1.
Assessment of the Effectiveness of a Computerised Decision-Support Tool for Health Professionals for the Prevention and Treatment of Childhood Obesity. Results from a Randomised Controlled Trial.
Moschonis, G, Michalopoulou, M, Tsoutsoulopoulou, K, Vlachopapadopoulou, E, Michalacos, S, Charmandari, E, Chrousos, GP, Manios, Y
Nutrients. 2019;11(3)
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Plain language summary
Obesity is related to the increased risk for chronic diseases and to nutrient insufficiencies, a paradox that has been characterised as the “double burden of malnutrition”. The aim of this study was to examine the effectiveness of a computerised decision-support tool as a means of childhood obesity management. The effectiveness of the decision-support tool was assessed through a pilot randomised controlled intervention trial. The study recruited a total sample of 80 children (obese or overweight) with an age range between 6 and 12 years. The participants were allocated to two study groups – intervention group and control group. Results indicate that a computerised decision-support tool, designed to assist paediatric healthcare professionals in providing personalised nutrition and lifestyle optimisation recommendations to overweight or obese children and their parents, can result in favourable changes to certain dietary intake and anthropometric indices in the children that received the intervention. Authors conclude that the computerised decision-support tool resulted in improvement of the children’s dietary intake and body mass index. Hence, the tool can support clinicians to improve the effectiveness of care.
Abstract
We examined the effectiveness of a computerised decision-support tool (DST), designed for paediatric healthcare professionals, as a means to tackle childhood obesity. A randomised controlled trial was conducted with 65 families of 6⁻12-year old overweight or obese children. Paediatricians, paediatric endocrinologists and a dietitian in two children's hospitals implemented the intervention. The intervention group (IG) received personalised meal plans and lifestyle optimisation recommendations via the DST, while families in the control group (CG) received general recommendations. After three months of intervention, the IG had a significant change in dietary fibre and sucrose intake by 4.1 and -4.6 g/day, respectively. In addition, the IG significantly reduced consumption of sweets (i.e., chocolates and cakes) and salty snacks (i.e., potato chips) by -0.1 and -0.3 portions/day, respectively. Furthermore, the CG had a significant increase of body weight and waist circumference by 1.4 kg and 2.1 cm, respectively, while Body Mass Index (BMI) decreased only in the IG by -0.4 kg/m². However, the aforementioned findings did not differ significantly between study groups. In conclusion, these findings indicate the dynamics of the DST in supporting paediatric healthcare professionals to improve the effectiveness of care in modifying obesity-related behaviours. Further research is needed to confirm these findings.
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Body composition status and the risk of migraine: A meta-analysis.
Gelaye, B, Sacco, S, Brown, WJ, Nitchie, HL, Ornello, R, Peterlin, BL
Neurology. 2017;88(19):1795-1804
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Both migraine and obesity are conditions associated with substantial personal and societal burdens. The aim of this study was to evaluate the pooled risk of migraine by body composition status as characterized by the WHO physical status categories and the influence of age and sex on this relationship. This study is a meta-analysis of twelve studies with data from 288,981 unique participants. The age of the participants ranged between 18 and 98 years. Results indicate that obesity and underweight status are associated with an increased risk of migraine, and that age and sex are important covariates for the increased risk. Authors conclude that further research to better understand the mechanisms underlying the association between body composition and migraine, has the potential to advance the understanding of migraine and lead to the development of targeted therapeutic strategies based on obesity status.
Abstract
OBJECTIVE To evaluate the association between migraine and body composition status as estimated based on body mass index and WHO physical status categories. METHODS Systematic electronic database searches were conducted for relevant studies. Two independent reviewers performed data extraction and quality appraisal. Odds ratios (OR) and confidence intervals (CI) were pooled using a random effects model. Significant values, weighted effect sizes, and tests of homogeneity of variance were calculated. RESULTS A total of 12 studies, encompassing data from 288,981 unique participants, were included. The age- and sex-adjusted pooled risk of migraine in those with obesity was increased by 27% compared with those of normal weight (odds ratio [OR] 1.27; 95% confidence interval [CI] 1.16-1.37, p < 0.001) and remained increased after multivariate adjustments. Although the age- and sex-adjusted pooled migraine risk was increased in overweight individuals (OR 1.08; 95% CI 1.04, 1.12, p < 0.001), significance was lost after multivariate adjustments. The age- and sex-adjusted pooled risk of migraine in underweight individuals was marginally increased by 13% compared with those of normal weight (OR 1.13; 95% CI 1.02, 1.24, p < 0.001) and remained increased after multivariate adjustments. CONCLUSIONS The current body of evidence shows that the risk of migraine is increased in obese and underweight individuals. Studies are needed to confirm whether interventions that modify obesity status decrease the risk of migraine.