• Journal of Dairy Science and Biotechnology
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• v.36 no.3
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• pp.133-145
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• 2018

Breastfeeding is highly recommended due to its benefits for both the infant and mother; however, most mothers predominantly use formula feed. Breastfeeding affords protection against a wide variety of medical conditions that may emerge at different time points over the lifespan, including hospital admissions for respiratory infections and neonatal fever, offspring childhood obesity, and cancer as well as cardiovascular disease, hyperlipidemia, hypertension, and diabetes. Moreover, breastfeeding is expected to decrease the risk of adolescent depression and other psychopathologies. It is also important for the development of the gut, gut-brain axis, and immune system, and night-time breast milk is likely to have higher antioxidant, anti-inflammatory, and immune regulatory effects due to the impact of breast milk melatonin on the infant's developing microbiome and gut permeability. Melatonin can be added to a night-time-specific formula feed; however, it is not included in the Korean Food Additive Codex.

• Nutrition Research and Practice
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• v.13 no.4
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• pp.352-357
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• 2019

BACKGROUND/OBJECTIVES: Youth is the crucial stage between childhood and adulthood during which an individual acquires new behavior and practices including dietary habits, that may be influenced by his peers, social circle, nutrition knowledge level and other factors. The increase in awareness of young adults is of special importance from the perspective of health and prevention of obesity related chronic diseases. To measure the nutrition literacy level of university students using the Turkish version of Adolescent Nutrition Literacy Scale (ANLS). We evaluated their food habits using the Adolescent Food Habit Checklist (AFHC) tool and analysed it, if the eating habits were affected by nutrition literacy level. SUBJECTS/METHODS: A cross-sectional descriptive study was conducted on randomly selected 276 students studying in the Faculty of Health Sciences of Istanbul Aydin University, Turkey. Data was collected by means of ANLS and AFHC tools by face to face interview method. SPSS statistical sofware (IBM SPSS Statistics 19) was used to analyse the obtained data. RESULTS: Participants comprised of 47.1% males and 52.9% females with mean age of $20.0{\pm}1.60years$. Mean body mass index (BMI) was determined as $22.4{\pm}3.76$ ($23.6{\pm}3.63$ males $21.3{\pm}3.57$ females). Functional, interactive and critical nutritional literacy scores for male participants were $22.49{\pm}5.71$, $17.45{\pm}4.84$, and $28.28{\pm}7.13$ respectively (total $64.98{\pm}10.15$). For females the values were $24.66{\pm}5.13$, $20.17{\pm}4.28$, and $32.20{\pm}5.65$ (total $69.72{\pm}8.59$) respectively. For all the three sub-categories of nutrition literacy, the scores acquired by females were significantly higher than males (P < 0.001). In the AFHC tool, the mean score acquired by males were $9.26{\pm}4.18$ whereas for females it was $10.37{\pm}3.40$ significantly higher as compared to males (P = 0.007). CONCLUSION: The food habits of female participants were better than males; in accordance with their nutrition literacy status. It may be concluded that food habits are influenced by nutrition literacy and therefore stress much be given to increase the nutrition awareness among children youth as well as adults.

• Clinical and Experimental Pediatrics
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• v.57 no.12
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• pp.520-525
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• 2014

Purpose: Childhood obesity is an increasing public health issue worldwide. We examined dietary patterns among adolescents in a dormitory school, identified obese adolescents and tried to intervene to improve food habits and physical activity. Methods: We conducted an experimental prospective longitudinal study based on 36 obese (body mass index $[BMI]{\geq}95th$ percentile) adolescents (aged 12-18 years) compared with controls (healthy children: normal age-appropriate BMI ($BMI{\leq}85th$ percentile). Six months' intervention included lifestyle-modification counseling (once a week by a clinical dietician), and an exercise regimen twice a week, 60 minutes each time, instructed by a professional pediatric trainer). Both groups underwent baseline measurements at the beginning of the study and 6 months later (arterial stiffness, blood pressure, pulse, weight and height, hemoglobin, creatinine, liver enzymes, highly sensitive C-reactive protein and complete lipid profile). Results: Twenty-one participants completed the study. Low compliance from participants, school staff and parents was observed (participation in planned meetings; 71%-83%). BMI significantly decreased from $32.46{\pm}3.93kg/m^2$ to $30.32{\pm}3.4kg/m^2$ (P=0.002) in the study group. Arterial stiffness was not significantly different between the 2 groups and did not change significantly after 6 months' intervention (P=0.494). No significant changes in CRP and lipid profile were observed after the intervention. Conclusion: Making lifestyle modifications among adolescents in a dormitory school is a complex task. Active intervention indeed ameliorates BMI parameters. However, in order to maximize the beneficial effects, a multidisciplinary well-trained team is needed, with emphasis on integrating parents and the school environment.

• Korean journal of health promotion
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• v.17 no.2
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• pp.109-118
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• 2017

Background: Abdominal obesity as measured by waist-to-height ratio (WHtR) may have stronger and inverse associations with cardiovascular (CV) health than overall obesity as measured by body mass index (BMI). However, there was some challenges for controversies. We aimed to examine the associations of WHtR and BMI with CV health among Korean children using data of the 2010-2012 Korea National Health and Nutrition Examination Survey. Methods: A cross-sectional study was conducted with the sample of 2,363 children by analyzing by gender and two-age groups (10-12 and 13-18 years). Overall obesity was categorized into 3 groups by BMI percentile: non-overweight (<85), overweight (${\geq}85$), and obesity groups (${\geq}95$). Abdominal obesity was categorized into 2 groups by WHtR: normal (<0.5) and abdominal obesity groups (${\geq}0.5$). The CV health score was defined as a z-score by calculating the sum of 7 CV factors. Results: The overweight/obesity groups had significantly lower CV health scores than the normal group (P<0.05) in boys and girls aged either 10-12 years or 13-18 years after adjusting for covariates. The abdominal obesity group also showed significantly lower CV health scores than the normal group (P<0.05) in all the groups; this significant association remained significant in boys aged 13-18 years even after further adjusting for BMI category (P<0.01). Conclusions: Among boys aged 13-18 years, abdominal obesity as measured by WHtR was significantly and inversely associated with CV health, independent of BMI category. Therefore, it should be considered to assess the level of abdominal obesity as a measure of CV health in late adolescent boys.

• Clinical and Experimental Pediatrics
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• v.50 no.8
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• pp.767-773
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• 2007

Purpose : Obesity has become a pandemic and especially the prevalence of childhood obesity has increased remarkably over the past years. Childhood obesity is often accompanied by the expected morbidities such as hyperlipidemia, fatty liver and glucose intolerance. We evaluated the pattern of alteration in the body mass index (BMI), serum adiponectin concentration, insulin resistance (HOMA-IR), and complication rates after one year follow-up. Methods : Forty two obese children (age: 8-15 years, 95th percentile of BMI for age and sex) were examined twice annually on June, 2004 and July, 2005. The body mass index (BMI) and sexual maturityrating (SMR) were determined annually by the same examiner and serum fasting glucose, liver enzyme, lipid profiles, adiponectin, insulin and HOMA-IR were measured and annual results were compared. Upper abdominal sonography was performed to detect fatty liver. Results : BMI ($25.3{\pm}2.9kg/m^2$ vs. $26.0{\pm}2.9kg/m^2$) and HOMA-IR ($3.6{\pm}1.8$ vs. $4.7{\pm}1.9$) have increased significantly after one-year follow-up. The serum adiponectin concentration ($17.2{\pm}5.2g/mL$ vs. $12.6{\pm}5.2g/mL$) has decreased after one year. The prevalence of hyperlipidemia and fatty liver were not changed significantly but that of hyperinsulinemia increased after one-year. HOMA-IR showed a positive correlation with BMI and SMR, but was negatively correlated with serum adiponectin concentration. Conclusion : Obese children in our study showed significant increment of insulin resistance during one year. These results suggest that well-organized and continuous obesity control is required especially for obese adolescent to prevent complication of obesity.

• Nutrition Research and Practice
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• v.17 no.4
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• pp.780-788
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• 2023

BACKGROUND/OBJECTIVES: This study examined the relationship between famine exposure in early life and the risk of type 2 diabetes in adulthood during the 1959-1961 Chinese Famine. SUBJECTS/METHODS: A total of 3,418 individuals aged 35-74 years free of diabetes from two studies in 2006 and 2009 were followed up prospectively in 2009 and 2012, respectively. Famine exposure was classified as unexposed (individuals born in 1962-1978), fetal exposed (individuals born in 1959-1961), child exposed (individuals born in 1949-1958), and adolescent/adult exposed (born in 1931-1948). A logistic regression model was used to assess the relationship between famine exposure and diabetes after adjustment for potential covariates. RESULTS: During a three-year follow-up, the age-adjusted incidence rates of type 2 diabetes were 5.7%, 14.5%, 12.7%, and 17.8% in unexposed, fetal-exposed, child-exposed, and adolescent/adult-exposed groups, respectively (P < 0.01). Relative to the unexposed group, the relative risks (95% confidence interval) for diabetes were 2.15 (1.29-3.60), 1.53 (0.93-2.51), and 1.65 (0.75-3.63) in the fetal-exposed, child-exposed, and adolescent/adult-exposed groups, after controlling for potential covariates. The interactions between famine exposure and obesity, education level, and family history of diabetes were not observed, except for the urbanization type. Individuals living in rural areas with fetal and childhood famine exposure were at a higher risk of type 2 diabetes, with relative risks of 8.79 (1.82-42.54) and 2.33 (1.17-4.65), respectively. CONCLUSIONS: These findings indicate that famine exposure in early life is an independent predictor of type 2 diabetes, particularly in women. Early identification and intervention may help prevent diabetes in later life.

• Clinical and Experimental Pediatrics
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• v.50 no.11
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• pp.1078-1084
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• 2007

Purpose : The prevalence of childhood obesity has doubled over the last 30 years. Obesity-associated sequelae in the vasculature begins in the early stages of life. The purpose of this study was to investigate how pulse wave velocity (PWV) and ankle brachial index (ABI) change with height, weight and body mass index (BMI) in obese adolescents. Methods : Seventy-nine obese adolescents (group 1: $85th{\leq}BMI<95th$ percentile, n=40; group 2 ($BMI{\geq}95th$ percentile, n=39) were included. The control group(group 3) included 99 healthy adolescents. Brachial- ankle (ba) PWV and ABI were estimated with blood pressure from four extremities. Heart rate (HR), and pre-ejection period/ejection time (PEP/ET) were also estimated. BMI was calculated from individual height and weight. Linear regression analysis was performed to evaluate the correlations between BMI and PWV. Results : Blood pressure and baPWV were significantly higher in group 2, compared to either group 1 or group 3. However, there was no significant difference in ABI, HR and PEP/ET between the groups. PWV showed linear correlation with both BMI and body weight. Conclusion : Obesity was associated with higher arterial stiffness in adolescents, which was demonstrated by an increase in PWV. There was no significant correlation between obesity and ABI.

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.754-763
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• 2002

Purpose : The incidence of type 2 diabetes in children and adolescents has been reported to increase recently. The aim of this study is to investigate the clinical features of type 2 diabetes developing during childhood and adolescent period. Methods : The medical records of 33 patients with type 2 diabetes were reviewed. We analysed clinical manifestations, demographic data, and modes and responses of treatment. Results : Age at diagnosis was $13.4{\pm}1.8$ years. Seventy percent of patients revealed pubertal signs at diagnosis. Half of the patients had BMI more than $25kg/m^2$. Seventy-three percent of patients had family history of type 2 diabetes. Acanthosis nigricans were found in 18% of patients. Nineteen(57.6%) patients were diagnosed incidentally by random urine or blood glucose test without any typical diabetic symptom or sign. The modes of therapy to control hyperglycemia were insulin alone(75.8%), oral hypoglycemic agents alone(9.1%), insulin and oral hypoglycemia agents(9.1%), and only diet with exercise(6%). At the time of investigation, 45.5% of patients were not using insulin. The typical diabetic symptoms at diagnosis were more prevalent in patients who required insulin for more than two years than patients who did not(P<0.05). Conclusion : The development of type 2 diabetes in children and adolescents is possibly related to puberty, obesity, family history, and defects in insulin secretion rather than insulin resistance. Many children and adolescents with type 2 diabetes required insulin initially and some of them could discontinue. More than half of the patients were diagnosed as diabetes without any typical symptom or sign, which might be one of the predictive factors of the prolonged insulin requirement.