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Neurotrophic factors and cardiorespiratory fitness are both considered important in developmental trajectories but their link to brain health remains poorly understood. The aims of the study were to examine whether levels of plasma-derived neurotrophic factors were associated with brain health indicators in children with overweight or obesity; and to test whether these associations were moderated by cardiorespiratory fitness. 100 children (41% girls) were included in this analysis. Plasma levels of brain-derived neurotrophic factor, insulin-like growth factor-1, vascular endothelial growth factor A, and epidermal growth factor were determined by XMap technology. Academic performance and executive function were assessed using validated neuropsychological tests. Hippocampal volume was measured using magnetic resonance imaging. Cardiorespiratory fitness was assessed using the 20-m Shuttle Run Test. Insulin-like growth factor-1 was positively associated with cognitive flexibility. Stratified analyses by fitness categories (i.e. unfit vs. fit) showed that brain-derived neurotrophic factor was positively associated with right posterior hippocampal volume in fit children, and epidermal growth factor was negatively associated with right hippocampal, and right anterior hippocampal volumes in their unfit peers, with a moderating role of cardiorespiratory fitness in these associations. However, all these significant associations disappeared after correction for multiple comparisons. The association between neurotrophic factors and brain health indicators in children with overweight/obesity was neither strong nor consistent. These results could help enhance our understanding of determinants of brain health in children with overweight/obesity. Highlights This study provides novel findings on the associations between neurotrophic factors and a wide range of brain health indicators in children. This study additionally explored the role of cardiorespiratory fitness in these asso

Importance: Childhood obesity is a risk factor associated with type 2 diabetes, cardiovascular disease, and mental disorders later in life. Investigation of the parallel effects of a defined exercise program on cardiometabolic and mental health in children with overweight or obesity may provide new insights on the potential benefits of exercise on overall health. Objective: To investigate the effects of a 20-week exercise program on cardiometabolic and mental health in children with overweight or obesity. Design, Setting, and Participants: This secondary analysis of a parallel-group randomized clinical trial was conducted in Granada, Spain, from November 1, 2014, to June 30, 2016. Data analyses were performed between February 1, 2020, and July 14, 2022. Children with overweight or obesity aged 8 to 11 years were eligible, and the study was performed in an out-of-school context. Intervention: The exercise program included 3 to 5 sessions/wk (90 min/session) of aerobic plus resistance training for 20 weeks. The wait-list control group continued with their usual routines. Main Outcomes and Measures: Cardiometabolic outcomes as specified in the trial protocol included body composition (fat mass, fat-free mass, and visceral adipose tissue), physical fitness (cardiorespiratory, speed-agility, and muscular), and traditional risk factors (waist circumference, blood lipid levels, glucose levels, insulin levels, and blood pressure). Cardiometabolic risk score (z score) was calculated based on age and sex reference values for levels of triglycerides, inverted high-density lipoprotein cholesterol, and glucose, the mean of systolic and diastolic blood pressure, and waist circumference. An additional cardiometabolic risk score also included cardiorespiratory fitness. Mental health outcomes included an array of psychological well-being and ill-being indicators. Results: The 92 participants included in the per-protocol analyses (36 girls [39%] and 56 boys [61%]) had a mean (SD)

Introduction: Childhood and adolescent obesity and overweight is associated with serious physical, psychological and social health complications. The aim of the present study was to explore in depth parents’ perceptions of factors associated with obesity and overweight in their adolescent children. Methodology: A descriptive phenomenological qualitative study was carried out through focus groups. Twenty-five mothers and fathers whose children were diagnosed with obesity or overweight who were under follow-up in the Paediatric Department of the Hospital Clínico San Cecilio (Spain) participated. Data analysis was performed with Atlas.ti 6.2 software through thematic analysis. Results: Lack of limit with food was perceived as a source of conflict and anxiety. The most common unhealthy lifestyle habits were sedentary, lack of time for cooking and skiping breakfast. Parents’ perceptions of the negative effects of obesity are related to traumatic events, effects on body image, isolation and discrimination and the occurrence of other diseases associated with excess weight. Modulating factors of eating behavior were observed such as the promotion of healthy habits in the school environment, awareness of the problem, meal planning, talking about the issue and the search for solutions. Conclusions: Parents encounter obstacles that hinder change and improvement in this population. Thus, it is necessary to address obesity and overweight as a multifactorial problem., Introducción: La obesidad y el sobrepeso infantil y juvenil se asocia con complicaciones graves de salud a nivel físico, psicológico y social. El objetivo del presente estudio fue explorar en profundidad la percepción que tienen padres y madres sobre los factores asociados con la obesidad y el sobrepeso de sus hijos adolescentes. Metodología: Estudio cualitativo de carácter fenomenológico descriptivo utilizando grupos focales. Participaron 25 padres y madres de adolescentes diagnosticados con Obesidad o Sobrepeso que se encontraban en seguimiento en el Servicio de Pediatría del Hospital Clínico San Cecilio (España). El análisis de los datos se llevó a cabo con el software Atlas.ti 6.2 a través de un análisis temático. Resultados: La falta de límite con la comida es percibida como una fuente de conflictos y de ansiedad. Los hábitos vitales no saludables más comunes son el sedentarismo, la falta de tiempo para cocinar y no desayunar. Las percepciones de los progenitores sobre los efectos negativos de la obesidad se relacionan con acontecimientos de carácter traumático, los efectos sobre la imagen corporal, el aislamiento y la discriminación y la aparición de otras enfermedades asociadas al exceso de peso. Se observan factores moduladores del comportamiento alimentario como el fomento de hábitos saludables en el entorno escolar, la toma de conciencia del problema, la planificación de las comidas, hablar sobre el tema y la búsqueda de soluciones. Conclusiones: En el abordaje de la malnutrición por exceso, los progenitores encuentran obstáculos que dificultan el cambio y la mejora en esta población. Así, es necesario abordar la obesidad y el sobrepeso como un problema multifactorial.