Alternative options for prescribing physical activity among obese children and adolescents: brisk walking supported by an exergaming platform

[EN] Background: Physical inactivity has been identified as an important public health concern for children. An increasing sedentary way of life is directly related to obesity; hence, prevention and management of childhood obesity are commonly based on lifestyle interventions wherein increasing physical activity is one of the main targets. The use of exergames can be useful in promoting physical activity, but it is necessary more research. This study analyzes the effects of an exergaming platform that involves brisk walking, on perceived exertion, self-efficacy, positive expectations and satisfaction in a sample of clinically obese children, as compared with normal weight children. Physiological variables like heart rate, oxygen consumption and energy expenditure were also measured. Method: A total sample of 42 children was recruited. Children were randomized into those walking on a treadmill and those using a treadmill with the support of the exergaming platform (Wii-Fit). Results: The obese children scored significantly higher in expectations and satisfaction in the exergame condition but not in self-efficacy, perceived exertion or physiological measures. Conclusions: These results suggest that this exergaming platform could be a tool to assist obese children in the practice of brisk walking as part of a programme designed to treat obesity.CIBEROBN is an initiative of ISCIII (Instituto de Salud Carlos III). Thanks are extended to the Ministerio de Economia y Competitividad (Plan Nacional I+D+I 2008-2011), en el proyecto (PSI2011-25767); y la red de investigacion en excelencia PROMETEO 2013 Fase II (PROMETEOII/2013/003).Cebolla Martí, A.; Alvarez Pitti, JC.; Guixeres Provinciale, J.; Lison, JF.; Baños Rivera, RM. (2015). Alternative options for prescribing physical activity among obese children and adolescents: brisk walking supported by an exergaming platform. Nutricion Hospitalaria. 31(2):841-848. https://doi.org/10.3305/nh.2015.31.2.7929S84184831

Psychosocial and environmental risk factors of obesity and hypertension in children and adolescents—a literature overview

Childhood obesity has become a worldwide epidemic in the 21st century. Its treatment is challenging and often ineffective, among others due to complex, often not obvious causes. Awareness of the existence and meaning of psychosocial and environmental risk factors seems to be an essential element in the prevention and treatment of obesity and its complications, especially arterial hypertension. In this review, we will discuss the role of that risk factors linking obesity and increased cardiovascular disorders including the role of nutritional factors (including the role of unhealthy diet, inadequate hydration), unhealthy behaviors (e.g. smoking, alcohol and drugs, sedentary behavior, low physical activity, disrupted circadian rhythms, sleep disorders, screen exposure), unfavorable social factors (such as dysfunctional family, bullying, chronic stress, mood disorders, depression, urbanization, noise, and environmental pollution), and finally differences in cardiovascular risk in girls and boys

Uric acid is linked to cardiometabolic risk factors in overweight and obese youths

Objective:Observational studies have indicated that high levels of serum uric acid are associated with the risk of cardiovascular disease. The aim of the present study is to investigate the association of uric acid with individual cardiometabolic risk factors, as well as their degree of clustering, in overweight and moderate obese youth.Methods:Three hundred and thirty-three Caucasians of both sexes (149 women), from 5-18 years of age from those who underwent an assessment of overweight/obesity. Anthropometric parameters, office and 24-h blood pressure measurements and metabolic profile, including HDL-cholesterol, triglycerides, insulin, HOMA index and uric acid were assessed.Results:Uric acid was significantly higher in boys than in girls. A positive significant association between uric acid, and office, daytime and night-time SBP, insulin and triglycerides was observed. When boys and girls were grouped by sex-specific uric acid tertiles, a progressive increment was observed in BMI, BMI z-score and waist circumference as well as fasting insulin and HOMA index. In boys, this was also present in office and ambulatory SBP. Likewise, the number of abnormal metabolic risk factors also increases with the uric acid values and the higher the number of metabolic components the higher the uric acid values. Moreover, in a multiple regression analysis, uric acid was significantly related with male sex, waist circumference, both office and night-time SBP and birth weight.Conclusion:The present study found a positive association between uric acid and blood pressure, insulin and triglycerides. As uric acid levels increase there is a relevant clustering of metabolic risk factors, whereas elevated blood pressure is the risk factor less frequently present. Further studies need to assess the mechanistic link between uric acid and the cardiometabolic risk factors

Using Virtual Reality to Distract Overweight Children from Bodily Sensations During Exercise

This study analyzes the potential of virtual reality (VR) to enhance attentional distraction in overweight children as they experience bodily sensations during exercise. It has been suggested that one reason why obese children stop exercising is the perception of bodily sensations. In a counterbalanced design, a total of 109 children (33 overweight, 10-15 years old) were asked to walk twice for 6 minutes on a treadmill under one of two conditions: (a) traditional condition (TC)-focusing their attention on their physical feelings and sensations or (b) distraction condition (DC)-focusing their attention on a virtual environment. Attentional focus during exercise, bad-good feeling states (pre- and postexperimental), perceived exertion (3 minutes and post), heart rate, and enjoyment were assessed. Results indicated that overweight children focused on internal information under the TC, but they significantly shifted their attention to regard the external environment in the DC. This attentional distraction effect of VR was more intense in overweight than in normal-weight children. No differences between groups were found when examining changes in feeling states and perceived exertion. VR increased enjoyment during exercise, and children preferred exercise using virtual environments. VR is useful to promote distraction and may help overweight and obese children to enjoy exercise.This study was funded in part by ACTIOBE (MINECO, Spain, Plan Nacional I+D+I 2008-2011 PSI2011-25767), PROMOSAM(MINECO, Spain, PSI2014-56303-REDT), and CIBEROBN, an initiative of ISCIII (ISC III CB06 03/0052).Baños, RM.; Escobar, P.; Cebolla, A.; Guixeres Provinciale, J.; Alvarez Pitti, J.; Lisón, JF.; Botella, C. (2016). Using Virtual Reality to Distract Overweight Children from Bodily Sensations During Exercise. Cyberpsychology, Behavior, and Social Networking. 19(2):115-119. https://doi.org/10.1089/cyber.2015.0283S11511919

What makes the difference in children with unexpected good outcome 6 months after cardiac arrest?

Purpose of the study: To analyse the peculiarities of patients with unexpected good overall outcome at 6 months in emergency department and out-of-hospital paediatric cardiac arrest (OHCA).Materials and methods: Prospective multicentre study of paediatric cardiac arrest in emergency department and OHCA in children under 18 years old. We selected patients with at least one of the following criteria: asystole as first rhythm, bloodpH&lt;7, blood lactate ≥12 mmol/l or death probability &gt;80% according to PELOD scale at 24 first hours. We also collected Paediatric Overall Performance Category (POPC) at 6 months. T-test, Fisher’s exact test and Chi-square test.Results: 181/229 cardiac arrests had at least one criterium of bad prognosis, 166 were followed 6 months and 15.7% had good overall outcome (POPC 1 or 2). In patients with bad prognosis and POPC 1 or 2 at 6 months we found: - lower proportion of trauma as cause of cardiac arrest (4% vs 22,1%, p = 0.037) and orotracheal intubation during cardiac arrest (87.1 vs 69.2%, p = 0.021), - higher proportion of witnessed cardiac arrests (21.4% vs 8.1%, p = 0.016), shockable rhythms as first rhythm (38.5% vs 13.5%, p = 0.017) and treatment with hypothermia (36.4% vs 10.5%, p &lt; 0.001). When we studied only patients with sustained ROSC, those who were treated with hypothermia had higher proportion of POPC 1 or 2 at 6 months, next to statistical significance (42.9% vs 23%, p = 0.055). There was not any significative difference in age, gender, time until basic or advanced life support.Conclusions: Some patients with criterium of bad prognosis achieved good overall outcome at 6months, mainly those who had witnessed cardiac arrests and shockable rhythms. Traumatic cardiac arrest is still a challenge. While orotracheal intubations could not always be the first line of airway management, hypothermia seems to be useful to improve the overall outcome.</p