RESUMEN
World Health Organization (WHO) Europe organizes Childhood Obesity Surveillance Initiative (COSI), in which the Czech Republic participates since the beginning. The aim of this project is to monitor the prevalence of overweight and obesity of 7-year-old children in the Czech Republic. Data were obtained from 2349 children examined by 72 pediatricians across the Czech Republic. Anthropometric parameters were measured and subjects filled questionnaire. The prevalence of obesity and overweight did not change significantly between 2008 and 2019. Although in the fifth round in 2019, the prevalence of obesity increased and the prevalence of overweight slightly decreased in both sexes. In 2019 6.09 % of boys and 7.12 % of girl had overweight. The prevalence of obesity in the fifth round was 9.26 % in boys and 8.64 % in girls (assessed according to the Czech reference values). Already in the first round we noticed a relatively high prevalence of severe obesity (3.21 % for boys and 0.8 % for girls), which did not differ significantly between rounds. Even if the prevalence of overweight has not significantly increased until 2019, preventive and treatment programs are very important, because it is an important part of the prevention and early detection of obesity in children.
Asunto(s)
Sobrepeso , Obesidad Infantil , Masculino , Femenino , Niño , Humanos , Sobrepeso/epidemiología , Obesidad Infantil/epidemiología , República Checa/epidemiología , Prevalencia , Índice de Masa CorporalRESUMEN
The increasing prevalence of obesity and its associated complications leads to the need to intensify its prevention and treatment. The treatment of obesity is currently based on lifestyle modification, which often fails in the long term. For the next decade, the long-term administration of anti-obesity drugs, i.e. drugs that have a positive effect not only on the reduction of excess weight but also on the health risks associated with obesity, seems to be a necessary part of obesity treatment, along with surgical approaches. This text provides an overview of the current options for the pharmacotherapy of obesity, including their indications, appropriate patient selection and adverse effects of treatment. It also provides an overview of studies that demonstrate the long-term efficacy and safety of these treatments. Although effective and safe anti-obesity drugs are currently available, it is not even partially covered by general health insurance. However, the cost of treatment is unaffordable in the long term for a large proportion of the obese. The virtual unavailability of effective antiobesity drugs for indicated patients has serious health-economic consequences. Failure to take advantage of effective therapeutic options, confirmed by evidence-based medicine, results in a high prevalence of obesity-related diseases, which are even more costly to treat economically and, in the case of type 2 diabetes, even less effective. We consider at least partial reimbursement of antiobesity drugs from general health insurance for cooperating patients under clearly defined conditions to be a necessary step towards improving the situation, and clearly cost-effective in its consequences.
Asunto(s)
Fármacos Antiobesidad , Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Obesidad/tratamiento farmacológico , Fármacos Antiobesidad/uso terapéuticoRESUMEN
INTRODUCTION: Parents can act as important agents of change and support for healthy childhood growth and development. Studies have found that parents may not be able to accurately perceive their child's weight status. The purpose of this study was to measure parental perceptions of their child's weight status and to identify predictors of potential parental misperceptions. METHODS: We used data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative and 22 countries. Parents were asked to identify their perceptions of their children's weight status as "underweight," "normal weight," "a little overweight," or "extremely overweight." We categorized children's (6-9 years; n = 124,296) body mass index (BMI) as BMI-for-age Z-scores based on the 2007 WHO-recommended growth references. For each country included in the analysis and pooled estimates (country level), we calculated the distribution of children according to the WHO weight status classification, distribution by parental perception of child's weight status, percentages of accurate, overestimating, or underestimating perceptions, misclassification levels, and predictors of parental misperceptions using a multilevel logistic regression analysis that included only children with overweight (including obesity). Statistical analyses were performed using Stata version 15 1. RESULTS: Overall, 64.1% of parents categorized their child's weight status accurately relative to the WHO growth charts. However, parents were more likely to underestimate their child's weight if the child had overweight (82.3%) or obesity (93.8%). Parents were more likely to underestimate their child's weight if the child was male (adjusted OR [adjOR]: 1.41; 95% confidence intervals [CI]: 1.28-1.55); the parent had a lower educational level (adjOR: 1.41; 95% CI: 1.26-1.57); the father was asked rather than the mother (adjOR: 1.14; 95% CI: 0.98-1.33); and the family lived in a rural area (adjOR: 1.10; 95% CI: 0.99-1.24). Overall, parents' BMI was not strongly associated with the underestimation of children's weight status, but there was a stronger association in some countries. DISCUSSION/CONCLUSION: Our study supplements the current literature on factors that influence parental perceptions of their child's weight status. Public health interventions aimed at promoting healthy childhood growth and development should consider parents' knowledge and perceptions, as well as the sociocultural contexts in which children and families live.
Asunto(s)
Obesidad Infantil , Índice de Masa Corporal , Peso Corporal , Niño , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Sobrepeso/epidemiología , Padres , Obesidad Infantil/diagnóstico , Obesidad Infantil/epidemiología , Encuestas y Cuestionarios , Organización Mundial de la SaludRESUMEN
Childhood obesity is a serious global health problem. Waist circumference (WC) and waist-to-height ratio (WHtR) reflect body fat distribution in children. The objectives of this study were to assess WC and WHtR in 7-year-old children and to determine body mass index (BMI), WC, and WHtR differences in children from 10 selected countries across Europe (Bulgaria, Czechia, Greece, Ireland, Latvia, Lithuania, North Macedonia, Norway, Spain, and Sweden) participating in the World Health Organization (WHO) Europe Childhood Obesity Surveillance Initiative (COSI). The 50th and 90th percentile of WC (according to COSI and "Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS" (IDEFICS) cutoff values) and WHtR above 0.5 were used as measures of abdominal obesity in a unique sample of 38,975 children aged 7.00-7.99 years. Southern European countries, including Greece and Spain, showed significantly higher BMI, WC, and WHtRin both genders (p < 0.0001) than Eastern and Northern Europe. The highest values for WC were observed in Greece (60.8 ± 7.36 cm boys; 60.3 ± 7.48 cm girls), North Macedonia (60.4 ± 7.91 cm boys; 59.0 ± 8.01 cm girls), and Spain (59.7 ± 6.96 cm boys; 58.9 ± 6.77 cm girls). WC and WHtRin may add an information about the occurrence of central obesity in children.
Asunto(s)
Obesidad Infantil , Estatura , Índice de Masa Corporal , Niño , Femenino , Humanos , Masculino , Obesidad Abdominal/epidemiología , Obesidad Infantil/epidemiología , Circunferencia de la Cintura , Relación Cintura-Estatura , Organización Mundial de la SaludRESUMEN
In order to address the paucity of evidence on the association between childhood eating habits and urbanization, this cross-sectional study describes urban-rural differences in frequency of fruit, vegetable, and soft drink consumption in 123,100 children aged 6-9 years from 19 countries participating in the fourth round (2015-2017) of the WHO European Childhood Obesity Surveillance Initiative (COSI). Children's parents/caregivers completed food-frequency questionnaires. A multivariate multilevel logistic regression analysis was performed and revealed wide variability among countries and within macroregions for all indicators. The percentage of children attending rural schools ranged from 3% in Turkey to 70% in Turkmenistan. The prevalence of less healthy eating habits was high, with between 30-80% and 30-90% children not eating fruit or vegetables daily, respectively, and up to 45% consuming soft drinks on >3 days a week. For less than one third of the countries, children attending rural schools had higher odds (OR-range: 1.1-2.1) for not eating fruit or vegetables daily or consuming soft drinks >3 days a week compared to children attending urban schools. For the remainder of the countries no significant associations were observed. Both population-based interventions and policy strategies are necessary to improve access to healthy foods and increase healthy eating behaviors among children.
Asunto(s)
Acceso a Alimentos Saludables , Obesidad Infantil , Bebidas Gaseosas , Niño , Estudios Transversales , Dieta , Conducta Alimentaria , Frutas , Humanos , Internacionalidad , Obesidad Infantil/epidemiología , Obesidad Infantil/prevención & control , Encuestas y Cuestionarios , Verduras , Organización Mundial de la SaludRESUMEN
Childhood overweight and obesity have significant short- and long-term negative impacts on children's health and well-being. These challenges are unequally distributed according to socioeconomic status (SES); however, previous studies have often lacked standardized and objectively measured data across national contexts to assess these differences. This study provides a cross-sectional picture of the association between SES and childhood overweight and obesity, based on data from 123,487 children aged 6-9 years in 24 countries in the World Health Organization (WHO) European region. Overall, associations were found between overweight/obesity and the three SES indicators used (parental education, parental employment status, and family-perceived wealth). Our results showed an inverse relationship between the prevalence of childhood overweight/obesity and parental education in high-income countries, whereas the opposite relationship was observed in most of the middle-income countries. The same applied to family-perceived wealth, although parental employment status appeared to be less associated with overweight and obesity or not associated at all. This paper highlights the need for close attention to context when designing interventions, as the association between SES and childhood overweight and obesity varies by country economic development. Population-based interventions have an important role to play, but policies that target specific SES groups are also needed to address inequalities.
Asunto(s)
Sobrepeso , Obesidad Infantil , Niño , Estudios Transversales , Humanos , Sobrepeso/epidemiología , Obesidad Infantil/epidemiología , Prevalencia , Clase Social , Factores Socioeconómicos , Organización Mundial de la SaludRESUMEN
Overweight and obesity prevalence in middle aged subjects in the Czech Republic is more than 50 per cent, obesity is found in around 26 per cent of population. Obesity management is a long-term and time-consuming process. Early start of the treatment can prevent continuous weight gain and development of co-morbidities. General practitioners see obese patients usually as the first and they represent the first point of contact for adults with obesity. The basis of obesity management is a change of the lifestyle with added pharmacotherapy and/or bariatric/metabolic surgery. The paper presents overview of methods in obesity diagnostics and management and possibilities of their use in GPs daily practice.
Asunto(s)
Obesidad , Sobrepeso , Adulto , República Checa/epidemiología , Humanos , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/diagnóstico , Obesidad/epidemiología , Atención Primaria de Salud , Aumento de PesoRESUMEN
It is unclear how dietary, physical activity and sedentary behaviors co-occur in school-aged children. We investigated the clustering of energy balance-related behaviors and whether the identified clusters were associated with weight status. Participants were 6- to 9-year-old children (n = 63,215, 49.9% girls) from 19 countries participating in the fourth round (2015/2017) of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative. Energy balance-related behaviors were parentally reported. Weight and height were objectively measured. We performed cluster analysis separately per group of countries (North Europe, East Europe, South Europe/Mediterranean countries and West-Central Asia). Seven clusters were identified in each group. Healthier clusters were common across groups. The pattern of distribution of healthy and unhealthy behaviors within each cluster was group specific. Associations between the clustering of energy balance-related behaviors and weight status varied per group. In South Europe/Mediterranean countries and East Europe, all or most of the cluster solutions were associated with higher risk of overweight/obesity when compared with the cluster 'Physically active and healthy diet'. Few or no associations were observed in North Europe and West-Central Asia, respectively. These findings support the hypothesis that unfavorable weight status is associated with a particular combination of energy balance-related behavior patterns, but only in some groups of countries.
Asunto(s)
Metabolismo Energético/fisiología , Conductas Relacionadas con la Salud , Obesidad/epidemiología , Niño , Análisis por Conglomerados , Europa (Continente) , Ejercicio Físico , Femenino , Humanos , Masculino , Organización Mundial de la SaludRESUMEN
BACKGROUND: Childhood overweight prevalence increases worldwide. The aim of the study was to clarify the change in underweight, overweight and obesity in seven year old Czech children since 1951. METHODS: Data on underweight, overweight and obesity prevalence were obtained using repeated cross-sectional surveys. In 1951-2001 six Czech National Anthropological Surveys were conducted. In years 2008 and 2010 the data were collected as a part of the WHO Europe initiated Childhood Obesity Surveillance Initiative (COSI). The data were evaluated according to WHO references (2007), in 2010 results were assessed also according to the Czech reference standards (1991). RESULTS: From 1951, overweight and obesity prevalence increased in both genders up to 2001. In 2008, a modest decrease in obesity and stable overweight prevalence in girls and in boys a slight increase in obesity and decrease in overweight were found. In 2010, a modest increase in obesity prevalence in girls achieving the levels assessed in 2001 and stable level of overweight were found; in boys the levels remained as in 2008. BMI z score increased significantly between 1951 and 2001. CONCLUSION: These results suggest stabilisation of obesity and overweight prevalence in the Czech Republic in 7 years old children during the last 10 years. Underweight prevalence has remained low.
Asunto(s)
Obesidad/epidemiología , Sobrepeso/epidemiología , Delgadez/epidemiología , Índice de Masa Corporal , Niño , Preescolar , República Checa/epidemiología , Femenino , Humanos , Masculino , Prevalencia , Estudios RetrospectivosRESUMEN
BACKGROUND: Childhood obesity is a global health problem. For monitoring of trends in obesity prevalence and comparison between countries standardized methods are necessary. WHO/Europe launched the "Childhood Obesity Surveillance Initiative" project in 2006 aiming to monitor childhood obesity and associated factors in European countries. This paper provides an overview of the situation in the Czech Republic with focus on diet and physical activity. METHODS AND RESULTS: The cohort included 1704 seven-year olds who were examined by paediatricians in 2008 (essential anthropometric measurements). Questionnaires on children's eating habits, physical activity, family, and school environment were filled in. Statistical methods employed. Multivariate regression with reduction of dimensionality (bi-directional orthogonal projection to the latent structure), one-way ANOVA. Low-fat milk intake frequency was positively correlated with BMI (p = 0.0001), while full-fat milk intake was negatively correlated (p = 0.005). These results probably reflect the change in the diet due to increasing BMI. Number of preventive school programmes aimed on health promotion was negatively associated with BMI (p = 0.026). CONCLUSIONS: Surprisingly, low-fat milk consumption was associated with higher BMI in seven years old children, while full-fat milk consumption was associated with lower BMI. School preventive programmes positively affect children's weight.
Asunto(s)
Dieta , Actividad Motora , Obesidad/epidemiología , Niño , Dieta/efectos adversos , Femenino , Humanos , Masculino , Obesidad/etiologíaRESUMEN
The mechanisms controlling fat depot-specific metabolism are poorly understood. During starvation of mice, downregulation of lipogenic genes, suppression of fatty acid synthesis, and increases in lipid oxidation were all more pronounced in epididymal than in subcutaneous fat. In epididymal fat, relatively strong upregulation of uncoupling protein 2 and phosphoenolpyruvate carboxykinase genes was found. In mice maintained both at 20 and 30 degrees C, AMP-activated protein kinase was activated in epididymal but did not change in subcutaneous fat. Our results suggest that AMPK may have a role in the different response of various fat depots to starvation.
Asunto(s)
Tejido Adiposo/metabolismo , Ácidos Grasos no Esterificados/metabolismo , Metabolismo de los Lípidos , Complejos Multienzimáticos/fisiología , Proteínas Serina-Treonina Quinasas/fisiología , Inanición/enzimología , Proteínas Quinasas Activadas por AMP , Animales , Peso Corporal , Epidídimo/metabolismo , Ácidos Grasos no Esterificados/genética , Regulación de la Expresión Génica , Canales Iónicos , Metabolismo de los Lípidos/genética , Masculino , Proteínas de Transporte de Membrana/genética , Ratones , Proteínas Mitocondriales/genética , Proteínas Serina-Treonina Quinasas/genética , Inanición/genética , Proteína Desacopladora 2RESUMEN
OBJECTIVE: To study whether or not the amount of vitamin A consumed affects the resting metabolic rate (RMR) and fat oxidation at rest in severely obese subjects. MATERIALS AND METHODS: In 239 obese subjects, RMR and fasting respiratory quotient (RQ) were determined by indirect calorimetry. Vitamin A consumption was calculated by the Czech PC program 'Nutrition'. The relation between the intake of vitamin A and RMR and RQ was tested by simple regression. High and low vitamin A consumers were defined by an upper and a lower quintile of vitamin A intake (>842 vs. <382 IU/day). RESULTS: The RMR for high and low vitamin A consumers were 7,693.5 +/- 1,557 and 7,479.8 +/- 1,708 kJ/day, respectively, while the corresponding values for fasting RQ were 0.800 +/- 0.077 and 0.809 +/- 0.049, respectively. No significant correlation was found between vitamin A consumption and both RMR and RQ. Similarly, there was no significant difference in RMR and RQ, as well as weight, body mass index, body fat, waist girth and food quotient between the two groups characterized by high and low consumption of vitamin A. However, the energy intake of high vitamin A consumers was significantly higher than that of low vitamin A consumers, due to higher carbohydrate and protein intake. CONCLUSION: There was no significant correlation between the vitamin A intake and RMR or RQ in obese subjects determined in this study.