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This Month in Archives of Pediatrics and Adolescent Medicine
April 6, 2009

This Month in Archives of Pediatrics & Adolescent Medicine

Author Affiliations

Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2009

Arch Pediatr Adolesc Med. 2009;163(4):295. doi:10.1001/archpediatrics.2009.33
Self-regulation and Rapid Weight Gain in Children From Age 3 to 12 Years

One area of research in obesity is the ability to self-regulate and how this is affected by external cues. In this national longitudinal study, the self-regulation capacity of 1061 children was measured when they were aged 3 and 5 years. Children who had low self-regulation at both times gained more weight between ages 3 and 12 years than those who were low only on delay of gratification or low on neither. These findings, however, were seen only in girls. Early childhood self-regulatory problems are important longitudinal predictors of weight problems in early adolescence. These findings support other studies that show that obesity has its roots early in life. Interventions to enhance energy-balance regulation in young children may benefit from efforts to encourage self-regulation, such as encouraging self-control and delayed gratification.

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Child body mass index (BMI) z score from age 3 to 12 years by self-regulation group. The BMI z scores are standardized for age and sex and represent deviations from the group median at each point. Age 3 years, n = 1090; age 5 years, n = 1031; age 7 years, n = 991; age 9 years, n = 938; age 11 years, n = 929; and age 12 years, n = 917. Different superscript letters indicate significant differences between groups in the rate of change over time at P < .05.

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Obesity Intervention in Teenagers: Effectiveness of a School-Based Program

This study was a large randomized controlled trial of 12- to 13-year-old students in 18 secondary schools in the Netherlands. The focus of the intervention was to increase awareness and induce behavior change regarding consumption of sugar-sweetened beverages and high-caloric snacks, physical activity, and screen-viewing behavior. The intervention consisted of an 11-session curriculum and encouraging schools to offer additional physical education classes and to change their cafeterias. Twelve months after the intervention, both boys and girls in the intervention group had lower skin-fold thicknesses. The intervention group had less consumption of sugar-sweetened beverages and less screen-viewing time. While these changes were small, they were significant and indicate that school-wide interventions can make a difference in the health of children.

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Effect of a Low-Sugar, High-Fiber Dietary Intervention in Overweight Latino Adolescents

Latino adolescents have a high prevalence of obesity, are more insulin resistant, and are thus more likely to develop obesity-related chronic diseases than other adolescents. The purpose of this study was to determine if reductions in added sugar or increases in fiber in response to a 16-week intervention could improve risk markers for type 2 diabetes mellitus. The study found that overweight Latino adolescents who decreased added sugar intake by an average of 47 g/d (equivalent to the sugar in 1 can of soda) had an average 33% decrease in insulin secretion during an oral glucose tolerance test. Those who increased fiber by an average of 5 g/d had an average 10% reduction in visceral adipose tissue volume. Modest changes in sugar and fiber consumption could lead to substantial improvements in adiposity and metabolic parameters.

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Adjusted changes in postchallenge glucose response by sugar intake improvement categories. Sugar intake improvement was defined as a decrease of any magnitude in the percentage of calories from added sugar intake. Models are adjusted for sex, randomization group, and baseline added sugar intake. Body composition was evaluated in the model but removed because it was not significant. IAUC indicates incremental area under the curve.

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Pacifiers and Breastfeeding: A Systematic Review

While pacifiers have traditionally been thought to interfere with optimal breastfeeding, the evidence (mainly from observational studies) linking pacifiers to breastfeeding difficulties has been limited. This systematic review examined 29 studies conducted between 1950 and 2006 (4 randomized trails, 20 cohort studies, and 5 cross-sectional studies). Four randomized trials did not give evidence for an adverse relationship between pacifier use and breastfeeding duration or exclusivity.

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