Effectiveness and process evaluation in obesity and type 2 diabetes prevention programs in children: a systematic review and meta-analysis

Background: Obesity in children is one of the most severe public health challenges of the current century and Type 2 Diabetes Mellitus (T2DM) frequency is also escalating. More so, the importance of process evaluation (PE) in complex interventions is increasingly recognized. The present review, aims to identify the effectiveness in terms of body composition parameters in a generation of articles to prevent obesity and T2DM in children. We hypothesise that those studies reporting PE applying the latest implementation guidelines suggested by the researchers would potentially show positive changes in body composition compared to those not reporting it. Additionally, we will evaluate the implementation degree of PE in those articles considering it and describe the PE subcomponents. Lastly, we aim to assess the intervention target used and its results. Methods: A literature review was performed in parallel by 2 independent reviewers. A final number of 41 studies were selected for inclusion criteria. Results: Meta-analysis of BMI and zBMI found non-significant effects of the proposed interventions. Sub-group analysis revealed only a significant effect in studies which performed PE. Moreover, PE was reported in 42% effective studies and 57% non-effective studies. Fidelity and satisfaction were the most implemented PE subcomponents, although there was a generally low grade of PE use (7/41). The highest proportion of effectiveness (83%) was shown in interventions of physical activity alone while the intervention most used was 3-arm target (diet, PA and BS). Conclusions: Overall, obesity and T2DM prevention studies included in this review are not effective in terms of BMI and zBMI. Those studies performing PE reported to be effective in terms of BMI, while studies not reporting PE did not have positive results in terms of BMI and zBMI. In addition, none of the intervention studies included all PE indicators and most studies, which included PE in their interventions, did not provide full report of the PE components, according to the guidelines used for the present review. PROSPERO registration number: CRD42018093667

Rapid weight gain, infant feeding practices, and subsequent body mass index trajectories: The calina study

We aimed to study growth patterns according to rapid weight gain (RWG) and infant feeding practices during the first 120 days and whether infant feeding practices mediated the association between RWG in the first semester of life and subsequent body mass index (BMI) z-score in children from age 1 to 6. (1) Methods: 862 children from the Growth and Feeding during Lactation and Early Childhood in Children of Aragon study (CALINA in Spanish) were examined. Repeated-measures ANOVA analyses were conducted to assess growth trajectories according to RWG and type of feeding practice. The product of coefficients mediation method was used to assess the potential contribution of infant feeding practices to the association between RWG and BMI z-score. Mediation models were conducted using IBM SPSS-PROCESS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp. (2) Results: BMI and weight z-score trajectories were significantly higher in the RWG group and the formula-fed group. No significant differences were found regarding height. Infant feeding practices did not mediate the association between RWG and BMI z-score but were associated with BMI at 6 years. (3) Conclusions: Infant feeding practices and RWG determine different growth trajectories of BMI and weight during childhood. Although infant feeding practices did not mediate the association between early RWG and BMI later in life, formula feeding is independently related to higher BMI growth patterns later in childhood

Cardiometabolic and Cardiovascular Complications of Obesity in Children

The rise in obesity in both children and adults has made obesity one of the biggest public health problems of this century. Obesity along with other factors such as hypertension, insulin resistance, dyslipidemia and diabetes mellitus are risk factors for the development of cardiovascular diseases. Overweight and/or obesity during childhood and its maintenance until adult life has been associated with early stages of cardiovascular disease. For this reason, the aim of this study is to revise the state of the art of cardiometabolic and cardiovascular complications related with overweight and/or obesity in children and adolescents. The first consequence of weight gain is an increase in adipose tissue, with different distribution depending on the sex. The excess of fat mass entails dysfunction of adipose tissue with an altered secretion of adipokines and instauration of a proinflammatory environment, which may derive in metabolic syndrome condition. The increase of adipose tissue along with an increase in sympathetic nervous system, triggers an increased left ventricular mass and with a reduced diastolic function. Therefore, obesity should be prevented from the early stages of life, in order to avoid obesity itself and the metabolic disturbances that could undermine quality of life further on

CMOS Compatible Anodic Al2O3 Based Sensors for Bacteria Detection

AbstractRapid, real-time detection of pathogenic microorganisms is an emerging evolving field of research, especially for microorganisms that pose a major threat to public health. Alumina covered interdigitated capacitive microsensors were previously designed in our laboratory for DNA hybridization electrical detection (LOD of 30 nM target DNA). The device is constructed with standard CMOS materials. We show here that when coated with an appropriate anti- Staphylococcus aureus monoclonal antibody (MoAb), this device also permits to specifically detect this bacteria. The binding of bacteria to the microsensors induce a significant capacitance shift that is proportional to the amount of immobilized bacteria, thus enabling a possible quantitative analysis

Breakfast characteristics and its association with daily micronutrients intake in children and adolescents–a systematic review and meta-analysis

Breakfast is an important source of key nutrients in the diet. For this reason, the aim of this review was to investigate the associations between breakfast consumption and daily micronutrients intake in both children and adolescents (aged 2–18 years). A peer-reviewed systematic search was conducted in three datasets (PubMed, Scopus and Cochrane Library) in February 2020 in English and Spanish. Two independent reviewers evaluated 3188 studies considering the AXIS critical appraisal and PRISMA methodologies. Meta-analysis was carried out comparing results according to type of breakfast consumed (Ready to eat cereals (RTEC) breakfast or other types of breakfast) and breakfast skipping. Thirty-three articles were included in the systematic review (SR) and 7 in the meta-analysis. In the SR, we observed that those children and adolescents who usually consume RTEC at breakfast had a higher consumption of B-vitamins than those not consuming RTEC at breakfast. Breakfast consumers had a higher mineral intake (iron, calcium, magnesium, potassium, zinc, and iodine) than breakfast skippers. In the Meta-Analysis, RTEC consumers had significantly higher vitamin C intake than breakfast skippers (SMD, -4.12; 95% confidence intervals (CI): -5.09, -3.16). Furthermore, those children who usually consume breakfast had significantly higher daily intake of calcium than breakfast skippers (SMD, -7.03; 95%CI: -9.02, -5.04). Our review proposes that breakfast consumption seems to be associated with higher daily micronutrients intake than breakfast skippers

Numerical analysis of gas-solidsflow hydrodynamics and heat transfer in two outlet configurationindustrial riser using mesoscale theory to predict the interfacialdrag

Se analizan numéricamente dos configuraciones de un riser del proceso FCC variando la disposición de la salida superior, usando un modelo CFD en 2 D que incluye el Modelo de los Dos Fluidos (TMF), la Teoría Cinética del Flujo Granular (KTGF) y como modelo de arrastre el modelo de la Minimización de la Energía Multi-Escala (EMMS). El modelo se resuelve a través del programa ANSYS Fluent® 14.5 solucionando las ecuaciones de balance de masa, momentum y energía; y ecuaciones constitutivas para calcular la interacción entre las fases, la fase sólida con las paredes, y las propiedades de la fase granular. El modelo propuesto en este trabajo predice adecuadamente el comportamiento del flujo gas-sólido, prediciendo diferentes patrones de flujo en las coordenadas axial y radial del riser; así como zonas concentradas y diluidas de sólidos en la parte baja y alta del riser, respectivamente. Las fluctuaciones en la concentración y las velocidades de los sólidos tanto radial como axialmente que se observan son producto del alto grado de mezclado radial que se acentúa cerca de las paredes del riser debido al arrastre considerado por el modelo utilizado. Por otro lado se observa una rápida estabilización térmica radial y axial alcanzando en poco tiempo el estado estacionario. Los perfiles obtenidos en las dos configuraciones analizadas son muy similares, lo que motiva a que en trabajos futuros se analicen otras configuraciones de salida del riser que permitan mejorar los patrones de concentración y velocidades de los sólidos.In the FCC process two configurations riser are numerically analyzed varying the upper outlet orientation using a 2 D CFD model which includes the Two Fluid Model (TFM), Kinetic Theory of Granular Flow (KTGF), and Energy Minimization Multi-Scale (EMMS) theory as drag model. This model is solved using the ANSYS Fluent® 14.5 software, solving the governing equations of mass, momentum, and energy balance; and the constitutive equations to calculate interfacial interaction, wall-solid phase interaction, and granular phase properties. The model proposed in this work properly predicts the gas-solid flow behavior, predicting different solid flow patterns in radial and axial riser directions, as well as concentrated and diluted zones at riser's top and bottom respectively. The radial and axial solids concentration and velocities profiles fluctuations observed are produced by the high radial solid mix which is higher near the riser walls due to drag force considered by the model used. On the other hand, a rapid radial and axial thermal stabilization is observed reaching the steady state rapidly. The profiles obtained from riser configurations analyzed are very similar, so in future works other riser outlets configurations will be analyzed to try to improve the solid concentration and velocity profiles.Peer Reviewe

Is it important to achieve physical activity recommendations at early stages of life to improve bone health?

Research in bone health during childhood is limited and important to prevent future diseases, particularly, osteoporosis. Bone parameters using DXA and pQCT in 295 Spanish children were evaluated and we found a benefit of meeting the World Health Organization physical activity recommendations in bone composition in childhood. Purpose To investigate the association between physical activity (PA) and bone health in a Spanish paediatric cohort, considering the influence of meeting/not meeting the current World Health Organization (WHO) PA recommendations and to elucidate if there are differences between boys and girls. Methods In a cohort of children born in the region of Aragon (Spain) in 2009, followed until the age of 7 years, bone parameters were assessed using dual-energy X-ray absorptiometry (DXA) (whole body scan) and peripheral quantitative computed tomography (pQCT) (tibia scanned at the 8% (distal) and 38% (diaphyseal) of the total tibia length) in 295 7-year-old children (154 boys) in the last evaluation performed between 2016 and 2017. PA was assessed using GT3X Actigraph accelerometers. Results Boys had significantly higher areal bone mineral density (aBMD), higher total bone mineral content (BMC) at the diaphyseal site and higher trabecular BMC and vBMD, and higher total bone area at the distal site than girls (p<0.01 for all of them). Both boys and girls complying with the WHO PA recommendations had significantly higher trabecular BMC than their inactive counterparts. Conclusions Meeting WHO PA recommendations has a beneficial effect in bone composition in childhood both in boys and in girls

Mediators of the effectiveness of a kindergarten-based, family-involved intervention on pre -s choolers' snacking behaviour: The ToyBox-study

ObjectiveThe present study aimed to explore the mediating role of family-related determinants on the effects of the ToyBox-intervention on pre-school children''s consumption of healthy and unhealthy snacks.DesignThe ToyBox-intervention was a kindergarten-based, family-involved intervention with a cluster-randomized design, aiming to promote healthy lifestyle behaviours to prevent obesity at pre-school age.SettingKindergartens (n 309) in six European countries.SubjectsA total of 6290 pre-schoolers and their families participated in the ToyBox-intervention in 2012-2013 and data from 5212 pre-schoolers/families were included in the current analyses.ResultsEven though the total effect of the ToyBox-intervention on healthy and unhealthy snacking was not significant, the ToyBox-intervention significantly improved parental rule setting on children''s unhealthy snack consumption (i.e. restriction of snacking while watching television and permission only at certain occasions) and parental consumption of unhealthy snacks, while it increased parental knowledge on snacking recommendations. Regarding healthy snacking, the ToyBox-intervention improved children''s attitude towards fruit and vegetables (F&V). All previously mentioned family-related determinants mediated the intervention effects on pre-schoolers'' consumption of healthy and unhealthy snacks. Almost all family-related determinants examined in the study were independently associated with pre-schoolers'' consumption of healthy and unhealthy snacks.ConclusionsThe intervention was effective in improving relevant family-related determinants. Interventions aiming to promote F&V consumption and limit the consumption of unhealthy snacks in pre-schoolers should target on these mediators, but also identify new family-, school- or peer-related determinants, to enhance their effectiveness

Parameters of the Magnetic Flux inside Coronal Holes

Parameters of magnetic flux distribution inside low-latitude coronal holes (CHs) were analyzed. A statistical study of 44 CHs based on Solar and Heliospheric Observatory (SOHO)/MDI full disk magnetograms and SOHO/EIT 284\AA images showed that the density of the net magnetic flux, $B_{{\rm net}}$, does not correlate with the associated solar wind speeds, $V_x$. Both the area and net flux of CHs correlate with the solar wind speed and the corresponding spatial Pearson correlation coefficients are 0.75 and 0.71, respectively. A possible explanation for the low correlation between $B_{{\rm net}}$ and $V_x$ is proposed. The observed non-correlation might be rooted in the structural complexity of the magnetic field. As a measure of complexity of the magnetic field, the filling factor, $f(r)$, was calculated as a function of spatial scales. In CHs, $f(r)$ was found to be nearly constant at scales above 2 Mm, which indicates a monofractal structural organization and smooth temporal evolution. The magnitude of the filling factor is 0.04 from the Hinode SOT/SP data and 0.07 from the MDI/HR data. The Hinode data show that at scales smaller than 2 Mm, the filling factor decreases rapidly, which means a mutlifractal structure and highly intermittent, burst-like energy release regime. The absence of necessary complexity in CH magnetic fields at scales above 2 Mm seems to be the most plausible reason why the net magnetic flux density does not seem to be related to the solar wind speed: the energy release dynamics, needed for solar wind acceleration, appears to occur at small scales below 1 Mm.Comment: 6 figures, approximately 23 pages. Accepted in Solar Physic

Effect of Lifestyle Intervention in the Concentration of Adipoquines and Branched Chain Amino Acids in Subjects with High Risk of Developing Type 2 Diabetes: Feel4Diabetes Study

Introduction: The global prevalence of type 2 diabetes (T2D) is increasing rapidly, especially in low- and middle-income countries and has a high number of associated comorbidities. Plasmatic concentrations of branched chain amino acids (BCAA) and retinol-binding protein 4 (RBP4) have been shown to be elevated in T2D subjects in cross-sectional studies. However, the effect of lifestyle community-based interventions on BCAA and RBP4 concentrations has not yet been analyzed. Material and methods: The Feel4Diabetes study is a school and community-based intervention that identified 360 European families with a high risk of developing T2D according to the FINDRISC questionnaire. Families were randomized in control and intervention groups were followed-up from 2016 to 2018. In the Spanish families, the concentration of BCAA and RBP4 was determined in 266 subjects (115 control and 151 intervention group) that attended the three time-point assessments by colorimetric and ELISA reaction, respectively. Results: Baseline BCAA levels showed positive correlations with the FINDRISC score and glucose impairment (baseline glucose, insulin, and glycated hemoglobin), body mass index, and body weight. The participants receiving the community-based intervention showed a significant decrease in glycated hemoglobin and BCAA levels compared to the control group (p = 0.011 and p < 0.001, respectively). However, baseline RBP4 did not show significant correlations with anthropometric and glycemic parameters, and no significant change was observed in anthropometric parameters and RBP4 concentrations throughout the follow-up. Conclusion: A community-based intervention on lifestyle led to a significant reduction in BCAA levels regardless of weight loss. These findings suggest that this interventional approach could be promising in T2D prevention