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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.

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Youth obesity and depression are public health concerns. Although meta-analyses suggest a positive association between those conditions in adults and adolescents, evidence remains unclear in prepubertal children. We examined the bidirectional associations between levels of depressive symptoms and weight status in 8–10-year-old children with a parental history of obesity, over two years, and whether they differ by sex. Methods: Data were drawn from the QUebec Adipose and Lifestyle InvesTigation in Youth Cohort Study's baseline and first follow-up evaluations (n = 558). Depressive symptoms were assessed using the 12-item Center for Epidemiological Studies Depression scale and weight status using body mass index z-scores based on World Health Organization standards. Linear and logistic regression models were used to test the directionality and magnitude of the associations, adjusting for age, sex, physical activity, screen time, parental education, alcohol and cigarette use, and baseline outcome measure. Results: Children with higher levels of depressive symptoms at baseline were not more likely to have overweight/obesity at follow-up (odds ratio [95 % Coefficient Interval] = 0.95[0.88;1.02]). Baseline overweight/obesity was not associated with subsequent higher levels of depressive symptoms (beta coefficient [95 % Coefficient Interval] = 0.20 [−0.47;0.87]). No sex differences emerged. Limitations: Selection bias may have occurred due to loss at follow-up (10 % attrition) and exclusion of 6 participants taking mood disorder medication. Conclusions: Unlike in adults and adolescents, no association between weight status and depressive symptoms was observed in childhood over two years. Underlying mechanisms linking both conditions later in life may not apply as early as prepubertal childhood. • No association between weight and depressive symptoms emerged in prepubertal youth. • No sex differences were observed over a two-year period. • Associations between weight and depression might not manifest as early as childhood. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The rising prevalence of overweight and obesity among children and adolescents is a global public health issue. This trend has led to increased obesity-related comorbidities and a higher risk of adulthood obesity in this sensitive population. This study aims to establish the first obesity registry for Iranian children and adolescents to enhance the understanding of pediatric obesity and its determinants and consequents. Methods: We intended to establish a detailed registry for pediatric obesity in Iran, focusing on epidemiological, demographic, and clinical aspects, as well as evaluating various interventions and outcomes. The study will enroll eligible children aged 2 to 17 years with gender- and age-specific BMI > 85th percentile. The initial phase will involve the collaboration of Tehran University of Medical Sciences (TUMS)-affiliated children's hospitals, aiming to register at least 1200 patients over three years (2023–2026). Data collection will include demographic information, medical and medication history, family history, lifestyle behaviors, quality of life, behavioral and psychological assessments, physical examinations, anthropometric measurements, biochemical markers, and obesity-related outcomes. Conclusion: The goal of this registry is to gather extensive information on the factors influencing the occurrence, management, and treatment of obesity and overweight among children and adolescents at individual, family, and community levels. This extensive data is expected to facilitate improvements in health outcomes and behaviors related to obesity and to provide a solid foundation for future research in this field. [ABSTRACT FROM AUTHOR]

Evaluate RESPOND, a community-based systems intervention to prevent childhood obesity and non-communicable diseases (NCD). Cluster randomized trial of building community capacity to use systems science for child obesity and NCD prevention in 10 local government areas in northeast Victoria, Australia. Four-year stepped wedge trial, adapted due to COVID-19 restrictions Cluster randomized trial of building community capacity to use systems science for child obesity and NCD prevention in 10 local government areas in northeast Victoria, Australia. Four-year stepped wedge trial, adapted due to COVID-19 restrictions. Data from 31 primary schools participating at both March to June 2019 (60 % school participation rate), and March to August 2022 (30 %) analysed using linear mixed models. Primary outcome was age-sex-adjusted body mass index z-scores (BMIz) calculated from measured height and weight (children in grades 2, 4 and 6 [aged 7–12 years]). Secondary outcomes were health-related quality of life (HRQoL) and self-reported health behaviours (grades 4 and 6). Non-significant intervention effects were observed for BMIz (−0.10; 95 % CI: 0.30, 0.11), and percentage with overweight or obesity (−5.4 %; 95 % CI: 13.6 %, 2.7 %). HRQoL deteriorated between 2019 and 2022, except where intervention effects for HRQoL were observed in boys' psychosocial health summary score (7.4; 95% CI: 3.5, 11.2) and total scale score (9.9; 95% CI: 5.5, 14.2). There was an intervention effect for the proportion of boys consuming ≥5 glasses of water per day (15.2 %; 95% CI: 0.9–29.6). RESPOND protected overall and psychosocial health and had positive effects on BMIz. [ABSTRACT FROM AUTHOR]

Incidences of childhood obesity and type 2 diabetes (T2D) are climbing at alarming rates. Evidence points to prenatal exposures to maternal obesity and gestational diabetes mellitus (GDM) as key contributors to these upward trends. Children born to mothers with these conditions face higher risks of obesity and T2D, beyond genetic or shared environmental factors. The underpinnings of this maternal-fetal programming are complex. However, animal studies have shown that such prenatal exposures can lead to changes in brain pathways, particularly in the hypothalamus, leading to obesity and T2D later in life. This article highlights significant findings stemming from research funded by my American Diabetes Association Pathway Accelerator Award and is part of a series of Perspectives that report on research funded by the American Diabetes Association Pathway to Stop Diabetes program. This critical support, received more than a decade ago, paved the way for groundbreaking discoveries, translating the neural programming findings from animal models into human studies and exploring new avenues in maternal-fetal programming. Our BrainChild cohort includes >225 children, one-half of whom were exposed in utero to maternal GDM and one-half born to mothers without GDM. Detailed studies in this cohort, including neuroimaging and metabolic profiling, reveal that early fetal exposure to maternal GDM is linked to alterations in brain regions, including the hypothalamus. These neural changes correlate with increased energy intake and predict greater increases in BMI, indicating that early neural changes may underlie and predict later obesity and T2D, as observed in animal models. Ongoing longitudinal studies in this cohort will provide critical insights toward breaking the vicious cycle of maternal-child obesity and T2D. Article Highlights: Over the past 15 years, rates of youth-onset type 2 diabetes (T2D) have surged, closely linked to rising rates in childhood obesity. Prenatal exposure to maternal obesity and gestational diabetes mellitus significantly increases the risk of obesity and T2D in offspring, beyond genetic and environmental factors. Studies in the BrainChild cohort show that early fetal exposure to maternal gestational diabetes mellitus is associated with neural alterations, particularly in the hypothalamus, that are linked to longitudinal increases in BMI in children. Understanding these prenatal influences is critical for developing interventions to prevent the intergenerational transmission of obesity and T2D. [ABSTRACT FROM AUTHOR]

Objective: To assess effects of Healthy Change intervention on maternal perception of her child's body weight (MPCW), maternal feeding style, and obesogenic home environment. Methods: A randomized control trial was conducted, consisting of two arms: the intervention group received the Healthy Change program, and the control group received the Hygiene and Accident Prevention program. A total of 356 mother-preschool child dyads participated, 182 in the intervention group and 174 in the control group, residing in Mexico and the United States. Data were collected at baseline and after the program through self-administered questionnaires completed by mothers and child anthropometric measurements. Results: Although no significant between-group difference in pre- and post-intervention change of MPCW was found, sub-analyses revealed that a higher proportion of mothers in the intervention group accurately perceived their child's body weight at the study endpoint using categorical (67% vs. 57.1%, p < 0.005) and visual scales (48.9% vs. 41.8%, p < 0.015). Additionally, more mothers of overweight children in the intervention group accurately perceived their children's overweight and obese status compared to those in the control group (29.8% vs. 10.3%, X2 = 4.26, df = 1, p < 0.039). The intervention group also displayed a higher proportion of mothers with authoritative feeding style (26.4% vs. 16.5%, p < 0.036) and significantly higher family nutrition and physical activity scores (29.1 vs. 28.0, p < 0.000) at the study endpoint. Conclusions for practice: Healthy Change Intervention led to improved accuracy of MPCW, a shift toward maternal authoritative feeding styles, and positive changes in obesogenic home environments. Significance: What is already known on this subject?: Mothers of overweight or obese children often underestimate their children's weight status. Research shows when mothers are unaware of their children's weight issues, they are less likely to take preventive actions, or seek health services. The most frequent maternal child feeding style in Hispanic mothers is the authoritarian, What this study adds?: Healthy Change intervention was first of its kind designed to increase mothers' awareness about their preschooler's overweight and obese status. Healthy Change promote authoritative feeding style, and favorable changes in family nutrition and physical activity. [ABSTRACT FROM AUTHOR]

Background: Since 1990, childhood overweight and obesity have been rising on every continent and have almost doubled worldwide. The deleterious consequences include hypertension, type 2 diabetes mellitus, and dyslipidemia leading to metabolic syndrome in childhood and myocardial infarction, stroke, cancer and other disabling conditions in adulthood. Purpose: In Southern Europe, including Greece, Italy, and Spain, 10 to 15% of children are obese. Obesity in Eastern European countries is somewhat lower, but the rates of rise are very steep and will approach those in Southern Europe during the next few years. Worldwide, Asia accounts for nearly half of all overweight children under the age of 5, while Africa is home to one quarter of overweight children under 5. In Latin America, about 20% of children under 20 are overweight. Further, children living in poverty can suffer simultaneous overweight and obesity as well as malnutrition. In the US, the risk of being overweight in adolescence is several times higher when a younger child has a body mass index (BMI) in the 50th or greater percentile. Findings: If the clinical, non-clinical and public health communities ignore these challenges, such inaction will surely portend an unprecedented future pandemic of overweight and obesity in children and adolescents leading to future premature morbidity and mortality. All clinical, non-clinical and public health professionals should exert concerted efforts concerning their individual patients, their families, communities, and policymakers. Conclusions: Such coordinated interdisciplinary efforts may curb these alarming trends and secure healthier futures for children and their families throughout the world. Significance: Pediatric overweight and obesity are emerging as a pandemic and cause hypertension, type 2 diabetes mellitus, and dyslipidemia leading to metabolic syndrome. In adults, these conditions markedly increase risks of myocardial infarction and stroke as well as liver disease, obstructive sleep apnea, arthritis, and certain cancers, all of which are increasing at younger ages. This commentary contains challenges and potential solutions to clinical, non-clinical and public health professionals to increase efforts with their individual patients, families, communities, and policymakers. Exerting concerted interdisciplinary efforts may curb these alarming trends and secure healthier futures for children and their families throughout the world. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between the amount of ultra‐processed food (UPF) in the diet and low‐grade inflammation in children. This cross‐sectional study was conducted in 50 healthy children recruited from children attending the Social Paediatrics Outpatient Clinic for follow‐up of normal developmental stages. Low‐grade inflammation was calculated by INFLA‐score, dietary intake by three 24‐h dietary recalls and dietary content analyses by BeBiS™ software. The mean age of the 50 children included in our study was 10.18 ± 3.98 years (5–17 years). UPF accounted for 24.5% of the total daily energy intake of children. In children with higher inflammation scores (INFLA‐score ≥ 2), the amount in grams of UPF and the percentage of total energy from UPF were found to be significantly higher (p = 0.030 and p = 0.015, respectively). A weak positive correlation was found between the INFLA‐score and the percentage of daily dietary energy intake coming from UPFs (r = 0.350, p < 0.01), the average daily energy intake from UPFs (r = 0.313, p < 0.05), and the average daily amount of UPF consumed (r = 0.260, p < 0.05). The linear regression model revealed that every one‐unit increase (1%) in the percentage of total daily energy intake coming from UPF caused an increase in β = 0.154‐unit in the INFLA‐score. It was found that obesity was not a mediator in the association between the percentages of total energy intake from UPF on the INFLA‐score, instead, the energy intake from UPF had a significant direct association with the INFLA‐score. The average amount of UPF consumed daily showed an increasing pattern in parallel with inflammation‐score quartile classes (Q1 to Q4) with 33.3% in Q1, 38.5% in Q2, 53.8% in Q3 and 66.7% in Q4 (p = 0.049). In conclusion, a positive association was found between low‐grade inflammation and UPF consumption in children, independent of obesity. [ABSTRACT FROM AUTHOR]

Summary: Preventing childhood obesity from early life is considered essential. However, evidence from recent systematic reviews has highlighted inconsistent results and limited effectiveness of preconception and pregnancy lifestyle interventions regarding offspring weight outcomes and adiposity. Therefore, to improve our understanding regarding the mixed success of these early life interventions, we conducted a scoping review examining intervention complexity, process evaluation components, and authors' statements. Eligible articles (preconception or pregnancy lifestyle trials with offspring data beyond 1 month of age) were identified by searching databases (PubMed, Embase, and CENTRAL), previous reviews, and performing CLUSTER searches. The Intervention Complexity Assessment Tool for Systematic Reviews (iCAT_SR) was used to evaluate intervention complexity. A thematic analysis provided insight into process evaluation components and authors' interpretations. Finally, an expert consultation on the results was conducted. We identified 40 eligible publications corresponding to 27 trials. Only two trials started before conception. Potential reasons for interventions' limited success included the late intervention initiation, short intervention duration, and insufficient sample size. Few studies reported process evaluations and included stakeholder involvement, which are essential according to the expert group. We discuss current limitations and outline suggestions for future interventions in this field of research. [ABSTRACT FROM AUTHOR]

Summary: Background: 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. Methods: 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. Results: 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. Conclusion: 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]

Summary: Background: Macrosomia (birthweight ≥4 kg) may alter the associations of physical activity (PA) and screen time (ST) throughout childhood with later cardiometabolic risk. Objective: To investigate associations of PA and ST over a 4–6‐year follow‐up period with cardiometabolic outcomes in preteens (9–11‐year‐olds) who were born to mothers with previous macrosomic delivery. Methods: This is an analysis of 402 preteens from the ROLO study, who were born to mothers that previously delivered an infant with macrosomia. Parental‐reported measures of PA and ST were obtained in early childhood at 5‐years of age. Preteen self‐reported PA, parental‐reported ST, anthropometry, dual‐energy x‐ray absorptiometry, blood pressure, heart rate, cardiorespiratory endurance, and blood biomarkers were obtained at 9–11‐years. Crude and adjusted linear regression models explored associations and the interaction of birthweight was investigated in all models. Results: Early childhood PA and ST at the 5‐year follow‐up were not related to preteen cardiometabolic outcomes. In adjusted models, higher preteen PA was associated with lower sum of skinfolds (B = −3.00, 95% CI −5.98, −0.02, p = 0.048) and higher cardiorespiratory endurance (B = 0.50, 95% CI 0.20, 0.80, p = 0.001) at the same time point. No strong evidence for modification by birthweight was found. Conclusion: Higher preteen PA may have potential benefits for cardiometabolic health, irrespective of birthweight. [ABSTRACT FROM AUTHOR]

Summary: Objectives: To assess the predictive potential of the in utero exposome in relation to childhood adiposity as indicated by body mass index z‐scores (BMIz) and the fourth versus first quartile of % fat mass (FM) at median age of 4.6 years. Methods: We leveraged data on clinical risk factors for childhood obesity during the perinatal period, along with cord blood per/polyfluoroalkyl substances (PFAS) and cord blood DNA methylation, in 268 mother–offspring pairs. We used the sparsity ranked LASSO penalized regression framework for each outcome and assessed model performance based on % variability explained for BMIz and area under the receiver operating characteristic curve (AUC) for the fourth versus first quartile of %FM. We employed cross‐validation for model tuning and split‐sample validation for model evaluation. Results: Mean ± SD BMIz was 0.01 ± 1.1, %FM was 19.8 ± 6.34%. The optimal model for predicting BMIz explained 19.1% of the variability in the validation set and included only clinical characteristics: maternal pre‐pregnancy BMI, paternal BMI, gestational weight gain, physical activity during pregnancy and child race/ethnicity. The optimal model for fourth versus first quartiles of %FM achieved an AUC of 0.82 ± 0.01 in the validation set, with the clinical features again emerging as the strongest predictors. Conclusion: In this study sample, perinatal chemical exposures and the epigenome have low utility in predicting childhood adiposity, beyond known clinical risk factors. [ABSTRACT FROM AUTHOR]

Summary: Background: Childhood obesity remains a public health crisis and identification of unique prenatal and early infancy predictors of obesity risk are critically needed. Objectives: We test a comprehensive biopsychosocial model of the predictors of rapid weight gain (RWG) in the first 6 months of life. Methods: Two hundred and ninety nine pregnant women and their infants participated. Maternal prenatal psychobiological risk (PPBR) was assessed during the third trimester via maternal anthropometrics, serum biomarkers (insulin, leptin, adiponectin), and maternal report of pregnancy complications, substance use, mental health and stress. Infant stress reactivity was measured at 2 months (cortisol output, resting RSA, observed irritability, negative emotionality). At 2 and 6 months, maternal self‐report of obesogenic feeding practices and observed maternal sensitivity during three tasks were collected. RWG was classified based on change in weight‐for‐age z scores from birth to 6 months (>0.67 SD). Results: Obesogenic feeding practices predicted greater likelihood of RWG, β = 0.30, p =.0.01, independent of other predictors and covariates. Obesogenic feeding practices was the only proposed intervening mechanism that produced a significant indirect effect of PPBR on RWG, b = 0.05, S.E. = 0.04, 95% CI [0.002, 0.15], β = 0.06. Conclusion: Identifying proclivity towards obesogenic feeding practices and providing support to reduce these behaviours may enhance childhood obesity prevention efforts. [ABSTRACT FROM AUTHOR]

Summary: Background: The COVID‐19 pandemic led to school closures, potentially impairing children's behaviours and health. We aimed to explore the effects of school closure on lifestyle behaviours (dietary habits, physical activity) and health outcomes (adiposity, fitness, self‐esteem, self‐concept) in children. Methods: We measured 247 children before school closure (October–November 2019) and after school reopening (October–November 2021) (COVID‐19 group). To distinguish the changes due to school closure from changes due to growth, we included 655 age‐matched children with cross‐sectional measurements in October–November 2019 (control group). The response of this group (i.e., differences between children with 2 years of difference) was considered the expected response to growth. Two‐way ANOVA was used to test age‐by‐group interactions, indicating an effect of school closure. Results: In 7‐to‐9‐year‐old children, the COVID‐19 group had larger‐than‐expected decreases in physical activity (by 0.4 points), resulting in higher physical inactivity prevalence (by 19 percent points) at 9 years. This was accompanied by larger‐than‐expected increases in fat percentage (by 6.1 percent point). In 8‐to‐10‐year‐old children, the COVID‐19 group had higher physical inactivity prevalence at 10 years (by 20 percent points). This was accompanied by larger‐than‐expected increases in fat percentage (by 8.3 percent points), z‐score BMI (by 0.90 units), and waist circumference (by 6.1 cm). In 9‐to‐11‐year‐old children, the COVID‐19 group had larger‐than‐expected decreases in physical activity (by 0.3 points) and increases in self‐concept (by 0.2 points). The response in dietary habits, fitness, or self‐esteem was not different between groups. Conclusion: Overall, school closure negatively impacted physical activity and adiposity, particularly in the youngest children. [ABSTRACT FROM AUTHOR]

Summary: Background: Evidence shows that overweight and obesity are associated with advanced bone age (BA). Objective: To analyse the effect of adiposity on BA among Mexican children. Methods: This cross‐sectional study included 902 children (5–18 years old). Anthropometric measurements, dual‐energy X‐ray absorptiometry (DXA) and automated hand X‐ray‐based BA measurements were obtained. BA curves of children stratified by sex and age were created based on nutritional status. We also calculated odds ratios for advanced BA associated with the body mass index (BMI), waist/height ratio and adiposity estimated using DXA (total and truncal fat mass). Results: Participants with overweight/obesity by BMI (SDS ≥1) advanced earlier in BA than did normal weight participants (6.0 vs. 12.0 years in boys and 6.0 vs. 10.3 in girls, p < 0.01); similarly, participants with a greater body fat percentage (SDS ≥1) exhibited earlier advanced BA (7.5 vs. 10.0 years in boys and 6.0 vs. 9.6 in girls, p < 0.01). Differences were also observed according to the waist/height ratio and truncal fat. Children with a BMI or DXA SDS ≥1 had greater odds of presenting an advanced BA of more than 1 year (OR 1.79–3.55, p < 0.05). Conclusions: Increased adiposity in children, mainly in boys, is associated with advanced BA at earlier ages. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Hair cortisol concentration (HCC) is a biomarker of long‐term stress. Higher HCC is associated with higher adiposity in adults; however, associations are not well characterized in adolescents. Objective: To examine cross‐sectional associations of HCC with adiposity in late adolescence. Methods: Amongst 336 non‐Hispanic White participants (48.5% female, mean 17.7 years) in Project Viva, we used multivariable linear regression models, overall and sex‐stratified, to estimate associations of HCC with body mass index (BMI), bioelectric impedance (BIA) percent body fat, waist circumference (WC) and dual X‐ray absorptiometry‐measured percent and total fat or trunk fat mass. We adjusted models for age and known predictors of adiposity. Results: Median (interquartile range) HCC was 2.1 pm/mg (1.0–4.5) and mean (SD) BMI was 23.1 kg/m2 (3.9), BIA %body fat 20.2% (9.9) and WC 80.6 cm (10.9). In adjusted models, higher HCC (per doubling) was associated with higher BMI (β = 0.19 kg/m2; 95%CI 0.00, 0.37) and BIA percent body fat (β = 0.41%; 95%CI 0.04, 0.77). We observed no evidence of effect modification by sex. Conclusions: Higher HCC was associated with greater adiposity in late adolescence. Further research is needed to disentangle the relationship between HCC and adolescent adiposity, including the temporal direction of the relationship and sex‐specific associations. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Clustering of cardiometabolic risk factors in childhood significantly increases the risk of atherosclerotic cardiovascular disease later in life. Identification of modifiable parental factors that contribute to offspring cardiometabolic health is critical for the prevention of disease. The objective was to identify factors associated with child cardiometabolic risk factors at age 5 years. Methods: Triads from a longitudinal cohort were recalled at 5 years (n = 68). Dietary intake, anthropometrics, physical activity and serum‐based risk factors were collected. Best subset selection, linear and logistic regressions were used to identify triad variables associated with increased risk of cardiometabolic risk factor clustering at age 5 years. Results: In this cohort, best subset modelling revealed that increased paternal fat mass, serum low‐density lipoproteins and triglycerides, maternal dietary added sugar and being female were associated with increased odds of offspring having two or more cardiometabolic risk factors at age 5 years. Conclusions: Dietary and exercise interventions prior to conception targeting paternal adiposity and dyslipidaemia as well as maternal dietary habits could decrease children's cardiometabolic risk in later life. [ABSTRACT FROM AUTHOR]

Given the rising prevalence of pediatric obesity, new approaches to the delivery of targeted nutrition counseling to not only prevent but also treat pediatric obesity are needed. The integration of a dietitian virtually was a successful quality improvement measure in this academic pediatric primary care clinic. The virtual dietitian provided age-appropriate nutrition counseling at well-child visits from 9 months to 6 years of age. Dietary counseling was also provided for children with overweight and obesity regardless of age. Vegetable, fruit, snack, and dairy intake was assessed in children who received counseling versus those who had traditional well childcare. Improved dairy habits were noted in the counseling cohort. A decrease in body mass index was not demonstrated in the patients with obesity or overweight; however, patient and provider satisfaction was quite high with this novel quality improvement measure. Virtual nutrition counseling can be easily integrated to facilitate a comprehensive pediatric medical home. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the reference values for serum uric acid (SUA) levels and their association with overweight/obese in children. We conducted a retrospective analysis of 8522 participants, including 6227 normal weight children, aged 2 to 18 years in China. Among normal children, SUA levels increased with age, showing significant sex differences in children over 10 years. Age-specific and sex-specific 95% reference intervals for SUA levels were established. Furthermore, we observed that the percentage of overweight/obesity significantly increased as SUA quartiles rose. Elevated SUA levels were associated with a high odds ratio (OR) for overweight/obesity (OR = 4.45, 95% confidence interval = 3.33, 5.93). We propose that the 97.5th percentile is a suitable value for defining elevated SUA levels, and there is a positive correlation between SUA levels and the presence of overweight or obesity. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between childhood overweight or obesity and gestational diabetes mellitus (GDM). Methods: Data were sourced from the Genome‐Wide Association Studies database on childhood body mass index (BMI), with 39 620 samples and 8 173 382 single‐nucleotide polymorphisms (SNPs), and GDM, with 143 441 samples, including 12 332 GDM cases and 20 149 608 SNPs. Mendelian randomization (MR) was conducted, including inverse variance weighting (IVW), MR‐Egger regression, and the weighted median method. Statistical heterogeneity among SNPs was assessed using Cochran's Q test. MR‐Egger's intercept, the MR‐Pleiotropy RESidual Sum and Outlier (PRESSO) test, and funnel plots were used to evaluate pleiotropy. The leave‐one‐out method tested the robustness of the IVW results by excluding individual SNPs. Results: Fifteen SNPs highly related to childhood BMI were identified. IVW analysis indicated that higher childhood BMI is a significant risk factor for GDM (odds ratio 1.50 [95% confidence interval 1.20–1.87]; p < 0.001). The direction of the β value derived from the weighted median method analysis was consistent with that from the IVW analysis. Cochran's Q test showed statistical heterogeneity among SNPs highly related to childhood BMI (p = 0.001), thus prioritizing IVW analysis results. The MR‐Egger regression intercept, MR‐PRESSO test, and funnel plot analyses demonstrated no horizontal pleiotropy among SNPs highly related to childhood BMI. The leave‐one‐out analysis indicated that the MR analysis results were largely unchanged after the exclusion of individual SNPs. Conclusion: Elevated childhood BMI is associated with an increased risk of developing GDM, underscoring the need to address childhood obesity as a preventive strategy. Effective interventions to reduce childhood obesity could be crucial in mitigating this risk. [ABSTRACT FROM AUTHOR]

The article analyzes trends in pharmacological management of pediatric patients with type 2 diabetes in German-speaking countries from 2000 to 2023 based on the Diabetes Prospective Follow-up Registry. The study shows changes in treatment regimens over the years, with an increase in the use of oral antidiabetic drugs (OADs) and glucagon-like peptide-1 receptor agonists (GLP1-RAs), and a decrease in insulin monotherapy or lifestyle intervention alone. Despite the availability of new treatment options, significant improvements in metabolic control and body mass index (BMI) are challenging to achieve in real-world settings. The study highlights the need for further research to determine the impact of expanded therapeutic options on pediatric patients with type 2 diabetes. [Extracted from the article]

Purpose: To investigate longitudinal associations between the vitamin D status and inflammatory markers in children and adolescents. Methods: Children from eight European countries from the IDEFICS/I.Family cohort with repeated measurements were included in this study. A linear mixed-effect model was used to model the association of serum 25(OH)D as independent variable and z-scores of inflammatory markers [CRP, cytokines, adipokines, combined inflammation score] as dependent variables, where one level accounts for differences between individuals and the other for changes over age within individuals. Results: A total of 1,582 children were included in the study. In the adjusted model, 25(OH)D levels were positively associated with adiponectin (β = 0.11 [95% CI 0.07; 0.16]) and negatively with the inflammation score (β = − 0.24 [95% CI − 0.40; − 0.08]) indicating that the adiponectin z-score increased by 0.11 units and the inflammation score decreased by 0.24 units per 12.5 nmol/l increase in 25(OH)D. In children with overweight or obesity, only a positive association between 25(OH)D and IP-10 was observed while in children with normal weight adiponectin was positively and the inflammation score was negatively associated. Associations of vitamin D with adiponectin and the inflammation score were stronger in girls than in boys and a positive association with TNF-α was observed only in girls. Conclusion: Our results suggest that an increase in vitamin D concentrations may help to regulate inflammatory biomarkers. However, it seems to be no benefit of a better vitamin D status in children with overweight/obesity unless their weight is managed to achieve an improved inflammatory marker status. [ABSTRACT FROM AUTHOR]

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Summary Community‐based interventions (CBIs) can be effective and feasible for the prevention of childhood obesity. The aim of this umbrella review is to determine if systematic reviews report sufficient information to guide replication or adaptation of CBIs to a variety of contexts and aid in further development of childhood obesity prevention CBIs. Six databases were searched for systematic reviews including obesity prevention CBIs involving 0–18 year olds and reporting weight‐related outcomes. Two researchers screened results. Evidence‐to‐decision frameworks guided which details may be required for decision‐makers to design and carry‐out a CBI, including information on intervention characteristics, outcome reporting and translation factors. From 3935 search results, 40 studies were included. The most frequently reported relevant pieces of information were behaviors targeted (100% of systematic reviews), intervention duration (90%) and settings involved (97.5%). Less frequently reported factors included specific actions implemented (48%), intervention intensity (30%) and organizations, or contributors involved (40%). There was a low level of reporting of equity considerations (27.5%), adverse events (20%), and costs/cost‐effectiveness (17.5%). Multilevel interventions for child obesity prevention have demonstrated effectiveness, yet additional documentation of successful intervention processes is needed. [ABSTRACT FROM AUTHOR]

Summary Childhood obesity leads to early puberty development in girls, but its effect in boys remains unclear. We conducted a systematic review and meta‐analysis to study the association between childhood obesity and puberty development in boys. We included 14 cohort studies with 114,822 boys. Meta‐analysis showed that childhood overweight (RR, 1.44; 95%CI, 1.08–1.93; the number of studies [N] = 4) and obesity (RR, 1.35; 95%CI, 1.11–1.64; N = 5) were associated with the earlier occurrence of testicular volume ≥4 mL (Tanner stage 2). Age reaching Tanner stage 2 in overweight boys was earlier than normal‐weight boys (mean difference: −0.23 years, 95% CI: −0.37 to −0.08; N = 2); a similar trend was observed in obese boys, but the effect estimate did not reach significance level (mean difference: −0.27 years, 95% CI: −0.59 to 0.05; N = 3). Similarly, the age at pubarche in boys with overweight/obesity was earlier than those with normal weight. Qualitative analysis shows first nocturnal emission; change in voice and peak height velocity in boys with overweight/obesity appeared to develop earlier than those with normal weight. These findings suggest overweight/obesity is associated with earlier pubertal development in boys. Due to the limited number of studies identified in this review, further studies are warranted to confirm these associations. [ABSTRACT FROM AUTHOR]

Pediatric obesity is a growing health concern that has many secondary adverse health implications. Personalized medicine is a tool that can be used to optimize diagnosis and treatments of many diseases. In this review, we will focus on three areas related to the genetics of pediatric obesity: (i) genetic causes predisposing to pediatric obesity, (ii) pharmacogenomics that may predict weight gain associated with pharmacotherapy, and (iii) pharmacogenomics of anti‐obesity pharmacotherapy. This narrative review evaluates genetic cause of pediatric obesity and how genetic findings can be used to optimize pharmacotherapy to minimize weight gain and optimize obesity treatment in pediatric patients. Pediatric obesity has many genetic causes including genomic obesity syndromes and monogenic obesity disorders. Several genetic etiologies of obesity have current or emerging targeted genetic therapies. Pharmacogenomic (PGx) targets associated with pharmacotherapy‐induced weight gain have been identified for antipsychotic, antiepileptic, antidepressant therapies, and steroids, yet to date no clinical guidelines exist for application use of PGx to tailor pharmacotherapy to avoid weight gain. As legislation evolves for genetic testing coverage and technology advances, this will decrease cost and expand access to genetic testing. This will result in identification of potential genetic causes of obesity and genes that predispose to pharmacotherapy‐induced weight gain. Advances in precision medicine can ultimately lead to development of clinical practice guidelines on how to apply genetic findings to optimize pharmacotherapy to treat genetic targets of obesity and avoid weight gain as an adverse event associated with pharmacotherapy. [ABSTRACT FROM AUTHOR]

Background/Objectives: Among US breastfeeding women, those with obesity have significantly increased breast milk fat and caloric content from foremilk to hindmilk, with a 4-fold increase in fat content from the first to last milk sample. In view of different dietary norms and nutritional standards, we sought to evaluate the relationship between maternal BMI with breast milk fat and calorie content in women from Brazil, a low–middle-income country. Methods: Women who delivered singleton-term neonates were recruited from the Ana Abrao Breastfeeding Center (AABC) and Human Milk Bank at the Federal University of Sao Paulo, Brazil. These women were then studied at 7–8 weeks postpartum. Women were grouped by BMI categories of nonobese (NonOB; BMI 18.5–29.9) and obese (OB; BMI ≥ 30). A breast pump was applied, and milk samples were obtained continuously in 10 mL aliquots from foremilk to hindmilk; samples were analyzed for macronutrients and lipids, and maternal blood was analyzed for serum lipids and glucose. Results: As compared to NonOB women, those with OB had significantly higher milk fat in the mid (4.9 ± 0.3 vs. 3.9 ± 0.2) and last hindmilk (6.6 ± 0.4 vs. 5.5 ± 0.3) samples, though not in the first foremilk sample, as compared to NonOB women. In both NonOB and OB subjects, milk caloric and fat content increased 1.5 to 2-fold from foremilk to hindmilk, with the average milk caloric value being 11% greater in OB women. Protein content was significantly increased in all three milk samples (first, middle, and last) in women with OB. Conclusions: Although the value of breastfeeding remains clear, these findings may have significant implications for infant nutrition and excessive infant weight gain in women with OB. [ABSTRACT FROM AUTHOR]

Childhood obesity is a complex and multifactorial phenomenon. Understanding these factors is crucial in developing effective interventions to prevent and treat childhood obesity. The purpose of this study is to provide an update on factors related to childhood obesity in the United States. This cross‐sectional study analyzed data from the 2021 Youth Risk Behavior Surveillance System (YRBSS) survey to assess factors associated with childhood obesity among US children aged 12 to 17 years. Logistic regression analysis was used to identify the sociodemographic factors associated with overweight and obesity. Data were analyzed using R studio (4.3.2). A total of 12,836 respondents were enrolled in this study. Among them, the prevalence of overweight, obesity, and morbid obesity was found to be 17.66%, 11.21%, and 1.76%, respectively. Respondents with a BMI over 25 were mostly male (17.63%) and of White race (32.77%). The main sociodemographic factors associated with overweight and obesity were being 14 or 15 years old, male, non‐White, having a history of alcohol or marijuana consumption, and not practicing physical activity. These findings can inform targeted interventions for prevention and management. This research sheds light on critical sociodemographic factors related to childhood obesity in the U.S., highlighting its complexity. The findings emphasize the influence of age, gender, ethnicity, and lifestyle behaviors, such as substance use and physical inactivity, on obesity rates among youth. These insights are crucial for developing targeted interventions. Addressing these factors offers a real chance to enhance future health outcomes, and underscoring the need for comprehensive strategies that include both health education and broader community support to instill healthy habits early on. In addition, unexpected results concerning vegetable consumption and the omission of genetic and familial data suggest areas for further research. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is an ongoing public health crisis, and recent clinical practice guidelines identify addressing the role of social inequities in the disparity of health among children with obesity as an area to address. This study aimed to assess the feasibility of a community navigation intervention in a pediatric weight management clinic. Methods: A single-center pilot randomized controlled trial (RCT) recruiting families from a tertiary hospital pediatric weight management program to evaluate the feasibility of a community navigation intervention. The primary feasibility outcomes were recruitment rates (goal to recruit 80% of the sample in 6 months), uptake of the intervention (goal > 80% of participants in the intervention group to have a visit with the navigator), and acceptability (goal > 90% of families in the intervention group complete all follow-up). Results: Eighty participants completed the social needs screening, and 42 (52.5%) participants screened positive for an unmet social need. In the first 6 months of recruitment, 18 participants were recruited out of a goal of 40 participants (the recruitment rate was 45% vs. the goal of 80% in 6 months), and complete recruitment was achieved in 12 months. Of the 21 participants randomized to the intervention arm, 20 completed the intervention (uptake of intervention was 95% vs. goal 80%). Ten participants in the intervention arm completed all four planned follow-up study visits (the acceptability of follow-up was 48% vs. the goal of 90%). Conclusion: We completed a pilot RCT of implementing a community navigator program in a pediatric weight management program. We found feasibility in the intervention's uptake but limited feasibility in recruiting participants and the acceptability of the follow-up. Trial registration: Clinicaltrials.gov, NCT04711707, https://clinicaltrials.gov/ct2/show/NCT04711707 [ABSTRACT FROM AUTHOR]

Background: In recent years, there has been a surge of interest in the metabolic phenotype among children with obesity characterized by the absence of associated cardiometabolic risk factors (CRFs), known as metabolically healthy obesity (MHO), as opposed to those with metabolically unhealthy obesity (MUO). This study investigated the effect of lifestyle intervention on CRFs among children with MHO and MUO. Methods: A total of 102 school-aged children with obesity (54 girls and 48 boys) aged 8–16 years completed a 16-week school-based lifestyle modification intervention program, MyBFF@school Phase I. The intervention consisted of physical activity, healthy eating promotion, and psychological empowerment. MHO and MUO statuses were defined based on the 2018 consensus-based criteria. Fasting venous blood collection, body composition measurement, clinical assessment and physical fitness testing were conducted at baseline and at the end of week 16. Results: After the intervention, the CRFs of the children with MUO improved with significant decreases in systolic (p < 0.001) and diastolic (p = 0.01) blood pressure and a significant increase in high-density lipoprotein cholesterol (HDL-C) (p = 0.005), while the CRFs of the children with MHO had a significant decrease in uric acid (p = 0.04). Additionally, 51.6% of the children with MHO transitioned to the MUO, while 26.8% of the children with MUO crossed over to the MHO at the end of the intervention. Furthermore, the odds of having high systolic blood pressure among children with MUO were 59% lower at week-16 than at baseline (OR = 0.41 (95% CI = 0.18, 0.92), p = 0.03). Conclusions: Our findings demonstrated that CRFs improved more prominently among children with MUO following the intervention. More importantly, our findings indicate that MHO in children is transient, hence, strategies to protect children against MUO are warranted. Trial registration: ClinicalTrials.gov NCT02212873. [ABSTRACT FROM AUTHOR]

Pediatric obesity is a serious global health challenge. In East Asia, rapid socioeconomic changes have increased obesity rates. This study examines weight distribution and obesity trends in East Asian children using WHO criteria. Data from the Non-Communicable Disease Risk Factor Collaboration was used to analyze weight categories (thinness, normal weight, overweight, and obesity) among children aged 5 to 19 in China, Japan, South Korea, and Taiwan. Data were collected through probabilistic sampling and national surveys and classified using WHO BMI standards. Age standardized prevalence rate enabled cross-country comparisons for boys and girls from 2010 to 2022. Statistical methods included arithmetic statistics, linear regression, and time series analysis using the ARIMA model, with SAS 9.4 and SPSS for analysis. Significant trends were found (p for trend < 0.05). Taiwan and South Korea showed increased thinness, while China and Japan showed decreases. Normal weight prevalence declined, notably among South Korean boys. Overweight and obesity rates rose, especially among South Korean boys and Chinese girls. Japan's rates remained stable, while Taiwan showed minor fluctuations. Boys had higher overweight and obesity rates than girls in all countries. The highest rates were among children aged 10 to 11 years. East Asia, particularly South Korea and China, has seen rising obesity rates. Increasing thinness in South Korea and Taiwan also requires attention. The decline in healthy-weight children is concerning. Interventions should target children before ages 10 to 11. Urgent, tailored public health interventions are needed. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion To clarify the possible role of accidental asphyxiation/suffocation for infants in shared sleeping situations.As it has recently been shown that there is an association between maternal obesity and sudden unexpected infant death (SUID) an index was calculated by dividing parental body mass index (BMI) by the shared sleeping surface area.A much higher index was derived for an obese individual on a narrow sleeping area such as a sofa (50) compared to a thin adult on a queen‐sized mattress (5).The index may be a way of semi‐quantitating high, and low, risk shared sleeping situations. [ABSTRACT FROM AUTHOR]

Background: The Systemic Immune-Inflammatory Index (SII) and Systemic Inflammatory Response Index (SIRI) are novel composite inflammatory markers. Previous studies suggest that obesity in individuals correlates with persistently low levels of chronic inflammation. This study aims to explore the association between SII and SIRI and Body Mass Index (BMI) among children and adolescents. Methods: A cross-sectional survey was conducted using the National Health and Nutrition Examination Survey (NHANES) dataset from 2 consecutive cycles from 2017-2020. Multivariate linear regression models were employed to examine the linear relationships between BMI and SII and SIRI. Non-linear associations were explored using smooth curve fitting and threshold effect analysis. Results: A total of 2980 children and adolescents aged 6-19 years were included in this population-based study. In the population description of body mass index categories, we found progressively higher levels of SII and SIRI, notably peaking among obese children (SII mean ± SD: 528.83 ± 285.46; SIRI mean ± SD: 1.12 ± 0.79). Weighted multivariate linear regression confirmed a significant positive association between BMI and both inflammatory indices (P < 0.0001). Subgroup analyses revealed consistent correlations across gender divisions and highlighted a non-linear relationship between BMI and SII. Conclusions: SII and SIRI are positively associated with BMI in children and adolescents, indicating their potential as markers for assessing systemic inflammation in pediatric obesity. Further large-scale prospective studies are required to substantiate these findings. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions Parents' perspectives on their child's obesity (BMI >IOTF‐30) management are essential to ensure positive outcomes. This study explored parents' experiences in managing their children's obesity and investigated the sociocultural and environmental factors influencing such management on Reunion Island, a French overseas department in the Indian Ocean.This qualitative study used a general inductive analysis approach. Semi‐structured telephone interviews were conducted from France, between January and April 2019, with nine parents of children treated in the Childhood Obesity Unit of the Children's Hospital on Reunion Island. The interviews were analysed by using thematic analysis until data saturation.Four main themes emerged reflecting the stages of parents' experiences during treatment: a life history with feelings of justification and guilt, acceptance, involvement and activism. Cultural food traditions were a barrier to implementing healthier habits. Support and advice from the healthcare services alleviated feelings of isolation and motivated parents to be more proactive in their children's obesity management. Parents' involvement motivated their children and improved their relationships.Parent's involvement is essential in managing children's obesity. To maximise treatment outcomes, tailored interventions that address parents' unique family dynamics and sociocultural perspectives are key. [ABSTRACT FROM AUTHOR]

Background: Between 2006 and 2016 the prevalence of overweight and obesity among children and adolescents aged 5–19 years in Peru increased from 22.7 to 27.0%. This investment case quantifies the economic impacts of childhood and adolescent overweight and obesity in Peru. It identifies and quantifies the potential impact of a set of new or expanded interventions that can strengthen current national efforts to prevent and reduce child and adolescent overweight and obesity. Methods: A deterministic Markov cohort model with a societal cost perspective estimated reductions in mortality and morbidity from implementing interventions to prevent and reduce child and adolescent overweight and obesity and the impact in savings in healthcare costs and gains in wages and productivity. Interventions identified through a review of published literature includes a school-based social marketing campaign, exclusive breastfeeding promotion and support, a healthy food and drink policy for school premises, and a 20% subsidy on fruits and vegetables for people living below the national poverty line. The return on investment (ROI) was calculated along with the estimated cost savings associated with the interventions. Analysis was conducted to test ROI sensitivity to changes in the key parameters and assumptions. Results: Between 2025 and 2092, the expected combined direct and indirect healthcare costs attributable to child and adolescent overweight and obesity in Peru are 210.6 billion USD. The direct healthcare costs are 1.8 billion USD, and the indirect costs are 208.8 billion USD. Expected savings for all interventions combined is 13.9 billion USD with a per-person savings of 12,089.8 USD. The expected ROI of the four interventions combined is 39.3 USD (30-years), 64.6 USD (50-years), and 164.1 USD (66-years) per one USD invested. Conclusions: The overweight and obesity epidemic among children and adolescents in Peru requires wide-ranging and expanded implementation of policies to achieve long-term reductions in prevalence. This study's findings show that the four priority interventions have high ROIs and can be used to guide policy to address the complex interplay of factors that contribute to the obesogenic environment. [ABSTRACT FROM AUTHOR]

Background: There is limited evidence regarding the modifying effects of parents' age at childbirth on the relationship between air pollution and obesity in plateau areas. This study aimed to explore the association between particulate matter (PM) and child obesity, specifically investigating whether parents' age at childbirth could modify this relationship in the Tibetan plateau, China. Methods: Satellite-based random forest models were used to estimate the concentrations of PM2.5 (particulate matter with aerodynamic diameters ≤ 2.5 μm), PMc (particulate matter with aerodynamic diameters between 2.5 μm and 10 μm), and PM10 (particulate matter with aerodynamic diameters ≤ 10 μm). Linear and logistic regression models were employed to assess associations between PM exposure and obesity indicators, and effect estimates of PM across different particle sizes were compared. Results: The study comprised 2,015 children under five years old. Postnatal exposure to PM was positively associated with overweight and obesity (OWO), waist-to-hip ratio (WHR) and body mass index (BMI). Among these pollutants, PM10 exhibited the strongest association with BMI and OWO, whereas PMc showed the strongest association with WHR. An interquartile range (IQR) increase in PM2.5 (5.67 µg/m3), PMc (5.25 µg/m3), and PM10 (11.06 µg/m3) was positively associated with OWO (odd ratio [OR] for PM2.5 = 1.52, 95% confidence interval [CI] for PM2.5 = 1.24 to 1.85; OR for PMc = 1.50, 95% CI for PMc = 1.19 to 1.88; OR for PM10 = 1.56, 95% CI for PM10 = 1.25 to 1.96), respectively. Stratified analysis by parents' age at childbirth indicated that the effects of PM on obesity indicators were more pronounced in the advanced age group. Conclusions: Long-term exposure to PM was positively associated with OWO, WHR, and BMI. Our findings also underscore the importance of examining the effects of ambient PM exposure on OWO, particularly in parents of advanced age at childbirth. [ABSTRACT FROM AUTHOR]

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]

Background: To assess the adverse food reactions (AFR) prevalence in children with autism spectrum disorder (ASD) and in non-ASD healthy controls (NASD). Nutritional status alterations, food selectivity and adherence to Mediterranean Diet (MD) were also evaluated. Methods: The NAFRA (Nutritional status and Adverse Food Reactions in children with Autism Spectrum Disorder) project was an observational, case-control, comparative study conducted at a tertriary center for pediatrics involving Caucasian patients of both sexes, aged 18 months-7 years, with a diagnosis of ASD, and matched NASD controls. Results: From October 2017 to December 2023, 100 ASD patients [79 male, mean (± SD) age 49.9 months (± 15.4)] and 100 NASD controls [75 male, mean (± SD) age 49.8 months (± 17.7)] were enrolled at the Pediatric Section of the Department of Translational Medical Science of the University of Naples Federico II. A significantly higher prevalence of AFR was observed in ASD patients if compared with NASD (16% vs. 2%, p = 0.001), mainly due to a higher prevalence of food allergy (7% vs. 1%, p = 0.03). A significantly higher prevalence of food intolerance and celiac disease was also observed in ASD children. The rate of obesity was significantly higher in ASD patients compared to NASD. Food selectivity and low MD-adherence were more frequent in ASD children (26% vs. 2%, p < 0.0001 and 28% vs. 16%, p = 0.041, respectively). Conclusions: The high rate of AFR, obesity and unhealthy dietary habits observed in ASD children strongly suggest the importance of a multidisciplinary approach, providing early diagnosis of AFR and appropriate nutritional management to improve core and associated ASD-related conditions. Trial registration: The NAFRA Project was registered on https://clinicaltrials.gov/ with the identifier NCT04719923. Registered 18 January 2021. https://clinicaltrials.gov/study/NCT04719923. [ABSTRACT FROM AUTHOR]

Summary Background Objective Methods Findings Conclusion Complex interventions that include responsive infant feeding components can potentially prevent childhood obesity. To develop a replicable responsive feeding intervention, an understanding of the most effective behavior change techniques (BCTs) and theory is needed.To identify the BCTs and theories used in interventions with responsive feeding components for caregivers of children ≤2 years.PsycINFO, CINAHL, Cochrane Library, EMBASE, and MIDIRS were searched from inception to May 2023. Studies of obesity prevention interventions with a responsive feeding component were included. BCT Taxonomy Version 1 and Michie and Prestwich theory coding method were applied.Eighteen interventions were identified; the number of BCTs ranged from 3 to 11 (mean = 5.5). The most used BCTs were “Instruction on how to perform a behaviour” (17/18) and “Adding objects to the environment” (13/18), which were commonly used in the nine trials demonstrating higher responsive feeding behaviours and the four trials reporting reduced likelihood of overweight or obesity, or rapid weight gain. Fifteen trials reported use of theory.BCT use was low in interventions with responsive feeding components. BCTs are replicable; their use in interventions, alongside theory, will ensure that key determinants of responsive feeding behavior are included in future obesity prevention interventions. [ABSTRACT FROM AUTHOR]

Introduction: The coexistence of under-nutrition and over-nutrition in developing countries like Ethiopia results in the "mother-child pair double burden of malnutrition," with children experiencing either stunting, wasting or underweight while mothers face overweight or obesity. This poses a major public health challenge, prompting global health organizations to prioritize the issue and urge governments to act quickly. Despite this, there is a lack of research in Ethiopia on the double burden of malnutrition among mother-child pairs at the household level and the factors that worsen it. Objective: To assess the magnitude of double burden of malnutrition and its associated factors among mother-child pair at household level in East Ethiopia, 2022. Method: A community-based cross-sectional study was conducted in East Ethiopia from April 15 to June 11, 2022. Multi-stage sampling was used, and data were collected through structured interviews. Child nutrition indicators were processed using WHO Anthro software. Binary logistic regression analysis was performed, calculating both crude and adjusted odds ratios to assess associations. Variables with a P value <0.05 in multivariable analysis were deemed statistically significant. Result: The study revealed that coexisting malnutrition rates for (OM/SC), (OM/WC), and (OM/UC) were 8.5%, 7.0%, and 7.9% respectively. The double burden of malnutrition among mother-child pairs was found to be 12.3% [95% CI: 10.7, 13.7]. Marital status (divorced) [AOR = 1.80; 95% CI: 1.15, 2.82], child birth order (fourth or above) [AOD = 1.88; 95% CI:1.08, 3.26], number of under-five children in the household (five or more under-five children) [AOR = 1.58; 95% CI: 1.04, 2.39], poor maternal and child dietary diversity score [AOR = 2.76; 95% CI: 1.71, 4.45] and [AOR = 8.66; 95% CI: 4.85, 15.44], respectively, household food security status (food insecurity) [AOR = 3.68; 95% CI: 2.36, 5.75], and maternal stature (short stature) [AOR = 2.39; 95% CI: 1.65,3.45] were factors significantly associated with this burden. Conclusion: The study emphasized the double burden of malnutrition affecting both mothers and children, a major public health concern in the area. Early-life nutrition is vital in preventing childhood under nutrition and adult obesity, leading to this dual burden. Breaking the cycle of malnutrition across generations is crucial. Policy makers should prioritize improving child nutrition and maternal health, stressing early-life nutrition to address the mother-child double burden of malnutrition. [ABSTRACT FROM AUTHOR]

Background: Saudi Arabia has one of the highest childhood obesity rates worldwide. The primary factor associated with the high prevalence of obesity among adolescents is a lack of physical activity (PA). Compared tomale adolescents, very few Saudi female adolescents meet the World Health Organization recommendation of achieving 60 minutes of moderate-to-vigorous PA per day, putting them at a higher risk of overweight and obesity. Objective: This cross-sectional study aimed to examine the relationship between the theory of planned behavior and psychosocial factors, including attitude toward PA, subjective norms, perceived behavioral control (PBC), PA intention, and selfreported PA among Saudi female adolescents. Methods: A convenience sample of 329 Saudi female adolescents was recruited from all-female public intermediate and high schools in the Eastern Region of Saudi Arabia. Data were collected using online self-administered questionnaires. The theoretical model was examined using structural equation modeling. Results: The findings revealed a higher prevalence of overweight compared to obesity among participants. About half the participants were from families with a medium monthly income. The mean PA score indicated a low level of PA. The model demonstrated significant explanatory power for both PA intention and PA behavior, respectively. The strongest predictor of adolescents' intention was attitude, followed by PBC. Moreover, the female adolescents' attitudes and PBC had significant indirect effects on self-reported PA through intention, whereas intention had a direct effect on PA. The model did not support a direct or indirect relationship between subjective norms and PA. Discussion: The findings provide essential support for targeting attitude and perceived behavior control of female adolescents in order to enhance their PA intention. This theoretical understanding can help design effective theory-based interventions that promote PA among Saudi female adolescents. [ABSTRACT FROM AUTHOR]

The objectives of the present study were to (i) re-evaluate and expand the psychometric properties of two weight stigma instruments—the Perceived Weight Stigma Scale (PWSS) and the Weight Self-Stigma Questionnaire (WSSQ) among a large sample of adolescents using advanced psychometric methods and (ii) examine how the different types of weight stigma (i.e., PWSS and WSSQ) are associated with psychological distress. Cross-sectional study. In September 2023, a cross-sectional survey utilising convenience sampling was used to recruit 9995 adolescents (mean age = 16.36 years [standard deviation = 0.78]; 57.8% males). They completed the PWSS, WSSQ, and a measure on psychological distress. The data were analysed using Rasch analysis, confirmatory factor analysis (CFA), structural equation modelling (SEM), and network analysis. The CFA and Rasch model results showed acceptable psychometric properties regarding factor structure, factor loading, difficulty, and infit and outfit mean squares (except Items 4 and 7 of the PWSS). There was no substantial differential item functioning for any tested items across the sex and weight categories. The CFA and SEM results showed promising validity indices with significant associations between both weight stigma scales and psychological distress (i.e., depression, anxiety, and stress). Network analysis showed inter-variable connectivity between nodes PWSS3 (" People act as if they are afraid of you ") and WSSQF7 (" I feel insecure about others' opinions of me "). Both weight stigma scales had acceptable psychometric properties and were significantly associated with psychological distress, although each assessed different types of weight stigma. This suggests that researchers and clinicians can use these scales to reliably and validly assess weight stigmas among adolescents. [ABSTRACT FROM AUTHOR]

Adolescence is a crucial life stage that can lead to excess weight and body dissatisfaction. Social inequalities in these issues may have been exacerbated by the COVID-19 pandemic. We aimed to analyze the presence of socioeconomic inequalities and their changes in these inequalities stratified by sex in 13- to 19-year-olds in a large Mediterranean city (Barcelona, Spain). Cross-sectional population-based study. We used data from the 2016 and 2021 editions of the FRESC survey, which is a representative citywide survey that captures various aspects of adolescent health. Excess weight was determined by objective body mass index measurements. Body dissatisfaction was defined as the discrepancy between perceived and desired body shape. Socioeconomic status was divided into five pseudo-quintiles by using the Family Affluence Scale. We calculated the corresponding prevalence estimates and fitted robust Poisson regression models to estimate both simple and complex measures of inequality, including relative and absolute differences between the two survey years. The overall prevalence of excess weight increased from 25.3% [23.9–26.6] to 29.8% [28.2–31.4] between 2016 and 2021. Similarly, body dissatisfaction increased from 44.2% [42.6–45.8] to 60.4% [58.7–62]. Socioeconomic inequalities in excess weight significantly increased in girls (adjusted ratio of the relative index of inequalities = 1.72 [1.08; 2.74] but not in boys. No significant changes were detected in body dissatisfaction in either girls or boys. Our findings highlight the presence of a sex-specific change in socioeconomic inequalities in adolescent well-being regarding excess weight and body dissatisfaction. These results underscore the need for local public policies to improve social equity in adolescent health. [ABSTRACT FROM AUTHOR]