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No Effect of Glucomannan on Body Weight Reduction in Children and Adolescents with Overweight and Obesity: A Randomized Controlled Trial.
Zalewski, BM, Szajewska, H
The Journal of pediatrics. 2019;:85-91.e1
Abstract
OBJECTIVE To assess the efficacy of water-soluble dietary fiber, glucomannan supplementation, on the body mass index (BMI) in children with overweight or obesity. STUDY DESIGN In this randomized, double-blind, placebo-controlled trial, we enrolled 96 children aged 6-17 years with overweight or obesity based on the World Health Organization growth criteria (>+1 SD or >+2 SD, respectively). Participants were assigned to receive glucomannan or placebo (maltodextrin), both at a dose of 3 g/d for 12 weeks and were followed up for the next 12 weeks. Concomitant care included dietary and lifestyle advice. The primary outcome was the difference in the BMI-for-age z score change between the groups at 12 weeks. RESULTS Compared with the placebo, glucomannan had no effect on the BMI-for-age z score at 12 weeks (mean difference: 0.0, 95% CI -0.1 to 0.1). Compared with the placebo, the glucomannan group had lower total and low-density lipoprotein cholesterol concentrations at 12 weeks. In addition, the blood pressure was greater at 12 weeks (systolic) and at 24 weeks (diastolic) in the glucomannan group. No differences between the groups in adverse events and other secondary outcomes were observed. CONCLUSIONS Glucomannan supplementation compared with placebo had no effect on weight reduction in children with overweight and obesity. TRIAL REGISTRATION ClinicalTrials.govNCT02280772.
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Nutritional interventions or exposures in infants and children aged up to 3 years and their effects on subsequent risk of overweight, obesity and body fat: a systematic review of systematic reviews.
Patro-Gołąb, B, Zalewski, BM, Kołodziej, M, Kouwenhoven, S, Poston, L, Godfrey, KM, Koletzko, B, van Goudoever, JB, Szajewska, H
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2016;(12):1245-1257
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Abstract
This study, performed as part of the international EarlyNutrition research project (http://www.project-earlynutrition.eu), provides a systematic review of systematic reviews on the effects of nutritional interventions or exposures in children (up to 3 years of age) on the subsequent risk of obesity, overweight and adiposity. Electronic databases (including MEDLINE, Embase and Cochrane Library) were searched up until September 2015. Forty systematic reviews were included. A consistent association of breastfeeding with a modest reduction in the risk of later overweight and obesity in childhood and adulthood was found (the odds decreased by 13% based on high-quality studies), but residual confounding cannot be excluded. Lowering the protein content of infant formula is a promising intervention to reduce the risk of later overweight and obesity in children. There is no consistent evidence of an association of the age of introducing complementary foods, sugar-sweetened beverage or energy intake in early childhood with later overweight/obesity, but there are some indications of an association of protein intake during the complementary feeding period with later overweight/obesity. There was inadequate evidence to determine the effects of other nutritional interventions or exposures, including modifications of infant formula composition, fat intake or consumption of different food groups.
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Effect of oligofructose supplementation on body weight in overweight and obese children: a randomised, double-blind, placebo-controlled trial.
Liber, A, Szajewska, H
The British journal of nutrition. 2014;(12):2068-74
Abstract
Limited evidence suggests that the dietary inclusion of oligofructose, an inulin-type fructan with prebiotic properties, may increase satiety and, thus, reduce energy intake and body weight in overweight and obese adults. The aim of the present study was to assess the effect of oligofructose supplementation for 12 weeks on the BMI of overweight and obese children. A total of ninety-seven children aged 7-18 years who were overweight and obese (BMI >85th percentile) were randomly assigned to receive placebo (maltodextrin) or oligofructose (both at an age-dependent dose: 8 g/d for children aged 7-11 years and 15 g/d for children aged 12-18 years) for 12 weeks. Before the intervention, all children received dietetic advice and they were encouraged to engage in physical activity. The primary outcome measure was the BMI-for-age z-score difference between the groups at the end of the intervention. Data from seventy-nine (81%) children were available for analysis. At 12 weeks, the BMI-for-age z-score difference did not differ between the experimental (n 40) and control (n 39) groups (mean difference 0.002, 95% CI - 0.11, 0.1). There were also no significant differences between the groups with regard to any of the secondary outcomes, such as the mean BMI-for-age z-score, percentage of body weight reduction and the difference in total body fat. Adverse effects were similar in both groups. In conclusion, oligofructose supplementation for 12 weeks has no effect on body weight in overweight and obese children.
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Maternal and paternal body mass index and offspring obesity: a systematic review.
Patro, B, Liber, A, Zalewski, B, Poston, L, Szajewska, H, Koletzko, B
Annals of nutrition & metabolism. 2013;(1-2):32-41
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Abstract
BACKGROUND/AIMS: It has been hypothesized that the intrauterine environment is an independent factor in obesity development. If so, the maternal effect is likely to be a stronger influencing factor ('fetal overnutrition hypothesis'). We aimed to systematically evaluate the associations of offspring body mass index (BMI, or adiposity) with pre-pregnancy BMI (or adiposity) of the mother and the father. METHODS The Medline, Embase and Cochrane Library databases were searched in March 2012. RESULTS Seven cohort studies were eligible for the analysis. Among these, 2 groups of trials presented different data from the same parent-offspring cohorts (the Avon Longitudinal Study of Parents and Children, ALSPAC, and the Mater-University Study of Pregnancy, MUSP). In total, 3 large birth cohorts and 1 additional small study were identified. Three studies provided a direct comparison of parent-offspring associations, with a statistically stronger maternal influence found only in the MUSP cohort. Equivocal results were obtained from all studies describing the ALSPAC cohort. The parental effect (indirectly estimated based on the presented odds ratio) was similar in the Finnish cohort. In 1 additional small study, maternal BMI was found to be a strong predictor of childhood obesity. CONCLUSIONS There is only limited evidence to support the 'fetal overnutrition hypothesis'.