P.M. Mollerup

A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting

Background Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. Methods In this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children’s Obesity Clinics’ Treatment protocol. Height, weight, and WC were measured at all consultations. Changes in BMI SDS and WC were analyzed using linear mixed models based upon the repeated measures in each child. Results From June 2012 to January 2015, 1,001 children (455 boys) were consecutively enrolled in the community-based treatment program. Upon entry, the median age was 11 years (range: 3−18), and the median BMI SDS was 2.85 (range: 1.26−8.96) in boys and 2.48 (range: 1.08−4.41) in girls. After 1.5 years of treatment BMI SDS was reduced in 74% of the children. BMI SDS was reduced by a mean of 0.38 (95% confidence interval (CI): 0.30−0.45, p<0.0001) in boys and 0.18 (95% CI: 0.12−0.25, p<0.0001) in girls after 1.5 years of treatment, independently of baseline age, BMI SDS, and Tanner stage (all p>0.08). WC was reduced by a mean of 3.8 cm (95% CI: 2.7−4.9, p>0.0001) in boys and 5.1 cm (95% CI: 4.0−6.2, p>0.0001) in girls. The dropout rate was 31% after 1.5 years. A median of 4.5 consultation hours was invested per child per year. Conclusion BMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility.

No influence of sugar, snacks and fast food intake on the degree of obesity or treatment effect in childhood obesity

Increased consumption of sweetened beverages has previously been linked to the degree of childhood obesity.

Impaired fasting glucose and the metabolic profile in Danish children and adolescents with normal weight, overweight, or obesity

Whether the definitions of impaired fasting glucose (IFG) from the American Diabetes Association (ADA) and the World Health Organization (WHO) differentially impact estimates of the metabolic profile and IFG‐related comorbidities in Danish children and adolescents is unknown.

Childhood obesity treatment; Effects on BMI SDS, body composition, and fasting plasma lipid concentrations.

Objective The body mass index (BMI) standard deviation score (SDS) may not adequately reflect changes in fat mass during childhood obesity treatment. This study aimed to investigate associations between BMI SDS, body composition, and fasting plasma lipid concentrations at baseline and during childhood obesity treatment. Methods 876 children and adolescents (498 girls) with overweight/obesity, median age 11.2 years (range 1.6–21.7), and median BMI SDS 2.8 (range 1.3–5.7) were enrolled in a multidisciplinary outpatient treatment program and followed for a median of 1.8 years (range 0.4–7.4). Height and weight, body composition measured by dual-energy X-ray absorptiometry, and fasting plasma lipid concentrations were assessed at baseline and at follow-up. Lipid concentrations (total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), non-HDL, and triglycerides (TG)) were available in 469 individuals (264 girls). Linear regressions were performed to investigate the associations between BMI SDS, body composition indices, and lipid concentrations. Results At baseline, BMI SDS was negatively associated with concentrations of HDL (p = 6.7*10−4) and positively with TG (p = 9.7*10−6). Reductions in BMI SDS were associated with reductions in total body fat percentage (p<2*10−16) and percent truncal body fat (p<2*10−16). Furthermore, reductions in BMI SDS were associated with improvements in concentrations of TC, LDL, HDL, non-HDL, LDL/HDL-ratio, and TG (all p <0.0001). Changes in body fat percentage seemed to mediate the changes in plasma concentrations of TC, LDL, and non-HDL, but could not alone explain the changes in HDL, LDL/HDL-ratio or TG. Among 81 individuals with available lipid concentrations, who increased their BMI SDS, 61% improved their body composition, and 80% improved their lipid concentrations. Conclusion Reductions in the degree of obesity during multidisciplinary childhood obesity treatment are accompanied by improvements in body composition and fasting plasma lipid concentrations. Even in individuals increasing their BMI SDS, body composition and lipid concentrations may improve.

No influence of sugar, snacks and fast food intake on the degree of obesity or treatment effect in childhood obesity: Sugar intake in childhood obesity treatment

Increased consumption of sweetened beverages has previously been linked to the degree of childhood obesity.

No influence of sugar, snacks and fast food intake on the degree of obesity or treatment effect in childhood obesity: Pediatric Obesity

Increased consumption of sweetened beverages has previously been linked to the degree of childhood obesity.

Influence of sugar, snacks, and fast food intake on childhood obesity treatment

Nutrition preference lists do exist for adults (NPL-E) and children between 8 and 18 years (NPL-CJ, Ardelt-Gattinger & Meindl, 2010). For children 4–6 they are limited to fruits and vegetables (Carraway-Stage, Spangler, Borges, & Goodell, 2014). Thus, this prestudy of SALzburg Together against Obesity aimed to revise, standardize and validate the NPL-CJ for 4–6 year olds. For item analysis and validation the NPL_4–6 was tested in thirty 4to 6-yearold children. Pictures of various foods were evaluated using a 3-point smiley scale. The results were validated by parental rating (P_Val) and children’s buying behaviour in a grocery play situation (GS_Val). Test consistency was measured with reliability analysis and retest reliability was set as significant at p < .05. Twenty-eight items were extracted for overall scale (Cronbach’s Alpha .81). Retest reliabilities were r = −.12–.68. Validation with P_Val was partly significant with rs = −.22–.59 and with GS_Val partly significant with rs = −.31–.76. Consistency was moderate to high. However, due to children’s unexpected misperceptions of some food, validity did not achieve standards in test development (see also Vereecken, Vandervorst, Nicklas, Covents, & Maes, 2010). Further research is warranted.