Development of a Dutch intervention for obese young children

Hoek, Esther van; Bouwman, L.I.; Koelen, M.A.; Lutt, M. A. J.; Feskens, Edith J. M.; Janse, A.

doi:10.1093/heapro/dav115

Cited by 5 publications

(6 citation statements)

References 43 publications

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“…Obese children exhibited typical clinical and biochemical characteristics compared to age and sex-matched normal weight controls, with a higher BMI-SD, waist circumference and blood pressure, combined with a lower insulin sensitivity index (QUICKI) and higher plasma levels of alanine aminotransferase, chemerin and leptin ( Table 1 ). The obese children participated in an established lifestyle intervention program [ 21 ], which resulted in stabilization of their BMI-SD and other clinical and biochemical characteristics, and enabled sampling pre and post-lifestyle intervention ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

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Differential adipokine receptor expression on circulating leukocyte subsets in lean and obese children

et al. 2017

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BackgroundChildhood obesity prevalence has increased worldwide and is an important risk factor for type 2 diabetes (T2D) and cardiovascular disease (CVD). The production of inflammatory adipokines by obese adipose tissue contributes to the development of T2D and CVD. While levels of circulating adipokines such as adiponectin and leptin have been established in obese children and adults, the expression of adiponectin and leptin receptors on circulating immune cells can modulate adipokine signalling, but has not been studied so far. Here, we aim to establish the expression of adiponectin and leptin receptors on circulating immune cells in obese children pre and post-lifestyle intervention compared to normal weight control children.Methods13 obese children before and after a 1-year lifestyle intervention were compared with an age and sex-matched normal weight control group of 15 children. Next to routine clinical and biochemical parameters, circulating adipokines were measured, and flow cytometric analysis of adiponectin receptor 1 and 2 (AdipoR1, AdipoR2) and leptin receptor expression on peripheral blood mononuclear cell subsets was performed.ResultsObese children exhibited typical clinical and biochemical characteristics compared to controls, including a higher BMI-SD, blood pressure and circulating leptin levels, combined with a lower insulin sensitivity index (QUICKI). The 1-year lifestyle intervention resulted in stabilization of their BMI-SD. Overall, circulating leukocyte subsets showed distinct adipokine receptor expression profiles. While monocytes expressed high levels of all adipokine receptors, NK and iNKT cells predominantly expressed AdipoR2, and B-lymphocytes and CD4+ and CD8+ T-lymphocyte subsets expressed AdipoR2 as well as leptin receptor. Strikingly though, leukocyte subset numbers and adipokine receptor expression profiles were largely similar in obese children and controls. Obese children showed higher naïve B-cell numbers, and pre-intervention also higher numbers of immature transition B-cells and intermediate CD14++CD16+ monocytes combined with lower total monocyte numbers, compared to controls. Furthermore, adiponectin receptor 1 expression on nonclassical CD14+CD16++ monocytes was consistently upregulated in obese children pre-intervention, compared to controls. However, none of the differences in leukocyte subset numbers and adipokine receptor expression profiles between obese children and controls remained significant after multiple testing correction.ConclusionsFirst, the distinct adipokine receptor profiles of circulating leukocyte subsets may partly explain the differential impact of adipokines on leukocyte subsets. Second, the similarities in adipokine receptor expression profiles between obese children and normal weight controls suggest that adipokine signaling in childhood obesity is primarily modulated by circulating adipokine levels, instead of adipokine receptor expression.

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Section: Resultsmentioning

confidence: 99%

“…Obesity was defined using established international age and sex-specific BMI cut-off points [ 20 ]. The obese patients were enrolled in an established 1-year multidisciplinary, multicomponent, family-based treatment programme developed in the Gelderse Vallei Hospital in Ede, The Netherlands [ 21 ]. Patients were included from 2010 to 2015.…”

Section: Methodsmentioning

confidence: 99%

Differential adipokine receptor expression on circulating leukocyte subsets in lean and obese children

et al. 2017

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“…Children with endocrine, chromosomal or syndrome disorders were excluded from treatment. "AanTafel" is developed by integrating evidence from science and practice in a five step development process as reported earlier (van Hoek et al 2016). In sum, "AanTafel!"…”

Section: Methodsmentioning

confidence: 99%

Assessment of epicardial adipose tissue in young obese children

Hoek

Koopman

Feskens

et al. 2019

Child and Adolescent Obesity

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Objective: Epicardial adipose tissue thickness (EATT) is suggested to play a role in the development of cardiovascular disease. In adolescents it is correlated with BMI z-score, cardiovascular risk factors, and pro-and antiinflammatory markers. EATT of overweight/obese children was compared with EATT of normal weight peers (cross-sectional design). We investigated the association between EATT, cardiovascular risk factors and pro-and anti-inflammatory markers and the effect of a one year, multidisciplinary, treatment program on EATT in overweight/obese children (longitudinal design). Methods: EATT was measured by echocardiography (25 obese, 8 overweight and 15 normal weight children; median age 5.1 years). In the overweight/obese children blood pressure, lipid profile, glucose, insulin, high sensitive CRP, and adiponectin concentrations were measured. In overweight/obese children participating in a multidisciplinary treatment program, measurements were repeated after 4 and 12 months. Results: EATT was significantly higher in the overweight (median 1.38mm) and obese (median 1.57mm) children compared to normal weight children (median 0.87mm). Among obese children EATT was significantly inversely associated with adiponectin (r = −0.485). Conclusions: EATT is increased in overweight/obese children and is inversely associated with adiponectin. Echocardiographic measurement of EATT is easy and might serve as a simple tool for cardio-metabolic risk stratification.

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“…Intervention "AanTafel!" is developed by integrating evidence from science and practice in a five-step development process as reported earlier (van Hoek et al 2016). Evidence from clinical guidelines (step I) was combined with a systematic review with meta-analysis (Step II) and an extended literature review (Step III).…”

Section: Screeningmentioning

confidence: 99%

“…is Dutch for going to the table, which is associated with positive domesticity. This treatment program is based on clinical guidelines, scientific literature, interviews with parents of young obese children and expert opinion (van Hoek et al 2016). It has a low-intensity level and is complemented with a web-based learning module.…”

Section: Introductionmentioning

confidence: 99%

Effect on BMI of a multi-component treatment with E-modules for 3–8-year-old obese children

Hoek

Feskens

Bouwman

et al. 2019

Child and Adolescent Obesity

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Introduction: Childhood obesity has serious health risks including the development of metabolic syndrome, cardiovascular disease and mortality later in life. The critical growth period from 3 to 7 years provides a window of opportunity for interventions. The goal of this study is to evaluate a one year, multidisciplinary, low-intensity treatment program for young obese children, complemented with web-based modules, called "AanTafel!", on body composition, cardiometabolic risk profile, quality of life (HRQoL), eating behavior and physical activity. Methods: In the pre-post-test design all measures were taken at baseline, 4 months, at the end of treatment and 3 years after baseline. Results: Thirteen boys and 27 girls with median BMI z-score of, respectively, 4.2 and 3.3 aged 3 to 8 started "AanTafel!". Eighty percent (n = 32) completed treatment. BMI z-score decreased with 0.45 (end of treatment) and sustained after 3 years. At the start, 16.7% of the children had all four components of metabolic syndrome which decreased to 0%. HDL cholesterol significantly increased. Concentrations of the markers IL18, e-selectin, and sICAM significantly decreased indicating a reduction of inflammation. Conclusion: "AanTafel!" is effective in improving health of obese young children. The reduction of overweight is clinically relevant and sustained after 3 years.

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Development of a Dutch intervention for obese young children

Cited by 5 publications

References 43 publications

Differential adipokine receptor expression on circulating leukocyte subsets in lean and obese children

Differential adipokine receptor expression on circulating leukocyte subsets in lean and obese children

Assessment of epicardial adipose tissue in young obese children

Effect on BMI of a multi-component treatment with E-modules for 3–8-year-old obese children

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