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• Bioimpedance (BIA) may be an alternative to dual-energy X-ray absorptiometry (DXA). • BIA reliably tracks longitudinal body composition changes at pediatric group level. • BIA may supplement DXA in pediatric obesity research. • BIA is less accurate than DXA for individual measures of fat mass and fat-free mass. Accurate and efficient body composition assessment is essential for diagnosing and monitoring childhood obesity in clinical and research settings. This study evaluated the agreement between bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA) in assessing body composition and its changes during a long-term lifestyle intervention in children and adolescents with obesity. We hypothesized that BIA is comparable to DXA in tracking longitudinal changes in body composition in this population. The study included 92 children and adolescents 5 to 17 years of age (mean 10.5 ± 2.9 years) classified as obese at the time of measurement (body mass index-standard deviation score ≥ 2 SD). From January 1, 2014, to December 31, 2017, they participated in a lifestyle intervention at Randers Regional Hospital. Body composition was assessed using BIA and DXA at baseline and follow-up (mean 20.5 ± 9.3 months). Bland–Altman plots, correlation- and concordance analyses were used to evaluate the agreement between methods. Bland–Altman plots demonstrated wide limits of agreement without significant bias for longitudinal changes in fat mass (FM), FM%, fat-free mass (FFM), and FFM% (0.39 kg (CI –0.14, 0.93), –0.39% (CI –1.06, 0.26), –0.21 kg (CI –0.73, 0.31), and 0.39% (CI –0.27, 1.05), respectively). Correlations between methods for changes in FM, FM%, FFM, and FFM% were 0.93, 0.83, 0.88, and 0.83, respectively. In cross-sectional assessments, BIA underestimated FM and FM% and overestimated FFM and FFM% compared to DXA. Conclusively, BIA effectively monitors longitudinal changes in body composition at a group level in a pediatric population with obesity. However, caution is needed for individual assessments. The study evaluated the agreement between BIA and DXA for assessing body composition and its changes during a long-term lifestyle intervention in children and adolescents with obesity. While BIA proved reliable for tracking longitudinal changes in body composition at a group level, BIA tended to underestimate FM and FM% and overestimate FFM and FFM% in cross-sectional assessments. BIA, Bioelectrical impedance analysis; DXA, Dual-energy X-ray absorptiometry; FFM, Fat-free mass; FM, Fat mass. [Display omitted] [ABSTRACT FROM AUTHOR]

Children living with obesity are prevalent worldwide. It is an established finding that many children who start a lifestyle intervention tend to leave prematurely. The aim of this study was to identify characteristics in children with obesity who prematurely leave a lifestyle intervention. The cohort study includes children living with obesity aged 4–17, treated in a Danish family-centered lifestyle intervention between 2014 and 2017. Data were collected from patient records. BMI-SDS was calculated using an external Danish reference population and multivariable regression analysis was used to answer the research question. Of the 159 children included, 64 children who left the intervention within the first 1.5 years were older compared to those who stayed in the intervention (10.2 years ± 2.9 vs 11.5 years ± 3.1, p = 0.005). Older participants (> 66.6th percentile) had a shorter treatment duration (489 days) compared to the youngest (190 days 95% CI: 60; 320, p = 0.005) and middle third (224 days 95% CI: 89; 358, p = 0.001). Additionally, an inverse association was found between duration of treatment and age at baseline (−31 days, 95% CI (−50; −13), p = 0.001). Conclusion: The risk of leaving a lifestyle intervention prematurely was primarily dependent on the age of the participants, emphasizing the importance of including children early in lifestyle interventions. What is Known: •Lifestyle interventions for childhood obesity that are shorter in duration often lead to short-term weight reductions only. Limited knowledge exists on why some children prematurely leave these interventions. What is New: •This study observes a solid inverse correlation and association between age and time spent in the interventions, when treating childhood obesity. We hereby suggest age as an important determinant for the adherence to lifestyle interventions and emphasize the importance of treatment early in life. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is associated with impaired Quality-of-Life (QoL), increased stigmatization and higher risk of development of depression compared to their peers. This report describes the long-term development in QoL for cohort of children with obesity after a sustainable weight reduction. Methods: This pragmatic descriptive intervention study enrolled 120 children with obesity, age 5–17 years, in a multifactorial lifestyle intervention. The intervention was an across sectors collaboration between a department of pediatrics and community health care workers. QoL was assessed yearly throughout the intervention and evaluated by a 6-item Visual Analogue Scale (VAS). For analyzing changes in VAS, as function BMI-SDS, regression models were used, while ANOVA and Wilcoxon test were applied for normal and not-normal distributed data. 95% confidence interval not containing 0 and p-value < 0.05 was considered statistically significant. Results: After 26.4 months (13.9 SD) an overall decrease in bullying (0.6 vs. 0.0 median) and motivation (10.0 vs. 9.6) was observed. QoL increased in children with a BMI-SDS reduction (0.65 (2.49 SD)) opposite children with no-change or increasing BMI-SDS who reported reduced QoL (-0.36 (1.55 SD) and -0.96 (2.27 SD)). A significant inverse relationship was observed for Joy of Life, QoL and body perception as a function of BMI-SDS per year. Conclusion: Weight reduction causes improvement in QoL for children with obesity and an inverse relationship for QoL and changing BMI-SDS / year was establish. [ABSTRACT FROM AUTHOR]

Introduction: Childhood obesity may be associated with continuous obesity into adulthood and development of obesity-related comorbidities. In adult, studies have demonstrated an association between circulating levels of uric acid (UA), body mass index (BMI), and the development of type 2 diabetes and the metabolic syndrome. The aim of the current study was to investigate the relationship between UA in children and adolescents with obesity, involved in a municipality-based lifestyle intervention. Methods: One hundred and seventy-one children (age 4-18), with a body mass index standard deviation score (BMI-SDS) of +2 or higher were included in a multifactorial lifestyle intervention study. The intervention was a collaboration between the children, parents, community healthcare workers and the regional hospital. The children who participated, were annually invited to the hospital for anthropometrics, blood samples and DEXA-scans for up to 3 years. In between, the children were seen up 8 times per year by a community healthcare worker. Eighty-nine children were included for follow-up analysis. Results: After a follow-up of 20.7 ± 9.4 months a reduction in BMI-SDS of -0.34 ± 0.53 (p < 0.01) was observed. In parallel, UA was found to be positively associated with changes in BMI-SDS. UA levels decreased in the 76 children who lost weight during the intervention, conversely, UA increased in the 23 children who gained weight during the intervention (p < 0.01 between groups). Conclusion: Interestingly, UA was found to correlate with measures of childhood obesity, and for the first time this study demonstrates a positive relationship between weight reduction in children with obesity and changes in UA. Implications for applicability: This study implies that UA may be used as a marker when assessing health conditions (i.e. BMI-SDS) in children with obesity. [ABSTRACT FROM AUTHOR]