Excessive weight gain in children diagnosed with celiac disease (CD) is becoming more common. We describe 2 siblings (9-year and 6 months-old female and 6-year and 9 months-old male) with obesity showing attenuated gastrointestinal and atypical symptoms in which CD was diagnosed in the absence of a known family history of CD. After children's diagnosis, CD in their parents was also investigated. It was detected in their father affected by overweight. The presentation of patients with CD has changed. While patients with overweight and obesity commonly have symptoms such as abdominal pain, reflux, headache, and constipation due to lifestyle factors, CD should also be considered in patients with or without a family history of CD. Careful nutritional status assessment and follow-up monitoring after the diagnosis of CD are mandatory, especially in subjects who are already overweight at the presentation of this disease.
Abdominal Pain ; Celiac Disease ; Child ; Constipation ; Diagnosis ; Fathers ; Female ; Follow-Up Studies ; Headache ; Humans ; Life Style ; Nutritional Status ; Obesity ; Overweight ; Parents ; Recognition (Psychology) ; Siblings ; Weight Gain

Objective: To analyze the relationship between family-related factors and the status of overweight and obesity in children and adolescents aged 6-17 years in China. Methods: Data were collected from the China National Nutrition and Health Surveillance in 2010-2012 program. A sample of 6 343 subjects aged 6-17 years was selected, with matched weight, education levels, household income and other family related factors of their parents. Univariate analysis and multivariate logistic regression were used to explore the relationship between family factors and overweight and obesity in school-aged children and adolescents. Results: After adjusted for age, gender and region, results from the multivariate logistic regression showed that both the overweight and obesity of children and adolescents were associated with maternal BMI (OR=1.83, 95%CI: 1.63-2.05), paternal BMI (OR=1.74, 95%CI: 1.57-1.94), mother's educational level (OR=1.24, 95%CI: 1.12-1.37) and household income (OR=1.30, 95%CI: 1.15-1.46). Conclusion: Factors as overweight or obesity status of the parents, mother's educational level and household income were positively correlated with the prevalence of overweight and obesity in Chinese children and adolescents.
Adolescent ; Body Mass Index ; Body Weight ; Child ; China/epidemiology* ; Cross-Sectional Studies ; Family/psychology* ; Family Characteristics ; Female ; Humans ; Male ; Obesity/psychology* ; Overweight/psychology* ; Parent-Child Relations ; Parents ; Pediatric Obesity/ethnology* ; Prevalence ; Schools

BACKGROUND/OBJECTIVES: This study was conducted to evaluate the feasibility of a sodium reduction program at local restaurants through nutrition education and examination of the health of restaurant owners and cooks. SUBJECTS/METHODS: The study was a single-arm pilot intervention using a pre-post design in one business district with densely populated restaurants in Seoul, South Korea. The intervention focused on improving nutrition behaviors and psychosocial factors through education, health examination, and counseling of restaurant personnel. Forty-eight restaurant owners and cooks completed the baseline survey and participated in the intervention. Forty participants completed the post-intervention survey. RESULTS: The overweight and obesity prevalences were 25.6% and 39.5%, respectively, and 74.4% of participants had elevated blood pressure. After health examination, counseling, and nutrition education, several nutrition behaviors related to sodium intake showed improvement. In addition, those who consumed less salt in their baseline diet (measured with urine dipsticks) were more likely to agree that providing healthy foods to their customers is necessary. This study demonstrated the potential to reduce the sodium contents of restaurant foods by improving restaurant owners' and cooks' psychological factors and their own health behaviors. CONCLUSIONS: This small pilot study demonstrated that working with restaurant owners and cooks to improve their own health and sodium intake may have an effect on participation in restaurant-based sodium reduction initiatives. Future intervention studies with a larger sample size and comparison group can focus on improving the health and perceptions of restaurant personnel in order to increase the feasibility and efficacy of restaurant-based sodium reduction programs and policies.
Blood Pressure ; Commerce ; Counseling ; Diet ; Education ; Health Behavior ; Health Education ; Korea* ; Nutrition Policy ; Obesity ; Overweight ; Pilot Projects* ; Prevalence ; Psychology ; Restaurants* ; Sample Size ; Seoul ; Sodium* ; Surveys and Questionnaires

To identify target energy balance-related behaviors (ERBs), baseline data from 141 overweight or obese schoolchildren (aged 8-14 years old) was used to predict adiposity [body mass index (BMI) and fat percentage] one year later. The ERBs included a modified Dietary Approach to Stop Hypertension diet score (DASH score), leisure-time physical activity (PA, days/week), and leisure screen time (minutes/day). Several cardiometabolic variables were measured in the fasting state, including systolic blood pressure (SBP), diastolic blood pressure (DBP), blood glucose (GLU), total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C). BMI and fat percentage were measured using a BIA body composition analyzer (MC-980MA, TANITA, Tanita Co., Guangzhou, China). Partial correlation coefficients (partial r) and multiple linear regression models were used to predict BMI and fat percentage one year later. Our sample consisted of 114 boys and 83 girls with a mean BMI of 24.7±3.7 kg/m2 and fat percentage of 34.2%±8.3% at baseline. BMI, fat percentage, and certain cardiometabolic variables were negatively associated with DASH score and leisure-time PA (all P<0.05), but positively associated with leisure screen time (all P<0.05) at baseline. Statistically significant predictors of BMI and fat percentage one year later were baseline BMI (partial r=0.85), fat percentage (partial r=0.69), eating out (times/week, partial r=0.18), and DASH Score (partial r=-0.18). Overall, childhood obesity prevention interventions should target reductions in ERBs.
Adiposity ; Adolescent ; Blood Glucose ; metabolism ; Blood Pressure ; Child ; Cholesterol ; blood ; Feeding Behavior ; Female ; Humans ; Male ; Obesity ; metabolism ; physiopathology ; psychology ; Overweight ; metabolism ; physiopathology ; psychology ; Triglycerides ; blood

INTRODUCTIONWeight management programmes (WMPs) can help overweight individuals lose weight, and thus prevent complications associated with obesity. Herein, we describe the demographic profile, clinical characteristics, motivations and expectations, and outcomes of patients enrolled in a nonsurgical WMP.

METHODSThis was a retrospective study of consecutive patients with a body mass index (BMI) of > 23 kg/m2 enrolled in the four-month WMP at the Health For Life Clinic, Alexandra Hospital, Singapore, between 1 and 31 August 2009. Demographic data, medical history and source of referral were recorded. Details on personal motivations and weight loss goals were obtained from the completed self-administered questionnaires of the WMP participants. Weight, waist circumference, fat percentage and BMI were measured at the start and end of the WMP. A weight loss of ≥ 5% was deemed as a successful outcome.

RESULTSA total of 58 patients (mean age 37.2 years) were included in our study. Of these 58 patients, 58.6% were of Chinese ethnicity and 55.2% were male. Many patients (32.8%) attributed their weight gain to work- or study-related stress, and a minority to poor eating habits (12.1%) or a lack of exercise (10.3%). Patients' motivations included a desire for better health (53.4%) and better fitness (15.5%). However, only 53.4% patients scored their motivation as high (i.e. a score of > 7). The mean expected weight loss was 9.9 kg at 4 months, and 14.1 kg at 12 months. Among the 40 patients (69.0%) who completed the programme, the mean percentage weight loss was 1.8 ± 4.3%. A weight loss of ≥ 5% was achieved by 8 (13.8%) patients.

CONCLUSIONAlthough the patients in our study cohort were young and educated, only a portion of them appeared to be highly motivated to lose weight, despite joining the WMP. There is a need for patients to be guided on how to set realistic weight loss goals.

Adult ; Aged ; Body Mass Index ; Female ; Humans ; Male ; Middle Aged ; Motivation ; Obesity ; psychology ; therapy ; Overweight ; psychology ; therapy ; Retrospective Studies ; Singapore ; Surveys and Questionnaires ; Treatment Outcome ; Weight Loss ; Weight Reduction Programs ; methods ; Young Adult

OBJECTIVES: This study is to investigate the prevalence and related factors of metabolic syndrome among Korean adults aged 20 years and above. METHODS: From the database of the 5th Korea National Health and Nutrition Examination Survey (KNHANES V) conducted in 2010, data of 5,670 adults who responded to all the questionnaires of health interview and had metabolic syndrome in the health examination were included in this analysis. SAS 9.2 was used for statistical analysis with complex sample survey modules and commands. RESULTS: The prevalence rate of metabolic syndrome based on the criteria proposed by International Diabetes Federation (IDF) was 18.8%. The prevalence of metabolic syndrome in each group was: 20.7% of women, 43.1% among elderly over 70 years old, 40.6% of the divorced or the separated, 27.6% of recipients of economic support from the government, 23.6% of people who had alcohol dependency problem, and 43.7% of overweight or obese adults. Independent risk factors based on the multiple logistic regression analysis revealed that prevalence of metabolic syndrome was associated with female (odds ratio 1.59 [95% confidence interval 1.20-2.11]), age (50s 3.95 [2.11-7.37], 60s 5.62 [2.98-10.61], 70s 10.56 [5.25-21.25]), high school education (0.52 [0.37-0.74]), clerk occupation (2.14 [1.27-3.60]), divorced marital status (1.72 [1.15-2.59]), alcohol dependency (1.86 [1.16-2.98]), higher BMI (14.08 [10.60-18.70]). CONCLUSIONS: The metabolic syndrome is prevalent among Korean adult population according to IDF criteria. Several demographic characteristics and potentially modifiable factors are associated with metabolic syndrome. Identification of this high-risk group and management of these modifiable factors are warranted to reduce the prevalence of metabolic syndrome.
Adult ; Aged ; Dependency (Psychology) ; Divorce ; Female ; Health Surveys ; Humans ; Korea ; Logistic Models ; Marital Status ; Nutrition Surveys ; Occupations ; Overweight ; Phenothiazines ; Prevalence ; Risk Factors ; Surveys and Questionnaires

The purposes of this study were to: 1) describe the patterns of screen-based sedentary behaviors, and 2) examine the association between screen-based sedentary behavior and cardiovascular disease (CVD) risk factors in representative Korean children and adolescents, aged 12 to 18 yr, in the Korean National Health and Nutrition Examination Survey. Screen-based sedentary behavior was measured using self-report questionnaires that included items for time spent watching TV and playing PC/video games. Physical activity was measured using items for frequency and duration of moderate-to-vigorous physical activity (MVPA). CVD risk factors such as body mass index (BMI), waist circumference, LDL cholesterol, HDL cholesterol, total cholesterol, triglycerides, glucose, systolic blood pressure, and diastolic blood pressure were measured. Boys spent more time playing PC/video games, and girls spent more time watching TV. After adjusting for age, gender, annual household income, and MVPA, an additional hour of watching TV was significantly associated with the risk of overweight (OR 1.17 [95% CI 1.03-1.33]), high abdominal adiposity (OR 1.27 [1.06-1.51]), and low HDL cholesterol (OR 1.27 [1.10-1.47]). An additional hour spent playing PC/video games also increased the risk of high abdominal adiposity (OR 1.20 [1.03-1.40]). Prospective observations and interventions are needed to determine causal relationships between screen-based sedentary behavior and CVD risk profiles in Korean youth.
Abdominal Fat ; Adolescent ; Cardiovascular Diseases/*etiology ; Child ; Cholesterol, HDL/blood ; Cross-Sectional Studies ; Exercise ; Female ; Health Behavior ; Humans ; Male ; Nutrition Surveys ; Odds Ratio ; Overweight ; Questionnaires ; Republic of Korea ; Risk Factors ; *Sedentary Lifestyle ; Socioeconomic Factors ; Video Games/psychology

BACKGROUND AND OBJECTIVES: The use of oral appliances has recently risen as an effective alternative treatment methods for patients with simple snoring or mild to moderate obstructive sleep apnea, who prefer oral appliances to continuous positive airway pressure (CPAP) or who are unable to tolerate CPAP therapy. The objective of this study was to identify which polysomnographic parameters are related to the successful use of oral appliances in patients with sleep-disordered breathing. SUBJECTS AND METHOD: We performed a retrospective study of 29 subjects with sleep-disordered breathing and prescribed the use of an oral appliance. To determine which polysomnographic parameters were related to responsiveness to oral appliances, differences in responder rates were assessed according to apnea severity, sleep position, rapid eye movement-stage dependency, body mass index (BMI) and nasal surgery history. RESULTS: Twenty-one of 29 patients showed improved respiratory disturbance index after oral-appliance treatment. Responder rates of patients with mild, moderate, and severe sleep-disordered breathing were 72.3%, 80%, and 62.5%, respectively. Responder rates among position-dependent and non-position dependent groups were 85% and 44.4%, respectively. When grouping into overweight and normal weight groups according to BMI, responder rates were 69.57% and 83.3%, respectively. The responder rate for 24 patients who had undergone septoturbinoplasty was 75%, whereas it was 60% for the non-surgery group. CONCLUSION: Oral appliance therapy is confirmed to be useful for patients with simple snoring or mild to moderate sleep apnea, or position dependent sleep apnea, and those who have normal weight and low nasal resistance.Oral appliance therapy is confirmed to be useful for patients with simple snoring or mild to moderate sleep apnea, or position dependent sleep apnea, and those who have normal weight and low nasal resistance.
Apnea ; Body Mass Index ; Continuous Positive Airway Pressure ; Dependency (Psychology) ; Eye ; Humans ; Mandibular Advancement ; Nasal Surgical Procedures ; Orthodontic Appliances ; Overweight ; Retrospective Studies ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Snoring

This study was designed to compare the incidence and severity of premenstrual syndrome (PMS) between normal (N = 85) and overweight or obese (N = 28) college female students and investigated correlation between PMS, nutrient intake, hematological index and psychological index (depression, anxiety, stress). Each subject was asked a Menstrual Discomfort Questionnaire (MDQ) for PMS by 5 Likert scale. The PMS scores of women in the normal weight subjects ranked in order of severity were water retention (2.71), followed by behavioral change (2.58), negative affect (2.46), pain (2.31), autonomic reaction (2.27), decreased concentration (2.16). The symptoms of 'pain' and 'behavioral change' of overweight or obese subject were significantly higher than those of normal subject (p < 0.05). And total cholesterol concentration of overweight or obese subjects was significantly higher than in normal subject (p < 0.05). There was a significant positive correlation (p < 0.05) between the symptoms of 'negative effect' and BMI. And the triglyceride concentration was positively related with 'water retention (p < 0.01)'. The symptoms of 'decreased concentration' were negatively correlated with calcium (p < 0.01) and vitamin B6 intake (p < 0.05). The depression score were positively related with symptoms of 'behavioral change (p < 0.05)', 'negative affect' (p < 0.01), and the anxiety score was positively correlated with 'behavioral change (p < 0.05)' and 'decreased concentration (p < 0.05)'. The stress score was positively correlated with 'decreased concentration (p < 0.01)', 'behavioral change (p < 0.05)' and 'negative affect (p < 0.05)'. This suggests that PMS represents the clinical manifestation of a calcium, vitamin B6 deficiency and psychological disorder. Therefore we concluded that nutrient supplementation, depression and stress management may help to relieve PMS symptoms.
Anxiety ; Calcium ; Cholesterol ; Depression ; Female ; Humans ; Incidence ; Obesity ; Overweight ; Premenstrual Syndrome ; Surveys and Questionnaires ; Retention (Psychology) ; Vitamin B 6 ; Vitamin B 6 Deficiency ; Water

OBJECTIVES: Being overweight or obese is central to metabolic syndrome, and these characteristics constitute dominant risk factors for chronic diseases. Although behavioral factors, including eating habits and sedentary lifestyles, are considered to be determinants of obesity, the specific childhood factors that contribute to this condition have not been clearly defined. METHODS: The subjects consisted of 261 children aged 7-9 years who were recruited from an elementary school during October 2003. Information was obtained from their parents using a questionnaire focused on eating behaviors and lifestyle factors, additional data were also collected via anthropometric measurements and biochemical examinations, including blood tests. RESULTS: A total of 48 (18.4%) of the 261 children were overweight, and 34 (70.8%) had at least one other component of metabolic syndrome. Eating behaviors emerged as significant lifestyle-related risk factors for being overweight or obese. Those who engaged in overeating more than twice per week had three times the risk of being overweight (odds ratio [OR], 3.10, 95% confidence interval [CI], 1.39 to 6.92), and those who ate rapidly had three times the risk of being overweight (OR, 3.28; 95% CI, 1.68 to 6.41). Those who had fewer family meals (fewer than 2?3/month) had a nine times higher risk of being overweight than those who had family meals more frequently (at least 1/day) (OR, 9.51; 95% CI, 1.21 to 74.82). CONCLUSIONS: This study showed that being overweight or obese during preadolescence is associated with a higher risk of metabolic syndrome and is related to unhealthy eating behaviors. Thus, weight-control strategies and healthy eating behaviors should be developed early in life to reduce the risk for metabolic syndrome.
Child ; *Feeding Behavior ; Female ; Humans ; Life Style ; Logistic Models ; Male ; Metabolic Syndrome X/etiology ; Obesity/*etiology ; Odds Ratio ; Overweight/*etiology ; Parents/psychology ; Questionnaires ; Risk Factors