Association between childhood obesity and gut microbiota:16S rRNA gene sequencing-based cohort study

BACKGROUND This study aimed to identify characteristic gut genera in obese and normal-weight children(8-12 years old)using 16S rDNA sequencing.The research aimed to provide insights for mechanistic studies and prevention strategies for childhood obesity.Thirty normal-weight and thirty age-and sex-matched obese children were included.Questionnaires and body measurements were collected,and fecal samples underwent 16S rDNA sequencing.Significant differences in body mass index(BMI)and body-fat percentage were observed between the groups.Analysis of gut microbiota diversity revealed lowerα-diversity in obese children.Differences in gut microbiota composition were found between the two groups.Prevotella and Firmicutes were more abundant in the obese group,while Bacteroides and Sanguibacteroides were more prevalent in the control group.AIM To identify the characteristic gut genera in obese and normal-weight children(8-12-year-old)using 16S rDNA sequencing,and provide a basis for subsequent mechanistic studies and prevention strategies for childhood obesity.METHODS Thirty each normal-weight,1:1 matched for age and sex,and obese children,with an obese status from 2020 to 2022,were included in the control and obese groups,respectively.Basic information was collected through questionnaires and body measurements were obtained from both obese and normal-weight children.Fecal samples were collected from both groups and subjected to 16S rDNA sequencing using an Illumina MiSeq sequencing platform for gut microbiota diversity analysis.RESULTS Significant differences in BMI and body-fat percentage were observed between the two groups.The Ace and Chao1 indices were significantly lower in the obese group than those in the control group,whereas differences were not significant in the Shannon and Simpson indices.Kruskal-Wallis tests indicated significant differences in unweighted and weighted UniFrac distances between the gut microbiota of normal-weight and obese children(P<0.01),suggesting substantial disparities in both the species and quantity of gut microbiota between the two groups.Prevotella,Firmicutes,Bacteroides,and Sanguibacteroides were more abundant in the obese and control groups,respectively.Heatmap results demonstrated significant differences in the gut microbiota composition between obese and normal-weight children.CONCLUSION Obese children exhibited lowerα-diversity in their gut microbiota than did the normal-weight children.Significant differences were observed in the composition of gut microbiota between obese and normal-weight children.

Link between childhood obesity and gut microbiota

Childhood obesity is a critical global health concern with rising prevalence and significant long-term health implications.Recent studies have implicated gut microbiota in the development and progression of obesity.This editorial analyzes the research conducted by Li et al,who utilized 16S rRNA gene sequencing to compare the gut microbiome of overweight and healthy-weight children.The study found significant differences in microbial diversity and composition between the two groups,with potential implications for understanding and managing childhood obesity.We analyzed the study’s advantages and drawbacks,proposing potential areas for future research to better understand the connection between gut microbiota and obesity.

Assessing Moroccan physician knowledge and practices regarding maternal obesity's impact on childhood obesity:Implications for prevention and intervention

BACKGROUND Childhood obesity is a growing global concern with far-reaching health implications.This study focuses on evaluating the knowledge and practices of physicians in Morocco regarding the link between maternal obesity and childhood obesity.Despite the increasing prevalence of childhood obesity worldwide,this issue remains inadequately addressed in the Moroccan context.AIM To assess the awareness and practices of physicians in Morocco concerning the connection between maternal obesity and childhood obesity.METHODS The research encompasses a comprehensive survey of practicing physicians,revealing significant gaps in awareness and practices related to maternal obesity.RESULTS Notably,a significant portion of doctors do not provide adequate guidance to overweight pregnant women,highlighting the urgency for targeted educational programs.CONCLUSION In conclusion,this research illuminates critical areas for improvement in tackling childhood obesity in Morocco.By addressing these gaps,fostering awareness,and enhancing medical practices,the healthcare system can contribute significantly to preventing childhood obesity and improving the overall health of future generations.

Association and potential mediators between socioeconomic status and childhood obesity in China:findings from a national cohort study

Objective:Socioeconomic status(SES)is associated with childhood obesity,but the underlying factors remain unknown.This study aimed to identify mediators that may explain SES disparities in childhood obesity in China.Methods:Nationally representative longitudinal data from the China Education Panel Survey of 11 o019 children(13.03±0.79)collected from 2013-2014 to 2016-2017 academic years.Overweight/obesity was defined using Chinese national body mass index cut-points.Principal component analysis was used to convert the four SES indicators(maternal and paternal education,and occupation)into one comprehensive variable.Mediation analysis for SES disparities in childhood obesity was conducted using structure equation models.Results:The prevalence of overweight/obesity was 12.8%,and was higher in boys than in girls(17.8%vs.7.6%,P<0.001)at baseline.Among boys,relative risk(RR)of obesity was 1.23(95%CI:1.09 to 1.40,P<O.001)for per unit change in SES.There was no significant association between obesity and SES among girls.Mediation analyses showed that among boys,birth weight,being the only child in the family and children's selfperceived weight status mediated 70.0%of the effects of SES on obesity.No mediation effect was detected in girls.Conclusions:Chinese boys are more likely to be overweight or obese than girls.SES may impact childhood obesity through birth weight,being the only child in the family and children's self-perceived body weight status in boys,but not in girls.More attention should be made to address childhood obesity in high SES families among boys.Interventions targeting at these mediators are needed.

Report on Childhood Obesity in China (7) Comparison of NCHS and WGOC

Objective To test the validity of Working Group on Obesity in China （WGOC） reference in screening childhood obesity using obesity-related metabolic syndrome （MS） and its components as disease risk evidence. Methods A total of 2020 adolescents （1007 boys and 1013 girls） aged 14-16 years were sampled in Beijing, China. Anthropometric and biochemical measurements, as well as blood pressure parameters were available. Prevalence of overweight/obesity and related MS risk factors were analyzed across different body mass index （BMI） categories. The sensitivity and specificity of the WGOC cut-offs were compared with those of National Central Health Statistics （NCHS）. Results Significantly high prevalence of MS and its components were found both in the obesity and overweight groups, which were classified by the WGOC and NCHS references. Similar distribution pattern of MS risk factors existed among different BMI categories, but the frequency and clustering of these factors in the obesity group classified by the NCHS were much higher. Owing to its irrelevant high cut-offs for overweight/obesity （especially for girls since the mid- adolescence）, the NCHS reference had a high specificity but a low sensitivity. By contrast, the WGOC reference with a high sensitivity （90.1% for boys and 89.2% for girls） and a relative high specificity （96.4% and 92.8% for obese boys and girls, 78.1% and 68.9% for overweight boys and girls respectively） was more suitable to support the need for early screening, intervention, and treatment of childhood obesity in China. Conclusion High sensitivity is more important than specificity in choosing appropriate screening tools for childhood obesity. Validity test demonstrates that it is rational to use the WGOC reference, established on the basis of the Chinese own reference population as a uniform screening tool for childhood obesity, which can effectively overcome the unnecessary treatment and psychosociai implications of stigmatization caused by misclassification.

Projecting the impact of the coronavirus disease-2019 pandemic on childhood obesity in the United States: A microsimulation model

Purpose:The coronavirus disease-2019(COVID-19)pandemic in the United States led to nationwide stay-at-home orders and school closures.Declines in energy expenditure resulting from canceled physical education classes and reduced physical activity may elevate childhood obesity risk.This study estimated the impact of COVID-19 on childhood obesity.Methods:A microsimulation model simulated the trajectory of a nationally representative kindergarten cohort’s body mass index z-scores and childhood obesity prevalence from April 2020 to March 2021 under the control scenario without COVID-19 and under the 4 alternative scenarios with COVID-19—Scenario 1:2-month nationwide school closure in April and May 2020;Scenario 2:Scenario 1 followed by a 10%reduction in daily physical activity in the summer from June to August;Scenario 3:Scenario 2 followed by 2-month school closure in September and October;and Scenario 4:Scenario 3 followed by an additional 2-month school closure in November and December.Results:Relative to the control scenario without COVID-19,Scenarios 1,2,3,and 4 were associated with an increase in the mean body mass index z-scores by 0.056(95%confidence interval(95%CI):0.0550.056),0.084(95%CI:0.0840.085),0.141(95%CI:0.1400.142),and 0.198(95%CI:0.1970.199),respectively,and an increase in childhood obesity prevalence by 0.640(95%CI:0.5150.765),0.972(95%CI:0.8191.126),1.676(95%CI:1.4751.877),and 2.373(95%CI:2.1352.612)percentage points,respectively.Compared to girls and non-Hispanic whites and Asians,the impact of COVID-19 on childhood obesity was modestly larger among boys and non-Hispanic blacks and Hispanics,respectively.Conclusion:Public health interventions are urgently called to promote an active lifestyle and engagement in physical activity among children to mitigate the adverse impact of COVID-19 on unhealthy weight gains and childhood obesity.

The 100 top-cited articles on childhood obesity: a bibliometric analysis

Background:Childhood obesity(CHO)is a serious global health challenge affecting both developed and developing nations.The feats attained in addressing this global health challenge can be reflected through the top-cited studies.The study’s aim was to analyze the features of the 100 top-cited articles concerning CHO.Methods:We used a bibliometric analysis,and searched for relevant articles from the Web of Science(December 1,2021),using an appropriate keyword search-strategy((child OR childhood OR children OR adolescent)AND(obese OR obesity OR overweight)).The retrieved documents were analysed based on the citation number,publication year,authorship,institution,journal and country.The analyses were performed mainly by the Bibliometrix application(using R-studio cloud)and HistCite.Results:The 100 top-cited articles were published between 1976 and 2018,their citations ranged from 365 to 10789,with a mean citation of 1146.2 and 31 studies had more than 1000 citations.The articles were published in 31 journals,with the“Pediatrics”journal having the most publications(n=18).The studies were from 12 countries,with the most-productive being the USA(n=68),followed by the United Kingdom(n=12)and France(n=3).The leading institution was the University of Bristol(n=8),while Dietz WH(n=12),and Flegal KM(n=8)were the most productive authors.The most common research fields covered by these articles were;“General Internal Medicine”(n=34),“Pediatrics”(n=29),and“Nutrition Dietetics”(n=18).The study noted significant correlations between the total article citation and the number of authors(R=0.203),countries involved(R=0.407),institutions(R=0.407),and the publication year(R=0.847),all with P<0.001.Conclusions:Through these top-cited articles,this analysis provides discernment into the historical advancements,including the prime roles performed by various stakeholders in addressing the issue of CHO.However,Asian countries’contribution is not adequately reflected in these articles,and thus more focus and funding for CHO research are needed for effectual prevention and control.

Childhood Development Cross Culturally:Implications for Designing Childhood Obesity Interventions and Providing Culturally Competent Care

United States is experiencing significant growth in its foreign-born population,especially Chinese American population comprising of 1.2%of the U.S.population.Many healthcare providers are challenged in their efforts to provide culturally competent healthcare to this population.To provide culturally competent healthcare,healthcare providers should understand variations in cultural attributes that impact health.One group in which cultural variation holds great influence is that of children.Culture influences a child's behavior,development and health.This article provides a cross-cultural,comparative examination of important cultural influences on child behaviors development and health in China and the U.S.Using the findings about these two populations,interventions for childhood obesity cross culturally are addressed through the analysis of a U.S.based Children's Obesity Program.The author suggests that uniquely different approaches to childhood obesity intervention research are needed based upon the cultural differences identified within this paper.

Partnerships for Success： An Evaluation of Head to Toe, a Family Centered Childhood Obesity Intervention that Partners with an Obesity Clinic

The prevalence of childhood obesity is a growing epidemic in the United States and as of 2014 its prevalence among children ages two to 19 was 17.0%. Without intervention, obese children are at risk for negative health consequences and for the increased likelihood of staying obese through adulthood. St. Louis Children＇s Hospital provides HTT （Head to Toe）, an interactive 12-session fimess, nutrition, and social well-being class focuses on adopting healthier lifestyles through daily exercise, and proper nutrition. One program referral method is through a partnership with the hospital＇s HSC （Healthy Start Clinic）, a multi-disciplinary obesity clinic. Pretest and posttest assessments are used to measure changes in body metrics, health behaviors, knowledge, readiness to change, and self-concept. Between August 2011 and May 2016, 485 children and at least one parent or guardian with them were enrolled in the program, and up to 235 children completed at least one pretest- or post-assessment. Analysis determined multiple statistically significant improvements in body metrics, health behaviors, knowledge, including questions related to nutrition and food guidelines, readiness to change assessment, and self-concept. Total knowledge increased by 22%; questions related to nutrition increased by 28.2%, social emotional by 18.9% and physical activity by 17.8%. Findings suggest that the Head to Toe program is effective in improving nutrition, physical activity, social emotional knowledge and behaviors among participants. Childhood obesity is a growing epidemic and creating a relationship with a pediatric obesity clinic can increase the total number of children and teens that are introduced to weight management programs.

The Effect of Childhood Obesity on Social Welfare

The young generation is the most influenced and vulnerable segment of the market. Food with high level of fat, sugar and/or salt are popularised for this segment. At the same time nearly seven people die of obesity or from complications of obesity in Hungary each hour-one every nine minutes. Approximately 119 million Americans, or 64.5%, of adult Americans are either overweight or obese. 17.5 million obese young person live in the European Union. The result is the drastic elevation of the hygienic expenses. The average health care cost of overweight persons is higher by 42% than normal bodyweight ones. Per capita spending on fast foods is unbelievable and rising. The value of average spending was 2.5 E in 2002. Fast food sales continue to boom despite warnings about obesity. The consumption of these products can contribute to the increased level of childhood obesity. 12% of young person＇s visited a fast food restaurant at least with a weekly regularity. The value is 16.9% in case of young men higher than in case of young ladies （8.1%） to our research. We can state the respondents underestimate the costs of fast foods.

Association of Serum Folate and Vitamin B_(12) Concentrations with Obesity in Chinese Children and Adolescents

Objective This study aimed to evaluate the associations of serum folate and/or vitamin B12 concentrations with obesity among Chinese children and adolescents.Methods A cross-sectional study was conducted including 3,079 Chinese children and adolescents,aged 6 to 17 years,from Jiangsu,China.Anthropometric indices,such as,children's body mass index(BMI),BMI z-scores,waist circumference,and waist-to-height ratio were utilized.Multivariable linear regression and generalized additive models were used to investigate the associations of serum folate and vitamin B12 levels with anthropometric indices and odds of obesity.Results We observed that serum vitamin B12 concentrations were inversely associated with all anthropometric indices and the odds of general obesity[odds ratio(OR)=0.68;95%confidence interval(CI)=0.59,0.78]and abdominal obesity(OR=0.68;95%CI=0.60,0.77).When compared to participants with both serum vitamin levels in the two middle quartiles,those with both serum folate and vitamin B12 levels in the highest quartile were less prone to general(OR=0.31,95%CI=0.19,0.50)or abdominal obesity(OR=0.46,95%CI=0.31,0.67).Conversely,participants with vitamin B12 levels in the lowest quartile alongside folate levels in the highest quartile had higher odds of abdominal obesity(OR=2.06,95%CI=1.09,3.91).Conclusion Higher serum vitamin B12 concentrations,but not serum folate concentrations,were associated with lower odds of childhood obesity.Children and adolescents with high levels of vitamin B12 and folate were less likely to be obese.

Selenoprotein-p and insulin resistance in children and adolescents with obesity

BACKGROUND Insulin resistance and obesity present significant challenges in pediatric populations.Selenoprotein P1(SEPP1)serves as a biomarker for assessing selenium levels in the body.While its association with metabolic syndrome is established in adults,its relevance in children remains underexplored.AIM To ascertain SEPP1 blood levels in children and adolescents diagnosed with obesity and to assess its correlation with insulin resistance and adiposity indices.METHODS 170 children participated in this study,including 85 diagnosed with obesity and an equal number of healthy counterparts matched for age and sex.Each participant underwent a comprehensive medical evaluation,encompassing a detailed medical history,clinical examination,and anthropometric measurements like waist circumference and waist-to-height ratio.Furthermore,routine blood tests were conducted,including serum SEPP1,visceral adiposity index(VAI),and Homeostatic Model Assessment of Insulin Resistance(HOMA-IR)level.RESULTS Our findings revealed significantly lower serum SEPP1 levels in children with obesity compared to their healthy peers.Moreover,notable negative correlations were observed between serum SEPP1 levels and body mass index,VAI,and HOMA-IR.CONCLUSION The study suggests that SEPP1 could serve as a valuable predictor for insulin resistance among children and adolescents diagnosed with obesity.This highlights the potential utility of SEPP1 in pediatric metabolic health assessment and warrants further investigation.

Rising tide: The global surge of type 2 diabetes in children and adolescents demands action now

Childhood-onset obesity has emerged as a major public healthcare challenge across the globe,fueled by an obesogenic environment and influenced by both genetic and epigenetic predispositions.This has led to an exponential rise in the incidence of type 2 diabetes mellitus in children and adolescents.The looming wave of diabetes-related complications in early adulthood is anticipated to strain the healthcare budgets in most countries.Unless there is a collective global effort to curb the devastation caused by the situation,the impact is poised to be pro-found.A multifaceted research effort,governmental legislation,and effective social action are crucial in attaining this goal.This article delves into the current epidemiological landscape,explores evidence concerning potential risks and consequences,delves into the pathobiology of childhood obesity,and discusses the latest evidence-based management strategies for diabesity.

Improving BMI in Children While Utilizing Pediatric Provider Guided Telemedicine: A Pilot Study

Background: Childhood obesity is dramatically on the rise throughout the world. Screening and prevention are ideal, but treatment becomes necessary when a child’s body mass index (BMI) is 95% and greater. Obesity related illness leads to premature death. Local Problem: The current practice at the clinical site for this project is to send the child for lab work and follow up in three months after implementing lifestyle changes, including diet and exercise. Follow-up visits, often canceled or forgotten, contribute to a lack of evaluation and not being seen until the next annual well visit. Methods: The measurable outcomes are the pre and post BMI measurements. A paired t-test was used for data analysis. Compliance with the program was determined by the dietary logs. Interventions: The childhood obesity project was a self-management project, incorporating weekly telemedicine visits with a pediatric provider. The child’s progress was documented via the dietary log and addressed weekly with the provider. Results: There were five participants at the completion of the program. The BMI levels of the pre-intervention period (M = 21.06, SD = 2.86563) and the post-intervention period (M = 20.9, SD = 3.13688) indicated that there was not a significant change in participant BMI as a result of the eight-week intervention period, t(4) = 0.436, p = 0.685. Conclusions: This program is feasible and can be utilized by other families and providers in futures studies. The availability of telemedicine is convenient for busy families. Further studies are recommended with a larger sample size and a longer implementation period to recognize improved change.

Obesity is associated with the Arg389Gly ADRB1 but not with the Trp64Arg ADRB3 polymorphism in children from San Luis Potosí and León,México

This research was designed to analyze the possible associations of Arg389 Gly ADRB1 and Trp64 Arg ADRB3polymorphisms in children with obesity.A cross-sectional study included 1,046 school-age Mexican participants（6-12 years old） from the cities of San Luis Potosi and Leon.Children were classified as non-obese or obese according to their body mass index（BMI） percentile;obese children had a BMI≥95th percentile for sex and age.Biochemical data were collected.Polymorphisms were detected using TaqMan qPCR assay.A logistic regression analysis was used to calculate the risk of obesity based on genotypes.Differences were found between groups where obese children had a significant increase in systolic and diastolic blood pressure,fasting plasma glucose,insulin,HOMAIR,LDL-cholesterol,triglycerides,and lower HDL-cholesterol compared with the normal weight group（P 〈 0.05）.The distribution of allele frequency in the population was Arg = 87.4 and Gly = 12.6（Hardy Weinberg equilibrium x^2= 3.16,P = 0.07）;Trp = 81.5 and Arg= 18.5（Hardy Weinberg equilibrium x^2 = 2.2,P = 0.14） for ADRB1 and ADRB3,respectively.Even though no different frequencies of Arg389 Gly polymoiphism between groups were found（P = 0.08）,children carriers of one Gly389,ADRB1 allele had a risk for obesity of OR = 1.40（95%CI,1.03-1.90,P =0.03） after adjustment for age and gender.No other association was found for Trp64 Arg ADRB3 polymorphism.Only the Arg389 Gly ADRB1 polymorphism was associated with risk for obesity in Mexican children.

Associations of Gestational Diabetes Mellitus and Excessive Gestational Weight Gain with Offspring Obesity Risk

Objective Gestational diabetes mellitus(GDM)and gestational weight gain(GWG)are important risk factors that are known to affect offspring growth,but these outcomes are inconsistent and it remains unknown if both risk factors have a synergetic effect on early childhood growth.The present study aimed to conduct offspring body mass index-for-age Z-scores(BMIZ)trajectories and to evaluate the independent and interactive effect of the status of GDM and excessive GWG on the risks of overweight/obesity from birth to 24 months of age.Methods A total of 7949 mother-child pairs were enrolled in this study.The weight and length of children were measured at birth,6,12,and 24 months of age to calculate BMIZ.Results The status of GDM was positively associated with offspring BMIZ and risk of macrosomia at birth but was not associated with offspring BMIZ or the risks of overweight/obesity at 6,12,and 24 months of age.In contrast,excessive GWG was positively linked to offspring BMIZ,the stable high BMIZ trajectory pattern,and risks of overweight/obesity in the first 24 months of age.These two risk factors also had a significant synergistic effect on macrosomia at birth,but the interactive effect was only significant in boys during the follow-up years in the sex-stratified analyses.Conclusion The maternal GWG was a more pronounced predictor than GDM with relation to BMIZ and risk of overweight/obesity in early childhood.The interactive effect between these risk factors on offspring overweight/obesity may vary by sex.

Non-alcoholic fatty liver disease:An early mediator predicting metabolic syndrome in obese children?

AIM:To investigate if non-alcoholic fatty liver disease (NAFLD) is an early mediator for prediction of metabolic syndrome,and if liver B-ultrasound can be used for its diagnosis.METHODS:We classified 861 obese children (6-16 years old) into three subgroups:group 0 (normal liver in ultrasound and normal transaminases);group 1 (fatty liver in ultrasound and normal transaminases);and group 2 (fatty liver in ultrasound and elevated transaminases).We measured the body mass index,waist and hip circumference,blood pressure,fasting blood glucose,insulin,homeostasis model assessment of insulin resistance (HOMA-IR),whole-body insulin sensitivity index (WBISI),lipid profile and transaminases in all the participants.The risk of developing metabolic syndrome (MS) was assessed according to the degree of liver fatty infiltration based on the B-ultrasound examination.RESULTS:Among the 861 obese children,587 (68.18%) were classified as having NAFLD,and 221 (25.67%) as having MS.The prevalence of MS in NAFLD children (groups 1 and 2) was 37.64% (221/587),which was much higher than that in non-NAFLD group (group 0,12.04%) (P < 0.01).There were significantly higher incidences concerning every component of MS in group 2 compared with group 0 (P < 0.05).The incidence of NAFLD in MS patients was 84.61% (187/221),which was significantly higher than that of hypertension (57.46%,127/221) and glucose metabolic anomalies (22.62%,50/221),and almost equal to the prevalence of dyslipidemia (89.14%,197/221).Based on the B-ultrasound scales,the presence of moderate and severe liver fatty infiltration carried a high risk of hypertension [odds ratio (OR):2.18,95% confidence interval (95% CI):1.27-3.75],dyslipidemia (OR:7.99,95% CI:4.34-14.73),impaired fasting glucose (OR:3.65,95% CI:1.04-12.85),and whole MS (OR:3.77;95% CI:1.90-7.47,P < 0.01).The state of insulin resistance (calculated by HOMA-IR and WBISI) deteriorated as the degree of fatty infiltration increased.CONCLUSION:NAFLD is not only a liver disease,but also an early mediator that reflects metabolic disorder,and liver B-ultrasound can be a useful tool for MS screening.

Impact of exergaming on young children's school day energy expenditure and moderate-to-vigorous physical activity levels

Background: Although emerging research is demonstrating the potential health impact of exergaming,investigations have primarily been conducted in laboratory settings among small samples with short-term interventions.Information on the effectiveness of exergaming in underserved children's objective physical activity(PA) in population-based settings is also scarce.Moreover,most empirical studies have only included 1 type of exergame in the intervention.Therefore,this study's purpose was to investigate the long-term impact of a multigame exergaming intervention among underserved children integrated within school curricula.Specifically,this study examined the effect of exergaming on children's accelerometer-determined sedentary behavior(SB),light PA,moderate-to-vigorous PA(MVPA),and energy expenditure(EE) over 2 years as compared with regular physical education(PE) classes.Methods: A total of 261 second-and third-grade children(134 girls,127 boys; mean age 8.27 years) were recruited from 2 Texas elementary schools.Children's pre-test 3-day SB,light PA,MVPA,and EE at school were assessed in the fall of 2012.Participants were assigned to 1 of 2groups:(1) exergaming/PE group(125 min weekly of exergaming-based PA program) and (2) comparison group(125 min weekly of PE).PA(SB,light PA,and MVPA) and EE outcome variables were assessed again in 2013(post-test) and 2014(follow-up).Results: Significant time effects were observed for SB(F(1,162)=25.0,p<0.01,η~2= 0.14),light PA(F(1,162)=9.6,p<0.01,η~2= 0.06),and MVPA(F(1,162)=6.2,p=0.01,η~2= 0.04) but not for EE(F(1,162)=0.63,p>0.05,η~2= 0.004).Subsequent pairwise comparisons revealed significant increases from pre-to post-test for light PA(p<0.01),MVPA(p<0.01),and EE(p=0.02) with no changes in SB(p>0.05).Conversely,significant decreases occurred in light PA(p<0.01) from post-test to follow-up with no differences seen in MVPA(p=0.08) and EE(p=0.06) over the same time period.A significant increase was seen,however,for SB from post-test to follow-up.Conclusion: Exergaming PE can have the same positive effect on children's light PA,MVPA,and EE as regular PE.More research is necessary to discern how to promote long-term PA participation after conclusion of the intervention.

Impact of the COVID-19 kindergarten closure on overweight and obesity among 3-to 7-year-old children

Background Knowledge on the impact of the temporary kindergarten closure policy under COVID-19 in 2020 on childhood overweight and obesity is inadequate.We aimed to examine differences in rates of overweight and obesity from 2018 to 2021 among kindergarten children aged 3–7 years.Methods Overweight was defined as body mass index(BMI)>1 standard deviation(SD)for age and sex,and obesity was defined as BMI>2 SD for age and sex.Generalized linear mixed modeling was used for analysis.Results A total of 44,884 children and 71,216 growth data points from all 57 public kindergartens in Jiading District,Shanghai,China were analyzed.The rates of obesity from 2018 to 2021 were 6.9%,6.6%,9.5%,and 7.3%in boys and 2.8%,2.8%,4.5%,and 3.1%in girls,respectively.The rates of overweight from 2018 to 2021 were 14.3%,14.3%,18.2%,and 15.3%in boys and 10.6%,10.9%,13.9%,and 11.6%in girls.The rates of obesity and overweight among kindergarten children in 2020 were significantly higher than those in 2018,2019,and 2021.Compared to 2020,the odds ratios of the obesity rate in 2018,2019,and 2021 were 0.67[95%confidence interval(CI)=0.58–0.77,P<0.001],0.72(95%CI=0.64–0.80,P<0.001)and 0.81(95%CI=0.72–0.92,P=0.001),respectively.The odds ratios of the overweight rate in 2018,2019,and 2021 were 0.75(95%CI=0.69–0.82,P<0.001),0.78(95%CI=0.72–0.84,P<0.001),and 0.89(95%CI=0.81–0.97,P=0.008),respectively,compared to 2020.Conclusions The rates of overweight and obesity significantly increased among kindergarten children in 2020 after the 5-month kindergarten closure.It was critical to provide guidance to caregivers on fostering a healthy lifestyle for children at home under public health emergencies.

Is triglyceride to high-density lipoprotein cholesterol ratio a surrogates for insulin resistance in youth?

As elevated triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio has been described as predictor for cardio metabolic disease with insulin resistance (IR) in the background, the aim was to assess the relationship between this ratio and IR in youth. Oral glucose tolerance test was performed in 318 Brazilian students (175 girls, 11.2 ± 3.2 years, BMI_z-score 1.2 ± 1.4 SD). Measurements: BMI, waist circumference (WC), blood pressure (BP), lipids, insulin and high sensitivity Creactive protein (hsCRP). Excessive weight and abdominal obesity were defined using BMI_z-score and WC and IR by Homeostasis model assessment-insulin resistance (HOMA-IR). TG/HDL-C median was 2.37. There was an association between TG/ HDL-C and WC, systolic and diastolic BP, insulin, HOMA-IR, hsCRP, (p < 0.001). Stratified TG/HDL-C into two groups, based on a cut off point of 2.73 (Group 1: <2.73 and Group 2: ≥2.73). Ad- justing for age, gender, ethnicity TG/HDL-C was an independent variable predicting IR (PR = 1.44;CI: 1.07 - 1.96;p = 0.018). For every 1 (cm) in WC increased there was an addition of 0.04 of the value of TG/HDL-C and in those with TG/HDL-C ≥ 2.73 for every 10 (cm) increase in WC there was an improve of 4% in the ratio. In conclusion: In youth, the TG/HDL-C ratio could be a useful index for identifying groups with IR.