A low fructose diet in the treatment of pediatric obesity: A pilot study

Background: Over the last three decades the prevalence of overweight and obesity has increased dramatically among children and adolescents worldwide. As the results of animal and human studies suggest that a diet rich in fructose may be a risk factor for the development of overweight, the aim of the pilot study was to evaluate if a dietary counseling aimed at a moderate reduction of dietary fructose intake (?50% in comparison to intake at baseline) has a positive effect on the body mass index (BMI) of overweight and obese children. Methods: Fifteen overweight or obese children aged 5–8 years were included into the 3 month dietary intervention study. At baseline and after 4 and 8 weeks children and their parents were trained to reduce fructose in the children's diet. Anthropometric parameters for calculating BMI and BMI standard deviation scores (BMI‐SDS) as well as nutritional intake were assessed at baseline, after the 12‐week intervention and after 12 week of follow up. Results: After the 12‐week intervention children had significantly reduced their total energy, fructose, sucrose and glucose intake. BMI and BMI‐SDS were significantly reduced by 0.68 kg/m² and 0.21, respectively, at the end of the intervention. At follow up, the BMI‐SDS was significantly lower in comparison to baseline while the BMI was only decreased by trend (P= 0.08). Conclusions: The results of our pilot study indicate that counseling aimed towards a moderate reduction of dietary fructose and/or general sugar intake may have a positive effect on BMI in overweight and obese children.     

Molecular analysis of the CART gene in overweight and obese Italian children using family‐based association methods

Aim: In our study, we evaluated if CART gene A1475G and ΔA1457 polymorphisms could be associated with obesity. Patients and methods: We recruited 133 Italian trios from among 103 (50 males and 53 females) overweight children (mean age 10.5 years, range 6–14 years; mean BMI 26.1 ± 3.2 kg/m²), and 30 (16 males and 14 females) obese children (mean age 9.0 years, range 6–11 years; mean BMI 32.3 ± 2.0 kg/m²). We also selected 187 non‐obese unrelated controls. Results: The allele frequencies of the A1475G single nucleotide polymorphism (SNP) were significantly higher in overweight children (0.07) than in control children (0.02) (p = 0.03) and control adults (0.02) (p = 0.02). Moreover, the allele frequencies were significantly different between obese children (0.08) and control children (0.02) (p = 0.03), and between obese children (0.08) and control adults (0.02) (p = 0.02). The ΔA1457 SNP showed no significant association with overweight/obesity. TDT statistic revealed a preferential transmission of the 1475G allele from heterozygous parents to overweight children (p < 0.01) and to obese children (p < 0.05). No statistically significant excess transmission of the ΔA1457 allele was found. Conclusion: Our results supported the hypothesis that inherited variations of the CART gene could influence the development of obesity also in Italian children.     

Catecholamine response to exercise in children with attention deficit hyperactivity disorder

Resting energy expenditure (REE) increases during pulmonary exacerbation by Pseudomonas aeruginosa in cystic fibrosis (CF) patients, and decreases after i.v. anti-Pseudomonas aeruginosa antibiotic therapy (IVAT). However, the impact of IVAT on total energy expenditure (TEE) is unknown. The aim of this study was to assess the changes in TEE and its main components after IVAT administered at home. Body composition measured by skinfold thickness and bio-impedance analysis, energy intake (EI) assessed by a weekly diary, REE measured by indirect calorimetry (IC), TEE assessed by a technique using 24-h heart-rate monitoring method and physical activity (PA) monitored using an activity diary (AD) were assessed in 16 patients (9 boys and 7 girls) aged 12.1 +/- 2.3 y (range, 7.1-14.6 y), before and after 28 +/- 4 d including a 14-d IVAT course. After IVAT, weight increased significantly by 1.9% (32.1 +/- 7.5 versus 32.7 +/- 7.6 kg; p < 0.05), while fat mass and fat free mass increased non significantly. EI increased by 4.6% (10,797 +/- 3039 versus 11320 +/- 3074 kJ/d; p < 0.05). TEE was not affected by IVAT (7014 +/- 1929 versus 7081 +/- 1478 kJ/d) whereas REE decreased by 4.1% (5295 +/- 909 versus 5093 +/- 837 kJ/d; p < 0.05), resulting in 9.3% increase in PA assessed by AD converted to metabolic equivalent tasks (MET) (37.0 +/- 3.1 versus 40.7 +/- 4.5 MET; p < 0.05). The improvement in nutritional status after IVAT is not related to a decrease in TEE, but probably to an increase in EI and a decrease of REE after IVAT. After IVAT, the reduction in REE is probably compensated by an increase in PA in CF patients.     

Association of blood pressure, obesity and serum homocysteine levels in healthy children

AIM: Obesity, hypertension and total serum homocysteine levels are well-known risk factors for cardiovascular disease in adults. However, there is limited data on the relation of these risk factors in children. METHODS: Five hundred twenty-four healthy school children aged 6-15 years participated in the study. BMI were used to categorize our subjects in normal overweight and obese groups based on Internationally Obesity Task Force criteria. RESULTS: The prevalence of overweight and obesity was 21.1% and 8.4% for boys and 17.6% and 7.3% for girls, respectively. Diastolic blood pressure (DBP), systolic blood pressure (SBP) and waist circumference (WC) were significantly higher in overweight and obese group compared to normal ones, whereas for homocysteine levels no difference was observed. Based on the results derived from the multiple regression analysis, BMI was positively related to energy intake (beta=0.247, p<0.001) and WC (beta=0.014, p<0.001). Both SBP and DBP were positively related to age ([beta=0.251, p<0.001] and [beta=0.301, p<0.001, respectively]), and BMI ([beta=0.096, p<0.001] and [beta=0.022, p<0.001], respectively). CONCLUSION: The current study revealed an association of blood pressure and WC with overweight and obesity in children, and even though these children may not have increased homocysteine levels, they still have enough reasons to reduce weight in order to avoid cardiovascular disease in their life later on.     

Resting energy expenditure and body composition in children with myelomeningocele

PURPOSE: Myelomeningocele is a complex disease often complicated by obesity for reasons not well understood. The objectives of this study were to determine body composition and energy expenditure of children with MMC. METHODS: Resting energy expenditure (REE), body composition and anthropometry were measured in 19 children with MMC (12 M, 7 F). Total energy expenditure (TEE) was estimated using a 3-day activity record. Energy intake (EI) was measured in seven children (5 M, 2 F) with MMC. Data were then compared with predicted values. RESULTS: Mean REE (n = 19) was 4680 +/- 1452 kJ/day (96.1 +/- 18.1% of predicted REE). The range was large (45.8-125.7% of predicted REE). TEE (n = 7) was 4344 +/- 2376 kJ/day, hence only 73 34% of predicted TEE. EI (n = 7) was 6560 +/- 1329 kJ/day, approximating a normal energy requirement. Overall, BCM was lower than expected values. CONCLUSIONS: REE in children with MMC is variable when compared to predicted values. TEE was found to be lower in children with MMC than predicted values and EI was similar to predicted values in this group of seven children. BCM is reduced in children with MMC when compared to expected values.     

Energy metabolism in infants with cystic fibrosis

OBJECTIVE: To determine whether a defect in energy metabolism exists in infants with cystic fibrosis (CF). DESIGN: Unselected, newly-diagnosed subjects with CF (n = 46) and 24 healthy infants aged <20 weeks had measurements of resting energy expenditure (REE), total energy expenditure (TEE) (n = 25), and body composition. Metabolizable energy intake (MEI) was calculated. Genotype, energy intake, and pancreatic status was determined in all subjects with CF, and 24 underwent bronchial lavage. RESULTS: At diagnosis, infants with CF detected by newborn screening had significant anthropometric deficits (mean [SD] z-weight = 0.5 [1.0], z-length = 0.7 [1.3]) associated with pancreatic insufficiency. Their REE, TEE, or MEI (absolute measurements, per unit body weight or fat-free mass) were not increased. No relationship between REE, TEE, or MEI and Delta F(508) genotype, and no proportional differences in individual components of MEI between subjects with CF and controls, or between subjects with CF who were homozygotes or compound heterozygotes for Delta F(508) were observed. REE and TEE were not correlated with bronchial infection or inflammation. CONCLUSION: Growth impairment during the first weeks of life in infants with CF is associated with pancreatic insufficiency. However, there is no evidence for a defect of energy metabolism related to Delta F(508), and in infants with CF, minimal lung disease is unaccompanied by increased energy expenditure.     

Neck circumference: an additional tool of screening overweight and obesity in childhood

Obesity, particularly in the upper part of body, is a major health problem. Central obesity is related to cardiovascular disease and metabolic disorders. There are various techniques for assessing upper body fat content for the overweight and obese subjects other than waist circumference (WC). We tried to find out if neck circumference (NC) alone can be used to assess overweight and obesity. Four hundred twelve overweight and obese patients (208 girls and 204 boys) and 555 healthy children (284 girls and 271 boys) aged 6–18 years were recruited for this present study. There were significant and positive correlations between BMI-WC, BMI-NC, and WC-NC (p < 0.001). NC cutoffs for overweight and obesity were determined for each age and pubertal period. NC cutoffs of boys were increased from 28.0 to 38.0. This range was 27.0–34.5 for girls in the same range. We also calculated NC cutoffs for prepubertal and pubertal periods (respectively, 29.0 and 32.5 for boys and 28.0–31.0 for girls). Conclusion: NC is a reliable and easy to use tool to determine overweight and obesity in children, and NC is not as good as WC in determining overweight and obesity, both providing similar information.     

Total but not resting energy expenditure is increased in infants with ventricular septal defects

OBJECTIVE: The purpose of this study was to determine the effect of left-to-right shunting on the resting energy expenditure (REE), total energy expenditure (TEE), and energy intake in a group of 3- to 5-month-old infants with moderate to large unrepaired ventricular septal defects (VSDs) compared with age-matched, healthy infants. METHODS: Eight infants with VSDs and 10 healthy controls between 3 to 5 months of age participated in the study. Indirect calorimetry was used to measure REE and the doubly-labeled water method was used to measure TEE and energy intake. An echocardiogram and anthropometric measurements were performed on all study participants. Daily urine samples were collected at home for 7 days. Samples were analyzed by isotope ratio mass spectrometry. Data were compared using analysis of variance. RESULTS: No significant differences were found in REE (VSD, 42.2 +/- 8.7 kcal/kg/d; control, 43.9 +/- 14.1 kcal/kg/d) or energy intake (VSD, 90.8 +/- 19.9 kcal/kg/d; control, 87.1 +/- 11.7 kcal/kg/d) between the groups. The percent total body water was significantly higher in the VSD infants and the percent fat mass was significantly lower. TEE was 40% higher in the VSD group (VSD, 87.6 +/- 10.8 kcal/kg/d; control, 61.9 +/- 10.3 kcal/kg/d). The difference between TEE and REE, reflecting the energy of activity, was 2.5 times greater in the VSD group. CONCLUSIONS: REE and energy intake are virtually identical between the two groups. Despite this, infants with VSDs have substantially higher TEE than age-matched healthy infants. The large difference between TEE and REE in VSD infants suggests a substantially elevated energy cost of physical activity in these infants. These results demonstrate that, although infants with VSDs may match the energy intake of healthy infants, they are unable to meet their increased energy demands, resulting in growth retardation.     

Parental overweight/obesity,social factors,and child overweight/obesity at 7 years of age

Background: This study used gender‐based analyses to examine whether child overweight/obesity is related to parental overweight/obesity and sociodemographic factors, in a representative population‐based cohort of 7‐year‐old children. Methods: Data from the Québec Longitudinal Study of Child Development 1998–2010 was used. Children (n= 1336) were randomly selected from each public health region of Québec. The study was based on face‐to‐face interviews and a set of questionnaires addressed to mothers and fathers. Results: Compared to children with no overweight/obese parent, the adjusted odds ratio (OR) of being overweight/obese with two overweight/obese parents was 5 for boys (95% confidence interval [CI]: 2.31–10.85) and 5.87 for girls (95%CI: 2.63–13.12). Gender differences appeared when one parent was overweight/obese. For girls, having either an overweight/obese mother (OR, 3.10; 95%CI: 1.14–8.38) or father (OR, 3.64; 95%CI: 1.68–7.91) significantly increased the odds of being overweight/obese at 7 years. For boys, however, having only an overweight/obese father (OR, 2.05; 95%CI: 1.01–4.16) was related to overweight/obesity, but having only an overweight/obese mother was not related to overweight/obesity at 7 years for boys. In girls, but not in boys, having an immigrant mother also significantly related to overweight/obesity (OR, 2.71; 95%CI: 1.28–5.75) at 7 years, after controlling for other social factors. Conclusions: Gender differences in socialization may explain why at 7 years of age, girls' bodyweight is influenced by having even one overweight/obese parent (mother or father), while boys' bodyweight appears to be influenced only by father's overweight/obesity when only one parent is overweight/obese.     

Difference in dietary intake and activity level between normal-weight and overweight or obese adolescents

BACKGROUND: To investigate the prevalence of overweight and obesity in an adolescent group representative of a rural Mediterranean area and to determine possible associations with energy and nutrient intakes and levels of physical exercise. METHODS: A representative sample of adolescents was drawn from the secondary school of Torre Pacheco (Murcia), a rural Mediterranean area located in the southeast of Spain. The population selected (331 adolescents aged 14-18 years), was divided into two groups: normal-weight subjects with a body mass index less than 23 kg/m2 and overweight or obese subjects with a body mass index of 23 kg/m2 or more. Weight, height, abdominal and hip perimeters, triceps skinfold, and upper arm circumference were measured. A prospective 7-consecutive-days food record and physical activity questionnaire were completed. RESULTS: Overweight boys and girls had an apparently lower energy intake (P = 0.001 and P = 0.042, respectively), and carbohydrate intake (P = 0.000, P = 0.032) than their normal-weight counterparts, but they tended to underreport more often. Overweight boys derived a greater percentage of their energy from fat (P = 0.049) and less from carbohydrate (P = 0.016) than their normal-weight counterparts. Among girls, the percentage of energy derived from fat increased with body mass index (r = 0.210, P = 0.008), whereas fiber intake decreased (r = -0.145; P = 0.041). Overweight and obesity were negatively related to physical activity level only among boys (P = 0.033). CONCLUSION: There is a high prevalence of overweight and obesity in the adolescent population studied (48.2% in boys and 30.7% in girls). The study shows an association between overweight and obesity and nutrient intake and activity level.     

Metabolic predictors for early identification of fatty liver using doppler and B-mode ultrasonography in overweight and obese adolescents

The aims of our study were: (1) to evaluate the frequency of asymptomatic fatty liver disease (FLD) using both Doppler and B-mode ultrasound (US) in overweight and obese adolescents; (2) to compare metabolic findings of fatty liver (FL) assessed by two methods; and (3) to evaluate metabolic predictors of FL shown by these methods. Fifty-nine overweight and obese adolescents aged between 9.0 and 17.0 years and 41 non-obese healthy adolescents were included in this study. B-mode and right hepatic vein Doppler ultrasonography (US) were performed and anthropometric indices, lipid profiles, and adiponectin levels were evaluated in all adolescents. HDL-C levels were significantly lower in patients with FL detected by Doppler US compared to patients without FL (p < 0.05). HDL-C levels were inversely correlated with presence of FL assessed by two methods (r = −0.285, p = 0.004; r = −0.328, p = 0.001, respectively) and adiponectin levels were correlated with presence of FL only detected by B-mode US (r = −0.263, p = 0.008). Adiponectin levels were significantly lower in patients with FL than those without FL assessed by B-Mode US (p = 0.049). Multiple regression analysis revealed that HDL-C levels was the most important predictor of FL assessed by Doppler US (p = 0.027), while body mass index was the determinant of FL assessed by two methods (p < 0.001) in asymptomatic overweight and obese adolescents. It was found that FLD, identified by both B-mode and Doppler US, is seen frequently in asymptomatic overweight and obese adolescents. Elevated BMI is associated with increased risk of FL assessed by two ultrasonographic methods. When using Doppler US, low HDL-C levels can be used as a good predictor for presence of FLD in overweight and obese adolescents.     

NUTRITION, OVERNUTRITION, AND OBESITY IN THE FIRST YEAR OF LIFE IN MALMÖ, SWEDEN

ABSTRACT: Sveger, T., Lindberg, T., Weibull, B. and Olsson, U. L. (Department of Paediatrics, Malmö General Hospital, Malmö, Sweden). Nutrition, overnutrition, and obesity in the first year of life in Malmo, Sweden. Acta Paediatr Scand, 64:635, 1975___The feeding pattern, calorie intake, weight and height were studied at various ages during the first 12 months in 243 infants born in Sweden. The feeding pattern and calorie intake was close to that recommended. 0–6% in each age group were found to be obese (20–40% above the standard weight) and 15–23% overweight (10–20% above the standard weight). The mean calorie intake during the months before and when obesity and overweight were diagnosed exceeded the normal by 10% or less. When re-examined at age 2±½ years, 50% of those children obese up to 1 year remained so, and only 2 earlier overweight had become obese. 25 % of the obese children had one obese parent, compared with 10% of the normal children and overweight ones. The low incidence of overnutrition and the low freqency of obese and overweight infants in this study compared with previous studies support the idea that high calorie intake is of importance in the development of obesity during infancy. Accordingly, overnutrition seems to be one factor, in the multifactorial aetiology of obesity, and reduction of overnutrition can reduce, but not abolish, infantile obesity. Whether the reduction of this will subsequently prevent adult obesity remains to be proved.     

Calories,Caffeine and the Onset of Obesity in Young Children

ObjectiveHigh calorie foods and beverages, which often contain caffeine, contribute to child overweight/obesity. We evaluated the results of an educational intervention to promote healthy growth in very young children. Secondarily, we used detailed diet data to explore the association of nutrient intake with the early development of overweight and obesity.MethodsMothers were obese Latina women, enrolled prenatally, and their infants. Specially trained community health workers provided breastfeeding support and nutrition education during 10 home visits, birth to 24 months. At follow-up, age 18 to 36 months, we measured growth and completed detailed diet recalls (1–7 recall days/child).ResultsOf 174 infants randomized, 106 children were followed for 24 to 36 months. The educational intervention did not prevent overweight/obesity. Forty-two percent of children became overweight or obese. Fifty-eight percent of children consumed caffeine on at least 1 recall day. Mean intake was 0.48 mg/kg/day. Caffeine correlated with higher consumption of calories, and added sugar and decreased intake of protein, fiber and dairy. Compared with days without caffeine, on days when caffeine was consumed, children ingested 121 more calories and 3.8 gm less protein. Children frequently consumed less than the recommended daily intake of key nutrients such as fiber, vegetables, whole fruit, and vitamins.ConclusionsCaffeine was a marker for increased intake of calories and decreased intake of key nutrients. When discussing dietary intake in early childhood, practitioners should screen for nutrient deficiency in young children and recommend limiting the intake of caffeinated foods and beverages.     

Socio‐economic and ethnic differences in the prevalence of overweight and obesity among school children

Aims: To trial the collection of measurements to provide population‐based prevalence of overweight and obesity in school children in western Sydney and examine the association between healthy weight and ethnicity and socio‐economic status (SES) in a socio‐economically and culturally diverse population. Methods: A cross‐sectional population‐based survey of 2341 children in Years 4 and 7 (mean ages 9 and 12 years, respectively) in 2007. Results: Nineteen per cent of children were overweight and a further 6% were obese. The prevalence of combined overweight and obesity was similar for boys and girls (26% vs. 24%, P= 0.35). SES was significantly associated with the prevalence of unhealthy weight: the odds of being overweight or obese were 1.79 times (95% confidence interval (CI) 1.35 to 2.36) higher for children from the lowest quartile than for children from the highest quartile. Compared to children from an English speaking background, children from a non‐English speaking background were significantly more likely to be overweight or obese (21% vs. 31%, P < 0.001). The prevalence of combined overweight and obesity was significantly higher for children from a Pacific Island (odds ratio (OR) 2.66, 95% CI 1.63 to 4.33), Middle Eastern (OR 1.63, 95% CI 1.22 to 2.17) or European (OR 1.67, 95% CI 1.12 to 2.49) background than for English speaking background children. Conclusion: Large jumps in the prevalence of overweight and obesity in children observed from the 1980s appear to be diminishing, with comparable prevalence reports in 2004 and 2007. Ethnicity and SES are each independently associated with the prevalence of unhealthy weight in children.     

Nutrition, overnutrition, and obesity in the first year of line in Malm?, Sweden.

The feeding pattern, calorie intake, weight and height were studied at various ages during the first 12 months in 243 infants born in Sweden. The feeding pattern and calorie intake was close to that recommended. 0-6% in each age group were found to be obese (20-40% above the standard weight) and 15-23% overweight (10-20% above the standard weight). The mean calorie intake during the months before and when obesity and overweight were diagnosed exceeded the normal by 10% or less. When re-examined at age 2 plus or minus 1/2 years, 50% of those children obese up to 1 year remained so, and only 2 earlier overweight had become obese. 25% of the obese children had one obese parent, compared with 10% of the normal children and overweight ones. The low incidence of overnutrition and the low freqency of obese and overweight infants in this study compared with previous studies support the idea that high calorie intake is of importance in the development of obesity during infancy. Accordingly, overnutrition seems to be one factor, in the multifactorial aetiology of obesity, and reduction of overnutrition can reduce, but not abolish, infantile obesity. Whether the reduction of this will subsequently prevent adult obesity remains to be proved.     

Metabolic syndrome in children and adolescents with acute lymphoblastic leukemia after the completion of chemotherapy

The metabolic syndrome is a cluster of potent risk factors for cardiovascular diseases. To provide information on the late complications of chemotherapy for acute lymphoblastic leukemia (ALL), the authors prospectively studied the frequency of overweight, obesity, and metabolic syndrome in survivors of ALL in the initial years after the completion of therapy. Children and adolescents were classified as having the metabolic syndrome if they met three or more of the following criteria: hypertriglyceridemia, low levels of high-density lipoprotein (HDL), high fasting glucose, obesity, and hypertension. Obesity was defined on the basis of Body Mass Index (BMI) (kg/m2) standard deviation scores or z-scores. Cutoff points for triglycerides and HDL were taken from equivalent pediatric percentiles with the cutoff points proposed by the Adult Treatment Panel III (ATPIII). Hyperglycemia was defined using the ATPIII cutoff points. Elevated systolic or diastolic blood pressure was defined as a value greater than the 95th percentile for age, gender, and height. Fifty-two subjects (29 male and 23 female) with a median age of 15.2 years (range 6.1-22.6 years) were evaluated. Median interval since completion of therapy was 37 months (range 13-121 months). All of them had been treated according to the ALL-BFM 90 chemotherapy protocol and none had received cranial radiotherapy. Of the 52 subjects, 25 (48%) were overweight (BMI z-score >1.5) and 3 (5.76%) were obese (BMI z-score >2); among them, 1 was severely obese (BMI z-score >2.5). Three criteria for the metabolic syndrome (high triglyceride levels, glucose intolerance, and obesity) were fulfilled by three subjects (5.76%). Twenty-nine subjects (55.7%) had at least one risk factor for metabolic syndrome. Hyperglycemia and hypertension were infrequent. Prompt recognition of the risk factors for metabolic syndrome and intervention seem mandatory to ensure early prevention of cardiovascular disease in survivors of ALL.     

Patterns and energy expenditure of free-living physical activity in adolescents with sickle cell anemia

OBJECTIVE: Our purpose was to examine the relationship between physical activity (PA), PA-associated energy expenditure (PAEE), and total daily energy expenditure (TEE) in free-living adolescents with sickle-cell anemia (SCA).Study design: Adolescents with SCA (n = 28) were matched for sex and age with 22 healthy control participants. PA was measured for 6 to 8 consecutive days with a triaxial accelerometer and resting energy expenditure (REE) by whole-room indirect calorimetry. TEE was calculated by summing PAEE and REE. RESULTS: TEE was similar, REE was higher (difference, 209 kcal x day(-1); P =.0001), and PAEE was lower (difference, 657 kcal x day(-1); P <.001) in patients with SCA than in control participants. In SCA, there was a positive linear relationship between PAEE and hemoglobin concentration (r (2) = 0.583). Time spent in PA of moderate and high intensity was lower in patients with SCA than in control participants (18 +/- 22 vs 48 +/- 31 min/d; P <.0001). CONCLUSION: In adolescents with SCA under free-living conditions, there is a significant intra and interindividual variability in the amount of PA, PAEE, and PA patterns. Because of a lower PAEE and a higher REE, TEE is similar in adolescents with SCA and healthy adolescents. An association of PAEE with hemoglobin concentration may be a part of an energy saving compensatory mechanism in SCA.     

Influence of parental obesity on the physical constitution of preschool children in Japan

The objective of this study was to assess the influence of parental obesity on the physical constitution of preschool children. A total of 3187 children aged between 1–6 years and their parents were studied. A child whose per cent obesity (%OB; per cent overweight for age, height and sex) was greater than 15%, and a parent whose body mass index (BMI; kg/m²) was greater than the 95th percentile were defined to be obese (27.40 and 25.97 for a father and a mother, respectively). We found that the incidence of obesity in children with obese fathers (11.5%) was significantly higher than in those with non-obese fathers (6.2%), and a similar difference was obtained between children with obese mothers (14.5%) and with non-obese mothers (6.2%), respectively. The incidence of obesity in children was 6.0% if both parents were non-obese; this incidence rose to 22.7% if one parent was obese, and to 30.8% if both were obese. The %OB of children was more markedly correlated with the mothers' BMI (r = 0.219) than the fathers' BMI (r = 0.165). The %OB of children correlated significantly with fathers' BMI, but only from the age of 3–6 years, whereas mothers' BMI correlated from the age of 1–6 years. We concluded that parental obesity was of significance in determining the development of juvenile obesity even in the preschool period.     

Significance of gender of obese children and body weight of parents and siblings for the results of the treatment of obesity in childhood

We studied the influence of family size, family history of obesity, and the obese children's sex on the short and medium term outcome of an obesity therapy in children aged 10.7 +/- 3 years with mean percentage overweight of 41.4 +/- 16.9%. Family parameters such as obesity on other family members, single child families, and sex of the obese children did not influence the decision to stop or to complete therapy. Boys were more successful in weight reduction than girls both after 3-6 months and after 3-5 years; the difference being not significant, however. Children without family history initially were significantly less overweight than those with familial obesity, and they exhibited the best short and medium term results. Children of obese families initially were the fattest ones. They reduced their weight more than average, but they tended to regain weight during the following 3-5 years, reaching the highest levels of overweight after that time. Children without family history of obesity did not regain weight, however. Thus even after good short term results obese children of obese parents should be regarded at risk for relapse and should be checked for years after therapy to prevent weight regain.     

Prevalence of hypertension determined by ambulatory blood pressure monitoring (ABPM) and body composition in long-term survivors of childhood cancer

Aim: In recent years, survival rates of childhood cancers have significantly increased, and occurrence of long-term adverse late effects (eg, insulin resistance, diabetes mellitus, metabolic syndrome, hypertension) has become increasingly important. Early diagnosis of obesity/hypertension in childhood is essential to avoid morbidity in the adulthood. Therefore, this study was aimed to determine the blood pressure (BP) profile by ambulatory BP monitoring (ABPM) method, and prevalence of hypertension, obesity, abdominal obesity among childhood cancer survivors. Material and method: The study was carried out with 52 cancer survivors. The ABPM measurement was performed during 24 hours. The anthropometric measurements of patients were performed using standardized protocols. The body composition analysis was performed with bioelectrical impedance analysis (BIA) method. Statistical significance was considered at p < 0.05. Results: The mean age of patients was 12.84 ± 3.88 years. Time off therapy ranged 24–125 month. The prevalence of prehypertension and hypertension were 57.7% and 9.6%, respectively. There was no statistically significant relationship between diagnosis and BP status (p = 0.59). The prevalence of obesity, and abdominal obesity were 1.9% and 30.4%, respectively. There was a positive correlation between waist circumference (WC) and time off therapy (p = 0.046). The WC was found to be higher in patients who received cranial irradiation (p = 0.048). Weight/WC were higher in patients who used corticosteroids in the treatment (p = 0.019). Conclusion: Careful follow up of BP, weight and WC is necessary for long-term cancer survivors to prevent complications. Especially patients who receive cranial radiotherapy and use corticosteroid are at increased risk of abdominal obesity.