According to US research published in the American Heart Association’s journal, Circulation, obesity and other cardiovascular risk factors may have a greater role in cardiac arrest in the young than previously understood.
While sports activity often garners attention in cases of sudden cardiac arrest in younger patients, it was cited only in a small percentage of those ages 5 to 34 in the study, published in Circulation, a journal from the American Heart Association.
Instead, investigators found an unexpectedly high prevalence of standard cardiovascular risk factors among the young who suffered from sudden cardiac arrest, a disorder that can cause instantaneous death. Combinations of obesity, hypertension, high cholesterol, diabetes and smoking were found in nearly two-thirds of cases studied.
Background—Prevention of sudden cardiac arrest (SCA) in the young remains a largely unsolved public health problem and sports activity is an established trigger. While the presence of standard cardiovascular risk factors in the young can link to future morbidity and mortality in adulthood, the potential contribution of these risk factors to SCA in the young has not been evaluated.
Methods—The researchersprospectively ascertained subjects who suffered SCA between the ages of 5-34 years in the Portland, Oregon, USA metropolitan area (2002-2015). We assessed the circumstances, resuscitation outcomes and clinical profile of subjects that suffered SCA by a detailed evaluation of emergency response records, lifetime clinical records and autopsy examination. We specifically evaluated the association of standard cardiovascular risk factors and SCA, and sports as a trigger for SCA in the young.
Results—Out of 3775 SCAs in all age groups, 186 (5%) occurred in the young (Mean age 25.9 ± 6.8, 67% male). In young SCA, overall prevalence of warning signs before SCA was low (29%); and 26 (14%) were associated with sports as a trigger.
The remainder (n=160) occurred in other settings categorized as non-sports. Sports-related SCAs accounted for 39% of SCAs aged less than 18, 13% of SCAs aged 19-25, and 7% of SCAs aged 25-34. Sports-related SCA cases were more likely to present with shockable rhythms, and survival from cardiac arrest was 2.5-fold higher in sports-related vs. non-sports SCA (28% vs. 11%; p=0.05).
Overall, the most common SCA-related conditions were sudden arrhythmic death syndrome (31%), coronary artery disease (22%) and hypertrophic cardiomyopathy (14%). There was an unexpectedly high overall prevalence of established cardiovascular risk factors (obesity, diabetes, hypertension, hyperlipidemia, smoking) with greater than 1 risk factor in 58% of SCA cases.
Conclusions—Sports was a trigger of SCA in a minority of cases, and in most patients SCA occurred without warning symptoms. Standard cardiovascular risk factors were found in over half of patients, suggesting the potential role of public health approaches that screen for cardiovascular risk factors at earlier ages.
School children in the US, (n= 707) who participated in an short-term exercise programme experienced improvements in their body mass index (BMI) scores, significantly different than the comparison group. This group also had higher odds of being in a lower BMI category at follow-up; significantly different than the comparison group.
The 12-week initiative ran for an hour three times a week. Each session started with a warm-up, followed by a running activity, and incorporated a skills-based approach to teach a new skill each week. During the cool- down session there was discussion on nutrition for pupils.
By the end of the the programme the child participants had better body mass index scores, than the non- participants in the control group. There was also an additional benefit for those children who participated three times a week as their focus on schoolwork improved, and those who attended two sessions a week also had notable improvements in their mood and energy levels.
The journal article is published online and is available here
Full reference: Whooten, R. C. et al. |Effects of Before-School Physical Activity on Obesity Prevention and Wellness | American Journal of Preventative Medicine | 2018| doi: 10.1016/j.amepre.2018.01.017
This guide provides an overview of the challenges facing mental health and wellbeing services for children and young people | Local Government Association
At least one in 10 children and young people are affected by mental health problems, and the unreported figures are likely to be even higher. Young people are increasingly struggling with problems like anxiety, depression and self-harm, with nearly 19,000 young people admitted to hospital after harming themselves in 2015 – a 14 per cent rise over three years. This guide provides an overview of the challenges facing mental health and wellbeing services for children and young people.
This systematic review aims to evaluate recent effective and scalable community-based weight management programs for adolescents (13–17 years) who are overweight or obese | Obesity Reviews
Adolescent obesity is a risk factor for obesity and other chronic disease in adulthood. Evidence for the effectiveness of community-based obesity treatment programs for adolescents is required to inform policy and clinical decisions.
Eight databases (Medline, Embase, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Informit, and Scopus) were searched for studies published between January 2011–2 March 2017 which are scalable in a community setting and reported primary outcome measures relating to weight.
Following deduplication, 10,074 records were screened by title/abstract with 31 publications describing 21 programs included in this review. Reduction in adolescent BMIz ranged from 2 to 9% post-program and from 2 to 11% after varied lengths of follow-up. Study quality varied, and findings are limited by the risk of selection and retention bias in the included studies. Factors including the effectiveness and acceptability to the target population must be considered when selecting such community programs.
This report highlights associations between health behaviours, other self-rated life factors (such as bullying and body image) and wellbeing | Public Health England
The 2014 What About YOUth? (WAY) survey included measures of wellbeing which can be analysed to examine the relationships between health behaviours and attitudes on the wellbeing of 15-year-olds.
This report highlights 4 main findings:
Young people who engaged in behaviour which might harm their health such as drinking and smoking, having poor diet or exercising rarely, or who had negative feelings towards their body size reported lower wellbeing than those who did not.
Self-reported wellbeing varied depending on the relative affluence or deprivation of the family, with those whose families were in more affluent groups and living in the least deprived areas reporting higher average wellbeing.
Young people who stated that they had a disability, long-term illness or medical condition reported lower wellbeing than those who did not.
Young people who described their sexual orientation as gay, lesbian, bisexual or ‘other’ were more likely to have lower wellbeing than those who declared themselves heterosexual. On average these young people also reported lower life satisfaction and happiness, and higher anxiety.
Commissioners and providers of health, social care and education can use this information to target local resources where they are likely to have most impact in terms of improving the wellbeing of young people.