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Reference growth curves to identify weight status (underweight, overweight or obesity) in children and adolescents: systematic review
- Carlos Alencar Souza Alves Junior, Priscila Custódio Martins, Luis Alberto Moreno Aznar, Diego Augusto Santos Silva
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- Journal:
- British Journal of Nutrition / Volume 130 / Issue 4 / 28 August 2023
- Published online by Cambridge University Press:
- 25 January 2023, pp. 666-678
- Print publication:
- 28 August 2023
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The identification of somatic growth, through reference curves, can be used to create strategies and public policies to reduce public health problems such as malnutrition and obesity and to identify underweight, overweight and obesity. The purpose of this systematic review was to identify studies providing reference growth curves for weight status in children and adolescents. A systematic search was conducted in eight databases and in gray literature (Google scholar). To assess the risk of bias/methodological quality of studies, the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-sectional Studies (NHLBI) was used. Overall, 86 studies that met the inclusion criteria were included. Through the values of reference growth curves for the identification of underweight, overweight and obesity, it was possible to verify that there is great variability among percentiles for the identification of underweight, overweight and obesity. The most prevalent percentiles for underweight were P3 and P5; for overweight, the most prevalent was P85 and the most prevalent percentiles for obesity were P95 and P97. The most prevalent anthropometric indicators were Body Mass Index (BMI), Waist Circumference (WC), Body Mass (BM) for age and height for age. Conclusion: Such data can demonstrate that the optimal growth must be reached, through the standard growth curves, but that the reference curves demonstrate a cut of the population growth, raising possible variables that can influence the optimal growth, such as an increase in the practice of physical activities and an awareness of proper nutrition.
Sleep duration and blood pressure in Spanish children with obesity
- Gloria Pérez Gimeno, Azahara Iris Rupérez, Rocío Vázquez-Cobela, Rosaura Leis, Mercedes Gil-Campos, María Concepción Aguilera, Ángel Gil, Luis Alberto Moreno, Gloria Bueno
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E592
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Introduction:
Hypertension is a public health problem and its prevalence in children is on the rise, often continuing into adulthood and increasing the risk related cardiovascular complications. Sleep plays an essential role in children's growth and several studies suggest that insufficient sleep duration is associated with hypertension in adults. However, few studies have evaluated this association in children. Thus, the aim of the study is to ascertain whether the sleep duration is a risk factor for elevated blood pressure (BP) in children.
Methods:We studied 776 children (5–18 years old), (46.7% male, 78.8% 5–13 years, 73.6% overweight/obesity). Weight and height were measured and body mass index (BMI) was calculated. BP was measured with an electronic manometer to find a 25.3% of children with an elevated systolic BP (SBP, > P90th) and 14% with an elevated diastolic BP (DBP, > P90th) (Task Force 2017). Sleep duration was assessed by asking the parents “¿How many hours does your child sleep in a typical weekday?”. Weekday sleep hours were considered since they are more representative of children's routines than weekend hours. Hours were converted into a dichotomous variable based on the fulfillment or not of the “Canadian 24-Hour Movement Guidelines for Children and Youth recommendations”: 9–11 hours for 5- to 13-year-olds; 8–10 hours for 14- to 17-year-olds.
A spearman correlation analysis was performed between sleep duration, SBP and DBP. Then, a general linear model analysis adjusted for BMI Z-score was done to evaluate differences in SBP and DBP between children following the sleep recommendations. Analyses were stratified by sex and age range (5–13 and 14–17).
Results:In girls 5–13 years, we found a significant negative correlation between sleep duration and body mass index (BMI) (r = -0.226, p = 0.000) and between sleep and systolic BP (r = -0.188, p = 0.001). Girls 5–13 years not following sleep recommendations showed significantly higher SBP values than those who followed the recommendations (112 ± 11 mmHg vs. 106 ± 12 mmHg, p = 0.007), independently of BMI. No significant differences were observed in girls 14–17 years nor in males.
Discussion:In the present study, we show that girls 5–13 years with shorter sleep duration show increased SBP values independently of BMI, in contrast to previous studies which showed similar associations that disappeared when adjusting for BMI. Our results support the need for wider strategies in population education so that sleep recommendations are followed by children in the general population.
The adipose-derived Nerve Growth Factor is associated with abdominal obesity in prepubertal and pubertal children
- Pilar Argente Arizón, Azahara Iris Rupérez, Concepción Aguilera, Rosaura Leis, Mercedes Gil Campos, Ángel Gil, Luis Alberto Moreno, Gloria Bueno
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E510
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Introduction
Obesity is known to be associated with a low-grade inflammatory state. Most studies reporting inflammation in obesity have been done in pubertal children or adults or have focused only on the relation between body mass index (BMI) and the classical inflammatory markers. Nerve growth factor (NGF), monocyte chemoattractant protein–1 (MCP-1) and hepatocyte growth factor (HGF) are adipokines previously shown to be involved in the inflammatory context of obesity and metabolic syndrome but few studies have been conducted in children.
ObjectiveTo evaluate the association between NGF, MCP-1, HGF with total and abdominal adiposity and in prepubertal and pubertal children.
Methods889 children participated in a prospective obesity case-control study (50.2% males, 72% prepubertals, 27% overweight and 43% obesity), paired by age and sex. The relationship between total fat (assessed using the BMI, the sum of skinfolds thickness (SF) and fat mass index (FMI) from bioelectrical impedance analysis and waist circumference as a surrogate marker of abdominal obesity) and plasma concentrations of MCP-1, HGF, and NGF was studied in prepubertal and pubertal children.
Linear regression analysis for prepubertal and pubertal children, adjusting for age, sex and center was used.
ResultsNGF was associated with WC, with a stronger association in prepubertal than in pubertal children. MCP-1 was positively associated with WC, SF, FMI and BMI in pubertal children whereas HGF was positively associated with WC and BMI only in prepubertal children. The strongest associations were between WC and NGF (β 0.123 95%CI 0.133, 0.709; p < 0.001) in prepubertal children and WC and MCP-1 (β 0.123 95%CI 0.438, 2.035; p < 0.001) in pubertal children.
DiscussionTotal and abdominal adiposity are related to plasma concentrations of adipokines in prepubertal and pubertal children with obesity. Adipokines such as NGF, HGF and MCP-1 have not been so well studied so far in obese children. Particularly, NGF was associated with WC and BMI in prepubertal children and with WC in pubertal children. The association between this neurotrophin, secreted by adipose tissue and involved in the development and survival of sympathetic neurons, with adiposity, especially in prepubertal children, could suggest an anti-inflammatory mechanism and thus be a potential therapeutic target.
Conflict of interestNone
Associations between beverage consumption of parents and their children. The ToyBox-study
- Paloma Flores Barrantes, Alicia Larruy, Maria Luisa Miguel-Berges, Pilar De Miguel-Etayo, Iris Iglesia-Altaba, Greet Cardon, V. Iotova, Koletzko Berthold, Odysseas Androutsos, P. Socha, Yannis Manios, Luis Alberto Moreno
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E708
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Abstract
Introduction: Dietary habits are established from a very young age. Parental role modeling is an important factor influencing the eating behavior of their children. Drinking behavior may have an impact in the development of childhood obesity. This study aimed to explore the correlations of core drinking beverages between parents and their children.
Materials and Methods: The present study included children of 3.5–5.5 years and their parents from the (Multifactorial evidence-based approach using behavioral models in understanding and promoting fun, healthy food, play and policy for the prevention of obesity in early childhood) ToyBox study. The study was a kindergarten-based family-involved intervention, in preschool children from six European countries: Belgium, Bulgaria, Germany, Greece, Poland, and Spain. For this study, we analyzed data from the baseline cross-sectional survey.
Data on consumption frequency of water, homemade or fresh fruit juice, prepacked fruit juice, light beverages and sugared sweetened beverages consumption from parents and their children was obtained via a validated food frequency questionnaire. Parents were given examples of serving sizes and asked about how to self-report their usual consumption per day or week. Beverage consumption of children was reported by their parents and information about frequency and portion sizes was collected. Body weight and height of children was measured and classified according to the International Obesity Task Force (IOTF). Bivariate correlations were performed to analyze beverage consumption (servings per day) in children and their parents.
Results: The studied sample included 5266 pairs of children (49.2% girls) and parents (91.7% women) that were included in the analysis.
Girls presented higher correlations in water (r2 = 0,317) and sugar sweetened beverages (r2 = 0,302), whereas boys, presented slightly higher correlations of light soft drinks (r2 = 0,273), pure fruit juices (r2 = 0,308) and prepacked fruit juices (r2 = 0,324), all of them at < 0.01 level of significance. Considering boys and girls together, a slightly higher significant correlation coefficients were found between children-parents’ dyads with overweight/obesity compared to normal weight children-parentś for sugar sweetened beverages (r2 = 0,303) and light soft drinks (r2 = 0,396).
Discussion: Beverage consumption of children and their parents were found to be moderately correlated. Overweight children seem to have better correlations with their parents in relation of sugar sweetened beverages and light soft drinks. Parents should encourage a healthy beverage consumption for their own health and most important, because there are key role models to their children.
Findings of the International Nosocomial Infection Control Consortium (INICC), Part I: Effectiveness of a Multidimensional Infection Control Approach on Catheter-Associated Urinary Tract Infection Rates in Pediatric Intensive Care Units of 6 Developing Countries
- Victor D. Rosenthal, Bala Ramachandran, Lourdes Dueñas, Carlos Álvarez-Moreno, J. A. Navoa-Ng, Alberto Armas-Ruiz, Gulden Ersoz, Lorena Matta-Cortés, Mandakini Pawar, Ata Nevzat-Yalcin, Marena Rodriguez-Ferrer, Ana Concepción Bran de Casares, Claudia Linares, Victoria D. Villanueva, Roberto Campuzano, Ali Kaya, Luis Fernando Rendon-Campo, Amit Gupta, Ozge Turhan, Nayide Barahona-Guzmán, Lilian de Jesús-Machuca, María Corazon V. Tolentino, Jorge Mena-Brito, Necdet Kuyucu, Yamileth Astudillo, Narinder Saini, Nurgul Gunay, Guillermo Sarmiento-Villa, Eylul Gumus, Alfredo Lagares-Guzmán, Oguz Dursun
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 33 / Issue 7 / July 2012
- Published online by Cambridge University Press:
- 02 January 2015, pp. 696-703
- Print publication:
- July 2012
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Design.
A before-after prospective surveillance study to assess the impact of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infection (CAUTI) rates.
Setting.Pediatric intensive care units (PICUs) of hospital members of the International Nosocomial Infection Control Consortium (INICC) from 10 cities of the following 6 developing countries: Colombia, El Salvador, India, Mexico, Philippines, and Turkey.
Patients.PICU inpatients.
Methods.We performed a prospective active surveillance to determine rates of CAUTI among 3,877 patients hospitalized in 10 PICUs for a total of 27,345 bed-days. The study was divided into a baseline period (phase 1) and an intervention period (phase 2). In phase 1, surveillance was performed without the implementation of the multidimensional approach. In phase 2, we implemented a multidimensional infection control approach that included outcome surveillance, process surveillance, feedback on CAUTI rates, feedback on performance, education, and a bundle of preventive measures. The rates of CAUTI obtained in phase 1 were compared with the rates obtained in phase 2, after interventions were implemented.
Results.During the study period, we recorded 8,513 urinary catheter (UC) days, including 1,513 UC-days in phase 1 and 7,000 UC-days in phase 2. In phase 1, the CAUTI rate was 5.9 cases per 1,000 UC-days, and in phase 2, after implementing the multidimensional infection control approach for CAUTI prevention, the rate of CAUTI decreased to 2.6 cases per 1,000 UC-days (relative risk, 0.43 [95% confidence interval, 0.21–1.0]), indicating a rate reduction of 57%.
Conclusions.Our findings demonstrated that implementing a multidimensional infection control approach is associated with a significant reduction in the CAUTI rate of PICUs in developing countries.
Foreword
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- By Pascal Lamy, Director-General, World Trade Organization, Luis Alberto Moreno, President, Inter-American Development Bank
- Edited by Antoni Estevadeordal, Kati Suominen, Robert Teh
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- Book:
- Regional Rules in the Global Trading System
- Published online:
- 01 March 2011
- Print publication:
- 18 June 2009, pp xiii-xv
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Summary
The number of regional trade agreements (RTAs) has grown enormously over the last decade. Over 200 RTAs currently in force have been notified to the World Trade Organization, with many more being currently negotiated. More and more areas, that traditionally were not part of trade agreements, are being covered by these agreements. RTAs now typically include rules on competition policy, the environment, labour, services, investments, intellectual property, trade remedies or technical barriers to trade, in addition to the usual market access provisions in merchandise trade.
The proliferation of RTAs requires increased attention to be paid to the potential conflicts and complementarities between ‘regional’ and ‘global’ rules. The relationship between regionalism and multilateralism has sometimes been framed as one where RTAs are either a building bloc or a stumbling bloc to multilateralism. But, having closely witnessed integration arrangements in Europe, Latin America and the Caribbean, Africa, Asia and elsewhere around the globe, we believe that this is not as black and white. RTAs have delivered important trade gains for their participants. But, often, they have also been a source of trade diversion and have hampered movement towards greater multilateral liberalization, as is the case with certain rules of origin. In our view, the key research question is to identify those regional rules that promote complementarities with the multilateral trading system and those that conflict with it.