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Introduction: Excessive accumulation of body fat in obesity increases morbidities such as hypertension and cardiovascular diseases. This study investigated the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation on the level of high-sensitivity C-reactive protein (hs-CRP) and blood pressure in children with obesity. Methods: Fifty obese children, aged 6-10 years, were randomly assigned to the supplementation group (n=25) who received EPA and DHA supplementation or to the placebo group (n=25) for eight weeks. The trial was done in a single centre in Denpasar, Bali, Indonesia. Randomisation and allocation to the trial group were done by a computer system. The primary analysis was comparing the blood pressure and hs-CRP level between groups. Analysis of covariance (ANCOVA) and multivariate analysis of covariance (MANCOVA) tests were done to compare the differences between groups, with a p-value <0.05 considered as significant. Results: A total of 44 children completed the study, 24 (54.5%) were males and 20 (45.5%) were females. Initially, the systolic/diastolic blood pressure and hs-CRP level in the supplementation and placebo groups were 109.5/72.7 mmHg and 3.5 mg/L, 107.9/68.4 mmHg and 2.8 mg/L, respectively. At the end, they were 106.3/67.7 mmHg and 1.7 mg/L, and 108.1/71.8 mmHg and 2.8 mg/L, respectively. Systolic-, diastolic blood pressure and hs-CRP level were decreased by -2.6 mmHg (95% CI: -6.9 to 1.6; p=0.220), -7.5 mmHg (95% CI: -12.4 to -2.6; p=0.004), and -1.15 mg/L (95% CI: -2.1 to -0.2; p=0.022), respectively. Conclusion: EPA and DHA supplementation in obese children showed significant decrease in diastolic blood pressure and hs-CRP level.

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Background Highly active antiretroviral therapy (HAART) has been reported to improve growth, especially in the first 2 years of treatment. It is not clear whether catch up growth is maintained after 2 years of HAART. Objective To assess growth in stunted children with HIV after 3 years of HAART and analyze possible risk factors for non-reversal of stunting. Methods This study was done from May 2016 to April 2017 to follow children with HIV who started HAART between January 2009 and April 2014, and continued for 3 years. Inclusion criteria were children with HIV, aged < 18 years, compliance to the regimen, and stunting. Exclusion criteria were patients lost to follow up or who died prior to 3 years of HAART. Non-reversal of stunting was defined as HAZ ≤ -2SD after 3 years of HAART. Possible risk factors for non-reversal were analyzed using Chi-square test with P<0.05, as well as risk ratio (RR) and 95% confidence intervals (CI). Results Of 150 HIV-infected pediatric patients, 115 were on HAART and 55 (47.8%) were stunted at HAART initiation. Of the 55 stunted and HAART-treated children, 31 (56.4%) were male. Baseline median age was 3.6 years (interquartile range 0.37-8.48). Non-reversal occurred in 32 (58.2%) subjects. Multivariate Cox regression model analysis showed predictors of non-reversal after 3 years of HAART to be age >2 years (RR 16.05; 95%CI 2.89 to 89.02; P=0.002) and HIV stage III-IV (RR 8.93; 95%CI 1.47 to 54.37; P=0.017). Conclusion HAART initiation at age >2 years and HIV clinical stage III-IV at diagnosis are risk factors for non-reversal of stunting after 3 years of HAART.