Cardiorespiratory Fitness in Childhood and Adolescence Affects Future Cardiovascular Risk Factors: A Systematic Review of Longitudinal Studies The Influence of Yoga-Based Programs on Risk Profiles in Adults with Type 2 Diabetes Mellitus: A Systematic Review Focus on aripiprazole: a review of its use in child and adolescent psychiatry. Intensive low-glycaemic-load dietary intervention for the management of glycaemia and serum lipids among women with gestational diabetes: a randomized control trial. A low-GI diet is associated with a short-term improvement of glycaemic control in Asian patients with type 2 diabetes. 
The effect of consumption of low-glycemic-index and low-glycemic-load desserts on anthropometric parameters and inflammatory markers in patients with type 2 diabetes mellitus How to write an evidence-based clinical review article. A prospective randomised trial to determine the efficacy of a low glycaemic index diet given in addition to healthy eating and weight loss advice in patients with coronary heart disease Glycaemic index and glycaemic load of breakfast predict cognitive function and mood in school children: a randomised controlled trial. Efficacy of vitamin D supplementation in depression in adults: a systematic review protocol Sources of evidence for systematic reviews of interventions in diabetes. Effects of brown and golden flaxseed on the lipid profile, glycemia, inflammatory biomarkers, blood pressure and body composition in overweight adolescents. Effects of Cinnamon Consumption on Glycemic Status, Lipid Profile and Body Composition in Type 2 Diabetic Patients Methods for evidence synthesis in the case of very few studies Dietary fiber, glycemic index, glycemic load and renal cell carcinoma risk. Identification of those most likely to benefit from a low-glycaemic index dietary intervention in pregnancy. Tolerability and safety profile of risperidone in a sample of children and adolescents The Effect of an Energy Restricted Low Glycemic Index Diet on Blood Lipids, Apolipoproteins and Lipoprotein (a) Among Adolescent Girls with Excess Weight: a Randomized Clinical Trial
Background Although cardiorespiratory fitness ( CRF ) in childhood and adolescence may be linked to future cardiovascular health , there is currently limited evidence for a longitudinal association . Objectives To provide a systematic review on the prospect i ve association between CRF in childhood and adolescence and cardiovascular disease ( CVD ) risk factors at least 2 years later . Methods Using a systematic search of Medline , Embase , and SPORTD iscus , relevant articles were identified by the following criteria : generally healthy children and adolescents between 3 and 18 years of age with CRF assessed at baseline , and a follow-up period of ≥ 2 years . The outcome measures were CVD risk factors . We appraised quality of the included articles with STROBE and QUIPS checklists . Results After screening 7524 titles and abstract s , we included 38 articles , assessing 44,169 children and adolescents followed up for a median of 6 years . Eleven articles were of high quality . There was considerable heterogeneity in methodology , measurement of CRF , and outcomes , which hampered meta- analysis . In approximately half of the included articles higher CRF in childhood and adolescence was associated with lower body mass index ( BMI ) , waist circumference , body fatness and lower prevalence of metabolic syndrome in later life . No associations between CRF in childhood and adolescence and future waist-to-hip ratio , blood pressure , lipid profile , and glucose homeostasis were observed . Conclusion Although about half of the included articles reported inverse associations between CRF in childhood and adolescence and future BMI , body fatness , and metabolic syndrome , evidence for other CVD risk factors was unconvincing . Many articles did not account for important confounding factors such as adiposity . Recommendations for future research include st and ardizing the measurement of CRF , i.e. by reporting VO2max , using st and ardized outcome assessment s , and performing individual patient data meta-analyses There is growing evidence that yoga may offer a safe and cost-effective intervention for Type 2 Diabetes mellitus ( DM 2 ) . However , systematic review s are lacking . This article critically review s the published literature regarding the effects of yoga-based programs on physiologic and anthropometric risk profiles and related clinical outcomes in adults with DM 2 . We performed a comprehensive literature search using four computerized English and Indian scientific data bases . The search was restricted to original studies ( 1970–2006 ) that evaluated the metabolic and clinical effects of  yoga in adults with DM 2 . Studies targeting clinical population s with cardiovascular disorders that included adults with comorbid DM were also evaluated . Data were extracted regarding study design , setting , target population , intervention , comparison group or condition , outcome assessment , data analysis and presentation , follow-up , and key results , and the quality of each study was evaluated according to specific predetermined criteria . We identified 25 eligible studies , including 15 uncontrolled trials , 6 non-r and omized controlled trials and 4 r and omized controlled trials ( RCTs ) . Overall , these studies suggest beneficial changes in several risk indices , including glucose tolerance and insulin sensitivity , lipid profiles , anthropometric characteristics , blood pressure , oxidative stress , coagulation profiles , sympathetic activation and pulmonary function , as well as improvement in specific clinical outcomes .  Yoga may improve risk profiles in adults with DM 2 , and may have promise for the prevention and management of cardiovascular complications in this population . However , the limitations characterizing most studies preclude drawing firm conclusions . Additional high- quality RCTs are needed to confirm and further eluci date the effects of st and ardized yoga programs in population s with DM 2 OBJECTIVE To review published literature regarding aripiprazole in child and adolescent psychiatry . METHOD A literature review was conducted using the medline search term : ' aripiprazole ' with limits : Human trials , English language , All Child ( aged 0 - 18 years ) . Additional articles were identified from reference information and poster presentation data . RESULTS Aripiprazole is an atypical antipsychotic which was recently approved for use in Canada , but has been available for several years in the United States . Pharmacologically , aripiprazole is a partial agonist at D(2 ) and 5-HT(1A ) receptors and an antagonist at 5-HT(2A ) receptors . R and omized controlled trial data is available showing efficacy for aripiprazole in the treatment of children and adolescents with schizophrenia , bipolar disorder and behavioural problems associated with autism . Open-label evidence is also available for use of aripiprazole in other disorders such as tic disorders , aggression and disruptive behavior disorders . Unlike some other available atypical antipsychotics , there does not appear to be any effect on QTc interval on the electrocardiogram . Adverse effects including extrapyramidal symptoms ( EPS ) , akathisia , sedation , headache , nausea were significant in clinical trials in children and adolescents . The possibility of aripiprazole causing tardive dyskinesia can not be excluded . In this population , aripiprazole appears to have minimal impact on the metabolic profile compared to most other atypical antipsychotics , with minimal changes in weight or body mass index , no significant changes in glucose or lipid metabolism , and a decrease in serum prolactin . CONCLUSION Aripiprazole may represent an important alternative for some children and adolescents who have experienced poor efficacy or significant metabolic adverse effects with their current antipsychotic treatment regimen OBJECTIVE The present study aim ed to compare the effects of a general dietary intervention and an intervention with low glycaemic load ( GL ) on glycaemic control , blood lipid metabolism and pregnancy outcomes in women with gestational diabetes mellitus . DESIGN Participants were r and omly assigned to two groups , receiving either an individualized general dietary intervention ( Control group ) or an intensive low-GL intervention ( Low-GL group ) every two weeks , from 24 - 26 weeks of gestation to delivery . SETTING The Center of Maternal Primary Care in Guangdong General Hospital , China . SUBJECTS Ninety-five women with gestational diabetes mellitus were enrolled from June 2008 to July 2009 . RESULTS After the intervention , both groups significantly decreased their dietary intakes of energy , fat and carbohydrate . The Low-GL group had significantly lower values for GL ( 122 v. 136 ) and glycaemic index ( 50 v. 54 ) but greater dietary fibre intake ( 33 v. 29 g/d ) than did the Control group ( all P<0·01 ) . Significantly greater decreases in fasting plasma glucose ( -0·33 v. -0·02 mmol/l , P<0·01 ) and 2 h postpr and ial glucose ( -2·98 v. -2·51 mmol/l , P<0·01 ) , significantly lower increases in total cholesterol ( 0·12 v. 0·23 mmol/l ) and TAG ( 0·41 v. 0·56 mmol/l ) and a significantly lower decrease in HDL cholesterol ( -0·01 v. -0·11 mmol/l ) were also observed in the Low-GL group compared with the Control group ( all P<0·05 ) . There were no significant differences in body weight gain , birth weight or other maternal-fetal perinatal outcomes between the two groups . CONCLUSIONS The low-GL targeted dietary intervention outperformed the general dietary intervention in glycaemic control and the improvement of blood lipid levels in women with gestational diabetes mellitus AIMS The aim of this study is to compare the efficacy of low glycaemic index ( GI ) vs. conventional carbohydrate exchange ( CCE ) dietary advice on glycaemic control and metabolic parameters in patients with type 2 diabetes . METHODS A total of 104 patients with type 2 diabetes were r and omly assigned to either a low GI ( GI ) or CCE dietary advice over a 12-week period . The primary end-point was glycaemic control as assessed by glycated haemoglobin A1c ( HbA1c ) , fructosamine level and plasma glucose . The secondary end-points were anthropometric measurements and metabolic parameters that include blood pressure , lipid profile and insulin levels . The oral antidiabetic medications remained unchanged throughout the duration of the study . RESULTS A low-GI diet was associated with significant changes in the fructosamine level ( DeltaGI = -0.20 + /- 0.03 ; DeltaCCE = -0.08 + /- 0.03 mmol/l , p < 0.01 ) and waist circumference ( DeltaGI group = -1.88 + /- 0.30 cm ; DeltaCCE group : -0.36 + /- 0.4 cm , p < 0.05 ) at week 4 . At week 12 , the changes in fasting glucose ( DeltaGI = -0.03 + /- 0.3 ; DeltaCCE = 0.7 + /- 0.3 mmol/l ; p < 0.05 ) and waist circumference ( DeltaGI = -2.35 + /- 0.47 cm ; DeltaCCE group = -0.66 + /- 0.46 cm ; p < 0.05 ) in the GI group was significantly lower than the CCE group . With the low-GI diet , the changes in postpr and ial glycaemia at time 0 , 60 , 150 and 180 min after consuming the st and ard test meal was lower than with the CCE diet ( p < 0.05 ) . No significant differences were found between the groups for the remaining parameters that were measured . CONCLUSIONS Use of a low-GI diet result ed in significant changes of serum fructosamine level , plasma glucose and waist circumference in Asian patients with type 2 diabetes over a 12-week period compared with those following a CCE diet . The effect on HbA1c and other metabolic parameters was not significantly different between the two study groups but the improvement within the GI group was more pronounced and of clinical benefit Abstract Purpose The aim of the present study was to examine the effects of consumption of desserts with low glycemic index ( GI ) and low glycemic load ( GL ) , as part of a balanced hypo-caloric diet , on anthropometric and biochemical parameters in patients with type 2 diabetes mellitus ( T2DM ) . Methods A total of 61 subjects with T2DM were r and omly assigned to the intervention ( n = 30 ) or to the control group ( n = 31 ) . Both groups followed the same hypo-caloric ( −500 kcal ) diet for 12 weeks . Consumption of four portions of low-GI/low-GL desserts/week was included in the diet in the intervention group while one portion of a favorite usual sweet/week was allowed to be consumed in the control group . Results Thirty subjects in the control and 28 subjects in the intervention group completed the trial . Body weight , body mass index , and waist circumference were reduced significantly in both groups . Arterial blood pressure , fasting blood glucose , glycosylated hemoglobin , insulin , and γ-GT were reduced significantly only in the intervention group ; however , there were no significant differences between the two groups at endpoint . C-reactive protein was reduced in the intervention , and HDL cholesterol was also reduced in the control group ; the reductions were significantly different at the end of the trial . No significant changes were observed in the other plasma lipids , uric acid , leptin , adiponectin , and interleukin-6 in either study group . Conclusions Consumption of desserts with low GI/GL in a balanced hypo-caloric diet has a positive impact on anthropometric and metabolic parameters of patients with T2DM Traditional clinical review articles , also known as up date s , differ from systematic review s and meta-analyses . Up date s selectively review the medical literature while discussing a topic broadly . Non-quantitative systematic review s comprehensively examine the medical literature , seeking to identify and synthesize all relevant information to formulate the best approach to diagnosis or treatment . Meta-analyses ( quantitative systematic review s ) seek to answer a focused clinical question , using rigorous statistical analysis of pooled research studies . This article presents guidelines for writing an evidence -based clinical review article for American Family Physician . First , the topic should be of common interest and relevance to family practice . Include a table of the continuing medical education objectives of the review . State how the literature search was done and include several sources of evidence -based review s , such as the Cochrane Collaboration , BMJ 's Clinical Evidence , or the InfoRetriever Web site . Where possible , use evidence based on clinical outcomes relating to morbidity , mortality , or quality of life , and studies of primary care population s. In articles su bmi tted to American Family Physician , rate the level of evidence for key recommendations according to the following scale : level A ( r and omized controlled trial [ RCT ] , meta- analysis ) ; level B ( other evidence ) ; level C ( consensus/expert opinion ) . Finally , provide a table of key summary points Objective : Recent epidemiological and prospect i ve trial evidence suggests that consumption of a low glycaemic index ( LGI ) diet will reduce coronary risk . We hypothesise that introduction of an LGI diet will improve the metabolic profile of patients who have undergone coronary artery bypass grafting . Design : We conducted a r and omised parallel group trial comparing a  control group ( n=29 , age 61.8±9 y ) ,  who received currently advocated healthy eating dietary advice only , to an intervention group , who received healthy eating advice emphasising LGI carbohydrates ( n=26 , age 63.6±9.4 y ) over a 12-week period in free-living patients with coronary heart disease . Outcome measures included fasting glucose , insulin , total cholesterol , high-density lipoprotein cholesterol , very low-density lipoprotein cholesterol , low density lipoprotein cholesterol and triglycerides . Results : A significant lower dietary glycaemic index was achieved in the group assigned to an LGI diet compared to the healthy eating control group ( 71±1 vs 81±1 ) ; fibre intake was also higher in the LGI group ( 20±1 vs 15±1 g ) . All biochemical markers of glucose and lipid metabolism measured were similar after 12 weeks of the LGI diet or control diet . Discussion : The LGI group achieved a significant LGI and a higher dietary fibre intake . However , there was no measurable significant effect of either the LGI diet or the health eating diet on lipid levels ; this may have been hidden by concurrent drug therapy The macronutrient composition of a breakfast that could facilitate performance after an overnight fast remains unclear . As glucose is the brain 's major energy source , the interest is in investigating meals differing in their blood glucose-raising potential . Findings vary due to unaccounted differences in glucoregulation , arousal and cortisol secretion . We investigated the effects of meals differing in glycaemic index ( GI ) and glycaemic load ( GL ) on cognition and mood in school children . A total of seventy-four school children were matched and r and omly allocated either to the  high-GL or low-GL  group . Within each GL group , children received high-GI and low-GI breakfasts .  Cognitive function ( CF ) and mood were measured 95 - 140 min after breakfast . Blood glucose and salivary cortisol were measured at baseline , before and after the CF tests . Repeated- measures ANOVA was used to identify differences in CF , mood , glucose and cortisol levels between the breakfasts . Low-GI meals predicted feeling more alert and happy , and less nervous and thirsty ( P < 0·05 for each ) ; high-GL meals predicted feeling more confident , and less sluggish , hungry and thirsty ( P < 0·05 for each ) . High-GL ( P < 0·001 ) and high-GI ( P = 0·05 ) meals increased glucose levels 90 min after breakfast , and high-GI meals increased cortisol levels ( P < 0·01 ) . When baseline mood , glucose and cortisol levels were considered , low-GI meals predicted better declarative-verbal memory ( P = 0·03 ) , and high-GI meals better vigilance ( P < 0·03 ) ; observed GI effects were valid across GL groups . GI effects on cognition appear to be domain specific . On balance , it would appear that the low-GI high-GL breakfast may help to improve learning , and of potential value in informing government education policies relating to dietary recommendations and implementation concerning breakfast Background The role of vitamin D in management of depression is unclear . Results from observational and emerging r and omized controlled trials ( RCTs ) investigating the efficacy of vitamin D in depression lack consistency - with some suggesting a positive association while others show a negative or inconclusive association . Methods / Design The primary aim of this study is to conduct a systematic review of RCTs to assess the effect of oral vitamin D supplementation versus placebo on depression symptoms measured by scales and the proportion of patients with symptomatic improvement according to the authors ’ original definition . Secondary aims include assessing the change in quality of life , adverse events and treatment discontinuation . We will conduct the systematic review and meta- analysis according to the recommendations of the Cochrane H and book for Systematic Review s of Interventions . We will search the Cochrane Central Register of Controlled Trials ( CENTRAL ) , MEDLINE ( 1966 to present ) , EMBASE ( 1980 to present ) , CINAHL ( 1982 to present ) , PsychINFO ( 1967 to present ) and Clinical Trials.gov . Unpublished work will be identified by search ing two major conferences : the International Vitamin Conference , the Anxiety Disorders and Depression Conference , while grey literature will be acquired by contacting authors of included studies . We will use the r and om-effects meta- analysis to synthesize the data by pooling the results of included studies . Discussion The results of this systematic review will be helpful in clarifying the efficacy of vitamin D supplementation and providing evidence to establish guidelines for implementation of vitamin D for depression in general practice and other relevant setting s. Study registration Unique identifier : CRD42013003849 AIMS To analyse the effect on systematic review s in diabetes interventions of including only trials that are indexed in medline , and to assess the impact of adding trials from other data bases and the grey literature . METHODS All systematic review s of diabetes interventions which included a meta- analysis of r and omized controlled trials , and were published since 1996 , were selected . The impact on the meta- analysis of including only those trials indexed in medline , and the effect of then adding trials from other sources , was assessed . Where possible this was measured quantitatively , by redoing the meta- analysis , otherwise a qualitative estimate was made . RESULTS Forty-four systematic review s met our inclusion criteria . There were 120 articles reporting trial data which were not indexed in medline . These came from 52 % of the review s. In 34 % of the review s , basing a meta- analysis on a search of only medline would miss trials that could affect the result . Sources of non- medline data which had the biggest effect on the meta-analyses were journal articles from central and embase ( mainly in Diabetes , Nutrition and Metabolism ) and unpublished data ( mainly from industry ) . The exceptions were journal articles on herbal medicine , mostly indexed in Chinese language data bases . CONCLUSIONS A search of only the medline data base is insufficient for systematic review s of diabetes , because in about 34 % of review s the missed trials could affect the results of the meta- analysis . It is recommended that central ( on the Cochrane Library ) also be search ed . Scanning meeting abstract s , and seeking unpublished data are also recommended if the intervention has only recently been introduced BACKGROUND Flaxseed is a promising alternative to reduce the risk of diseases associated with body weight excess because it is rich in a-linolenic acid , lignans , and dietary fiber . Flaxseed ( Linum usitatissimum ) can be found in brown and golden varieties ; however , questions have arisen as to whether the variety may influence the health effects . OBJECTIVE The objective of this study was to compare the effects of brown and golden flaxseeds on lipid profile , glycemia , blood pressure , inflammatory status , body weight , and body composition in overweight adolescents . METHODS Seventy-five overweight adolescents ( 33 boys , 42 girls ; age 13.7 ! 2.1 y ) , from Alegre-ES , Brazil , were r and omized to one of the three groups ( n ¼ 25 ) on a parallel , single-blind clinical trial . They received 28 g/d of brown flaxseed ( BF ) , golden flaxseed ( GF ) , or the equivalent amount of wheat bran ( Control , CG ) in different preparations at school from Monday to Friday for 11 wk . Blood pressure , anthropometric evaluation , and the analyses of blood total cholesterol , lipoproteins , glucose , and inflammatory markers were performed at the beginning and at the end of the intervention . The data were analyzed by ANCOVA at 5 % significance . RESULTS The groups who consumed brown and golden flaxseed showed significant reduction in diastolic blood pressure . Brown and golden flaxseed did not differentially affect plasma lipid responses , plasma glucose and inflammatory profile , although all groups ( BF , GF , and CG ) showed increased levels of TNF-a . CONCLUSIONS The adolescents consumed about half the daily amount provided , which may not have been sufficient to exert the health benefits of flaxseed reported in the literature , concerning the lipid profile , inflammation biomarkers and body composition Objective : Type 2 diabetes is the most common metabolic disorder worldwide . Traditional herbs and spices can be used to control blood glucose concentrations . The objective of this study was to evaluate the effects of the daily intake of three grams cinnamon over eight weeks on glycemic status , lipid profiles and body composition in type 2 diabetic patients . Methods : A double blind , r and omized , placebo controlled clinical trial was conducted on 44 patients with type 2 diabetes . Participants were r and omly assigned to take either a three g/day cinnamon supplement ( n=22 ) or a placebo ( n=22 ) for eight weeks . Weight , height , body fat mass and systolic and diastolic blood pressure were measured at baseline and after intervention . The fasting blood glucose , insulin , HbA1c , total cholesterol , LDL C , HDL C , Apo lipoprotein A I and B were measured at baseline and endpoint . Results : From 44 subjects participated in this study 37 completed the study . There were no significant differences in baseline characteristics , dietary intake and physical activity between groups . In the treatment group , the levels of fasting blood glucose , HbA1c , triglyceride , weight , BMI and body fat mass decreased significantly compared to baseline , but not in placebo group . No significant differences were observed in glycemic status indicators , lipid profile and anthropometric indicators between the groups at the end of intervention . Conclusion : These data suggest that cinnamon may have a moderate effect in improving glycemic status indicators In systematic review s , meta‐analyses are routinely applied to summarize the results of the relevant studies for a specific research question . If one can assume that in all studies the same true effect is estimated , the application of a meta‐ analysis with common effect ( commonly referred to as fixed‐effect meta‐ analysis ) is adequate . If between‐ study heterogeneity is expected to be present , the method of choice is a meta‐ analysis with r and om effects . The widely used DerSimonian and Laird method for meta‐analyses with r and om effects has been criticized due to its unfavorable statistical properties , especially in the case of very few studies . A working group of the Cochrane Collaboration recommended the use of the Knapp‐Hartung method for meta‐analyses with r and om effects . However , as heterogeneity can not be reliably estimated if only very few studies are available , the Knapp‐Hartung method , while correctly accounting for the corresponding uncertainty , has very low power . Our aim is to summarize possible methods to perform meaningful evidence syntheses in the situation with only very few ( ie , 2‐4 ) studies . Some general recommendations are provided on which method should be used when . Our recommendations are based on the existing literature on methods for meta‐ analysis with very few studies and consensus of the authors . The recommendations are illustrated by 2 examples coming from dossier assessment s of the Institute for Quality and Efficiency in Health Care Several epidemiological studies have investigated the potential association between dietary fiber , glycemic index ( GI ) or glycemic load ( GL ) , and renal cell carcinoma ( RCC ) risk with inconsistent results . The aim of this study was to systematic ally evaluate this issue with a meta- analysis approach . A comprehensive literature search up to March 2018 was performed in PubMed and Web of Science data bases . Summary relative risks ( RRs ) and 95 % confidence intervals ( CIs ) were estimated with a r and om-effects model . Twelve studies were finally included in this study ( eight for fiber analysis , five for GI and five for GL ) . A significant positive association was observed between GI and the risk of RCC ( summary RR 1.16 , 95 % CI 1.02 - 1.32 ) , and no significant heterogeneity was detected among studies ( I2 = 22.8 % , P = 0.262 ) . A significant inverse association was found between fiber intake and the risk of RCC ( summary RR 0.82 , 95 % CI 0.72 - 0.92 ) , and no significant heterogeneity was observed across studies ( I2 = 27.6 % , P = 0.218 ) . GL was not significantly associated with RCC risk ( summary RR 1.14 , 95 % CI 0.81 - 1.60 ) , and significant heterogeneity was found across studies ( I2 = 78.6 % , P < 0.001 ) . In conclusion , this systematic review and meta- analysis suggests that dietary GI and fiber may be associated with the risk of RCC . Further large prospect i ve cohort studies are still warranted to confirm our preliminary findings The present study is a secondary analysis of the ROLO study , a r and omised control trial of a low-glycaemic index ( GI ) diet in pregnancy to prevent the recurrence of fetal macrosomia . The objectives of the present study were to identify which women are most likely to respond to a low-GI dietary intervention in pregnancy with respect to three outcome measures : birth weight ; maternal glucose intolerance ; gestational weight gain ( GWG ) . In early pregnancy , 372 women had their mid-upper arm circumference recorded and BMI calculated . Concentrations of glucose , insulin and leptin were measured in early pregnancy and at 28 weeks . At delivery , infant birth weight was recorded and fetal glucose , C-peptide and leptin concentrations were measured in the cord blood . Women who benefited in terms of infant birth weight were shorter , with a lower education level . Those who maintained weight gain within the GWG guidelines were less overweight in both their first and second pregnancies , with no difference being observed in maternal height . Women who at 28 weeks of gestation developed glucose intolerance , despite the low-GI diet , had a higher BMI and higher glucose concentrations in early pregnancy with more insulin resistance . They also had significantly higher-interval pregnancy weight gain . For each analysis , women who responded to the intervention had lower leptin concentrations in early pregnancy than those who did not . These findings suggest that the maternal metabolic environment in early pregnancy is important in determining later risks of excessive weight gain and metabolic disturbance , whereas birth weight is mediated more by genetic factors . It highlights key areas , which warrant further interrogation before future pregnancy intervention studies , in particular , maternal education level and inter-pregnancy weight gain The aim of this prospect i ve observational study was to verify the tolerability and safety profile of risperidone in a sample of antipsychotic-naive children/adolescent patients having a different psychiatric diagnosis . Twenty-two ( mean age of 12±3.2 ) antipsychotic-naive patients who started therapy with risperidone were recruited . The assessment involved anthropometric data ( weight , height , BMI , BMI z-score and BMI percentile ) , cardiovascular parameters ( blood pressure and QTc interval ) and blood tests ( levels of glucose , triglycerides , total cholesterol , glutamic oxaloacetic and pyruvic transaminases , & ggr;-glutamyl transferase , prolactin , free triiodothyronine , free thyroxine , thyroid-stimulating hormone , thyroglobulin , antithyroid peroxidase and antithyroglobulin ) . After an average follow-up of 6 months of risperidone therapy , a statistically significant increase in weight and body composition was observed . Furthermore , an increase in serum levels of prolactin was observed in 50 % of patients . No other significant changes in metabolic and cardiovascular parameters were found . Although an increase in these parameters was detected , it remained in the normal range . This study suggests the use of specific protocol s for monitoring children/adolescents treated with second-generation antipsychotics to manage the metabolic long-term complications and progression to more severe disease states Some studies focused on the effect of the dietary glycemic index on lipoproteins and apolipoproteins in adults ; however , little evidence exists among adolescents regarding the effect of a low glycemic index ( LGI ) diet on apolipoproteins and lipoprotein ( a ) ( Lpa ) . This study was conducted to evaluate the effect of an LGI diet on the lipid profile , apolipoproteins and Lpa among overweight and obese adolescent girls . For this parallel design ed r and omized clinical trial , 50 healthy overweight/obese girls at pubertal ages were r and omly allocated to an LGI or a healthy nutritional recommendations ( HNR ) based diet . Equal macronutrient distributed diets were prescribed to both groups . Biochemical measurements included lipid profile , apolipoprotein A , apolipoprotein B and Lpa were conducted before and after 10 weeks of intervention . Forty one adolescent girls completed the study . The dietary glycemic index in the LGI group was 42.67 ± 0.067 . There were no differences in the mean of blood lipid indices baseline and after intervention between two groups . There were no significant differences between the two groups regarding lipid profiles , apolipoproteins and Lpa . There were no significant differences in lipid profiles , apolipoproteins and Lpa  between the LGI diet and the HNR-based diet and the impact of these two diets on lipid profile was equal in this trial . Trial registry code : I RCT 201109272839N4
Other parameters under investigation were not affected by either low or high glycaemic indices .
The present systematic review and meta- analysis provides evidence of a beneficial effect of a low glycaemic index/load diet in children and adolescents being either overweight or obese .
The objective of the present systematic review and meta- analysis was to synthesize the available literature data investigating the effects of low glycaemic index/low glycamic load dietary regimens on anthropometric parameters , blood lipid profiles , and indicators of glucose metabolism in children and adolescents .