Parental perception of weight and weight-related behaviour in 2- to 4-year-old children in the eastern part of the Netherlands

Parental perception of weight status and weight-related behaviour of their toddler was determined through a questionnaire survey in child health care centres (CHCs). Complete data on weight, length, sex and age were available for 635 of 682 children (93.1%). The median age of the children was 37.0 months (range 24–56 months). Of all 635 children, 76.5% were normal weight, 16.2% underweight and 7.2% overweight. Parents’ perception of the weight of their child compared with their peers was moderately related to the actual weight status. Of the parents of overweight and underweight children, 87.0% and 89.3%, respectively, were not concerned. Only the parents’ perception of the amount of food eaten by their child was significantly related to the weight status. The primary goal of CHC workers should be to create parental awareness in case of their child being overweight or underweight and to support them in accomplishing a healthy lifestyle. An erratum to this article can be found at     

The association between BMI and metabolically unhealthy status with COVID-19 mortality: Based on 3019 inpatients from Wuhan,China

Background and aimsPatients with multiple metabolic diseases are at high risk for the occurrence and death of COVID-19. Little is known about patients with underweight and metabolically healthy obesity. The aim of this study is to evaluate the impact of BMI and COVID-19 mortality in hospitalized patients, and also explore the association in different metabolically healthy (MHS) and unhealthy status (MUS).Methods and resultsA retrospective cohort study based on 3019 inpatients from Wuhan was conducted. Included patients were classified into four groups according the BMI level (underweight, normal weight, overweight and obesity), and patients with at least one of the metabolic abnormalities (diabetes, hypertension, dyslipidemia) was defined as MUS. Multiple Cox model was used to calculate the hazard ratio (HR). Compared to patients with normal weight, the HRs of overweight and obesity for COVID-19 mortality were 1.91 (95%CI:1.02–3.58) and 2.54 (95%CI:1.22–5.25) respectively in total patients, and 2.58 (95%CI:1.16–5.75) and 3.89 (95%CI:1.62–9.32) respectively in the elderly. The HR of underweight for COVID-19 mortality was 4.58 (95%CI:1.56–13.48) in the elderly. For different metabolic statuses, both underweight, overweight and obesity had obviously negative association with COVID-19 mortality in total and elderly patients with MUS. However, no significance was found in non-elderly and patients with MHS.ConclusionNot only overweight or obesity, but also underweight can be associated with COVID-9 mortality, especially in the elderly and in patients with MUS. More large-scale studies are needed for patients with underweight and metabolically healthy overweight or obesity.     

Epidemiology of Diabetes in Bucharest

An analysis of the last 20 000 newly diagnosed diabetic patients consecutively registered from 1 January 1981 to 6 June 1991 in the Bucharest Registry of Diabetes showed the following: (1) primary insulin-dependence (Type 1 diabetes) was encountered in only 7% of cases: the rest were Type 2 diabetic patients (8745:43.7% treated with diet alone and 9856:49.3% treated with diet and oral drugs); (2) low body weight (BMI < 25) was encountered in 81.7% of patients in the age group 0–20 years, while obesity (BMI > 27) was encountered in 75.7% of cases in the age group 41–65 years; (3) the overall annual incidence of the Type 1 diabetes for all ages was 5.7/100 000, lowest (1.3/100 000) in the age group 0–4 years and the highest 10.1/100 000) in the age group 65–69 years; (4) the overall annual incidence for the Type 2 diabetes was 76.3/100 000, the lowest (2.4/100 000) in the age group 20–24 years and the highest (261.4/100 000) in the age group 60–64 years. Studying the relationship between the onset of Type 1 diabetes mellitus and age, we did not observe the previously reported strong relationship, so that the distribution of Type 1 diabetes can be considered relatively uniform, with the exception of extreme ages. In conclusion, each year, about 1 in 1000 inhabitants of Bucharest are registered as having diabetes, the majority (93%) had type 2 and only 7% had Type 1 diabetes, one of the lowest incidence rates in Europe.     

Effects of multiple herb formula SEC-22 supplementation on dietary intake,picky eating behaviors,and growth indices in thin preschool children

BACKGROUND/OBJECTIVESThin children may have insufficient intake of energy and nutrients, resulting in reduced immune function and growth. This study aimed to identify the effects of multiple herb formula SEC-22 supplementation on growth, dietary changes, and picky eating behaviors in thin children.SUBJECTS/METHODSA double-blind, randomized clinical trial was conducted on 79 children aged 2-5 years with poor appetites, BMI percentile < 25, and without any illness. Subjects were given either SEC-22 (n = 35) or placebo (n = 44) for 2 months and followed for an additional 2 months. Three-day dietary records, questionnaires on picky eating behaviors, and anthropometric measures were collected.RESULTSEnergy, carbohydrate intake, and feeding difficulty improved in both groups during the intervention period. However, changes were maintained only in the SEC-22 group after 2 months of follow-up post-supplementation. ''Frequency of trying to feed'' was improved in the SEC-22 group compared to the placebo group after the first month of follow-up (P < 0.05). Intakes of potassium and thiamine were improved in the SEC-22 group compared to the placebo group after the first month of intervention (P < 0.05). ''Frequency of food reward'', eating amount, and intakes of carbohydrate, potassium, and vitamin C showed significant improvement compared to the placebo group after the second month of follow-up (P < 0.05).CONCLUSIONSThese results suggest that SEC-22 supplementation can improve parental feeding difficulty resulting from insufficient eating amount or picky eating as well as increase nutrient intake in thin children. Although these improvements were observable at least 2 months after supplementation, effects beyond this time frame need to be confirmed.     

Autism spectrum disorder is associated with an increased risk of development of underweight in children and adolescents: A systematic review and meta-analysis

Background & AimsMultiple observational studies have examined the association between autism spectrum disorder (ASD) and underweight, yet the evidence remains ambiguous. We examined the pooled prevalence and relative risk of developing underweight among children with ASD in a systematic review and meta-analysis and examined the effects of potential risk factors in a meta-regression.MethodsProQuest, PubMed, Scopus and Web of Science databases were systematically searched and screened per the PRISMA guidelines. DerSimonian–Laird random-effects meta-analyses were performed using the ‘meta’ package in R to determine the pooled prevalence and the relative risk of underweight among children with ASD. Meta-regression analyses examined the moderator effects of risk factors.ResultsUnderweight had a prevalence of 6.5% (95% CI, 5.1–8.2) among children with ASD overall (29 study groups). Children with ASD possessed a 28.5% (8 studies) greater risk of being underweight vs. neurotypical controls. Meta-regression analyses revealed that non-Caucasian origin and male sex may increase the risk of being underweight in children with ASD.ConclusionsChildren with ASD seem to be at an increased risk of being underweight, which may further impair the clinical outcomes and quality of life. Clinicians need to vigilantly monitor weight and height among children with ASD to prevent underweight and associated complications. Future studies should aim to establish factors that may contribute to the development of underweight among children with ASD.     

Underweight and overweight or obesity and associated factors among school-going adolescents in five ASEAN countries, 2015

PurposeThe study examined the prevalence of underweight and overweight or obesity and its correlates among in-school adolescents in five ASEAN countries (Indonesia, Laos, Philippines, Thailand and Timor-Leste) in 2015.MethodsCross-sectional data were analysed from 30145 school-going adolescents (median age 14 years, interquartile range = 2) from Indonesia, Laos, Philippines, Thailand and Timor-Leste that took part in the “Global School-Based Student Health Survey (GSHS)” in 2015. Body weight was examined by self-reported weight and height and the “international child body mass index standards”. Associations with underweight and overweight or obesity were assessed using multinomial logistic regression analyses.ResultsThe prevalence of underweight was 8.7% and overweight or obesity 14.0%. In adjusted multinomial logistic regression analysis, students residing in Timor-Leste, older age, male sex, bullying victimization and parental supervision were positively associated with underweight, while residing in Laos, current alcohol use and peer support were negatively associated with underweight. Coming from the Philippines and Timor-Leste, older age, experiencing hunger, current alcohol use, and in a physical fight decreased the odds for overweight or obesity, while male sex, fruit consumption, sedentary behaviour, physically attacked and parental bonding increased the odds for overweight or obesity.ConclusionHigh prevalences of underweight and overweight/obesity were identified in ASEAN countries and several correlates were identified which can help to tailor interventions.