Übergewicht und Adipositas zeigen bei Kindern und Jugendlichen eine hohe Prävalenz und Persistenz. Entsprechende Therapien sind kaum individualisiert und zeigen nur moderate Erfolge. Die Psychopathologie bleibt zumeist unberücksichtigt. Die vorliegende Studie hat die Psychopathologie von Jugendlichen mit Übergewicht und Adipositas (N = 201, Alter 12 – 17 Jahre) vor einer Gewichtsreduktionsbehandlung erhoben und Alters- sowie Geschlechtseffekte untersucht. Mittels Fragebögen wurden selbstberichtet die allgemeine Symptombelastung, Essstörungs- und allgemeine Psychopathologie, gewichtsbezogene Selbststigmatisierung und die körperliche und psychische Lebensqualität erhoben. Mädchen zeigten hypothesenkonform ein höheres Maß an gewichtsbezogener Selbststigmatisierung und eine stärkere Essstörungspsychopathologie als Jungen. Ältere Jugendliche berichteten eine geringere Lebensqualität als jüngere. Vergleiche zu Referenzgruppen aus Bevölkerungs- und Normierungsstichproben zeigten auffälligere Werte bei Jugendlichen mit Übergewicht und Adipositas für alle untersuchten Parameter. Eine auffällige Psychopathologie ist demzufolge ein wichtiges Korrelat bei Jugendlichen mit hohem Gewichtsstatus und ein potenzieller Einflussfaktor auf den Erfolg einer Gewichtsreduktionsbehandlung. Zukünftige Studien sollten die Psychopathologie bei Übergewicht und Adipositas weiter differenzieren und therapeutische Ressourcen evaluieren. / Overweight and obesity in children and adolescents are highly prevalent and persistent. Current weight loss treatments are rarely individualized and show only small to moderate efficacy. Only rarely, psychopathological parameters are considered. The present study evaluated the psychopathology of adolescents with overweight and obesity (N = 201, ages 12 – 17 years) prior to obesity treatment. The data were analyzed for age and sex effects. Self-report questionnaires assessed general symptom burden, eating disorder and general psychopathology, weight-related self-stigmatization, and physical and mental quality of life. Girls showed higher rates of weight-related self-stigmatization and higher disordered eating behavior compared to boys. Older adolescents reported a lower quality of life compared to younger adolescents. In normative comparisons with population-based samples and norms, adolescents with overweight and obesity showed significantly adverse outcomes in all parameters. Thus, this study identified psychopathology as an important factor in adolescents with high weight status that may affect obesity treatment. Future studies should examine psychopathology more differentially and determine therapeutic resources in adolescent overweight and obesity.

Übergewicht und Adipositas bei Kindern und Jugendlichen stellen ein weltweit zunehmendes Gesundheitsproblem dar und sind zur häufigsten chronischen Erkrankung des Kindes- und Jugendalters in der entwickelten Welt geworden. Nicht nur die Prävalenz der Adipositas ist in den letzten 25 Jahren gestiegen, sondern auch der absolute BMI. Die kindliche Adipositas stellt nicht nur ein kosmetisches Problem dar, sondern einen Risikofaktor etwa für Herzerkrankungen, Diabetes mellitus oder Störungen des Bewegungsapparates. Voraussetzung für erfolgreiche Präventions- und Interventionsprogramme ist ein Bewusstsein für Übergewicht und der Wille zur Gewichtsreduktion bei den betroffenen Kindern sowie bei deren Eltern. Diese Dissertation hat daher zwei Ziele: Zunächst wird untersucht, wie Kinder sich und ihren Körper im Vergleich zum tatsächlichen Gewichtsstatus einschätzen. Darüber hinaus wird der Frage nachgegangen, ob Eltern das Vorliegen von Übergewicht oder Adipositas bei ihrem Kind erkennen. Die Dissertation besteht aus einem Artikel. Darin wird gezeigt, dass die meisten Kinder und Jugendlichen sowie ihre Eltern die Adipositas als ein Gesundheitsproblem erkennen. Eine Mehrheit der Kinder und Jugendlichen schätzt ihren eigenen Gewichtsstatus realistisch ein. Die Mehrheit der Eltern erkennt zumindest Übergewicht bei ihrem Kind. Das Ausmaß wird jedoch häufig unterschätzt.

Background. Maternal obesity and physical inactivity have been identified as correlates of overweight and obesity and physical inactivity in older preadolescents; however, no study has explored this relationship in Hispanic preadolescents. Furthermore, the relation between maternal physical activity (PA) and blood pressure (BP) in Hispanic preadolescents has not been examined. Purpose. This study aimed to assess the associations between Hispanic mothers’ PA and body mass index (BMI) and their preadolescents’ PA, screen time, BP, and BMI. Methods. Data of 118 mother-child (aged 2–10 years) dyads enrolled in a crosssectional study of metabolic syndrome in Hispanic preadolescents at a community health center in Johnson City, TN were used. Parent and child questionnaires were used to ascertain mothers’ BMI and PA and preadolescents’ PA and screen time.

<p>Gojaznost i fizička neaktivnost su među najznačajnijim faktorima rizika za hronične nezarazne bolesti, koje su vodeći javnozdravstveni problemi u svetu i kod nas. Cilj istraživanja je procena prevalencija gojaznosti, predgojaznosti i fizičke neaktivnosti u slobodno vreme kod odraslog stanovni&scaron;tva Vojvodine, kao i procena povezanosti demografskih, socio-ekonomskih i bihevioralnih faktora sa gojazno&scaron;ću i fizičkom neaktivno&scaron;ću u slobodno vreme. Istraživanje predstavlja deo Istraživanja zdravlja stanovni&scaron;tva Srbije iz 2013. godine koje je sprovedeno od strane Ministarstva zdravlja Republike Srbije, kao studija preseka na reprezentativnom stratifikovanom dvoetapnom uzorku. Istraživanjem je obuhvaćeno 3337 osoba uzrasta 20 i vi&scaron;e godina sa prebivali&scaron;tem u Vojvodini. Instrument istraživanja su bili upitnici konstruisani u skladu sa upitnikom Evropskog istraživanja zdravlja, a podaci o telesnoj masi i telesnoj visini su dobijeni merenjem. Rezultati istraživanja su pokazali da je u 2013. godini svaka četvrta odrasla osoba u Vojvodini bila gojazna, a svaka treća osoba predgojazna. U odnosu na 2000. godinu nije do&scaron;lo do značajnog povećanja prevalencija gojaznosti i predgojaznosti, mada su se prevalencije održale na visokom nivou. &Scaron;anse za gojaznost su rasle do 75-te godine života, a nakon toga opadaju. Najveću &scaron;ansu za gojaznost su imale osobe u braku ili vanbračnoj zajednici. Gojaznost je povezana sa socio-ekonomskim karakteristikama samo kod žena. Značajni prediktori gojaznosti kod žena su bili najniži nivo obrazovanja, lo&scaron; materijalni status i nezaposlenost/ekonomska neaktivnost. Biv&scaron;i pu&scaron;ači su imali oko dva puta veću &scaron;ansu za gojaznost u odnosu na pu&scaron;ače, dok je &scaron;ansa za gojaznost bila manja kod osoba koje su u poslednjih 12 meseci konzumirale alkohol. Fizička neaktivnost u slobodno vreme, kao i fizička neaktivnost u domenu transporta povećavaju verovatnoću za pojavu gojaznosti. Prevalencija fizičke neaktivnosti u slobodno vreme je bila veoma visoka (89%). &Scaron;anse za fizičku neaktivnost u slobodno vreme su se značajno povećavale sa staro&scaron;ću. Prediktori fizičke neaktivnosti su bili ženski pol, život u braku/vanbračnoj zajednici, nizak nivo obrazovanja i lo&scaron; materijalni status. Pu&scaron;ači su imali oko dva puta veću &scaron;ansu da budu fizički neaktivni u odnosu na nepu&scaron;ače, dok je stanovni&scaron;tvo koje je konzumiralo alkohol imalo manju &scaron;ansu da bude fizički neaktivno u slobodno vreme. Gojazne osobe, kao i fizički neaktivne osobe su lo&scaron;ije ocenjivale svoje zdravlje. Gojazne osobe (bez obzira na nivo fizičke aktivnosti) su imale oko 3,5 puta veću &scaron;ansu za pojavu multimorbiditeta u odnosu na osobe sa optimalnom telesnom masom koje su fizički aktivne u slobodno vreme. Gojazne osobe su imale četiri puta veću &scaron;ansu za arterijsku hipertenziju i skoro četiri puta veću &scaron;ansu za dijabetes u odnosu na normalno uhranjene osobe. Gojaznost i fizička neaktivnost u slobodno vreme su značajni javnozdravstveni problemi kod odraslog stanovni&scaron;tva u Vojvodini na &scaron;ta ukazuju visoke prevalencije, velika zastupljenost među vulnerabilnim kategorijama stanovni&scaron;tva, nejednakost u frekvenciji između različitih socio-ekonomskih kategorija stanovni&scaron;tva, preventabilnost, povezanost sa lo&scaron;ijom samoprocenom zdravlja i hroničnim bolestima.</p> / <p>Obesity and physical inactivity are one of the most significant risk factors for chronic noncommunicable diseases, which are one of the most important public health problems in the world and also in our country. The aim of the study was to evaluate the prevalence of obesity and leisure time physical inactivity among the adult population of Vojvodina, and also to evaluate the association of demographic, socio-economic and behavioral factors with obesity and leisure time physical inactivity. The study is part of the National Health Survey of Serbia, a cross-sectional study conducted in year 2013 by the Ministry of Health of Republic of Serbia on a representative stratified two-stage sample. The study included 3337 participants aged 20 and over who resided in Vojvodina. The instruments were questionnaires designed in line with the European Health Interview Survey questionnaire, and data on body mass and body height were measured. Results showed that in year 2013 every fourth adult person in Vojvodina was obese, and every third overweight. There was no increase in prevalences compared to year 2000, although they remained high. Odds of obesity increased until age 75, and afterwards decreased. The highest odds of obesity were among persons who were married or living with a partner. Obesity was associated with socio-economic factors only among women. The predictors of obesity among women were: low level of education, low wealth index and unemployment/economical inactivity. Former smokers had two times higher odds of obesity, compared to smokers, while persons who consumed alcohol in the last 12 months had lower odds to be obese. Leisure time physical inactivity, as well as transport related physical inactivity were important predictors of obesity. Prevalence of leisure time physical inactivity was very high (89%). With increasing age, odds of physical inactivity increased. Predictors of physical inactivity were female gender, being married or living with a partner, low level of education and low wealth index. Smokers had two times higher odds of physical inactivity in comparison to nonsmokers, while persons who consumed alcohol in the last 12 months had lower odds of physical inactivity. Obese and physically inactive persons were more likely to assess their health as average, poor or very poor. Obese persons (regardless of the level of physical activity) had three and a half times higher odds of multimorbidity compared to persons with healthy weight who were physically active. Obese persons had four times higher odds of arterial hypertension and almost four times higher odds of diabetes. Obesity and physical inactivity are important public health problems among the adult population in Vojvodina due to high prevalences in population, especially among vulnerable groups, inequality in frequency among different socio-economic groups, preventability and association with poor health perception and chronic diseases.</p>

Contexte : La prévalence de l'asthme et des allergies a augmenté au cours de ces dernières décennies,en particulier chez les enfants et dans le monde occidental. Cette augmentation de la prévalence estdevenue un problème très grave de santé publique et pourrait être liée à une combinaison deprédisposition génétique, de facteurs environnementaux et des changements dans le mode de vie, ycompris les habitudes alimentaires. Cependant, les études épidémiologiques concernant les maladiesallergiques chez l’enfant en relation avec l'alimentation sont rares.Objectifs : Ce travail analyse la littérature récente traitant l'alimentation, les habitudes alimentaires et lanutrition en relation avec les maladies allergiques chez les enfants en tenant compte de la méthodologieutilisée pour évaluer les habitudes alimentaires. En outre, il évalue en premier lieu l'association entre leshabitudes alimentaires et l'asthme et les maladies allergiques et en deuxième lieu la relation entrel'asthme et le surpoids/l’obésité dans l’étude des six villes françaises.Méthodes : MEDLINE/PubMed et Cochrane Database of Systematic Reviews ont été utilisés pour larevue de la littérature concernant l'alimentation et les maladies allergiques. Des études transversales ontété menées à Bordeaux, Clermont-Ferrand, Créteil, Marseille, Reims, Strasbourg sur 7 432 enfantsscolaires, choisis au hasard et âgés de 9-11 ans. Des questionnaires adressés aux parents, basés surl'Enquête internationale sur l'asthme et les allergies dans l'enfance (ISAAC), ont été utilisés pourrecueillir des informations sur les maladies allergiques et les facteurs de risque potentiels, y compris unquestionnaire de fréquence alimentaire pour évaluer les habitudes alimentaires des enfants. Des testscutanés aux allergènes communs ont été effectués afin d'identifier l'existence d'une hypersensibilitéallergique et des tests d’effort ont été effectués pour évaluer l'asthme à l’effort.Résultats : Les apports moyens de 12 principaux produits alimentaires consommés par les élèves ontété calculées et trois profils alimentaires ont été extraits par analyse en composantes principales:l’alimentation proche du régime méditerranéen, l’alimentation à base d’oméga-3 et de poissons gras etl’alimentation non équilibrée. Les risques relatifs des maladies allergiques ont été estimés par des odds7ratios (OR) et le contrôle des facteurs de confusion a été réalisé par des régressions logistiques. Lessifflements, l’asthme et la rhinite sont plus fréquents chez les garçons que chez les filles. En analysemultivariée, l’alimentation à base d’oméga-3 avait un effet protecteur contre l'asthme vie et l’asthmesévère chez les enfants (OR ajusté: 0,77 ; IC 95%: [0,62 -0,96] et OR ajusté: 0,55 ; IC 95%: [0,32 -0,94]respectivement). L’adhérence à une alimentation proche du régime méditerranéen et riche enantioxydants semble avoir un effet protecteur contre les maladies allergiques. Le surpoids et l’obésitéont été positivement associés avec l’asthme vie chez les enfants ne présentant pas de sifflements (ORajusté: 1,98 ; IC 95%: [1,06 -3,70]) et ont été de même associé positivement avec la rhinite vie et larhinite 12 mois chez les enfants présentant des sifflements (OR ajusté: 1,63 ; IC 95%: [1,09 -2,45] etOR ajusté: 2,20 ; IC 95%: [1,13 -4,27] respectivement), mais pas avec l’asthme à l’effort.Conclusion: Dans l'ensemble, l'adhésion à un régime alimentaire sain, y compris les antioxydants et lesoméga-3 semble avoir un effet protecteur sur l'asthme et les allergies chez les enfants. Le surpoids etl’obésité a été associé significativement avec l’asthme chez les enfants non atopiques et la rhiniteallergique chez les enfants atopiques. Des études prospectives longitudinales sont donc nécessaires pourpouvoir évaluer les relations de causalité. / Background: The prevalence of asthma and allergy has risen in recent decades, especially amongchildren and in the Western world. This increase in prevalence has become a serious public healthproblem and might be related to a combination of genetic predisposition, environmental factors, andlifestyle changes, including dietary habits. However, epidemiological studies concerning childhood dietrelatedallergic diseases are scarce.Objectives: This work reviews published literature dealing with diet, dietary patterns and nutrition inrelation with allergic diseases among children taking into account the methodology used to evaluatedietary patterns. Moreover, it assesses primary the association between food patterns and asthma andallergic diseases and secondary the relation between asthma and overweight/obesity in the French SixCities Study.Methods: MEDLINE/PubMed and Cochrane Database of Systematic Reviews were used for theliterature review concerning diet and allergic diseases. Cross-sectional studies were conducted inBordeaux, Clermont-Ferrand, Créteil, Marseille, Reims, and Strasbourg among 7432 randomly selectedschoolchildren aged 9-11 years. Parental questionnaires, based on the International Study on Asthmaand Allergies in Childhood (ISAAC), were used to collect information on allergic diseases and potentialrisk factors including a food frequency questionnaire to evaluate dietary habits. Skin prick testing tocommon allergens was performed to identify the existence of an allergic hypersensitivity and exercisetest was performed to assess Exercise-Induced Asthma (EIA).Results: The mean intakes of 12 main food items were calculated and three food patterns wereextracted by principal component analysis labeled: the Mediterranean-like diet, the diet rich in omega-3fatty acids and the unhealthy diet. Relative risks of allergic diseases were estimated as odds ratios (OR)and confounders control was performed with multiple logistic regressions. Wheezing, asthma andrhinitis were more prevalent in boys than in girls. In the multivariate analysis, diet rich in omega-3 wasprotective for lifetime and severe asthma in children (adjusted OR: 0.77; 95% CI: [0.62 -0.96] and9adjusted OR: 0.55; 95% CI: [0.32 -0.94] respectively). Adherence to the Mediterranean-like diet rich inantioxidants tended to be protective against allergic diseases. Overweight and obesity were positivelyassociated with lifetime asthma in non-wheezing children (adjusted OR: 1,98 ; 95% CI: [1,06 -3,70])and were also positively associated with lifetime and past year allergic rhinitis in wheezing children(adjusted OR: 1.63; 95% CI: [1.09 -2.45] and adjusted OR: 2.20; 95% CI: [1.13 -4.27] respectively), butwere not associated with EIA.Conclusion: Overall, adherence to a healthy diet including antioxidants and omega-3 fatty acids seemsto have a protective effect on asthma and allergy in childhood. Overweight and obesity weresignificantly associated with asthma in non-atopic children and with allergic rhinitis in atopic children.Prospective longitudinal studies should be necessary for evaluation of causal relations.

SELECTED NUTRIENTS IN ETIOLOGY, PREVENTION AND TREATMENT OF OBESITY The 21st century pandemic of obesity is given by to the obesitogenic environment that helps to develop a positive energy balance, where the energy intake of an individual chronically exceeds his energy need, ie energy expenditure. There is an increase in body weight by increased or abnormal body fat accumulation in the body. Preventing the development of obesity is aimed at achieving energy balance, in the case of existing overweight or obesity, the treatment lies in inducing and maintaining a negative energy balance for some time, ie stimulating energy expenditure and reducing energy intake. Selected diet determines not only energy intake, but its individual nutrients can also partially affect energy expenditure and fat tissue physiology. The aim of this work is to describe and experimentally verify some nutrients that could help in weight reduction and physiological function of adipose tissue. Based on the literature data, 19 active substances or mixtures were considered. A mixture of ω-3 polyunsaturated fatty acids (ω-3 PUFA), eicosapentaenoic acid and docosahexaenoic acid, in a daily dose of 0.6 g, in the form of fish oil in a certified food supplement was chosen as the most suitable for the experiment. In a 12-week, three-arm, parallel...

Background: Overweight and obesity are significant public health concerns that are prevalent in younger age cohorts. Preventive or therapeutic interventions are difficult to implement and maintain over time. On the other hand, the majority of adolescents in the United States have a smartphone, representing a huge potential for innovative digitized interventions, such as weight loss programs delivered via smartphone applications. Although the number of available smartphone applications is increasing, evidence for their effectiveness in weight loss is insufficient. Therefore, the proposed study aims to assess the efficacy of a gamification-based smartphone application for weight loss in overweight and obese adolescents. The trial is designed to be a phase II, single-centre, two-arm, triple-blinded, randomized controlled trial (RCT) with a duration of 6 months. Method: The intervention consists of a smartphone application that provides both tracking and gamification elements, while the control arm consists of an identically designed application solely with tracking features of health information. The proposed trial will be conducted in an urban primary care clinic of an academic centre in the United States of America, with expertise in the management of overweight and obese adolescents. Eligible adolescents will be followed for 6 months. Changes in body mass index z score from baseline to 6 months will be the primary outcome. Secondary objectives will explore the effects of the gamification-based application on adherence, as well as anthropometric, metabolic and behavioural changes. A required sample size of 108 participants (54 participants per group) was calculated. Discussion: The benefits of the proposed study include mid-term effects in weight reduction for overweight and obese adolescents. The current proposal will contribute to fill a gap in the literature on the mid-term effects of gamification-based interventions to control weight in adolescents. This trial is a well-designed RCT that is in line with the Consolidated Standards of Reporting Trials statement.