Scholars@Duke
Sarah Commisso Armstrong

Sarah Commisso Armstrong

Professor of Pediatrics
Pediatrics, General Pediatrics and Adolescent Health
sarah.c.armstrong@duke.edu
Box 3675 Med Ctr, Durham, NC 27710
3116 N Duke Street, Durham, NC 27704
Office hours Monday - Friday 8am - 5pm  

Scholarly Works - Journal articles

Design and Rationale of the pERSonalized cardIovascuLar dIsease prEvention, treatmeNt, and CarE (RESILIENCE) study.

Journal article Contemp Clin Trials · August 2026 BACKGROUND: Obesity is a growing epidemic associated with cardiovascular disease (CVD). The RESILIENCE study aimed to understand the factors underlying heterogeneity in CVD development among individuals with obesity as well as the variability in response t ... Full text Link to item Cite

Branched chain amino acid metabolism and microbiome in adolescents with obesity during weight loss therapy.

Journal article J Clin Invest · July 15, 2026 BACKGROUNDObesity and weight loss in adults have been associated with distinct metabolome and gut microbiome features, but the extent to which those associations apply to adolescent stages remain unclear.METHODSThe Pediatric Obesity Microbiome and Metaboli ... Full text Link to item Cite

Assessing Implementation of Clinic-Community Partnerships Treating Pediatric Obesity.

Journal article Child Obes · July 2026 BACKGROUND: Although intensive health behavior and lifestyle treatment (IHBLT) is effective for treating youth obesity, it is not accessible to many. Our objective was to examine the implementation of Fit Together, an evidence-based IHBLT clinic-community ... Full text Link to item Cite

Duke STAR Program and the Pediatric Trials Network.

Journal article J Pediatr Pharmacol Ther · February 2026 Full text Open Access Link to item Cite

Nutrition and obesity in under-represented population (NOURISH): study protocol to examine the effect of restricted and unrestricted financial benefits on infant food insecurity, growth, and nutrition.

Journal article BMC Pediatr · January 10, 2026 BACKGROUND: Studies have shown that food insecurity (FI) during infancy is associated with higher odds of obesity in early childhood, but the evidence regarding the impact of FI interventions on improving child body mass index (BMI) remains inconclusive. T ... Full text Link to item Cite

Parent Perspectives on the 2023 Clinical Practice Guideline for Pediatric Obesity: A Mixed-Methods Study of Acceptance and Concerns.

Journal article Pediatr Obes · January 2026 BACKGROUND: The 2023 Clinical Practice Guideline for pediatric obesity recommends immediate, intensive treatment, including behavioral therapy, medications, and surgery when indicated. Understanding parental agreement with the guideline is critical for suc ... Full text Link to item Cite

The Feasibility of Using Best Practice Alerts in Pediatric Primary Care for Obesity Research.

Journal article Acad Pediatr · 2026 OBJECTIVE: Recruiting participants in pediatric obesity research is challenging due to logistical and systemic barriers. This study evaluated the use of a best practice alert (BPA) within the electronic health record (EHR) to aid in recruitment for a rando ... Full text Link to item Cite

The influence of acculturation and stress on obesity in US latino dyads using systems science.

Journal article Ethn Health · October 2025 OBJECTIVE: Pediatric obesity continues to grow in the US Latino population despite public health efforts. Little work has explored the link between acculturation and stress across caregiver-child dyads using systems science. METHODS: Semi-structured interv ... Full text Link to item Cite

Branched chain amino acid metabolism and microbiome in adolescents with obesity during weight loss therapy.

Journal article medRxiv · June 9, 2025 BACKGROUND: Obesity and weight loss in adults have been associated with distinct metabolome and gut microbiome features, but the extent to which those associations apply to adolescent stages remain unclear. METHODS: The Pediatric Obesity Microbiome and Met ... Full text Link to item Cite

Increased BMI Velocity is Associated with Elevated Patient Health Questionnaire-9 Scores in Adolescents with Obesity.

Journal article Child Obes · June 2025 Existing studies that have demonstrated a positive association between obesity and depression have been among adults, did not utilize the Patient Health Questionnaire (PHQ), or were conducted in a homogenous patient population. In this retrospective longit ... Full text Link to item Cite

Using Parks and Recreation Providers to Enhance Obesity Treatment: A Randomized Controlled Trial.

Journal article Pediatrics · February 10, 2025 OBJECTIVE: Intensive health behavior and lifestyle treatment (IHBLT) is recommended for children aged 6-18 years with obesity. The objective was to evaluate the effectiveness of Fit Together, a health care and parks and recreation partnership to deliver IH ... Full text Link to item Cite

Grocery intervention and DNA-based assessment to improve diet quality in pediatric obesity: a pilot randomized controlled study.

Journal article Obesity (Silver Spring) · February 2025 OBJECTIVE: We assessed the impact of a food-provisioning intervention on diet quality in children with obesity. METHODS: Participants (n = 33, aged 6-11 years) were randomly assigned to either usual care (intensive health behavior and lifestyle treatment) ... Full text Link to item Cite

Acceptability, feasibility, and program outcomes of an equity-focused, adapted community-based healthy lifestyle program for children, young people, and their families in Perth, Western Australia: an implementation hybrid research protocol.

Journal article Front Health Serv · 2025 BACKGROUND: International guidelines recommend multidisciplinary intervention programs for addressing childhood obesity. In Western Australia, community-based healthy lifestyle programs for children and young people are insufficient for demand, especially ... Full text Link to item Cite

Pediatric Obesity Pharmacotherapy: State of the Science, Research Gaps, and Opportunities.

Journal article Pediatrics · November 1, 2024 Pediatric obesity is a major public health problem, affecting nearly 20% of children and adolescents living in the United States. In 2023, the American Academy of Pediatrics released its first clinical practice guideline for the evaluation and management o ... Full text Link to item Cite

A Randomized Trial of Inspiratory Training in Children and Adolescents With Obesity.

Journal article Child Obes · October 2024 Introduction: Children with obesity suffer excess dyspnea that contributes to sedentariness. Developing innovative strategies to increase exercise tolerance and participation in children with obesity is a high priority. Because inspiratory training (IT) ha ... Full text Link to item Cite

Obesity in Adolescents: A Review.

Journal article JAMA · September 3, 2024 IMPORTANCE: Obesity affects approximately 21% of US adolescents and is associated with insulin resistance, hypertension, dyslipidemia, sleep disorders, depression, and musculoskeletal problems. Obesity during adolescence has also been associated with an in ... Full text Link to item Cite

Associations Between Neighborhood Opportunity and Indicators of Physical Fitness for New York City Public School Youth.

Journal article Child Obes · July 2024 Background: Fewer than 1/4th of US children and adolescents meet physical activity (PA) guidelines, leading to health disparities that track into adulthood. Neighborhood opportunity may serve as a critical modifiable factor to improve fitness attainment an ... Full text Link to item Cite

Mitigation measures against Coronavirus Disease 2019 (COVID-19) in overnight faith-based camps: summer 2021.

Journal article Public Health · July 2024 OBJECTIVE: In this study, we describe community-based nonpharmaceutical interventions (NPIs) incorporated into COVID-19 mitigation protocols, and SARS-CoV-2 incidence at five faith-based summer camps in the US. STUDY DESIGN: Retrospective cohort study. MET ... Full text Link to item Cite

Families Benefit After Utilization of a Clinic-Based Food Pantry Irrespective of Food Insecurity Experiences in a Pediatric Obesity Treatment Program.

Journal article Am J Health Promot · June 2024 PURPOSE: To evaluate the congruence between food insecurity screening outcome and clinic-based food pantry utilization and to examine caregiver reported comfort, motivation, and benefits of utilization. DESIGN: Mixed-methods study. SETTING: Academic pediat ... Full text Link to item Cite

Physical activity and sleep changes among children during the COVID-19 pandemic.

Journal article NPJ Digit Med · March 16, 2024 Daily routines, including in-person school and extracurricular activities, are important for maintaining healthy physical activity and sleep habits in children. The COVID-19 pandemic significantly disrupted daily routines as in-person school and activities ... Full text Link to item Cite

Sex Differences in Branched-chain Amino Acid and Tryptophan Metabolism and Pathogenesis of Youth-onset Type 2 Diabetes.

Journal article J Clin Endocrinol Metab · March 15, 2024 OBJECTIVES: Insulin resistance is associated with elevations in plasma branched-chain amino acids (BCAAs). BCAAs compete with aromatic amino acids including tryptophan for uptake into β cells. To explore relationships between BCAAs and tryptophan metabolis ... Full text Link to item Cite

The longitudinal association between neighbourhood quality and cardiovascular risk factors among youth receiving obesity treatment.

Journal article Pediatr Obes · December 2023 BACKGROUND: Neighbourhood factors are associated with cardiovascular health in adults, but these relationships are under-explored in youth. OBJECTIVES: To characterize the associations between neighbourhood factors and child and adolescent health among you ... Full text Open Access Link to item Cite

The longitudinal association between asthma severity and physical fitness by neighborhood factors among New York City public school youth.

Journal article Ann Epidemiol · December 2023 PURPOSE: This paper aims to examine the association between asthma severity and one-year lagged fitness in New York City Public school youth by neighborhood opportunity. METHODS: Using the Child Opportunity Index 2.0 and individual-level repeated measures ... Full text Link to item Cite

Longitudinal Associations Between Neighborhood Child Opportunity and Physical Fitness for New York City Public School Youth.

Journal article Am J Epidemiol · August 4, 2023 Neighborhood environments can support fitness-promoting behavior, yet little is known about their influence on youth physical fitness outcomes over time. We examined longitudinal associations between neighborhood opportunity and youth physical fitness amon ... Full text Link to item Cite

Effects of caregiver-child acculturation on child obesity among US Latino individuals.

Journal article Obesity (Silver Spring) · August 2023 OBJECTIVE: The goal of this study was to assess the association of Latino caregiver-child nativity status (US- and foreign-born) with child obesity using a nationally representative sample. METHODS: Using data from the National Health and Nutrition Examina ... Full text Link to item Cite

Diversity of plant DNA in stool is linked to dietary quality, age, and household income.

Journal article Proc Natl Acad Sci U S A · July 4, 2023 Eating a varied diet is a central tenet of good nutrition. Here, we develop a molecular tool to quantify human dietary plant diversity by applying DNA metabarcoding with the chloroplast trnL-P6 marker to 1,029 fecal samples from 324 participants across two ... Full text Link to item Cite

In-Person Instruction and Educational Outcomes of K-8 Students During the COVID-19 Pandemic.

Journal article Pediatrics · July 1, 2023 OBJECTIVES: Quantify the relationship between district policy permitting in-person instruction and educational outcomes during the 2020 to 2021 academic year for kindergarten through eighth grade students. METHODS: An ecological, repeated cross-sectional a ... Full text Link to item Cite

Timing and Magnitude of Peak Body Mass Index and Peak Weight Velocity in Infancy Predict Body Mass Index at 2 Years in a Retrospective Cohort of Electronic Health Record Data.

Journal article J Pediatr · June 2023 OBJECTIVES: To use growth data from electronic health records to describe and model infant growth (weight velocity and peak body mass index [pBMI]) characteristics. STUDY DESIGN: We extracted data from all children born at ≥34 weeks of gestation within one ... Full text Link to item Cite

"It all depends on why it's red": qualitative interviews exploring patient and professional views of a traffic light system for IVF add-ons.

Journal article Reprod Fertil · June 1, 2023 Background IVF add-ons are techniques, medicines or procedures used in addition to standard IVF with the aim of improving the chance of success. The United Kingdom's IVF regulator, ( the Human Fertilisation Embryology Authority (HFEA) developed a traffic l ... Full text Link to item Cite

The longitudinal association between asthma severity and physical fitness among new York City public school youth.

Journal article Prev Med · May 2023 Severe persistent childhood asthma is associated with low physical activity and may be associated with poor physical fitness. Research on the asthma severity-fitness association longitudinally and across sociodemographic subgroups is needed to inform fitne ... Full text Link to item Cite

American Heart Association's Children's Strategically Focused Research Network Experience.

Journal article J Am Heart Assoc · April 4, 2023 The American Heart Association's Strategically Focused Children's Research Network started in July 2017 with 4 unique programs at Children's National Hospital in Washington, DC; Duke University in Durham, North Carolina; University of Utah in Salt Lake Cit ... Full text Link to item Cite

Longitudinal Association between Weight Status, Aerobic Capacity, Muscular Strength, and Endurance among New York City Youth, 2010-2017.

Journal article Child Obes · April 2023 Background: Child weight status is inversely associated with fitness, but less is known about this relationship across fitness domains. This study examined the longitudinal association between weight status and fitness domains in a large, diverse sample of ... Full text Link to item Cite

Translating knowledge into action for child obesity treatment in partnership with Parks and Recreation: study protocol for a hybrid type II trial.

Journal article Implement Sci · February 24, 2023 BACKGROUND: Safe and effective treatment exists for childhood obesity, but treatment recommendations have largely not been translated into practice, particularly among racial and ethnic minorities and low-wealth populations. A key gap is meeting the recomm ... Full text Open Access Link to item Cite

Severe obesity and fitness in New York City public school youth, 2010-2018.

Journal article BMC Public Health · February 16, 2023 BACKGROUND: Obesity is associated with poorer youth fitness. However, little research has examined the magnitude of this relationship in youth with severe obesity. Therefore, we sought to determine the relationship between increasing weight status and fitn ... Full text Link to item Cite

Appraisal of Clinical Care Practices for Child Obesity Treatment. Part I: Interventions.

Journal article Pediatrics · February 1, 2023 The objective of this technical report is to provide clinicians with evidence-based, actionable information upon which to make assessment and treatment decisions for children and adolescents with obesity. In addition, this report will provide an evidence b ... Full text Link to item Cite

Appraisal of Clinical Care Practices for Child Obesity Treatment. Part II: Comorbidities.

Journal article Pediatrics · February 1, 2023 The objective of this technical report is to provide clinicians with actionable evidence-based information upon which to make treatment decisions. In addition, this report will provide an evidence base on which to inform clinical practice guidelines for th ... Full text Link to item Cite

Branched-chain α-keto acids and glutamate/glutamine: Biomarkers of insulin resistance in childhood obesity.

Journal article Endocrinol Diabetes Metab · January 2023 OBJECTIVES: Insulin resistance (IR) in adolescents with obesity is associated with a sex-dependent metabolic 'signature' comprising the branched-chain amino acids (BCAAs), glutamate/glutamine, C3/C5 acylcarnitines and uric acid. Here, we compared the level ... Full text Link to item Cite

Disrupted Circadian Rhythm of Epinephrine in Males With Youth-Onset Type 2 Diabetes.

Journal article J Endocr Soc · December 15, 2022 CONTEXT: Blood pressure and plasma catecholamines normally decline during sleep and rapidly increase in early morning. This is blunted in adults with type 2 diabetes (T2D). OBJECTIVE: We hypothesize that increased sympatho-adrenal activity during sleep dif ... Full text Link to item Cite

Advanced Obesity Treatment Selection among Adolescents in a Pediatric Weight Management Program.

Journal article Child Obes · June 2022 Background: Treatment options for adolescents with obesity are limited. Yet, therapies previously reserved for adults, such as medications and bariatric surgery, are increasingly available to adolescents in tertiary obesity treatment settings. We aimed to ... Full text Link to item Cite

Association between parenthood and cardiovascular disease risk: Analysis from NHANES 2011-2016.

Journal article Prev Med Rep · June 2022 The objective of this study was to examine the association between parenthood and cardiovascular disease (CVD) risk factors among a nationally representative sample of United States adults. A cross sectional analysis was conducted with adults aged 20-59 ye ... Full text Link to item Cite

The Childhood Obesity Data Initiative: A Case Study in Implementing Clinical-Community Infrastructure Enhancements to Support Health Services Research and Public Health.

Journal article J Public Health Manag Pract · March 2022 CONTEXT: We describe a participatory framework that enhanced and implemented innovative changes to an existing distributed health data network (DHDN) infrastructure to support linkage across sectors and systems. Our processes and lessons learned provide a ... Full text Link to item Cite

Building a National Framework to Pair Scientists and Schools During a Global Pandemic.

Journal article Pediatrics · February 1, 2022 The coronavirus disease 2019 (COVID-19) pandemic forced the suspension of in-person education in schools serving students in kindergarten through 12th grade (K-12) across the United States. As time passed, teachers, students, and parents struggled with rem ... Full text Link to item Cite

A Mixed-Methods Examination of Referral Processes to Clinic-Community Partnership Programs for the Treatment of Childhood Obesity.

Journal article Child Obes · December 2021 Background: Partnerships with community programs have been used to improve access to obesity care and address clinical barriers to childhood obesity management; however, little is known about the program referral process. The objective of this study was to ... Full text Link to item Cite

The Association Between Neighborhood Public Transportation Usage and Youth Physical Activity.

Journal article Am J Prev Med · November 2021 INTRODUCTION: Routine adolescent physical activity is a well-established predictor of positive health across the lifespan, although wide disparities in youth physical activity engagement persist across sex and race/ethnicity. Transportation barriers may be ... Full text Link to item Cite

Community SARS-CoV-2 Surge and Within-School Transmission.

Journal article Pediatrics · October 2021 OBJECTIVES: When the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic began, experts raised concerns about in-person instruction in the setting of high levels of community transmission. We describe secondary transmission of SARS-CoV-2 ... Full text Link to item Cite

Weight-Related Behaviors of Children with Obesity during the COVID-19 Pandemic.

Journal article Child Obes · September 2021 Background: During the coronavirus disease 2019 (COVID-19) pandemic, children and families have had to adapt their daily lives. The purpose of this study was to describe changes in the weight-related behaviors of children with obesity after the onset of th ... Full text Link to item Cite

Predictors and Patterns of Physical Activity From Transportation Among United States Youth, 2007-2016.

Journal article J Adolesc Health · August 2021 PURPOSE: Physical activity is strongly associated with health benefits in youth, although wide disparities in physical activity persist across sex, race/ethnicity, and income. Active transportation is an important source of youth physical activity. We aime ... Full text Link to item Cite

Adolescent Bariatric Surgery: Racial Disparities in 30-Day Outcomes Using the MBSAQIP from 2015 to 2018.

Journal article Obes Surg · August 2021 INTRODUCTION: Racial disparities exist in obesity prevalence and obesity-related comorbid conditions among youth. We hypothesized that non-White adolescents would have poorer 30-day outcomes after adolescent bariatric surgery. METHODS: Adolescent patients ... Full text Link to item Cite

Impact of lifestyle Intervention on branched-chain amino acid catabolism and insulin sensitivity in adolescents with obesity.

Journal article Endocrinol Diabetes Metab · July 2021 UNLABELLED: Insulin resistance in adolescents with obesity associates with a sex-dependent metabolic 'signature' comprising branched-chain amino acids (BCAAs), glutamate and C3/C5 acylcarnitines (C3/C5), implicating altered flux through BCAA catabolic path ... Full text Link to item Cite

Scaling-Up Stage 4 Pediatric Obesity Clinics: Identifying Barriers and Future Directions Using Implementation Science.

Journal article Obesity (Silver Spring) · June 2021 Nearly one-fifth of the pediatric population in the United States has obesity. Comprehensive behavioral interventions, with at least 26 contact hours, are the recommended treatment for pediatric obesity; however, there are various barriers to implementing ... Full text Link to item Cite

Genotypic and Phenotypic Diversity among Human Isolates of Akkermansia muciniphila.

Journal article mBio · May 18, 2021 The mucophilic anaerobic bacterium Akkermansia muciniphila is a prominent member of the gastrointestinal (GI) microbiota and the only known species of the Verrucomicrobia phylum in the mammalian gut. A high prevalence of A. muciniphila in adult humans is a ... Full text Link to item Cite

The association between neighborhood quality, youth physical fitness, and modifiable cardiovascular disease risk factors.

Journal article Ann Epidemiol · May 2021 PURPOSE: Striking disparities persist in cardiovascular disease risk factors among minority youth. We examined the association between multiple indicators of neighborhood quality and minority youth fitness. METHODS: The primary exposure was the Child Oppor ... Full text Link to item Cite

Incidence and Secondary Transmission of SARS-CoV-2 Infections in Schools.

Journal article Pediatrics · April 2021 BACKGROUND: In an effort to mitigate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), North Carolina closed prekindergarten through grade 12 public schools to in-person instruction on March 14, 2020. On July 15, 2020, North Carol ... Full text Link to item Cite

Symptomatic SARS-CoV-2 Transmission in Youth and Staff Attending Day Camps.

Journal article Pediatrics · April 2021 BACKGROUND AND OBJECTIVES: As schools reopen nationwide, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in youth settings remains a concern. Here, we describe transmission of SARS-CoV-2 among >6800 youth and staff at YMCA of the Tri ... Full text Link to item Cite

COVID-19 Response Strategies at Large Institutes of Higher Education in the United States: A Landscape Analysis, Fall 2020.

Journal article J Adolesc Health · April 2021 PURPOSE: To examine the pandemic response plans of institutes of higher education (i.e., colleges and universities), including COVID-19 prevention, enforcement, and testing strategies. METHOD: Data from the largest public (n = 50) and private (n = 50) US i ... Full text Link to item Cite

The Pediatric Obesity Microbiome and Metabolism Study (POMMS): Methods, Baseline Data, and Early Insights.

Journal article Obesity (Silver Spring) · March 2021 OBJECTIVE: The purpose of this study was to establish a biorepository of clinical, metabolomic, and microbiome samples from adolescents with obesity as they undergo lifestyle modification. METHODS: A total of 223 adolescents aged 10 to 18 years with BMI ≥9 ... Full text Open Access Link to item Cite

The Dose-Response Relationship Between Physical Activity and Cardiometabolic Health in Adolescents.

Journal article Am J Prev Med · January 2021 INTRODUCTION: This study examines the dose-response relationship between moderate-to-vigorous physical activity and cardiometabolic measures in adolescents. METHODS: Cross-sectional spline analyses were performed using 2003-2016 National Health and Nutriti ... Full text Link to item Cite

Short-Chain Fatty Acid Production by Gut Microbiota from Children with Obesity Differs According to Prebiotic Choice and Bacterial Community Composition.

Journal article mBio · August 11, 2020 Pediatric obesity remains a public health burden and continues to increase in prevalence. The gut microbiota plays a causal role in obesity and is a promising therapeutic target. Specifically, the microbial production of short-chain fatty acids (SCFA) from ... Full text Link to item Cite

The Dose-Response Relationship Between Physical Activity and Cardiometabolic Health in Young Adults.

Journal article J Adolesc Health · August 2020 PURPOSE: Guidelines recommend 150 minutes of weekly moderate-to-vigorous physical activity (MVPA) for all adults, although physical activity level correlation with cardiometabolic health is not well characterized for young adults. We determined the dose-re ... Full text Link to item Cite

GM-CSF (granulocyte macrophage colony-stimulating factor) supplementation in culture media for women undergoing assisted reproduction.

Journal article Cochrane Database Syst Rev · July 16, 2020 BACKGROUND: GM-CSF (granulocyte macrophage colony-stimulating factor) is a growth factor that is used to supplement culture media in an effort to improve clinical outcomes for those undergoing assisted reproduction. It is worth noting that the use of GM-CS ... Full text Link to item Cite

Rationale and design of "Hearts & Parks": study protocol for a pragmatic randomized clinical trial of an integrated clinic-community intervention to treat pediatric obesity.

Journal article BMC Pediatr · June 26, 2020 BACKGROUND: The prevalence of child and adolescent obesity and severe obesity continues to increase despite decades of policy and research aimed at prevention. Obesity strongly predicts cardiovascular and metabolic disease risk; both begin in childhood. Ch ... Full text Link to item Cite

Associations between milk fat content and obesity, 1999 to 2016.

Journal article Pediatr Obes · May 2020 BACKGROUND: The relationship between milk fat content and body mass index (BMI) remains unclear. The objective of this study was to determine if milk fat content is associated with obesity in children, adolescents and young adults. METHODS: We used repeate ... Full text Link to item Cite

Physical Activity Assessment and Counseling in Pediatric Clinical Settings.

Journal article Pediatrics · March 2020 Physical activity plays an important role in children's cardiovascular health, musculoskeletal health, mental and behavioral health, and physical, social, and cognitive development. Despite the importance in children's lives, pediatricians are unfamiliar w ... Full text Link to item Cite

Clinician Identification of Birth Asphyxia Using Intrapartum Cardiotocography Among Neonates With and Without Encephalopathy in New Zealand.

Journal article JAMA Netw Open · February 5, 2020 IMPORTANCE: Despite improvements in antenatal care and increasing cesarean delivery rates, birth asphyxia leading to neonatal encephalopathy (NE) continues to contribute to neonatal death and long-term neurodevelopmental disability. Cardiotocography (CTG) ... Full text Link to item Cite

Weight-related quality of life and temperament as predictors and moderators of outcomes among treatment-seeking, low-income, ethnically diverse children with obesity.

Journal article Transl Behav Med · February 3, 2020 Within any childhood obesity treatment program, some children have better outcomes than others. Little is known about predictors or moderators of more positive outcomes. We aimed to identify whether child temperament and weight-related quality of life pred ... Full text Link to item Cite

Body Mass Index Change Between Referral to and Enrollment in Pediatric Weight Management.

Journal article Clin Pediatr (Phila) · January 2020 This study describes changes in body mass index z score (BMIz) and percent of 95th percentile (P95) between referral to pediatric weight management (PWM) and initial PWM visit. We conducted a prospective cohort analysis among subjects (n = 77) aged 5 to 11 ... Full text Link to item Cite

Pediatric Metabolic and Bariatric Surgery: Evidence, Barriers, and Best Practices.

Journal article Pediatrics · December 2019 Severe obesity among youth is an "epidemic within an epidemic" and portends a shortened life expectancy for today's children compared with those of their parents' generation. Severe obesity has outpaced less severe forms of childhood obesity in prevalence, ... Full text Link to item Cite

Metabolic and Bariatric Surgery for Pediatric Patients With Severe Obesity.

Journal article Pediatrics · December 2019 Severe obesity affects the health and well-being of millions of children and adolescents in the United States and is widely considered to be an "epidemic within an epidemic" that poses a major public health crisis. Currently, few effective treatments for s ... Full text Link to item Cite

Add-ons in the laboratory: hopeful, but not always helpful.

Journal article Fertil Steril · December 2019 All the steps in an in vitro fertilization cycle are important but none more so than those that occur in the laboratory. To improve the chance of success, adjuncts, commonly referred to as 'add-ons', are offered. Yet as with other new interventions, add-on ... Full text Link to item Cite

Medicaid and CHIP Child Health Beneficiary Incentives: Program Landscape and Stakeholder Insights.

Journal article Pediatrics · August 2019 OBJECTIVES: To describe the landscape of Medicaid and the Children's Health Insurance Program beneficiary incentive programs for child health and garner key stakeholder insights on incentive program rationale, child and family engagement, and program evalu ... Full text Link to item Cite

Adolescent and Young Adult Recreational, Occupational, and Transportation Activity: Activity Recommendation and Weight Status Relationships.

Journal article J Adolesc Health · July 2019 PURPOSE: Physical activity can occur in many settings, or domains, including recreation, occupation, and transportation. We described patterns of adolescent and young adult (YA) activity in each domain, and the extent that accounting for different domains ... Full text Link to item Cite

Greenspace, physical activity, and BMI in children from two cities in northern Mexico.

Journal article Prev Med Rep · June 2019 Numerous previous studies have reported positive associations between exposure to greenspace and children's physical activity, but in high-income countries only. Prior studies have also examined greenspace and obesity in children, but these have yielded in ... Full text Link to item Cite

Time-lapse systems for embryo incubation and assessment in assisted reproduction.

Journal article Cochrane Database Syst Rev · May 29, 2019 BACKGROUND: Embryo incubation and assessment is a vital step in assisted reproductive technology (ART). Traditionally, embryo assessment has been achieved by removing embryos from a conventional incubator daily for quality assessment by an embryologist, un ... Full text Link to item Cite

Health Outcomes of Youth in Clinical Pediatric Weight Management Programs in POWER.

Journal article J Pediatr · May 2019 OBJECTIVE: To describe treatment outcomes of children and adolescents enrolled in the Pediatric Obesity Weight Evaluation Registry, a consortium of multicomponent pediatric weight management programs in the US. STUDY DESIGN: This multicenter prospective ob ... Full text Link to item Cite

Public Policies to Reduce Sugary Drink Consumption in Children and Adolescents.

Journal article Pediatrics · April 2019 Excess consumption of added sugars, especially from sugary drinks, poses a grave health threat to children and adolescents, disproportionately affecting children of minority and low-income communities. Public policies, such as those detailed in this statem ... Full text Link to item Cite

Long and Short of It: Early Response Predicts Longer-Term Outcomes in Pediatric Weight Management.

Journal article Obesity (Silver Spring) · February 2019 OBJECTIVE: This study aimed to examine whether 1-month BMI improvement is predictive of superior 6- and 12-month BMI changes in a national sample of youth in pediatric weight management treatment. METHODS: Participants were 4- to 18-year-olds from the Pedi ... Full text Link to item Cite

Interventions to reduce shoulder pain following gynaecological laparoscopic procedures.

Journal article Cochrane Database Syst Rev · January 30, 2019 BACKGROUND: Laparoscopy is a common procedure used to diagnose and treat various gynaecological conditions. Shoulder-tip pain (STP) as a result of the laparoscopy occurs in up to 80% of women, with potential for significant morbidity, delayed discharge and ... Full text Link to item Cite

Digital Weight Loss Intervention for Parents of Children Being Treated for Obesity: A Prospective Cohort Feasibility Trial.

Journal article J Med Internet Res · December 20, 2018 BACKGROUND: The prevalence of childhood obesity continues to increase, and clinic-based treatment options have failed to demonstrate effectiveness. One of the strongest predictors of child weight is parent weight. Parental treatment for weight loss may ind ... Full text Link to item Cite

Association of Physical Activity With Income, Race/Ethnicity, and Sex Among Adolescents and Young Adults in the United States: Findings From the National Health and Nutrition Examination Survey, 2007-2016.

Journal article JAMA Pediatr · August 1, 2018 IMPORTANCE: Physical activity in youth is associated with adult health. Understanding the prevalence and factors of moderate to vigorous physical activity among adolescents and young adults will guide public health and policy efforts. OBJECTIVES: To descri ... Full text Link to item Cite

Feasibility of a Clinic-Community Partnership to Treat Childhood Obesity.

Journal article Clin Pediatr (Phila) · June 2018 BACKGROUND: "Bull City Fit" is a childhood obesity treatment partnership between Duke Children's pediatric weight management clinic and Durham Department of Parks and Recreation. OBJECTIVES: Report on feasibility and implementation, characteristics of part ... Full text Link to item Cite

Time-lapse systems for embryo incubation and assessment in assisted reproduction.

Journal article Cochrane Database Syst Rev · May 25, 2018 BACKGROUND: Embryo incubation and assessment is a vital step in assisted reproductive technology (ART). Traditionally, embryo assessment has been achieved by removing embryos from a conventional incubator daily for quality assessment by an embryologist, un ... Full text Link to item Cite

Digital Weight Loss Intervention for Parents of Children Being Treated for Obesity: A Prospective Cohort Feasibility Trial (Preprint)

Journal article · May 18, 2018 BACKGROUNDThe prevalence of childhood obesity continues to increase, and clinic-based treatment options have failed to demonstrate effectiveness. One of the strongest predictors of child ... Full text Cite

Prevalence of Obesity and Severe Obesity in US Children, 1999-2016.

Journal article Pediatrics · March 2018 OBJECTIVES: To provide updated prevalence data on obesity trends among US children and adolescents aged 2 to 19 years from a nationally representative sample. METHODS: We used the NHANES for years 1999 to 2016. Weight status was determined by using measure ... Full text Link to item Cite

Time-lapse systems for ART.

Journal article Reprod Biomed Online · March 2018 Full text Link to item Cite

Intrauterine insemination with ovarian stimulation versus expectant management for unexplained infertility (TUI): a pragmatic, open-label, randomised, controlled, two-centre trial.

Journal article Lancet · February 3, 2018 BACKGROUND: Women with unexplained infertility are often offered intrauterine insemination (IUI) with ovarian stimulation as an alternative to in-vitro fertilisation (IVF). However, little evidence exists that IUI is an effective treatment. In 2013, the UK ... Full text Link to item Cite

An Integrated Clinic-Community Partnership for Child Obesity Treatment: A Randomized Pilot Trial.

Journal article Pediatrics · January 2018 BACKGROUND AND OBJECTIVES: Effective treatment of childhood obesity remains elusive. Integration of clinical and community systems may achieve effective and sustainable treatment. However, the feasibility and effectiveness of this integrated model are unkn ... Full text Link to item Cite

Texting Motivational Interviewing: A Randomized Controlled Trial of Motivational Interviewing Text Messages Designed to Augment Childhood Obesity Treatment.

Journal article Child Obes · January 2018 BACKGROUND: Text messages improve health outcomes for adults engaged in weight management. Little is known about whether text messaging parents of children enrolled in obesity treatment will improve child health. METHODS: We conducted a 2-group randomized ... Full text Link to item Cite

Stigma Experienced by Children and Adolescents With Obesity.

Journal article Pediatrics · December 2017 The stigmatization of people with obesity is widespread and causes harm. Weight stigma is often propagated and tolerated in society because of beliefs that stigma and shame will motivate people to lose weight. However, rather than motivating positive chang ... Full text Link to item Cite

Parent-adolescent influences on everyday dietary practices: Perceptions of adolescent females with obesity and their mothers.

Journal article Matern Child Nutr · October 2017 Parents demonstrate an important influence on adolescent obesity and dietary behavior; yet, family-based obesity interventions continue to exhibit limited success among adolescents. To further inform family-based approaches for adolescent obesity treatment ... Full text Link to item Cite

The Intestinal Microbiome and Childhood Obesity

Journal article Current Pediatrics Reports · September 1, 2017 Purpose of Review: Pediatric obesity has reached epidemic proportions worldwide. The community of microbes inhabiting the human intestine affects differential nutrient absorption, metabolism, and weight status. However, the majority of our knowledge is der ... Full text Cite

The Metabolic Syndrome in Children and Adolescents: Shifting the Focus to Cardiometabolic Risk Factor Clustering.

Journal article Pediatrics · August 2017 Metabolic syndrome (MetS) was developed by the National Cholesterol Education Program Adult Treatment Panel III, identifying adults with at least 3 of 5 cardiometabolic risk factors (hyperglycemia, increased central adiposity, elevated triglycerides, decre ... Full text Link to item Cite

Adolescent preferences and reactions to language about body weight.

Journal article Int J Obes (Lond) · July 2017 Over 30% of youth and adolescents have overweight or obesity, and health care providers are increasingly discussing weight-based health with these patients. Stigmatizing language in provider-patient communication about obesity is well documented and could ... Full text Link to item Cite

Establishment of the Pediatric Obesity Weight Evaluation Registry: A National Research Collaborative for Identifying the Optimal Assessment and Treatment of Pediatric Obesity.

Journal article Child Obes · February 2017 BACKGROUND: Prospective patient registries have been successfully utilized in several disease states with a goal of improving treatment approaches through multi-institutional collaboration. The prevalence of youth with severe obesity is at a historic high ... Full text Link to item Cite

Effect of teaching motivational interviewing via communication coaching on clinician and patient satisfaction in primary care and pediatric obesity-focused offices.

Journal article Patient Educ Couns · February 2016 OBJECTIVE: Studies indicate needed improvement in clinician communication and patient satisfaction. Motivational interviewing (MI) helps promote patient behavior change and improves satisfaction. In this pilot study, we tested a coaching intervention to te ... Full text Link to item Cite

Physical Examination Findings Among Children and Adolescents With Obesity: An Evidence-Based Review.

Journal article Pediatrics · February 2016 Overweight and obesity affects 1 in 3 US children and adolescents. Clinical recommendations have largely focused on screening guidelines and counseling strategies. However, the physical examination of the child or adolescent with obesity can provide the cl ... Full text Link to item Cite

Left atrial phasic function interacts to support left ventricular filling during exercise in healthy athletes.

Journal article J Appl Physiol (1985) · August 15, 2015 We studied the contribution of phasic left atrial (LA) function to left ventricular (LV) filling during exercise. We hypothesized that reduced LV filling time at moderate-intensity exercise limits LA passive emptying and increases LA active emptying. Twent ... Full text Link to item Cite

Under-reporting of maternal and perinatal adverse events in New Zealand.

Journal article BMJ Open · July 23, 2015 OBJECTIVES: To determine the proportion of maternal and perinatal mortality and morbidity cases, identified by the Perinatal and Maternal Mortality Review Committee (PMMRC), that are also reported within the annual serious adverse events (SAEs) reports pub ... Full text Link to item Cite

Time-lapse systems for embryo incubation and assessment in assisted reproduction.

Journal article Cochrane Database Syst Rev · February 27, 2015 BACKGROUND: Embryo incubation and assessment is a vital step in assisted reproductive technology (ART). Traditionally, embryo assessment has been achieved by removing embryos from a conventional incubator daily for assessment of quality by an embryologist, ... Full text Link to item Cite

Dehydroepiandrosterone for women in the peri- or postmenopausal phase.

Journal article Cochrane Database Syst Rev · January 22, 2015 BACKGROUND: During menopause a decreasing ovarian follicular response generally causes a fluctuation and eventual decrease in estrogen levels. This can lead to the development of various perimenopausal and postmenopausal symptoms (for example hot flushes, ... Full text Link to item Cite

Time-lapse in the IVF-lab: how should we assess potential benefit?

Journal article Hum Reprod · January 2015 Time-lapse imaging of embryos has been widely introduced to fertility laboratories worldwide with the aim of identifying the best quality embryos to transfer that will ultimately improve IVF success rates. In this opinion paper, we explore the lack of evid ... Full text Link to item Cite

Sex differences in biomarkers associated with insulin resistance in obese adolescents: metabolomic profiling and principal components analysis.

Journal article J Clin Endocrinol Metab · December 2014 OBJECTIVE: Obesity and insulin resistance (IR) predispose to type 2 diabetes mellitus. Yet only half of obese adolescents have IR and far fewer progress to type 2 diabetes mellitus. We hypothesized that amino acid and fatty acid metabolites may serve as bi ... Full text Link to item Cite

What is the best treatment option for infertile women aged 40 and over?

Journal article J Assist Reprod Genet · June 2013 PURPOSE: To summarise the causes of decreased fecundity with age and review chronological vs biological ovarian ageing. To explore the clinician's means of assessing a woman's ovarian reserve. To review the recent literature on the effectiveness of differe ... Full text Link to item Cite

The clinical treatment of childhood obesity.

Journal article Indian J Pediatr · March 2013 With the rising prevalence of childhood obesity, pediatricians are increasingly called upon to treat clinically overweight children. The primary treatment options are behavioral lifestyle modification, pharmacotherapy, and surgery. The cornerstone of child ... Full text Link to item Cite

The association between vitamin D and cardiometabolic risk factors in children: a systematic review.

Journal article Clin Pediatr (Phila) · March 2013 The objective of this systematic review was to evaluate the association between serum 25-hydroxyvitamin D (25OHD) and cardiometabolic risk in children and the effect of vitamin D supplementation on risk. We included 35 clinical trials, cross-sectional stud ... Full text Link to item Cite

Predictors of attrition from a clinical pediatric obesity treatment program.

Journal article Clin Pediatr (Phila) · December 2012 OBJECTIVE: To assess the predictors of attrition from a clinical pediatric obesity treatment program. METHODS: We evaluated 2- through 20-year-old patients first seen at the Duke University Healthy Lifestyles Program between October 2006 and December 2008. ... Full text Link to item Cite

The YMCA Healthy, Fit, and Strong Program: a community-based, family-centered, low-cost obesity prevention/treatment pilot study.

Journal article Child Obes · December 2012 BACKGROUND: Many resources are available for adults, but there are few community-based programs for overweight and obese children. Community engagement may be instrumental in overcoming barriers physicians experience in managing childhood obesity. Our obje ... Full text Link to item Cite

The effectiveness of a primary care-based pediatric obesity program.

Journal article Clin Pediatr (Phila) · April 2012 The objective of this retrospective cohort study was to evaluate the effectiveness of the Duke University Healthy Lifestyles Program (HLP), a primary care-based childhood obesity treatment program. The study population included obese 2- through 19-year-old ... Full text Link to item Cite

Treating pediatric obesity in the primary care setting to prevent chronic disease: perceptions and knowledge of providers and staff.

Journal article N C Med J · 2012 BACKGROUND: The national and international epidemic of chronic disease, including among children, is largely fueled by increasing obesity. It is recommended that primary care play a key role in the treatment of pediatric obesity. METHODS: A written survey ... Link to item Cite

An 8-year-old girl with headache and syncope.

Journal article Pediatr Ann · December 2011 Full text Link to item Cite

Payment for obesity services: examples and recommendations for stage 3 comprehensive multidisciplinary intervention programs for children and adolescents.

Journal article Pediatrics · September 2011 OBJECTIVE: The Reimbursement and Payment Subcommittee of the National Association of Children's Hospitals and Related Institutions FOCUS on a Fitter Future group sought to guide medical providers, patients, and payers to better serve obese children and ado ... Full text Link to item Cite

A "novel" intervention: a pilot study of children's literature and healthy lifestyles.

Journal article Pediatrics · March 2010 OBJECTIVE: To determine if reading an age-appropriate novel has the potential to improve BMI percentile and exercise- and nutrition-related knowledge and behaviors in girls aged 9 to 13 years who were enrolled in a childhood obesity-treatment program. METH ... Full text Link to item Cite