Clinical Practice Guideline for the Diagnosis and Treatment of Pediatric Obesity: Recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition

Yi, Dae Yong; Kim, Soon Chul; Lee, Ji Hyuk; Lee, Eun Hye; Kim, Jae Young; Kim, Yong Joo; Kang, Kyu-Suk; Hong, Jeana; Shim, Jung Ok; Lee, Yoon; Kang, Ben; Lee, Yeoun Joo; Kim, Mi Jin; Moon, Jin Soo; Koh, Hong; You, Jeong Ae; Kwak, Young Sook; Lim, Hyunjung; Yang, Hye Ran

doi:10.5223/pghn.2019.22.1.1

Cited by 21 publications

(26 citation statements)

References 153 publications

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“…These observations not only recommend that patients with obesity do physical activities such as home training to the extent possible during school closing, but also emphasize that family members and pediatricians should pay attention to the lifestyle of pediatric patients with obesity. Although further studies in post-school closing are needed, aggravated obesity and other metabolic diseases during out-of-school circumstances may not be easily reversible and might contribute to excess adiposity and cardiometabolic or non-cardiometabolic comorbidities, which can persist into adulthood 2 , 19 , 33 .…”

Section: Discussionmentioning

confidence: 99%

“…Obesity was defined as a BMI above the 95th percentile in children and adolescents in accordance with the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition 19 . NAFLD was diagnosed by excluding alternative etiologies for elevated ALT and/or hepatic steatosis, such as medication (amiodarone, glucocorticoids, L-asparaginase, valproic acid) and the presence of co-existing chronic liver disease including Wilson’s disease, type 1 diabetes mellitus, hepatitis B, and hepatitis C 20 .…”

Section: Methodsmentioning

confidence: 99%

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COVID-19-related school closing aggravate obesity and glucose intolerance in pediatric patients with obesity

Kim

Kwon

Choe

et al. 2021

Sci Rep

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It is important to pay attention to the indirect effects of the social distancing implemented to prevent the spread of coronavirus disease 2019 (COVID-19) pandemic on children and adolescent health. The aim of the present study was to explore impacts of a reduction in physical activity caused by COVID-19 outbreak in pediatric patients diagnosed with obesity. This study conducted between pre-school closing and school closing period and 90 patients aged between 6- and 18-year-old were included. Comparing the variables between pre-school closing period and school closing period in patients suffering from obesity revealed significant differences in variables related to metabolism such as body weight z-score, body mass index z-score, liver enzymes and lipid profile. We further evaluated the metabolic factors related to obesity. When comparing patients with or without nonalcoholic fatty liver disease (NAFLD), only hemoglobin A1c (HbA1c) was the only difference between the two time points (p < 0.05). We found that reduced physical activity due to school closing during COVID-19 pandemic exacerbated obesity among children and adolescents and negatively affects the HbA1C increase in NAFLD patients compared to non-NAFLD patients.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

COVID-19-related school closing aggravate obesity and glucose intolerance in pediatric patients with obesity

Kim

Kwon

Choe

et al. 2021

Sci Rep

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“…In some countries, obesity rates in children and adolescents exceed 30%. According to the Korean Ministry of Education, the Korean childhood obesity rate in 2018 reached 25%, increasing rapidly from 8.4% in 2008 [2]. Childhood and adolescent obesity are related to anthropometric and metabolic changes, such as metabolic syndromes, including dyslipidemia, hypertension, Metabolites 2022, 12, 27 2 of 12 and insulin resistance [3].…”

Section: Introductionmentioning

confidence: 99%

Metabolomic Signatures for the Effects of Weight Loss Interventions on Severe Obesity in Children and Adolescents

Sohn

Chae

et al. 2021

Metabolites

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Childhood obesity has increased worldwide, and many clinical and public interventions have attempted to reduce morbidity. We aimed to determine the metabolomic signatures associated with weight control interventions in children with obesity. Forty children from the “Intervention for Children and Adolescent Obesity via Activity and Nutrition (ICAAN)” cohort were selected according to intervention responses. Based on changes in body mass index z-scores, 20 were responders and the remaining non-responders. Their serum metabolites were quantitatively analyzed using capillary electrophoresis time-of-flight mass spectrometry at baseline and after 6 and 18 months of intervention. After 18 months of intervention, the metabolite cluster changes in the responders and non-responders showed a difference on the heatmap, but significant metabolites were not clear. However, regardless of the responses, 13 and 49 metabolites were significant in the group of children with obesity intervention at 6 months and 18 months post-intervention compared to baseline. In addition, the top five metabolic pathways (D-glutamine and D-glutamate metabolism; arginine biosynthesis; alanine, aspartate, and glutamate metabolism; TCA cycle; valine, leucine, and isoleucine biosynthesis) including several amino acids in the metabolites of obese children after 18 months were significantly changed. Our study showed significantly different metabolomic profiles based on time post obesity-related intervention. Through this study, we can better understand and predict childhood obesity through metabolite analysis and monitoring.

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“…Although various interventions have been performed to prevent or treat childhood obesity in Korea, the overall effect of those interventions remains unclear [ 14 ]. Pediatricians in Korean generally recommend multidisciplinary behavioral interventions for the treatment of childhood obesity [ 14 ], but evidence for such a recommendation is based on studies [ 15 - 18 ] conducted outside of Korea. In Western countries, many meta-analyses have been performed to investigate the effect of obesity interventions among adults [ 19 - 24 ] and children [ 15 - 18 , 25 - 27 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of obesity interventions among South Korean children and adolescents and importance of the type of intervention component: a meta-analysis

Choe

Chaput

et al. 2022

Clin Exp Pediatr

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Background: Various interventions have been tested to prevent or treat childhood obesity in South Korea. However, the overall effect of those interventions is unclear, as very few reviews and meta-analyses were specific to Korean children and adolescents.Purpose: We aimed to examine the overall effect of obesity interventions among Korean children and adolescents, while also examining differences by sex, age group, baseline weight category, intervention duration, number of intervention components, and type of intervention components.Methods: A meta-analysis was conducted for all intervention studies sampling Korean children and adolescents, with at least one control group and one month of follow-up, published between January 2000 and August 2020. Cohen d was calculated as an effect size for treatment effect, using the standardized difference between intervention group’s body mass index (BMI) change and control group’s BMI change.Results: The final sample included 19 intervention studies with 2,140 Korean children (mean age, 12.2 years). Overall, interventions were strongly favored over their controls (d=1.61; 95% confidence interval [CI], 1.12–2.09). The subgroup analysis showed that interventions with at least one physical activity component (d=2.43; 95% CI, 1.63–3.24) were significantly better than those that did not include physical activity (d=0.02; 95% CI, -0.26 to 0.31).Conclusion: Type of intervention component appeared important, though no differential association was observed by sex, age, baseline weight category, intervention duration, and number of intervention components. Korean and non-Korean interventions may be substantively different. Additional studies are needed to understand why and how Korean interventions differ from non-Korean interventions.

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Clinical Practice Guideline for the Diagnosis and Treatment of Pediatric Obesity: Recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition

Cited by 21 publications

References 153 publications

COVID-19-related school closing aggravate obesity and glucose intolerance in pediatric patients with obesity

COVID-19-related school closing aggravate obesity and glucose intolerance in pediatric patients with obesity

Metabolomic Signatures for the Effects of Weight Loss Interventions on Severe Obesity in Children and Adolescents

Effectiveness of obesity interventions among South Korean children and adolescents and importance of the type of intervention component: a meta-analysis

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