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  • Ferrari, Nina  (4)
  • Klaudius, Marlen  (4)
  • 1
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 19, No. 4 ( 2022-02-20), p. 2442-
    Abstract: Juvenile obesity is associated with insulin resistance, among other comorbidities. In the pathogenesis of insulin-resistance-related diseases, including obesity and diabetes, Vitamin D deficiency is very common. Therefore, the relationship between insulin resistance, body composition, vitamin D level, and cardiorespiratory fitness in obese children and youth were analyzed based on the Children’s Health InterventionaL Trial III project, Germany. Data on vitamin D levels and homeostatic model assessment (HOMA) indices were available from 147 participants (52.4% female; 90.5% obese; 12.3 ± 2.3 years, BMI: 30.5 ± 5.2 kg/m2, BMI standard deviation score (BMI-SDS): 2.52 ± 0.46). Vitamin D levels correlated negatively with the HOMA index, BMI, BMI-SDS, abdominal circumference, and body fat percentage but positively with relative cardiorespiratory fitness (p 〈 0.05 in each case). In the backward stepwise linear regression analysis, body fat (in kg; β = 0.403) and vitamin D levels (β = −0.154) explained 21.0% of the variance in the HOMA index. In summary, increased body fat and lower vitamin D levels are associated with increased HOMA indices in overweight and obese children and adolescents. In order to prevent potential negative consequences, including the development of manifest Type 2 diabetes, a healthy lifestyle with a vitamin-D-enriched diet and more time spent outdoors should be promoted.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2175195-X
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  • 2
    In: Journal of Clinical Medicine, MDPI AG, Vol. 11, No. 1 ( 2022-01-05), p. 277-
    Abstract: Sarcopenic obesity is increasingly found in youth, but its health consequences remain unclear. Therefore, we studied the prevalence of sarcopenia and its association with cardiometabolic risk factors as well as muscular and cardiorespiratory fitness using data from the German Children’s Health InterventionaL Trial (CHILT III) programme. In addition to anthropometric data and blood pressure, muscle and fat mass were determined with bioelectrical impedance analysis. Sarcopenia was classified via muscle-to-fat ratio. A fasting blood sample was taken, muscular fitness was determined using the standing long jump, and cardiorespiratory fitness was determined using bicycle ergometry. Of the 119 obese participants included in the analysis (47.1% female, mean age 12.2 years), 83 (69.7%) had sarcopenia. Affected individuals had higher gamma-glutamyl transferase, higher glutamate pyruvate transaminase, higher high-sensitivity C-reactive protein, higher diastolic blood pressure, and lower muscular and cardiorespiratory fitness (each p 〈 0.05) compared to participants who were ‘only’ obese. No differences were found in other parameters. In our study, sarcopenic obesity was associated with various disorders in children and adolescents. However, the clinical value must be tested with larger samples and reference populations to develop a unique definition and appropriate methods in terms of identification but also related preventive or therapeutic approaches.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662592-1
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  • 3
    In: Children, MDPI AG, Vol. 10, No. 1 ( 2023-01-07), p. 127-
    Abstract: Juvenile obesity is associated with a lower self-concept. Given the continued prevalence of obesity, we examined the secular trend of body mass index standard deviation score (BMI-SDS) and self-concept in participants of a German weight management programme (n = 242, 53.3% female, mean age 12.5 ± 2.1 years, mean BMI-SDS 2.45 ± 0.46) over a period of 15 years. Anthropometric data, physical fitness (watt/kg), and demographic data were assessed. The years 2005 to 2020 were grouped into six sections containing a mean of n = 40 participants. The questionnaire for the assessment of self and competence in children (FSK-K) was used to assess the following domains: “scholastic competence”, “social competence”, “physical appearance”, “global self-worth”, and “behavioural conduct”. No significant between-group differences in self-assessment across self-concept domains were found. In all time periods, heavier children assigned the lowest rating to physical appearance. Social competence increased with higher physical fitness. Even though no negative trend in the self-concept of children with obesity was found in this cohort, the findings confirmed an association between juvenile overweight/obesity and lower physical self-concept, and between a better social competence and increasing physical fitness. Accompanying psychosocial care, therefore, rightly remains an important pillar of obesity therapy.
    Type of Medium: Online Resource
    ISSN: 2227-9067
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2732685-8
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  • 4
    In: European Journal of Pediatrics, Springer Science and Business Media LLC, Vol. 182, No. 5 ( 2023-03-03), p. 2225-2234
    Abstract: This longitudinal study analyzes data from the Children’s Health Interventional Trial (CHILT) III, an 11-month juvenile multicomponent weight management program. The objective is to identify predictors of changes in body mass index standard deviation scores (BMI-SDS), so as to further enable the advancement of existing interventions with sustained impact. This study’s sample consists of 237 children and adolescents with obesity (8–17 years, 54% girls) participating in the CHILT III program between 2003 and 2021. Anthropometrics, demographics, relative cardiovascular endurance (W/kg), and psychosocial health (i.e., physical self-concept and self-worth) were assessed at program entry ( $$t1$$ t 1 ), end ( $$t2$$ t 2 ), and one-year follow-up ( $$t3$$ t 3 ; n  = 83). From $$t1$$ t 1 to $$t2$$ t 2 , the mean BMI-SDS was reduced by −0.16 ± 0.26 units ( p   〈  0.001). Media use and cardiovascular endurance at baseline and improvements in endurance and self-worth over the course of the program predicted changes in BMI-SDS (adj. R 2  = 0.22, p   〈  0.001). From $$t2$$ t 2 to $$t3$$ t 3 , mean BMI-SDS increased ( $$M = 0.09 \pm 0.29$$ M = 0.09 ± 0.29 , p  = 0.005). Changes in BMI-SDS from $$t2$$ t 2 to $$t3$$ t 3 were associated with parental education, improvements in cardiovascular endurance and physical self-concept, and BMI-SDS, media use, physical self-concept, and endurance level at program end (adj. R 2  = 0.39, p   〈  0.001).   Conclusions : This study highlights the need for comprehensive, sustainable weight management approaches, in order to sustain the initial treatment benefits. In this context, improvements in cardiovascular endurance and psychosocial health could be essential strategies to pursue in practice, as they significantly predicted reductions in BMI-SDS – both pre- to post-intervention and at follow-up. Trial registration : DRKS00026785; date of registration: 13.10.202, retrospectively registered. What is Known: • Childhood obesity is associated with the onset of noncommunicable diseases, many of which are likely to carry into adulthood. Thus, effective weight management strategies for affected children and their families are vital. However, achieving lasting positive health outcomes with multidisciplinary weight management programs remains challenging. What is New: • According to this study, short- and longer-term BMI-SDS reductions are associated to cardiovascular endurance and psychosocial health. These factors should therefore be given even greater consideration in weight management strategies, as they may be important not only in themselves but also for long-term weight loss (maintenance).
    Type of Medium: Online Resource
    ISSN: 1432-1076
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2647723-3
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