Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 17 de 17
Filtrar
1.
Nutrients ; 10(11)2018 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-30355970

RESUMO

BACKGROUND: Fruits and vegetables are key to a healthy diet, particularly in children; however, parents may be concerned about contaminants found in fruits and vegetables. Making informed food choices for children requires understanding and balancing the risks of contaminant exposure with the importance of providing a healthy diet. The objective of this work is to identify fruits and vegetables commonly consumed by infants and toddlers; identify potential contaminants in fruits and vegetables; and outline considerations in assessing contaminant risks in food categories with a critical role in a healthy diet. METHOD: Commonly consumed fruits and vegetables were obtained from the Feeding Infants & Toddlers Study (FITS 2016). The US Food and Drug Administration Total Diet Study was reviewed for contaminant occurrence, and multiple experts were consulted on considerations in assessing risk of certain contaminants. RESULTS: FITS data show eight fruits and nine vegetables account for over 80% of consumption in infants and toddlers. Several contaminants have been detected in fruits and vegetables. Questions to be addressed prior to establishing contaminant guidance were identified. CONCLUSION: Contaminant guidance for fruits and vegetables consumed by infants and toddlers raises several challenges. Expertise from multiple disciplines is required to find an approach that maximizes public health benefit.


Assuntos
Dieta , Contaminação de Alimentos , Frutas , Verduras , Bebidas , Estudos Transversais , Inquéritos sobre Dietas , Poluentes Ambientais , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Metais Pesados , Valor Nutritivo , Resíduos de Praguicidas , Estados Unidos
3.
J Pediatr Gastroenterol Nutr ; 66 Suppl 3: S50-S51, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29762378

RESUMO

It is appropriate that we begin the clinical part of this conference with a discussion of acquired monosaccharide intolerance. This disease is the most severe form of carbohydrate malabsorption and maldigestion that can afflict an infant. The following article describes the pathophysiology of the disease, as well as its treatment, much of which was based on studies done by the Section of Pediatric Gastroenterology and Nutrition at Baylor College of Medicine. Acquired monosaccharide intolerance has almost disappeared from the United States but remains a problem in the developing world where it is included as part of the diagnosis of environmental enteropathy. Present research on this disease seems to sometimes duplicate what is already known.


Assuntos
Erros Inatos do Metabolismo dos Carboidratos/história , Intestino Delgado/patologia , Síndromes de Malabsorção/história , Erros Inatos do Metabolismo dos Carboidratos/diagnóstico , Erros Inatos do Metabolismo dos Carboidratos/terapia , História do Século XX , Humanos , Lactente , Síndromes de Malabsorção/diagnóstico , Síndromes de Malabsorção/terapia , Monossacarídeos/metabolismo , Texas
4.
Obesity (Silver Spring) ; 21(4): 808-14, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23712984

RESUMO

UNLABELLED: Osteocalcin (OCN), a marker of osteoblast activity, has been implicated in the regulation of energy metabolism by the skeleton and thus may affect body fat measures. OBJECTIVE: To examine the relationships of OCN to body fat measures and whether they vary according to markers of energy and vitamin D metabolism. DESIGN AND METHODS: Data were obtained from 58 obese adolescents aged 13-17.9 years (38 females, 8 black or African-American). Total fat mass (FM) [dual X-ray absorptiometry (DXA)] and visceral adipose tissue (VAT) [computerized axial tomography (CT)] were calculated. Blood tests included leptin, OCN, 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), thyroid function tests, and triglycerides. Markers of glucose metabolism were obtained from fasting and OGTT samples. RESULTS AND CONCLUSIONS: Adolescents with 25(OH)D <20 ng mL(-1) were considered deficient (n = 17/58); none had high PTH (PTH ≥ 65 pg mL(-1) ). OCN was associated with lower VAT (-84.27 ± 33.89 mm(2) ) and BMI (-0.10 ± 0.05 kg m(-2) ), not FM (P = 0.597) in a core model including age, sex, race, geographic latitude, summer, height z-score, and tanner stage. Adding 25(OH)D deficiency and PTH attenuated the inverse association of OCN to VAT. There was a significant interaction of OCN and 25(OH)D deficiency on FM (0.37 ± 0.18 kg, P = 0.041) and BMI (0.28 ± 0.10 kg m(-2) , P = 0.007) in this adjusted model, which was further explained by leptin. Adding A1C to the core model modified the relationship of OCN to VAT (-93.08 ± 35.05 mm(2) , P = 0.011), which was further explained by HOMA-IR. In summary, these findings provide initial evidence for a relationship between OCN and body fat measures that is dependent on energy metabolism and vitamin D status among obese adolescents.


Assuntos
Tecido Adiposo/química , Obesidade/sangue , Osteocalcina/sangue , Absorciometria de Fóton , Adolescente , Negro ou Afro-Americano , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Gordura Intra-Abdominal/química , Leptina/sangue , Masculino , Hormônio Paratireóideo/sangue , Vitamina D/sangue
5.
J Pediatr Gastroenterol Nutr ; 54(1): 113-6, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21857252

RESUMO

The aim of the study was to determine the effectiveness of a school-initiated cognitive and behavioral program to reduce childhood obesity. Height, weight, body mass index (BMI), and BMI z scores were obtained at the beginning and end of the school year at an intervention school (n = 1022) and at a control school (n = 692). The prevalence of overweight and obesity was 18.9% and 30.4% versus 19% and 30.2%, respectively, in the intervention and control schools. The incidence of overweight increased in the control school, but the incidence of obesity, weight, and BMI z scores increased significantly in the intervention school, suggesting that implementation of any school-based obesity intervention programs requires careful planning to achieve goals.


Assuntos
Terapia Comportamental , Obesidade/terapia , Avaliação de Resultados em Cuidados de Saúde , Programas de Redução de Peso , Índice de Massa Corporal , Peso Corporal , Criança , Cognição , Feminino , Hispânico ou Latino , Humanos , Incidência , Masculino , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Sobrepeso/terapia , Avaliação de Programas e Projetos de Saúde , Risco , Serviços de Saúde Escolar , Texas , Falha de Tratamento
6.
J Pediatr Gastroenterol Nutr ; 49(4): 493-7, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19590448

RESUMO

To determine the potential benefits of a residential summer camp to treat childhood obesity, 21 obese, multiethnic children (aged 11.4+/-1.4 years; body mass index [BMI] percentile 98.5+/-1.4; BMI z score 2.30+/-0.33) from a diverse socioeconomic background were enrolled in a 2-week summer camp program. Significant improvements (P<0.04) were observed in self-esteem (+0.27+/-0.33 point), body weight (-3.7+/-1.2 kg), BMI (-1.60+/-0.48 kg/m), BMI z score (-0.12+/-0.06), number of curl ups (+10.9+/-21.5), systolic and diastolic blood pressure (-10.8+/-13.4 and -9.4+/-5.5 mmHg, respectively), and heart rate (-8.2+/-12.7 bpm).


Assuntos
Peso Corporal , Acampamento , Dieta Redutora , Exercício Físico , Obesidade/terapia , Autoimagem , Pressão Sanguínea , Índice de Massa Corporal , Criança , Feminino , Comportamentos Relacionados com a Saúde , Educação em Saúde , Frequência Cardíaca , Humanos , Estilo de Vida , Masculino , Obesidade/fisiopatologia , Obesidade/psicologia , Aptidão Física , Avaliação de Programas e Projetos de Saúde , Fatores Sexuais , Resultado do Tratamento
7.
Am J Clin Nutr ; 90(3): 459-67, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19640956

RESUMO

BACKGROUND: Data on the relation between vitamin D status and body fat indexes in adolescence are lacking. OBJECTIVE: The objective was to identify factors associated with vitamin D status and deficiency in obese adolescents to further evaluate the relation of body fat indexes to vitamin D status and deficiency. DESIGN: Data from 58 obese adolescents were obtained. Visceral adipose tissue (VAT) was measured by computed tomography. Dual-energy X-ray absorptiometry was used to measure total bone mineral content, bone mineral density, body fat mass (FM), and lean mass. Relative measures of body fat were calculated. Blood tests included measurements of 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), osteocalcin, type I collagen C-telopeptide, hormones, and metabolic factors. Vitamin D deficiency was defined as 25(OH)D < 20 ng/mL. PTH elevation was defined as PTH > 65 ng/mL. RESULTS: The mean (+/-SD) age of the adolescents was 14.9 +/- 1.4 y; 38 (66%) were female, and 8 (14%) were black. The mean (+/-SD) body mass index (in kg/m(2)) was 36 +/- 5, FM was 40.0 +/- 5.5%, and VAT was 12.4 +/- 4.3%. Seventeen of the adolescents were vitamin D deficient, but none had elevated PTH concentrations. Bone mineral content and bone mineral density were within 2 SDs of national standards. In a multivariate analysis, 25(OH)D decreased by 0.46 +/- 0.22 ng/mL per 1% increment in FM (beta +/- SE, P = 0.05), whereas PTH decreased by 0.78 +/- 0.29 pg/mL per 1% increment in VAT (P = 0.01). CONCLUSIONS: To the best of our knowledge, our results show for the first time that obese adolescents with 25(OH)D deficiency, but without elevated PTH concentrations, have a bone mass within the range of national standards (+/-2 SD). The findings provide initial evidence that the distribution of fat may be associated with vitamin D status, but this relation may be dependent on metabolic factors. This study was registered at www.clinicaltrials.gov as NCT00209482, NCT00120146.


Assuntos
Tecido Adiposo , Índice de Massa Corporal , Densidade Óssea , Obesidade/complicações , Hormônio Paratireóideo/sangue , Deficiência de Vitamina D/complicações , Vitamina D/análogos & derivados , Absorciometria de Fóton , Adolescente , Análise de Variância , Feminino , Humanos , Gordura Intra-Abdominal , Modelos Lineares , Masculino , Obesidade/sangue , Obesidade/fisiopatologia , Tomografia , Vitamina D/administração & dosagem , Vitamina D/sangue , Deficiência de Vitamina D/sangue
9.
Clin Pediatr (Phila) ; 48(1): 50-7, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18832535

RESUMO

The objectives are to: (1) characterize ethnic-specific differences in alanine aminotransferase (ALT) elevation among obese children, (2) investigate the earliest ages at which significant ALT elevation occurs, and (3) determine associations between ALT and biochemical parameters. A cohort of 134 multiethnic obese children and adolescents was analyzed retrospectively. ALT levels > or =45 U/L or <45 U/L, denoting high or normal risk, were used to categorize obese children's risk for developing nonalcoholic steatohepatitis. In all, 60% of Hispanics had high-risk ALT levels compared with 12% of whites and 8% of blacks. A significantly higher proportion of boys had ALT > or = 45 U/L (49.4%, vs 37.9% for girls, P = .002); 17.5% were Hispanic boys less than 7 years old. Obese Hispanic children, particularly boys, not only have higher ALT levels but present alarmingly young with high-risk levels. This study highlights a discrete subgroup of children who may present with fatty liver at a younger age and should be screened earlier.


Assuntos
Alanina Transaminase/sangue , Fígado Gorduroso/etiologia , Obesidade/enzimologia , Adolescente , Fatores Etários , População Negra , Criança , Pré-Escolar , Etnicidade , Feminino , Hispânico ou Latino , Humanos , Masculino , Obesidade/complicações , População Branca , Adulto Jovem
10.
J Pediatr ; 151(5): 513-7, 517.e1, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17961696

RESUMO

OBJECTIVE: To assess an intervention strategy--a 6-week obesity intervention program, Project KidFIT, at 3 Houston, Texas park centers--to address the obesity epidemic in minority children. STUDY DESIGN: Project KidFIT is a physical fitness and nutrition education program aimed at promoting the benefits of physical activity and improving nutrition knowledge in overweight (body mass index [BMI] > or = 95th percentile) minority children. RESULTS: A total of 120 minority children (77 boys and 43 girls; mean age, 10.1 years) were enrolled in the program. Approximately 71% of these children were at risk of overweight (BMI > or = 85th percentile), and 54% were overweight. Decreases in body weight (0.3 +/- 0.2 kg [mean +/- standard error]) and BMI (0.1 +/- 0.1 kg/m2) were detected in the overweight children, whereas increases in body weight (0.4 +/- 0.1 kg) and BMI (0.2 +/- 0.1 kg/m2) were observed in the children with normal body weight (BMI < 85th percentile but > 5th percentile). Significant improvements (P < .05) in flexibility, muscular endurance, and muscular strength were detected in all children, regardless of weight status. CONCLUSIONS: The findings suggest that the city park-based KidFIT program might be effective at promoting stabilization for body weight and BMI and improving physical activity performance and nutrition knowledge in overweight minority children.


Assuntos
Dieta , Exercício Físico , Promoção da Saúde/organização & administração , Obesidade/prevenção & controle , Serviços Urbanos de Saúde , Criança , Serviços de Saúde Comunitária , Feminino , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Grupos Minoritários , Força Muscular , Resistência Física , Avaliação de Programas e Projetos de Saúde , Texas , População Urbana
12.
Pediatrics ; 114(1): 217-23, 2004 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15231931

RESUMO

As the prevalence of obesity and obesity-related disease among adolescents in the United States continues to increase, physicians are increasingly faced with the dilemma of determining the best treatment strategies for affected patients. This report offers an approach for the evaluation of adolescent patients' candidacy for bariatric surgery. In addition to anthropometric measurements and comorbidity assessments, a number of unique factors must be critically assessed among overweight youths. In an effort to reduce the risk of adverse medical and psychosocial outcomes and increase compliance and follow-up monitoring after bariatric surgery, principles of adolescent growth and development, the decisional capacity of the patient, family structure, and barriers to adherence must be considered. Consideration for bariatric surgery is generally warranted only when adolescents have experienced failure of 6 months of organized weight loss attempts and have met certain anthropometric, medical, and psychologic criteria. Adolescent candidates for bariatric surgery should be very severely obese (defined by the World Health Organization as a body mass index of > or =40), have attained a majority of skeletal maturity (generally > or =13 years of age for girls and > or =15 years of age for boys), and have comorbidities related to obesity that might be remedied with durable weight loss. Potential candidates for bariatric surgery should be referred to centers with multidisciplinary weight management teams that have expertise in meeting the unique needs of overweight adolescents. Surgery should be performed in institutions that are equipped to meet the tertiary care needs of severely obese patients and to collect long-term data on the clinical outcomes of these patients.


Assuntos
Derivação Gástrica , Gastroplastia , Obesidade Mórbida/cirurgia , Adolescente , Índice de Massa Corporal , Feminino , Derivação Gástrica/normas , Gastroplastia/normas , Humanos , Consentimento Livre e Esclarecido , Masculino , Competência Mental , Obesidade Mórbida/complicações , Consentimento dos Pais , Educação de Pacientes como Assunto , Seleção de Pacientes , Complicações Pós-Operatórias
14.
Pediatrics ; 110(1 Pt 2): 222-8, 2002 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12093999

RESUMO

OBJECTIVE: The primary aim of this study was to determine how pediatric health care providers identify overweight in children and adolescents and how they evaluate obesity-related medical complications. This information can guide development of programs to help providers improve their evaluation practices. A secondary objective was to examine the association of certain provider characteristics with recommended evaluation practices. METHODS: A random sample of pediatricians, pediatric nurse practitioners (PNPs), and registered dietitians received a questionnaire about their evaluation of overweight children and adolescents. Results were compared with published recommendations. Associations between respondent characteristics and adherence to published recommendations were examined. RESULTS: A total 940 providers responded (response rate: 19%-33%). Among all 3 groups a majority frequently used clinical impression, weight-for-age percentile, weight-for-height percent, and weight-for-height percentile to assess degree of overweight. Nearly all pediatricians and PNPs routinely evaluated blood pressure, but a minority routinely looked for orthopedic problems, insulin resistance, and sleep disorders. Less than 10% followed all recommendations for history and physical examination. Two thirds of pediatricians and PNPs routinely tested for lipid abnormalities. Most providers asked about family history of overweight, hypertension, cardiovascular disease, and diabetes, but only one third asked about gallbladder disease. In general, the provider's specialty, years in practice, gender, and body mass index were not associated with adherence to recommended practices. CONCLUSIONS: Medical evaluation of overweight children and adolescents fell short of recommended practices. These results point to the need for educational efforts to increase awareness of medical risks and for tools to facilitate more complete evaluation during office visits.


Assuntos
Dietética/estatística & dados numéricos , Obesidade/diagnóstico , Enfermagem Pediátrica/estatística & dados numéricos , Pediatria/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Adolescente , Índice de Massa Corporal , Criança , Diabetes Mellitus Tipo 2/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Anamnese/métodos , Profissionais de Enfermagem/estatística & dados numéricos , Exame Físico/métodos , Distribuição Aleatória , Dobras Cutâneas , Inquéritos e Questionários , Testes de Função Tireóidea/estatística & dados numéricos , Estados Unidos
15.
Pediatrics ; 110(1 Pt 2): 229-35, 2002 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12094000

RESUMO

OBJECTIVE: The primary aim of this study was to identify interventions used by pediatric health care providers in treatment of overweight children and adolescents to identify provider educational needs. A secondary aim was to examine the association of certain provider characteristics with recommended evaluation practices. STUDY DESIGN: A random sample of pediatricians, pediatric nurse practitioners, and registered dietitians (RDs) received questionnaires about their diet, activity, and medication recommendations for overweight patients and about referrals to specialists and programs. Results were examined for adherence to published recommendations and for associations with certain respondent characteristics. RESULTS: A total of 940 providers responded (response rate: 19%-33%). The majority recommended "changes in eating patterns" and "limitations of specific foods." Half or more used "low-fat diet" and "modest calorie restriction" in adolescents. Less than 15% used "very low-calorie diet." Fewer RDs recommended more restrictive diets. More than 60% of all groups followed recommended eating interventions for school-aged children and adolescents. More than 80% followed recommended physical activity interventions for all age groups. In each group, about 5% sometimes recommended prescription medication and herbal remedies for adolescents. None recommended surgery. Two thirds of pediatricians and pediatric nurse practitioners often referred to RDs. Approximately 20% referred to child/adolescent weight programs, but for 27% to 42%, these programs or pediatric obesity specialists were not available. No consistent associations between respondent characteristics and adherence to recommended interventions were identified. CONCLUSIONS: The providers generally promoted healthy eating and activity with minimal use of highly restrictive diets or medication to control weight.


Assuntos
Dietética/estatística & dados numéricos , Obesidade/terapia , Enfermagem Pediátrica/estatística & dados numéricos , Pediatria/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Dieta com Restrição de Gorduras , Dieta Redutora/métodos , Exercício Físico , Comportamento Alimentar , Feminino , Promoção da Saúde/métodos , Promoção da Saúde/estatística & dados numéricos , Humanos , Masculino , Medicamentos sem Prescrição/uso terapêutico , Profissionais de Enfermagem/estatística & dados numéricos , Fitoterapia , Encaminhamento e Consulta/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...