Lihava nuori

Nuorten lihominen on maailmanlaajuinen ongelma, joka näkyy myös Suomessa. Välipalasyömistä ja niukkaa liikuntaa suosiva elämäntapamme edistää painonnousua, joka korostuu, jos perintötekijät suosivat lisäksi lihomista. Painonnousuun pitää puuttua mahdollisimman varhaisessa vaiheessa ja varata vastaanotolla riittävästi aikaa asian perusteelliseen selvittämiseen. Anamneesi ja kliininen tutkimus riittävät useimmissa tapauksissa diagnoosiin - laboratoriotutkimukset ovat tarpeen vain erityistapauksissa. Luottamuksellisen hoitosuhteen syntymiseen tarvitaan aikaa ja asiaan paneutumista. Pikahoitomahdollisuuksia ei ole tarjolla, vaan nuoren kanssa yhdessä laaditaan pitkän aikavälin hoitosuunnitelma, jossa asetetaan riittävän pienet osatavoitteet. Tavoitteiden saavuttamista seurataan yhdessä kouluterveydenhuollon kanssa. English summary: Obese adolescent Our lifestyle involving eating snacks and having little exercise promotes weight gain also in the young, especially if this is additionally favored by genetic factors. An intervention of weight gain restriction should be made as early as possible, with adequate time during the consultation to profoundly deal with the issue. Anamnesis and clinical examination usually suffice for diagnosis. Establishment of a confidential therapeutic relationship will require time and involvement. Possibilities for a quick treatment are not available, but a long-term treatment plan with the young person is instead devised, setting partial goals that are small enough

Early Detection of Abnormal Growth Associated with Juvenile Acquired Hypothyroidism

Context Development of the typical growth phenotype in juvenile acquired hypothyroidism (JHT), the faltering linear growth with increasing weight, has not been thoroughly characterized. Objective To describe longitudinal growth pattern in children developing JHT and investigate how their growth differs from the general population in systematic growth monitoring. Design Retrospective case-control study. Setting JHT cases from 3 Finnish University Hospitals and healthy matched controls from primary health care. Patients A total of 109 JHT patients aged 1.2 to 15.6 years (born 1983-2010) with 554 height and weight measurements obtained for 5 years preceding JHT diagnosis. Each patient was paired with 100 healthy controls (born 1983-2008) by sex and age. Longitudinal growth pattern was evaluated in mixed linear models. Growth monitoring parameters were evaluated using receiver operating characteristics analysis. Results At diagnosis, JHT patients were heavier (mean adjusted body mass index-for-age [BMISDS] difference, 0.65 [95% CI, 0.46-0.84]) and shorter (mean adjusted height-for-age deviation from the target height [(THSDS)-S-DEV] difference, -0.34 [95% CI, -0.57 to -0.10]) than healthy controls. However, 5 years before diagnosis, patients were heavier (mean BMISDS difference, 0.33 [95% CI, 0.12-0.54]) and taller (mean (THSDS)-S-DEV difference, 0.29 [95% CI, 0.06-0.52]) than controls. JHT could be detected with good accuracy when several growth parameters were used simultaneously in screening (area under the curve, 0.83 [95% CI, 0.78-0.89]). Conclusions Abnormal growth pattern of patients with JHT evolves years before diagnosis. Systematic growth monitoring would detect abnormal growth at an early phase of JHT and facilitate timely diagnosis of JHT.Peer reviewe

Parental reports showed that snoring in infants at three and eight months associated with snoring parents and smoking mothers

Aim This prospective study examined the prevalence of snoring during infancy and the prenatal and postnatal risk factors for this condition. Methods The study population comprised 1388 infants from the CHILD-SLEEP birth cohort, who were recruited in the Pirkanmaa Hospital District, Finland, between 2011 and 2013. Sleep and background factor questionnaires were filled out prenatally by parents and when the infant was three and eight months old. Results The prevalence of habitual snoring was 3.2% at the age of three months and 3.0% at eight months, and snoring infants had more sleeping difficulties at those ages, with odds ratios (ORs) of 3.11 and 4.63, respectively. At three months, snoring infants slept for a shorter length of time (p = 0.001) and their sleep was more restless (p = 0.004). In ordinal logistic regression models, parental snoring (adjusted OR = 1.65 and 2.60) and maternal smoking (adjusted OR = 2.21 and 2.17) were significantly associated with infant snoring at three and eight months, while formula feeding and dummy use (adjusted OR = 1.48 and 1.56) were only associated with infant snoring at three months. Conclusion Parental snoring and maternal smoking increased the risk of snoring. Infants who snored also seemed to suffer more from other sleep difficulties.Peer reviewe

Sociodemographic factors affecting glycaemic control in Finnish paediatric patients with type 1 diabetes

Aims: Socioeconomic problems may present significant challenges when trying to reach optimal glycaemic control in paediatric patients with type 1 diabetes. We examined sociodemographic factors affecting metabolic control in patients in one of the biggest paediatric diabetes clinics in Finland. Methods: One hundred ninety-one children (age 2–15 years; median 11 years; 47% female) with type 1 diabetes and their families were recruited during outpatient visits in the paediatric diabetes clinic of Tampere University Hospital, Finland. The participants completed a questionnaire on the family's sociodemographic background. The child's glycaemic control was assessed by both glycosylated haemoglobin (HbA1c) and time in range (TIR). Risk factors for poor (HbA1c ≥75 mmol/mol; TIR <40%) and optimal (HbA1c <53 mmol/mol; TIR ≥70%) metabolic control were searched using logistic regression analyses. Results: Living in a nuclear family, male gender, younger age and a school assistant for diabetes management were associated with the simultaneous presence of both indicators of optimal metabolic control. Poor glycaemic control, as estimated by HbA1c, was associated with lower parental education and the child's older age. Parental smoking and the child's older age were associated with poor TIR. Conclusion: This study confirms the importance of sociodemographic factors in care of Finnish paediatric patients with type 1 diabetes. Sociodemographic status markers of the family could be used as triggers to alert paediatric diabetes teams to offer more tailored care to families with new-onset type 1 diabetes mellitus.Peer reviewe

Three factor eating questionnaire-R18 as a measure of cognitive restraint, uncontrolled eating and emotional eating in a sample of young Finnish females

<p>Abstract</p> <p>Background</p> <p>The aim of the study was to examine the construct validity of the Three-Factor Eating Questionnaire -R18 (TFEQ-R18), a measure of eating behaviour, and to evaluate cognitive restraint, uncontrolled eating and emotional eating in a sample of adolescent and young adult females of different weights.</p> <p>Methods</p> <p>Subjects were 2 997 females, aged 17 to 20 years, who participated in a phase III human papillomavirus vaccination trial in Finland in 2004 – 2009.</p> <p>Self-administered questionnaires and weight and height measurements were used. The factor structure of the TFEQ-R18 was verified by factor analysis. Connections between measured eating behaviour and Body Mass Index (BMI) were tested using analysis of variance.</p> <p>Results</p> <p>The original factor structure of the TFEQ-R18 was replicated: six of the eighteen items measured cognitive restraint, nine measured uncontrolled eating, and three measured emotional eating. On average, higher BMI was associated with higher levels of cognitive restraint (p < 0.001) and emotional eating (p < 0.001), but not with uncontrolled eating.</p> <p>Conclusion</p> <p>Structural validity of the TFEQ-R18 was good in this sample of young Finnish females with a varying range of body weights. Use of the instrument as a measure of eating behaviour was thus corroborated. Connections of restrained and emotional eating with BMI were in accordance with previous findings from young females.</p

Maternal weight, smoking, and diabetes provided early predictors of longitudinal body mass index growth patterns in childhood

Aim: The aim of this study was to identify factors affecting overweight growth development using extended body mass index (BMI) data combined with birth and maternal records from Finnish national registries. Methods: The longitudinal data consist of growth measurements of 7372 from six birth cohorts in Finland: 1974 (n = 1109), 1981 (n = 983), 1991 (n = 607), 1994–1995 (n = 829), 2001 (n = 821), and 2003–2004 (n = 3023). Anthropometric data were collected from birth to age 15 years from the health records. Pregnancy health data were included for the four most recent birth cohorts (n = 2810). A statistical method called trajectory analysis was used to identify different BMI development trajectories. Factors associated with abnormal growth tracks were analysed using logistic regression models. Results: High pre-pregnancy BMI, gestational diabetes mellitus, maternal smoking, and greater gestational weight gain than the Institute of Medicine (United States) recommendations were associated with the overweight growth track. Two of the trajectories didn't seem to follow the normal growth pattern: overweight growth track appeared to lead to overweight, while low birth BMI track showed accelerating growth after the adiposity rebound point of BMI growth. Conclusion: These findings suggest that maternal overweight before pregnancy, excessive gestational weight gain, gestational diabetes mellitus, and smoking could potentially be associated with the risk of obesity in children.Peer reviewe

Prevalence and evolution of snoring and the associated factors in two-year-old children

Objectives: To evaluate the prevalence and persistence of snoring during the first two years of life in two Finnish birth cohorts and to assess the associated factors. Study design: The study population comprised 947 children from the CHILD-SLEEP (CS) and 1393 children from the FinnBrain (FB) birth cohorts. Questionnaires were provided to both parents when the child was 24 months of age. The questionnaire consisted of parts concerning the child's sleep and environmental factors. Results: The combined prevalence of habitual snoring in the two birth cohorts at the age of 24 months was 2.3% (95% CI 1.5-3.1), which is markedly lower than reported previously. Children suffering from recurrent infections (CS odds ratio (OR) 3.9, 95% CI 1.2-12.5) or asthma (FB OR 4.3, 1.4-13.5) snored habitually more often. Both the mother's (CS OR 3.2, 1.2-9.0) and father's (CS OR 3.4, 1.4-8.0) snoring every night added to the risk of the child snoring. In the multivariate models, parental snoring (CS adjusted odds ratio (ORa) 2.8, 1.1-6.8), the mother's lower level of education (CS ORa 2.9, 1.2-7.5, FB ORa 2.1, 1.0-4.5), and the mother's lower monthly income (FB ORa 2.9, 1.3-6.3) associated with the child's habitual snoring. Conclusions: The prevalence of habitual snoring in two Finnish birth cohorts is lower than reported previously. The independent risk factors for habitual snoring at the age of two years were the parents' snoring and the mother's low income and low education.Objectives: To evaluate the prevalence and persistence of snoring during the first two years of life in two Finnish birth cohorts and to assess the associated factors. Study design: The study population comprised 947 children from the CHILD-SLEEP (CS) and 1393 children from the FinnBrain (FB) birth cohorts. Questionnaires were provided to both parents when the child was 24 months of age. The questionnaire consisted of parts concerning the child's sleep and environmental factors. Results: The combined prevalence of habitual snoring in the two birth cohorts at the age of 24 months was 2.3% (95% CI 1.5-3.1), which is markedly lower than reported previously. Children suffering from recurrent infections (CS odds ratio (OR) 3.9, 95% CI 1.2-12.5) or asthma (FB OR 4.3, 1.4-13.5) snored habitually more often. Both the mother's (CS OR 3.2, 1.2-9.0) and father's (CS OR 3.4, 1.4-8.0) snoring every night added to the risk of the child snoring. In the multivariate models, parental snoring (CS adjusted odds ratio (ORa) 2.8, 1.1-6.8), the mother's lower level of education (CS ORa 2.9, 1.2-7.5, FB ORa 2.1, 1.0-4.5), and the mother's lower monthly income (FB ORa 2.9, 1.3-6.3) associated with the child's habitual snoring. Conclusions: The prevalence of habitual snoring in two Finnish birth cohorts is lower than reported previously. The independent risk factors for habitual snoring at the age of two years were the parents' snoring and the mother's low income and low education. (C) 2021 The Authors. Published by Elsevier B.V.Peer reviewe

Prevalence and evolution of snoring and the associated factors in two-year-old children

AbstractObjectivesTo evaluate the prevalence and persistence of snoring during the first two years of life in two Finnish birth cohorts and to assess the associated factors.Study designThe study population comprised 947 children from the CHILD-SLEEP (CS) and 1393 children from the FinnBrain (FB) birth cohorts. Questionnaires were provided to both parents when the child was 24 months of age. The questionnaire consisted of parts concerning the child's sleep and environmental factors.ResultsThe combined prevalence of habitual snoring in the two birth cohorts at the age of 24 months was 2.3% (95% CI 1.5–3.1), which is markedly lower than reported previously.Children suffering from recurrent infections (CS odds ratio (OR) 3.9, 95% CI 1.2–12.5) or asthma (FB OR 4.3, 1.4–13.5) snored habitually more often. Both the mother's (CS OR 3.2, 1.2–9.0) and father's (CS OR 3.4, 1.4–8.0) snoring every night added to the risk of the child snoring. In the multivariate models, parental snoring (CS adjusted odds ratio (ORa) 2.8, 1.1–6.8), the mother's lower level of education (CS ORa 2.9, 1.2–7.5, FB ORa 2.1, 1.0–4.5), and the mother's lower monthly income (FB ORa 2.9, 1.3–6.3) associated with the child's habitual snoring.ConclusionsThe prevalence of habitual snoring in two Finnish birth cohorts is lower than reported previously. The independent risk factors for habitual snoring at the age of two years were the parents' snoring and the mother's low income and low education.</p

Lihava nuori

Nuorten lihominen on maailmanlaajuinen ongelma, joka näkyy myös Suomessa. Välipalasyömistä ja niukkaa liikuntaa suosiva elämäntapamme edistää painonnousua, joka korostuu, jos perintötekijät suosivat lisäksi lihomista. Painonnousuun pitää puuttua mahdollisimman varhaisessa vaiheessa ja varata vastaanotolla riittävästi aikaa asian perusteelliseen selvittämiseen. Anamneesi ja kliininen tutkimus riittävät useimmissa tapauksissa diagnoosiin - laboratoriotutkimukset ovat tarpeen vain erityistapauksissa. Luottamuksellisen hoitosuhteen syntymiseen tarvitaan aikaa ja asiaan paneutumista. Pikahoitomahdollisuuksia ei ole tarjolla, vaan nuoren kanssa yhdessä laaditaan pitkän aikavälin hoitosuunnitelma, jossa asetetaan riittävän pienet osatavoitteet. Tavoitteiden saavuttamista seurataan yhdessä kouluterveydenhuollon kanssa. English summary: Obese adolescent Our lifestyle involving eating snacks and having little exercise promotes weight gain also in the young, especially if this is additionally favored by genetic factors. An intervention of weight gain restriction should be made as early as possible, with adequate time during the consultation to profoundly deal with the issue. Anamnesis and clinical examination usually suffice for diagnosis. Establishment of a confidential therapeutic relationship will require time and involvement. Possibilities for a quick treatment are not available, but a long-term treatment plan with the young person is instead devised, setting partial goals that are small enough