Background: Childhood obesity is a serious health concern affecting over 155 million children in developed countries worldwide. Childhood obesity is associated with significantly increased risk for development of type 2 diabetes, cardiovascular disease and psychosocial functioning problems (i.e., depression and decreased quality of life). The two major strategies for management of obesity and associated metabolic abnormalities are lifestyle modification and pharmacologic therapy. This paper will provide the background rationale and methods of the REACH childhood obesity treatment program.
Methods/design: The REACH study is a 2-year multidisciplinary, family-based, childhood obesity treatment program. Seventy-two obese adolescents (aged 10-16 years) and their parents are being recruited to participate in this randomized placebo controlled trial. Participants are randomized to receive either metformin or placebo, and are then randomized to a moderate or a vigorous intensity supervised exercise program for the first 12-weeks. After the 12-week exercise program, participants engage in weekly exercise sessions with an exercise facilitator at a local community center. Participants engage in treatment sessions with a dietitian and social worker monthly for the first year, and then every three months for the second year. The primary outcome measure is change in body mass index and the secondary outcome measures are changes in body composition, risk factors for type 2 diabetes and cardiovascular disease, changes in diet, physical activity, and psychosocial well-being (e.g., quality of life). It is hypothesized that participants who take metformin and engage in vigorous intensity exercise will show the greatest improvements in body mass index. In addition, it is hypothesized that participants who adhere to the REACH program will show improvements in body composition, physical activity, diet, psychosocial functioning and risk factor profiles for type 2 diabetes and cardiovascular disease. These improvements are expected to be maintained over the 2-year program.
Discussion: The findings from this study will advance the knowledge regarding the long-term efficacy and sustainability of interventions for childhood obesity.
Trial Registration: ClinicalTrials.gov number NCT00934570.
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http://dx.doi.org/10.1186/1471-2458-9-434 | DOI Listing |
J Rural Health
January 2025
Avera Research Institute, Avera McKennan Hospital, Sioux Falls, South Dakota, USA.
Purpose: The Environmental influences on Child Health Outcomes (ECHO) Cohort has enrolled over 60,000 children to examine how early environmental factors (broadly defined) are associated with key child health outcomes. The ECHO Cohort may be well-positioned to contribute to our understanding of rural environments and contexts, which has implications for rural health disparities research. The present study examined the outcome of child obesity to not only illustrate the suitability of ECHO Cohort data for these purposes but also determine how various definitions of rural and urban populations impact the presentation of findings and their interpretation.
View Article and Find Full Text PDFMol Med
December 2024
Center for Cancer Immunology, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
Metabolic syndrome (MetS) is an indicator and diverse endocrine syndrome that combines different metabolic defects with clinical, physiological, biochemical, and metabolic factors. Obesity, visceral adiposity and abdominal obesity, dyslipidemia, insulin resistance (IR), elevated blood pressure, endothelial dysfunction, and acute or chronic inflammation are the risk factors associated with MetS. Abdominal obesity, a hallmark of MetS, highlights dysfunctional fat tissue and increased risk for cardiovascular disease and diabetes.
View Article and Find Full Text PDFJ Pediatr Urol
December 2024
Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA, United States; Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States. Electronic address:
Background: The prevalence of pediatric urolithiasis has increased rapidly, leading to more emergency department (ED) visits across the United States.
Objective: The purpose of this study was to determine emergency care practices for children and adolescents with urinary stones and characteristics associated with management.
Methods: We performed a cross-sectional study of the 2021 Nationwide Emergency Department Sample to identify pediatric patients (≤21 years) presenting to an ED in the United States with a primary diagnosis of urinary stone disease.
Obes Res Clin Pract
December 2024
Department of General Practice, Geriatric Hospital Affiliated To Wuhan University of Science and Technology, Wuhan 433000, China. Electronic address:
Background: microRNAs (miRNAs) could mediate the glucose and lipid metabolism progress in metabolic syndrome (MetS).
Objectives: To analyze the value of miRNA (miR)-21-5p for MetS diagnosis in children with obesity. Function of miR-21-5p has been explored by the prediction of target genes and functional and pathway enrichment analysis.
J Pediatr Surg
December 2024
Valley Vein Health Center, 840 Delbon Ave, Turlock, CA 95382, USA; University of Central Florida, College of Medicine, 6850 Lake Nona Blvd, Orlando, FL 32827, USA.
Background: Endovascular radiofrequency ablation (RFA) and Endovascular Laser Ablation (EVLA) are minimally invasive methods to safely treat symptomatic varicose veins in pediatric patients. This research aimed to review the management of pediatric patients with venous insufficiency, evaluate the outcome, and determine the efficacy, convenience, and safety of ablation procedures in an outpatient setting.
Methods: A retrospective chart review of all patients seen at six locations from 2013 to 2024 was completed.
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