Childhood Obesity最新文献

{"title":"Who Gets a Code for Obesity? Reliability, Use, and Implications of Combining International Classification of Diseases-Based Obesity Codes, 2014-2021.","authors":"Lyudmyla Kompaniyets, Samantha Pierce, Brook Belay, Alyson B Goodman","doi":"10.1089/chi.2024.0267","DOIUrl":"10.1089/chi.2024.0267","url":null,"abstract":"<p><p><b><i>Background:</i></b> Many studies rely on the International Classification of Diseases, 9th or 10th Revision, Clinical Modification codes to define obesity in electronic health records data. While prior studies found misclassification and low sensitivity of codes for pediatric obesity, it remains unclear whether this misclassification is random and what are the implications of combining different code types to define obesity. <b><i>Methods:</i></b> We assessed prevalence, sensitivity, and specificity of obesity codes among 7.4 million children aged 2-19 years over 2014-2021. Among those with obesity in 2021, we estimated the probability of receiving any code or a specific code type by patient characteristics. <b><i>Results:</i></b> Obesity code utilization increased in prevalence from 3.9% in 2014 to 9.8% in 2021; prevalence of obesity based on BMI increased from 17.4% to 20.5%. Code sensitivity increased from 19.8% to 40.8%. Among children with obesity in 2021, those with severe obesity (reference: no severe obesity) and chronic disease (reference: no chronic disease) were more likely to get a code, and the highest likelihood was associated with obesity diagnosis codes (vs. status codes). <b><i>Conclusions:</i></b> Despite increases, obesity code utilization remained low. Obesity code misclassification is not random and certain child characteristics (e.g., severe obesity or chronic disease) are associated with a higher probability of getting a code. There are also significant differences by code type; thus, caution should be taken before combining obesity codes as a proxy for obesity status, especially in longitudinal analyses. More universal documentation of obesity may improve the quality of care and the use of these data for evaluation and research purposes.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":"168-174"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change in Child Opportunity Index in Early Childhood Is Associated with Youth BMI Growth.","authors":"Alexandra Ursache, Brandi Y Rollins","doi":"10.1089/chi.2024.0299","DOIUrl":"10.1089/chi.2024.0299","url":null,"abstract":"<p><p><b><i>Background:</i></b> The neighborhood-level child opportunity index (COI) has been used in policy-based initiatives to identify and improve low-resource neighborhoods in order to impact child health. Understanding of how changes in COI can impact child growth, however, is lacking. <b><i>Methods:</i></b> Participants were 1124 children from the Family Life Project, a longitudinal birth cohort of families in rural, high-poverty areas. Youth anthropometrics were measured at eight assessments (ages 2 months through 12 years). Neighborhood COI was obtained at seven assessments (ages 2 months through 5 years) and used to create seven trajectory groups representing a change in COI: stayed low on all seven assessments, stayed moderate, stayed high, left low, declined from moderate, declined from high, and bounced around. <b><i>Results:</i></b> As hypothesized, moving from high COI neighborhoods into lower COI neighborhoods was associated with greater BMI growth and increased risk for obesity and severe obesity at 12 years. As hypothesized, the opposite effect, which approached significance at <i>p</i> = 0.056, was found among children who moved from low COI neighborhoods into higher COI neighborhoods. Specifically, moving into higher COI neighborhoods was associated with reduced BMI growth, and lower risk for severe obesity at 12 years. <b><i>Conclusions:</i></b> Moving into higher COI neighborhoods may be associated with healthier BMI growth, while the opposite effect may occur when moving into lower COI neighborhoods. Given the use of the COI in public health initiatives and growing evidence for its potential positive impact on child growth, future work is needed to replicate our findings among larger diverse samples.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":"129-136"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Associations Between Physical Activity and Skin Carotenoid Levels in a Small Sample of Preschoolers: A Pilot Study.","authors":"Faten Hasan, Damon Swift, Christopher Kuenze, Wen You, Jamie Zoellner, Amanda J Nguyen, Carolyn Dunn, Sibylle Kranz","doi":"10.1089/chi.2024.0345","DOIUrl":"https://doi.org/10.1089/chi.2024.0345","url":null,"abstract":"<p><p>Recent literature proposed an association between physical activity (PA) and carotenoid status due to their overlapping role in mediating oxidative stress. However, this relationship has yet to be explored in young children. This study examined the relationship between objectively measured PA (ActiGraph triaxial accelerometry) and skin carotenoid levels (pressure-mediated reflection spectroscopy) in a sample of 3- to 5-years-old. Fourteen children (44 ± 7 months old, 71% male) from a single child care center were included in this cross-sectional analysis. Linear regression modeling indicated more time spent in PA was associated with higher skin carotenoid scores (β = 3.448, <i>p</i> = 0.032). These findings from our pilot study indicate a potential cross-sectional link between physical activity and carotenoid status in young children.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Well-Being and Child Appetitive Traits at 5 Years Old: Findings from the ROLO Longitudinal Birth Cohort Study.","authors":"Anna Delahunt, Sarah Louise Killeen, Aisling A Geraghty, Eileen C O'Brien, Marie C Conway, Sharleen L O'Reilly, Ciara M McDonnell, Fionnuala M McAuliffe","doi":"10.1089/chi.2024.0336","DOIUrl":"https://doi.org/10.1089/chi.2024.0336","url":null,"abstract":"<p><p><b><i>Background:</i></b> Maternal depression has been linked with increased risk of childhood obesity. Furthermore, maternal negative affectivity in early childhood has been associated with food fussiness. We explored the relationship between longitudinal maternal well-being mid-pregnancy, at 2 years and 5 years postpartum and children's appetitive traits at 5 years of age. <b><i>Methods:</i></b> This is a secondary analysis of the ROLO (randomized control trial of low glycemic diet in pregnancy) longitudinal birth cohort study including pregnancy (<i>n</i> = 279), 2 years (<i>n</i> = 168), and 5 years (<i>n</i> = 295) postpartum. Maternal well-being was measured using the World Health Organization-Five Well-Being Index. Children's appetitive traits were measured at 5 years of age using the Children's Eating Behavior Questionnaire. Bivariate correlation and then linear regression, adjusted for potential confounders, were used to determine relationships between maternal well-being at each timepoint and offspring's appetitive traits at 5 years old. <b><i>Results:</i></b> Mean maternal well-being was higher at 5 years postpartum (63.3%) than mid-pregnancy (58.2%) or at 2 years postpartum (61.0%) (<i>p</i> = 0.001). No relationships were observed between maternal well-being mid-pregnancy and child's appetitive traits at 5 years. In adjusted regression, at 2 years postpartum, maternal well-being was negatively associated with \"Emotional Overeating\" (<i>B</i> = -0.029, <i>p</i> = 0.024), \"Satiety Responsiveness\" (<i>B</i> = -0.040, <i>p</i> = 0.014), \"Slowness Eating\" (<i>B</i> = -0.072, <i>p</i> = <0.001), and \"Emotional Undereating\" (<i>B</i> = -0.054, <i>p</i> = 0.010) and positively associated with \"Enjoyment of Food\" (<i>B</i> = 0.050, <i>p</i> = 0.007). Maternal well-being at 5 years postpartum was negatively associated with \"Satiety Responsiveness\" (<i>B</i> = -0.025, <i>p</i> = 0.033) and \"Slowness Eating\" (<i>B</i> = -0.031, <i>p</i> = 0.024). <b><i>Conclusion:</i></b> Maternal well-being in early childhood may influence children's appetitive traits; however, further research is required to fully explore this relationship.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resting Energy Expenditure Equations Have Lower Accuracy for Adolescents with Overweight/Obesity Versus Healthy-Weight Adolescents.","authors":"Paige M Posson, Paul R Hibbing, Anthony Damiot, Aaron F Carbuhn, David A White, Valentina Shakhnovich, Debra Sullivan, Robin P Shook","doi":"10.1089/chi.2024.0226","DOIUrl":"10.1089/chi.2024.0226","url":null,"abstract":"<p><p><b><i>Objective:</i></b> The objectives of the study were (1) to assess whether resting energy expenditure (REE) equations have comparable validity for adolescents with overweight/obesity vs. adolescents with healthy weight and (2) to examine determinants of measured REE in adolescents with overweight/obesity vs. adolescents with healthy weight. <b><i>Methods:</i></b> Ten equations were used to predict REE for 109 adolescents (70% males; 36.7% with overweight/obesity); 95% equivalence testing was used to assess how well each equation agreed with the criterion measure of indirect calorimetry. Linear regression models were fitted to examine how much REE variance was accounted for by age, sex, race, fat-free mass (FFM), and fat mass. <b><i>Results:</i></b> For adolescents with healthy weight, all ten equations were significantly equivalent to the criterion measure within ±8.4% (<i>p</i> < 0.05), whereas for participants with overweight/obesity, only three equations were equivalent within the same range (<i>p</i> < 0.05). Controlling for age, sex, race, fat mass, and FFM accounted for 74% of REE variance. FFM explained the greatest amount (26%) of variance in REE, while weight status itself explained an additional 22%. <b><i>Conclusions:</i></b> Prediction equations tend to be more accurate for adolescents with healthy weight than adolescents with overweight/obesity unless the original sample specifically included participants with overweight/obesity. Determinants of REE are similar regardless of weight status.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":"30-38"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Home Access Among Children with Obesity: The Role of Family-Centered Communication.","authors":"Coleman R Hayes, Olasunkanmi Kehinde, Dmitry Tumin, Shaundreal D Jamison","doi":"10.1089/chi.2024.0303","DOIUrl":"10.1089/chi.2024.0303","url":null,"abstract":"<p><p><b><i>Objective:</i></b> The American Academy of Pediatrics recommends all children receive care in a patient-centered medical home. With weight stigma potentially hampering family-centered communication in the care of children with overweight or obesity, we aimed to determine how children's weight status was associated with access to a medical home and its components. <b><i>Methods:</i></b> We analyzed 2016-2021 data on children age 10-17 years in the National Survey of Children's Health. Children's weight status was classified as underweight/normal weight, overweight, or obese, based on caregiver-reported height and weight. Outcomes included receiving care in a medical home and each category of the medical home definition (personal health care provider, usual source of health care, family/patient-centered care, care coordination, and assistance with referrals). <b><i>Results:</i></b> Based on the study sample (<i>n</i> = 105,111), we estimated that 16% of children were overweight and 16% were obese, while 42% had access to a patient-centered medical home. On multivariable analysis, obesity compared to normal weight was associated with lower access to a medical home (odds ratio: 0.87; 95% confidence intervals: 0.80, 0.95; <i>p</i> = 0.003) and, specifically, with lower access to family-centered care and assistance with care coordination. <b><i>Conclusions:</i></b> Children with obesity encounter barriers to accessing care meeting medical home criteria, with one plausible mechanism being that weight stigma disrupts family-centered communication. Lower access to care coordination among children with obesity may also indicate a need to improve the integration of obesity-related specialty care with pediatric primary care services.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":"84-91"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving Beyond Research to Public Health Practice: Spread And Scale of Interventions that Support Healthy Childhood Growth.","authors":"Alyson B Goodman, Eileen Bosso, Ruth Petersen, Heidi M Blanck","doi":"10.1089/chi.2024.0255","DOIUrl":"10.1089/chi.2024.0255","url":null,"abstract":"<p><p>Equitable access to affordable, effective, and safe obesity prevention and treatment remains a problem for many children and families in the U.S. In 2023, the American Academy of Pediatrics (AAP) published its first Clinical Practice Guideline (CPG) for pediatric obesity evaluation and treatment, aiding the field's awareness of effective approaches. CDC has supported the adapting and packaging of existing, effective Family Healthy Weight Programs that deliver CPG-recommended intensive behavioral treatment for kids. Currently, at least six family-centered programs are recognized by CDC and can be implemented in clinical and community settings to support child health. CDC and other national partners are coordinating the movement of these research-tested FHWPs into public health practice. This work includes implementing FHWPs in over 60 US communities and supporting national-level infrastructure improvements. CDC is committed to engaging with stakeholders to help scale proven strategies that ensure all children receive the care they need to thrive.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":"1-2"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High BMI z-Scores from Different Growth References Are Not Comparable: An Example from a Weight Management Trial with an Anti-Obesity Medication in Pubertal Adolescents with Obesity.","authors":"Craig M Hales, Cynthia L Ogden, David S Freedman, Kushal Sahu, Paula M Hale, Rashmi K Mamadi, Aaron S Kelly","doi":"10.1089/chi.2024.0248","DOIUrl":"10.1089/chi.2024.0248","url":null,"abstract":"<p><p><b><i>Background:</i></b> The BMI z-score is a standardized measure of weight status and weight change in children and adolescents. BMI z-scores from various growth references are often considered comparable, and differences among them are underappreciated. <b><i>Methods:</i></b> This study reanalyzed data from a weight management clinical study of liraglutide in pubertal adolescents with obesity using growth references from CDC 2000, CDC Extended, World Health Organization (WHO), and International Obesity Task Force. <b><i>Results:</i></b> BMI z-score treatment differences varied 2-fold from -0.13 (CDC 2000) to -0.26 (WHO) overall and varied almost 4-fold from -0.05 (CDC 2000) to -0.19 (WHO) among adolescents with high baseline BMI z-score. <b><i>Conclusions:</i></b> Depending upon the growth reference used, BMI z-score endpoints can produce highly variable treatment estimates and alter interpretations of clinical meaningfulness. BMI z-scores cited without the associated growth reference cannot be accurately interpreted.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":"22-29"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledgment of Reviewers 2024.","authors":"","doi":"10.1089/chi.2024.04562.revack","DOIUrl":"https://doi.org/10.1089/chi.2024.04562.revack","url":null,"abstract":"","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":"21 1","pages":"98-99"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scoping Review of Tailoring in Pediatric Obesity Interventions.","authors":"Emily S Fu, Cady Berkel, James L Merle, Sara M St George, Andrea K Graham, Justin D Smith","doi":"10.1089/chi.2024.0214","DOIUrl":"10.1089/chi.2024.0214","url":null,"abstract":"<p><p><b><i>Background:</i></b> Families with children who have or are at risk for obesity have differing needs and a one-size-fits-all approach can negatively impact program retention, engagement, and outcomes. Individually tailored interventions could engage families and children through identifying and prioritizing desired areas of focus. Despite literature defining tailoring as individualized treatment informed by assessment of behaviors, intervention application varies. This review aims to exhibit the use of the term \"tailor\" in pediatric obesity interventions and propose a uniform definition. <b><i>Methods:</i></b> We conducted a scoping review following PRISMA-ScR guidelines among peer-reviewed pediatric obesity prevention and management interventions published between 1995 and 2021. We categorized 69 studies into 6 groups: (1) individually tailored interventions, (2) computer-tailored interventions/tailored health messaging, (3) a protocolized group intervention with a tailored component, (4) only using the term tailor in the title, abstract, introduction, or discussion, e) using the term tailor to describe another term, and (5) interventions described as culturally tailored. <b><i>Results:</i></b> The scoping review exhibited a range of uses and lack of explicit definitions of tailoring in pediatric obesity interventions including some that deviate from individualized designs. Effective tailored interventions incorporated validated assessments for behaviors and multilevel determinants, and recipient-informed choice of target behavior(s) and programming. <b><i>Conclusions:</i></b> We urge interventionists to use tailoring to describe individualized, assessment-driven interventions and to clearly define how an intervention is tailored. This can elucidate the role of tailoring and its potential for addressing the heterogeneity of behavioral and social determinants for the prevention and management of pediatric obesity.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":"3-21"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}