^{10th International Conference on} Childhood Obesity and Nutrition June 12-13, 2017 Rome, Italy

Dr. Salcedo received her medical degree and master of public health from George Washington University. After medical school, Dr. Salcedo became a Fulbright Scholar where she conducted research on the growing prevalence of childhood obesity in Spain. Subsequently, she completed her residency in Pediatrics at Columbia University Medical Center. During residency, she was selected as a New Century Scholar from the Academic Pediatric Association while also serving as Chair of the Council of Residents and Board Member of the National Hispanic Medical Association (NHMA). Dr. Salcedo is a community-academic pediatrician at Union Community Health Center a Federally Health Qualified Center in Bronx, NY. Dr. Salcedo holds a faculty appointment as Assistant Professor of Pediatrics at The City University of New York (CUNY) School of Medicine. Dr. Salcedo’s research interest includes leading the development and implementation of childhood obesity prevention strategies specifically through healthy beverage initiatives.

Background: Residents of underserved communities, especially Blacks and Latinos, are disproportionately targeted by big soda companies. Youth participation in placed-based initiatives at worksites could prove useful in countering such marketing. Methods: In 2015, thirty-three youth participating a six-week summer employment program at an urban federally qualified health center (FQHC) assisted in the launch of the “Sugar Sweetened Beverage (SSB) Free Zone” at the FQHC. Through a train-the-trainer approach, youth received a formal education on SSBs; the youth created and implemented activities to educate and encourage staff along with patients to drink water and reduce their consumption of SSBs; in addition, the youth modeled positive SSB behavior throughout the health center. Results: The youth were 16.5 +/-2.0 years, 80.7% were female, 51.5% were Black, and 61.3% were Latino (n=31) showed that a greater proportion of youth correctly identified the sugar content of soda (57.6% to 87.1%; p-value = 0.0087) and that SSBs were related to liver disease (57.6% to 90.3%; p-value 0.0030). The frequency of drinking Iced-T (54.5% to 29.0%; p-value = 0.0389) decreased significantly. The proportion of youth motivated to consume water several times per day nearly tripled from 12.1% to 35.5% (p-value = 0.0275) and nearly all youth considered drinking less SSBs next year (66.7% vs. 96.7%; p-value = 0.0025). Conclusion: Involvement in a healthy beverage worksite environment may improve youth knowledge of SSBs, decrease consumption of some SSBs, and increase consumption of water. A relatively short worksite placed-based initiatives may result in favorable healthy behavioral changes and intentions among youth.

Background: Intracranial lesions (ICL) may effect hypothalamo-hypophyseal axis and lead to some neuro-endocrinological dysfunctions (hyperphagia, sleep disorders and hormonal dysfunctions). There’s very limited study about childhood obesity and ICL. Aim: Purpose of this study is to evaluate the incidence of ICL and their role in clinical symptoms and etiology in cases with morbid obesity (MO), who has admitted to the pediatric endocrinology department with this complaint. Method: One hundred twenty cases admitted to the pediatric endocrinology department with the complaint of MO in between 2002-2015 were included in this study. Detailed history and physical examination was performed, biochemical, hormonal parameters were evaluated. Contrast dynamic magnetic resonance imaging (CDMRI) was performed in order to visualize cranial pathologies. Results: 16.6 % of the patients had an ICL and 55% of these lesions were adenoma of the hypophysis. Prolactin levels were increased in the 6 patients but front hypophyseal hormone levels were in between normal range in the rest of the patients. Growth velocity of the patients was not affected. Conclusion: In our study incidence of ICL in children and adolescents with MO was much more higher than normal population. It’s an important finding that increment in body weight and body mass index appeared before clinical symptoms (especially decrement in growth velocity) in this cases. According to this data, we are of opinion that CDMRI is helpful in children with MO for early detection of the mass before it causes any clinical or neurological symptoms and prevention of future complications.

Laís Simino is a Nutritionist, PhD student at State University of Campinas – UNICAMP, and belongs to the Obesity and Comorbidities Research Center (OCRC). She belongs to the Laboratory of Metabolic Diseases, a laboratory that has been specializing in fetal programming research, especially triggered by maternal consumption of high fat diets.

Background: Changes in nutritional status in embryonic development and lactation period, as an excessive caloric intake, may lead to a phenomenon known as metabolic programming. Moreover, recent studies have shown that maternal obesity can have transgenerational effects, affecting not only the F1 generation, but also future generations. These effects, transmitted across generations, can be triggered by epigenetics mechanisms, such as miRNA expression. The miRNA Let-7 is shown to be involved in glucose homeostasis and here, we aimed to evaluate its expression in the liver of F1 offspring from obese mothers and the impacts of its modulation to the F2 generation. Methods: Female Swiss mice were fed with a HF or control diet for an adaptation period and through gestation and lactation. Weaned offspring received control diet until d28. Part of female offspring remained in control diet until mating to generate F2 offspring, which were weaned and received control diet until d28. Results: After the adaptation period, F0 females that consumed a HFD were divided in 2 groups: obese prone (OP) or obese resistant (OR), according to their weight gain. OP presented higher body weight, adiposity, serum glucose and NEFA than OR. Male and female offspring from OR and OP (OR-O and OP-O) showed an increase in body weight and adiposity at d28, but OP-O presented impaired glucose tolerance and insulin sensitivity, besides higher serum lipid biomarkers. F1 OP-O also had an overexpression in hepatic Let-7 and downregulation of Ampk, a predicted mRNA target of this miRNA. F2 offspring showed no alteration in body weight and adiposity, but F2 OP-O presented higher fasting glucose as early as d0 and d28, and an elevated liver fat content. Conclusion: Nutritional overload in critical periods of development leads offspring to epigenetic changes that may have transgenerational negative impacts.

Song Jae Lee and Sang Won Shin are interested in developing a uniform theory on the metabolic syndrome. As part of that project, they proposed glycation induced insulin resistance model and argued, in a correspondence to New England Journal of Medicine (NEJM), that glycation on insulin receptors on the surface of the cells would induce insulin resistance, against the more conventional notion of lipid induced insulin resistance. Recently, they reasoned in another correspondence to NEJM that dietetic factor is as important as environmental or genetic factor in inducing obesity.

Statement of the problem: Most previous researches on obesity were based on the premise that obesity is simply caused by imbalance between calorie intake and expenditure and thereby almost ignored the metabolism involved in obesity. As a result, we have no consensus yet on even the cause of the obesity. Methodology & Theoretical Orientation: We have reviewed the basics of the metabolism and physiology behind the fat accumulation in the fed state and fat mobilization in the fasted state in healthy individuals without any sign of insulin resistance—most children would be metabolically healthy. Findings: Fig. 1 illustrates the healthy metabolic transition diagram for carbohydrate rich diet (CRD). The postprandial hyperglycemia and subsequent postprandial hyperinsulinemia induced when relying on CRD would enhance fat accumulation in the fed sate. Postprandial hyperinsulinemia would then transition to basal hyperinsulinemia—a relatively low level of insulin in the fasted state—and not only inhibit lipolysis, lowering the level of plasma acids, but also suppress hepatic glucose production (HGP), lowering the level of plasma glucose. The enhanced fat accumulation in the fed state combined with limited lipolysis in the fasted state would lead to net weight gain. Furthermore, the low level of plasma fatty acids and glucose—the energy fuel—in the fasted state is likely to induce intense hunger and physiological weakness, which are in turn likely to induce overfeeding and physical inactivity, respectively, leading to positive energy balance and eventual obesity. Conclusion & Significance: Obesity is a metabolic disorder proceeding in the physiological condition of hyperglycemia and subsequent hyperinsulinemia induced when relying on CRD. Heathy obesity exhibiting no sign of insulin resistance yet, frequently observed in children, would be treated relatively easily by carbohydrate restriction or more specifically by reliance on fat rich diet (FRD).

Rejane Figueiredo is a statistician, with master degree in Statistical and Phd in Epidemiology. Her interest areas are obesity in childhood and adolescence, metabolism and cancer. She is working at The Finnish Health in Teens study (Fin-HIT). Fin-HIT is a cohort study including more than 10 000 Finnish preadolescents in the age 9-12 years. Fin-HIT enables to study a series of etiological hypotheses regarding the role of exposures and mediating factors, including genetic susceptibility, epigenetics, and microbiota on the development of body size.

Aims: Little is known about impact of maternal alcohol and tobacco consumption on adolescents’ body size. The purpose of this study was to evaluate whether maternal alcohol or tobacco consumption is associated with their children’s body size in adolescence, assessed by Body Mass Index (BMI). Methods: This study was conduct in subjects recruited into the Finnish Health in Teens cohort (Fin-HIT) between 2011 and 2014. A total of 4,525 subjects aged between 9 and 14 years and their mothers or female adults responsible for the children were analysed. Relative risks (RR) and 95% confidence intervals (CI) were estimated using Multinomial Logistic Regression. Results: Most children were normal weight (74.5%), 10.6% were underweight and 14.9% were overweight or obese. Among mothers, 50.6% were never smokers, 35.7% were former smokers, and 13.7% were current smokers. Alcohol consumption was classified by Alcohol Use Disorders Identification Test (AUDIT), 12.7% were abstainers (score=0), 65.0% were low-moderate drinkers (scores 1- 4) and 22.3% were harmful drinkers (scores ≥ 5). There were statistically significant associations between currently smoking mothers and children’s overweight (RR=1.36; 95% CI: 1.05-1.75). There was an inverse association between maternal former smoking and children’s underweight (RR = 0.70; CI: 0.56–0.87) compared to never smoker mothers. Among children in puberty, abstainer mothers were more likely to have underweight children compared to low-moderate mothers (RR=1.57; 95% CI: 1.03-2.41). Conclusion: Current smoker mothers were associated with children’s overweight and former-smoker mothers were inversely associated with the children’s underweight. Being an abstainer mother was associated with the children’s underweight in puberty stage. If other studies confirm these results, public health interventions aiming at healthy weight of adolescents should target the whole family, not only the adolescents themselves.

She has studied nutrition for about 10 years. She has got her bachelor, master and PhD in nutrition from Ahvaz University of medical sciences, Tabriz University of medical sciences and Shahid Beheshty University of medical sciences respectively. She has been teaching at Shiraz University of medical sciences since 2010. Most of her researches are on obesity and chronic diseases such as diabetes, hypertension and so on. She is interested in both prevention and control of obesity, metabolic syndrome and diabetes and its complications.

Statement of the problem: Increasing prevalence of childhood obesity has been associated in part to diet quality. This study examined the relationship between body composition and nutritional quality of the meals, in Primary school children in Shiraz (Iran). Methodology and theoretical orientation: This cross-sectional study was done on 431 primary school student (219 boys and 212 girls) aged between 6 and 10 years. Using standard methods anthropometric indices including weight, height, body fat and waist circumference (WC) were measured and body mass index (BMI) was calculated. Also, three 24-h dietary records (2 weekdays and 1 weekend) were taken. The linear regression test was used to determine relationship between percent of energy intake of macronutrients in each meals with body composition. Data were analyzed using SPSS version 19. Findings: The mean age of participants was 7.8±1.03 years and the mean BMI was 16.03±2.71 kg/m2. Results showed that WC was inversely associated with the percentage of energy intake from breakfast (β= -2.04; CI: -4, 0.002) but it was not significant anymore after adjustment for total energy intake. Also the percentage of energy intake from fat content of snacks were significantly associated with BMI (β= 1.47; CI: (0.36, 2.59), and WC (β= 0.43; CI: 0.02, 0.85) even after adjusting for total energy intake. There were no associations between other meals quality and body composition indices. Conclusion and significance: Our study showed that snacks quality but no other meals were associated with WC and BMI, and having fatty snacks was related to central and abdominal obesity among children

Parisa Keshani is a Ph.D. candidate in nutrition sciences at School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran. Her research interests are community nutrition, community-based nutrition education and promotion issues and behavioral changes.

Introduction Diet quality in children has been associated with prevention of obesity during adulthood. The aim of this study was to examine diet quality and its association with weight status among Iranian adolescents. Methods The revised-children diet quality index (RC-DQI) was used to determine diet quality in a representative sample of 13 to 15 years old adolescents (n=480) selected by stratified sampling from four educational districts of Shiraz, Iran. Food intake was determined by a valid food frequency questionnaire. Overweight and obesity were defined as a body mass index (BMI) at or above the 85th and 95th percentile respectively, for adolescents of the same age and sex. All statistical analysis were conducted using SPSS 19 and food analyses were done using modified nutritionist 4 for Iranian food. Linear and Logistic regressions were used to explore the relation between diet quality and its components or BMI. P-value less than 0.05 was considered statistically significant. Results The participants mean age was 14.7 years and 56% of students were girls. The overall prevalence of overweight and obesity was 16.16%. Mean RC-DQI score was 58 points (range_28 to 89). Diet quality scores were higher in girls (p=0.02) and were inversely associated with adolescents weight (p=0.01). Overweight+obesity was significantly associated with poor diet quality: OR of 1.54 (95 % CI 1.02 2.36). There was an inverse association between diet quality and sugar consumption (OR 0.65, 95% CI 0.59 to 0.72). Furthermore, diet quality score was positively associated with dairy products (OR 1.40, 95% CI 1.04 to 2.17), fruits (OR 1.75, 95% CI 1.16 to 2.73), and vegetables (OR 1.55, 95% CI 1.02 to 2.36). Conclusion There is an association between diet quality and obesity in adolescents. Childhood Obesity might be prevented if diet quality based on dietary guidelines have been improved among adolescents.

I am student in psychology in M.A. from two years ago I am working as a psychologist in a children obesity clinic.in this clinic, we are working in a spectrum of obese children with a psychological approach.

Objective: purpose of present study was to comparison anxiety, depression and lifestyle between obese and normal weight children. Material & Methods: sample were 240 children (120 girls, 120 boys) aged 10-13 including 120 obese children with Body Mass Index (BMI) higher than 24.5 and 120 normal weight children with BMI around 16.3-24.4 .they selected from Rasht / Iran second grade school during 2015-2016. Body Mass Index (BMI) formula was used to assess obesity and revised children’s obvious anxiety scale by Reynolds& Richmond, Maria Coax depression inventory (CDI) and (ISCOLE) questionnaire were used to measure anxiety, depression and lifestyle. The data were analyzed through one way covariance analysis. Results: The finding of the present study showed that there was no statistically significant difference in anxiety and depression between two groups of obese and normal weight children but a statistically significant difference in their lifestyle was clear. Conclusion: considering a difference between obese and normal weight children’s lifestyle, future studies and interventions on school-age children’s lifestyle is essential.