obese mice and prevent insulin and leptin resistance. FGL may be potentially useful for the prevention of obesity. Copyright © 2013 John Wiley & Sons, Ltd. PMID:23873605
Oh, Jin Sun; Lee, Seung Ri; Hwang, Keum Taek; Ji, Geun Eog
TUDCA treatment preserved ERG b-waves and the outer nuclear layer in Bardet-Biedl syndrome mice and prevented obesity assessed at P120. TUDCA treatment preserved ERG b-waves and the outer nuclear layer in rd10 mice to P30.
Drack, Arlene V.; Dumitrescu, Alina V.; Bhattarai, Sajag; Gratie, Daniel; Stone, Edwin M.; Mullins, Robert; Sheffield, Val C.
Process evaluations are critical in determining whether outcome evaluations are warranted. This study assessed the extent to which a childhood obesity prevention initiative, "NY Fit WIC", was adopted and implemented by the New York State Supplemental Nutrition Program for Women, Infants and Children (WIC). Process data came from qualitative
Sekhobo, Jackson P.; Egglefield, Katherine; Edmunds, Lynn S.; Shackman, Gene
Full Text Available The prevalence of obesity is increasing in many developing countries and is followed by many cardiovascular disorders. The aim of the study was to investigate the effect of obesity on diastolic function in patients with arterial hypertension. Both obesity and hypertension have influence on diastolic function. The study group was comprised of 93 patients with arterial hypertension: 24 (25,80% were obese, 69 (74,20% were not obese. Obese patients with arterial hypertension and those patients that were not obese with arterial hypertension didn't significantly differ in terms of: age, gender distribution, systolic BP, diastolic BP, heart rate, left atrial volume, EF. Obese patients with arterial hypertension in relation to those that were not obese with arterial hypertension had significantly greater left ventricular mass (p<0,01 and left ventricular mass index (p<0,05. In both groups diastolic function parameters didn't significantly differ. Linear correlation between BMI (body mass index and diastolic function parameters: IVRT, DT i E/A ratio has shown that BMI had significant influence on E/A ratio (p<0,05. No correlation was found between BMI and: IVRT and DT.
The connections between gut microbiota, energy homeostasis, and inflammation and its role in the pathogenesis of obesity-related disorders are increasingly recognized. We aimed to investigate the effect of the probiotic strain Lactobacillus salivarius Ls-33 on a series of biomarkers related to inflammation and the metabolic syndrome (MS) in adolescents with obesity.
GÃ¸bel, Rikke Juul; Larsen, Nadja
Obesity promotes a cascade of secondary pathologies including diabetes, insulin resistance, dyslipidemia, inflammation, thrombosis, hypertension, the metabolic syndrome, and OSA, which collectively heighten the risk for cardiovascular disease. Obesity may also be an independent moderator of cardiac risk apart from these comorbid conditions. Rates of obesity and cardiac disease continue to rise in a parallel and exponential manner. Because obesity is potentially one of the most modifiable mediators of cardiovascular morbidity and mortality, effective treatment and prevention interventions should have a profound and favorable impact on public health.
Zalesin, Kerstyn C
Full Text Available Childhood obesity is a major public health crisis nationally and internationally. The prevalence of childhood obesity has increased over few years. It is caused by imbalance between calorie intake and calories utilized. One or more factors (genetic, behavioral, and environmental cause obesity in children. Physical, psychological, and social health problems are caused due to childhood obesity. Hence, effective intervention strategies are being used to prevent and control obesity in children. The purpose of this paper is to address various factors influencing childhood obesity, a variety of interventions and governmental actions addressing obesity and the challenges ahead for managing this epidemic. In order to collect materials for this review a detailed search of CINAHL, MEDLINE, ERIC, Academic Search Premier databases was carried out for the time period 1999 2011. Some of the interventions used were family based, school based, community based, play based, and hospital based. The effective school based interventions were seen targeting physical activity along with healthy diet education. The major challenges faced by these intervention programs are financial, along with stigmatization of obese children. Governments along with other health care organizations are taking effective actions like policy changing and environmentally safe interventions for children to improve physical activity. Childhood obesity can be tackled at the population level by education, prevention and sustainable interventions related to healthy nutrition practices and physical activity promotion.
Abstract Background Even though the obesity epidemic continues to grow in various parts of the world, recent reports have highlighted disparities in obesity trends across countries. There is little empirical evidence on the development and growth of obesity in Lebanon and other countries of the Eastern Mediterranean Region. Acknowledging the need for effective obesity preventive measures and for accurate assessment of trends in the obesity epidemic, this study aims at examini...
Nasreddine Lara; Naja Farah; Chamieh Marie; Adra Nada; Sibai Abla-Mehio; Hwalla Nahla
Full Text Available Obesity has been linked to higher inflammatory status and periodontal breakdown. OBJECTIVE: The purpose of this study was to investigate the effect of obesity on alveolar bone loss in experimental periodontitis in rats. MATERIAL AND METHODS: Twenty-four female Wistar rats were randomly divided into two groups: obese (n=13, which were fed with "cafeteria diet" (CAF diet - high amounts of sucrose and fat for 90 days in order to gain weight, and non-obese (n=11 regularly fed rats. Ligature-induced experimental periodontitis was created in all animals. Body weight differed statistically between obese and non-obese groups (277.59 and 223.35 g, respectively at the moment of the ligature placement. Morphometric registration of alveolar bone loss was carried out after 30 days of ligature placement to determine the effect of obesity on the progression of experimental periodontitis. RESULTS: Intra-group comparisons showed significantly higher alveolar bone loss mean values in maxillary teeth with ligature (P<0.05. Alveolar bone loss [mean (SD, mm] was not statistically different between obese and non-obese groups [0.71 (0.09 and 0.65 (0.07 mm, respectively]. However, when palatal sides are analyzed separately, obese group presented significantly higher alveolar bone loss (P<0.05 as compared to non-obese [0.68 (0.12 and 0.53 (0.13 mm, respectively]. CONCLUSIONS: In spite of the weak differences, it is possible to conclude that the progression of alveolar bone loss in ligature-induced periodontitis can be potentially influenced by body weight in rats.
Giliano Nicolini Verzeletti
The effects of environmental temperature on blood pressure and hormones in obese subjects in Japan were compared in two seasons: summer vs winter. Five obese (BMI, 32 ± 5 kg/m2) and five non-obese (BMI, 23 ±3 kg/m2) men participated in this experiment at latitude 35°10' N and longitude 136°57.9' E. The average environmental temperature was 29 ± 1 °C in summer and 3 ± 1 °C in winter. Blood samples were analyzed for leptin, ghrelin, catecholamines, thyroid stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), total cholesterol, triglycerides, insulin and glucose. Blood pressure was measured over the course of 24 h in summer and winter. A Japanese version of the Profile of Mood States (POMS) questionnaire was also administered each season. Systolic and diastolic blood pressures in obese men were significantly higher in winter (lower environmental temperatures) than in summer (higher environmental temperatures). Noradrenaline and dopamine concentrations were also significantly higher at lower environmental temperatures in obese subjects, but ghrelin, TSH, fT3, fT4, insulin and glucose were not significantly different in summer and winter between obese and non-obese subjects. Leptin, total cholesterol and triglyceride concentrations were significantly higher in winter in obese than non-obese men. Results from the POMS questionnaire showed a significant rise in Confusion at lower environmental temperatures (winter) in obese subjects. In this pilot study, increased blood pressure may have been due to increased secretion of noradrenaline in obese men in winter, and the results suggest that blood pressure control in obese men is particularly important in winter.
Kanikowska, Dominika; Sato, Maki; Iwase, Satoshi; Shimizu, Yuuki; Nishimura, Naoki; Inukai, Yoko; Sugenoya, Junichi
Full Text Available Introduction Obesity prevalence is increasing all over the world. Obese patients are at increased risk for developing many medical problems, including insulin resistance and type 2 diabetes mellitus, hypertension, dyslipidemia, cardiovascular diseases and stroke. Excess body weight is associated with substantial increase in mortality from all causes, cardiovascular diseases in particular. Weight control is part of the major health priorities identified for the future. The aim of the study was to evaluate effects of a one-year weight reduction program on obesity and its comorbid conditions and to make a model for long term weight reducing program. Material and methods Two hundred obese (ITM> 30kg/m2 subjects, who attended a 15-day weight reduction ("?igota" program, three times during a year, were followed up. Participants from group A strictly adhered to the prescribed regimen, while participants from group B followed their own routine of diet and physical activity. Two groups were comparable in terms of gender, age, duration of obesity, previous and concomitant diseases. Results A year later, a statistically significant mean weight loss was established in both groups, but it was greater in group A (p<0.05. In both groups, all serum lipid parameters, parameters of glycemic control, as well as values of systolic and diastolic blood pressures improved. There was a further decrease in serum levels of total cholesterol, LDL-cholesterol, and LDL/HDL ratio in group A. As compared to group B, group A experienced better glycemic control in diabetic and non-diabetic obese patients, and enhanced reversion from diabetes to impaired glucose tolerance or normal glucose tolerance. This study has demonstrated a well-known fact that body mass reduction is associated with a decrease in blood pressure. Conclusion Treatment of obesity can make a substantial contribution to reducing hyperlipidemia, improving glycemic control, and treating hypertension. Prevention and treatment of obesity may reduce overall morbidity and mortality in the years to come. We suggest starting with weight reducing program "?igota" and combining it with balanced program of diet and physical activity until normalizing body weight.
Phenolic compounds and flavonoids ameliorate bodyweight, blood glucose, and serum lipid profile. Since seabuckthorn (Hippophae rhamnoides L.) is known as a rich source of isoflavones and flavonoids, we hypothesized that ethanolic extract of seabuckthorn leaves (SL) may have anti-obesity and hypoglycemic effects. To investigate the effect of ethanolic extract of SL, 32 C57BL/6J mice were randomly divided into 4 dietary groups, containing 8 mice in each group: normal diet group; high-fat diet (HD) control group; high-fat diet with SL extract, 500 mg/kg body weight (BW) (SL1) group; and high-fat diet with SL extract, 1000 mg/kg BW (SL2) group. After 13 weeks, it was observed that oral administration of SL extract significantly reduced the energy intake; BW gain; epididymal fat pad weight; hepatic triglyceride, hepatic, and serum total cholesterol levels; and serum leptin levels in the SL groups compared to the HD group. However, differences in serum triglyceride and insulin levels in the SL groups were not significant in comparison to the HD group. The hepatic mRNA expression of peroxisome proliferator-activated receptor (PPAR) ? and carnitine palmitoyltransferase 1 along with PPAR-? were significantly increased in SL groups, whereas the level of acetyl-CoA carboxylase was significantly reduced in SL groups compared to HD group. Our results indicated that SL is effective in preventing BW gain and fat accumulation in the liver; it also reduced adipose tissue mass, hepatic lipid profile, and serum leptin level in the mouse. Together, these observations suggest that SL is a potential agent to study in the management of obesity and related disorders. PMID:23176796
Pichiah, P B Tirupathi; Moon, Hye-Jung; Park, Jeong-Eun; Moon, Yeon-Jeong; Cha, Youn-Soo
Obesity in men is associated with reduced insulin sensitivity and hypoandrogenism, while obesity in women is associated with reduced insulin sensitivity and hyperandrogenism. In children, the effect of obesity and weight reduction on the hypothalamo-pituitary-gonadal axis is rarely investigated. The aim of the present study was to investigate the effect of weight reduction in obese Caucasian children on insulin sensitivity, sex hormone-binding globulin (SHBG), DHEAS and the hypothalamo-pituitary-gonadal axis.
Birkebaek, N H; Lange, A
Full Text Available Abstract Background The prevalence of childhood obesity has increased rapidly during the last three decades in the Netherlands. It is assumed that mainly environmental factors have contributed to this trend. Parental overweight and low social economic status are risk factors for childhood obesity. Childhood obesity affects self-esteem and has negative consequences on cognitive and social development. Obese children tend to become obese adults, which increases the risk for developing cardiovascular complications, type 2 diabetes mellitus, and psychosocial problems. Additionally, the secretion of several gastrointestinal hormones, responsible for appetite and food intake, is impaired in obese subjects. Weight reduction through lifestyle changes in order to change health risks is, until now, suggested as the preferred treatment for childhood obesity. The objective of this study is the effect evaluation of a family-based cognitive behavioral multidisciplinary lifestyle treatment. The intervention aims to establish long-term weight reduction and stabilization, reduction of obesity-related health consequences and improvement of self-image by change of lifestyle and learning cognitive behavioral techniques. Study design/Methods In this randomized clinical trial newly presented children with obesity (8-17 years old are divided, by randomization, in an intervention and control group, both consisting of 40 obese children. The intervention is carried out in groups of 8-11 children, and consists of respectively 7 and 5 separate group meetings for the children and their parents and 1 joint group meeting of 2 ½ hours. Main topics are education on nutrition, self-control techniques, social skills, physical activity and improvement of self-esteem. The control group is given advice on physical activity and nutrition. For normal data comparison, data were collected of 40 normal-weight children, 8-17 years old. Discussion Because of the increasing prevalence of childhood obesity and the impact on the individual as well as on society, prevention and treatment of obesity in children is of great importance. For evaluation of short- and long-term effects of the treatment, measurements are taken before and after 3 months of treatment, and after 12 and 24 months follow-up. During these visits clinical and biochemical data are determined, cardiovascular fitness tests are performed and quality of life questionnaires are completed. Trial registration International Standard Randomised Controlled Trial Number Register ISRCTN36146436
Kruyff Carolien C