Association of Habitual Activity and Body Mass Index in Survivors of Congenital Heart Surgery: A Study of Children and Adolescents With Tetralogy of Fallot, Transposition of the Great Arteries, and Fontan Palliation

O’Byrne, Michael L.; McBride, Michael G.; Paridon, Stephen M.; Goldmuntz, Elizabeth

doi:10.1177/2150135117752122

Cited by 26 publications

(22 citation statements)

References 30 publications

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“…36 The time spent in physical activity in our sample of CCHD was 3.59 hours per week, which is lower than 5.9 hours in subjects with Tetralogy of Fallot, transposition of the great arteries, and a Fontan circulation, as reported by O'Byrne et al (2018). 35 In our study, there was no significant association between physical activity and BMI categories, which was found in the O'Byrne et al study 35 . However, we identified an association between a sedentary lifestyle among children and being overweight/obese.…”

Section: Discussioncontrasting

confidence: 59%

“…34 However, the findings differ from those of studies that have reported a prevalence of 18.2%-35.7% for overweight/obesity in CCHD in Western countries. [11][12][13][14][15][16][17][18][19]35 This suggests that findings from Western studies cannot be generalized for Asian populations and that studies such as the present one are necessary. Our study also indicated that BMI in the CCHD did not differ significantly from the age-and sex-adjusted BMI of the children in the general Taiwanese population.…”

Section: Discussionmentioning

confidence: 85%

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Energy Balance-Related Behaviors and Body Mass Index in Asian School-Aged Children With Congenital Heart Disease

et al. 2020

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Background: Overweight/obesity is a substantial global public health concern, which can be caused by genetic factors and energy balance-related behaviors (EBRBs). If it occurs in children with congenital heart disease (CCHD), it can yield an extra burden on their health. Most studies on CCHD have taken place in Western societies, leaving Asian populations understudied, especially children. Objective: We sought (1) to determine body mass index (BMI) distribution among school-aged CCHD in Taiwan; (2) to ascertain whether the BMI of CCHD differs from that of the general population; (3) to describe EBRBs in CCHD; and (4) to identify the associated factors of underweight and overweight/obesity among CCHD.Methods: In this cross-sectional study, 97 child-parent dyads (53.6% boys; mean age 9.73 years; 25.8% moderate-to-severe heart conditions) were enrolled. Self-administered questionnaires were used to collect demographics, medical factors, food frequency, physical activity, and sedentary behaviors. Anthropometric measurements were taken in the hospital. Independent variables of EBRBs and health conditions were calculated through logistic regression analysis.Results: Among Taiwanese CCHD, 19.6% were underweight and 14.4% were overweight/obesity. Children with moderate-to-severe heart defects were more often underweight. BMI did not differ between CCHD and children in the general population.More complex heart defects and asthma were associated with being underweight, whereas sedentary behaviors, cardiomegaly, and the New York Heart Association Classification Ⅱ-Ⅳ were associated with being overweight/obesity. Conclusions:Sedentary lifestyle is seemingly the only EBRBs correlated with being overweight. Physical activity programs for children may help prevent and treat overweight or obesity in Asian CCHD, similar to Western countries.

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Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 85%

Energy Balance-Related Behaviors and Body Mass Index in Asian School-Aged Children With Congenital Heart Disease

et al. 2020

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“…Twenty-six of the included studies were cross-sectional studies that examined the prevalence of overweight and obesity in patients with CHD [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ], and four were cohort studies that investigated the longitudinal change of the prevalence across the lifespan [ 10 , 43 , 44 , 45 ]. The body composition of patients with CHD was compared to a healthy reference cohort in 13 of the included studies [ 20 , 21 , 22 , 23 , 24 , 28 , 29 , 30 , 33 , 35 , 40 , 41 , 45 ], whereas 9 studies merely investigated the prevalence of overweight and obesity in patients with CHD [ 10 , 17 , 18 , 19 , 24 , 32 , 36 ,…”

Section: Resultsmentioning

confidence: 99%

Overweight and Obesity in Patients with Congenital Heart Disease: A Systematic Review

Willinger

Brudy

Meyer

et al. 2021

IJERPH

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Background: Overweight and obesity have become a major public health concern in recent decades, particularly in patients with chronic health conditions like congenital heart disease (CHD). This systematic review elaborates on the prevalence and the longitudinal development of overweight and obesity in children and adults with CHD. Methods: A systematic literature search was conducted in PubMed, Cochrane, and Scopus from January 2010 to December 2020 on overweight and obesity prevalence in children and adults with CHD. Results: Of 30 included studies, 15 studies evaluated 5680 pediatric patients with CHD, 9 studies evaluated 6657 adults with CHD (ACHD) and 6 studies examined 9273 both pediatric patients and ACHD. Fifteen studies received the quality rating “good”, nine studies “fair”, and six studies “poor”. In children with CHD, overweight prevalence was between 9.5–31.5%, and obesity prevalence was between 9.5–26%; in ACHD, overweight prevalence was between 22–53%, and obesity was between 7–26%. The prevalence of overweight and obesity was thereby similar to the general population. Overweight and obesity have been shown to increase with age. Conclusion: The prevalence of overweight and obesity in children and adults with CHD is similar to the general population, demonstrating that the growing obesity pandemic is also affecting the CHD population.

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“…A recent study from a group in Philadelphia had reported the positive effect of exercise on BMI in the adolescent population with CHD and found that increasing exercise duration was associated with lower BMI (P = 0.01). 23 The possibility of intervention into a modifiable risk factor before non-emergent cardiothoracic surgery represents a great opportunity to improve outcomes in this population. Further studies should evaluate if intervention in the preoperative period with a structured program aimed to decrease BMI can improve short-term post-operative outcomes in this population.…”

Section: Obesity and Short-term Outcomes In Paediatric Cardiac Criticmentioning

confidence: 99%

Does obesity affect the short-term outcomes after cardiothoracic surgery in adolescents with congenital heart disease?

2020

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Background:Obesity is a modifiable, independent risk factor for mortality and morbidity after cardiovascular surgery in adults. Our objective was to evaluate the impact of obesity on short-term outcomes in adolescents undergoing surgery for congenital heart disease (CHD).Methods:This retrospective chart review included patients 10–18 years of age who underwent CHD surgery. Our exclusion criteria were patients with a known genetic syndrome, heart transplantation, and patients with incomplete medical records. The clinical data collected included baseline demographics and multiple perioperative variables. Charting the body mass index in the Centers for Disease Control and Prevention growth curves, the entire cohort was divided into three categories: obese (>95th percentile), overweight (85th–95th percentile), and normal weight (<85th percentile). The composite outcome included survival, arrhythmias, surgical wound infection, acute neurologic injury, and acute kidney injury.Results:The study cohort (n = 149) had a mean standard deviation (SD), body mass index (BMI) of 22.6 ± 6.5 g/m2, and 65% were male. There were 27 obese (18.1%), 24 overweight (16.1%), and 98 normal weight (65.8%) patients. Twenty-seven (18%) patients had composite adverse outcomes. Overweight and obese patients had significantly higher adverse outcomes compared with normal weight patients (odds ratio (OR): 2.9; confidence interval (CI): 1–8.5, p = 0.04 and OR: 3; CI: 1–8.5, p = 0.03, respectively). In multivariate analysis, obesity was an independent predictor of adverse outcome in our cohort (p = 0.04).Conclusions:Obesity is associated with short-term adverse outcome and increased health resource utilisation in adolescents following surgery for CHD. Further studies should evaluate if intervention in the preoperative period can improve outcomes in this population.

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Association of Habitual Activity and Body Mass Index in Survivors of Congenital Heart Surgery: A Study of Children and Adolescents With Tetralogy of Fallot, Transposition of the Great Arteries, and Fontan Palliation

Abstract: Increased habitual activity was associated with lower BMI, emphasizing the potential role of recreational sport in the health of children with congenital heart disease.

Cited by 26 publications

References 30 publications

Energy Balance-Related Behaviors and Body Mass Index in Asian School-Aged Children With Congenital Heart Disease

Energy Balance-Related Behaviors and Body Mass Index in Asian School-Aged Children With Congenital Heart Disease

Overweight and Obesity in Patients with Congenital Heart Disease: A Systematic Review

Does obesity affect the short-term outcomes after cardiothoracic surgery in adolescents with congenital heart disease?

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