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Purpose: To assess associations between sedentary time (ST), physical activity (PA), and cardiovascular health in early childhood. Method: Cross-sectional study including 160 children (age 6.1 y [SD 0.5], 86 boys, 93 maternal body mass index ≥ 30 kg/m2, and 73 gestational diabetes) assessed for pulse wave velocity, echocardiography, ultra-high frequency 48–70 MHz vascular ultrasound, and accelerometery. Results: Boys had 385 (SD 53) minutes per day ST, 305 (SD 44) minutes per day light PA, and 81 (SD 22) minutes per day moderate to vigorous PA (MVPA). Girls had 415 (SD 50) minutes per day ST, 283 (SD 40) minutes per day light PA, and 66 (SD 19) minutes per day MVPA. In adjusted analyses, MVPA was inversely associated with resting heart rate (β = −6.6; 95% confidence interval, −12.5 to −0.7) and positively associated with left ventricular mass (β = 6.8; 1.4–12.3), radial intima-media thickness (β = 11.4; 5.4–17.5), brachial intima-media thickness (β = 8.0; 2.0–14.0), and femoral intima-media thickness (β = 1.3; 0.2–2.3). MVPA was inversely associated with body fat percentage (β = −3.4; −6.6 to −0.2), diastolic blood pressure (β = −0.05; −0.8 to −0.1), and femoral (β = −18.1; −32.4 to −0.8) and radial (β = −13.4; −24.0 to −2.9) circumferential wall stress in boys only. ST and pulse wave velocity showed no significant associations. Conclusions: In young at-risk children, MVPA is associated with cardiovascular remodeling, partly in a sex-dependant way, likely representing physiological adaptation, but ST shows no association with cardiovascular health in early childhood. [ABSTRACT FROM AUTHOR]

Purpose: Previous literature has demonstrated the mediating role of adiposity in the association between cardiorespiratory fitness (CRF) and cardiometabolic risk as well as the potential role of CRF in attenuating the adverse consequences associated with excess weight. This study aimed to evaluate the mediating role of CRF and adiposity in the possible association with cardiometabolic risk. Method: Observational 3-year longitudinal study that included 420 children and adolescents (10.50 [2.05] y of age at baseline; 56.2% girls). Body mass index (BMI) was calculated, and CRF was evaluated using field assessments. A clustered cardiometabolic risk score (cMetS) was calculated from glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, and triglycerides z scores. Analyses evaluated the mediating role of BMI in the association between CRF and cMetS as well as whether CRF mediated the association between BMI and cMetS. Results: BMI at baseline was directly associated with the cMetS at follow-up (0.102; 95% confidence interval, 0.020 to 0.181), independently of CRF, whereas CRF was only indirectly associated with cMetS at follow-up through BMI (−0.036; 95% confidence interval, −0.070 to −0.009), meaning that the association between CRF and cMetS was explained via the mediation role of BMI. Conclusions: BMI presented direct association with cMetS, whereas CRF exhibited indirect association with cMetS mediated via BMI. [ABSTRACT FROM AUTHOR]

Childhood obesity is a major problem worldwide and a key contributor to adult obesity. This research explores caregivers' lay beliefs and food parenting practices, and their long-term, intergenerational effects on their children's food consumption and physiology. First, a cross-cultural survey reveals the link between parents' belief that tasty food is unhealthy and the use of extrinsic rewards to encourage their children to eat healthily, with adverse downstream consequences for the children's body mass indices. Next, two studies demonstrate the mechanism by which this strategy backfires, as providing extrinsic rewards ironically increases children's unhealthy food consumption, which in turn leads to an increase in their body mass indices. The final two studies demonstrate potential solutions for public policy and health practitioners, either by manipulating "unhealthy = tasty" beliefs directly or by breaking the association between these food beliefs and the use of extrinsic rewards through an intervention. [ABSTRACT FROM AUTHOR]

Family-based behavioral treatment (FBT) is one of the most effective treatments for childhood obesity. These programs include behavior change strategies and basic parenting training to help parents make healthy diet and physical activity changes for their children. While effective, not all families respond to this program. Additional training on how to effectively deliver these behavior change strategies may improve outcomes. The authoritative parenting style is associated with many positive academic and socio-emotional outcomes in children, and is characterized by displays of warmth and support while also being consistent with setting limits and boundaries. This parenting style has also been associated with normal weight status. Furthermore, parenting training programs that promote this parenting style for children with behavioral issues have shown unintended effects on decreasing child weight status. Therefore, our goal was to examine the effect of adding more intensive parenting training to FBT on child weight status. We randomized 140 children and their parent to either FBT or FBT + Parenting Training (FBT + PT). Assessments were conducted at baseline, mid-treatment (month 3), post-treatment (month 6), 6-month follow-up (month 12), and 12-month follow-up (month 18). Primary outcome was change in child weight status. Secondary outcomes were rates of drop-out, treatment adherence, and acceptability. If effective, this program may provide another alternative for families to help improve outcomes in childhood obesity management.

IntroductionMeta-analyses across diverse independent studies provide improved confidence in results. However, within the context of metabolomic epidemiology, meta-analysis investigations are complicated by differences in study design, data acquisition, and other factors that may impact reproducibility.ObjectiveThe objective of this study was to identify maternal blood metabolites during pregnancy (> 24 gestational weeks) related to offspring body mass index (BMI) at age two years through a meta-analysis framework.MethodsWe used adjusted linear regression summary statistics from three cohorts (total N = 1012 mother-child pairs) participating in the NIH Environmental influences on Child Health Outcomes (ECHO) Program. We applied a random-effects meta-analysis framework to regression results and adjusted by false discovery rate (FDR) using the Benjamini-Hochberg procedure.ResultsOnly 20 metabolites were detected in all three cohorts, with an additional 127 metabolites detected in two of three cohorts. Of these 147, 6 maternal metabolites were nominally associated (P  100), we failed to identify significant metabolite associations after FDR correction. Our investigation demonstrates difficulties in applying epidemiological meta-analysis to clinical metabolomics, emphasizes challenges to reproducibility, and highlights the need for standardized best practices in metabolomic epidemiology.

Summary The study aims to test the efficacy of a family‐centred healthy lifestyle program in primary care health centres among children with overweight or obesity, evaluating the results at 3, 6, and 9 months post‐intervention. A single‐blind, randomised controlled cluster study where participants will be blinded to group assignment to reduce bias will be followed. The intervention comprises a 6‐month program with intensive and maintenance behavioural therapies, including dietary modifications and guidelines for physical activity, administered by a multidisciplinary team. Participants will be assigned to an intervention group or a treatment‐as‐usual control group. Primary health centres in Seeb Wilayat, serving densely populated areas and willing to participate, will be included. Randomisation will be conducted at the cluster level to improve recruitment efficiency. A sample size calculation will ensure adequate power to detect significant differences. Ethical approval is granted and informed consent/assent will be obtained from all participants. The proposed study focusses on testing the efficacy of a family‐centred healthy lifestyle program in primary care centres through a controlled, randomised study. Successful outcomes could lead to informed interventions, improvements in the health system, policy recommendations, positive community impacts, information on behavioural therapies, and improved long‐term health outcomes for affected children and their families. This study will contribute to the literature by providing a culturally sensitive and evidence‐based solution to a pressing public health issue, which can be adapted to similar contexts in Oman and beyond. [ABSTRACT FROM AUTHOR]

Background. Obesity's negative impact on young people's health has long been known. The family and its socioeconomic position (SEP) are key determinants in adolescent obesity. However, understanding which familial determinants explain the association remains limited. Method. The analyses are based on data from the "German Health Interview and Examination Survey for Children and Adolescents" (KiGGS) (1,384 females and 1,332 males aged 11 to 17 years). Logistic regression models explored how familial determinants (family stress, family cohesion, parental smoking, parental sporting activity, and parental overweight) mediated the association between family SEP (parental education, occupational status, and household income) and adolescent obesity. Results. Significant total effects for the associations between family SEP in childhood and adolescent obesity were found. Splitting the total effect of the family SEP on obesity into direct and indirect effects, all direct effects turned out to be significant. However, all associations involved also indirect effects of familial determinants, except for household income for female adolescents. Parental smoking and overweight were the most relevant mediators for males and females. For male adolescents, parental sporting activity additionally mediated the association between SEP and obesity. Conclusion. A low SEP in childhood was associated with adolescent obesity. Parental health and health behaviors partly explained the association. For increasing health equality in adolescent health, the consideration of parental health behavior in the planning and implementation of health promotion programs seem to be important. [ABSTRACT FROM AUTHOR]

Epidemiologic research has identified numerous interpersonal and individual risk factors for and warning signs of emerging eating disorders in adolescents. These findings have informed public health prevention and treatment strategies, including translation of findings to clinical recommendations for primary care providers (PCPs). A next step in this translational work could include a comprehensive approach where PCPs are seen as partners in efforts to improve population health outcomes. PCPs have great potential to implement high-yield interventions that prevent or attenuate the course of adolescent eating disorders. To illustrate this potential, we present a case that highlights missed opportunities for a PCP to prevent, detect, and intervene during a patient's developing eating disorder. We then relate the case to two emerging research programs that utilize PCP partnerships: one trains PCPs in Strengths-Based Adolescent Healthcare to improve eating disorder prevention; the other adapts Family-Based Treatment for primary care to improve early access to evidence-based treatment. In addition to these promising areas of research, efforts are needed to widen requirements for eating disorder curricula in medical training programs and to address weight stigma in primary care. Together these efforts will help PCPs become effective partners in the prevention and treatment of eating disorders. [ABSTRACT FROM AUTHOR]

Introduction: Childhood obesity is associated with maternal obesity, but the link to gestational weight gain (GWG) is not fully elucidated. We examined the relationship between early pregnancy maternal body mass index (BMI) and GWG on early childhood growth. Material and Methods: Data from 30 197 mother–child pairs from Uppsala County Mother and Child Cohort were divided into 15 groups according to maternal BMI and GWG, based on World Health Organization classification and Institute of Medicine guidelines, respectively. Postnatal growth patterns were analyzed with linear mixed regression models within maternal BMI groups. Odds ratios of overweight and obesity at 4 years of age were assessed with logistic regression analyses. We treated children of mothers with normal weight and adequate GWG as the reference group, and all analyses were adjusted for potential confounders. Results: GWG was associated with infant BMI z‐score at birth, independent of potential confounding factors. Independent of GWG, we observed an overall decrease in BMI z‐score from 18 months to 5 years in children of mothers who were underweight, while an increase in BMI z‐score was seen in children of mothers who were overweight or obese. In children of normal‐ and overweight mothers, the risk of childhood overweight and obesity was associated with excessive compared to adequate GWG (adjusted odds ratio [aOR] 1.17, 95% confidence interval [CI] 1.01–1.36 for normal‐weight mothers, and aOR 1.25, 95% CI 1.04–1.51 for overweight mothers, respectively). Children of mothers with obesity and excessive GWG had the highest risk of being overweight or obese at 4 years (aOR 2.88, 95% CI 2.40–3.44, and 4.38, 95% CI 3.37–5.67, respectively). Associations did not differ between children of mothers with obesity class 1 and 2–3 when comparing excessive and adequate GWG (aOR 1.33, 95% CI 0.96–1.85, and 1.12, 95% CI 0.74–1.70, respectively). Conclusions: Maternal GWG affects infant birth size and growth until 18 months, although maternal BMI is more crucial for childhood growth beyond 18 months. Further, children of mothers who are normal‐ or overweight and experience excessive GWG have an increased risk of obesity at 4 years. [ABSTRACT FROM AUTHOR]

Childhood obesity is a pervasive health issue, with multifaceted implications for developmental trajectory. Participants included 5,573 K-5 students enrolled in a high-poverty urban public-school setting. Through an informal yet holistic assessment process, students identified as exhibiting overweight issues were compared to peers not designated as overweight across several relevant categories. Overweight students were more likely to be from lower socioeconomic backgrounds; have a high association with special education service needs; represent a more intensive overall risk level as perceived by student support staff; and mostly exhibit decreased performance in report card grades, standardized test scores, and academic engagement. Results confirm previously documented disparities in school functioning and consideration for at-risk status; this is especially relevant in an underserved context, in which regular access to services may be limited. Therefore, reliance on initial screening measures becomes necessary as a preventative mechanism to better assist children in need and to facilitate intervention planning. [ABSTRACT FROM AUTHOR]

Summary: Objective: To summarize the literature on pharmacotherapy for managing paediatric obesity. Methods: A systematic review and meta‐analysis were conducted of randomized controlled trials (RCTs) with <18‐year‐olds of pharmacotherapeutic agents published up to November 2022. Estimates of effect for outcomes were presented relative to minimal important differences and GRADE certainty of evidence. We examined data on patient/proxy‐reported outcome measures (PROMs), cardiometabolic risk factors, anthropometry and adverse events (AEs). Results: Overall, 35 RCTs were included. Trials examined metformin (n = 26), glucagon‐like peptide‐1 receptor agonists (GLP1RAs) (n = 7) and a lipase inhibitor (orlistat; n = 2). Intervention duration varied (3−24 months). Metformin had little to no benefit on PROMs (e.g., health‐related quality of life [HRQoL]; 6 RCTs), moderate reductions in triglycerides, a moderate decline in insulin resistance, a small to moderate decline in BMI z‐score (BMIz) and a moderate increase in mild to moderate gastrointestinal AEs. Response to GLP1RAs was heterogeneous and results of subgroup analysis demonstrated variability of impact. Liraglutide (2 RCTs) resulted in a small reduction in HOMA‐IR and BMIz, but little to no benefit on other outcomes. Exenatide (4 RCTs) had a moderate reduction on blood pressure and a small decrease in BMIz with little to no benefit on other outcomes. Semaglutide (1 RCT) had a small benefit on HRQoL, a small reduction on SBP, a moderate reduction on total cholesterol and LDL‐cholesterol, a large reduction on triglyceride, and a very large decline in BMIz accompanied by a small increase in mild to moderate gastrointestinal AEs. Orlistat had a moderate reduction in DBP and little to no benefit in other outcomes measured, but had a very large increased risk of mild to moderate gastrointestinal AEs. Serious AEs were rare and for interventions with sufficent AE reporting, were considered not likely attributable to the interventions. Conclusion: Few studies examined the impact of pharmacotherapy on PROMs. There is evidence that metformin and GLP1RAs lead to important improvements in cardiometabolic and anthropometric outcomes while accompanied by mild to moderate AEs. Long‐term effectiveness and safety of GLP1RAs remain to be evaluated. [ABSTRACT FROM AUTHOR]

Summary: Objective: To summarize the literature on bariatric surgery for managing pediatric obesity, including intervention effects to improve patient‐reported outcome measures (PROMs), cardiometabolic risk factors, anthropometry, and assess adverse events (AEs). Methods: Eligible studies were published between January 2012 and January 2022 and included randomized controlled trials (RCTs) and observational (controlled and uncontrolled) studies before and after surgery with a mean age <18 years old. Outcomes and subgroups were selected a priori by stakeholders; estimates of effect for outcomes were presented relative to minimal important differences (MIDs) and GRADE certainty of evidence. We examined data on PROMs, cardiometabolic risk factors, anthropometry, and AEs. Subgroup analyses examined outcomes by follow‐up duration and surgical technique, when possible. Results: Overall, 63 publications (43 original studies) met our inclusion criteria (n = 6128 participants; 66% female). Studies reported six different surgical techniques that were evaluated using uncontrolled single arm observational (n = 49), controlled observational (n = 13), and RCT (n = 1) designs. Most studies included short‐term follow‐up (<18 months) only. PROMs were measured in 12 (28%) studies. Surgery led to large improvements in health‐related quality of life compared to baseline and control groups, and moderate to very large improvements in cardiometabolic risk factors compared to baseline. Large to very large improvements in BMIz were noted compared to baseline across all follow‐up periods. There was limited evidence of AEs with most reporting mild or non‐specific AEs; serious AEs were uncommon. Conclusion: Bariatric surgery demonstrated primarily moderate to very large improvements across diverse outcomes with limited evidence of AEs, albeit with low to moderate certainty of evidence. [ABSTRACT FROM AUTHOR]

Summary: Background: The precise mechanisms underlying the health benefits of time‐restricted eating (TRE) are unclear, particularly in adolescents. Objectives: This secondary analysis examines the impact of 8‐h TRE on energy intake, dietary composition and quality in adolescents with obesity, using data from a 12‐week randomized, controlled pilot trial. Methods: Participants (14–18 years with BMI >95th percentile) were assigned to either 8‐h TRE with real‐time or blinded continuous glucose monitoring or a control group with a 12+ h eating window. Dietary intake was analysed using the Nutrient Data System Recall 24‐h Dietary Recall and the Healthy Eating Index (HEI‐2020) for assessing diet quality. Results: The study included 44 participants (32 TRE, 12 control), predominantly female and Hispanic/Latino. The TRE group showed a significant reduction in mean energy intake (−441 kcal/day), carbohydrates (−65 g/day), added sugar (−19 g/day) and fat (−19 g/day), while the control group had a similar reduction in energy intake (−437 kcal/day) and carbohydrates (−63 g/day), but no significant changes in added sugar or fat. The percent energy intake from protein increased more in the TRE group compared to the control. The TRE group experienced a significant improvement in diet quality, with a 6.3‐point increase in HEI‐2020 score; however, between‐group comparisons were not statistically significant. Conclusion: There were no significant differences between the TRE and control groups in energy intake, dietary composition or quality. Future research with larger sample sizes is needed to further evaluate the potential impact of TRE on dietary behaviours. [ABSTRACT FROM AUTHOR]

Summary: Anti‐obesity medications (AOMs) have emerged as one element of comprehensive obesity clinical care intended to improve long‐term health outcomes for children and adolescents. The number of pediatric AOM clinical trials has burgeoned in recent years as new pharmacotherapeutics have been developed. Factors related to growth and development in children and adolescents can present unique challenges in terms of designing and conducting clinical trials investigating the safety and efficacy of AOMs. These barriers can delay the AOM development and evaluation process, increase the cost of performing trials, create challenges in the interpretation of results, influence the generalizability of the findings and present ethical dilemmas. In an effort to address these issues and provide guidance to streamline the process of designing and conducting pediatric AOM clinical trials, relevant key stakeholders convened a series of roundtable meetings to discuss, debate and achieve harmonization on design features. Stakeholder participants included a multidisciplinary group of international pediatric obesity experts, patient (parent) representatives and representatives from academic medicine, key regulatory agencies and industry. Topics of discussion included primary efficacy end‐points, secondary end‐points, eligibility criteria, trial run‐in and follow‐up phases, use of active comparators and guidelines for down‐titration and/or stopping rules for excessive weight reduction. Consensus recommendations were agreed upon. Regarding end‐points, emphasis was placed on moving away from BMI z‐score as a primary outcome, incorporating multiple alternative BMI‐related outcomes and measuring adiposity/body fat as a prominent secondary end‐point. Trial eligibility criteria were carefully considered to maximize generalizability while maintaining safety. The limited value of trial run‐in phases was discussed. It was also underscored that designing trials with extended follow‐up periods after AOM withdrawal should be avoided owing to ethical issues (including possible psychological harm) related to weight regain without providing the opportunity to access other treatments. The panel emphasized the value of the randomized, placebo‐controlled trial but recommended the thoughtful consideration of the use of active comparators in addition to, or instead of, placebo to achieve clinical equipoise when appropriate. Finally, the panel recommended that clinical trial protocols should include clear guidance regarding AOM down‐titration to avoid excessive weight reduction when applicable. [ABSTRACT FROM AUTHOR]

Summary: Background: Dietary interventions and increased physical activity are the cornerstones for management of the paediatric non‐alcoholic fatty liver disease (NAFLD). Though, no specific diet has been proven superior, Indo‐Mediterranean diet (IMD) has shown promise in adult literature. Thus, we aimed to compare the effect of IMD and a standard calorie‐restricted diet (CRD) in Indian overweight children and adolescents with biopsy‐proven NAFLD. Methods: Thirty‐nine consecutive biopsy‐proven NAFLD children between the ages of 8 and 18 years were randomized into either IMD or CRD for 180 days, and various parameters were evaluated at baseline and then after 180 days (NCT05073588). Results: A total of 34 subjects (18 in IMD and 16 in CRD group) completed the study. There was a significantly higher decrease in controlled attenuation parameter (CAP) values (as a marker of hepatic steatosis; on transient elastography) (95% CI: 4.2–73.4, p = 0.042), weight (95% CI: 0.75–5.5, p = 0.046) and body mass index (BMI) (95% CI: 0.21–2.05, p = 0.014) (but not in Pediatric NAFLD Fibrosis Index or PNFI; as a marker of hepatic fibrosis) in IMD group compared to the CRD group. Liver stiffness measurement, serum cholesterol and low‐density lipoprotein levels and HOMA‐IR decreased only in the IMD group (p < 0.001). Our statistical model showed that delta‐Weight was the only independent variable associated with delta‐CAP. Conclusion: Both IMD and CRD can improve the various anthropometric, clinical, imaging and biochemical parameters but IMD was superior to CRD in terms of reducing CAP values and weight/BMI over 180 days in overweight/obese NAFLD children. [ABSTRACT FROM AUTHOR]

Summary: Background: Up to 50% of adolescents who undergo metabolic and bariatric surgery (MBS) have obesity 3 years post‐MBS, placing them at continued risk for the consequences of obesity. Objectives: We conducted an open‐label, 16‐week pilot study of liraglutide in adolescents with obesity after sleeve gastrectomy (SG) to investigate liraglutide effects on weight and body mass index (BMI) post‐SG. Methods: Adolescents aged 12–20.99 years with obesity and a history of SG ≥1 year prior were enrolled. Liraglutide was initiated at 0.6 mg/day, escalated weekly to a maximum of 3 mg/day, with treatment duration 16 weeks. Fasting laboratory assessments and an oral glucose tolerance test were performed at baseline and end‐treatment. Results: A total of 43 participants were screened, 34 initiated liraglutide (baseline BMI 41.2 ± 7.7 kg/m2), and 31 (91%) attended the end‐treatment visit. BMI decreased by 4.3% (p < 0.001) with liraglutide. Adolescents who had poor initial response to SG (<20% BMI reduction at BMI nadir) had less weight loss with liraglutide. Fasting glucose and haemoglobin A1C concentrations significantly decreased. There were no serious treatment‐emergent adverse events reported. Conclusions: Liraglutide treatment was feasible and associated with a BMI reduction of 4.3% in adolescents who had previously undergone SG, quantitatively similar to results obtained in adolescents with obesity who have not undergone MBS. [ABSTRACT FROM AUTHOR]

Background: Masticatory function seems to play a role in the aetiology of obesity. However, literature on the association between oral myofunctional status and overweight and obesity in children and adolescents is scarce and contrasting. Objective: To compare masticatory performance, orofacial myofunctional status and tongue strength and endurance between children and adolescents with overweight and obesity and those with normal weight. Methods: Thirty children and adolescents with overweight and obesity and 30 subjects with normal weight matched for age and sex were recruited. All subjects were evaluated with the Test of Masticating and Swallowing Solids in Children (TOMASS‐C) for masticatory performance and with the Italian Orofacial Myofunctional Evaluation with Scores (I‐OMES) for the orofacial myofunctional status. Anterior and posterior maximum tongue pressures and tongue endurance were measured. Parents‐reported (PRO) duration of meals was recorded. Data were compared between the groups through the paired samples t‐test or the Wilcoxon signed‐rank test. Results: Children and adolescents with overweight showed significantly lower number of bites (p =.033), lower I‐OMES scores (p <.05), and shorter meal duration (p =.005) compared to their peers with normal weight. No significant differences were found between the two groups for the number of swallows, the number of masticatory cycles and the total time of the TOMASS‐C, and none of the tongue pressure measurements. Conclusions: Eating in children and adolescents with overweight and obesity is characterised by a larger bolus sizes and shorter PRO meal duration. Additionally, overweight and obesity seem to be associated with poorer orofacial skills and structures in the paediatric population. [ABSTRACT FROM AUTHOR]

The aim with the present study was to evaluate the effects and tolerability of Family Meals on Prescription, a 3-month intensive dietary intervention with a participatory approach on body mass index (BMI) and metabolic health in children living with obesity. In this prospective randomized controlled trial, children aged 5–15 years were included from the Pediatric Obesity outpatient Clinics in Halland, Sweden. Participants were randomly assigned to receive lifestyle treatment with or without Family Meals on Prescription (FMP) consisting of a subsidized prepacked grocery bag including recipes and provisions for five Family Meals per week for 3 months. The primary endpoint was changed in BMIz after 3, 12 and 18–24 months and secondary endpoints included to assess tolerability of FMP and effects on metabolic biomarker and frequency of shared meals. Eighty-nine children (51.7% female) entered the study, 54 patients in the intervention group and 35 in the control group. There were no significant differences between the groups concerning gender, age or level of obesity at baseline. The Family Meal on Prescription intervention combined with lifestyle treatment led to a significantly greater reduction in BMIz than lifestyle treatment alone after the 3-month long intervention (− 0.17 vs + 0.01, p < 0.01); however, this difference was not sustained throughout the study period, and in fact, the control group had a greater reduction in BMIz after 18–24 months. A subsidized prepacked grocery bag may be a novel, well-tolerated and effective tool in the treatment of childhood obesity. The fact that the BMIz reduction shown at the end of the intervention did not persist over time emphasized the need of long-term treatment. Registered at clinicaltrals.gov 27 Nov 2020, retrospectively registered: clinicaltrials.gov number 19002468. https://clinicaltrials.gov/study/NCT05225350 What is Known: • Swedish data shows that lifestyle treatment alone is not sufficient for many families undergoing treatment for childhood obesity. • Regular family meals and mealtime routines have been shown to be important for nutritional health and dietary patterns in children and adolescents. What is New: • This intervention with a participatory approach involving prepacked family meals was well tolerated and led to a significant reduction in BMIz during the intervention. • That fact that these results were not sustained over time indicates a need to evaluate longer interventions, and that childhood obesity is a chronic and complex disease which requires long-time treatments. [ABSTRACT FROM AUTHOR]

With the healthy food decision trends and conflicting taste preferences, wide array of experience augmentation strategies have been developed to maintain healthy diet without reducing sensory expectations. Employed appropriate physical, chemical, biological, and psychophysics strategies in the preparation and consumption of enhanced-flavor dairy products were assessed in this review. Multimodal perception to adjust flavor at the neurosensory level through visual, olfactory, and individual differences have been successfully applied to reduce sugar content in milk dessert products targeted at children to avoid the childhood obesity epidemic. Natural plant-based homogenates can also replace sugar to achieve healthy and all-natural goals in dairy production. Innovative and emerging physical methods used as alternative to traditional thermal processing to remove odors of fermented dairy products and contribute to new flavor, nutty, savory, and fresh. This review indicated that flavor experience augmentation strategies show promise in predicting flavor formation mechanisms, facilitating the synthesis of desirable flavor compounds, and tackling the contradictory information between health and flavor. [ABSTRACT FROM AUTHOR]

Summary: The aim of this study was to provide a quantitative synthesis of the effects of randomized controlled pediatric lifestyle interventions in treating obesity among 11–17‐year‐old children. We conducted a systematic review and meta‐analysis on the randomized controlled trials, consisting of actual exercise training and nutrition education, published between January 2000 and August 2022. The initial search yielded 2598 articles, with eight articles meeting the inclusion criteria. The articles were analyzed using a multivariate random effects model. The primary outcome variables were body mass index (BMI), standardized BMI (BMIz), and waist circumference (WC). Our analyses showed that lifestyle interventions were efficacious in improving BMI (−1.77 kg/m2, 95% CI [−2.70, −0.83], p < 0.001), BMIz (−0.30, 95% CI [−0.45, −0.16], p < 0.001), and WC (−3.32 cm, 95% CI [−5.35, −1.29], p < 0.001) in children with overweight and obesity. In addition, moderation analyses suggested that the efficacy of the lifestyle interventions correlated positively with participants' weight status and was enhanced when an intervention was boosted with a longer intervention duration and higher frequency. In conclusion, the current evidence suggests that lifestyle interventions are efficacious in treating children with obesity. The available evidence further indicates that duration, frequency, along weight status, were moderating the effectiveness of these lifestyle interventions. [ABSTRACT FROM AUTHOR]

Summary: This systematic review with the Delphi study aimed to identify effective and resource‐efficient (optimal) strategies for recruiting schools into health promotion interventions in the United States. A literature search was conducted in PubMed, Cochrane Library, and CINAHL (EBSCO). A total of 116 interventions reported in 160 articles were included. Most school‐based interventions did not report data regarding school recruitment duration (81%), target school size (63%), and school recruitment strategies (78%). Further, no details were provided regarding the reasons for declining to participate despite being eligible. For the Delphi, responses from 23 researchers in school‐based clinical trials were collected. A qualitative descriptive approach was used for coding responses and collapsed into higher‐order categories based on school recruitment strategies. Delphi participants reported that (1) creating new or leveraging pre‐existing partnerships, (2) intervention champion, (3) minimal school disruptions, (4) working with open mind/flexibility, and (5) transparent communication are the most optimal school recruitment strategies. Staff time and travel were the most frequently reported costs for implementing those strategies. The overall trend in school‐based obesity prevention intervention studies illustrates the importance of a better understanding school recruitment. Improved reporting can allow researchers to budget their time and resources better and provide greater confidence in reaching their target school size. [ABSTRACT FROM AUTHOR]

Summary: Childhood obesity represents a significant public health concern, imposing a substantial burden on the healthcare system. Furthermore, weight‐loss programs often exhibit reduced effectiveness in adults who have a history of childhood obesity. Therefore, early intervention against childhood obesity is imperative. Presently, the primary method for diagnosing childhood obesity relies on body mass index (BMI), yet this approach has inherent limitations. Leptin, a satiety hormone produced by adipocytes, holds promise as a superior tool for predicting both childhood and subsequent adulthood obesity. In this review, we elucidate the tools employed for assessing obesity in children, delve into the biological functions of leptin, and examine the factors governing its expression. Additionally, we discuss maternal and infantile leptin levels as predictors of childhood obesity. By exploring the relationship between leptin levels and weight loss, we present leptin as a potential indicator of the effectiveness of obesity interventions. [ABSTRACT FROM AUTHOR]

Background: Obesity is associated with increased complications, rejection, and graft loss after kidney transplantation in adult and pediatric recipients. Elevated body mass index (BMI) is a common contraindication to transplant at adult kidney transplant programs; however, there is no data on such limitations for pediatric patients. Methods: Between October and December 2022, we conducted a survey of Pediatric Nephrology Research Consortium centers assessing the use of BMI in pediatric kidney transplant evaluation. Centers reporting utilization of BMI cutoffs were invited to submit patient-level data on children declined for active transplant listing due to BMI. Results: Thirty-nine centers responded to the survey (42% response rate); 51% include BMI in their written listing criteria, with a median BMI "cutoff" of 39 kg/m2 (range 30–50 kg/m2). Between January 1, 2016, and December 31, 2021, 30 children at 15 transplant centers were declined for listing status due to BMI. Patient-level data was provided for 19 children (63%) who were denied active listing status; median BMI was 42 kg/m2 (range 35.8–49.4 kg/m2) and 84% were on dialysis. One year after evaluation, seven patients (37%) had proceeded to active wait list status. Eight (42%) remained in inactive status and four (21%) were unlisted; ten of these 12 patients (83%) were on dialysis. Conclusions: The use of BMI in pediatric kidney transplant evaluation and listing varies among centers, but BMI limits access to transplant for some children. More information is needed on the outcomes of obese pediatric kidney candidates who are and are not transplanted, to guide development of national and international consensus. [ABSTRACT FROM AUTHOR]

Background: Children with overweight and obesity are at risk for developing chronic kidney disease (CKD). During lifestyle adjustment, the first step in the treatment of childhood obesity, body proportions are likely to change. The aim of this study was to examine how lifestyle intervention affects creatinine-based kidney function estimation in children with overweight and obesity. Methods: This longitudinal lifestyle intervention study included 614 children with overweight and obesity (mean age 12.17 ± 3.28 years, 53.6% female, mean BMI z-score 3.32 ± 0.75). Loss to follow-up was present: 305, 146, 70, 26, and 10 children were included after 1, 2, 3, 4, and 5 (about yearly) follow-up visits, respectively. Serum creatinine (SCr) was rescaled using Q-age and Q-height polynomials. Results: At baseline, 95–97% of the children had a SCr/Q-height and SCr/Q-age in the normal reference range [0.67–1.33]. SCr/Q significantly increased each (about yearly) follow-up visit, and linear mixed regression analyses demonstrated slopes between 0.01 and 0.04 (corresponding with eGFR FAS reduction of 1.1–4.1 mL/min/1.73 m2) per visit. BMI z-score reduced in both sexes and this reduction was significantly higher in males. No correlation between change in rescaled SCr and BMI z-score reduction could be demonstrated. Conclusions: Rescaled serum creatinine (SCr/Q) slightly increases during multidiscipline lifestyle intervention in this cohort of children with overweight and obesity. This effect seems to be independent from change in BMI z-score. Whether this minor decrease in estimated kidney function has clinical consequences in the long term remains to be seen in trials with a longer follow-up period. Clinical Trial registration: ClinicalTrial.gov; Registration Number: NCT02091544. [ABSTRACT FROM AUTHOR]

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Background: Over the past three decades, there has been a significant increase in the prevalence and incidence of overweight and obesity worldwide. The obesogen hypothesis suggests that certain external agents may affect pathways related to fat accumulation and energy balance by stimulating fat cell differentiation and proliferation. Previous research has indicated that exposure to bisphenol A (BPA) and some of its analogues may influence fat accumulation by promoting the transformation of preadipocytes into adipocytes. This study aimed to assess the possible contribution of dietary bisphenol exposure to the odds of developing overweight and obesity in a sample of Spanish children according to sex. Methods: Dietary and anthropometric data were collected from 179 controls and 124 cases schoolchildren aged 3–12 years. Dietary exposure to BPA and bisphenol S (BPS) was assessed using a food consumption frequency questionnaire. Logistic regression models were used to assess the influence of dietary exposure to bisphenols on overweight and obesity stratified by sex. Results: For females, cases had significantly higher exposure to BPA from meat and eggs compared to controls (median = 319.55, interquartile range (IQR) = 176.39–381.01 vs 231.79 (IQR) = 162.11–350.19, p-value = 0.046). Diet quality was higher for controls (6.21 (2.14) vs 4.80 (2.24) p < 0.001) among males independently of a high or low exposure to bisphenols. However, higher diet quality was observed for female controls with an high exposure of total bisphenols (6.79 (2.04) vs 5.33 (2.02) p = 0.031). Females exposed to high levels of BPA from meat and eggs had higher likelihood of being overweight and obese (adjusted Odds Ratio = 2.70, 95% confidence interval = 1.00 – 7.32). However, no consistent associations were found in males. Conclusions: High BPA levels from meat and eggs were positively associated with overweight and obesity in females. The dietary intake of BPA in the schoolchildren in the present study was much higher than the acceptable daily intake established by EFSA for the last year. [ABSTRACT FROM AUTHOR]

Overweight and obesity are linked to the severity of infections and the development of chronic conditions among children and adolescents in Ghana. Hence, estimating the current prevalence and its determinants is imperative to guide public health interventions. This review mapped evidence on the prevalence and determinants of overweight and obesity among in‐school children and adolescents (aged 5–19 years) in Ghana. Three main databases (PubMed, Central, and JSTOR) were searched for studies conducted in Ghana. Also, the study included only studies published online between 2010 and 2022. The search produced 1214 records, with an additional 23 identified through a search conducted in Google, Google Scholar, the WHO library, HINARI, and institutional repositories. After a thorough screening, 24 records were synthesized. The prevalence of overweight/obesity among the 23,663 in‐school children and adolescents in Ghana was 0.5%–47.06%. Females have higher odds of being overweight than males. In addition, lack of nutrition and physical activity (PA) knowledge and low participation in school sports and physical activities exposed in‐school children and adolescents in Ghana to overweight and obesity. Consumption of unhealthy foods, late bed, smoking, loneliness, watching television, and playing computer games exposed schoolchildren and adolescents in Ghana to overweight and obesity. There are relatively high levels of overweight and obesity among school‐going children and adolescents in Ghana. Addressing sex gaps in PA, ensuring healthy eating, and limiting sedentary lifestyles is the surest way to promote healthy weight among in‐school children and adolescents in Ghana. [ABSTRACT FROM AUTHOR]

Summary Background Methods Results Conclusion The diagnosis of monogenic obesity is burdened by frequent variants of uncertain significance (VUS). We describe our real‐life approach of variant reassessment over time and we assess whether inconclusive variants are decreasing in monogenic obesity.We tested for monogenic obesity (genes: LEPR, POMC, ADCY3, PCSK1, CARTPT, SIM1, MRAP2, LEP, NTRK2, BDNF, KSR2, MAGEL2, SH2B1, MC4R, MC3R) in 101 children/adolescents (11.7 [7.3–13.7] years, 3.6 [3.3–4.0] z‐BMI) in Verona and 183 (11.3 [8.4–12.2] years, 3.2 [2.7–3.9] z‐BMI) in Naples from January 2020 to February 2023. In March–July 2024 we reassessed the baseline variants by updated software interpretation and literature renavigation.We initially found 20 VUS, 4 Likely Pathogenic (LP), 5 Likely Benign (LB) and 1 benign variant in 33 individuals. At follow‐up, 6 VUS were reclassified as benign/LB, one LP as pathogenic and 3 LB as benign. Overall, 10/30 variants (6/18 in Verona, 3/11 in Naples and a variant found in both centres) were reclassified, leading to a less uncertain report for 13 of 33 variant‐carrying patients. Monogenic obesity was diagnosed in 3 probands in Verona and 4 in Naples, carrying variants at MC4R or NTRK2.Our variant reassessment was effective to improve classification certainty for the 39% of patients and suggested that the molecular diagnosis of monogenic obesity is becoming more accurate over time. [ABSTRACT FROM AUTHOR]

Background: The prevalence of excessive body mass (BMI) is increasing in pediatric population. Accordingly, the number of musculoskeletal problems in this population is also likely to increase. The quadriceps angle (Q-angle) is a clinical measure used to measure knee alignment in relation to the hip, femur, and tibia, as well as evaluating alignment of the patella. Tibial torsion (T.T) is an important morphological feature of human tibia. The aim of that study was to study the relationship between the Q-angle and TT in children 8 to 12 years old, the effect of BMI on Q-angle and T.T, and the difference in Q-angle and TT between dominant and non-dominant side. Results: "Seventy-five children from primary schools" were enrolled in the study and allocated into 3 groups (25 subjects in each group), according to BMI: group I (normal weight = 25), group II (overweight = 25), and group III (obese = 25). The mean value of age of groups I, II, and III was 10.35 ± 1, 10.74 ± 1.2, and 10.17 ± 1.18 years respectively; the mean value of weight was 29.88 ± 3.94, 43.68 ± 6.55, and 50.06 ± 10.44 kg respectively; the mean value of height was 135.28 ± 7.63, 143.2 ± 8.85, and 140.72 ± 9.3 cm respectively; and the mean value of BMI was 16.22 ± 1, 21.18 ± 1.4, and 25.17 ± 2.67 kg/m2. The number (%) of boys in groups I, II, and III was 15 (60%), 18 (72%), and 17 (68%) respectively and of girls was 10 (40%), 7 (28%), and 8 (32%) respectively. The significant values were Q-angle and TT. Data were expressed as mean ± SD. ANOVA was used to compare between subjects' characteristics of the groups. Kolmogorov-Smirnov test was used for testing normality of data distribution. One-way MANOVA was used to compare parametric variables (Q-angle and TT) between the two groups. Compared with normal weight children, there was statistically significant increase in Q-angle and TT angle in overweight and obese children. Conclusion: Any change in BMI would eventually lead to change in both Q-angle and TT angle. The greater the BMI values, the greater the values of Q-angle and TT angle. [ABSTRACT FROM AUTHOR]

Background: Childhood and adolescent obesity are persistent public health issues in the United States. Childhood obesity Electronic Health Record (EHR) tools strengthen provider-patient relationships and improve outcomes, but there are currently limited EHR tools that are linked to adolescent mHealth apps. This study is part of a larger study entitled, CommitFit, which features both an adolescent-targeted mobile health application (mHealth app) and an ambulatory EHR tool. The CommitFit mHealth app was designed to be paired with the CommitFit EHR tool for integration into clinical spaces for shared decision-making with patients and clinicians. Objectives: The objective of this sub-study was to identify the functional and design needs and preferences of healthcare clinicians and professionals for the development of the CommitFit EHR tool, specifically as it relates to childhood and adolescent obesity management. Methods: We utilized a user-centered design process with a mixed-method approach. Focus groups were used to assess current in-clinic practices, deficits, and general beliefs and preferences regarding the management of childhood and adolescent obesity. A pre- and post-focus group survey helped assess the perception of the design and functionality of the CommitFit EHR tool and other obesity clinic needs. Iterative design development of the CommitFit EHR tool occurred throughout the process. Results: A total of 12 healthcare providers participated throughout the three focus group sessions. Two themes emerged regarding EHR design: (1) Functional Needs, including Enhancing Clinical Practices and Workflow, and (2) Visualization, including Colors and Graphs. Responses from the surveys (n = 52) further reflect the need for Functionality and User-Interface Design by clinicians. Clinicians want the CommitFit EHR tool to enhance in-clinic adolescent lifestyle counseling, be easy to use, and presentable to adolescent patients and their caregivers. Additionally, we found that clinicians preferred colors and graphs that improved readability and usability. During each step of feedback from focus group sessions and the survey, the design of the CommitFit EHR tool was updated and co-developed by clinicians in an iterative user-centered design process. Conclusion: More research is needed to explore clinician actual user analytics for the CommitFit EHR tool to evaluate real-time workflow, design, and function needs. The effectiveness of the CommitFit mHealth and EHR tool as a weight management intervention needs to be evaluated in the future. [ABSTRACT FROM AUTHOR]

Childhood obesity is a persistent public health concern, and community-based interventions have become crucial for addressing it by engaging local communities and implementing comprehensive evidence-based strategies. The Catalyzing Communities intervention takes a "whole-of-community"approach to involve leaders from diverse sectors in thinking systematically about child healthy weights and implementing evidence-based solutions. Using systems thinking and the Getting to Equity framework to guide interview analysis, this study examines changes in participants' use of systems thinking concepts and health equity in 43 participants across four U.S. communities involved in the Catalyzing Communities intervention. Our findings reveal significant shifts in systems thinking concepts, as participants develop a deeper understanding of childhood obesity as a complex adaptive system, and system insights, as participants increasingly recognize the interconnections and leverage points within the system driving childhood obesity. Participants also experienced increases in health equity thinking and action, particularly when discussing social and structural determinants of health, commitment to targeted actions, and a focus on addressing barriers and enhancing resources. The intersection between systems insights and health equity action, such as explaining leverage points and interventions to reduce deterrents to health behaviors, suggests the need for systems thinking activities to be integrated into health equity planning. Future research is needed to develop measures to connect systems thinking concepts to health equity, and the impact of these to community-level policy, systems, and environmental changes in public health. [ABSTRACT FROM AUTHOR]

In recent decades, global rates of overweight and obesity have surged, posing significant health challenges, Maternal obesity is particularly concerning because of its potential adverse effects on women, foetuses, and children. The intrauterine environment plays a crucial role in shaping long-term health outcomes, with maternal factors significantly influencing childhood obesity and related health markers. This review synthesises current evidence on the associations between macrosomia, maternal weight, pregnancy weight gain, and offspring obesity risk. It explores how maternal weight status during pregnancy may impact a child’s susceptibility to obesity later in life, examining potential underlying mechanisms. By consolidating these findings, the review aims to deepen our understanding of the complex relationships between maternal health, prenatal factors, and childhood obesity. This knowledge can inform future research and public health strategies aimed at addressing this global health issue effectively. [ABSTRACT FROM AUTHOR]

Objective: Exploring changing trends in the burden caused by overweight and obesity among children and adolescents from 1990 to 2019 at the global, regional, and national levels, based on data from the Global Burden of Disease study (GBD) 2019. Methods: The annual number and rate of deaths and disability-adjusted life years (DALYs) associated with a high BMI among children and adolescents at global, regional, and national levels by age groups, sexes, and the sociodemographic index from 1990 to 2019 were collected from the GBD study 2019. Change percentage for number, and the estimated annual percentage changes (EAPCs) for rate were calculated to determine the temporal trends. Results: From 1990 to 2019, global high BMI-related deaths decreased by 34% but DALYs increased by 48%. Death rates in females were higher than in males, although both showed decreasing trends. For the rate of DALYs, both sexes showed increasing trends, but since 1999, the rate in males has surpassed that in females. A high BMI had the greatest impact on children under 5 years of age, and the burden in other age groups continued to increase. Regionally, High-income Asia Pacific experienced the fastest decrease in death rate (EAPC=-9.57), and East Asia saw the fastest increase in the DALYs rate (EAPC= 3.47). Globally, as age increases, the proportion of disease burden attributed to a high BMI in females generally increases. Conclusions: Our findings emphasize the urgent need to improve efforts to prevent children and adolescents becoming overweight and obese. [ABSTRACT FROM AUTHOR]

The document "Global death and disability burden of overweight and obesity in children and adolescents, 1990-2019" analyzes the impact of high body mass index (BMI) on individuals under 20 years old. It presents data on deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost prematurely (YLLs) due to high BMI from 1990 to 2019, examining trends by sex, age group, geographical region, and sociodemographic index (SDI) region. The study includes information on various countries, such as Bermuda, Bhutan, Bolivia, Bosnia and Herzegovina, Botswana, Brazil, and others, detailing health indicators like mortality rates and disease prevalence. This data is valuable for researchers studying global health trends and disparities among young populations worldwide. [Extracted from the article]

Objectives: to estimate insulin-like growth factor-1 (IGF-1) levels in apparently healthy infants and prepubertal children and compare results among different nutritional statuses. Methods: Our cross-sectional work is a sub-study of a screening project for anemia and nutritional status. We included 252 apparently healthy infants and children with a mean age of 3.7 ± 1.3 years (1.1–6.6), with equal gender distribution. Data retrieved included breastfeeding and anthropometric measures. We tested the stored blood samples for IGF-1 levels. The sample size was reached when all kits were consumed. Results: abnormal anthropometric measures were detected in 32.9%, either a single or multiple, and 86.5% were breastfed. Girls had significantly higher serum IGF-1 levels than boys (P: <0.001), which was noticeable in girls with abnormal nutritional status detected with anthropometry. Breastfeeding showed no significant association with IGF-1 levels. No significant difference was observed between IGF-1 levels between children with normal versus those with abnormal growth measures. Children with overweight or obesity had significantly lower IGF-1 than children with other body mass index (BMI) categories. Serum IGF-1 levels correlated positively with arm muscle area Z scores in infants and toddlers and weight and BMI Z scores in children between three and four. Also, IGF-1 correlated positively with the triceps skinfold Z score and arm muscle area Z score between four and five. Conclusions: Among studied infants and prepubertal children, serum IGF-1 was significantly higher in girls than boys and was considerably lower in children with overweight or obesity. Breastfeeding showed no association with IGF-1 levels. [ABSTRACT FROM AUTHOR]

The article discusses the health disparities facing the next U.S. president, particularly how factors like maternal mortality, firearm-related deaths, and opioid use disproportionately affect marginalized communities.Topics include the differing policy approaches of Kamala Harris and Donald Trump regarding health equity, the implications of their ideologies on healthcare access and affordability, and the need for effective responses to the ongoing health crises in the country.

Background: Non-village indigenous people may face urban lifestyle influences, impacting their nutritional profile. Therefore, this study aimed to analyze the temporal trends in the nutritional status (2008–2023) and food consumption (2015–2023) of non-village indigenous people in Brazil, using data from the Food and Nutrition Surveillance System (SISVAN). Methods: In this time series study, secondary data available on the SISVAN online platform were used. All records of non-village indigenous people from all regions of Brazil were evaluated. Nutritional status was assessed using height-for-age (H/A) and Body Mass Index-for-age (BMI/A) for children and adolescents, and BMI for adults and the elderly. Food consumption trends were analyzed using food consumption screeners, based on specific food groups consumed the day before the assessment. An annual percentage change (APC) was calculated using Prais-Winsten regression models. Results: There was a reduction in severe stunting among children aged 2 to 4 years old (APC = -0.80%; p = 0.025) and 5 to 9 years old (APC = -4.02%; p < 0.001). Adolescents showed an increase in thinness (APC = 0.91%; p = 0.016) and obesity (APC = 4.38%; p < 0.001). In adults and the elderly, there was a decrease in underweight (APC = -5.59%; p = 0.002 and APC = -3.12%; p < 0.001, respectively) and an increase in obesity grade 1 and overweight (APC = 3.81%; p < 0.001 and APC = 1.82%; p < 0.001, respectively). There was an increase in vegetable consumption among children, adolescents and the elderly, and a rise in the consumption of hamburgers and sausages across all age groups. Conclusion: There was an improvement in the nutritional status of children and adolescents, with reduced stunting, but a rise in obesity among adolescents, adults and the elderly. Food consumption trends showed increased consumption of vegetables and ultra-processed foods. [ABSTRACT FROM AUTHOR]

Background: Hyperuricaemia is common among obese children and adolescents, and is closely related to insulin resistance. The aim of this study was to explore the relationships between youth insulin resistance and hyperuricaemia, as well as their relationships with lifestyle factors in youths, to provide early guidance on the risk factors for hyperuricaemia in adolescents. Methods: This study included 233 adolescents aged 10 to 20 years. Insulin resistance was evaluated via the homeostasis model assessment-insulin resistance (HOMA-IR) method. Binary logistic regression analysis was used to assess the associations of HOMA-IR with hyperuricaemia status and serum uric acid (UA) levels. The participants were subsequently divided into two groups, the noninsulin resistant group (HOMA-IR ≤ 3.2) and the insulin resistant group (HOMA-IR > 3.2), to further explore the factors that may affect the serum UA level. Finally, the predictive ability of different indicators of hyperuricaemia was evaluated via the ROC curve. Results: Binary logistic regression analysis revealed a significant increase in the risk of developing hyperuricaemia for individuals with elevated HOMA-IR (p < 0.001) and insulin resistance (p < 0.01). Spearman's correlation analysis revealed a significant positive linear correlation between HOMA-IR and serum UA levels (r = 0.4652, p < 0.001). Among insulin-resistant adolescents, UA levels were positively correlated with weight ratings, frequency of staying up late, and sugary beverages intake. Notably, individuals who engaged in 1–3 h of weekly exercise had the lowest UA levels. The area under the ROC curve for HOMA-IR was 0.847 (cut-off value = 2.165, p < 0.001), and the optimal prediction model included HOMA-IR, BMI z-score, and other lifestyle factors (AUC: 0.870, p < 0.001)). Conclusion: HOMA-IR was identified as an independent risk factor for the development of hyperuricaemia and could be used as a sensitive indicator for the prediction its development in adolescents. In insulin-resistant adolescents with hyperuricaemia, maintaining normal weight, engaging in physical exercise for 1–3 h per week, avoiding staying up late and limiting sugary beverages intake are recommended to reduce the prevalence of hyperuricaemia among adolescents. [ABSTRACT FROM AUTHOR]

Summary Fathers remain under‐represented in early childhood obesity prevention research and interventions, despite growing evidence that paternal biopsychosocial factors and behaviors from pre‐ and post‐conception can influence lifelong offspring health. Informed by a literature review of high‐quality evidence, “CO–Parent” (childhood obesity–Parent) is a new conceptual model underpinned by couple interdependence theory and a socioecological framework. Literature was searched for the concepts parental AND weight‐related behaviors AND child weight or weight‐related behaviors, in databases including MEDLINE, PsycINFO, Global Health, Scopus, and SocINDEX. Prior evidence syntheses were prioritized as source data to inform model development. “CO–Parent” illustrates the interdependent and independent effects of maternal and paternal weight, weight‐related behaviors, and well‐being, across preconception, pregnancy, postpartum, and the early years on child weight‐related behaviors and weight up to age five. The influences of public policy, social, environmental, economic, community, and other complex modifiable mediating factors are included in the model. The “CO–Parent” conceptual model paves the way for a paradigm shift by recognizing fathers as key figures in early childhood obesity prevention initiatives, encouraging them to “share the motherload.” It highlights both the independent and interdependent roles fathers play in the epidemiology of obesity starting from preconception. CO–Parent also provides the foundations necessary to guide future theory and research to be more inclusive of fathers to further understanding of the independent and interdependent influences of parents in early childhood obesity prevention. [ABSTRACT FROM AUTHOR]

Background: Although it is well established that obesity is a risk factor for hypertension, the effect of distinct long-term patterns of body mass index (BMI) on blood pressure (BP) in later life is poorly understood. Methods: Based on the China Health and Nutrition Survey, we analyzed 2920 participants aged 3–17 years with initial normal BP at baseline (1991–2011), who were followed up for the development of hypertension (1993–2015). The group-based trajectory model was applied to identify BMI trajectories, and Cox regression was used to assess their associations with hypertension risk. Stratified analyses were conducted to explore differences across subgroups. Results: During an average follow-up time of 11.20 (7.69) years for males and 7.20 (5.21) years for females, 339 males and 212 females were identified with hypertension, respectively. Three BMI trajectories were identified: low-increasing (60.58% of males and 73.03% of females), moderate-increasing (33.08% of males and 24.22% of females), and high-increasing (6.34% of males and 2.76% of females). Our study found a significant positive association between a higher BMI trajectory and hypertension risk in males (all P for trend < 0.05). Specifically, males in the high-increasing BMI group had a higher risk of hypertension compared with those in the low-increasing group (HR = 1.76, 95% CI: 1.04–2.97). Stratified analyses revealed stronger associations among smokers, drinkers, and inactive individuals. Conclusion: Our findings suggest that maintaining a normal BMI and healthy lifestyle from childhood may lower subsequent risk of hypertension. [ABSTRACT FROM AUTHOR]

Childhood obesity has risen and is one of the most important global problems of our time, and school physical education programs are the key to ameliorating it. In American schools, physical fitness scores have declined; yet, global, national, state, and local concerns for the overall health, physical fitness, and wellbeing of children are at an all-time high. The lack of safe and affordable options for physical activity coupled with the significant decrease in physical activity rates among most American children underscores the need for programs, data, and research on physical fitness in schools, where children spend a significant amount of their time. The purpose of this brief research report is to call the federal government and states to mandate physical fitness programs and to increase data collection capacity on physical fitness in schools. Subsequently, this study asks researchers to study physical fitness in schools in the U.S. to increase its importance to policy makers and educational stakeholders and advance our understanding of educational inequities in school physical fitness. As an example, using descriptive analyses, we have provided policymakers, educational stakeholders, and researchers with a first look at California's physical fitness data which shows how our findings complement prior literature as well as extend them. Implications for the research and practice are discussed. [ABSTRACT FROM AUTHOR]

Objective To assess the body mass index (BMI), percentage of body fat (PBF), and bone age of school-age children in Xuzhou city, and to explore the relationship between BMI, PBF, and bone age, so as to provide reference for promoting the health of children. Methods A cluster sampling method was used to select 601 students of grade three from three schools in Xuzhou from July to August 2023, questionnaire surveys and physical examinations were used to collect children's data, and disordered multi-classification logistic regression analysis was used to explore the association between different types of BMI or PBF and bone age development. Results The rates for thinness, overweight, and obesity in boys were 14.2%, 11.1%, and 19.2% respectively, in girls were 17.6%, 9.3%, and 14.0%, respectively; Multivariate logistic regression showed that after adjusting for covariates such as gender, development of secondary sexual characteristics, average monthly household income, birth weight, father's height, and mother's height, the risk of early bone age development was significantly increased in both the BMI obese and overweight groups compared to the BMI normal group (OR=10.10, 95%CI:4.83-21.12; OR=3.78, 95%CI:1.53-9.33); The PBF high body fat group had a significantly increased risk of early bone age development compared to the PBF normal group (OR=3.79, 95%CI:2.01-7.13); BMI obese and PBF high body fat groups are protective factors for delayed bone age development (OR=0.40, 95%CI: 0.20-0.78; OR=0.52, 95%CI:0.31-0.87). Conclusion Overweight and obese children are prone to premature bone age. It is recommended to regularly monitor weight, bone age and body composition while preventing and controlling overweight and obesity in children. [ABSTRACT FROM AUTHOR]

Background Obesity is on the rise globally in adults and children, including in tropical areas where diseases such as dengue have a substantial burden, particularly in children. Obesity impacts risk of severe dengue disease; however, the impact on dengue virus (DENV) infection and dengue cases remains an open question. Methods We used 9 years of data from 5940 children in the Pediatric Dengue Cohort Study in Nicaragua to determine whether pediatric obesity is associated with increased susceptibility to DENV infection and symptomatic presentation. Analysis was performed using generalized estimating equations adjusted for age, sex, and preinfection DENV antibody titers. Results From 2011 to 2019, children contributed 26 273 person-years of observation, and we observed an increase in prevalence of overweight (from 12% to 17%) and obesity (from 7% to 13%). There were 1682 DENV infections and 476 dengue cases in the study population. Compared with participants with normal weight, participants with obesity had higher odds of DENV infection (adjusted odds ratio [aOR], 1.21; 95% confidence interval [CI]: 1.03–1.42) and higher odds of dengue in DENV-infected individuals (aOR, 1.59; 95% CI: 1.15–2.19). Children with obesity infected with DENV showed increased odds of presenting fever (aOR, 1.46; 95% CI: 1.05–2.02), headache (aOR, 1.51; 95% CI: 1.07–2.14), and rash (aOR, 2.26; 95% CI: 1.49–3.44) when compared with children with normal weight. Conclusions Our results indicate that obesity is associated with increased susceptibility to DENV infection and dengue cases in children, independent of age, sex, and preinfection DENV antibody titers. [ABSTRACT FROM AUTHOR]

Background: Overweight/ obesity among under-five children is an emerging public health issue of the twenty-first century. Due to the quick nutritional and epidemiological change, non-communicable diseases, premature death, disability, and reproductive disorders have grown in low-income countries. Besides, little attention has been given. Therefore, we aimed to explore spatial variations and predictors of overweight/obesity among under-five children in Ethiopia using a geospatial technique. Methods: A total weighted sample of 3,609 under-five children was included in the study. A cross-sectional study was conducted using a nationally representative sample of the 2019 Ethiopia Mini Demographic and Health Survey data set. ArcGIS version 10.8 was used to explore the spatial variation of obesity. SaTScan version 9.6 software was used to analyze the spatial cluster detection of overweight/obesity. Ordinary least square and geographically weighted regression analysis were employed to assess the association between an outcome variable and explanatory variables. A p-value of less than 0.05 was used to declare it statistically significant. Results: The spatial distribution of overweight/obesity among under-five children in Ethiopia was clustered (Global Moran's I = 0.27, p-value<0.001). The significant hot spot areas or higher rates of childhood obesity, were found in Southern Amhara, Northwest Somalia, Border of Harari, central Addis Ababa, Eastern SNNPR, and Northwestern Oromia region. In spatial SaT Scan analysis, 79 significant clusters of overweight/obesity were detected. The primary clusters were located in SNNPR, Oromia, and Addis Ababa (RR = 1.48, LLR = 31.40, P-value < 0.001). In the geographically weighted regression analysis, urban residence, cesarean section, rich households, and female children were statistically significant predictors. Conclusions: Overweight or obesity among under-five children show spatial variations across Ethiopian regions. GWR analysis identifies cesarean section, wealth index, urban residence, and child sex as significant predictors. The Ministry of Health and Ethiopian Public Health Institute should target regions with these contributing predictors, promoting localized physical education, health education campaigns, and ongoing community monitoring to encourage active lifestyles and reduce sedentary behaviors among children. [ABSTRACT FROM AUTHOR]

ABSTRACT Clustering analysis of functional data, which comprises observations that evolve continuously over time or space, has gained increasing attention across various scientific disciplines. Practical applications often involve functional data that are contaminated with measurement errors arising from imprecise instruments, sampling errors, or other sources. These errors can significantly distort the inherent data structure, resulting in erroneous clustering outcomes. In this article, we propose a simulation‐based approach designed to mitigate the impact of measurement errors. Our proposed method estimates the distribution of functional measurement errors through repeated measurements. Subsequently, the clustering algorithm is applied to simulated data generated from the conditional distribution of the unobserved true functional data given the observed contaminated functional data, accounting for the adjustments made to rectify measurement errors. We illustrate through simulations show that the proposed method has improved numerical performance than the naive methods that neglect such errors. Our proposed method was applied to a childhood obesity study, giving more reliable clustering results. [ABSTRACT FROM AUTHOR]

Background: We aimed to evaluate the role of nutrition and behavior education intervention in the prevention and treatment of childhood obesity by comparing changes in obesity-related characteristics among obese children during a follow-up period of 12 months. Methods: This study was designed as a prospective cohort study in children aged between 6 and 18 years, with exogenous obesity who applied to Istanbul Research and Training Hospital, Pediatrics Department, between January 2018 and July 2019. Beginning at the sixth month, a program for nutrition and behavior education for obesity prevention and treatment was initiated and continued during the second half of the study period. Results: The mean age of 59 children (29 females, 30 males) was 11.73 ± 2.78. BMI levels did not show a significant difference in the first 6 months, but decreased significantly during the second 6 months of the study. Screen time, fast eating behavior, overeating behavior and food score index scores also demonstrated significant improvements during the intervention period of the study, between 6 and 12 months. Conclusion: It was concluded that nutrition and behavior education for the prevention and treatment of childhood obesity could be a successful intervention with close follow-up. [ABSTRACT FROM AUTHOR]

Background: Obesity in childhood and adolescence represents a major public health problem, mostly attributed to dietary and physical activity factors. We aimed to determine the dietary and physical activity habits of participants before and after the implementation of a personalized, multidisciplinary, lifestyle intervention program for the management of obesity in the context of the Horizon Research Project 'BigO: Big Data against Childhood Obesity'. Methods: Three hundred and eighty-six (n = 386) children and adolescents (mean age ± SD: 12.495 ± 1.988 years, 199 males and 187 females) participated in the study prospectively. Based on body mass index (BMI), subjects were classified as having obesity (n = 293, 75.9%) and overweight (n = 93, 24.1%) according to the International Obesity Task Force (IOTF) cut-off points. We implemented a personalized, multidisciplinary, lifestyle intervention program providing guidance on diet, sleep, and exercise, and utilized the BigO technology platform to objectively record data collected via a Smartphone and Smartwatch for each patient. Results: Following the intervention, a statistically significant decrease was noted in the consumption of cheese, cereal with added sugar, savory snacks, pasta, and fried potatoes across both BMI categories. Also, there was an increase in daily water intake between meals among all participants (p = 0.001) and a reduction in the consumption of evening snack or dinner while watching television (p < 0.05). Boys showed a decrease in the consumption of savory snacks, fried potato products, and pasta (p < 0.05), an increase in the consumption of sugar-free breakfast cereal (p < 0.05), and drank more water between meals daily (p < 0.001). Conclusions: Our findings suggest that a personalized, multidisciplinary, lifestyle intervention improves the dietary habits of children and adolescents. [ABSTRACT FROM AUTHOR]

Background: Universal community engagement interventions can address childhood obesity. Objectives: This review aimed to evaluate the effectiveness of these interventions in improving body mass index (BMI) (primary outcome) as well as dietary choices and activity levels (secondary outcomes) among children and adolescents. Methods: Eight electronic databases were searched from inception dates to January 2024. A meta-analysis was conducted using the random-effect model, when appropriate; otherwise, the findings were narratively synthesized. Heterogeneity was determined by the I2 statistics and Cochran's Q chi-squared test. The Cochrane ROB tool and the GRADE approach were used to assess the quality appraisal at the study and outcome levels, respectively. Results: Twenty-two studies were included in this review. The results showed that these interventions had a limited effect in improving children's standardized BMI (BMI-z) scores post-intervention. A meta-analysis on BMI-z scores showed that the intervention group had a statistically non-significantly lower BMI-z score than the control group (MD = −0.02, 95%CI = [−0.07, 0.03], Z = 0.83, p = 0.40) at immediate post-intervention. It was also reported that universal community engagement interventions had a limited effect in improving children's dietary choices and activity levels. Only the meta-analysis on children's daily sugar-sweetened beverage intake measured using continuous data reported a statistically significant small effect favoring the intervention group (SMD = −0.25, 95%CI = [−0.38, −0.13], Z = 3.98, p < 0.0001) at immediate post-intervention. Conclusions: Universal community engagement interventions have the potential to address childhood obesity. Children and adolescents could benefit more from interventions that focus on implementing both environmental and behavioral changes, and interventions that include parental involvement. [ABSTRACT FROM AUTHOR]

Background: In recent years, the prevalence of childhood obesity has escalated alarmingly, posing significant threats to the physical and mental well-being of children, with an elevated likelihood of persisting into adulthood. Notably, recent investigations have uncovered a profound association between intestinal microbiota, a crucial component of the internal milieu, and childhood obesity. Disturbances in intestinal microbiota and their by-products are now understood to be profoundly intertwined with the evolutionary pathway of childhood obesity. Bibliometric analysis offers a deep understanding of the current research landscape, so we apply it to a review of the emerging trends and patterns between childhood obesity and gut microbiota. Materials and Methods: We conducted a rigorous and extensive search of the Web of Science (WoS) Core Collection database, spanning the years from 1900 to 2023, to analyze scholarly articles pertaining to childhood obesity and gut microbiota. Utilizing VOSviewer, CiteSpace, the R package "bibliometrix," and the online bibliometric analysis platform (https://bibliometric.com/), we delved into the intricate details of research hotspots, academic collaborations, and emerging trends within this domain. Results: The exhaustive search encompassed the globe, uncovering a cumulative total of 1,384 pertinent studies originating from 429 nations. The results were compelling, revealing a profound influence exerted by the United States and China in this specific field of research. Furthermore, it was observed that the volume of scholarly works pertaining to childhood obesity and gut microbiota is steadily growing year on year. The current hot topics in this field include "abuse," "maltreatment," "adverse childhood experiences," "students," and "food addiction". Conclusion: This comprehensive review offers a meticulous exploration of the evolving trends and emerging research agendas pertaining to childhood obesity and gut microbiota over the past two decades. It strives to equip researchers with a thorough understanding of the key nations, institutions, journals, and potential collaborators in these specialized fields. Additionally, it sheds light on the current frontiers of research and strategic avenues for further exploration, thus serving as an invaluable resource for scholars delving deeper into the intricacies of childhood obesity and the gut microbiome. [ABSTRACT FROM AUTHOR]

Maternal diet is a key predictor of child diet, yet an in‐depth inquiry into the barriers and facilitators for the adoption of healthy eating behaviours during the post‐partum period is lacking, specifically for non‐Hispanic Black mothers. This study used qualitative research methods to investigate healthy eating practices among a sample of non‐Hispanic Black mothers participating in a family‐based obesity prevention intervention. In‐depth interviews were conducted with 22 mothers who participated in the Mothers and Others: Family‐based Obesity Prevention for Infants and Toddlers intervention trial. Interviews were audio‐recorded and transcribed verbatim. A deductive and inductive process was used to develop a consensus codebook; once the data were coded, matrices were developed to explore the data and identify similarities and differences between respondents. Relevant themes were identified, and salient quotes were used to illustrate each theme. Mothers believed that time and taste were significant barriers to eating healthy. Social influence and social support had both positive and negative influences on mothers' ability to adopt healthy eating behaviours. Despite their children often being a facilitator to healthy eating, many mothers struggled with finding the time, energy and desire to focus on themselves when it came to healthy eating. Many mothers were intent on preparing healthy meals and snacks for their children but did not prepare them for themselves. Future interventions should focus on the importance of role‐modelling healthy eating behaviours for their children and include behaviour change strategies that incorporate skill‐building activities emphasizing time‐saving methods for planning and preparing healthy meals and snacks for the whole family to eat. [ABSTRACT FROM AUTHOR]