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Search Results (667)

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19 pages, 604 KiB  
Article
Maternal Perception and Childhood Overweight: Examining Parenting Styles and Eating Behaviors Among Preschoolers: A Cross-Sectional Study from Samsun, Türkiye
by Refia Gözdenur Savcı and Sıddıka Songül Yalçın
Nutrients 2025, 17(1), 195; https://doi.org/10.3390/nu17010195 - 6 Jan 2025
Viewed by 322
Abstract
Background: Accurate maternal perceptions of children’s weight status are crucial for early childhood obesity prevention, with evidence suggesting that maternal misperception may delay timely interventions. This study investigated the accuracy of maternal perceptions of child weight and examined associations with parenting styles and [...] Read more.
Background: Accurate maternal perceptions of children’s weight status are crucial for early childhood obesity prevention, with evidence suggesting that maternal misperception may delay timely interventions. This study investigated the accuracy of maternal perceptions of child weight and examined associations with parenting styles and children’s eating behaviors and demographic factors among preschool-aged children in Samsun, Türkiye. Methods: This cross-sectional study included 318 mother–child pairs recruited from preschools in socio-economically diverse areas of Samsun. Maternal perceptions of child weight status were assessed using a visual scale, while children’s anthropometric measurements (height, weight) were recorded to calculate BMI-for-age Z-scores. Parenting styles and children’s eating behaviors were evaluated using the Parental Attitude Scale (PAS) and the Children’s Eating Behavior Questionnaire (CEBQ), respectively. Data analysis involved chi-square tests and multiple logistic regression to explore associations between maternal perception accuracy, parenting styles, and children’s eating behaviors. Results: Among 318 mother–child pairs, 59.7% underestimated their child’s weight status, with this figure being 84.9% among overweight children. Authoritative parenting was the most common style (78%); no significant association was found between parenting style and maternal perception accuracy. Accurate estimators showed significantly higher scores for food responsiveness (median: 9 (7–12), p = 0.028) and the enjoyment of food (mean: 16.3 ± 4.8, p = 0.003), whereas underestimators scored higher for satiety responsiveness (mean: 23.2 ± 5.7, p = 0.042) and slowness in eating (mean: 11.2 ± 4.2, p = 0.004). Conclusions: Maternal underestimations of child weight are prevalent, particularly for overweight children, are associated with children’s specific eating behaviors. Targeted educational interventions focusing on improving maternal awareness and promoting responsive feeding practices are essential to combat childhood obesity. Full article
(This article belongs to the Section Pediatric Nutrition)
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<p>Participant flow diagram: illustrating selection and exclusion process.</p>
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<p>Association between maternal perception of child size and BAZs.</p>
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22 pages, 1550 KiB  
Systematic Review
Effects of Exergaming on Morphological Variables, Biochemical Parameters, and Blood Pressure in Children and Adolescents with Overweight/Obesity: A Systematic Review with Meta-Analysis of Randomized Controlled Trials
by Jordan Hernandez-Martinez, Joaquín Perez-Carcamo, Hassan Melki, Izham Cid-Calfucura, Edgar Vasquez-Carrasco, Pedro Delgado-Floody, Claudio Romero, Tomás Herrera-Valenzuela, Braulio Henrique Magnani Branco and Pablo Valdés-Badilla
Children 2025, 12(1), 29; https://doi.org/10.3390/children12010029 - 27 Dec 2024
Viewed by 443
Abstract
Objectives: This systematic review with meta-analysis aimed to evaluate the available body of published peer-reviewed studies on the effects of exergaming (EXG) compared to the control group (CG) on morphological variables, biochemical parameters, and blood pressure in children and adolescents with overweight/obesity. Methods: [...] Read more.
Objectives: This systematic review with meta-analysis aimed to evaluate the available body of published peer-reviewed studies on the effects of exergaming (EXG) compared to the control group (CG) on morphological variables, biochemical parameters, and blood pressure in children and adolescents with overweight/obesity. Methods: A systematic literature search was conducted until September 2024 using five databases: PubMed, Medline, CINAHL Complete, Scopus, and Web of Science. PRISMA, TESTEX, RoB 2, and GRADE tools assessed the methodological quality and certainty of evidence. Hedge’s g effect sizes (ES) for morphological, biochemical, and blood pressure variables were calculated for meta-analyses. Using a random effects model, potential sources of heterogeneity were selected, including subgroup analyses (age) and single training factor analysis (program duration, training frequency). The protocol was registered in PROSPERO (code: CRD42024626992). Results: Out of 72 records, 6 randomized controlled trials with 191 children and adolescents with overweight/obesity were included. Nine meta-analyses were performed, showing significant decreases in body mass index (p = 0.04), waist circumference (p = 0.03), and systolic blood pressure (p = 0.007). However, no significant improvements were observed in diastolic blood pressure, body fat percentage, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, and glucose. Subgroup analyses showed significant decreases in total cholesterol (<15 years, ES = 0.56; p = 0.006), HDL-cholesterol (<15 years, ES = 0.51; p = 0.01), LDL-cholesterol (<15 years, ES = 0.63; p = 0.01), and triglycerides (<15 years, ES = 0.82; p = 0.000). In training duration, only significant decreases in total cholesterol (ES = 0.69; p = 0.02) were presented in favor of <12 weeks vs. ≥12 weeks. While in training frequency only significant decreases in triglycerides (ES = 0.70; p = 0.03) were reported in favor of ≥3 sessions per week vs. <3 sessions per week. Conclusions: EXG significantly decreases body mass index, waist circumference, and systolic blood pressure in children and adolescents with overweight/obesity. Full article
(This article belongs to the Section Pediatric Endocrinology & Diabetes)
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<p>Flowchart of the review process.</p>
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<p>Risk of bias within studies. Legends: D1: randomization process; D2: deviations from the intended interventions; D3: missing outcome data; D4: measurement of the outcome; D5: selection of the reported result.</p>
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<p>Risk of bias summary: Review the authors; judgments about each risk of bias item in each included study.</p>
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13 pages, 3360 KiB  
Article
Body Weight Changes During Childhood and Predictors of Excessive Body Weight in Adolescence—A Longitudinal Analysis
by Aleksandra Lemanowicz-Kustra, Michał Brzeziński, Magdalena Dettlaff-Dunowska, Anna Borkowska, Maciej Materek, Kacper Jagiełło and Agnieszka Szlagatys-Sidorkiewicz
Nutrients 2024, 16(24), 4397; https://doi.org/10.3390/nu16244397 - 21 Dec 2024
Viewed by 528
Abstract
Introduction: Abnormal body weight, including overweight and obesity, is a common health problem affecting children and adolescents. The present study aimed to analyse weight changes in children from preschool age to adolescence and to identify early predictors of excessive weight in adolescence, such [...] Read more.
Introduction: Abnormal body weight, including overweight and obesity, is a common health problem affecting children and adolescents. The present study aimed to analyse weight changes in children from preschool age to adolescence and to identify early predictors of excessive weight in adolescence, such as blood pressure and physical fitness observed in preschool children. Methodology: Data from 3075 children (1524 girls and 1594 boys), collected as part of the Gdańsk Centre for Health Promotion’s “Your Child’s Healthy Life” programme, were analysed, with each child assessed at ages 6, 10, and 14. Results: The results indicated that boys were more likely to be overweight, with a tendency for obesity to increase with age. Children who were overweight or obese at age 6 had a higher risk of remaining so for a longer period of time. In addition, low physical fitness (as measured by the KPRT test) and elevated blood pressure were significantly associated with excess body weight. Conclusions: The study underscores the importance of early intervention and consistent monitoring of childhood overweight and obesity to reduce their long-term impact on health. Full article
(This article belongs to the Section Pediatric Nutrition)
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<p>Boys.</p>
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<p>Girls.</p>
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<p>BMI at the 14 y.o. follow-up within BMI groups, as categorised at the age of 6 years in girls.</p>
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<p>BMI at the 14 y.o. follow-up within BMI groups, as categorised at the age of 6 years in boys.</p>
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<p>BMI categories of 14-year-olds by KPRT result at 6 years old—girls.</p>
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<p>BMI categories of 14-year-olds by KPRT result at 6 years old—boys.</p>
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<p>KPRT results at 14 years of age by BMI category at 6 years of age—girls.</p>
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<p>KPRT results at 14 years of age by BMI category at 6 years of age—boys.</p>
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37 pages, 641 KiB  
Review
Prenatal Exposure to Dibutyl Phthalate and Its Negative Health Effects on Offspring: In Vivo and Epidemiological Studies
by Ana R. Quelhas, Melissa Mariana and Elisa Cairrao
J. Xenobiot. 2024, 14(4), 2039-2075; https://doi.org/10.3390/jox14040109 - 19 Dec 2024
Viewed by 481
Abstract
Dibutyl phthalate (DBP) is a low-molecular-weight phthalate commonly found in personal care products, such as perfumes, aftershaves, and nail care items, as well as in children’s toys, pharmaceuticals, and food products. It is used to improve flexibility, make polymer products soft and malleable, [...] Read more.
Dibutyl phthalate (DBP) is a low-molecular-weight phthalate commonly found in personal care products, such as perfumes, aftershaves, and nail care items, as well as in children’s toys, pharmaceuticals, and food products. It is used to improve flexibility, make polymer products soft and malleable, and as solvents and stabilizers in personal care products. Pregnancy represents a critical period during which both the mother and the developing embryo can be significantly impacted by exposure to endocrine disruptors. This article aims to elucidate the effects of prenatal exposure to DBP on the health and development of offspring, particularly on the reproductive, neurological, metabolic, renal, and digestive systems. Extensive research has examined the effects of DBP on the male reproductive system, where exposure is linked to decreased testosterone levels, reduced anogenital distance, and male infertility. In terms of the female reproductive system, DBP has been shown to elevate serum estradiol and progesterone levels, potentially compromising egg quality. Furthermore, exposure to this phthalate adversely affects neurodevelopment and is associated with obesity, metabolic disorders, and conditions such as hypospadias. These findings highlight how urgently stronger laws prohibiting the use of phthalates during pregnancy are needed to lower the risks to the fetus’s health and the child’s development. Full article
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<p>Flow diagram of the literature review process.</p>
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11 pages, 658 KiB  
Article
Prevalence of Abdominal Obesity in Children and Adolescents with Intellectual Disability in Southeastern Poland
by Justyna Podgórska-Bednarz, Justyna Wyszyńska, Lidia Perenc, Marta Yatsula, Anna Gagat-Matuła and Artur Mazur
J. Clin. Med. 2024, 13(24), 7608; https://doi.org/10.3390/jcm13247608 - 13 Dec 2024
Viewed by 359
Abstract
Background/Objectives: The aim of the study was to determine the frequency of occurrence of a significant health problem—abdominal obesity (AO)—in children and adolescents with intellectual disability (ID) compared to children and adolescents without disabilities, examined in the period 2013–2014. Methods: The [...] Read more.
Background/Objectives: The aim of the study was to determine the frequency of occurrence of a significant health problem—abdominal obesity (AO)—in children and adolescents with intellectual disability (ID) compared to children and adolescents without disabilities, examined in the period 2013–2014. Methods: The study group included 568 students with various ID degrees (n = 265 mild; n = 249 moderate; n = 54 severe) (age range 7–18 years) attending care and educational facilities. The comparison group (non-ID) was randomly selected based on the principle of matching the group (age and sex) among students without ID. Anthropometric measurements were taken: waist circumference (WC), height, and body mass. To classify WC and BMI values, percentile charts developed within the OLAF project were used. Analyses were performed using the independence chi-square test, odds ratio (95% confidence interval) and logistic regression for multivariate analysis. The level of significance was assumed as α = 0.05. Results: The prevalence of AO in the ID group was not statistically significant (OR = 1.31; p = 0.056). The risk in the study group was significantly higher in the older age category (OR = 1.88; p < 0.001) and increased with the level of intellectual disability, amounting (OR = 3.71; p < 0.001) to moderate ID and (OR = 5.62; p < 0.001) for profound ID, respectively. Conclusions: Consideration should be given to the extension of preventive and therapeutic measures to defined subgroups of children and adolescents with intellectual disabilities, who are particularly vulnerable to AO. Full article
(This article belongs to the Section Endocrinology & Metabolism)
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<p>Flowchart illustrating the size of the ID group at each stage of the study.</p>
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<p>Flowchart illustrating the size of the non-ID group at each stage of the study.</p>
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21 pages, 827 KiB  
Review
Multi-Context Strategies and Opportunities for Increasing Levels of Physical Activity in Children and Young People: A Literature Review
by Víctor Arufe-Giráldez, Javier Pereira Loureiro, María Betania Groba González, Laura Nieto Riveiro, Nereida María Canosa Domínguez, María del Carmen Miranda-Duro, Patricia Concheiro Moscoso, Rocío Rodríguez-Padín, Javier Roibal Pravio, Manuel Lagos Rodríguez and Oliver Ramos-Álvarez
Children 2024, 11(12), 1475; https://doi.org/10.3390/children11121475 - 30 Nov 2024
Viewed by 1133
Abstract
Background: In today’s society, low levels of physical activity are observed in the child and adolescent population, which can cause numerous pathologies, such as obesity and mental health problems. Objective: This article aims to compile all the contexts and scenarios where it is [...] Read more.
Background: In today’s society, low levels of physical activity are observed in the child and adolescent population, which can cause numerous pathologies, such as obesity and mental health problems. Objective: This article aims to compile all the contexts and scenarios where it is possible to increase the levels of daily physical activity of children and young people, and which have significant scientific support. Method. To do so, a literature review was carried out examining four key contexts for intervention: school, extracurricular, family, and socio-community. Results: The results indicate that the school context, with strategies such as physical education classes and active breaks, is crucial but insufficient on its own, so it is essential to complement it with interventions in extracurricular, family, and socio-community environments. The involvement of families, access to adequate infrastructure such as parks and green areas, and the responsible use of technology, including active video games and the role of influencers on social networks, are presented as key elements to combat a sedentary lifestyle. Conclusions: It is important to highlight the importance of establishing socio-educational programs that adopt a comprehensive approach to promote physical activity in children and youth, highlighting the scientific evidence that supports the effectiveness of intervening in multiple scenarios. This review concludes that a coordinated approach between different actors (schools, families, communities) is necessary to ensure that children and youth reach adequate levels of physical activity, which not only improves their physical health, but also their mental well-being and cognitive development. Full article
(This article belongs to the Section Global Pediatric Health)
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<p>Multi-context strategy to increase physical activity levels in the child and youth population.</p>
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13 pages, 884 KiB  
Article
How Parents Perceive Their Children’s Body Weight: Insights from a Sample of Schoolchildren from Vienna, Austria
by Paula Moliterno, Stefanie Franceschini, Victoria Donhauser and Kurt Widhalm
Nutrients 2024, 16(23), 4094; https://doi.org/10.3390/nu16234094 - 27 Nov 2024
Viewed by 522
Abstract
Background/Objectives: Effective school-based childhood obesity prevention strategies should include parental involvement. In the EDDY (“Effect of sports and diet training to prevent obesity and secondary diseases and to influence young children’s lifestyle”) program, we aimed to describe parental perceptions of children’s body weight [...] Read more.
Background/Objectives: Effective school-based childhood obesity prevention strategies should include parental involvement. In the EDDY (“Effect of sports and diet training to prevent obesity and secondary diseases and to influence young children’s lifestyle”) program, we aimed to describe parental perceptions of children’s body weight in a sample of schoolchildren from Vienna, Austria. Methods: A cross-sectional analysis, including 128 children from the third grade in three Viennese primary schools, was conducted. A self-administered questionnaire was used to collect sociodemographic data and parentally reported weight and height. Parental perception of the child’s weight status was assessed using the question, “In your opinion, you would describe your child as being”. Children’s nutritional status was assessed through measurements. Results: Almost 15% of the children had obesity. The median SDS-BMI was 0.39 (−1.00–2.83) and 0.21 (−1.39–2.47) for girls and boys, respectively. More mothers of girls had overweight/obesity compared to mothers of boys (59.2% vs. 41.1%, p = 0.05). Almost half (48.4%) of the parents underestimated their child’s weight. The percentage of mothers with overweight/obesity was higher in the group that underestimated their child’s weight (59.3% vs. 37.7%, p = 0.018). Parents perceived 59.4% of the children as having a normal weight, while BMI classification indicated that 71.9% had a normal weight. Misperception was higher among children who were overweight (75%) and obese (89.5%). Parents of children with a normal weight were less likely to underestimate [Adjusted OR = 0.16 (95% CI: 0.050–0.49)]. Conclusions: The prevalence of misperception was high, especially for children with overweight or obesity. These findings highlight the need to incorporate children’s adequate weight recognition into the EDDY program as part of parents’ content. Full article
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<p>Parent’s perception of their child’s weight status vs. real BMI classification.</p>
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<p>Parental misperception of children’s weight status by actual nutritional status.</p>
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16 pages, 322 KiB  
Article
Correlates of Overweight and Obesity in German Primary School Children
by Anna Reißner, Olivia Wartha, Jens Dreyhaupt and Susanne Kobel
Nutrients 2024, 16(23), 3987; https://doi.org/10.3390/nu16233987 - 21 Nov 2024
Viewed by 594
Abstract
Background/Objectives: Childhood obesity is a consistent public health issue, which often persists into adulthood. This study determined risk factors of childhood obesity and associated comorbidities in German school children. Methods: Data of 1956 primary school children (7.1 ± 0.6 years) were analysed. Anthropometrics [...] Read more.
Background/Objectives: Childhood obesity is a consistent public health issue, which often persists into adulthood. This study determined risk factors of childhood obesity and associated comorbidities in German school children. Methods: Data of 1956 primary school children (7.1 ± 0.6 years) were analysed. Anthropometrics were taken on site, other (health) parameters were assessed using a parental questionnaire. Binary logistic regression models were calculated, controlling for age, gender, family education level, and migration background. Results: Father’s physical illness (OR 1.092 [1.177; 3.073], p = 0.009) and a child’s chronic illness (OR 1.687 [1.077; 2.644], p = 0.022), maternal and paternal overweight (OR 2.180 [1.492; 3.185]; OR 2.494 [1.547; 4.022], p < 0.001, respectively), as well as maternal and paternal smoking (OR 1.942 [1.306; 2.889]; OR 1.972 [1.334; 2.917], p = 0.001, respectively) were significantly associated with the child being overweight. Also associated with the child being overweight were physical activity, regular screen media use (OR 0.605 [0.408, 0.896], p = 0.012; OR 2.029 [1.306; 3.152], p = 0.002, respectively), the mother and/or father thinking their child is too fat (OR 2.213 [1.504; 3.258], p < 0.001; OR 1.537 [1.048; 2.253], p = 0.028), the father’s physical inactivity (OR 1.69 [1.133; 2.521], p = 0.010), and if the child has not been breastfed (OR 1.632 [1.056; 2.521], p = 0.027), the mother smoked during pregnancy (OR 1.992 [1.224; 3.246], p = 0.006) as well as if the mother and/or father admonished their child about their weight (OR 25.521 [14.578; 44.680]; OR 19.448 [11.865; 31.877], p < 0.001, respectively). Children of unemployed mothers and in low-income households had an increased risk of being overweight (OR 4.811 [1.642; 14.096], p = 0.004; OR 2.203 [1.360; 3.568], p = 0.001, respectively). Conclusions: This study shows that parental health, lifestyle, and social behaviours matter in determining childhood obesity. Understanding those is essential to promoting a healthy lifestyle. Full article
9 pages, 1991 KiB  
Case Report
Broadening the PHIP-Associated Neurodevelopmental Phenotype
by Giulia Pascolini, Giovanni Luca Scaglione, Balasubramanian Chandramouli, Daniele Castiglia, Giovanni Di Zenzo and Biagio Didona
Children 2024, 11(11), 1395; https://doi.org/10.3390/children11111395 - 17 Nov 2024
Viewed by 671
Abstract
Background: Monoallelic damaging variants in PHIP (MIM*612870), encoding the Pleckstrin Homology Domain Interacting Protein, have been associated with a novel neurodevelopmental disorder, also termed Chung–Jansen syndrome (CHUJANS, MIM#617991). Most of the described individuals show developmental delay (DD)/intellectual disability (ID), obesity/overweight, and variable congenital [...] Read more.
Background: Monoallelic damaging variants in PHIP (MIM*612870), encoding the Pleckstrin Homology Domain Interacting Protein, have been associated with a novel neurodevelopmental disorder, also termed Chung–Jansen syndrome (CHUJANS, MIM#617991). Most of the described individuals show developmental delay (DD)/intellectual disability (ID), obesity/overweight, and variable congenital anomalies, so the condition can be considered as an ID–overweight syndrome. Case Description: We evaluated a child presenting with DD/ID and a craniofacial phenotype reminiscent of a Pitt–Hopkins syndrome (PTHS)-like condition. We performed a clinical exome analysis on his biological sample, as well as an in silico prediction of the obtained data. At the same time, we interrogated the DeepGestalt technology powered by Face2Gene (F2G), using a frontal image of the proband, and clinically reviewed the earlier CHUJANS patients. In this child, we found a novel PHIP pathogenetic variant, which we corroborated through a protein modeling approach. The F2G platform supported the initial clinical hypothesis of a PTHS-like condition, while the clinical review highlighted the lack of the main frequent CHUJANS clinical features in this child. Conclusions: The unusual clinical presentation of this novel patient resembles a PTHS-like condition. However, a novel variant in PHIP has been unexpectedly detected, expanding the phenotypic spectrum of CHUJANS. Notably, PTHS (MIM#610954), which is a different ID syndrome caused by heterozygous variants in TCF4 (MIM*610954), is not classically considered in the differential diagnosis of CHUJANS nor has been cited in the previous studies. This could support other complex diagnoses and invite further patients’ descriptions. Full article
(This article belongs to the Special Issue Neurodevelopmental Disorders in Pediatrics)
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<p>Face masks of PTHS and CHUJANS (acquired from F2G) and respective causative genes. In this patient, a connection (indicated by the arrow) between the PTHS clinical spectrum, mainly caused by <span class="html-italic">TCF4</span> perturbations, and <span class="html-italic">PHIP</span>, associated with CHUJANS, is recognizable.</p>
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<p>(<b>A</b>,<b>B</b>) Frontal and lateral views of the craniofacial phenotype of this patient at the ages of 4 years and 5 months and 9 years and 9 months, respectively. Note: wide mouth with full lips, wide nasal tip with flared alae nasi, and full and prominent cheeks. (<b>C</b>) Widely spaced teeth. (<b>D</b>,<b>E</b>) Extremities phenotype, consisting of clinodactyly of 5th finger and hands brachydactyly (<b>D</b>), broad halluces with camptodactyly, partial 2nd–3rd toe overriding, bilateral 4th–5th clinodactyly in his feet, and small nails on the 5th toes (<b>E</b>).</p>
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<p>Structural model of WD40. The protein is depicted as a ribbon along the vdW surface (in gray).</p>
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<p>Overlapping facial regions with PTHS elaborated by F2G for the patient. The D-score for evaluating the degree of craniofacial dysmorphisms in this child is shown.</p>
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25 pages, 611 KiB  
Article
Trends in the Prevalence and Factors Associated with Undernutrition in Tunisian Children Aged 0–23 Months
by Nagwa Farag Elmighrabi, Catharine A. K. Fleming and Kingsley E. Agho
Nutrients 2024, 16(22), 3893; https://doi.org/10.3390/nu16223893 - 14 Nov 2024
Viewed by 894
Abstract
Background: In recent years, undernutrition has remained a significant public health issue in Tunisia, increasing the risk of illness and mortality in young children. Therefore, this study aims to analyse the prevalence and factors contributing to undernutrition among Tunisian children aged 0–23 months. [...] Read more.
Background: In recent years, undernutrition has remained a significant public health issue in Tunisia, increasing the risk of illness and mortality in young children. Therefore, this study aims to analyse the prevalence and factors contributing to undernutrition among Tunisian children aged 0–23 months. Methods: The study included 3265 children aged 0–23 months from the 2011–2023 Tunisia Multiple Indicator Cluster Surveys (MICS). Trends and logistic regression analyses were used to determine the prevalence and predictors of undernutrition. Results: The prevalence of stunting, wasting, and underweight in infants and children aged 0–23 months has increased by 3.3%, 0.5%, and 2.1%, respectively. Stunting and underweight were more common among infants aged 0–5 months (11.8% for stunting, 8.9% for underweight, p < 0.01), and first-time mothers (8.3% for stunting, 4.1% for underweight, p < 0.01). In 2023, compared to 2011, the odds of stunting, wasting, and being underweight had increased by 22%, 16%, and 70%, respectively. Infants aged 0–5 months had higher odds of undernutrition in all three indices. Children of obese or overweight mothers, and those who started breastfeeding late, were more likely to be stunted. Boys had significantly higher odds of wasting and underweight. Children with low birth weight, and duration of breastfeeding > 12 months, had significantly higher odds of being underweight. Conclusions: This study shows that infants aged 0–5 months, first-time mothers, boys, and children from poor households in Tunisia are at a higher risk of undernutrition. To address the growing issue of undernutrition in Tunisian children, enhancing maternal and child health and nutrition services, improving parental education, and implementing community-based programs that provide breastfeeding and nutritional education to infants born to new mothers and mothers with high/low BMI is recommended. Full article
(This article belongs to the Section Pediatric Nutrition)
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<p>Prevalence of stunting, wasting and underweight by year of survey among children 0–23 months in Tunisia.</p>
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11 pages, 288 KiB  
Article
Psychometric Hepatic Encephalopathy Tests and Electroencephalogram Results Among Cirrhotic Patients
by Alaa Aboud Mohamed, Mostafa M. Elkholy, Ola O. Mangoud, Ahmed R. N. Ibrahim, Marwa O. Elgendy and Ali M. Abdel Fattah
Medicina 2024, 60(11), 1861; https://doi.org/10.3390/medicina60111861 - 14 Nov 2024
Viewed by 822
Abstract
Background and Objectives: Patients with cirrhosis who seem normal during physical examinations may still have abnormalities in their electroencephalogram (EEG) or show pathological results in neuropsychological tests. This study aimed to investigate the progression of minimal hepatic encephalopathy, its effects on quality [...] Read more.
Background and Objectives: Patients with cirrhosis who seem normal during physical examinations may still have abnormalities in their electroencephalogram (EEG) or show pathological results in neuropsychological tests. This study aimed to investigate the progression of minimal hepatic encephalopathy, its effects on quality of life, its prognostic value, and its significance for daily functioning. Materials and Methods: This study involved 50 patients with confirmed cirrhosis (28 Child A, 12 Child B, 10 Child C) who were assessed for psychological symptoms and underwent several tests: the Minimal Mental State Examination (MMSE), the Letter Cancellation Test, the Digit Symbol Coding Test, and EEG. Results: showed that 40% of patients exhibited neuropsychiatric symptoms, with somatization being the most common at 96%. The MMSE revealed cognitive impairment in 48% of patients. In the Letter Cancellation Test (LCT) (total error), 80% of patients had organic disorders, and 24% showed affections with (LCT) (completion time). The Digit Symbol Coding Test results showed affection in 28% of patients. Significant EEG changes were observed in patients with Child C cirrhosis. Patients with portal hypertension (including varices and variceal bleeding), liver cell failure symptoms (such as ascites, lower limb edema, and bleeding tendency), as well as those who smoke, or obese, or have hyperlipidemia, all displayed notable EEG and psychological test abnormalities, making them more likely to develop hepatic encephalopathy. Conclusions: psychological testing and EEG changes are effective in detecting minimal hepatic encephalopathy, with a higher incidence in Child C patients compared to those in Child A and B. Full article
(This article belongs to the Special Issue Novelties in Chronic Liver Diseases)
19 pages, 307 KiB  
Article
Low Antenatal Care Number of Consultations Is Associated with Gestational Weight Gain and Birth Weight of Offspring of Teenage Mothers: A Study Based on Colombian and Mexican Cohorts
by Reyna Sámano, Hugo Martínez-Rojano, Gabriela Chico-Barba, María Eugenia Mendoza-Flores, María Eugenia Flores-Quijano, Ricardo Gamboa, Andrea Luna-Hidalgo, Sandra L Restrepo-Mesa, Jennifer Mier-Cabrera and Guillermina Peña-Camacho
Nutrients 2024, 16(21), 3726; https://doi.org/10.3390/nu16213726 - 31 Oct 2024
Viewed by 955
Abstract
Background: More than 70% of pregnant adolescents in developing countries experience inappropriate gestational weight gain (GWG). Objective: To determine the association of the number of antenatal care visits (ANC) with GWG, birth weight, and their differences between two countries. Methods: A prospective study [...] Read more.
Background: More than 70% of pregnant adolescents in developing countries experience inappropriate gestational weight gain (GWG). Objective: To determine the association of the number of antenatal care visits (ANC) with GWG, birth weight, and their differences between two countries. Methods: A prospective study was conducted in two cohorts of adolescents, one from Mexico and one from Colombia. The study calculated pregestational body mass index (BMI), obtained GWG and birth weight, and collected socioeconomic characteristics. Birth weight was categorized according to gestational age. A total of 690 mother-child pairs were included, of which 42.6% were Colombian and 57.4% Mexican. Results: The study found no association between socioeconomic characteristics and GWG or birth weight. Colombian adolescents were more likely to experience insufficient GWG (68%), compared with 36% of Mexican adolescents. Colombian adolescents who attended fewer than eight ANC visits were at increased risk of insufficient GWG, whereas Mexican adolescents were at increased risk of excessive GWG. Mexican adolescents who began their pregnancies overweight or obese were at increased risk of excessive GWG. Fewer than eight ANC visits were associated with small for gestational age (SGA) in the Mexican cohort. Conclusions: Inadequate numbers of ANC visits were associated with excessive and insufficient GWG, and SGA. Promoting ANC in adolescent pregnancy is essential to prevent suboptimal GWG and SGA. This study highlights the need for interventions targeting pregnant adolescents from low socioeconomic backgrounds, prioritizing early initiation of prenatal care (first trimester) and a drastic reduction in the high rates of cesarean sections in this group. Full article
(This article belongs to the Section Nutrition and Diabetes)
11 pages, 1251 KiB  
Article
Maternal Obesity and Differences in Child Urine Metabolome
by Ellen C. Francis, Kelly J. Hunt, William A. Grobman, Daniel W. Skupski, Ashika Mani and Stefanie N. Hinkle
Metabolites 2024, 14(11), 574; https://doi.org/10.3390/metabo14110574 - 25 Oct 2024
Viewed by 732
Abstract
Background/objective: Approximately one-third of pregnant individuals in the U.S. are affected by obesity, which can adversely impact the in utero environment and offspring. This study aimed to investigate the differences in urine metabolomics between children exposed and unexposed to maternal obesity. Methods: In [...] Read more.
Background/objective: Approximately one-third of pregnant individuals in the U.S. are affected by obesity, which can adversely impact the in utero environment and offspring. This study aimed to investigate the differences in urine metabolomics between children exposed and unexposed to maternal obesity. Methods: In a study nested within a larger pregnancy cohort of women–offspring pairs, we measured untargeted metabolomics using liquid chromatography–mass spectrometry in urine samples from 68 children at 4–8 years of age. We compared metabolite levels between offspring exposed to maternal obesity (body mass index [BMI] ≥ 30.0 kg/m2) vs. unexposed (maternal BMI 18.5–24.9 kg/m2) and matched them on covariates, using two-sample t-tests, with additional sensitivity analyses based on children’s BMI. This study reports statistically significant results (p ≤ 0.05) and potentially noteworthy findings (fold change > 1 or 0.05 < p < 0.15), considering compounds’ involvement in common pathways or similar biochemical families. Results: The mean (SD) maternal age at study enrollment was 28.0 (6.3) years, the mean child age was 6.6 (0.8) years, 56% of children were male, and 38% of children had a BMI in the overweight/obese range (BMI ≥ 85th percentile). Children exposed to maternal obesity had lower levels of 5-hydroxyindole sulfate and 7-hydroxyindole sulfate and higher levels of secondary bile acids. Phenylacetic acid derivatives were lower in offspring exposed to obesity and in offspring who had a current BMI in the overweight/obese range. Exposure to maternal obesity was associated with lower levels of androgenic steroid dehydroepiandrosterone sulfate (DHEA-S). Conclusions: In this preliminary study, children exposed to maternal obesity in utero had differences in microbiome-related metabolites in urine suggestive of altered microbial catabolism of tryptophan and acetylated peptides. Some of these differences were partially attributable to the offspring’s current BMI status. This study highlights the potential of urine metabolomics to identify biomarkers and pathways impacted by in utero exposure to maternal obesity. Full article
(This article belongs to the Special Issue Newborn Metabolomic Profile)
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<p>Mean differences in acetylated peptides measured in offspring urine during childhood. Orange boxplots show the distribution of acetylated peptides in urine among offspring exposed to maternal obesity in utero. Gray boxplots show the distribution of acetylated peptides in urine among offspring unexposed to maternal obesity. Pre-pregnancy maternal BMI is categorized by normal weight (BMI 18.5–24.9 kg/m<sup>2</sup>) and obesity (BMI ≥ 30.0 kg/m<sup>2</sup>).</p>
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<p><b>Preservation of metabolite network modules in offspring urine.</b> Module preservation is used to assess the biological relevance of correlated metabolites in modules. Poor preservation can occur when the interrelatedness of metabolites differs between “reference/control” and “case/disease” samples. In our study, the reference group was based on BMI status—either exposure to maternal normal BMI range (<b>A</b>), or offspring normal BMI range in childhood (<b>B</b>). Modules with good preservation indicate that the interrelatedness of metabolites is similar in reference and case samples. Poor module preservation indicates that the interrelatedness of metabolites is not preserved in the case samples. Preservation is assessed qualitatively by superimposing the network derived in the reference group onto the cases, as well as quantitatively using a series of different preservation metrics that are summarized in a z-summary score. Metabolites assigned to the Gray module are considered unassigned. (<b>A</b>) The panel on the left shows the reference network and the two modules identified (Blue and Turquoise). The right panel shows the network after it is superimposed onto the urine metabolomics data from offspring exposed to obesity. Overall, the Turquoise cluster was well preserved, while the Blue cluster was poorly preserved. (<b>B</b>) This row of figures shows the metabolomic network derived using data from urine metabolomics in offspring who had a BMI in the normal range at the time of urine sampling (on the left panel). The right panel shows the network after it is superimposed onto the urine metabolomics data from offspring who had a BMI in the overweight/obese range at the time of urine sampling. Overall, the Turquoise cluster was well preserved, while the Blue cluster was poorly preserved.</p>
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8 pages, 2415 KiB  
Case Report
The Synergistic Effects of Incobotulinum Toxin and Physiotherapy in a Rare Case of Paraparesis in a 7-Year-Old Affected by Klippel–Feil Syndrome Related to an MYH3 Gene Mutation: A Case Report
by Maurizio Ranieri, Mariagrazia Riccardi, Maria Vittoria Raele, Giacomo Farì, Marisa Megna and Riccardo Marvulli
J. Pers. Med. 2024, 14(11), 1073; https://doi.org/10.3390/jpm14111073 - 24 Oct 2024
Viewed by 763
Abstract
Background: Klippel–Feil disease is a condition characterized by a defect in the spine, consisting of the fusion or non-separation of two or more vertebrae of the cervical tract. It affects 1 in every 50,000 newborns, and the pathogenesis remains unknown to date, although [...] Read more.
Background: Klippel–Feil disease is a condition characterized by a defect in the spine, consisting of the fusion or non-separation of two or more vertebrae of the cervical tract. It affects 1 in every 50,000 newborns, and the pathogenesis remains unknown to date, although the role of certain genes that are involved in segmentation processes is being studied. A single case of a genetic Myosin Heavy Chain 3 (MYH3) mutation is described here. Affected patients are typically distinguished by a relatively short neck, which leads to limited mobility, a low hairline, and obesity; they may also experience various other health issues. The common occurrence of comorbidities further diminishes the quality of life of these young individuals. Methods: The following case report describes the synergistic effect of Incobotulinum toxin type A and physiotherapy in a 7-year-old patient with MYH3 mutation-related Klippel–Feil syndrome (KFS) complicated by bilateral paraplegia to improve the spasticity condition of the lower limbs. To assess improvements over time, the patient underwent rating scales to determine spasticity (Modified Ashworth Scale: MAS), the neck’s range of motion (ROM), and muscle tone by using MyotonPro®. Specifically, measurements were taken on the day of the first medical examination (T0), the month after the injection and the startup of therapeutic exercise (T1), at three months (T2), and then once a month for a total of 6 months (T3, T4, and T5). Results: This therapeutic approach resulted in highly satisfactory outcomes for the child’s well-being, which was maintained until the sixth month and was accompanied by a complete absence of any side effects. Full article
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<p>Antero-posterior and lateral X-rays of the patient’s spine.</p>
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<p>Zoomed-in antero-posterior and lateral X-rays of the patient’s spine.</p>
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12 pages, 284 KiB  
Article
Parental Acculturation and Its Effect on Preschool-Aged Children’s Health Behaviors Among Latinos in Nevada: A Cross-Sectional Study
by Christopher Johansen, Miguel Antonio Fudolig, Liliana Davalos and Brisa Rodriguez Alcantar
Nutrients 2024, 16(21), 3610; https://doi.org/10.3390/nu16213610 - 24 Oct 2024
Viewed by 737
Abstract
Background: Latino children in the United States (US) have a higher prevalence of overweight/obesity compared to white children. Previous studies suggest that acculturation to the US is associated with health behaviors such as diet, body mass index (BMI), and physical activity. However, the [...] Read more.
Background: Latino children in the United States (US) have a higher prevalence of overweight/obesity compared to white children. Previous studies suggest that acculturation to the US is associated with health behaviors such as diet, body mass index (BMI), and physical activity. However, the role of parental acculturation remains understudied, particularly with the use of validated measures. Objective: The objective of this study was to evaluate parental acculturation and its association with parental interpersonal factors and health behaviors in the preschool-aged child. Methods: Data were analyzed from 187 Latino parents in Nevada. Parents completed a self-reported, cross-sectional survey. Acculturation was assessed using Norris’ 4-item validated acculturation measure. The average age of the preschool-aged children was 45.5 months, and their mean BMI percentile was 96.4% (SD ± 18.7). The mean parental acculturation score was 2.1 (SD ± 1.2). Children were physically active an average of 4.9 (SD ± 2.0) days per week. After controlling for covariates, the results indicated that parental acculturation was positively associated with physical activity and sugar-sweetened beverage consumption. However, parental acculturation was not associated with child BMI percentile, or the consumption of fruits, vegetables, and sweet snacks. Conclusions: These findings can inform future research on culturally tailored intervention strategies to boost physical activity and reduce sugar-sweetened beverage intake among Latino preschool-aged children. Full article
(This article belongs to the Special Issue Dietary Behaviors and Obesity Predisposition)
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