ABSTRACT
Children of parents participating in weight management programs (WMPs) are more likely to adopt their parents' weight control practices. Little is known about the weight outcomes of children who have a parent participating in a WMP. This study aimed to assess this relationship. Children 2-17 years of age with a parent who participated in a WMP were included in the study. Multilevel linear mixed-effects regression models were used, stratified by child weight status at the time of parental WMP participation (healthy weight, overweight/obesity) to determine change in children's BMIz from before to after parents WMP participation, including covariates of parent BMI and parental feeding practices. Parents (N = 77) were mostly white (76%) and female (84%). Children (N = 114) had a mean age of 10.5 ± 4.6; 47% had overweight or obesity. Children with overweight or obesity prior to their parent's WMP had a decrease in BMIz (-0.68) after the WMP while children with a healthy weight had no significant change. Children with overweight or obesity had a decrease in BMIz from before to after parent's participation in a WMP. Further research is needed to understand changes in family eating practices that occur during and after parent WMP participation.
Subject(s)
Overweight , Weight Reduction Programs , Child , Humans , Adult , Female , Child, Preschool , Adolescent , Body Weight , Obesity , Parents , Body Mass Index , Surveys and QuestionnairesABSTRACT
Background Preclinical studies suggest that volatile anesthetics decrease infarct volume and improve the outcome of ischemic stroke. This study aims to determine their effect during noncardiac surgery on postoperative ischemic stroke incidence. Methods and Results This was a retrospective cohort study of surgical patients undergoing general anesthesia at 2 tertiary care centers in Boston, MA, between October 2005 and September 2017. Exclusion criteria comprised brain death, age <18 years, cardiac surgery, and missing covariate data. The exposure was defined as median age-adjusted minimum alveolar concentration of all intraoperative measurements of desflurane, sevoflurane, and isoflurane. The primary outcome was postoperative ischemic stroke within 30 days. Among 314 932 patients, 1957 (0.6%) experienced the primary outcome. Higher doses of volatile anesthetics had a protective effect on postoperative ischemic stroke incidence (adjusted odds ratio per 1 minimum alveolar concentration increase 0.49, 95% CI, 0.40-0.59, P<0.001). In Cox proportional hazards regression, the effect was observed for 17 postoperative days (postoperative day 1: hazard ratio (HR), 0.56; 95% CI, 0.48-0.65; versus day 17: HR, 0.85; 95% CI, 0.74-0.99). Volatile anesthetics were also associated with lower stroke severity: Every 1-unit increase in minimum alveolar concentration was associated with a 0.006-unit decrease in the National Institutes of Health Stroke Scale (95% CI, -0.01 to -0.002, P=0.002). The effects were robust throughout various sensitivity analyses including adjustment for anesthesia providers as random effect. Conclusions Among patients undergoing noncardiac surgery, volatile anesthetics showed a dose-dependent protective effect on the incidence and severity of early postoperative ischemic stroke.
