Overweight Children and Adolescents: A Clinical Report of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

Baker, Susan; Barlow, Sarah E.; Cochran, William; Fuchs, George J.; Klish, William J.; Krebs, Nancy F.; Strauß, Richard; Tershakovec, Andrew M.; Udall, John N.

doi:10.1097/01.mpg.0000161147.16590.12

Cited by 103 publications

(111 citation statements)

References 93 publications

(94 reference statements)

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“…Smoking history could be elicited in only participant. More than half (57%) of study population was either overweight or obese (as defined by accepted standard definition of overweight and obesity; overweight defined by body mass index (BMI): 26 6 5.94 kg/m 2 and obesity as BMI 30 6 5.11 kg/m 2 ) [20]. Family history of VTE (second-degree relatives) was identified in two subjects.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

Hypercoagulability in adolescent girls on oral contraceptives‐global coagulation profile and estrogen receptor polymorphisms

Zia

Callaghan

et al. 2015

American J Hematol

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Oral contraceptive (OCP) induced changes on coagulation are complex with high inter-individual variability. The precise reason for differences in this variability is unknown. We hypothesized that global coagulation assays better delineate these changes and variability in hypercoagulability may be the result of differences in estrogen metabolism and thrombophilia. Fifty-two adolescents initiating OCPs were prospectively enrolled; 33 subjects completed the study. Samples were analyzed prior to and after OCPs for procoagulant and anticoagulant factor activities and thrombin generation (TG) 1/-thrombomodulin. Participants were genotyped for common thrombophilia and estrogen receptor-a (ESR-a) single nucleotide polymorphisms (SNPs). SNP genotypes were compared to coagulation parameters; TG parameters and differences pre and post OCPs were examined. At baseline, a striking finding was elevated FVIII levels. FVL was absent in all and F2 G20210A was present in one participant. The ESR-a polymorphism was present in heterozygous state in 59% and homozygous state in 21% participants. There were no differences in VWF levels and FVIII: C after being on OCPs. Protein S levels decreased with OCPs. Sixty percent of participants showed evidence of hypercoagulability on TG testing on OCPs. Higher thrombin peak and endogenous thrombin potential (ETP) were seen on TG after OCPs. With thrombomodulin, ETP and thrombin peak did not decrease after OCPs, signifying 'thrombomodulin resistance'. We demonstrated that OCPs induce a state of "variable" hypercoagulability in adolescents, predominantly through the protein S pathway. Genetic and nongenetic factors may account for the variable increase in hypercoagulability. Further research is needed to understand this.

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Section: Baseline Characteristicsmentioning

confidence: 99%

Hypercoagulability in adolescent girls on oral contraceptives‐global coagulation profile and estrogen receptor polymorphisms

Zia

Callaghan

et al. 2015

American J Hematol

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“…For instance, there has been an increase in the consumption of high sugar beverages and fruit juices (Al-Dossary et al, 2010) and replacement of traditional food with fast food as a result of maternal employment (Baker et al, 2005). Furthermore, physical activity is limited and more time is being spent engaging in seated activities (El-Hazmi and Warsy, 2002) such as watching television and playing computer and video games.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of obesity among preschool children and its relation with dental caries

Elkhodary¹,

Farsi²,

Merdad³

et al. 2017

J. Dent. Oral Hyg.

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There is increasing interest in investigating the association between dental caries and childhood obesity, particularly among preschoolers where the evidence is limited. We aimed to measure the prevalence of obesity/overweight among preschool children aged 3 to 6 years, and to determine the relationship between obesity and dental caries in the primary dentition. A cross-sectional study was carried out in eight public and private preschools using a multi-stage stratified sample of 820 children. Waist circumference (WC) and body mass index (BMI) measurements were obtained. Caries was assessed using the National Institute of Dental Research's decayed, missed or filled score (dmft). Based on BMI, 15% of children were obese and 10% were overweight. Based on WC, 13% of children were obese. The prevalence of obesity/overweight based on BMI was significantly higher among girls (p-value=0.014) and private preschools (p-value<0.001). Based on BMI, obese and overweight children had lower dmft scores than underweight and normal children (p-value<0.001). Based on WC, obese children had lower dmft scores than non-obese children (p-value<0.001). Obesity prevalence was high, particularly among girls and private preschool children. Caries activity was lower in overweight and obese children. Longitudinal studies are essential to investigate the association between caries and obesity in preschool children.

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“…69 Right upper quadrant pain consistent with biliary colic should suggest cholelithiasis, also associated with obesity. 70 Hepatomegaly is defined as a liver span greater than age norms (5 cm in 5-year-olds and 15 cm in adults) or liver edge palpable below the right costal margin by >3.5 cm in adults or >2 cm in children. 10 The difficulty of detecting hepatomegaly in patients with obesity, even by trained hepatologists, limits the identification of children with NAFLD.…”

Section: Gastrointestinal Right Upper Quadrant Pain and Hepatomegalymentioning

confidence: 99%

Physical Examination Findings Among Children and Adolescents With Obesity: An Evidence-Based Review

et al. 2016

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Overweight and obesity affects 1 in 3 US children and adolescents. Clinical recommendations have largely focused on screening guidelines and counseling strategies. However, the physical examination of the child or adolescent with obesity can provide the clinician with additional information to guide management decisions. This expert-based review focuses on physical examination findings specific to children and adolescents with obesity. For each physical examination element, the authors define the finding and its prevalence among pediatric patients with obesity, discuss the importance and relevance of the finding, describe known techniques to assess severity, and review evidence regarding the need for additional evaluation. The recommendations presented represent a comprehensive review of current evidence as well as expert opinion. The goal of this review is to highlight the importance of conducting a targeted physical examination during pediatric weight management visits.

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Overweight Children and Adolescents: A Clinical Report of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

Cited by 103 publications

References 93 publications

Hypercoagulability in adolescent girls on oral contraceptives‐global coagulation profile and estrogen receptor polymorphisms

Hypercoagulability in adolescent girls on oral contraceptives‐global coagulation profile and estrogen receptor polymorphisms

Prevalence of obesity among preschool children and its relation with dental caries

Physical Examination Findings Among Children and Adolescents With Obesity: An Evidence-Based Review

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