Previous reviews of childhood obesity prevention have focused largely on schools and findings have been inconsistent. Funded by the US Agency for Healthcare Research and Quality (AHRQ) and the ...National Institutes of Health, we systematically evaluated the effectiveness of childhood obesity prevention programmes conducted in high‐income countries and implemented in various settings. We searched MEDLINE®, Embase, PsycINFO, CINAHL®, ClinicalTrials.gov and the Cochrane Library from inception through 22 April 2013 for relevant studies, including randomized controlled trials, quasi‐experimental studies and natural experiments, targeting diet, physical activity or both, and conducted in children aged 2–18 in high‐income countries. Two reviewers independently abstracted the data. The strength of evidence (SOE) supporting interventions was graded for each study setting (e.g. home, school). Meta‐analyses were performed on studies judged sufficiently similar and appropriate to pool using random effect models. This paper reported our findings on various adiposity‐related outcomes. We identified 147 articles (139 intervention studies) of which 115 studies were primarily school based, although other settings could have been involved. Most were conducted in the United States and within the past decade. SOE was high for physical activity‐only interventions delivered in schools with home involvement or combined diet–physical activity interventions delivered in schools with both home and community components. SOE was moderate for school‐based interventions targeting either diet or physical activity, combined interventions delivered in schools with home or community components or combined interventions delivered in the community with a school component. SOE was low for combined interventions in childcare or home settings. Evidence was insufficient for other interventions. In conclusion, at least moderately strong evidence supports the effectiveness of school‐based interventions for preventing childhood obesity. More research is needed to evaluate programmes in other settings or of other design types, especially environmental, policy and consumer health informatics‐oriented interventions.
We report on transport properties of Josephson junctions in hybrid superconducting-topological insulator devices, which show two striking departures from the common Josephson junction behavior: a ...characteristic energy that scales inversely with the width of the junction, and a low characteristic magnetic field for suppressing supercurrent. To explain these effects, we propose a phenomenological model which expands on the existing theory for topological insulator Josephson junctions.
Abstract Background Limited evidence from the United States suggests that county/state rates of people with obesity are positively associated with voting for the Republican Party presidential ...candidate, although this question has not yet been studied at the individual level, and/or outside of the United States, where the health and political systems are very different in other countries. Objectives Using individual level data, assess differences in rates of people with obesity according to political voting in the United Kingdom 2019 general election, and examine whether people living in constituencies won by Members of Parliament (MPs) from the Conservative Party were more likely to be living with obesity than those living in constituencies won by MPs from other parties. Methods Data was obtained by the Ipsos KnowledgePanel where panellists are recruited via a random probability unclustered address-based sampling method. 4000/14,016 panellists were randomly invited to provide data on socio-demographics, health outcomes, voting behaviour and height/weight. Results 2668/4000 (67%) of invitees provided data, 95/2668 (3.5%) were not eligible to vote, with the remaining 2573 (96.5%) included. Conservative Party voters were more likely to be living with obesity than those who voted Labour (OR:1.42 95% CI (1.01–1.99)) or Liberal Democrats (1.54 95% CI (1.00–2.37)). Conservative Party voters on average had significantly higher BMI scores than those voting Labour and Liberal Democrats; BMI mean difference 0.88 points (95% CI: 0.16–1.61) between Conservative and Labour voters, and 1.04 points (95% CI: 0.07–2.02) between Conservatives and Liberal Democrats voters. There was no evidence participants living in constituencies won by Conservative MPs were more likely to be living with obesity than constituencies won by other party MPs. Conclusion Governments and public health agencies may need to focus on the political affiliation of the public when developing strategies to reduce the number of people with obesity.
Background
Prader–Willi syndrome (PWS) is a rare genetic disorder that in many cases is associated with mental health disorders, in addition to characteristic symptoms such as hyperphagia. The ...current Sars‐CoV‐2 coronavirus pandemic has led to massive restrictions in health care and social life worldwide. People with PWS represent a particularly vulnerable population group to these restrictions, with unknown impact on their mental health.
Methods
We conducted an online questionnaire to assess the impact of the restrictions associated with the COVID‐19 pandemic on the mental health of people with PWS.
Results
One hundred and eight caregivers completed the survey about individuals with PWS. Individuals with PWS > 6 years (n = 89) were included for evaluation with regard to psychopathological change. Respondents frequently reported an increase in psychopathological symptoms associated with PWS during the lockdown, with 51.7% reporting increased temper outbursts, 43.8% showing signs of sadness, 38.2% being anxious, 55.0% more irritable, and 39.3% showing more food seeking behaviour. Adjusted for the type of accommodation food seeking behaviour and irritability is increased to a significantly lesser extent in people with PWS accommodated in specialised care facilities compared with those living in their family home. No significant difference could be found between the sexes.
Conclusion
The COVID‐19 pandemic has had a significant effect on the mental health of individuals with PWS, evidenced by an increase in behaviours associated with PWS, including temper outbursts, food‐seeking, and irritability, which again underlines their need for specialised care. Individuals living with their families were particularly vulnerable, indicating that they and their families are in special need of support.
Understanding the relative importance of overconsumption and physical inactivity to excess weight gain among children and adolescents can contribute to the development and evaluation of interventions ...and policies to reduce childhood obesity. However, whether energy intake or expenditure is the dominant contributor to childhood obesity is a subject of debate. To date, no study has systematically reviewed the literature on this subject.
We searched PubMed and Ovid Medline (January 1970 to January 2010) for potentially relevant English-language abstracts and obtained full-text articles for the abstracts, which passed the initial inclusion-exclusion criteria. Reference lists of full-length articles were hand searched to identify additional studies potentially relevant for inclusion. Relevant studies were characterized into one of the following three categories: cross-sectional studies with a nationally representative sample, cross-sectional studies among population subgroups and longitudinal studies.
This review identified 26 studies examining factors related to energy intake, energy expenditure and obesity among children and adolescents. Cross-sectional and longitudinal studies suggest that the primary determinant of energy imbalance at both the population and the individual levels is not definitive. Our findings further suggest that there is wide variation in data quality between studies. Future research in this area should aim to improve the accuracy of measures of energy intake, expenditure and their net balance over time; capitalize on under-utilized, non-traditional data sources, which have not been widely used; use modeling techniques to synthesize studies of shorter follow-up period and different outcome measures; and examine the unique determinants of energy imbalance among demographic groups at higher risk for obesity.
On the basis of the current evidence, there is no consensus on the main driver of secular trends on weight gain among US children and adolescents. More research and better methods are needed to identify the relative contribution of energy intake and energy expenditure to obesity in the pediatric population.
Abstract The emerging field of epigenetics provides a biological basis for gene-environment interactions relevant to depression. We focus on DNA methylation of exon 1 and 2 of the oxytocin receptor ...gene ( OXTR ) promoter. The research aims of the current study were to compare OXTR DNA methylation of depressed patients with healthy control subjects and to investigate possible influences of the OXTR rs53576 genotype. The sample of the present study consisted of 43 clinically depressed women recruited from a psychosomatic inpatient unit and 42 healthy, female control subjects – mean age 30 years (SD = 9). DNA methylation profiles of the OXTR gene were assessed from leukocyte DNA by means of bisulfite sequencing. Depressed female patients had decreased OXTR exon 1 DNA methylation compared to non-depressed women. The association between depression and methylation level was moderated by OXTR rs53576 genotype. Exon 2 methylation was associated with OXTR rs53576 genotype but not with depression. Our findings suggest exon-specific methylation mechanisms. Exon 1 methylation appears to be associated with depressive phenotypes whereas exon 2 methylation is influenced by genotype. Previously reported divergent associations between OXTR genotype and depression might be explained by varying exon 1 methylation. In order to further understand the etiology of depression, research on the interplay between genotype, environmental influences and exon-specific methylation patterns is needed.
To evaluate the theoretical impact of restricting sugar‐sweetened beverage (SSB) purchases in the Supplemental Nutrition Assistance Program (SNAP) on calorie intake, dental caries, and obesity risk ...in children.
Using SNAP participation and dietary consumption data from a nationally representative sample of children (ages 0 to 19) completing the National Health and Nutrition Examination Survey (2009‐2014, N = 9,753), we constructed a stochastic microsimulation model to evaluate the effectiveness of restricting SSB purchases in SNAP on childhood obesity and dental caries among children enrolled in the SNAP. We simulated the population over a 10‐year period to be consistent with policy planning horizons, and to minimize longitudinal uncertainty in our estimates. From the simulation, we assessed changes in SSB consumption, total daily calorie intake, body mass index (BMI), prevalence of obesity, and the incidence of dental caries given observed SSB consumption rates and differences in disease risks within the SNAP population as compared to the general US population. Sensitivity analyses were conducted to assess whether variations in food substitution patterns and SNAP enrollment rates could alter the benefits of the proposed program.
Hypothetical cohort of US children aged less than 19 years, stratified by age, gender, race/ethnicity, income, and SNAP enrollment status.
SSB consumption among the target SNAP participants was 105.2 grams/person/day (95% CI: 64.8, 145.6) higher than non‐SNAP participants, and restricting SSB purchases in SNAP would result in an estimated 108.3 grams lower SSB consumption per day (95% CI: −150.6, −66.0). The most SSB consumption reduction was observed among non‐Hispanic Black male population given higher baseline SSB consumption level. If SSB was substituted for 100% fruit juice and milk based on a recent review, a restriction on SSB purchases would be expected to reduce calorie intake by a net average of 16.9 kcal/person/day (95% CI: −18.4, −14.3) among SNAP participants, resulting in a 1.2 kg/m‐ (95% CI: −1.5, −0.8) decrease in BMI. Obesity prevalence would not be expected to decrease significantly based on this change in BMI, −4.7 percentage point (95% CI: −14.1, 4.7). The anticipated decrease in dental caries incidence averaged 49.0 per 10,000 (95% CI: −52.2, −45.8), 0.9% decline from baseline. When SSB was substituted for other most typically purchased food items by the SNAP participants, such as meat, vegetables, and frozen prepared foods, the participants consumed 5.1 more kcals/person/day (95% CI: 4.70, 5.54), but BMI or obesity prevalence among the participants was not significantly impacted by this change.
Restricting SSB purchases in SNAP would be expected to significantly lower the risk of dental caries and BMI among children. However, it would not be expected to have a significant effect on obesity due to food substitutions.
Children enrolled in the SNAP are at a higher risk of poor diet, including higher SSB consumption compared with non‐SNAP participants. Restricting SSB purchases in SNAP could potentially promote healthier diet, and significantly reduce dental caries—one of the most common chronic diseases of childhood in the United States.
Summary
Objective
The objective of this study is to summarize evidence for strategies designed to reduce sugar‐sweetened beverage (SSB) consumption among children aged 0 to 5 years.
Data sources
...PubMed, Web of Science, EMBASE, CINAHL, ERIC, Cab s and the Cochrane Central Register of Controlled Trials are the electronic databases searched in this systematic review.
Study selection
Each included study evaluated an intervention to reduce SSB consumption in children aged 0 to 5 years, was conducted in a high‐income country and was published between 1 January 2000 and 15 December 2017.
Data synthesis
Twenty‐seven studies met the inclusion criteria. The primary intervention settings were healthcare (n = 11), preschool/daycare (n = 4), home (n = 3), community venues (n = 3) and other settings (n = 6). Overarching strategies which successfully reduced SSB consumption included (i) in‐person individual education, (ii) in‐person group education, (iii) passive education (e.g. pamphlets), (iv) use of technology, (v) training for childcare/healthcare providers and (vi) changes to the physical access of beverages. Studies were of moderate methodological quality (average score of 20.7/29.0 for randomized studies; 3.1/9.0 for non‐randomized studies).
Conclusions
Evidence suggests that interventions successful at reducing SSB consumption among 0‐year to 5‐year olds often focused on vulnerable populations, were conducted in preschool/daycare settings, specifically targeted only SSBs or only oral hygiene, included multiple intervention strategies and had higher intervention intensity/contact time.
Neutropenia and agranulocytosis (N&A) are relatively rare, but potentially fatal adverse drug reactions (ADR). This study presents cases of N&A related to one or more antipsychotic drugs (APDs) in ...psychiatric inpatients. Data on APD utilization and reports of N&A caused by APDs were analyzed by using data from an observational pharmacovigilance program in German-speaking countries—Arzneimittelsicherheit in der Psychiatrie (AMSP)—from 1993 to 2016. 333,175 psychiatric inpatients were treated with APDs for schizophrenia and other indications during the observation period. A total of 124 cases of APD-induced N&A were documented, 48 of which fulfilled the criteria for agranulocytosis, corresponding to a rate of 0.37, respectively, 0.14 in 1000 inpatients treated with APDs. Neutropenia was more often detected in women, whereas there was no difference regarding sex in cases of agranulocytosis. Clozapine had the highest relative risk for inducing N&A and was imputed alone as a probable cause of N&A in 60 cases (1.57‰ of all patients exposed). Perazine showed the second highest relative risk with 8 cases and an incidence 0.52‰, followed by quetiapine (15 cases resp. 0.23‰ of all patients exposed) and olanzapine (7 cases; 0.13‰ of all patients exposed). N&A most often occurred during the first 3 months of treatment. Overall N&A are severe and potentially fatal complications that can occur during treatment with APDs. The results from this study largely agree with the currently available literature, highlighting the positive effects of alertness and established appropriate monitoring.
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