1,720,975 research outputs found
Modificazioni comportamentali
No full textLa terapia dell'obesità è difficile e i risultati ottenuti spesso scoraggianti. Al momento attuale, gli interventi più efficaci nel medio-lungo ternmine sono risultati quelli basati su strategie indirizzate a modificare il comportamento alimentare e motorio della famiglia e del bambino piuttosto che alla prescrizione di diete o prigrammi di esercizio. Il pediatra ha quindi la necessità di modificare l'atteggiamento terapeutico da prescrittivo ad educativo. Vengono quindi riportati gli obiettivi dell'intervento e le modalità più efficaci per raggiungerli
L’attività fisica: come e perché
No full textIl ruolo giocato dal metabolismo muscolare nei processi che conducono allo sviluppo dell'obesità ed al suo mantenimento è del tutto centrale. Il tessuto muscolare ossida la maggior quota di nutrienti, in particolare grassi e carboidrati, fattore determinante per la regolazione del bilancio dei substrati e quindi del peso corporeo e della massa adiposa. Sia il trattamento che la prevenzione dell'obesità non possono prescindere dall'attività motoria. Il primo obiettivo è la riduzione della sedentarietà ed il secondo un incremento della fitness. Infactti accanto alla riduzione dell'eccesso di massa adiposa, l'intervento ha lo scopo di ridurre i fattori di rischio cardiovascolare ad essa correlati, che risentono positivamente soprattutto di un incremento della fitness
Perché l’attività fisica ha un ruolo fondamentale nel trattamento dell’obesità? Giustificazioni fisiopatologiche ad una prassi non consolidata
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Does waist circumference predict fat gain in children?
No full textOBJECTIVE: The aim of this study was to identify in a group of 8-y-old prepubertal children the anthropometric parameter with the highest prediction power of overweight, measured 4 y later. SUBJECTS: One-hundred and twelve Caucasian children (54 males, 58 females), aged 8.7 ± 0.9 y, were studied. RESULTS: An analysis of the association between relative body mass index (BMI) at follow-up (%) and some indexes of adiposity like relative BMI (%), waist circumference, subscapular and triceps skinfolds, the sum of four skinfolds and percentage fat mass measured at baseline, showed that relative BMI (relBMI) at baseline had the highest association with relBMI at follow-up (r=0.77; P < 0.001); waist circumference had a slightly lower significant association with relBMI at follow-up (r=0.74; P < 0.001). In a multiple regression analysis, waist circumference (adjusted for age) accounted for ∼ 64% of the variation of relBMI at follow-up (P < 0.001). RelBMI measured at baseline accounted for ∼ 59% of the variation of relBMI at follow-up (P < 0.001). Multiple logistic regression analysis included waist circumference, adjusted for age, mother's BMI and relBMI measured at baseline as independent variables in the final equation. In particular, each centimeter increase of waist circumference at the age of 8 y doubled the risk of having a relBMI greater than 120% at the age of 12 y. CONCLUSION: The results of this study, the first which has approached this investigation in children, showed that waist circumference measured at the age of 8 y, which is simple to perform and easy to reproduce, may be a promising index to assess adiposity as well as to predict overweight at puberty
Waist circumference and cardiovascular risk factors in prepubertal children.
No full textObjective: Intra-abdominal fat has been identified as being the most clinically relevant type of fat in humans. Therefore, an assessment of body-fat distribution could possibly identify subjects with the highest risk of adverse lipid profile and hypertension. Few data on the relationship between body-fat distribution and cardiovascular risk factors are available in children, especially before puberty. Research Methods and Procedures: This cross-sectional study was undertaken to explore the relationship between anthropometric variables, lipid concentrations, and blood pressure (BP) in a sample of 818 prepubertal children (ages 3 to 11 years) and to assess the clinical relevance of waist circumference in identifying prepubertal children with higher cardiovascular risk. Height, weight, triceps and subscapular skinfolds, waist circumference, and BP were measured. Plasma levels for triacylglycerol, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB) were determined. Results: Females were fatter than males (5.8 [3.5] vs. 4.8 [3.3] kg of fat mass; p < 0.01). Males had higher HDL cholesterol and ApoA1/ApoB plasma concentrations than females (p < 0.001 and p < 0.01, respectively). Waist circumference had a higher correlation with systolic and diastolic BP (r = 0.40 and 0.29, respectively; p < 0.001) than triceps (r = 0.35 and 0.21, respectively; p < 0.001) and subscapular (r = 0.28 and 0.16, respectively; p < 0.001) skinfolds and relative body weight (0.33 and 0.23, respectively; p < 0.001). Multivariate linear model analysis showed that ApoA1/ApoB, HDL cholesterol, total cholesterol/HDL cholesterol, and systolic as well as diastolic BP were significantly associated with waist circumference and triceps and subscapular skinfolds, independently of age, gender, and body mass index. Discussion: Waist circumference as well as subscapular and triceps skinfolds may be helpful parameters in identifying prepubertal children with an adverse blood-lipids profile and hypertension. However, waist circumference, which is easy to measure and more easily reproducible than skin-folds, may be considered in clinical practice. Children with a waist circumference greater than the 90th percentile are more likely to have multiple risk factors than children with a waist circumference that is less than or equal to the 90th percentile
Effects of dinner composition on postprandial macronutrient oxidation in prepubertal girls.
No full textObjective: To see whether a fat-rich (50%) evening meal promoted fat oxidation and a different spontaneous food intake on the following day at breakfast than a meal with a lower fat content (20%) in 10 prepubertal obese girls. Research Methods and Procedures: The postabsorptive and postprandial (10.5 hours) energy expenditure after a low-fat (LF) (20% fat, 68% carbohydrate, 12% protein) and an isocaloric (2.1 MJ) and isoproteic high-fat (HF; 50% fat, 38% carbohydrate, 12% protein) meal were measured by indirect calorimetry. Results: Fat oxidation was not significantly different after the two meals [LF, 31 ± 9 vs. HF, 35 ± 9 g/10.5 hours, p = not significant (NS)]. The girls oxidized 1.8 ± 0.9 times more fat than that ingested (11.1 grams) with the LF meal vs. 0.3 ± 0.3 times more fat than that ingested (27.1 grams) with the HF meal (p < 0.001). Carbohydrate oxidation was significantly higher after an LF than an HF meal (39 ± 12 vs. 29 ± 9 g/10.5 hours, p < 0,05). At breakfast, the girls spontaneously ingested a similar amount of energy (1.5 ± 0.7 vs. 1.5 ± 0.6 MJ, p = NS) and macronutrient proportions (fat, 23% vs. 26%, p = NS; protein, 9% vs. 10%; carbohydrate, 68% vs. 64%,) independently of their having eaten an HF or an LF dinner. Discussion: An HF dinner did not stimulate fat oxidation, and no compensatory effect in spontaneous food intake was observed during breakfast the following morning. Cumulated total fat oxidation after dinner was higher than total fat ingested at dinner, but a much larger negative fat balance was observed after the LF meal. Spontaneous energy and nutrient intakes at breakfast were similar after LF and HF isocaloric, isoproteic dinners. This study points out the lack of sensitivity of short-term fat balance to subsequently readjust fat intake and emphasizes the importance of an LF meal to avoid transient positive fat imbalance
Meal-induced thermogenesis and obesity: is a fat meal a risk factor for fat gain in children?
No full textDiet composition, in particular fat intake, has been suggested to be a risk factor for obesity in humans. Several mechanisms may contribute to explain the impact of fat intake on fat gain. One factor may be the low thermogenesis induced by a mixed meal rich in fat
Could the savory taste of snacks be a further risk factor for overweight in children?
No full textIntroduction: The quantity, type and composition of snack foods may play a role in the development and maintenance of obesity in children. A high consumption of energy-dense snacks 41 may promote fat gain. Aims: To assess the type and number of snacks consumed weekly by a large sample of 8- to 10-year-old children, as well as to assess its relationship with body size. Results: The children consumed oil average 4 snacks per day. There was no statistical difference in the number of servings per day between obese and nonobese children. However, the mean energy density of the foods consumed was significantly higher for obese and overweight children than for normal weight children [6.8 (0.3) kJ/g, 6.8 (0.16) kJ/g, and 6.3 (0.08) kJ/g, respectively; P < 0.05]. Logistic regression analysis showed that the energy density of the snacks (kJ/g), their savory taste (servings/week), television viewing (hours/day) and sports activity (hours/week) independently contributed to predict obesity in children. However, when the parents' body mass index was included among the independent variables of the regression, only salty foods and sports activity showed ail independent association with childhood obesity. Conclusions: Parents' eating habits and lifestyle influence those of their children, as suggested by the association between parents' obesity and their children's energy-dense food intake at snacktime, the savory taste of snacks and sedentary behavior. However, regardless of parents' body mass index, the preference for savory snacks seems to be associated with overweight in prepubertal children
Obesity and insulin-resistance in childhood
No full textInsulin-resistance is the most common metabolic complication of obesity. Fatness per sé is associated with insulin-resistance but it is mainly visceral, hepatic and skeletal muscle fat mass distribution that promotes and maintains insulin-resistance. Fat infiltration in the liver, pancreas and skeletal muscle is associated with a lower glucose uptake in the muscle, a lower insulin-mediated suppression on hepatic glucose production, a lower insulin-sensitivity, a greater susceptibility to diabetes and metabolic syndrome. Proliferative and differentiative capacity of fat cells contribute to the development of the metabolic complications of obesity. In fact, in the case of high proliferative and differentiative capacity, the mesenchimal precursor of the adipocite will give origin to mature adipocites high in number and low in volume, with a lower infiltration of the skeletal muscle, liver and pancreas. On the contrary in the case of low proliferative and differentiative capacity of the precursor, a hypertrophic obesity will develop, with low number of adipocites with high volume and a high infiltration of the organs. Skeletal muscle metabolism plays an important role in the fat balance regulation and, therefore, fat mass. Training and prolonged muscular work increases intramuscular fat oxidation, favouring insulin action and reducing insulin-resistance associated with intramuscular fat concentration. A high insulin sensitivity and a high insulin response are obesity risk factors in children. On the contrary, during puberty, insulin resistance associated with the increase of fat mass and with the changes of fat mass distribution seems to oppose, at least in females, further fat gain in adulthood. A high sensitivity to the insulin and a high insulinic answer seem to be obesity risk factors in the adult subjects. Several studies performed on children about the relationship between obesity and insulin-resistance are few and contradictory amongst them. These studies evidence that high insulin-sensitivity favours the increase of adiposity in non-obese children. Afterwards children's insulin-resistance associated to increase of fat mass opposes to a new increase of adiposity, at least in the girls
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