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Tee LP, Brandreth RA, Sauven N, Clarke L, Frampton I. Successful outcomes in childrens specialist weight management: Impact assessment of a novel early years weight management programme. J Hum Nutr Diet 2021; 34:819-826. [PMID: 33894093 DOI: 10.1111/jhn.12872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/11/2021] [Accepted: 02/04/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND In the UK, more than one in five children are overweight on starting school. An elevated body mass index (BMI) in childhood increases the likelihood of developing many health and social issues. The Lifestyles, Eating and Activity for Families (LEAF) programme is a weight management service for clinically obese children under the age of 7 years and their families. This study evaluates the effectiveness of the LEAF programme by measuring BMI z-score change, the reduction in calorific beverage consumption and user satisfaction. METHODS Data were collected over 6 years from 2012 and children who met the local weight management pathway criteria were recruited. Contact time was typically 20 h over 12 months and included home and clinic-based assessment by the multidisciplinary team and community-based intervention through six group sessions. This study compared baseline and post-intervention BMI z-scores (zBMI) for 65 children, as well as daily total calorific intakes from beverages for 41 children, and, in addition, 20 parents completed user satisfaction questionnaires. RESULTS There was a highly significant reduction in both mean zBMI (0.5; p < 0.001) and mean total calories from beverages (199; p < 0.001) across the intervention period. There was no significant correlation between zBMI and beverage calorific trends. Families who completed user satisfaction questionnaires reported that they had changed their dietary habits and 90% would recommend the programme to others. CONCLUSIONS This initial evaluation indicates that the LEAF programme was effective in reducing the zBMI of a group of clinically obese young children. Keywords obesity epidemic, young children, intervention, multidisciplinary.
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Affiliation(s)
- Louise P Tee
- Department of Child Health, Royal Cornwall Hospitals Trust, Truro, UK
| | | | - Natasha Sauven
- Department of Child Health, Royal Cornwall Hospitals Trust, Truro, UK
| | - Lia Clarke
- Cornwall Children's Research Service, Truro, UK.,School of Psychology, University of Exeter, Exeter, UK
| | - Ian Frampton
- Cornwall Children's Research Service, Truro, UK.,School of Psychology, University of Exeter, Exeter, UK
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Guildford L, Crofts C, Lu J. Can the Molar Insulin: C-Peptide Ratio Be Used to Predict Hyperinsulinaemia? Biomedicines 2020; 8:biomedicines8050108. [PMID: 32375229 PMCID: PMC7277201 DOI: 10.3390/biomedicines8050108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 01/18/2023] Open
Abstract
Hyperinsulinaemia is the precursor to numerous metabolic disorders. Early diagnosis and intervention could improve population health. Diagnosing hyperinsulinaemia is problematic because insulin has a very short half-life (2–5 min). It is theorised that c-peptide levels (half-life 20–30 min) would be a better proxy for insulin due to both hormones being released in equimolar amounts. However, the correlation between c-peptide and insulin levels is unknown. We aim to identify their correlation following a four-hour oral glucose tolerance test (OGTT). Data were obtained from records of routine medical care at St Joseph’s Hospital, Chicago, IL, USA, during 1977. Two hundred and fifty-five male and female participants aged over 20 years undertook a four-hour OGTT with plasma glucose, insulin and c-peptide levels recorded. Correlation was assessed with Pearson’s correlation. There was a weak correlation between insulin and c-peptide, which increased to moderate across the four-hour OGTT (r = 0.482–0.680). There was no significant change in this relationship when data was subdivided according to either the WHO glucose status or Kraft insulin response. Although there was a correlation between insulin and c-peptide, it was too weak to recommend the use of c-peptide as an alternative biomarker for the diagnosis of hyperinsulinaemia.
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Affiliation(s)
- Lynda Guildford
- School of Public Health and Interdisciplinary Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 0627, New Zealand;
- School of Science, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 1010, New Zealand
| | - Catherine Crofts
- School of Public Health and Interdisciplinary Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 0627, New Zealand;
- Human Potential Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 0632, New Zealand
- Correspondence: (C.C.); (J.L.); Tel.: +64-9-921-9999 (ext. 6030) (C.C.); +64-9-921-9999 (ext. 7381) (J.L.)
| | - Jun Lu
- School of Public Health and Interdisciplinary Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 0627, New Zealand;
- School of Science, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 1010, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland 1010, New Zealand
- Institute of Biomedical Technology, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
- College of Life and Marine Sciences, Shenzhen University, Shenzhen 518071, China
- College of Food Engineering and Nutrition Sciences, Shaanxi Normal University, Xi’an 710119, China
- Correspondence: (C.C.); (J.L.); Tel.: +64-9-921-9999 (ext. 6030) (C.C.); +64-9-921-9999 (ext. 7381) (J.L.)
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Mostazir M, Jeffery A, Voss L, Wilkin T. Generational change in fasting glucose and insulin among children at ages 5-16y: Modelled on the EarlyBird study (2015) and UK growth standards (1990) (EarlyBird 69). Diabetes Res Clin Pract 2017; 123:18-23. [PMID: 27918974 DOI: 10.1016/j.diabres.2016.11.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 11/21/2016] [Indexed: 01/09/2023]
Abstract
AIM Pre-diabetes is a state of beta-cell stress caused by excess demand for insulin. Body mass is an important determinant of insulin demand, and BMI has risen substantially over recent time. We sought to model changes in the parameters of glucose control against rising BMI over the past 25years. METHODS Using random coefficient mixed models, we established the correlations between HbA1C, fasting glucose, fasting insulin, HOMA2-IR and BMI in contemporary (2015) children (N=307) at ages 5-16y from the EarlyBird study, and modelled their corresponding values 25years ago according to the distribution of BMI in the UK Growth Standards (1990). RESULTS There was little change in HbA1C or fasting glucose over the 25y period at any age or in either gender. On the other hand, the estimates for fasting insulin and HOMA2-IR were substantially higher in both genders in 2015 compared with 1990. CONCLUSION Insofar as it is determined by body mass, there has been a substantial rise in beta cell demand among children over the past 25years. The change could be detected by fasting insulin and HOMA2-IR, but not by fasting glucose or HbA1C.
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Affiliation(s)
- Mohammod Mostazir
- Institute of Health Research, University of Exeter Medical School, Exeter, UK; College of Life and Environmental Sciences (CLES), University of Exeter, Exeter, UK.
| | - Alison Jeffery
- Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, UK
| | - Linda Voss
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - Terence Wilkin
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
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Li T, Jiao W, Li W, Li H. Sex effect on insulin secretion and mitochondrial function in pancreatic beta cells of elderly Wistar rats. Endocr Res 2016; 41:167-79. [PMID: 26865180 DOI: 10.3109/07435800.2015.1124437] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIMS/HYPOTHESIS Glucose tolerance progressively declines with age, and there is a high prevalence of type 2 diabetes in the elderly people. Previous studies have reported the sex differences in risk for type 2 diabetes, especially in the elderly people, whereas reasons for these sex differences remain poorly understood. This study aims to evaluate the effect of sex on glucose-stimulated insulin secretion and mitochondrial function in pancreatic beta cells of Wistar rats. METHODS 3-month-old and 18-month-old Wistar rats of both sexes were used. Insulin secretion of islets was analyzed by glucose-stimulated insulin secretion and islet perifusion assays; ATP content and oxygen consumption rate of islets were determined to evaluate the mitochondrial function. RESULTS Insulin secretion of islets under high glucose conditions declined significantly with age in both sexes. Glucose-stimulated insulin secretion of elderly female groups was markedly higher than that of male groups under high glucose conditions. Importantly, islets from elderly female groups showed higher mitochondrial function compared with male counterparts, evidenced by higher ATP content and oxygen consumption rate under high glucose conditions. It was also noted that mitochondrial biogenesis of islets from elderly female rats was significant higher compared with male rats. There were notable increases in expression of genes involved in mitochondrial biogenesis in islets from elderly female rats compared with male rats. CONCLUSION This study demonstrates a sex dimorphism in the age-associated impairment of pancreatic beta cell function in elderly rats, while the potential mechanism may be related to the sexual differences in mitochondrial biogenesis and function.
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Affiliation(s)
- Tianyi Li
- a Department of Elderly Endocrinology, First Affiliated Hospital , Zhengzhou University , Zhengzhou , China
| | - Wenjun Jiao
- a Department of Elderly Endocrinology, First Affiliated Hospital , Zhengzhou University , Zhengzhou , China
| | - Weifang Li
- a Department of Elderly Endocrinology, First Affiliated Hospital , Zhengzhou University , Zhengzhou , China
| | - Hua Li
- a Department of Elderly Endocrinology, First Affiliated Hospital , Zhengzhou University , Zhengzhou , China
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Jeffery AN, Hyland ME, Hosking J, Wilkin TJ. Mood and its association with metabolic health in adolescents: a longitudinal study, EarlyBird 65. Pediatr Diabetes 2014; 15:599-605. [PMID: 24552539 DOI: 10.1111/pedi.12125] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 01/06/2014] [Accepted: 01/08/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Mood comprises two main traits - positive and negative affect, both associated with depression and anxiety. Studies in children have linked depression with obesity, but the association with metabolic health is unclear. OBJECTIVE To explore the relationship between mood and metabolic health in adolescents. METHODS We studied 208 healthy children (115 boys) enrolled in the longitudinal EarlyBird Diabetes Study, and reviewed at 7 and 16 yr. Participants completed the Positive Affect and Negative Affect Schedule - Child Form (PANAS-C) at 16yr to assess positive and negative affect, together representing mood. Measures at 7 and 16 yr: body mass index (BMI), fat (%; dual energy X-ray absorptiometry), physical activity (accelerometer), metabolic risk z-score comprising homeostasis model assessment-insulin resistance (HOMA-IR), triglycerides, total cholesterol/high density lipoprotein (HDL) ratio and blood pressure. Pubertal development was determined by age at peak height velocity. RESULTS Positive affect was higher in boys than girls, (50 vs. 46, p = 0.001), negative affect higher in girls than boys (26 vs. 22, p < 0.001). Those with lower mood were fatter (r = -0.24, p < 0.001), had higher HOMA-IR (r = -0.12, p = 0.05), higher cholesterol:HDL ratio (r = -0.14, p = 0.02), were less active (r = 0.20, p = 0.003) and had earlier pubertal development (r = 0.19, p = 0.004). Inverse associations between mood and metabolic risk z-score and change in metabolic risk z-score 7-16yr (β = -0.26, p = 0.006, and -0.40, p = 0.004, respectively) were independent of adiposity, physical activity and puberty and sex. CONCLUSIONS Low mood in healthy children is associated with poorer metabolic health independently of adiposity. These findings may have implications for the physical and mental health of contemporary youngsters, given their increasing obesity and cardiometabolic risk.
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Affiliation(s)
- Alison N Jeffery
- Institute of Translational and Stratified Medicine, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
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De Coen V, De Bourdeaudhuij I, Verbestel V, Maes L, Vereecken C. Risk factors for childhood overweight: a 30-month longitudinal study of 3- to 6-year-old children. Public Health Nutr 2014; 17:1993-2000. [PMID: 24172063 PMCID: PMC11108727 DOI: 10.1017/s1368980013002346] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 06/14/2013] [Accepted: 07/25/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The increasing prevalence of childhood overweight is an important health issue. There is a need for longitudinal research among children in order to identify risk factors for childhood overweight. The objective of the present research was to identify potential sociodemographic and behavioural risk factors for development of childhood overweight among 3- to 6-year-old children. DESIGN Longitudinal study. SETTING Sixteen pre-primary and primary schools. SUBJECTS BMI Z-scores at baseline and two follow-up measurements were calculated for 568 children. Sociodemographic, parental adiposity, familial composition, child's diet, physical activity and sedentary behavioural data were collected through questionnaires. RESULTS Several risk factors for the development of childhood overweight were found. Being an only child, lower maternal educational level, maternal and paternal overweight, more than 1 h screen time on weekdays and high soft drinks consumption were shown to be positively associated with the development of childhood overweight. CONCLUSIONS Although behavioural factors are important, our findings support the thesis that interventions on the prevention of childhood overweight should focus on high-risk groups, i.e. children from low socio-economic background or with high parental BMI. Interventions should address the whole family and take into account their lifestyle and structure.
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Affiliation(s)
- Valerie De Coen
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, De Pintelaan 185, B-9000 Ghent, Belgium
| | - Ilse De Bourdeaudhuij
- Faculty of Medicine and Health Sciences, Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Vera Verbestel
- Faculty of Medicine and Health Sciences, Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Lea Maes
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, De Pintelaan 185, B-9000 Ghent, Belgium
| | - Carine Vereecken
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, De Pintelaan 185, B-9000 Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
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Abstract
Men are well known to have a higher risk than women for cardiovascular disease. In recent years, however, studies show adult men also have higher risk for type 2 diabetes, an observation which has important clinical implications, particularly in the public health arena. This chapter explores the relevant data underlying this observation, examines potential mechanisms including life course changes in insulin resistance and role of adiposity, and discusses relevant clinical implications and solutions.
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Affiliation(s)
- Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK.
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8
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Jeffery A. Prepubertal insulin resistance. PRACTICAL DIABETES 2012. [DOI: 10.1002/pdi.1676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Jeffery AN, Metcalf BS, Hosking J, Streeter AJ, Voss LD, Wilkin TJ. Age before stage: insulin resistance rises before the onset of puberty: a 9-year longitudinal study (EarlyBird 26). Diabetes Care 2012; 35:536-41. [PMID: 22279034 PMCID: PMC3322712 DOI: 10.2337/dc11-1281] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Insulin resistance (IR) is associated with diabetes. IR is higher during puberty in both sexes, with some studies showing the increase to be independent of changes in adiposity. Few longitudinal studies have reported on children, and it remains unclear when the rise in IR that is often attributed to puberty really begins. We sought to establish from longitudinal data its relationship to pubertal onset, and interactions with age, sex, adiposity, and IGF-1. RESEARCH DESIGN AND METHODS The EarlyBird Diabetes study is a longitudinal prospective cohort study of healthy children aged 5-14 years. Homeostasis model assessment (HOMA-IR), skinfolds (SSF), adiposity (percent fat, measured by dual-energy X-ray absorptiometry), serum leptin, and IGF-1 were measured annually in 235 children (134 boys). Pubertal onset was adduced from Tanner stage (TS) and from the age at which luteinizing hormone (LH) first became serially detectable (≥0.2 international units/L). RESULTS IR rose progressively from age 7 years, 3-4 years before TS2 was reached or LH became detectable. Rising adiposity and IGF-1 together explained 34% of the variance in IR in boys and 35% in girls (both P < 0.001) over the 3 years preceding pubertal onset. The contribution of IGF-1 to IR was greater in boys, despite their comparatively lower IGF-1 levels. CONCLUSIONS IR starts to rise in mid-childhood, some years before puberty. Its emergence relates more to the age of the child than to pubertal onset. More than 60% of the variation in IR prior to puberty was unexplained. The demography of childhood diabetes is changing, and prepubertal IR may be important.
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Harron KL, Feltbower RG, McKinney PA, Bodansky HJ, Campbell FM, Parslow RC. Rising rates of all types of diabetes in south Asian and non-south Asian children and young people aged 0-29 years in West Yorkshire, U.K., 1991-2006. Diabetes Care 2011; 34:652-4. [PMID: 21278139 PMCID: PMC3041200 DOI: 10.2337/dc10-1512] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate incidence trends of all diabetes types in all children and young people and in the south Asian subpopulation. RESEARCH DESIGN AND METHODS Annual incidence per 100,000 and time trends (1991-2006) were analyzed for 2,889 individuals aged 0-29 years diagnosed with diabetes while resident in West Yorkshire, U.K. RESULTS Diagnoses comprised type 1 (83%), type 2 (12%), maturity-onset diabetes of the young (0.7%), "J"-type/other (0.1%), and uncertain/unclassified (4%). There was a lower incidence of type 1 and a threefold excess of type 2 in south Asians compared with non-south Asians. Type 1 incidence leveled out and type 2 increased after the first south Asian case of type 2 was diagnosed in 1999. Type 2 and unclassified diabetes incidence rose in all population subgroups. CONCLUSIONS The burden of diabetes increased over time for both ethnic groups, with a significant excess of type 2 diabetes in south Asians. The rising incidence of type 1 diabetes in south Asians attenuated as type 2 diabetes increased after 1999.
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Affiliation(s)
- Katie L Harron
- Paediatric Epidemiology Group, University of Leeds, Leeds, UK
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Bundy V, Johnson M, Gutin B, Zhu H, Stallmann-Jorgensen I, Dong Y. Adiponectin moderates the relationship between adiposity and leptin in adolescents regardless of gender or race. J Pediatr Endocrinol Metab 2011; 24:119-24. [PMID: 21648277 PMCID: PMC3909950 DOI: 10.1515/jpem.2011.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To determine gender or race differences in associations between adiposity and leptin, and whether adiponectin moderates these relationships. METHODS Subjects were 441 adolescents, 14-18 years old (44% black, 56% white; 50% female, 50% male). Percent body fat (%BF) was measured with dual-energy X-ray absorptiometry. Leptin and adiponectin were measured using immunoassays. RESULTS Among the four groups (white boys, white girls, black boys and black girls), white girls had the highest adiponectin (p = 0.0017) and black girls had the highest leptin (p = 0.0164). Percent BF and leptin were positively correlated (p = 0.0164). The %BF-leptin relationship was stronger in boys than girls (p < 0.0001). Those with lower adiponectin had a stronger %BF-leptin relationship than those with high adiponectin in the entire sample (p = 0.0220). Statistical models were adjusted for age, race, gender and the interaction between race and gender. CONCLUSION Our data suggest a protective metabolic interaction for adiponectin and lend additional support for obesity prevention strategies in adolescents.
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Affiliation(s)
- Vanessa Bundy
- Department of Pediatrics, Georgia Prevention Institute, Medical College of Georgia, Augusta, GA 30912, USA
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Otabe S, Nakayama H, Fukutani T, Yuan X, Wada N, Hashinaga T, Mitsui A, Kato T, Inada C, Tajiri Y, Yamada K. Excessive maternal transmission of diabetes in Japanese families with young-onset type 2 diabetes and insulin secretion defect according to clinical features. Acta Diabetol 2010; 47 Suppl 1:133-8. [PMID: 19787289 DOI: 10.1007/s00592-009-0152-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Accepted: 08/26/2009] [Indexed: 10/20/2022]
Abstract
The aim of the study is to identify the clinical characteristics of Japanese patients with young-onset type 2 diabetes (YT2D). Family history of diabetes and clinical data were collected for 30 unrelated males (from 11 to 20 years old at age of onset) and 20 females (from 10 to 20 years old at age of onset) with YT2D diagnosed at ≤ 20 years of age. Fasting C-peptide levels were measured in all, and glucagon stimulation tests were performed twice in six of them over several years. Moreover, 858 people with type 2 diabetes (T2D) diagnosed at >20 years of age were randomly recruited in order to compare the transmission pattern of them. Among the study subjects, 68% reported at least one parent with diabetes. Diabetes was more frequent among mothers than fathers of probands (P = 0.020), although this tendency was not observed in T2D diagnosed at >20 years of age. Fasting C-peptide levels of patients with diabetes duration of ≥ 10 years were significantly lower than for patients with diabetes duration of <10 years (0.61 ± 0.26 vs. 0.84 ± 0.43 nmol/l, P = 0.036). The fasting C-peptide levels among male patients with a family history of diabetes were also significantly lower than those without a family history (0.56 ± 0.25 vs. 0.83 ± 0.37 nmol/l, P = 0.034), while all female subjects had a family history of diabetes. Glucagon stimulation tests showed the following data; 0 min: 0.56 ± 0.31 vs. 0.39 ± 0.22 nmol/l, 3 min: 1.41 ± 0.77 vs. 0.87 ± 0.47 nmol/l, 6 min: 1.37 ± 0.80 vs. 0.79 ± 0.35 nmol/l, 10 min: 1.06 ± 0.60 vs. 0.81 ± 0.49 nmol/l, and 30 min: 0.58 ± 0.30 vs. 0.50 ± 0.19 nmol/l, respectively. These results demonstrated that YT2D among Japanese people occurring in excess with maternal transmission is associated with β-cell dysfunction at the onset of diabetes and as the disease advances.
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Affiliation(s)
- Shuichi Otabe
- Division of Endocrinology and Metabolism, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan.
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Head BJ, Barr KL, Baker SK. Mexican American Parents’ Perceptions of Childhood Risk Factors for Type 2 Diabetes. J Sch Nurs 2010; 27:51-60. [DOI: 10.1177/1059840510392050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A study was conducted to identify the norms, values, and perceptions of urban immigrant Mexican American (MA) parents of school children relative to physical activity, healthy eating, and child risk factors for type 2 diabetes. Investigators facilitated five focus groups in an urban elementary school setting and analyzed data using qualitative analysis techniques. Methods for participant recruitment, conduct of focus groups, and qualitative data analysis are detailed. Results of analysis are presented. The relationship between parent focus group discussion and the conceptual framework guiding the study are depicted. Implications for practice and research are discussed.
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Eriksson S, Palsdottir V, Garemo M, Mellström D, Strandvik B. Metabolic profiles of fat and glucose differ by gender in healthy 8-year-olds. Acta Paediatr 2010; 99:78-82. [PMID: 19785634 DOI: 10.1111/j.1651-2227.2009.01513.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim was to investigate if metabolic markers were associated with anthropometry and weight increase in healthy 8-year-olds. METHODS Ninety-seven healthy children, 66 of whom had been examined at the age of 4 years, were investigated. Dual energy X-ray absorptiometry was performed to determine fat (FM) and lean body mass (LBM). Plasma glucose and serum levels of insulin, cholesterol, triglycerides, adiponectin and leptin were analysed and HOMA-indices were calculated. RESULTS Despite similar anthropometry, metabolic markers differed by gender. Sixteen % of the children were overweight or obese. Body mass index (BMI) was strongly correlated to FM. Anthropometric measures except LBM correlated to metabolic markers in the girls. Boys had higher concentrations of plasma glucose than girls. In overweight children, insulin was negatively associated with LBM. Leptin and the ratio between leptin and adiponectin, but not adiponectin, were significantly associated with HOMA-IR and body composition. CONCLUSION The metabolic profile of plasma glucose, serum leptin, fasting insulin and related HOMA indices differed by gender, despite no difference in BMI or FM. LBM, but not FM correlated to the insulin concentration in the overweight children. Leptin was the best marker of overweight.
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Affiliation(s)
- Susanne Eriksson
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
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Nagy V, Benltifa M, Vidal S, Berzsényi E, Teilhet C, Czifrák K, Batta G, Docsa T, Gergely P, Somsák L, Praly JP. Glucose-based spiro-heterocycles as potent inhibitors of glycogen phosphorylase. Bioorg Med Chem 2009; 17:5696-707. [DOI: 10.1016/j.bmc.2009.05.080] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2009] [Revised: 05/25/2009] [Accepted: 05/31/2009] [Indexed: 02/06/2023]
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Tóth M, Kun S, Bokor É, Benltifa M, Tallec G, Vidal S, Docsa T, Gergely P, Somsák L, Praly JP. Synthesis and structure–activity relationships of C-glycosylated oxadiazoles as inhibitors of glycogen phosphorylase. Bioorg Med Chem 2009; 17:4773-85. [DOI: 10.1016/j.bmc.2009.04.036] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2009] [Revised: 04/15/2009] [Accepted: 04/17/2009] [Indexed: 12/22/2022]
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Hendershot C, Telljohann SK, Price JH, Dake JA, Mosca NW. Elementary school nurses' perceptions and practices regarding body mass index measurement in school children. J Sch Nurs 2009; 24:298-309. [PMID: 18941154 DOI: 10.1177/1059840508323094] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study examines elementary school nurses' perceived efficacy expectations, perceived barriers, and perceived benefits to measuring body mass index (BMI) in students in schools with mandated BMI policies versus schools without mandated policies. Of the 2,629 school nurses participating in the study, 67% believe nurses should measure BMI in schools, 62% believe BMI results should be sent home, and 81% believe nurses should be designing programs to help children address overweight issues. In schools with a BMI assessment mandate, the nurses' efficacy expectations are statistically significantly greater and nurses' perceptions of barriers to measuring BMI are significantly lower. The most common perceived barriers to measuring BMI are inadequate school resources (57.6%) and inadequate or inappropriate parental responses (55.2%). Obese school nurses perceive significantly more barriers to measuring youths' BMIs than do nonobese school nurses. Having mandates has a positive influence on school nurses and their measurement of BMI and increases the likelihood that nurses will measure BMI.
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Sheikh Rashid A, Jabbar A, Michels RPJ, DeVries JH. Metabolic risk factors, insulin-resistance and lifestyle in children of type 2 diabetes patients in Karachi, Pakistan. Diabetes Res Clin Pract 2008; 80:399-404. [PMID: 18313164 DOI: 10.1016/j.diabres.2008.01.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2007] [Accepted: 01/19/2008] [Indexed: 11/17/2022]
Abstract
AIMS To assess metabolic risk factors, insulin-resistance and lifestyle in children aged 8-20 years of patients with type 2 diabetes and to compare these with children aged 8-20 years of non-diabetic subjects. METHODS Case-control study. Data were collected from 37children/adolescents of type 2 diabetes patients and 37 controls from parents without diabetes. Variables included physical activity, diet, socioeconomic class, family history, ethnic background, anthropometric measures, blood pressure and fasting glucose and insulin. RESULTS Groups were comparable for age and gender. Differences between cases and controls were found for BMI (22.6 vs. 19.1kg/m(2), p=0.004), waist circumference (70.1 vs. 62.1cm, p=0.014), systolic blood pressure (104.5+/-15.1 vs. 97.9+/-13.4mmHg, p=0.05), diastolic blood pressure (66.2+/-10.9 vs. 60.7+/-10.1mmHg, p=0.025). Vegetable intake (3% of cases having two and 19% one full serving a day vs., respectively, 14% and 32% amongst controls, p=0.01) was less favourable in cases, and physical activity tended to be (5h vs. 9h/week, p=0.065). CONCLUSIONS Children of type 2 diabetes patients have higher BMI and blood pressure than controls but also lead a less healthy lifestyle. This suggests that both genetic and lifestyle factors contribute to the increased risk of metabolic syndrome in children and early preventive measures towards changing lifestyle could help in prevention.
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Affiliation(s)
- A Sheikh Rashid
- Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands.
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19
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Syn WK, Nightingale P, Bateman JM. Nonalcoholic fatty liver disease in a district general hospital: clinical presentation and risk factors. Hepatol Int 2008; 2:190-5. [PMID: 19669303 PMCID: PMC2716851 DOI: 10.1007/s12072-008-9044-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Accepted: 01/16/2008] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Nonalcoholic fatty liver disease (NAFLD) affects one-fifth of the adult population and is currently the commonest liver problem in the western world. The prevalence of NAFLD is likely to rise over the coming decades in parallel to the obesity and diabetes epidemics. A retrospective study was undertaken in a UK. district general hospital (DGH) to determine the clinical and laboratory features of patients with NAFLD. METHODS AND FINDINGS A total of 48 patients with NAFLD were identified. Most (54%) were asymptomatic on presentation and 90% had an echogenic liver on ultrasonography (USS). Liver tests were elevated in the majority, but did not distinguish between simple steatosis and steatohepatitis. Having features of the metabolic syndrome and a low platelet count (P = 0.028) may help identify patients with advanced hepatic fibrosis. CONCLUSIONS NAFLD is common in the DGH and should be considered in all patients with metabolic risk factors. A liver biopsy should be considered in those with low platelets, type II diabetes mellitus, and the metabolic syndrome.
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Affiliation(s)
- Wing-Kin Syn
- Princess Royal Hospital, Apley Castle, Telford, Shropshire, TF1 6TF UK
- Liver Unit and Hepatobiliary Unit, Queen Elizabeth Hospital, 3rd Floor Nuffield House, Birmingham, B15 2TH UK
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20
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Abstract
The rapid increase in the population prevalence of type 2 diabetes mellitus (T2DM) in youth can only be explained by changes in lifestyle. However, even when most members of a population have changed their lifestyle, only a minority of children develop diabetes, and genetic factors are important in determining which children are affected. Support for the role of genetic factors comes from epidemiological evidence that diabetes in youth is most common in high diabetes prevalence racial groups, in subjects with a strong family history, and in girls. Defining the genes predisposing to T2DM is extremely difficult as there are multiple genes involved each contributing only a small amount and lifestyle factors play a large role. Defining the molecular genetics of T2DM in youth is even harder because in addition to the low number of subjects, there is also the ethnic heterogeneity of the subjects and the lack of robust diagnostic criteria. Recently, there has been considerable progress in defining the predisposing genes for adults with T2DM using thousands of cases and controls and a collaborative genome-wide approach. Similar numbers will be needed to assess if the genes found in adults also predispose to T2DM of youth and this will require large multi-center studies. Progress to date in the molecular genetics of T2DM in youth is limited to one population, the Oji-Cree Native Canadians, where the private variant - G319S - a variant of HNF1A strongly predisposes to diabetes in children as well as in adults.
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Affiliation(s)
- Olivia Gill-Carey
- Institute of Biomedical and Clinical Sciences, Peninsula Medical School, Barrack Road, Exeter, UK
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21
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Abstract
Pediatric obesity is increasing worldwide and disproportionately affects the economically and socially disadvantaged. Obese children are at risk of developing the (dys)metabolic syndrome, insulin resistance, early-onset type 2 diabetes mellitus, polycystic ovarian syndrome, hypertension, hyperlipidemia, and obstructive sleep apnoea. Those with diabetes may have mixed features of type 1 and type 2 diabetes mellitus. Pediatric obesity is the result of persistent adverse changes in food intake, lifestyle, and energy expenditure. It may be because of underlying a genetic syndrome or a conduct disorder. Children living in urban settings often lack safe, affordable, and accessible recreational facilities. Tight educational schedules mean less free time, while computer games and television have become preferred recreational activities. More families are eating out or eating take-out meals and processed foods at home because of pressures of work and time constraints. Consumer advertising targeted at children and the ready availability of vending machines encourage unwise food choices. Some children eat excessively because they are depressed, anxious, sad, or lonely. Often families and obese children are aware of the need for healthy eating and exercise but are unable to translate knowledge into weight loss. Population-based measures such as public education, school meal reforms, child-safe exercise friendly environments, and school-based and community-based exercise programs have been shown to be successful to varying degrees, but there remain individuals who will need special help to overcome obesity. Overeating (e.g. binge eating) may be a manifestation of disordered coping behavior but may also be because of defects in the neural and hormonal control of appetite and satiety. New pharmacological approaches are targeting these areas. We need a coordinated approach involving government, communities, and healthcare providers to provide a continuum of population-based interventions, focused screening, and personalized multidisciplinary interventions for the obese child and family.
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Affiliation(s)
- Warren W R Lee
- Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore 229899, Singapore.
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Otabe S, Nakayama H, Fukutani T, Yuan X, Wada N, Hashinaga T, Kato T, Inada C, Yamada K. Clinical and genetic features of childhood-onset Type 2 diabetes in Japan. Acta Diabetol 2007; 44:181-5. [PMID: 17763998 DOI: 10.1007/s00592-007-0002-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2006] [Accepted: 06/07/2007] [Indexed: 10/22/2022]
Abstract
We aimed to define the detailed clinical features of Japanese childhood-onset Type 2 diabetes mellitus (T2DM) patients who were followed-up, and to determine whether discernable characteristics were dissimilar or not from those of adult- and childhood-onset T2DM in other countries. Subjects were 22 patients (10 males and 12 females) under treatment without HNF-1alpha or mitochondrial gene mutations, and who were apparently diagnosed as diabetic when less than 15 years of age. Body mass indexes at onset in boys and girls were 25.8 +/- 6.3 and 24.7 +/- 3.6, respectively, with mean ages 13.3 +/- 1.7 and 12.8 +/- 2.0 years, respectively. Most patients had a short diabetic duration that required insulin treatment. One or both parents of 18 of the 22 T2DM subjects were diabetic and 7 subjects had a history of diabetes in their family across three generations. We demonstrated that a relatively large number of Japanese childhood-onset T2DM cases have a strong genetic factor, and are not necessarily related to excessive obesity. Furthermore, most required insulin therapy in the initial stages because of insufficient pancreatic beta-cell reserves. This suggests that malfunction of pancreatic beta-cells triggers hyperglycemia resulting in the requirement for insulin in Japanese some childhood-onset T2DM patients.
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Affiliation(s)
- Shuichi Otabe
- Division of Endocrinology and Metabolism, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
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Syn WK, Bruckner-Holt C, Farmer A, Howdle S, Bateman J. Liver biopsy in a district general hospital: Changes over two decades. World J Gastroenterol 2007; 13:5336-42. [PMID: 17879403 PMCID: PMC4171323 DOI: 10.3748/wjg.v13.i40.5336] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To study liver biopsy practice over two decades in a district general hospital in the United Kingdom.
METHODS: We identified all patients who had at least one liver biopsy between 1986 and 2006 from the databases of the radiology and gastroenterology departments. Subjects with incomplete clinical data were excluded from the study.
RESULTS: A total of 103 liver biopsies were performed. Clinical data was available for 88 patients, with 95 biopsies. Between 1986 and 1996, 18 (95%) out of the 19 liver biopsies performed were blind and 6 (33%) were for primary biliary cirrhosis. Between 1996 and 2006, 14 (18%) out of 76 biopsies were blind; and the indications were abnormal liver tests (33%), hepatitis C (12%) and targeted-biopsies (11%). Liver biopsies were unhelpful in 5 (5%) subjects. Pain was the most common complication of liver biopsy (5%). No biopsy-related mortality was reported. There was a trend towards more technical failures and complications with the blind biopsy technique.
CONCLUSION: Liver biopsies performed in small district hospitals are safe and useful for diagnostic and staging purposes. Abnormal liver tests, non-alcoholic fatty liver disease and targeted biopsies are increasingly common indications. Ultrasound-guided liver biopsies are now the preferred method and are associated with fewer complications.
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Affiliation(s)
- Wing-Kin Syn
- Liver and Hepatobiliary Unit, Queen Elizabeth Hospital, Birmingham, B15 2TH, United Kingdom.
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Wilkin TJ. Changing perspectives in diabetes: their impact on its classification. Diabetologia 2007; 50:1587-92. [PMID: 17457564 DOI: 10.1007/s00125-007-0665-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2007] [Accepted: 02/05/2007] [Indexed: 01/30/2023]
Abstract
Type 1 and type 2 diabetes are usually regarded as distinct disorders, but the convergence of their phenotypes over recent years, the relationship of body weight to the risk of type 1 diabetes, the diminishing importance of the type 1 susceptibility genes and the finding of autoantibodies in patients with type 2 diabetes, invite a different interpretation. The possibility that type 1 and type 2 diabetes, rather than being different, are merely poles of a single spectrum, where variation in the tempo of beta cell loss determines age at onset and symptoms at presentation, has important implications. Correct classification is crucial because it directs appropriate treatment and, where available, prevention. This article argues that type 1 diabetes is currently misclassified, provides evidence that insulin resistance drives type 1 diabetes as it does type 2, and proposes how the 'accelerator hypothesis' can be tested in a randomised controlled trial, which could demonstrate, for the first time, the safe and effective prevention of type 1 diabetes.
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Affiliation(s)
- T J Wilkin
- Department of Endocrinology and Metabolism, Peninsula Medical School, Plymouth, UK.
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Chiolero A, Bovet P, Paradis G, Paccaud F. Has blood pressure increased in children in response to the obesity epidemic? Pediatrics 2007; 119:544-53. [PMID: 17332208 DOI: 10.1542/peds.2006-2136] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The associations between elevated blood pressure and overweight, on one hand, and the increasing prevalence over time of pediatric overweight, on the other hand, suggest that the prevalence of elevated blood pressure could have increased in children over the last few decades. In this article we review the epidemiologic evidence available on the prevalence of elevated blood pressure in children and trends over time. On the basis of the few large population-based surveys available, the prevalence of elevated blood pressure is fairly high in several populations, whereas there is little direct evidence that blood pressure has increased during the past few decades despite the concomitant epidemic of pediatric overweight. However, a definite conclusion cannot be drawn yet because of the paucity of epidemiologic studies that have assessed blood pressure trends in the same populations and the lack of standardized methods used for the measurement of blood pressure and the definition of elevated blood pressure in children. Additional studies should examine if favorable secular trends in other determinants of blood pressure (eg, dietary factors, birth weight, etc) may have attenuated the apparently limited impact of the epidemic of overweight on blood pressure in children.
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Affiliation(s)
- Arnaud Chiolero
- Community Prevention Unit, Institute of Social and Preventive Medicine, University of Lausanne, 17 Rue du Bugnon, 1005 Lausanne, Switzerland.
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McGarvey EL, Collie KR, Fraser G, Shufflebarger C, Lloyd B, Norman Oliver M. Using focus group results to inform preschool childhood obesity prevention programming. ETHNICITY & HEALTH 2006; 11:265-85. [PMID: 16774878 DOI: 10.1080/13557850600565707] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE This study about maternal feeding practices and beliefs was conducted as background for the development of a childhood obesity prevention program for multi-ethnic parents in the USA receiving services from a federal government supplemental nutrition program for low-income mothers. DESIGN Using a grounded theory approach, focus groups were conducted with low-income African American, white non-Hispanic (i.e. the majority Caucasian American population), Hispanic and Vietnamese parents to collect cross-cultural perspectives on: (a) infant and child feeding practices, (b) childhood overweight, (c) healthy dietary intake, (d) physical activity and inactivity, and (e) infant feeding information sources. RESULTS A content analysis of the data yielded three main themes common to all four groups: (a) lack of awareness of the relationship between increased physical activity and health, (b) the use of food to influence behavior, and (c) the loss of parental control over feeding when a child starts child care or school, and revealed perspectives on age-appropriate food, infant satiety, overweight and information sources that were specific to each group. CONCLUSION Interventions that enhance parent self-efficacy that build on themes that are specific to ethnic groups toward preventing childhood obesity are needed. There is also a need for culturally appropriate information for governmental nutrition programs that is in the client's own language and takes into account ethnic differences in beliefs and traditions.
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Affiliation(s)
- Elizabeth L McGarvey
- University of Virginia Health System, Department of Psychiatric Medicine, Charlottesville, VA 22908, USA.
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27
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Wei Y, Wang D, Topczewski F, Pagliassotti MJ. Fructose-mediated stress signaling in the liver: implications for hepatic insulin resistance. J Nutr Biochem 2006; 18:1-9. [PMID: 16854579 DOI: 10.1016/j.jnutbio.2006.03.013] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2006] [Revised: 03/14/2006] [Accepted: 03/30/2006] [Indexed: 02/08/2023]
Abstract
Organisms reprogram metabolic pathways to adapt to changes in nutrient availability. This requires that nutrient-based stimuli are sensed, signals are transmitted, and highly specific responses are engaged. We propose that in the liver, the mitogen-activated protein kinase, c-jun N-terminal kinase (JNK), links excessive nutrient metabolism with impaired insulin regulation of glucose production. The liver, by virtue of its anatomic position and selective regulatory features, buffers and is highly responsive to changes in nutrient delivery. In particular, sugars such as sucrose and fructose uniquely regulate and are selectively metabolized by the liver. We propose that when hepatic fructose uptake exceeds requirements for glycogen and energy (hepatic sugar excess), the JNK-signaling pathway is engaged as part of the adaptive response.
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Affiliation(s)
- Yuren Wei
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO 80523, USA
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28
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Welsh JA, Cogswell ME, Rogers S, Rockett H, Mei Z, Grummer-Strawn LM. Overweight among low-income preschool children associated with the consumption of sweet drinks: Missouri, 1999-2002. Pediatrics 2005; 115:e223-9. [PMID: 15687430 DOI: 10.1542/peds.2004-1148] [Citation(s) in RCA: 213] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine the association between sweet drink consumption and overweight among preschool children. METHODS A retrospective cohort design was used to examine the association between sweet drink consumption and overweight at follow-up among 10904 children who were aged 2 and 3 years and had height, weight, and Harvard Service Food Frequency Questionnaire data collected between January 1999 and December 2001 and height and weight data collected 1 year later. Sweet drinks included vitamin C-containing juices, other juices, fruit drinks, and sodas as listed on the Harvard Service Food Frequency Questionnaire. Logistic regression was used to adjust for age; gender; race/ethnicity; birth weight; and intake of high-fat foods, sweet foods, and total calories. Results were stratified by baseline BMI. RESULTS Among children who were normal or underweight at baseline (BMI <85th percentile), the association between sweet drink consumption and development of overweight was positive but not statistically significant. Children who were at risk for overweight at baseline (BMI 85th-<95th percentile) and consumed 1 to <2 drinks/day, 2 to <3 drinks/day, and > or =3 drinks/day were, respectively, 2.0 (95% confidence interval [CI]: 1.3-3.2), 2.0 (95% CI: 1.2-3.2), and 1.8 (95% CI: 1.1-2.8) times as likely to become overweight as the referent (<1 drink/day). Children who were overweight at baseline (BMI > or =95th percentile) and consumed 1 to <2 drinks/day, 2 to <3 drinks/day, and > or =3 drinks/day were, respectively, 2.1, 2.2, and 1.8 times as likely to remain overweight as the referent. CONCLUSIONS Reducing sweet drink consumption might be 1 strategy to manage the weight of preschool children. Additional studies are needed to understand the mechanism by which such consumption contributes to overweight.
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Affiliation(s)
- Jean A Welsh
- Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Mailstop K-25, 4770 Buford Hwy NE, Atlanta, Georgia 30341-3717, USA.
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Alberti G, Zimmet P, Shaw J, Bloomgarden Z, Kaufman F, Silink M. Type 2 diabetes in the young: the evolving epidemic: the international diabetes federation consensus workshop. Diabetes Care 2004; 27:1798-811. [PMID: 15220270 DOI: 10.2337/diacare.27.7.1798] [Citation(s) in RCA: 285] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- George Alberti
- International Diabetes Institute, 250 Kooyong Rd., Caulfield, Victoria 3162, Australia
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