RESUMEN
BACKGROUND: An important area of research in childhood obesity is the identification of factors that predict or moderate the responses to obesity intervention programmes, yet few studies have examined the impact of self-esteem and family functioning on obesity treatment outcomes. OBJECTIVES: We sought to determine whether baseline self-esteem and family functioning predicted or moderated childhood obesity intervention outcomes at 6 months. METHODS: From 2009 to 2011, seventy-five 10-16 year old, racially/ethnically diverse obese youths with abnormal glucose tolerance were randomized to 6 months of an intensive family-based obesity lifestyle intervention (Bright Bodies) or routine outpatient Clinic Care. We examined youth self-concept, parent-rated family functioning and 6-month outcomes (youths' glucose tolerance, weight, body mass index and percent fat). We set the significance threshold as P ≤ 0.05 for moderator and predictor analyzes. RESULTS: Having poor family functioning and self-concept scores indicating high anxiety and low self-esteem at baseline predicted poor 6-month outcomes overall (Bright Bodies and Clinic Care groups combined). Additionally, baseline self-esteem and family functioning moderated treatment effects such that Bright Bodies outperformed Clinic Care in youths with low self-esteem and poorly functioning families, whereas youths with high self-esteem and high-functioning families did similarly well with either intervention. DISCUSSION: Our findings suggest intensive family-based lifestyle programmes are particularly beneficial for youth with low self-esteem and poorly functioning families.
Asunto(s)
Obesidad Infantil/psicología , Autoimagen , Programas de Reducción de Peso/métodos , Adolescente , Índice de Masa Corporal , Peso Corporal , Niño , Etnicidad , Femenino , Humanos , Masculino , Padres , Obesidad Infantil/terapia , Resultado del TratamientoRESUMEN
OBJECTIVE: To determine whether relatively low leptin levels predict changes in adiposity in prepubertal and pubertal obese children. RESEARCH METHODS AND PROCEDURES: In a biracial cohort of 68 obese children (33 male and 35 female; 46 Caucasians and 22 African-Americans, age range 7-18 y), we measured at baseline fasting insulin and leptin levels, height and weight and calculated body mass index (kg/m(2)) and expressed body mass index as (BMI) Z-score. After a 2.5-y follow-up, anthropometric measurements were repeated and changes in weight gain were calculated as changes in BMI Z-score. RESULTS: At baseline obese preadolescent boys and girls had similar age and BMI Z-score, fasting insulin and leptin levels. After an average follow-up of 2.5 y, mean weight change calculated by changes in BMI Z-score from baseline was similar in both groups. In obese adolescent boys and girls at baseline, no significant gender differences were observed for BMI Z-score and insulin levels. In contrast, plasma leptin levels were significantly higher in obese girls compared with obese adolescent boys. At follow-up, there was no significant difference in change in BMI Z-score between obese boys and girls. Multiple linear regression analysis revealed that high basal leptin levels were positively associated with greater changes in BMI Z-score only in girls (r(2)=0.18, P<0.02), after adjusting for basal BMI Z-score, Tanner stage, years of follow-up and basal insulin. High basal leptin levels in girls explained 18% of the weight gain. CONCLUSION: High leptin levels are associated with excessive future weight gain only in girls.
Asunto(s)
Leptina/sangre , Obesidad/sangre , Aumento de Peso , Adolescente , Índice de Masa Corporal , Niño , Ayuno , Femenino , Humanos , Insulina/sangre , Modelos Lineales , Estudios Longitudinales , Masculino , Fenotipo , Pubertad , Caracteres SexualesRESUMEN
Plasmid pGBG1 was constructed to isolate mobile genetic elements in a wide variety of gram-negative bacteria. The mutation target, carried on a broad-host-range vector, allows positive selection for tetracycline resistance. In tests using several gram-negative bacteria we could detect transposition events of either insertion sequences or transposons. A new insertion sequence (IS) element was identified in Ralstonia eutropha.
Asunto(s)
Cupriavidus necator/genética , ADN Bacteriano/aislamiento & purificación , Bacterias Gramnegativas/genética , Plásmidos , Retroelementos/genética , Agrobacterium tumefaciens/genética , Azospirillum/genética , Burkholderia cepacia/genética , Conjugación Genética , Elementos Transponibles de ADN/genética , ADN Bacteriano/genética , Escherichia coli/genética , Técnicas Genéticas , Mutagénesis Sitio-Dirigida , Mapeo RestrictivoRESUMEN
Optimal metabolic control is a primary management objective for adolescents with insulin-dependent diabetes mellitus. Nutrition therapy plays an important role in meeting this challenging treatment goal. This article presents broad nutrition goals, makes macronutrient recommendations, and describes their effect on blood glucose levels. Various meal-planning techniques and other developmentally appropriate approaches to assist adolescents in meeting these nutrition objectives are described. Finally, challenges in implementing nutrition therapy in an adolescent population are discussed.
