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The objective of this study is to explore the associations between obesity, body composition, and the self-reported risk of obstructive sleep apnea (OSA) and to examine whether the risk of OSA is related to metabolic abnormalities in children and adolescents aged 6–17 years. Utilizing data from the 2022 to 2023 Beijing Children and Adolescents Health Cohort baseline survey, 5000 school-aged participants were analyzed. OSA risk was assessed via the Pediatric Sleep Questionnaire, with anthropometric and body composition measurements taken. Metabolic markers included blood pressure, lipid levels, blood glucose, and uric acid. Associations were analyzed using logistic regression and generalized linear models. Results showed that 88.6% were low-risk and 11.4% were high-risk for OSA. Overweight (aOR 1.53, 95% CI 1.22–1.92), obesity (aOR 1.94, 95% CI 1.57–2.40), and abdominal obesity (aOR 1.59, 95% CI 1.31–1.93) significantly increased OSA risk. High fat mass was a critical factor, while muscle mass was not, especially in those who were overweight and obese. Associations of OSA risk with metabolic abnormalities were non-significant after adjusting for BMI. Our research highlights the significant associations of obesity and body composition with OSA risk, with child BMI influencing the relationship between OSA and metabolic abnormalities. Future research should explore causative relationships and the enduring impacts of OSA on metabolic health in children. [ABSTRACT FROM AUTHOR]

This systematic review aimed to assess the impact of Bifidobacterium genus probiotics on body weight and body composition parameters in overweight and obese individuals. A systematic search for randomized controlled trials was conducted in MEDLINE, EMBASE, LILACS, and Google Scholar databases until April 17, 2023. The inclusion criteria required the trials to involve Bifidobacterium genus probiotics interventions and the evaluation of obesity-related anthropometric and body composition outcomes in overweight or obese subjects. Studies were excluded when involving obese individuals with genetic syndromes or pregnant women, as well as probiotic mixture interventions. The revised Cochrane risk-of-bias tool for randomized trials was utilized to assess the quality of the included studies. A random-effects meta-analysis was performed using the mean difference between endpoint measurements and change from baseline for body mass index, body weight, body fat mass, body fat percentage, waist circumference, waist-to-hip ratio, and visceral fat area. From 1,527 retrieved reports, 11 studies (911 subjects) were included in this review. Bifidobacterium probiotics administration resulted in significant reductions in body fat mass (MD = −0.64 kg, 95% CI: −1.09, −0.18, p = 0.006), body fat percentage (MD = −0.64%, 95% CI: −1.18, −0.11, p = 0.02), waist circumference (MD = −1.39 cm, 95% CI: −1.99, −0.79, p < 0.00001), and visceral fat area (MD = −4.38 cm2, 95% CI: −7.24, −1.52, p = 0.003). No significant differences were observed for body mass index, body weight, or waist-to-hip ratio. This systematic review suggests that Bifidobacterium genus probiotics may contribute to managing overweight and obesity by reducing body fat mass, body fat percentage, waist circumference, and visceral fat area. Further research is required to understand strain and species interactions, optimal dosages, and effective delivery methods for probiotics in obesity management. This review was pre-registered under the PROSPERO record CRD42022370057. Probiotics from the Bifidobacterium genus show promise in reducing body fat mass, body fat percentage, waist circumference, and visceral fat area in overweight and obese adults. Further research is needed to identify the most effective species and strains within the Bifidobacterium genus for achieving these outcomes. There is an urgent need to determine the best probiotic delivery vehicle among enriched foods, capsules, or powders. More randomized controlled trials are necessary to determine optimal probiotic doses and intervention durations. [ABSTRACT FROM AUTHOR]

Background: This study investigated the association of psychological well-being (PWB), resilience, depressive symptoms, and social–emotional learning (SEL) with physical activity (PA) in school-aged children. The objective was to understand how these psychosocial factors influence PA levels and identify gender-specific differences in these relationships. Methods: This cross-sectional study involved 534 fourth grade and sixth grade students from eight schools in the Midwest region of the United States, with data collected through a Qualtrics survey. Multiple linear regression models were used to analyze the data, with gender-specific analyses conducted to identify differences between boys and girls. Results: The models indicated that all psychosocial factors taken together are significantly associated with PA (F = 26.937, p < 0.001). Of the factors, PWB and resilience were associated with higher PA individually for the total sample (β = 0.383, p = 0.001; β = 0.146, p = 0.005). A gender-specific analysis revealed that all factors collectively were significantly associated with PA in boys and girls (F = 15.846, p < 0.001; F = 6.869, p < 0.001). Individually, PWB and resilience were significantly associated with PA in boys (β = 0.358, p = 0.001; β = 0.171, p = 0.013), while only PWB was significantly associated with PA in girls (β = −0.355, p = 0.001). Conclusions: This study highlights the necessity of promoting resilience and psychological well-being through structured physical activities, aiming to reduce the risk of obesity and improve mental health among children. Future research should consider longitudinal designs and objective measures to further elucidate these relationships and inform effective educational strategies. [ABSTRACT FROM AUTHOR]

Background: This study aimed to analyze the relationship between socioeconomic status (SES), poverty rate, and the prevalence of overweight/obesity or obesity in children and adolescents aged 2–14. Methods: Parents or guardians reported the weight and height of participants, used to calculate body mass index (BMI) and BMI z-scores according to the International Obesity Task Force standards. Participants were categorized into "overweight/obesity" and "no overweight/obesity" and further into "obesity" and "no obesity". The rate of poverty rate was determined using data from the National Statistics Institute of Spain, defining it as the percentage of people with income below 60% of the national median. SES was based on the head of household's occupation and categorized into low, medium, and high levels. Results: Adjusted multilevel models showed participants with medium or high SES had lower odds of overweight/obesity compared to those with low SES (medium SES: odds ratio [OR]: 0.63, 95% confidence interval [CI]: 0.54–0.73; high SES: OR: 0.59, 95% CI: 0.49–0.70). Participants in the high-poverty group had higher odds of having overweight/obesity (OR: 1.40, 95% CI: 1.13–1.74) compared to the low-poverty group. Conclusions: The study highlights significant socioeconomic disparities in childhood overweight/obesity, emphasizing the potential impact of SES and poverty on health outcomes in Spanish children and adolescents. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study aimed to investigate the association of body mass index (BMI) with the weekly frequency of moderate-intensity physical activity, eating behavior, and the use of the Internet or games among Korean middle school students. Methods: The data of 23,583 Korean middle school students were collected from the 2023 Korean Student Health Examination. The collected data were analyzed using frequency, chi-square, and multivariate logistic regression analyses. Results: The results also showed that the higher the BMI, the greater the likelihood of moderate-intensity physical activity. The likelihood of breakfast intake reduced as the BMI increased. However, the likelihood of using the Internet or games increased with an increase in BMI. The results revealed that 28% (6594 of 23,583) of middle school students rarely participate in moderate-intensity physical activity, while 32% (7553 of 23,583) participate only once or twice a week. The results also showed that the higher the BMI, the higher the likelihood of moderate-intensity physical activity. Among those who were underweight, the odds ratio (OR) of 3–4 days of participation in moderate-intensity physical activity was 0.764 (95% confidence interval [CI]: 0.664–0.880; p < 0.001). Among those who were healthy, the OR of more than 5 days of participation was 1.279 (95% CI: 1.131–1.446; p < 0.001). Among those who were overweight, the OR of 3–4 days and more than 5 days of participation was 1.172 (95% CI: 1.019–1.348; p = 0.026) and 1.181 (95% CI: 1.011–1.380; p = 0.036), respectively. The likelihood of the use of the Internet or games increased with an increase in BMI. The OR of the use of the Internet or games was 0.876 (95% CI: 0.806–0.952; p = 0.002) and 0.824 (95% CI: 0.743–0.913; p < 0.001) among those who were healthy and those who were overweight, respectively. However, the likelihood of breakfast intake reduced as the BMI increased. Among those who were underweight, the OR of always eating breakfast and mostly eating breakfast was 1.299 (95% CI: 1.114–1.515; p < 0.001) and 1.236 (95% CI: 1.045–1.461; p = 0.013), respectively. Among those who were healthy, the OR of always eating breakfast was 1.157 (95% CI: 1.026–1.305; p = 0.018). Among those who were overweight, the OR of mostly eating breakfast was 1.215 (95% CI: 1.030–1.433; p = 0.021). Conclusions: Given this, outdoor sports may increase adolescents' participation in physical activities by helping them break away from repetitive ball games and increasing their overall interest and participation in physical activities. Overall, our results suggest the need to move away from traditional physical education and develop engaging physical activity programs that motivate students to participate in moderate-intensity physical activities. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity presents a significant public health concern globally, with implications for cardiovascular health and metabolic syndrome. In Portugal, approximately 31.6% of children are affected, highlighting the urgency for intervention strategies. This study aimed to assess the prevalence of overweight and obesity in Portuguese school-aged children, with a focus on sex and age differences. Methods: Anthropometric measurements were conducted on 1564 children aged 6–10 years, including weight, height, and skinfold thickness. Body Mass Index (BMI) and the percentage of body fat were calculated using established methods. Results: The results revealed significant differences in BMI (≤0.001) and body fat percentage (≤0.001) among different BMI categories, with a notable prevalence of overweight and obesity, particularly among boys. A total of 37% of the studied population is overweight or obese, among which 40.1% and 33.9% are boys and girls, respectively. Conclusions: This study highlights statistically significant differences in BMI and body fat percentage for both sexes in different BMI categories. A large proportion of the population is overweight or obese, with a greater prevalence in boys. In short, childhood obesity has a negative impact on body composition and is associated with significant differences in anthropometric parameters, emphasizing the importance of preventative and intervention strategies to address this health problem. [ABSTRACT FROM AUTHOR]

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease in adolescents with obesity. Nonetheless, the guidelines for screening and managing this disease are contradictory. The purpose of this study is to non-invasively assess the prevalence, patient characteristics, and potential associated factors of MASLD in this demographic. Methods: This study used baseline data from an RCT in adolescents eligible for bariatric surgery. MASLD was determined by measuring the hepatorenal index (HRI) with ultrasonography, blood liver tests, and the fatty liver index (FLI). Results: A total of 56 adolescents enrolled in the analyses; the majority were female n = 44 (79%); the mean age was 15.75 (±1.01) years; the average body mass index (BMI) was 44.08 (±5.16) kg/m2. In 35 (62.5%) of the patients, the HRI was abnormal. This group had a higher waist/hip ratio, elevated liver biochemistry, and significantly lower leptin levels (mean difference = −46.35, 95% CI −76.72, −15.99) compared to the group with a normal HRI. In 32 (55.2%) of the patients, ALT levels were elevated and the FLI was abnormal in all (100%) participants. Linear regression analysis indicated associations between the HRI and typical anthropometric and metabolic measurements; and an inverse association between HRI and leptin B = −0.003 (95% CI −0.005, −0.00), independently of sex- and age-adjusted BMI. Conclusions: MASLD is highly prevalent in adolescents with severe obesity. However, the prevalence strongly depends on which tool is used, namely the HRI (62.5%), alanine transaminase levels (55.2%), and FLI (100%). Our findings suggest that leptin may be a valuable biomarker in supporting the diagnosis of MASLD. [ABSTRACT FROM AUTHOR]

Background: Fear of fat is a relevant variable in initiating weight regulation behaviors in adolescents. However, little is known about the experiential and behavioral change processes that mediate the choice between healthy and unhealthy weight regulation behaviors in this population. Method: The general objective was to examine the predictive role of fear of fat on weight-related behaviors (healthy and unhealthy weight control behaviors) through the mediation of experiential and behavioral change processes (consciousness raising, counterconditioning, helping relationships, reinforcement management, self-liberation, self-reevaluation, stimulus control, substance use) in 838 adolescents aged 15–19 years from Mexico and Spain using parallel mediation analysis. Additionally, the study examined the correlations between the variables with regard to gender and country, as well as the differences in the use of processes of change across stages of change through the use of a multivariate analysis of variance. The Spanish version of the Fear of Fat, Stages of Change, Processes of Change, and Weight-Related Behaviors scales were used. Results: The mediation analysis showed that fear of fat predicted healthy weight control behaviors through consciousness raising, self-liberation, and stimulus control. On the other hand, fear of fat predicted unhealthy weight control behaviors through counterconditioning, stimulus control, and the use of weight loss substances. Intervening to reduce fear of fat may be a way to modify the processes of change used by adolescents to regulate their weight. Conclusions: The results of this study indicate that adolescents may initiate weight control behaviors as a result of fear of fat. This process is mediated by experiential and behavioral processes that influence weight regulation. [ABSTRACT FROM AUTHOR]

Childhood obesity is a major public health burden. The prevalence of weight excess for children and the adolescent population (8 to 16 years) is 34.9%. During childhood, lifestyles are acquired, which are developed in adulthood. In this context, the role of parents is crucial, since they are the model to imitate. We aimed to evaluate the current evidence on the effects of family-based interventions as a tool in the treatment of childhood obesity. We reviewed studies indexed in several databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Original articles published from 1 January 2014 to 30 May 2024 with a controlled trial design were considered, in which family-based interventions were carried out compared to a control group or to data before the intervention. Although 148 records were identified in the search, 6 studies met inclusion criteria. Overall, studies reported beneficial effects of family-based interventions on improving anthropometric parameters: BMI z-score, BMI, waist circumference, and body fat percentage. Regarding nutritional and physical activity guidelines, general recommendations must consider increased consumption of fruits and vegetables, reducing sugary drinks, controlled screen time, and 30–60 min of physical activity/day. Thus, family-based interventions could be an effective non-pharmacological strategy for modulating childhood obesity, allowing families to modify their lifestyles. [ABSTRACT FROM AUTHOR]

Introdroduction Methods Results Conclusions Obesity and its associated metabolic conditions have become a significant global health problem in recent years, with many people living with obesity fulfilling criteria for pharmacological treatment. The development of the glucagon‐like peptide‐1 receptor agonists for chronic weight management has triggered new interest in the incretins and other hormones as targets for obesity, and investigations into dual and triple co‐agonists.The objective of this narrative review was to summarize the available data on approved and emerging incretin‐based agents for the treatment of obesity.In clinical trials of currently available agents in people with overweight or obesity, weight loss of between 6% and 21% of baseline body weight has been observed, with between 23% and 94% of participants achieving 10% or higher weight loss, depending on the study and the agent used. Favourable outcomes have also been seen with regard to cardiovascular risk and outcomes, diabetes prevention, metabolic dysfunction‐associated steatotic liver disease/steatohepatitis and prevention of weight regain after metabolic surgery. Limitations associated with these agents include high costs, the potential for weight regain once treatment is stopped, the potential loss of lean body mass and gastrointestinal adverse events; potential issues with respect to gallbladder and biliary diseases require further investigation.Many dual and triple co‐agonists are still in development, and more data are needed to assess the efficacy, safety and tolerability of these emerging therapies versus the established incretin‐based therapies; however, data are promising, and further results are eagerly awaited. [ABSTRACT FROM AUTHOR]

Background: We investigate and try to find out the optimal duration and intensity for the treatment and content useful for clinical work. The aim of our study is to evaluate the effects of lifestyle intervention on the management of childhood overweight and to explore the factors that contribute to the outcome, as well as the costs for the health care system. The hypotheses of the study are that lifestyle intervention is efficient in reducing BMI-SDS and thus effective in preventing overweight from progressing to obesity, and it is also cost-effective. Methods and analyses: We aim to recruit 80 children and they randomize either to an intervention group or a control group with standard care. The intervention group receives intensive, family-based diet, and physical activity counseling, delivered by a multidisciplinary team of a pediatrician, a nurse, and a clinical nutritionist. The control group does not receive any lifestyle intervention during the study. The inclusion criteria are age of 6–12 years, weight-for-height ≥ + 40% or ≥ + 30%, and increasing curve. All participants fill out the study questionnaires and plasma samples are taken at baseline and at 12 months. Outcome variables will be compared between intervention and control groups. Discussion: If the effects of this lifestyle intervention are positive and it is also cost-effective, the implication of our study will be of great importance to the treatment of childhood obesity and to improve the health care system. Trial registration: ClinicalTrials.gov NCT06126679. Registered on 25 October 2028 in Finland. ORCID: 0009-0009-6659-5290. [ABSTRACT FROM AUTHOR]

Speech sound disorder (SSD) is one of the most common communication disorders in children, which must be diagnosed and treated in childhood to prevent its negative psychological, occupational, and social consequences in adulthood. The use of serious games is one technology that could help treat SSD. This study aims to design and evaluate the usability of a digital game for 3–6-year-old children. This developmental study was carried out in three main stages: determining information requirements, designing and developing a digital game, and evaluating the usability of the designed game. In the first stage, the consonants, syllables, words, and sentences that should be used in the game were determined through focus group sessions and a questionnaire completed by 30 speech-language pathologists (SLPs) in two Delphi rounds. In the designing and developing stage, the game design document was first written, and then sketches and wireframes were drawn based on this document. Then, the game was developed in the second phase using Java programming language. In the third stage, the usability of the designed game was evaluated by six experts and 22 SLPs using Nielsen's usability heuristics and the Post-Study System Usability Questionnaire (PSSUQ), respectively. Also, the usability of the game was evaluated by ten children. To determine the information requirements, SLPs confirmed 23 consonants, 138 syllables, 564 words, and 69 sentences to teach children the game. According to Nielsen's usability heuristics, the designed game had 23 unique usability problems with a mean severity of 2.29. "User control and freedom," with five usability problems, was the most frequently identified problem, and "error prevention," with a mean severity of 3.83, was the most severe problem. The results of the SLPs' evaluation also showed that the "interface quality" of the designed game obtained the highest score, with a mean score of 6.25 out of 7. Also, 100% of children stated that the game was designed beautifully, and 90% of children also liked the game. A serious game designed for children with SSDs achieved satisfactory results in usability evaluation. Therefore, this smartphone-based game can be easily used among these children to provide fun therapy sessions under the supervision of parents. [ABSTRACT FROM AUTHOR]

The purpose of this text is to point out the contradiction existing in Chilean educational public policy regarding the curricular reform that converted the subjects of Physical Education and Health, History, Arts, and Religion into optional subjects for the 3rd and 4th years of high school. As far as Physical Education is concerned, scientific evidence shows that such conversion to the status of optional subject goes against the policies of other executive ministries and against the possibilities of reversing the statistics that show Chile as one of the countries in America with the highest percentage of overweight and obese children and adolescents. [ABSTRACT FROM AUTHOR]

Environmental and lifestyle factors, including air pollution, impaired diet, and low physical activity, have been associated with cardiometabolic risk factors in childhood and adolescence. However, environmental and lifestyle exposures do not exert their physiological effects in isolation. This study investigated associations between an exposome score to measure the impact of multiple exposures, including diet, physical activity, sleep duration, air pollution, and socioeconomic status, and serum metabolites measured using LC-MS and NMR, compared to the individual components of the score. A general population of 504 children aged 6–9 years at baseline was followed up for eight years. Data were analysed with linear mixed-effects models using the R software. The exposome score was associated with 31 metabolites, of which 12 metabolites were not associated with any individual exposure category. These findings highlight the value of a composite score to predict metabolic changes associated with multiple environmental and lifestyle exposures since childhood. A composite exposome score was associated with 31 serum metabolites measured by LC-MS and NMR in children followed to adolescence. Altogether, 12 of these associations were unique to the exposome score, with several findings modified by adiposity. [ABSTRACT FROM AUTHOR]

Background: Overweight/obesity has become global health concern with increasing prevalence. This study examined district-level disparities and spatial clustering of overweight/obesity among women of reproductive age (WRA) in India using the latest National Family Health Survey-5 (2019–2021) data. Method: Information of 623,656 women aged 15 to 49 from the NFHS-5 (2019–2021) were analysed in this study. The outcome variable was BMI as classified by the world health organisation (WHO). Utilising Global Moran's I, Anselin's Local Moran's I, and spatial regression models spatial clustering and associated factors were analysed. Result: The study found that 24% (95% CI: 23.8–24.3) of WRA in India were overweight/obese in 2019–21. The prevalence was greatest in Punjab (41%) and lowest in Meghalaya (11%). Additionally, the Global Moran's I value for the outcome variable was 0.73, indicating a positive spatial autocorrelation in the overweight/obesity. Districts of Tamil Nadu, Andhra Pradesh, Karnataka, Kerala, Telangana, Punjab, Himachal Pradesh, Jammu & Kashmir, Haryana, and Delhi were hotspots of overweight/obesity. Several factors of overweight/obesity among WRA were identified, including place of residence (β: 0.034, p: 0.011), parity (β: 0.322, p: 0.002), social group (β: -0.031, p: 0.016), religion (β: -0.044, p: <0.001), household wealth status (β: 0.184, p: <0.001), mass-media exposure (β: 0.056, p: 0.031), and diabetes (β: 0.680, p: <0.001). Conclusion: The study emphasizes the importance of targeted interventions and region-specific strategies, while also stressing the need to address associated factors to develop effective public health initiatives aimed at reducing overweight/obesity prevalence among WRA in India. [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]

The prevalence of obesity and its associated comorbidities has surged dramatically in recent decades. Especially concerning is the increased rate of childhood obesity, resulting in diseases traditionally associated only with adulthood. While obesity fundamentally arises from energy imbalance, emerging evidence over the past decade has revealed the involvement of additional factors. Epidemiological and murine studies have provided extensive evidence linking parental obesity to increased offspring weight and subsequent cardiometabolic complications in adulthood. Offspring exposed to an obese environment during conception, pregnancy, and/or lactation often exhibit increased body weight and long-term metabolic health issues, suggesting a transgenerational inheritance of disease susceptibility through epigenetic mechanisms rather than solely classic genetic mutations. In this review, we explore the current understanding of the mechanisms mediating transgenerational and intergenerational transmission of obesity. We delve into recent findings regarding both paternal and maternal obesity, shedding light on the underlying mechanisms and potential sex differences in offspring outcomes. A deeper understanding of the mechanisms behind obesity inheritance holds promise for enhancing clinical management strategies in offspring and breaking the cycle of increased metabolic risk across generations. [ABSTRACT FROM AUTHOR]

Background: The nutritional status and growth of children with Autism spectrum disorders (ASD) is influenced significantly by two factors; food selectivity behaviors due to their consumption of a limited variety of food and the high incidence of gastrointestinal (GIT) disorders. Aim: This study aimed to assess the nutritional adequacy and growth pattern of ASD children aged three to twelve years compared to their healthy developing peers. Methods: A national comparative, facility-based cross-sectional study was conducted in eight Egyptian governorates on 285 Egyptian children diagnosed with ASD and 224 children who are their relatives as healthy developing peers. Anthropometric measurements were obtained, including weight, height, head circumference, and mid-upper arm circumference. Body Mass Index (BMI) was calculated and all numbers were plotted on WHO growth charts. Assessment of food preferences, and nutrient intake adequacy of children was done using the Food preference questionnaire, and the Dietary Reference Intakes (DRIs) of Egyptian children. Results: Calorie-dense food and sugar intake were higher among ASD children than their healthy developing peers. ASD children omit some important protein sources such as dairy (COR = 5.2, 95% CI:2.7–9.9), meat, and poultry (COR = 2.7, 95% CI: 1.6–4.7), and a lower intake of fruits and vegetables than their healthy developing peers. For children with ASD in all age groups, a deficiency in the range of 50–60% was detected for vitamins (C, D, B6, thiamine, riboflavin, niacin) and minerals (iron). A deficiency in the range of 60–70% was detected for folate and calcium. A deficiency of vitamin C calcium and iron was also detected for both children with ASD and their healthy developing relatives aged 6 to 12 years. GIT disorders were common among ASD children compared to healthy developing peers (COR = 2.8 to 10.3). Children with ASD had four-fold higher odds of stunting (COR = 4.1, CI: 1.7–10.1), threefold higher odds of being overweight (COR = 3.3, CI: 1.48–7.32), and nearly eleven-fold higher odds of obesity (COR = 11.4, CI: 4.05–32.17) compared to their healthy developing peers. Conclusion: ASD children are prone to overweight and protein malnutrition. Their intake of fruits and vegetables is inadequate and hence their intake of vitamins and minerals is insufficient, contributing to stunting. [ABSTRACT FROM AUTHOR]

Current studies have presented conflicting findings regarding the associations between light at night (LAN) exposure and the risk of overweight/obesity, hypertension, and diabetes. Our study systematically summarized the evidence of the association between LAN exposure and the risk of overweight/obesity, hypertension, and diabetes. We searched five databases (PubMed, Web of Science, Embase, Scopus, and Cochrane) for observational studies published up to 1 August 2023. The pooled odds ratio (ORs) and 95% confidence intervals (CIs) were estimated by random-effects models for the association. Eighteen studies were included in the meta-analysis. Compared with the group with the lowest level of LAN, the group with the highest level of LAN is associated with an increased risk of overweight/obesity (pooled OR = 1.19, 95%CI: 1.13–1.26), hypertension (pooled OR: 1.86, 95% CI:1.28–2.72), and diabetes (pooled OR = 1.21, 95%CI: 1.07–1.31). Our meta-analysis demonstrated LAN exposure is associated with increased risk of overweight/obesity, hypertension, and diabetes. [ABSTRACT FROM AUTHOR]

AbstractOur meta-analysis, encompassing 30 studies with 46,976 subjects, aimed to explore the impact of fat mass and obesity-associated protein (FTO) genotypes on weight response to exercise and dietary interventions in overweight and obese adults. Electronic databases including PubMed and Google Scholar were searched from 2020 to September 2023 to identify relevant studies. Results revealed a significant reduction in body weight among individuals with the FTO risk allele following exercise and diet interventions (standardized mean difference [SMD] = − 0.619, 95% CI: − 1.137, − 0.100; p = .01). When examining FTO variants, both AA (SMD = − 0.148, 95% CI: − 0.282, − 0.014, p = .03, I2 = 24.96) and TA genotypes (SMD = − 0.674, 95% CI: − 1.162, − 0.186, p = .007, I2 = 91.12) showed significant weight reduction compared to the TT genotype. Moreover, individuals with the high-risk genotype AA + TT achieved greater weight loss compared to those with the normal-risk genotype TT (SMD = − 0.419, 95% CI: − 0.655, −0.183, p = .0001, I2 = 92.08) in the dominant genetic model. Subgroup analysis indicated that FTO risk allele carriers (AA + AT) with exercise interventions lasting six months and a body mass index of 25 – 29 experienced greater weight loss compared to TT carriers. These findings emphasize the importance of genetic considerations in weight management interventions and suggest personalized approaches for combating obesity. Further clinical trials are warranted to validate our study’s findings. [ABSTRACT FROM AUTHOR]

Background: Obesity has become an important threat to children's health, with physical and psychological impacts that extend into adulthood. Limited physical activity and sedentary behavior are associated with increased obesity risk. Because children spend approximately 6 h each day in school, researchers increasingly study how obesity is influenced by school-day physical activity and energy expenditure (EE) patterns among school-aged children by using wearable devices that collect data at frequent intervals and generate complex, high-dimensional data. Although clinicians typically define obesity in children as having an age-and sex-adjusted body mass index (BMI) value in the high percentiles, the relationships between school-based physical activity interventions and BMI are analyzed using traditional linear regression models, which are designed to assess the effects of interventions among children with average BMI, limiting insight regarding the effects of interventions among children categorized as overweight or obese. Methods: We investigate the association between wearable device-based EE measures and age-and sex-adjusted BMI values in data from a clusterrandomized, school-based study. We express and analyze EE levels as both a scalar-valued variable and as a continuous, high-dimensional, functional predictor variable. We investigate the relationship between school-day EE (SDEE) and BMI using four models: a linear mixed-effects model (LMEM), a quantile mixed-effects model (QMEM), a functional mixed-effects model (FMEM), and a functional quantile mixed-effects model (FQMEM). The LMEM and QMEM include SDEE as a summary measure, whereas the FMEM and FQMEM allow for the modeling of SDEE as a high-dimensional covariate. The FMEM and FQMEM allow the influence of the time of day at which physical activity is performed to be assessed, which is not possible using the LMEM or the QMEM. The FMEM assesses how frequently collected SDEE data influences mean BMI, whereas the FQMEM assesses the effects on quantile levels of BMI. Results: The LMEM and QMEM detected a statistically significant effect of overall mean SDEE on log (BMI) (the natural logarithm of BMI) after adjusting for intervention, age, race, and sex. The FMEM and FQMEM provided evidence for statistically significant associations between SDEE and log (BMI) for only a short time interval. Being a boy or being assigned a stand-biased desk is associated with a lower log (BMI) than being a girl or being assigned a traditional desk. Across our models, age was not a statistically significant covariate, and white students had significantly lower log (BMI) than non-white students in quantile models, but this significant effect was observed for only the 10th and 50th quantile levels of BMI. The functional regression models allow for additional interpretations of the influence of EE patterns on age-and sex-adjusted BMI, whereas the quantile regression models enable the influence of EE patterns to be assessed across the entire BMI distribution. Conclusion: The FQMEM is recommended when interest lies in assessing how device-monitored SDEE patterns affect children of all body types, as this model is robust and able to assess intervention effects across the full BMI distribution. However, the sample size must be sufficiently large to adequately power determinations of covariate effects across the entire BMI distribution, including the tails. [ABSTRACT FROM AUTHOR]

Purpose: The development of multiple system diseases is increased by obesity. However, the connection between obesity and developmental disabilities (DDs) in children is unclear. As an obesity index, the weight-adjusted waist index (WWI) assessed fat distribution and muscle mass. In this study, we examined the correlation between WWI and DDs among children 6 to 17 years of age. Methods: This study used data from the National Health and Nutrition Examination Survey database (NHANES) covering 2003 to 2018, which included the data of 17,899 participants between 6 and 17 years of age. Data regarding their waist circumference, weight, and DDs were collected via physical examinations and questionnaire, respectively. A person's WWI is calculated by dividing their waist circumference by their weight squared. The correlation between WWI and DDs was studied using weighted multiple logistic regression models. Additionally, a sensitivity analysis was conducted utilizing a generalized additive model and smooth curve fitting. Results: After adjusting for all covariates, WWI was positively related to DDs in children ages 6-17. Based on the sensitivity analysis, the correlation between the WWI and prevalence of DDs remained consistent across subgroups. Additionally, there was a J-shaped correlation between the WWI and the prevalence of DDs in children ages 6 through 11. Conclusion: Children 6-17 years of age with a high WWI were at greater risk for DDs; however, the causal relationships and potential mechanisms require further exploration. [ABSTRACT FROM AUTHOR]

Background: Fasting levels of glucagon are known to be elevated in youth and adults with type 2 diabetes mellitus (T2D). Children and adolescents with obesity were previously reported to show increasing fasting and post-glucose-challenge hyperglucagonemia across the spectrum of glucose tolerance, while no data are available in those with impaired fasting glucose (IFG). Materials and methods: Individuals from the Beta-JUDO study population (Uppsala and Salzburg 2010-2016) (n=101, age 13.3 ± 2.8, m/f=50/51) were included (90 with overweight or obesity, 11 with normal weight). Standardized OGTT were performed and plasma glucose, glucagon and insulin concentrations assessed at baseline, 5, 10, 15, 30, 60, 90 and 120 minutes. Patients were grouped according to their glycemic state in six groups with normal glucose metabolism (NGM) and normal weight (NG-NW), NGM with obesity or overweight (NG-O), impaired glucose tolerance (IGT), impaired fasting glucose (IFG), IGT+IFG and T2D, and in two groups with NGM and impaired glucose metabolism (IGM), for statistical analysis. Results and conclusion: Glucagon concentrations were elevated in young normoglycemic individuals with overweight or obesity (NG-O) compared to normoglycemic individuals with normal weight. Glucagon levels, fasting and dynamic, increased with progressing glycemic deterioration, except in IFG, where levels were comparable to those in NG-O. All glycemic groups showed an overall suppression of glucagon during OGTT. An initial increase of glucagon could be observed in T2D. In T2D, glucagon showed a strong direct linear correlation with plasma glucose levels during OGTT. Glucagon in adolescents, as in adults, may play a role in the disease progression of T2D. [ABSTRACT FROM AUTHOR]

Background & aims: Obesity has been linked to various detrimental health consequences. While there is established evidence of a negative correlation between seafood consumption and obesity in adults, the current research on the association between seafood intake in childhood/adolescence and the risk of obesity is lacking. Our aim was to evaluate the association between seafood intake in childhood/adolescence and the risk of obesity in a Chinese nationwide cohort. Methods: We utilized data from the China Health and Nutrition Survey (CHNS) from the year of 1997 to 2015. Seafood consumption was evaluated through 3-day 24-hour recalls. In our study, overweight/obesity status was determined based on the Chinese Criteria of Overweight and Obesity in School-age Children and Adolescents (WS/T 586–2018), while abdominal obesity status was determined according to the Chinese Criteria of Waist Circumference Screening Threshold among Children and Adolescents (WS/T 611–2018). Results: During an average follow-up of 7.9 years, 404 cases developed overweight/obesity among 2206 participants in the seafood-overweight/obesity analysis, while 381 cases developed abdominal obesity among 2256 participants in the seafood-abdominal-obesity analysis. The high-consumer group was associated with 35% lower risk of overweight/obesity risk and 26% lower risk of abdominal obesity after fully adjusting for sociodemographic and lifestyle factors, compared with the non-consumer group. Considering different cooking methods, boiled seafood consumption was associated with 43% lower risk of overweight/obesity and 23% lower risk of abdominal obesity in the fully adjusted model, while stir-fried seafood did not demonstrate a statistical significance. Conclusion: Higher intake of seafood in childhood/adolescents, particularly in a boiled way, was associated with lower obesity risk. [ABSTRACT FROM AUTHOR]

Background Objective Methods and Materials Results Conclusions This study focused on type 2 diabetes mellitus (T2DM) in a group of adult Mixe, an Indigenous population from Oaxaca, Mexico. Mixe comprised an estimated 9.4% (n ≅ 90 000) of the Indigenous population in Oaxaca. Mexico.This study focused on a group of adult Mixe, an Indigenous population from Oaxaca, Mexico. To compare the prevalence of T2DM, overweight (OW), obesity (OB), and hypertension (HTN) between 2007 and 2017 for a small, isolated Mixe community in the Valley of Oaxaca, Mexico. We test whether or not environmental changes have affected T2DM prevalence.Demographic and medical record data were collected in the community in 2007 and 2017 from the medical clinic and the mayor's office. T2DM was medically diagnosed among adults (>34 years old), in 2007 (n = 730) and in 2017 (n = 829).T2DM crude prevalence increased from 6.7% to 12.1% (p < .001) from 2007 to 2017. The mean age of the sample analyzed was 60.6 (SD = 9.7). Age‐adjusted T2DM prevalence increased from 6.7% to 10.8% (p < .002). T2DM was 5.7%–5.5% among males (p < .53) and 7.1%–13.6% among females (p < .001). Sex‐specific OW and OB simulation studies indicate females had 7% less OW in 2007, and males were unchanged compared with 2017. OB among males and females was significantly higher in 2017 compared with 2007 (increased by 15.2% and 8.3%, males and females, respectively). Sexes combined OW + OB increased 12.7% among males but was unchanged in females (−0.5%). In the sexes combined analysis, OW prevalence increased 12.7% to 27.1% (p < .001) and OB prevalence increased 10.7%–27.9% (p < .001) from 2007 to 2017. HTN did not change significantly from 2007 to 2017 (15.4% and 14.6%, respectively) (p = .63) in adults. Among T2DM individuals, the frequency of HTN was not significantly different in 2007 and 2017 (57.1% and 37%, respectively) (p = .65). Transition to a Western diet consisting of high‐carbohydrate foods occurred at the same time as increased T2DM from 2007 to 2017, with a higher prevalence of T2DM noted among females in 2017.An increased prevalence of T2DM, OW, and OB but not HTN was observed in the Mixe community from 2007 to 2017 and was associated with the adoption of a high‐carbohydrate Western diet. [ABSTRACT FROM AUTHOR]

This study examines whether the experience of being bullied at school has a long-term impact on three health outcomes in adulthood in Japan: subjective health, mental health, and activity restriction due to health conditions. We employed a random effects model and the Karlson-Holm-Breen method to decompose the total effect of being bullied at school on health inequality into a direct effect and an indirect effect working through intervening factors including education, marriage, economic well-being, and social networks. We used the Japanese Life Course Panel Surveys 2007–2020 (waves 1–14), a nationally representative panel data set that includes 2,260 male and 2,608 female respondents. The results demonstrate that for both men and women, the direct effect of being bullied at school was strong and significant. Bullying experiences in childhood had a long-term impact on health outcomes in adulthood, regardless of social background and mediating factors of education, marriage, economic well-being, and social networks. Bullying victimization increased the risk of poor subjective health, low mental health scores, and activity restriction due to health conditions. Intervening factors (especially economic well-being and friendship) mediated the association between bullying experiences and all health outcomes, but their contributions were modest. Policy measures not only to prevent bullying during childhood but also to alleviate its negative consequences in adulthood should be considered to help people who have encountered adverse childhood experiences. [ABSTRACT FROM AUTHOR]

Background: Every year, 60% of deaths from diarrhoeal disease occur in low and middle-income countries due to inadequate water, sanitation, and hygiene. In these countries, diarrhoeal diseases are the second leading cause of death in children under five, excluding neonatal deaths. The approximately 100,000 people residing in the Bentiu Internally Displaced Population (IDP) camp in South Sudan have previously experienced water, sanitation, and hygiene outbreaks, including an ongoing Hepatitis E outbreak in 2021. This study aimed to assess the gaps in Water, Sanitation, and Hygiene (WASH), prioritise areas for intervention, and advocate for the improvement of WASH services based on the findings. Methods: A cross-sectional lot quality assurance sampling (LQAS) survey was conducted in ninety-five households to collect data on water, sanitation, and hygiene (WASH) coverage performance across five sectors. Nineteen households were allocated to each sector, referred to as supervision areas in LQAS surveys. Probability proportional to size sampling was used to determine the number of households to sample in each sector block selected using a geographic positioning system. One adult respondent, familiar with the household, was chosen to answer WASH-related questions, and one child under the age of five was selected through a lottery method to assess the prevalence of WASH-related disease morbidities in the previous two weeks. The data were collected using the KoBoCollect mobile application. Data analysis was conducted using R statistical software and a generic LQAS Excel analyser. Crude values, weighted averages, and 95% confidence intervals were calculated for each indicator. Target coverage benchmarks set by program managers and WASH guidelines were used to classify the performance of each indicator. Results: The LQAS survey revealed that five out of 13 clean water supply indicators, eight out of 10 hygiene and sanitation indicators, and two out of four health indicators did not meet the target coverage. Regarding the clean water supply indicators, 68.9% (95% CI 60.8%-77.1%) of households reported having water available six days a week, while 37% (95% CI 27%-46%) had water containers in adequate condition. For the hygiene and sanitation indicators, 17.9% (95% CI 10.9%-24.8%) of households had handwashing points in their living area, 66.8% (95% CI 49%-84.6%) had their own jug for cleansing after defaecation, and 26.4% (95% CI 17.4%-35.3%) of households had one piece of soap. More than 40% of households wash dead bodies at funerals and wash their hands in a shared bowl. Households with sanitary facilities at an acceptable level were 22.8% (95% CI 15.6%-30.1%), while 13.2% (95% CI 6.6%-19.9%) of households had functioning handwashing points at the latrines. Over the previous two weeks, 57.9% (95% CI 49.6–69.7%) of households reported no diarrhoea, and 71.3% (95% CI 62.1%-80.6%) reported no eye infections among children under five. Conclusion: The camp's hygiene and sanitation situation necessitated immediate intervention to halt the hepatitis E outbreak and prevent further WASH-related outbreaks and health issues. The LQAS findings were employed to advocate for interventions addressing the WASH gaps, resulting in WASH and health actors stepping in. [ABSTRACT FROM AUTHOR]

Maternal metabolism during pregnancy shapes offspring health via in utero programming. In the Healthy Start study, we identified five subgroups of pregnant women based on conventional metabolic biomarkers: Reference (n = 360); High HDL-C (n = 289); Dyslipidemic–High TG (n = 149); Dyslipidemic–High FFA (n = 180); Insulin Resistant (IR)–Hyperglycemic (n = 87). These subgroups not only captured metabolic heterogeneity among pregnant participants but were also associated with offspring obesity in early childhood, even among women without obesity or diabetes. Here, we utilize metabolomics data to enrich characterization of the metabolic subgroups and identify key compounds driving between-group differences. We analyzed fasting blood samples from 1065 pregnant women at 18 gestational weeks using untargeted metabolomics. We used weighted gene correlation network analysis (WGCNA) to derive a global network based on the Reference subgroup and characterized distinct metabolite modules representative of the different metabolomic profiles. We used the mummichog algorithm for pathway enrichment and identified key compounds that differed across the subgroups. Eight metabolite modules representing pathways such as the carnitine–acylcarnitine translocase system, fatty acid biosynthesis and activation, and glycerophospholipid metabolism were identified. A module that included 189 compounds related to DHA peroxidation, oxidative stress, and sex hormone biosynthesis was elevated in the Insulin Resistant–Hyperglycemic vs. the Reference subgroup. This module was positively correlated with total cholesterol (R:0.10; p-value < 0.0001) and free fatty acids (R:0.07; p-value < 0.05). Oxidative stress and inflammatory pathways may underlie insulin resistance during pregnancy, even below clinical diabetes thresholds. These findings highlight potential therapeutic targets and strategies for pregnancy risk stratification and reveal mechanisms underlying the developmental origins of metabolic disease risk. [ABSTRACT FROM AUTHOR]

Purpose: Motor competence is negatively associated with body mass index (BMI) in young people. However, it is still unclear whether motor competence is linked to the risk of obesity in adolescents and longitudinal evidence is missing. The main purpose of this study was to assess the association between motor competence and risk of obesity across adolescence. Methods: A 2-year follow-up study was conducted with a total of 122 adolescents (59.8% girls) aged 12 to 13 years at baseline. Motor competence (KTK), weight status (BMI) and physical activity (questionnaire) were assessed at three time points. Generalized estimating equation and logistic regression models were conducted to examine the relationships between motor competence and weight status, adjusting for potential confounders (i.e. age, sex and physical activity). Results: Motor competence and BMI were inversely related over time. The chance to have overweight/obesity decreased by 6.5% and 8% with a 10-point increase in motor competence across time. In addition, adolescents had 6.4 to 8.2 greater chance to have low motor competence with a 1-point increase in BMI across time. Conclusion: Motor competence is inversely associated with the risk of overweight/obesity across adolescence. Therefore, the development of motor competence can be a protection factor against excessive weight gain. As such, we recommend the development of motor competence as a strategy to prevent pediatric obesity through diversified types of physical activities such as sports, active play and physical education classes. [ABSTRACT FROM AUTHOR]

Background: Interventions within preschool settings have gained prominence due to the need to increase physical activity (PA) in early childhood. We first developed a 10-week preschool-based behaviour change intervention, guided by the UK Medical Research Council's framework for complex interventions. We then conducted a cluster feasibility randomised controlled trial (RCT) among young children. Aim: This process evaluation was embedded within the cluster feasibility RCT and aimed to assess the acceptability of the 10-week IAAH intervention among both preschool staff and parents. Methods: The study utilised a mixed method, involving post-intervention questionnaires completed by preschool staff (n = 4) and children's parents/caregivers (n = 9) and focus groups with preschool staff (n = 3) and parents/caregivers (n = 7). Quantitative data were analysed using SPSS to calculate acceptability scores, while qualitative data underwent thematic analysis using NVivo 12. Results: The intervention was well-received, with preschool staff reporting a 94.5% acceptability rate (mean score of 10.4 out of 11) and parents/caregivers indicating an 86% acceptance rate (mean score of 5.2 out of 6). Thematic analysis of focus group discussions revealed facilitators to intervention delivery, such as user-friendly materials and alignment with preschool curricula, and identified barriers, including time constraints, spatial limitations, and policy conflicts. Parental engagement was hindered by time restrictions, although the intervention materials were praised for their clarity and visual appeal. Conclusions: The findings suggest that the IAAH programme was acceptable to both preschool staff and parents. However, the identified barriers to intervention delivery and engagement should be addressed in the planning of a future cluster RCT to evaluate the efficacy of the intervention. [ABSTRACT FROM AUTHOR]

The burden of health issues surrounding the children and adolescents (ChAds) population is of great concern. From metabolic disorders such as obesity, non-alcoholic fatty liver disease, diabetes, multiple sclerosis including mental and several other psychological disorders like attention deficit hyperactivity, internet addiction, autism spectrum, subthreshold mood symptoms and depression, and stress disorders, is a nexus of the gut microbiota (GM) profile and physical activity (PA), as they both play a crucial role in ameliorating these disorders. The aim of this review is to explore the disorders with regard to their association with ChAds' GM and its health. We started with brief descriptions of PA and its connections with GM profile cum health in ChAds. In addition, the disorders in ChAds were broadly classified into metabolic and psychological. Observations from the discussed sections show that exercise and physical activity are efficient methods for enhancing physical, metabolic, and mental health, which are often GM-mediated, and thus might require certain levels of personalization. Furthermore, age, gender, genetics, baseline BMI, baseline exercise level, and diet are key parameters to be explored when proffering intervention of combative mechanisms against these disorders. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate circadian rhythms in independently living adults with obesity and mental disease, exploring the interplay between biological markers and lifestyle factors. Eighty participants divided equally into four groups; (i) people with obesity and schizophrenia; (ii) people with obesity and bipolar disorder; (iii) people with obesity without mental disease or sleep disorders, and (iv) people without obesity, mental disease or sleep disorders. Over two consecutive days, participants engage in repeated self-sampling of hair follicle and saliva; concurrently, data is collected on diet, body temperature, light exposure, sleep parameters, and physical activity by accelerometry. Hair follicles are analyzed for circadian gene expression, saliva samples for cortisol and melatonin concentrations. Circadian rhythms are investigated by cosinor analysis. The study employs a participant-tailored sampling schedule to minimize disruptions to daily routine and enhance ecological validity. The methodology aims to provide a comprehensive insight into the factors contributing to circadian disruptions in people with obesity, bipolar disorder and schizophrenia, potentially informing strategies for future management and mitigation. Trial registration: (ClinicalTrials.gov Identifier: NCT05413486). [ABSTRACT FROM AUTHOR]

Background: The WHO has recently identified obesity as one of the growing health issues worldwide. Additionally, obesity has been linked to lower academic achievement. Many studies have shown that having a healthy weight correlates with improving academic performance. Other studies showed that there is no relationship between obesity and intellectual achievement among students. Objectives: This study aims to determine the association between obesity and GPA among College students in Saudi Arabia. With secondary objectives to look at differences between males and females. Methodology: This is a cross-sectional study looking at undergraduate students at different universities from different regions in Saudi Arabia. The data was collected through a self-administered survey which includes questions regarding (BMI, GPA, Age, Gender, Marital Status, Weight in Kg, Height in cm, name of the College, and academic level). The data was analyzed using SPSS version 27.0. Results: The study included 424 participants, the majority of respondents fall within the 21-25 age bracket, comprising 62.5% of the sample. As for BMI distribution, with the highest percentage falling within the normal range at 35.8%, closely followed by the obese category at 23.8%. The GPA distribution, both on a scale of 5 and 4, provides a comprehensive understanding of academic performance within the surveyed population. Notably, a significant proportion of respondents achieved a GPA between 4.75 and 5, constituting 26.4% of the sample on the 5-point scale, and 40.8% on the 4-point scale. Conclusion: There was no significant association between BMI and participants’ GPA whether out of 5 or 4. More research is needed to better understand the mechanisms behind this association and to develop effective interventions to support the academic success of all students, regardless of their weight status [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of childhood obesity is on the rise. Accurate parental awareness of their child's body weight status is imperative in helping them maintain a healthy lifestyle and ideal body weight. This study aimed to determine the accuracy of parental perception of their child's body weight status and identify factors influencing their perception. Materials and methods: This was a cross-sectional study involving 586 parents of school-going children aged between 10 to 11 years, in Kuala Lumpur, Malaysia. Parents responded to a self-administered questionnaire regarding their characteristics and perception of their child's weight status. Parental perception of their child's body weight status was compared with the actual body mass index (BMI) of the child. Parental attitude towards childhood obesity was evaluated using a validated questionnaire. Results: Thirty-nine percent of parents underestimated their child's body weight status. Among parents of children who were overweight and obese, 54.0% underestimated their child's body weight status. The child's BMI (OR 2.25, 95% CI:1.15-3.34) and parental attitude towards childhood obesity (OR 1.48, 95% CI:1.02-2.17) had a significant association with parental perception. Conclusion: More than one-third of parents misperceived their child's weight status. This was especially prominent among parents of overweight and obese children. The child's BMI and parental attitude towards childhood obesity were significantly associated with parental perception of their child's weight status. [ABSTRACT FROM AUTHOR]

Background Obesity is a worldwide and chronic disease with significant morbidity and mortality which often begins in childhood. Kindergartens and schools are unique settings that may contribute towards the prevention of childhood obesity through ensuring a safe and supportive environment and the development of personal life skills. The aim of this study was to identify good practices, as defined by the Joint Action across Europe on Nutrition and Physical Activity (JANPA), that are effective and sustainable for childhood obesity prevention in kindergarten and primary schools in Malta. Methods This descriptive study design involved the development of an online questionnaire using the nine core criteria of the JANPA toolbox. An operational definition of fulfilling six core criteria was used to qualify an initiative as a good practice. The questionnaire was sent to the Heads of School of all kindergartens and primary schools in Malta. Two researchers independently of each other reviewed the replies for each initiative and assigned one point for each fulfilled core criteria. The total sum of points produced a JANPA core criteria score for that initiative. Results The response rate for this study was 21.9%. 24 out of a total of 39 initiatives achieved the operational JANPA core criteria score of 6. Initiatives were grouped into nutrition only, physical activity only, and combined nutrition and physical activity good practices and were described. Conclusion This study identified several good practices that can be extended to other schools across Malta. The survey tool can also be used when designing and implementing new initiatives. [ABSTRACT FROM AUTHOR]

Issue Addressed: Co‐designed and culturally tailored preventive initiatives delivered in childhood have high potential to close the cross‐cultural gap in health outcomes of priority populations. Māori and Pacific Islander people living in Australia exhibit a higher prevalence of overweight and obesity and higher rates of multimorbidity, including heart disease, cancer and diabetes. Methods: This mixed‐methods, pilot implementation and evaluation study, aimed to evaluate the implementation of a community‐based, co‐designed and culturally tailored childhood obesity prevention program, using quantitative (pre–post anthropometric measurement, pre–post health behaviour questionnaire) and qualitative (semi‐structured interview) methods. Sessions relating to healthy eating, physical activity and positive parenting practices were delivered to families residing in Brisbane (Australia) over 8‐weeks. Results: Data were collected from a total of 66 children (mean age 11, SD 4) and 38 parents (mean age 40, SD 8) of Māori and Pacific Islander background, from July 2018 to November 2019. Anthropometric changes included a reduction in Body Mass Index (BMI) z‐score among 59% of children (median change −0.02, n = 38, p = 0.17) and BMI among 47% of adults (median change +0.06 kg/m2, n = 18, p = 0.64). Significant improvements (p < 0.05) in self‐reported health behaviours from pre‐ to post‐program included increased vegetable consumption among children, decreased discretionary food intake of children, decreased discretionary drink consumption among both children and adults, increased minutes of daily physical activity among adults and increased parental confidence in the healthy diets of their children. Qualitative data revealed participants valued the inclusion of all family members, learning of practical skills and cultural tailoring delivered by the Multicultural Health Coaches. Conclusions: This study provides preliminary evidence that the Healthier Together program improved self‐reported health behaviours and physical activity levels among Māori and Pacific Islander children and their families in the short‐term; however, due to the small sample size, these results must be interpreted carefully. The program empowered change via cultural tailoring and accessibility; however, long‐term implementation and evaluation with a larger cohort is needed to validate the observed health behaviour improvements and their sustainability. So What?: The co‐design framework that informed program development and key learnings of implementation will provide guidance to health practitioners, health workers, public health professionals and policy makers to develop inclusive and pragmatic co‐design solutions for priority cultural populations in Australia. Health outcomes will improve as a result, promoting health equity for future generations. [ABSTRACT FROM AUTHOR]

Aim: Previous studies suggest a lack of a unified approach in identifying and addressing children with obesity while being inpatients in individual Australian hospitals. Our study aimed to describe current clinical practice across Australia and identify discrepancies that can aid in developing a more unified response to children identified with obesity as hospital inpatients. Methods: A cross‐sectional exploratory online survey was distributed to major paediatric in‐patient departments in Australia, with a response rate of 68%. Questions focused on education, identification, interventions and attitudes towards a national protocol. Results: Twenty percent of respondents indicated that staff in their department regularly record body mass index, 66% address weight issues and only 8% consistently refer to appropriate outpatient services. Although 88% of respondents believe that a national protocol for addressing paediatric obesity would be beneficial, respondents emphasised concerns regarding their local resources. Conclusion: Our study can inform the development of a guideline for a unified response to opportunistically identify children with overweight and obesity as inpatients. [ABSTRACT FROM AUTHOR]

In an inpatient treatment center for pediatric obesity, the effectiveness of an emotion regulation (ER) training on top of the multidisciplinary obesity treatment (MOT) was tested by means of an RCT. The ER training was evaluated on primary outcomes: ER and emotional eating, and secondary outcomes: well-being and weight loss, taking into account pre, post, and follow-up measurements. Of the 115 10- to-14-year old adolescents with obesity (52.2% girls), 65 were allocated to the ER training. Physicians measured their height and weight objectively (4 times). Participants also filled out questionnaires on ER competencies (ER abilities and ER strategies), emotional eating and well-being (3 times). Significant pre-post interactions were found for "emotional awareness," "problem solving," and "evoking a positive mood." Moreover, the positive effects of the ER training on emotion regulation strategies were maintained at follow-up. Concerning well-being, no significant pre-post interaction effects were found but a significant interaction effect was found when comparing pre with follow-up. Analyses show a significant main effect of time on weight loss, but this was not qualified by a Time × Condition interaction effect. The current RCT study shows limited but promising effects of adding an ER training to the MOT. Further research should investigate whether the positive short-term effects will be maintained. [ABSTRACT FROM AUTHOR]

Background: There is only limited data on the association between psoriasis and metabolic comorbidities in South‑Asian children. Objective: To examine metabolic comorbidities among South‑Asian children with and without psoriasis. Materials and Methods: A hospital‑based, comparative, cross‑sectional study was conducted in children with and without psoriasis over 19 months. Anthropometric, clinical, and metabolic comorbidity details (including disease extent and severity scores, obesity, systemic hypertension, diabetes mellitus, lipid abnormalities, and metabolic syndrome) were obtained in both groups according to standard criteria. Results: Fifty‑eight children with psoriasis (25 males/33 females, age 11.3 ± 3.0 years, range 4 to 17 years) and 62 children without psoriasis (37 males/25 females, age 11.0 ± 3.6 years, range 4 to 18 years) were recruited. The prevalence of obesity (31.0% versus 14.5%, P = 0.031, odds ratio 2.65) and metabolic syndrome (18.6% versus 4.6%, P = 0.044, odds ratio 4.68) were higher in children with psoriasis than without. The prevalence of other metabolic comorbidities (systemic hypertension, pre‑diabetes, lipid abnormalities, elevated serum alanine aminotransferase, and non‑alcoholic fatty liver disease) was not different between children with and without psoriasis and between obese and non‑obese children with psoriasis. Among children with psoriasis, those with abdominal obesity had significantly lower disease severity and extent scores than those without. Conclusion: Psoriasis is associated with a significantly higher prevalence of obesity and close to significantly higher prevalence of metabolic syndrome in South‑Asian children. Screening for metabolic comorbidities is essential even in non‑obese children with psoriasis. Disease extent and severity are less in obese compared to non‑obese South‑Asian children with psoriasis. [ABSTRACT FROM AUTHOR]

Despite >1 in 5 children taking prescription drugs in the United States, offlabel drug use is common. To increase the study of drugs in children, regulatory bodies have enacted legislation to incentivize and require pediatric drug studies. As a result of this legislation, novel trial approaches, and an increase in personnel with pediatric expertise, there have been numerous advancements in pediatric drug development. With this review, we aim to highlight developments in pediatric pharmacology over the past 6 years for the most common disease processes that may be treated pharmacologically by the pediatric primary care provider. Using information extracted from label changes between 2018 and 2023, the published literature, and Clinicaltrials.gov, we discuss advances across multiple therapeutic areas relevant to the pediatric primary care provider, including asthma, obesity and related disorders, mental health disorders, infections, and dermatologic conditions. We highlight instances in which new drugs have been developed on the basis of a deeper mechanistic understanding of illness and instances in which labels have been expanded in older drugs on the basis of newly available data. We then consider additional factors that affect pediatric drug use, including cost and nonpharmacologic therapies. Although there is work to be done, efforts focused on pediatric-specific drug development will increase the availability of evidence-based, labeled guidance for commonly prescribed drugs and improve outcomes through the safe and effective use of drugs in children. [ABSTRACT FROM AUTHOR]

In 2020, the US Food and Drug Administration approved liraglutide (glucagonlike- peptide-1-receptor-agonist) as an adjunctive therapy for weight management in adolescents aged 12 to 18 years in combination with a reduced-calorie diet and increased physical activity. The 2023 American Academy of Pediatrics guidelines recommend pharmacotherapy with glucagon-like-peptide-1-receptoragonist as a second-line therapy in obesity management. Although reports in adults have suggested a link between liraglutide and adverse effects including hepatic injury and acute kidney injury (AKI), these effects have not previously been reported among adolescents treated with liraglutide for weight loss. We present a 17-year-old male who developed AKI and evidence of hepatic injury (significant elevation of hepatic transaminases) after 3 months administration of the lowest dosage of liraglutide (0.6 mg/day) for management of class III obesity. The patient experienced significant loss of appetite, weight loss, and melancholy during the treatment period. One month after discontinuing liraglutide, his mood had improved, his liver enzymes had returned to normal, and AKI had resolved. The Adverse Drug Reaction Probability Scale suggested a high likelihood of a causative association between liraglutide and his symptoms. Our report highlights the importance of vigilance in monitoring for these potential adverse effects among adolescents treated for obesity with any dose of liraglutide. [ABSTRACT FROM AUTHOR]

Objectives: The purposes ofthis study were to assess the association between exposure to particulate matter ( PM2 5) and adolescent obesity and to identi fy and visualize the world areas where the problems of adolescent obesity and air pollution by fine PM are more severe. Methods: This is an ecological study, based on publicly available data from a World Health Organization site. Resuits: For each increase in air pollution there was an increase in the probability matof being in the higher prevalence obesity group (OR = 1.18 (95% CI, 1.06-1.31). High prevalence rates for both adolescent obesity and air pollution obeby PM25 were identified in several countries, including Venezuela, Algeria. Libya, Saudi Arabia, Iraq, and Oceania islands. Conclusions: Efforts by local associauthorities and world organizations should be focused on the countries with the liighest prevalence rates for both conditions. [ABSTRACT FROM AUTHOR]

The high incidence of childhood obesity is a big healthcare challenge worldwide, which is fraught with the development of not only numerous somatic comorbidities but also children's social maladaptation. Searching for early biochemical markers of obesity stabilization and its progression at an older age is very important for identifying risk groups and preventing the development of obesity and its complications. Our study showed that the child' sex, which is often disregarded in these situations, should necessarily be considered when assessing the developmental dynamics of obesity. Whereas in girls, a decrease in serum serotonin concentrations may serve as a marker of obesity stabilization/progression, in boys, this tendency can be predicted by reduced serum indole-3-acrylate levels. In both sexes, elevated fecal indole-3-carboxaldehyde levels can be indicative of obesity stabilization/progression. [ABSTRACT FROM AUTHOR]

Aims: To establish which components of energy balance mediate the clinically significant weight loss demonstrated with use of cotadutide, a glucagon‐like peptide‐1 (GLP‐1)/glucagon receptor dual agonist, in early‐phase studies. Materials and Methods: We conducted a phase 2a, single‐centre, randomized, placebo‐controlled trial in overweight and obese adults with type 2 diabetes. Following a 16‐day single‐blind placebo run‐in, participants were randomized 2:1 to double‐blind 42‐day subcutaneous treatment with cotadutide (100–300 μg daily) or placebo. The primary outcome was percentage weight change. Secondary outcomes included change in energy intake (EI) and energy expenditure (EE). Results: A total of 12 participants (63%) in the cotadutide group and seven (78%) in the placebo group completed the study. The mean (90% confidence interval [CI]) weight change was −4.0% (−4.9%, −3.1%) and −1.4% (−2.7%, −0.1%) for the cotadutide and placebo groups, respectively (p = 0.011). EI was lower with cotadutide versus placebo (−41.3% [−66.7, −15.9]; p = 0.011). Difference in EE (per kJ/kg lean body mass) for cotadutide versus placebo was 1.0% (90% CI −8.4, 10.4; p = 0.784), assessed by doubly labelled water, and −6.5% (90% CI −9.3, −3.7; p < 0.001), assessed by indirect calorimetry. Conclusion: Weight loss with cotadutide is primarily driven by reduced EI, with relatively small compensatory changes in EE. [ABSTRACT FROM AUTHOR]

Summary: Objectives: This study aimed to investigate weight bias within young children's pro‐social choices between characters who differed in body size. Methods: Seventy‐six children aged 4–6 years read stories asking them to choose who they would first help, share with, comfort, and steal from, between a healthy weight and child with overweight. They also selected the one character they would most like to play with. Children's reasoning for these choices was recorded and analysed. Results: The character with overweight was helped first in only a third of the choices made. Children chose the characters with overweight more often as the target for anti‐social action. In friendship selections, children overwhelmingly rejected the characters with overweight. However, weight bias was not prominent in the reasons children gave for the choices. Most children were not negative about body shape, weight or appearance. Similarly, in friendship choices, these were mostly expressed positively to the character chosen. Only a small minority of children were explicitly negative about the character with overweight. Conclusions: A better understanding of weight bias acquisition and variation between children will benefit those working in health care and educational settings. Future research should link with developmental theory, such as on social categorization and theory of mind. [ABSTRACT FROM AUTHOR]

Summary: Introduction: The COVID‐19 pandemic posed tremendous challenges for children. However, the long‐term effects of the pandemic on various aspects of physical health at a national level remain unclear. Methods: In this retrospective cohort study, we analysed data from nationwide health checkup records amongst children aged 7–15 years. The dataset comprised 3 544 146 records from 393 794 individuals who graduated from junior high school during fiscal years 2007 to 2022. Difference‐in‐differences (DID) analyses with multiple time periods were used to examine the impact of COVID‐19 on physical health outcomes. Results: Compared with the pre‐pandemic period, the COVID‐19 pandemic was associated with excess increases in obesity for boys and girls, persisting over the 3 years (+0.42%; [95% CI, 0.23–0.61]). Also, it was associated with excess increases in underweight (+0.28% [0.25–0.32]) and poor visual acuity amongst boys in the 3rd year (+1.80% [1.30–2.30]). There were excess reductions in dental caries (−1.48% [−2.01 to −0.95]), glucosuria (−0.55 [−0.88 to −0.23]) and hematuria (−0.43% [−0.73 to −0.13]) during the 3rd year of the pandemic. Conclusions: These findings underscore the multifaceted impact of the pandemic on various health indicators for school‐aged children. This information could be valuable for public health policy and paediatric healthcare planning in the post‐pandemic era. [ABSTRACT FROM AUTHOR]

Summary: Background: Lifestyle factors play an important role in the development and management of childhood obesity and its related cardiometabolic complications. Objective/Methods: We aimed to explore childhood obesity subtypes based on lifestyle factors and examine their association with cardiometabolic health. We included 1550 children with obesity from the National Health and Nutrition Examination Survey. Cluster analysis identified obesity subtypes based on four lifestyle factors (physical activity, diet quality, sedentary time and smoking). Multiple linear regression assessed their association with cardiometabolic factors. Results: Five subtypes of childhood obesity were identified: unhealthy subtype (n = 571; 36.8%), physically active subtype (n = 185; 21.1%), healthy diet subtype (n = 404; 26.1%), smoking subtype (n = 125; 8.1%) and non‐sedentary subtype (n = 265; 17.1%). Compared with the unhealthy subtype, the physically active subtype had lower insulin and HOMA‐IR levels, and smoking subtype was associated with lower HDL levels. When compared with children with normal weight, all obesity subtypes had worse cardiometabolic profile, except the physically active subtype who had similar DBP, HbA1c and TC levels; smoking subtype who had similar TC levels; and healthy diet and non‐sedentary subtypes who had similar DBP levels. Conclusion: Children of different lifestyle‐based obesity subtypes might have different cardiometabolic risks. Our new classification system might help personalize assessment of childhood obesity. [ABSTRACT FROM AUTHOR]

Summary: Background and Objective: The aim was assessing a short training for healthcare providers on patient‐focused counselling to treat childhood obesity in primary care, along with dietitian‐led workshops and educational materials. Methods: Randomized clustered trial conducted with paediatrician‐nurse pairs (Basic Care Units [BCU]) in primary care centres from Tarragona (Spain). BCUs were randomized to intervention (MI) (motivational interview, dietitian‐led education, and educational materials) or control group (SC, standard care). Participants were 8–14‐year‐old children with obesity, undergoing 1–11 monthly treatment visits during 1 year at primary care centres. The primary outcome was BMI z‐score reduction. Results: The study included 44 clusters (23 MI). Out of 303 allocated children, 201 (n = 106 MI) completed baseline, final visits, and at least one treatment visit and were included in the analysis. BMI z‐score reduction was −0.27 (±0.31) in SC, versus −0.36 (±0.35) in MI (p = 0.036). Mixed models with centres as random effects showed greater reductions in BMI in MI than SC; differences were B = −0.11 (95% CI: −0.20, −0.01, p = 0.025) for BMI z‐score, and B = −2.06 (95% CI: −3.89, −0.23, p = 0.028) for BMI %. No severe adverse events related to the study were notified. Conclusion: Training primary care professionals on motivational interviewing supported by dietitians and educational materials, enhanced the efficacy of childhood obesity therapy. [ABSTRACT FROM AUTHOR]

Summary: Objective: To evaluate the preliminary effects of a theory‐based, multi‐component intervention on improving healthy lifestyle behaviours and preventing obesity amongst low‐income preschoolers. Methods: A cluster randomised controlled trial was conducted at 10 daycare centres. The 16‐week FirstStep2Health intervention, grounded in the Actor‐Partner Interdependence Model and the Social Cognitive Theory, included five components: a Facebook‐based parent programme, three virtual parent meetings, three weekly motivational text messages, parent–child learning via weekly child letters and daycare centre‐based child programme. Results: A total of 95 preschoolers (53 intervention and 42 control) participated. Preschoolers' mean age was 49.27 months, with 57.9% being female, 12.6% being Hispanic and 40% being African American. The intervention significantly decreased intervention preschoolers' fat intake (B = −33.76, p = 0.047) and % body fat (B = −1.18, p = 0.036) compared to the control. During year 2, there were significant intervention effects on increasing skin carotenoids (B = 87.06, p = 0.035). Although not statistically significant, the intervention showed positive effects on increasing preschoolers' fruit/vegetable intake; and decreasing screen time, body mass index z‐score and proportion of overweight/obesity. Conclusions: Even with some potential limitations (small sample size, measurement concerns and confounding with Coronavirus Disease 2019 pandemic), the study's results support the preliminary efficacy of the FirstStep2Health intervention in preventing obesity amongst low‐income racially diverse preschoolers. [ABSTRACT FROM AUTHOR]

Summary: Background: Internalized weight bias (IWB) has been identified as a correlate of higher depressive and anxiety symptoms in adolescents with higher weights. However, there has been limited investigation into how IWB relates to positive mental health and whether these associations differ across genders. Objectives: To examine the associations between IWB and mental health (depression, anxiety, flourishing) in adolescents with higher weights, and to test the potential moderating role of gender. Methods: Canadian adolescents with higher weights (N = 7538, 60% boys, 36% girls, 4% gender diverse, ages 12–19) from the COMPASS study completed a survey during the 2021–2022 school year. Data were analysed using generalized linear models. Results: Highest IWB and poorest mental health were noted within gender diverse adolescents, followed by girls then boys. Gender moderated the relationship between higher IWB and higher depression, higher anxiety and lower flourishing, with the strongest relationships noted among girls. Conclusion: IWB interventions should be tailored to gender subgroups that may be particularly vulnerable to maladaptive mental health outcomes associated with IWB. System‐level changes that mitigate perpetuation of weight bias and discrimination which lead to IWB are also essential, particularly for girls. [ABSTRACT FROM AUTHOR]