Childhood obesity in New Zealand

Background Paediatric obesity has reached epidemic proportions globally,resulting in significant adverse effects on health and wellbeing.Early life events,including those that happen before,during,and after pregnancy can predispose children to later obesity.The purpose of this review is to examine the magnitude of obesity among New Zealand children and adolescents,and to determine their underlying risk factors and associated comorbidities.Data sources PubMed,Web of Science,and Google Scholar searches were performed using the key terms 'obesity','overweight','children','adolescents',and 'New Zealand'.Results Obesity is a major public health concern in New Zealand,with more than 33% of children and adolescents aged 2-14 years being overweight or obese.Obesity disproportionately affects Māori (New Zealand's indigenous population) and Pacific children and adolescents,as well as those of lower socioeconomic status.New Zealand's obesity epidemic is associated with numerous health issues,including cardiometabolic,gastrointestinal,and psychological problems,which also disproportionately affect Māori and Pacific children and adolescents.Notably,a number of factors may be useful to identify those at increased risk (such as demographic and anthropometric characteristics) and inform possible interventions.Conclusions The prevalence of overweight and obese children and adolescents in New Zealand is markedly high,with a greater impact on particular ethnicities and those of lower socioeconomic status.Alleviating the current burden of pediatric obesity should be a key priority for New Zealand,for the benefit of both current and subsequent generations.Future strategies should focus on obesity prevention,particularly starting at a young age and targeting those at greatest risk.

Surrogate markers and predictors of endogenous insulin secretion in children and adolescents with type 1 diabetes

Background No studies have examined endogenous insulin secretion in pediatric patients with type 1 diabetes in China using the gold-standard mixed-meal tolerance test.Because the latter is labor-intensive,we examined simpler surrogate markers of endogenous insulin secretion in Chinese youth,as previously reported for a European population.Methods Participants were 57 children and adolescents with type 1 diabetes aged 4.4-16.8 years(56% females).We per-formed 120-minute mixed-meal tolerance tests with serum C-peptide(CP)measurements every 30 minutes.Severe insulin deficiency(SID)was defined as CP peak<0.2 nmol/L.Urine CP and creatinine levels were measured at 0 and 120 minutes.Results Twenty-five(44%)patients had SID.Fasting CP levels missed one case(96% sensitivity)with no false posi-tives(100% specificity).While the 120-minute urine CP/creatinine had 100% sensitivity,it yielded markedly lower speci-ficity(63%).Every 1-year increase in diabetes duration and 1-year decrease in age at diagnosis were associated with 37%(P<0.001)and 20%(P=0.005)reductions in serum CP area-under-the-curve,respectively.Thus,86% of children aged<5 years had SID compared to none among patients aged ≥11 years.Conclusions Simple fasting CP measurements could be used to detect most SID cases in Chinese youth with type 1 diabe-tes.Fasting CP is a far more reliable measure of endogenous insulin secretion than the more commonly used insulin dose.Therefore,it could more precisely determine insulin secretory capacity to target those who could benefit,if treatments to preserve residual insulin secretion are developed.