The Association between Maternal Folate Status and Childhood Obesity-Systematic Review and Meta-AnalysiPURPOSE: Maternal nutrition plays a crucial role in fetal growth and lifelong health outcomes. Folate is an essential methyl donor in the epigenetic programming of offspring. This review and meta-analysis was conducted to compile the evidence reported thus far to identify associations between maternal folate status and childhood obesity.METHODS: A keyword/reference search was performed in EBSCOhost and Web of Science databases. A CMA program was used for a meta-analysis to estimate the pooled effect of maternal folate status on childhood obesity in offspring and to examine the influence of moderating variables on the overall effect.RESULTS: Better maternal folate intake was associated with a lower risk of childhood obesity: the overall effect size (ES; Hedges’ g) was 0.168 (95% CI=0.075 to 0.260, <i>p</i><.001; small effects; cf., Cohen’s criteria). Moderator analysis revealed that the ≥Q statistic for the age group was statistically significant (Q_b=4.730, df=1. <i>p</i>=.030; heterogeneity of ES). In offspring <7 years and >7 years, the ES was 0.277 (95% CI=0.151, 0.404) and 0.089 (95% CI=-0.025, 0.202), respectively. The study design was a statistically significant variable (Q_b=4.310, df=1. <i>p</i>=.038; heterogeneity of ES). In cohort studies, ES was 0.251 (95% CI=0.135, 0.367), whereas in randomized controlled trial group, ES was 0.062 (95% CI=-0.073, 0.197).CONCLUSIONS: Maternal folate intake significantly affects childhood obesity, and the effect of maternal folate status is stronger inchildren younger than 7 years.

Exercise rehabilitation services connecting hospitals and communities increase patient participation and improve quality of life by reducing medical expenses. South Korea’s multi-ministerial governments have been working together to develop ICT-based hospital-community-linked services to create an exercise program that the public can easily use. This study aims to develop the exercise rehabilitation service components for the application and prescription of ICT-based exercise programs implemented in hospitals and communities. A literature review was conducted, and an expert committee was comprised to classify the components of exercise rehabilitation services. As a result, we classified the first components as functional classification, rehabilitation area, equipment uses, exercise type, frequency, and intensity. Subsequently, exercise programs were developed by applying the first components. Based on the purpose of exercise rehabilitation, we classified the representative standard exercise and grouped the same exercise movements using tools and exercise machines. The finding of this study will help to give the correct exercise prescription and manage patients’ improvement process for exercise instructors. In addition, it guides patients in need of exercise rehabilitation to participate in an accurate and safe exercise in the community. This study is a novel attempt to develop ICT based hospital-community-linked exercise rehabilitation service for patients.

This study aimed to investigate the relationship between vitamin D levels and physical activity in adolescents using data from the Korea National Health and Nutrition Survey (KNHANES). The serum vitamin D concentrations were measured between 2008 and 2014 and analyzed. Adolescents aged 13 to 18 years comprised 4527 of the 61,370 participants surveyed. A final dataset including 2811 adolescents was obtained after those with missing data were excluded. Those who did not participate or only participated in 1–3 days of intense physical activity (p < 0.001), moderate physical activity (p = 0.002), and muscular exercise (weight training) (p < 0.001) showed a higher level of vitamin D deficiency than those who performed the same activities 4–7 days per week. Our results showed that most of the adolescents (76%) were vitamin D-deficient, and the risk was higher among high school than middle school students (odds ratio (OR) = 1.70, 95% confidence interval (CI) = 1.40–2.06; p < 0.001) and higher in girls than boys (OR = 1.43, 95% CI = 1.18–1.72; p < 0.001). Reduced participation in physical activity was correlated with vitamin D deficiency. Furthermore, vitamin D deficiency was associated with a lower frequency of participation in all forms of physical activity, and the association increased significantly with an increase in body mass index.

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