Methane on Breath Testing Is Associated with Constipation: A Systematic Review and Meta-analysis

Background  

A growing body of literature suggests an association between methane and constipation. Studies also link degree of methane production to severity of constipation and have shown constipation is improved following antibiotics.     

Is there any association between overweight,physical activity,fat and fiber intake with functional constipation in adolescents?

Abstract

Objectives: To assess the prevalence of functional constipation and its association with overweight, physical activity and the estimation of fat and fiber intake in adolescents.

Methods: In all, 386 adolescents aged 14–19?years from the city of Maceió (Alagoas, Northeast Brazil) were included in this study. Participants responded to standardized questionnaires that assessed bowel habits, physical activity and the estimation of fat and dietary fiber intake. Functional constipation was defined according to the Rome criteria. Weight and height were measured using standard methods. Body mass index (BMI) was used to evaluate whether a participant was overweight.

Results: The prevalence of constipation was 24.9%. The median BMI was higher in female adolescents with constipation (22.6) compared with female adolescents without constipation (20.0; p?=?.001). Physical inactivity (fewer than 300?min of physical activity per week) was more frequent in females (62.7%; 126/201) than in males (42.2%; 78/185; p?=?.000). No association was observed between physical inactivity and functional constipation. Excessive intake of fat in the diet was found in 45.3% (175/386) of participants, while poor dietary fiber intake was found in 84.2% (325/386) of participants. No association was found between a fat-rich diet and constipation. Low dietary fiber intake was associated with constipation in female adolescents (odds ratio = 3.42, 95% confidence interval: 1.08 and 12.06).

Conclusions: The prevalence of constipation was high among this group of adolescents. Constipation was not associated with physical inactivity but was associated with a low dietary fiber intake and higher BMI values in female adolescents.     

Treatment outcomes in HIV-infected adolescents attending a community-based antiretroviral therapy clinic in South Africa

Background  

Very few data are available on treatment outcomes of adolescents living with HIV infection (whether perinatally acquired or sexually acquired) in sub-Saharan Africa. The present study therefore compared the treatment outcomes in adolescents with those of young adults at a public sector community-based ART programme in Cape Town, South Africa.     

Relation between sleep duration,overweight, and metabolic syndrome in Korean adolescents

Background and aimsThe increasing prevalence of obesity has been paralleled by a trend of reduced sleep duration. Sleep is considered a modulator of neuroendocrine function. The aim of this study was to determine the relation between sleep duration, overweight, and metabolic syndrome in Korean adolescents.Methods and resultsThis study was based on data from the Korean National Health and Nutrition Examination Survey (KNHANES) IV. Data from 1187 adolescents aged 12–18 years were included in the analysis. Subjects were classified according to self-reported sleep duration: ≤5 h, 6–7 h, 8–9 h, and ≥10 h. We analysed the association between sleep duration, overweight, and metabolic syndrome after adjustment for potential confounding variables. Body mass index (BMI), waist circumference (WC), and diastolic blood pressure (DBP) were higher in subjects who slept ≤5 h, and triglyceride level was higher in subjects who slept ≥10 h. According to logistic regression analysis, subjects who slept ≤5 h had a higher risk of overweight (odds ratio (OR) 2.04, 95% confidence interval (CI) 1.17–3.57) and elevated blood pressure (BP) (OR 2.11, 95% CI 1.22–3.65). We did not find any association between sleep duration and metabolic syndrome. Subjects who slept ≥10 h had a higher risk of hypertriglyceridemia (OR 2.17, 95% CI 1.14–4.13).ConclusionShort sleep duration was associated with overweight in adolescents. Although there was no association between sleep duration and metabolic syndrome, short sleep duration was associated with elevated BP and long sleep duration was associated with hypertriglyceridemia.     

Arterial hypertension in overweight and obese Algerian adolescents: role of abdominal adiposity

Objective

This study aimed to estimate the prevalence of hypertension in Algerian overweight and obese adolescents to assess the risk factors associated with hypertension and an increase in arterial stiffness.

Subjects and methods

This cross-sectional study included 305 adolescents (133 boys and 172 girls) aged 12–19 years, who were either overweight or obese (IOTF criteria). Their body weight, height, BMI, waist circumference (WC), WC-to-height ratio and blood pressure were also measured.

Results

Hypertension and prehypertension were found in 19.7 and 16.1%, respectively, of the study population, with significantly more hypertensives among the obese than among the overweight adolescents. The prevalence of hypertension was also twice as high in boys as in girls (27.1% vs 14%; P = 0.004), and WC and WC-to-height ratios were significantly higher in hypertensives than in normotensives. The risk of hypertension was also significantly higher in boys and associated with WC, independent of age and severity of weight excess (whether overweight or obese). Mean pulse pressure (PP) was significantly higher in boys versus girls, in obese versus overweight adolescents and in hypertensives versus normotensives, and was correlated with WC and WC-to-height ratio. PP >45 mmHg was associated with WC and hypertension only in boys, independent of age.

Conclusion

The prevalence of hypertension is high in overweight and obese adolescents, and higher in boys than in girls. Hypertension and arterial stiffness, as determined by high PP levels, were associated with abdominal adiposity. It is recommended that prehypertension be identified in overweight adolescents and that lifestyle changes be made to avoid its evolution towards obesity and hypertension.     

Liver-expressed antimicrobial peptide 2 is associated with improved pancreatic insulin secretion in adults with overweight and obesity

Aims

To examine association of liver-expressed antimicrobial peptide 2 (LEAP2), an endogenous ghrelin antagonist with anorexiant effects, to key cardiometabolic risk factors in people with overweight and obesity.

Methods

In this cross-sectional study, we sought to identify associations between LEAP2 levels and cardiometabolic risk factors, including body composition (dual X-ray absorptiometry), insulin and glucose metabolism (oral and intravenous glucose tolerance tests and hyperinsulinaemic-euglycaemic clamps), plasma lipids and inflammation markers (ELISA and multiplex assays).

Results

In 65 participants with overweight or obesity (63.1% male, mean age 31.3 ± 8.5 years), LEAP2 levels were associated with total body fat, but not with body mass index or waist-hip ratio in both univariable and age- and sex-adjusted models (P < 0.05). Higher LEAP2 level was also positively associated with higher insulin secretion in univariable (P = 0.047) and multivariable models adjusted for age, sex and body fat (P = 0.03), but not with fasting glucose levels (P ≥ 0.05). Higher LEAP2 levels were associated insulin resistance (P = 0.07) after adjustment for age and sex, but the association disappeared after an additional adjustment for body fat (P = 0.2). There was an inverse association between LEAP2 levels and nuclear factor kappa-B (NFκB) activity in the peripheral blood mononuclear cells in age-, sex- and body fat-adjusted models (P = 0.04). There were no associations with cardiovascular risk factors (lipids, blood pressure) or other inflammation markers.

Conclusions

These results provide important insights into the association between LEAP2 and cardiometabolic health in a high-risk population of individuals with overweight and obesity. This is a first report of an association between LEAP2 and insulin secretion, insulin sensitivity and NFκB activity. LEAP2 may represent an important potential therapeutic target to promote insulin secretion in people with type 2 diabetes and obesity.     

Dietary calcium intake and adiposity in children and adolescents: Cross-sectional and longitudinal results from IDEFICS/I.Family cohort

Background and aims

Studies in children and adolescents suggest that higher dairy consumption may exert a protective effect on adiposity. However, only few studies examined the association between dietary calcium intake and body mass measures with conflicting results. We evaluated the association between total dietary calcium, calcium from dairy and non-dairy sources and anthropometric indices in a large European cohort of children and adolescents.

Pathways between childhood maltreatment and life satisfaction in adolescents with eating disorders: A network analysis

Objective

This study explored the association between Childhood maltreatment (CM) experiences and life satisfaction in adolescents with eating disorders (EDs).

Methods

Adolescent inpatients with EDs completed the Childhood Trauma Questionnaire, the Satisfaction With Life Scale, the Brief Symptom Inventory and the Eating Disorder Inventory–2 at admission (n = 361) and discharge (n = 354). A network analysis was conducted to identify the shortest pathways between different types of CM and life satisfaction at admission and discharge.

Results

General psychopathology, life satisfaction, and ED symptoms improved from admission to discharge. At admission, emotional abuse and emotional neglect were included in the pathway between sexual/physical abuse and life satisfaction. Emotional neglect was directly connected with life satisfaction while emotional abuse was connected through feeling disliked by others, feelings of inferiority and worthlessness. At discharge, only the direct negative connection between emotional neglect and perception of excellent conditions in the life persisted.

Conclusions

Emotional maltreatment experiences and general psychopathology, but not disordered eating symptoms, are involved in the association between sexual/physical CM and life satisfaction in adolescents with EDs. Emotional neglect may affect life satisfaction regardless of symptoms severity. These findings inform clinicians for assessment and treatment of maltreated adolescents with EDs.     

Prevalencia de obesidad infantil y juvenil en España en 2012

Introduction and objectives

Obesity is a major cardiovascular risk factor. In Spain, few studies have physically measured height and weight to estimate the magnitude of the problem. The aim of this study was to determine the prevalence of child and adolescent obesity in Spain in 2012.

Methods

We performed a cross-sectional probability sample of 1018 children, representative of the Spanish population aged between 8 and 17 years old, with objectively measured height and weight, along with other sociodemographic variables. We calculated the prevalence of overweight and obesity according to the criteria of the World Health Organization, the International Obesity Task Force, and the enKid study.

Results

In the group aged 8 to 17 years old, the prevalence of overweight and obesity was 26% and 12.6%, respectively; 4 in 10 young people were overweight or obese. Excess weight was found in 45% of the group aged 8 to 13 years and in 25.5% of that aged 14 to 17 years. This cardiovascular risk factor was associated with lower social class and lower educational level.

Conclusions

The prevalence of overweight and obesity in children and adolescents in Spain remains high (close to 40%), but has not increased in the last 12 years.Full English text available from:www.revespcardiol.org/en.     

Associations between body weight and depression,social phobia,insomnia, and self-esteem among Taiwanese adolescents

The aims of this cross-sectional study were to examine the associations between body weight and mental health indicators including depression, social phobia, insomnia, and self-esteem among Taiwanese adolescents in Grades 7–12. The body mass index (BMI) of 5254 adolescents was calculated based on self-reported weight and height measurements. Body weight status was determined by the age- and gender-specific International Obesity Task Force reference tables. By using participants of average weight as the reference group, the association between body weight status (underweight, overweight, and obesity) and mental health indicators (depression, social phobia, insomnia, and self-esteem) were examined by using multiple regression analysis. The possible moderating effects of sociodemographic characteristics on the association were also examined. After controlling for the effects of sociodemographic characteristics, both overweight (p < 0.05) and obese adolescents (p < 0.001) had a lower level of self-esteem than did those of average weight; however, no significant differences in depression, social phobia, or insomnia were found between those who were overweight/obese and those of average weight. No significant differences in the four mental health indicators were found between those who were underweight and those of average weight. Sociodemographic characteristics had no moderating effect on the association between body weight and mental health indicators. In conclusion, mental health and school professionals must take the association between overweight/obesity and self-esteem into consideration when approaching the issue of mental health among adolescents.     

Sacral neuromodulation for the management of severe constipation: development of a constipation treatment protocol

Background  

Constipation is a common multifactorial gastrointestinal symptom with quality of life implications. Sacral neuromodulation has been used in the management of severe constipation with mixed results. The aim of this study was to review our experience of sacral neuromodulation as a treatment for chronic constipation and develop a chronic constipation management protocol.     

Food intake and high-sensitivity C-reactive protein levels in adolescents

Background and aims

Diet comprises factors with anti and pro-inflammatory potential that can contribute to modulate obesity-induced inflammation. We aimed to assess the association between food intake and high-sensitivity C-reactive protein (hsCRP) levels in adolescents.

Age at First Alcohol Use as a Possible Risk Factor for Adolescent Acute Alcohol Intoxication Hospital Admission in the Netherlands

Background

The primary objective of this study is to determine whether age at first alcohol use is a determinant for adolescent acute alcohol intoxication characteristics, such as age at first acute alcohol intoxication and blood alcohol concentration (BAC) at hospital admission. Around the world, as in the Netherlands, a key aim of alcohol policy is to postpone the age at first alcohol use. This is based on cohort studies that indicate a relationship between a younger age at first alcohol use and subsequent adult alcohol use disorders.

Methods

This study was conducted using a cohort of data comprising individuals under 18 years of age. Data were collected between 2007 and 2017 by the Dutch Pediatric Surveillance System (NSCK) in order to monitor trends in admissions for acute alcohol intoxication. Multivariate linear regression analyses were used to determine the association between age at first alcohol use and acute alcohol intoxication characteristics, such as age at first acute alcohol intoxication and BAC at admission.

Results

This study indicates that among adolescents admitted for acute alcohol intoxication, adolescents who started drinking at ≤ 14 years of age are significantly more often female, lower educated, and raised in nontraditional family structures than adolescents who started drinking between 15 and 18 years of age. Multiple linear regression analyses indicated that age at first alcohol use, corrected for covariates, significantly predicted the age at acute alcohol intoxication and BAC at admission. The association between age at first alcohol use and age at intoxication was also found to be clinically relevant.

Conclusions

Although causation cannot be implied based on the results of these analyses, the results of this study suggest that interventions delaying the age at first alcohol use could be successful in increasing the average age that adolescents are admitted to the hospital for acute alcohol intoxication.

     

Metabolic Syndrome and Importance of Associated Variables in Children and Adolescents in Guabiruba - SC,Brazil

Background

The risk factors that characterize metabolic syndrome (MetS) may be present in childhood and adolescence, increasing the risk of cardiovascular disease in adulthood.

Objective

Evaluate the prevalence of MetS and the importance of its associated variables, including insulin resistance (IR), in children and adolescents in the city of Guabiruba-SC, Brazil.

Methods

Cross-sectional study with 1011 students (6-14 years, 52.4% girls, 58.5% children). Blood samples were collected for measurement of biochemical parameters by routine laboratory methods. IR was estimated by the HOMA-IR index, and weight, height, waist circumference and blood pressure were determined. Multivariate logistic regression models were used to examine the associations between risk variables and MetS.

Results

The prevalence of MetS, IR, overweight and obesity in the cohort were 14%, 8.5%, 21% and 13%, respectively. Among students with MetS, 27% had IR, 33% were overweight, 45.5% were obese and 22% were eutrophic. IR was more common in overweight (48%) and obese (41%) students when compared with eutrophic individuals (11%; p = 0.034). The variables with greatest influence on the development of MetS were obesity (OR = 32.7), overweight (OR = 6.1), IR (OR = 4.4; p ≤ 0.0001 for all) and age (OR = 1.15; p = 0.014).

Conclusion

There was a high prevalence of MetS in children and adolescents evaluated in this study. Students who were obese, overweight or insulin resistant had higher chances of developing the syndrome.     

Long-Term Safety and Effectiveness of Lubiprostone,a Chloride Channel (ClC-2) Activator,in Patients with Chronic Idiopathic Constipation

Background  

Lubiprostone helps relieve constipation in short-term 4-week studies. There are limited data on long-term pharmacological treatment with lubiprostone for chronic idiopathic constipation.     

Colonic transit time in mentally retarded persons

Introduction  

Constipation is frequently seen in patients with mental retardation (MR). Its pathophysiology is poorly understood. Measurement of colon transit time (CTT) differentiates between retentive and non-retentive constipation.     

Comparison of colonic transit time between patients with constipation-predominant irritable bowel syndrome and functional constipation

Background/Aim  

Functional constipation (FC) and constipation-predominant IBS (C-IBS) are two main subtypes of constipation. Using radio-opaque markers is an easy and cost effective method to measure colonic transit time (CTT). We designed this study to compare the CTT between these two groups of constipated patients.     

Cardiovascular Risk-Factor Profiles of Normal and Overweight Children and Adolescents: Insights From the Canadian Health Measures Survey

Background

There is no cardiovascular disease (CVD) risk factor profile in a representative sample of Canadian children and adolescents according to weight status. The 2007-2009 Canadian Health Measures Survey, launched by Statistics Canada in partnership with Health Canada and the Public Health Agency of Canada, provides an opportunity to address this gap.

Methods

The Canadian Health Measures Survey collected information at 15 sites across Canada from March 2007 to March 2009 from Canadians aged 6 to 79 years living in private households. The survey consisted of a household interview and a visit to a mobile examination centre to perform physical measurements, including anthropometry, blood pressure, and biospecimen collection. The present analysis is based on data from 2087 children and adolescents aged 6 to 19 years.

Results

Children and adolescents who were overweight or obese had on average higher mean concentrations and higher prevalence of adverse levels of CVD risk factors (systolic and diastolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, apolipoprotein B, C-reactive protein, homocysteine, and insulin levels) than did normal-weight children and adolescents. Adjustment for covariates (gender, age, household education, household income adequacy, and province of residence) and compliance with recommendations for daily steps, soft-drink intake, and sleep duration did not alter the differences in CVD risk factors between normal weight and overweight or obese children and adolescents.

Conclusions

Results of this study underscore the importance of excess weight as an independent risk factor for CVD health in early life and call for primary prevention of overweight and obesity in childhood to reduce CVD risk.     

Associations of multiple unhealthy lifestyle behaviors with overweight/obesity and abdominal obesity among Brazilian adolescents: A country-wide survey

Background and Aims

Physical inactivity, unhealthy diet, smoking and heavy drinking are four key unhealthy lifestyle behaviors (ULB) that may influence body weight and obesity development. More recently, sedentary time has been recognized as another potentially emerging ULB related to obesity. We therefore investigated the association of multiple ULB with overweight/obesity and abdominal obesity among Brazilian adolescents.

Prescribing Patterns for the Outpatient Treatment of Constipation in the United States

Background  

The incidence of constipation is rising. National data on the prescribing of pharmacologic and nonpharmacologic therapies, or factors influencing the prescribing of therapies for constipation are limited.