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Background: Approximately 20% of US children are obese and these rates are expected to increase. The National School Lunch Program (NSLP) provides meals to millions of students and may influence their body mass index (BMI). This study aimed to investigate whether students who participate in the NSLP have a higher BMI when compared to those that do not. Methods: Secondary data from the US Census Bureau were analyzed. Kruskal-Wallis H tests were performed to find associations between NSLP participation and students' BMI. Race and economic stability were included as moderating variables. Results: NSLP participation and respondents that identified as White/Caucasian, African American, and Native American were positively associated with BMI. Lower economic stability was also positively associated with BMI. Conclusion: Participation in the NSLP was significantly associated with participants' BMI, race, and economic stability. While a cause-and-effect relationship cannot be determined, these results are important given their potential influence on students' long-term health.

Our objective was to systematically examine the characteristics of exercise interventions on adherence and dropout in children and adolescents with obesity. PubMed, Embase, PsycINFO, Lilacs, Scielo, and The Cochrane Central Register of Controlled Trials and reference lists of relevant articles were searched. We included randomized controlled trials with exercise interventions for pediatric patients with obesity presenting data on dropout and/or adherence. Two reviewers screened the records independently for eligibility with disagreements being resolved by a third reviewer. Twenty‐seven studies with 1268 participants were included. Because of high heterogeneity and poor reporting of adherence, it was not possible to perform a meta‐analysis. Dropout prevalence was calculated, and subgroup analyses comparing different types of exercise and a meta‐regression with potential moderators were performed. We found a dropout rate of 13%. Subgroup analyses did not identify significant differences. The duration of the exercise presented a moderating effect on dropout, suggesting that longer exercise sessions may lead to higher dropout in children and adolescents with obesity. Because of the poor adherence data, it is not clear which exercise characteristics may moderate adherence. To improve the quality of childhood obesity care, it is mandatory that future studies present adherence data. Systematic review registration: PROSPERO CRD42021290700. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to compare adherence and dropout rates in adolescents with obesity participating in a behavioral-counseling intervention with or without recreational physical activity (PA). Material and methods: Seventy-four adolescents (13 to 18y, 40 girls and 34 boys) with obesity (body mass index [BMI] z-score ≥ 2.0) were randomized into a counseling group (CG; n = 37) and a counseling + recreational physical activity group (CPAG; n = 37). Adolescents from both groups received behavioral counseling once a week for 12 weeks and monthly for an additional 12 weeks. CPAG adolescents participated in supervised recreational physical activity sessions twice a week for 12 weeks. Body composition, body image dissatisfaction, symptoms of depression, binge eating, bulimia, anorexia and quality of life were assessed at baseline and after 24-weeks. Result: The dropout rate was 2.73 times higher in adolescents from CG compared to CPAG (χ2 = 4.48; p =.034; R2McF = 0.044). Girls were 2.56 times more likely to withdraw when compared to boys (χ2 = 3.86; p =.049; R2McF = 0.038). Binomial logistic regression which incorporated sex, intervention group, BMI z-score and BSQ score at baseline (R2McF = 0.177) explained 75% of the dropout rate. Both interventions were effective in reducing waist circumference (p <.01) and improving quality of life, symptoms of depression, bulimia and binge eating (p <.01). Conclusion: Incorporating a recreational physical activity component to a non-intensive behavioral intervention may be a feasible strategy to reduce dropout rates in adolescents with obesity seeking treatment. [ABSTRACT FROM AUTHOR]

Purpose: To describe the presence of metabolic syndrome (MS) in Brazilian adolescents with obesity, and to compare anthropometric and cardiorespiratory fitness measurements in relation to the presence of MS. Methods: Sixty-seven adolescents (13–18 years, 36 girls) with obesity (body mass index z-score ≥2.0) were enrolled. The following were assessed for each participant: anthropometrics, body composition, lipid profile, glucose, serum insulin, insulin resistance, blood pressure (BP), and cardiorespiratory fitness. Results: The presence of MS was found in 47.76% of the sample. The following abnormal measurements were most frequently reported: waist circumference (WC) (100.0%), BP (85.07%), and triglycerides (TG) (50.75%). Boys with obesity were more likely to meet MS criteria when compared to girls (P = 0.040; odds ratio = 2.80 [1.04–7.56]). Conclusion: The presence of MS in Brazilian adolescents with obesity in this study was 47.76%. Among this sample, the most frequently reported MS variables above the established cutoffs were WC (100%), followed by altered BP (85%) and TG (50%). These data further support previously published studies that low levels of cardiorespiratory fitness may increase the risk of MS among adolescents with obesity. [ABSTRACT FROM AUTHOR]