Anthropometric indices associated with dyslipidemia in obese children and adolescents: a retrospective study in isfahan

<p class="abstract"><strong>&nbsp;&nbsp; </strong><strong>BACKGROUND:</strong> Central obesity is an important risk factor for cardiovascular diseases (CVD). Preventive interventions from childhood are necessary due to the increasing prevalence of childhood obesity. Body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and waist to height ratio (WSR) are anthropometric indices for measurement of obesity. This study aimed to assess the association between these anthropometric indices and dyslipidemia in obese children and adolescents.</p> <p class="abstract"><strong>&nbsp;&nbsp; METHODS:</strong><strong> </strong>This retrospective study was done on the records of 2064 obese children and adolescents aged 6-18 years at the obesity clinic, in Isfahan Cardiovascular Research center. Age, gender, weight, height, WC, hip circumference (HC), triglyceride (TG), total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), Fasting blood sugar (FBS), diastolic blood pressure (DBP) and systolic blood pressure (SBP) were taken from patients&rsquo; record. Receiver operating characteristics (ROC) curve and Pearson correlation were used to analyze the data.</p> <p class="abstract"><strong>&nbsp;&nbsp; RESULTS:</strong> 2064 girls and boys aged 6-18 years were divided into 3 age groups of 6-9.9 years, 10-13.9 years and 14-18 years. Prevalence of high LDL-C, TC, TG, FBS, SBP, DBP and low HDL-C was higher among the boys compared to the girls. There was a significant association between TC, LDL-C, TG and FBS with BMI, WC, WHR and WSR. However, no significant correlation was seen between HDL-C and the four anthropometric indices.<strong>&nbsp;</strong></p> <p class="abstract"><strong>&nbsp;&nbsp; </strong><strong>CONCLUSION:</strong> Our study showed a significant correlation between BMI, WC and WSR with high levels of TC, TG and LDL-C in children and adolescents. Correlation between WHR and dyslipidemia in this study was significant but its predictive value was weaker than other three indices.</p> <p class="abstract">&nbsp;</p><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td width="35" height="12"><br /></td></tr> <tr><td><br /></td> <td>&nbsp;</td></tr></tbody></table> &nbsp; <strong>Keywords:</strong> Body Mass Index, Waist Circumference, Waist to Hip Ratio, Waist to Height Ratio, Dyslipidemia, Children, Adolescents

Relationship Between Carotid Intima-Media Thickness with some Inflammatory Biomarkers, Ghrelin and Adiponectin in Iranians with and without Metabolic Syndrome in Isfahan Cohort Study

<p class="abstract"><strong>BACKGROUND:</strong> Recent studies have confirmed inflammatory factors and metabolic syndrome (MetS) as important cardiovascular disease (CVD) risk factors. Recently measurement of carotid intima-media thickness (IMT) has been used for evaluation of early atherosclerosis. This study was designed to assess the correlation between IMT with some inflammatory biomarkers, ghrelin and adiponectin in people with and without MetS in a cohort sample in Isfahan province.</p> <p class="abstract"><strong>&nbsp;&nbsp; METHODS:</strong><strong> </strong>Among participants of Isfahan Cohort Study (ICS) by random sampling, 88<strong> </strong>participants were selected and divided into case (with MetS) and control (without MetS)&nbsp;&nbsp; groups. A questionnaire including demographic data and CVD risk factors was completed for all of the participants. Physical examination and blood pressure, height, weight and waist circumference measurements were done for all subjects. Vascular echocardiography was done for evaluation of IMT of each carotid artery of both sides. Interlukin-6 (IL-6), interlukin-10 (IL-10), highly sensitive C-reactive protein (hs-CRP), ghrelin and adiponectin levels were measured using ELIZA method. Data were entered in SPSS version 15 and analyzed by t test, chi square, Pearson correlation and linear regression analyze.</p> <p class="abstract"><strong>&nbsp;&nbsp; RESULTS:</strong> The mean waist circumference, BMI, systolic blood pressure, diastolic blood pressure, hs &ndash;CRP and IMT of left carotid artery were significantly higher in participants with Mets. There was significant correlation between left carotid IMT and IL-6 level in all patients (P=0.03). After adjustment for age and sex, significant relationship in groups with MetS was only reported between the left IMT and IL-6 (P=0.02). There was no relation between IMT and other inflammatory markers in subjects with and without MetS.</p> <p class="abstract"><strong>&nbsp;&nbsp; </strong><strong>CONCLUSION:</strong> Significant correlation between IL-6 and IMT was reported in patients with MetS. While no significant correlation between IL-10, adiponectin and ghrelin with IMT was observed in metabolic syndrome group.</p> <p class="abstract">&nbsp;</p><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td width="35" height="12"><br /></td></tr> <tr><td><br /></td> <td>&nbsp;</td></tr></tbody></table><p class="abstract">&nbsp;</p> <strong>Keywords:</strong> Intima-media thickness (IMT), carotid artery, hs-CRP, Ghrelin, Adiponectin IL-6, IL-10

HEALTHY LIFESTYLE: THE ROLE OF EDUCATION IN IMPROVEMENT OF THE KNOWLEDGE OF PRIMARY AND MIDDLE SCHOOL STUDENTS IN ISFAHAN AND NAJAF-ABAD

Abstract&nbsp; INTRODUCTION: Lifestyle habits are established from early childhood and persist for many years, almost until the end of life. Thus, healthy lifestyle education should begin in childhood. This study was conducted to train primary and middle school students about healthy lifestyle via school campaigns and evaluate the results. methods: One-hundred primary and middle school students were selected. Topics on healthy lifestyle were included in their New Year homework book (Peyk-e-Noroozi). Their knowledge about healthy lifestyle was evaluated via questionnaires. Data were analyzed with SPSS and Student's t-test (P&lt;0.05). results: The most significant learning of students from Peyk-e-Noroozi in both primary and middle school was the importance of physical activity and exercise (32% in primary school students and 37% in middle school students, P&lt;0.05). Learning about healthy lifestyle from Peyk-e-Noroozi was significantly higher in primary school students than in middle school students (82% vs. 57%, P=0.04). Discussion: Our study suggests that healthy lifestyle education via school campaigns and media may have considerable effect on primary and middle school students. Such simple and feasible modes of educations should be integrated with the existing educational curricula.Keywords . Education . Lifestyle . School students . School campaign . Peyk-e-Noroozi</p

ASSOCIATION OF ANTHROPOMETRIC INDEXES AND CARDIO-METABOLIC RISK FACTORS AMONG OBESE CHILDREN

Abstract &nbsp;&nbsp; BACKGROUND: Childhood obesity is associated with many cardio-metabolic risk factors, and different anthropometric measures have been considered to be associated with these risk factors. The aim of this study was to determine the best anthropometric index associated with cardio-metabolic risk factors among obese children and adolescents. &nbsp;&nbsp; METHODS: This study was conducted by using data of the records of 2064 obese children and adolescents aged 6-18 years. Body mass index (BMI), waist circumference (WC), waist- to- hip ratio (WHR) and waist- to-stature ratio (WSR) were considered as anthropometric indexes. The cardio-metabolic risk factors were total cholesterol (TC), LDL-cholesterol (LDL-C),HDL-cholesterol (HDL-C), triglycerides (TG), fasting blood sugar (FBS), diastolic and systolic blood pressure (SBP and DBP).Data were analyzed with SPSS16 using Receiver Operator Curve (ROC) and Pearson correlation analyses. &nbsp;&nbsp; RESULTS: The prevalence of high LDL -C, TC, TG, FBS, SBP / DBP and low HDL - C was higher in boys than in girls. No single anthropometric index was found to be associated with risk factors in different sex and age groups. BMI, WC and WSR but not WHR had significant correlation with TC, LDL - C, TG, and FBS, whereas HDL - C had no significant correlation with anthropometric indexes.&nbsp; &nbsp;&nbsp; CONCLUSION: Our results showed that in spite of all its limitations in differentiating fat mass and obesity pattern, BMI can be considered as a useful anthropometric index for predicting cardio-metabolic risk factors in obese children and adolescents. It may be clinically useful in pediatric population to routinely use WC and WSR -but not WHR- as a screening tool to identify at-risk children. &nbsp; &nbsp;&nbsp; Keywords: Anthropometric measures, fat distribution, cardiovascular risk factors, children. &nbsp;</p

Assessment of Severity of Malnutrition in Peritoneal Dialysis Patients via Malnutrition: Infl ammatory Score

Background: Regarding to the complications of malnutrition in dialysis patients, using an easy and reliable method for evaluating of malnutrition is important in patients with the end-stage renal disease. Based on the effect of inflammatory factors in malnutrition, A new scale has been designed which is called malnutrition–inflammatory scale (MIS). We designed current study to assess the severity of malnutrition in peritoneal dialysis patients in Isfahan via MIS. Materials and Methods: In this cross-sectional MIS was used for evaluation of malnutrition. MIS includes 10 components: dry weight changes, dietary intake, functional capacity, comorbidity, muscle wasting and loss of subcutaneous fat as well as body mass index (BMI), serum albumin level and total iron binding capacity (TIBC). Each component has four levels of severity from 0 (normal) to 3 (severely abnormal). All analyses were performed using Statistical Package for Social Sciences version 20 (SPSS 20) and P < 0.05 were considered statistically significant. Results: Results showed no significant difference in MIS between male and female participants. Mean of minimum inhibitory concentration in this study was calculated about 4.1 (MIS <9) which means no or mild malnutrition. Significant correlation between MIS and weight (P < 0.001), BMI (P < 0.001), TIBC (P < 0.001), triglyseride (P = 0.04) and arm circumference (P < 0.001) was seen. Conclusion: We suggest That MIS is being used as a valuable tool for prevention of fatal outcomes in chronic dialysis patients

Can a Trial of Motivational Lifestyle Counseling be Effective for Controlling Childhood Obesity and the Associated Cardiometabolic Risk Factors?

This study was conducted to assess the effectiveness of a simple office-based program for encouraging healthy lifestyle on controlling childhood obesity and associated cardiometabolic risk factors. Methods: This non-randomized 24-week lifestyle modification trial was conducted among 457 obese children and adolescents, aged 2–18 years, who had at least one cardiometabolic risk factor in addition to obesity. This trial included three components of exercise, diet education and behavior modification, with all recommendations provided by a pediatrician, two general physicians and a nurse. Instead of strict inhibitory recommendations, healthier lifestyle was encouraged. Results: Overall 448 (98.04%) of enrolled children completed the trial with a mean age of 9.6 ± 2.9 years. After the trial, the mean of anthropometric measures and cardiometabolic risk factors decreased significantly, the mean high-density lipoprotein cholesterol (HDL-C) increased significantly, and the prevalence of the metabolic syndrome decreased from 20.8% to 1.8%. Triglycerides, LDL-C, diastolic blood pressure and WC had the highest decrease in all age groups, with the most prominent changes in the 14–18-year age group. By each -1SD decline in BMI and WC, risk factors had significant improvement. Conclusion: Motivational office-based counseling can be effective in treatment of childhood obesity and its associated cardio-metabolic risk factors. Such approach can be implemented in the primary health care system; and can be of special concern in low- and middle-income countries with limited human and financial resources. We suggest that expanding the roles of non-physician clinicians such as nurse practitioners can help to increase the amount of time available for such services

CAN EDUCATION THROUGH POSTER IMPROVE THE KNOWLEDGE AND PRACTICE OF PRESCHOOLERS ABOUT HEALTHY LIFESTYLE? IHHP-HHPC

AbstractINTRODUCTION: Lifelong behavior and risk factors of chronic diseases extend from earlylife to adulthood. It seems that dietary habits and unhealthy food consumption, as well aspassive smoking play an important role in the development of such diseases. Multiplestudies have shown that healthy lifestyle education in preschool children improves theirknowledge, attitude and practice about healthy lifestyle. This study was conducted toevaluate the effect of lifestyle education with educational posters in daycare centers onpreschool children.METHODS: In an interventional study, 250 preschool children were selected via 2-stagerandom cluster sampling and taught tips on healthy lifestyle via educational posters. Theirknowledge on healthy lifestyle was assessed before and after (1 week and 3 months)education via a picture-questionnaire, and their practice and behavior were assessed beforeand after education via their favorite choice of snack in daycare centers. Collected datawere analyzed using SPSS13 by paired t-test and Man Whitney test.RESULTS: The knowledge and practice scores of the studied subjects improvedsignificantly one week after intervention compared with baseline, and persisted until the thirdmonth after education.DISCUSSION: Healthy lifestyle education via poster for preschool children can significantlyimprove their knowledge and practice towards healthy lifestyle.Keywords &bull; Healthy life style &bull; Education &bull; Preschool childre

CAN RELAXATION BE USED TO ACHIEVE WEIGHT CONTROL IN YOUTHS?

&nbsp; Abstract INTRODUCTION: Childhood obesity is a cultural and medical problem and is usually a refractory to treatment. The objective of this study was to assess the effects of parental therapy behavior and relaxation methods on children in controlling childhood obesity. methods: In this randomized controlled clinical trial, 90 obese children aged 10-17 years were randomly divided into three groups of equal number. All three groups received similar diet and exercise recommendations. The first group of children attended 15 relaxation sessions. Parents of the second group participated in 15 behavior therapy sessions. The third group was considered as control. Data were analyzed by SPSS&nbsp;13. Mean changes of weight, BMI and WC were calculated. results: Mean BMI decreased in all three groups after the intervention. This decrease was more remarkable, but not significant in the first group. Mean weight decreased in the first group but increased in the second group. Mean WC decreased in all three groups. This decrease was more obvious, but not significant in the first group. CONCLUSIONS: Stress leads to sympathetic system arousal which it associated with many pathologic conditions. Elicitation of relaxation response can help individuals embrace healthy lifestyle choices. Relaxation and parent behavior therapy can be considered as useful methods of controlling childhood obesity. &nbsp; &nbsp; Keywords: Obesity, children and adolescents, relaxation, behavior therapy, parents.</div