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3. Metabolically healthy overweight adolescents: definition and components

Author

Videira-Silva, Antonio, Freira, Silvia, Fonseca, Helena, and Repositório da Universidade de Lisboa

Subjects
medicine.medical_specialty, Metabolic health, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Overweight, Adolescents, metabolic syndrome, 03 medical and health sciences, 0302 clinical medicine, Insulin resistance, Weight management, 030225 pediatrics, Internal medicine, medicine, overweight, adolescents, metabolic health, business.industry, lcsh:RJ1-570, lcsh:Pediatrics, Odds ratio, medicine.disease, Metabolic syndrome, Obesity, weight management, Pediatrics, Perinatology and Child Health, Homeostatic model assessment, Original Article, medicine.symptom, business, Body mass index
Abstract

© 2020 Annals of Pediatric Endocrinology & Metabolism. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited, Purpose: In adolescents, the definition and clinical implications of metabolically healthy overweight (MHO) status have not been established. This study aimed to investigate the prevalence of MHO according to its most widespread definition, which is based on metabolic syndrome (MS), and to explore further metabolic indicators such as Homeostatic Model Assessment of Insulin Resistance, total cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase, and C-reactive protein levels, together with metabolic health predictors in a sample of adolescents attending a pediatric obesity clinic. Methods: Data from 487 adolescents categorized as overweight (52.6% females, 88.1% white), with a mean body mass index (BMI) z-score of 2.74 (±1.07 standard deviation [SD]), and a mean age of 14.4 years (±2.2 SD) were cross-sectionally analyzed. From this original sample, a subsample of 176 adolescents underwent a second assessment at 12 (±6 SD) months for longitudinal analysis. Results: From the 487 adolescents originally analyzed, 200 (41.1%) were categorized as MHO, but only 93 (19.1%) had none of the metabolic indicators considered in this study. According to longitudinal analysis, 30 of the 68 adolescents (44%) categorized as MHO at baseline became non-MHO over time. BMI z-score was the best predictor of metabolic health both in cross-sectional and longitudinal analyses. Increased BMI z-score reduced the odds of being categorized as MHO (odds ratio [OR], 0.6; 95% confidence interval [CI], 0.4–0.9; P=.008) and increased the odds of having hypertension (OR 2.1, 95% CI: 1.4–3.3, P=0.001), insulin resistance (OR, 2.4; 95% CI, 1.4–4.1, P=0.001), or a proinflammatory state (OR, 1.2; 95% CI, 1.1–1.3, P=0.002). Conclusion: Diagnosis of MHO should not be exclusively based on MS parameters, and other metabolic indicators should be considered. Adolescents categorized as overweight should participate in weight-management lifestyle interventions regardless of their metabolic health phenotype., AVS is supported by the Portuguese Foundation for Science and Technology (SFRH/BD/130193/2017)

Published
2020

4. Life-stage factors associated with overweight severity in adolescents.

Author

Dut, Raziye, Videira-Silva, Antonio, Vilardouro, Ana Sofia, Freira, Silvia, and Fonseca, Helena

Abstract

Background. Investigating life-stage factors associated with overweight may be useful in the prevention of excessive BMI increase. The main aim of this study was to investigate the influence of the route of delivery, birth weight and overweight onset on overweight severity in a sample of overweight adolescents followed at a Pediatric Obesity Clinic. Methods. Clinical data from 412 adolescents with overweight (BMI = p85), aged 10-18 were retrospectively collected and analyzed. Results. Adolescents born by cesarean section (CS) showed a lower age of overweight onset, compared to other methods of delivery (d= 0.33, p= .009). Birth weight was positively associated with BMI z-score (r=.164, p= 002) and waist circumference (WC) (r=.191, p=.001). The overweight onset was negatively associated with BMI z-score (r= -.277, p <.001), WC (r= -.270, p <.001) and body fat mass (r= -.199, p=.001). Overweight duration was the best predictor of BMI z-score, explaining in 75% its variation (F=1,317)=26.94, p <.001), which increased to 99% when birth weight was included in the model (F(2,316)=18.47, p <.001). Conclusions. This study suggests that lifestyle may interrupt the burden of CS on BMI z-score throughout growth. Moreover, increased birth weight may anticipate overweight onset, and consequently overweight duration in the presence of inadequate lifestyle behaviors. [ABSTRACT FROM AUTHOR]

Published
2020
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5. Quality-of-life outcomes of a weight management program for adolescents based on motivational interviewing.

Author

Freira, Silvia, Fonseca, Helena, Williams, Geoffrey, Ribeiro, Marta, Pena, Fernanda, do Céu Machado, Maria, and Lemos, Marina Serra

Subjects
*MOTIVATIONAL interviewing, *REGULATION of body weight, *TEENAGERS, *WEIGHT loss, *QUALITY of life, *SCHOOL health services
Abstract

Objective: To compare motivational interviewing (MI) with conventional care regarding the health-related quality-of-life (HRQoL) of adolescents with overweight/obesity.Methods: RCT with parallel design, involving two groups: intervention group (MI group [MIG]) and control group (conventional intervention group [CIG]). The intervention included three 30-minute interviews 3 months apart.Outcome: Change in Pediatric Quality of Life Inventory (PedsQL) scores. A mixed repeated-measures analysis of variance was used to assess group versus time interactions.Results: Eighty-three participants finished the protocol (82% girls). MIG participants showed a significant average increase (+4.7) on the Psychosocial (t[41] = -2.388, p = .022, d = .37) and Emotional Subscales (+5.1) (t[41] = 5.733, p < .001, d = .88). CIG participants showed a significant average decrease on the Psychosocial (-6.1) (t[40] = 5.733, p < .001, d = .90), Emotional (-14.1) (t[40] = 7.249, p < .001, d = 1.13) and Social Subscales (-3.8) (t[40] = 3.782, p = .001, d = .59) and on the Total Score (-4.4) (t[40] = 3.535, p = .001, d = .55) CONCLUSION: MI improved HRQoL among overweight adolescents participating in a weight management program.Practice Implications: MI increases HRQoL and has the potential to benefit weight management programs for adolescents. [ABSTRACT FROM AUTHOR]

Published
2019
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