Background and objectives: The efficacy of a weight correction programme can be affected by such predictors as the number of contact hours, gender, age, baseline weight, parental weight status, psycho-emotional status, insulin resistance, and socioeconomic status. The aim of this current study was to evaluate the overall efficacy of the Weight Correction Programme at Children’s Clinical University Hospital, and explore the impact of the probable predictors. We evaluated the efficacy depending on gender, age, parental weight status, signs of depression, baseline body mass index z-score (z-BMI), and baseline waist circumference. Materials and Methods: The data were gathered from medical records. The inclusion criteria were as follows: Entered the programme by 13 June 2017, at least five years old, follow-up data available. All the respondents were divided into two age groups: <10 years old and ≥10 years old. Results: The study included 181 respondents. They were 5 to 17 years old on the first day of participation in the Weight Correction Programme. Results indicated that 117 (65%) patients managed to reduce z-BMI and 69 (38%) patients achieved clinically significant reduction of z-BMI. Boys had four times higher odds (odds ratio (OR) = 4,22; CI 1.37–13.05; p = 0.012) to reduce their z-BMI by at least 0.20 units than girls. The respondents of the older age group (≥10 years) had a better chance to reduce z-BMI than the younger ones (OR = 11,51; CI 2.04–64.83; p = 0.006). The odds to reduce z-BMI were lower by 7% for every extra cm of waist circumference (OR = 0.93; CI 0.88–0.99; p = 0.014) for reducing z-BMI. The follow-up time was also a positive predictor, and with every month the odds for clinically significant z-BMI reduction increased by 7% (OR = 1.07; CI 1.00–1.15; p = 0.047). The parental weight status, signs of depression, and baseline z-BMI were not significant predictors. Conclusions: More than half of the patients of the respondents managed to reduce their z-BMI. Female gender, younger age, and larger waist circumference were negative predictors.

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Objectives: Overweight and obesity has become an important worldwide health issue, that is why the risk factors for gaining excess weight are being studied a lot. Big birth weight and parental overweight are known risk factors for childhood overweight. The association between psychological issues and excess weight is bidirectional.  Aim of our research was assessing if there was any association between parental weight status, birth weight or signs of depression and the exact value of already overweight child’s standardized body mass index (z-BMI).  Study design: Cross-sectional study. Materials and Methods: All 303 respondents included were six to seventeen years old patients of the first weight correction programme in Baltic states. Their first day data were gathered from Children’s Clinical University Hospital electronic databases Andromeda and Saule, as well as from outpatient medical records. Height and weight data were turned into z-BMI. Depression signs had been assessed using Children Depression Inventory (by M. Kovacs, 1992). Parental weight status and child’s birth weight had also been documented. Results: From all 303 respondents 141 (47%) were boys. Median age 12 (IQR 10-15) years. The median z-BMI was significantly higher in boys than in girls (2.97 (IQR 2.59-3.37) vs. 2.59 (IQR 2.13-2.90), p<0.001). Parental weight status correlated significantly with z-BMI value in boys (r=0.17, p=0.043) and in girls (r=0.18, p=0.026). The correlation became stronger when controlled by birth weight and signs of depression: r=0.87, p=0.005 for boys; r=0.96, p<0.001 for girls. There was no significant correlation between z-BMI and either birth weight or signs of depression. Conclusions: The parental excess weight correlated significantly with the z-BMI of their son or daughter. The signs of depression and birth weight had no significant association with z-BMI.

Introduction. Public health research indicates that the prevalence of obesity is rapidly increasing not only among adults, but especially is rapidly increasing among adolescents, slightly less among young children. In Latvia, the prevalence of overweight and obesity is higher in seven-year-old boys compared to girls, 23.7 % and 21.8 %, respectively. However, for girls, this proportion has gradually increased since 2008 from 18.3 % to 21.8 %. Children and adolescents with obesity are at risk of early cardiovascular disease, arterial hypertension, dyslipidemia, metabolic syndrome, insulin resistance, type 2 diabetes mellitus, various types of tumors, orthopedic problems, serious psychological and neurological problems, and other health problems. Metabolic syndrome has a special role in adulthood and is associated with a higer risk for type 2 diabetes mellitus and cardiovascular disease. However, the definition, diagnostic criteria, risk factors, prevention, and treatment of metabolic syndrome in children and adolescents have not yet been standardized.Aim. To study the risk factors, complications and features of metabolic syndrome in children and adolescents with obesity.Materials and methods. The study included 198 children according to inclusion and exclusion criteria, including 181 children with obesity and 17 children with normal body weight. In the first phase of the study, the children were divided into groups according to weight and age, study group I – children 10 years and older with obesity, study group II – children under ten years with obesity, control group – children with normal body weight. In this study phase, prenatal and postnatal obesity risk factors were evaluated, and obesity complications were screened. The second phase of the study evaluated metabolic syndrome as defined by the International Federation of Diabetes at 10 years of age, only in children in study group I (n = 143). All research data were summarized in an Excel database and analyzed using RStudio V.1.4.1103. Differences were considered statistically significant if the significance level was p < 0.05.Results. There were no statistically significant differences regarding prenatal obesity risk factors, large birth weight (p = 0.530), maternal weight gain during pregnancy (p = 0.787), and a positive family history of type 2 diabetes mellitus (p > 0.999) between obese and normal weight children. No statistically significant differences were found in the duration of breast feeding (p = 0.120) between obese and normal weight children. A statistically significant difference was observed in the study groups only for the postnatal obesity risk factor – parental obesity (p = 0.004). Children with obesity had a high prevalence of parental obesity in study group I and group II, 79.8 % and 63.0 %, respectively, compared to children of normal weight. In children of normal weight, parental obesity was detected in only 33.3 % of the cases. Screening for obesity complications has shown statistically significant changes in cardiovascular disease, insulin resistance, and other biochemical parameters in obese children compared to normal weight children. In study group I, the median systolic blood pressure 123.0 (IQR 116.0; 132.0) and the median diastolic blood pressure 78.0 (IQR 71.5; 83.0) were significantly higher compared to controls, with the median systolic blood pressure 115.0 (IQR 110.0; 120.0) and the median diastolic blood pressure 70.0 (IQR 65.0; 76.0) (p = 0.012). No child had an elevated total cholesterol above 5.2 mmol/l in the control group, compared to 8.8 % in study group I. Children with obesity had a statistically significant higher median HOMA-IR in both study group I and group II, 3.9 (IQR 2.6; 5.6) and 2.3 (IQR 1.5; 3.4) in control group, respectively. The median HOMA-IR for children of normal weight was 1.1 (IQR 0.8; 2.1) (p < 0.001).In children in study group I, metabolic syndrome was diagnosed in 21 % (n = 30) according to the criteria developed by the International Federation of Diabetes. The incidence of metabolic syndrome in the study population increased with age, with 17.1 % of children diagnosed with metabolic syndrome between aged 10 to 16 years and 38.5 % of children over 16 years of age diagnosed with MS. Children with metabolic syndrome had significantly higher median weight (p < 0.001) and lower insulin sensitivity (p = 0.039) compared to children without metabolic syndrome. There was no evidence of prenatal risk factors for obesity such as large birth weight (p = 0.145), excessive weight gain during maternal pregnancy (p = 0.625), a positive family history of type 2 diabetes mellitus (p = 0.519) had an effect on the development of metabolic syndrome. The postnatal risk factor for obesity – the duration of exclusive breastfeeding also did not affect the development of metabolic syndrome (p > 0.999). The risk of metabolic syndrome in children increased with increasing body mass index, and the risk of metabolic syndrome was 11.13 times higher in the case of paternal obesity. Conclusions. Risk factors for cardiovascular disease and type 2 diabetes mellitus have been observed early in obese children. Children with obesity over 10 years of age had higher blood pressure, elevated total cholesterol and increased insulin resistance and HOMA-IR ratio. The diagnosis of metabolic syndrome was confirmed in almost a quarter of the pediatric study population. The risk of metabolic syndrome increased significantly with both the degree of obesity and the level of parental obesity.