Overweight Children Research Articles

Epidemiology of overweight in under-five children in India: insights from National Family Health Survey.

Childhood overweight is not only an immediate health concern due to its implications but also significantly increases the risk of persistent obesity and consequently CVD in the future, posing a serious threat to public health. The objective of this study was to examine the trends and associated factors of childhood overweight in India, using nationally representative data from three rounds of the National Family Health Survey (NFHS). For the primary analysis, we used data from 199375 children aged 0-59 months from fifth round of the NFHS (NFHS-5). Overweight was defined as BMI-for-age Z (BMI Z) score > +2 sd above the WHO growth standards median. We compared the prevalence estimates of childhood overweight with third round of the third round of NFHS and fourth round of the NFHS. Potential risk factors were identified through multiple logistic regression analyses. The prevalence of overweight increased from 1·9 % in third round of NFHS to 4·0 % in NFHS-5, a trend seen across most states and union territories, with the Northeast region showing the highest prevalence. The BMI Z-score distributions from the latest two surveys indicated that the increase in overweight was substantially larger than the decrease in underweight. The consistent upward trend in the prevalence across different demographic groups raises important public health concerns. While undernutrition rates have remained relatively stable, there has been a noticeable rise in the incidence of overweight during the same time frame. The increasing trend of overweight among children in India calls for immediate action.

Evaluating the distinct effects of body mass index at childhood and adulthood on adult major psychiatric disorders.

Children with high body mass index (BMI) are at heightened risk of developing health issues in adulthood, yet the causality between childhood BMI and adult psychiatric disorders remains unclear. Using a life course Mendelian randomization (MR) framework, we investigated the causal effects of childhood and adulthood BMI on adult psychiatric disorders, including Alzheimer's disease, anxiety, major depressive disorder, obsessive-compulsive disorder (OCD), and schizophrenia, using data from the Psychiatric Genomics Consortium and FinnGen study. Childhood BMI was significantly associated with an increased risk of schizophrenia, while adulthood BMI was associated with a decreased risk of OCD and schizophrenia. Multivariable MR analyses indicated a direct causal effect of childhood BMI on schizophrenia, independent of adulthood BMI and lifestyle factors. No evidence of causal associations was found between childhood BMI and other psychiatric outcomes. The sensitivity analyses yielded broadly consistent findings. These findings highlight the critical importance of early-life interventions to mitigate the long-term consequences of childhood adiposity.

Differentially methylated regions interrogated for metastable epialleles associate with offspring adiposity.

Aim: Assess if cord blood differentially methylated regions (DMRs) representing human metastable epialleles (MEs) associate with offspring adiposity in 588 maternal-infant dyads from the Colorado Health Start Study.Materials & methods: DNA methylation was assessed via the Illumina 450K array (~439,500 CpG sites). Offspring adiposity was obtained via air displacement plethysmography. Linear regression modeled the association of DMRs potentially representing MEs with adiposity.Results & conclusion: We identified two potential MEs, ZFP57, which associated with infant adiposity change and B4GALNT4, which associated with infancy and childhood adiposity change. Nine DMRs annotating to genes that annotated to MEs associated with change in offspring adiposity (false discovery rate<0.05). Methylation of approximately 80% of DMRs identified associated with decreased change in adiposity.

Caregivers' Perception of Child Weight and Its Implications on Children's BMI: Examining the Role of Weight Concern and Pressed Eating Behaviors as Mediators.

This study aims to investigate the relationship between caregivers' perception of child weight, their concern about children's weight, pressed eating behaviors, and children's BMI. A Child Feeding Questionnaire was administered to 442 primary caregivers of school-aged children (6-12y old) in Hangzhou, China. Significant differences were observed in age, family average monthly income, and family care type among children with different weight statuses (P<0.05). Caregivers' perception of child weight was positively correlated with children's BMI. Caregivers' perception of child weight and children's BMI were negatively correlated with pressed eating behaviors. Caregivers' perception of the child's weight, BMI, and pressed eating behaviors were positively correlated with caregivers' weight concerns. Caregivers' perception of child weight not only had a direct positive predictive effect on children's BMI but also influenced children's BMI through three paths: via the independent mediation of children's weight concern, the independent mediation of pressed eating behaviors, and the chain mediation of children's weight concern and pressed eating behaviors. Caregivers need to rectify perception biases regarding child weight, adopt reasonable feeding strategies, nurture children's self-regulation abilities regarding diet, and prevent the occurrence of childhood overweight and obesity.

Turkish Validity and Reliability of Family Eating and Activity Habits Questionnaire

Introduction: Overweight and obesity in childhood is a serious health problem. It causes many health problems; especially cardiovascular diseases and type 2 diabetes. Family eating behaviors, habits, home eating, and physical activity environment play an important role in shaping children’s behaviors and determining their weight status. Identification of these factors may be effective in the treatment and prevention of weight problems in children. In the literature review, a Turkish scale that could measure these factors could not be reached. The aim of this study was to evaluate the Turkish validity and reliability of the Family Eating and Activity Habits Questionnaire-Revised. Method: The text of scale was translated into Turkish using group translation and back translation methods. Firstly, as a pilot study group, pre-tests and retests were applied to the parents of students from different schools in Adana with a three-week interval. Then, in the main study group, the scale was applied to the parents in schools and parents of children in outpatient clinics. Findings: In the pilot study; Cronbach’s alpha value was 0,787 showing internal consistency, and the r value was calculated as 0,761 (p&amp;lt;0,001) according to the Pearson correlation analysis showing the correlation between the pretest and retest. In the main study, Cronbach’s alpha value was 0,780. The total scores of overweight/obese children were significantly higher than the total scores of normal-weight children. The total score of the scale was able to determine the weight status of the child with 71 % success. Results: According to these validity and reliability values; it can be suggested that the Turkish version of the Family Eating and Activity Habits Questionnaire-Revised can be used in a similar Türkiye population.

The Return on Investment for the Prevention and Treatment of Childhood and Adolescent Overweight and Obesity in Beijing: A Modeling Study.

Background: The increasing prevalence of child and adolescent overweight and obesity (CAOAO) in Beijing poses significant health and economic challenges. This study assesses the potential health and economic outcomes of implementing specific interventions to address CAOAO in Beijing. Methods: A deterministic Markov cohort model was used to estimate the impact of five interventions from 2025 to 2115: restrictions on unhealthy food marketing to children, mandatory front of package labeling (FOPL), family-based nutrition and exercise education, school-based nutritional health education, and nutritional counseling in primary healthcare. The model evaluated societal costs, healthcare savings, wages, and economic productivity in adulthood, calculating the return on investment (ROI) for each intervention and their combined effect. Result: Without intervention, Beijing is projected to experience a loss of 13.4 million disability-adjusted life years (DALYs) due to CAOAO. The health and economic impact of childhood obesity in Beijing is projected to be CNY 14.6 trillion (USD 2.1 trillion), or a lifetime loss of CNY 6.8 million (USD 0.96 million) per affected child, exceeding the sum of Beijing's GDP from 2021 to 2023. Restrictions on unhealthy food marketing to children and nutrition counseling in primary healthcare are projected to yield the highest returns, with benefits accruing within one year of implementation. Owing to the substantial upfront costs, including personnel, materials, and training, school-based and family-based interventions require a longer time horizon to realize significant health and economic benefits. Conclusions: Effective management of CAOAO in Beijing demands a multifaceted approach. The combination of restrictions on unhealthy food marketing to children, mandatory front of package labeling, nutrition counseling in primary healthcare, school-based intervention, and family-based intervention presents the most substantial health and economic returns. This comprehensive strategy aligns with global best practices and addresses the unique challenges faced by Beijing in combating childhood obesity.

Association between breastfeeding duration and BMI, 2009-2018: a population-based study.

In the 21st century, childhood overweight and obesity have become major public health issues worldwide. Previous studies have shown that breastfeeding helps prevent overweight or obesity in children. Despite the significant advantages of breastfeeding, the global exclusive breastfeeding rate for infants under 6 months old is only 40%, while in the United States, the rate is only 25%. The aim of this study is to explore the relationship between breastfeeding duration and BMI in children aged 2 to 6 in the United States, and to raise awareness of breastfeeding. A cross-sectional study included 2,769 participants between the ages of 2 and 6 from a sample that represented the entire NHANES 2009-2018. Data was analyzed using EmpowerStats, (www.empowerstats.com) linear regression as well as Chi-square test, t-tests, multivariate regression analysis and smooth cure fitting were done. Breastfeeding duration long-term group exhibited a statistically significant negative association with BMI, with a regression coefficient of -0.21 (P < 0.05). The continuous analysis of breastfeeding duration by tertile also demonstrate a statistically significant negative association with BMI. Subgroup analysis revealed that the potential benefits of breastfeeding on BMI were more obvious in low-income environments and maternal age 18 to 35 years, with a regression coefficient of -0.57 and -0.24, respectively (all P < 0.05). The findings emphasize the importance of breastfeeding in reducing childhood overweight/obesity and preventing associated diseases, both in clinical and public health settings.

The effects of physical exercise on fitness and emotion in Chinese preschoolers

BackgroundThe global prevalence of overweight and obesity in children under the age of five has emerged as a significant issue in recent years. Physical activity and fitness among children and adolescents have declined globally in the past few decades. Studies have indicated a link between levels of physical activity and cognitive performance in preschool children.MethodsThis quasi-experimental study investigated the effects of three different types of physical education programmes on the physical fitness and emotional competence of 239 preschoolers(mean age = 5.49 ± 0.60 years, 54.4% boys)in Haikou, China. The preschoolers were grouped based on which programme they were assigned to: the “Hello Sunshine” ball skills programme (HS group), ordinary physical education (OPE group), and free play (FP group). The “Hello Sunshine” ball skills programme used both a structured curriculum design and autonomous activity selection during outdoor time., which were conducive to children’s physical fitness.The National Physical Fitness Measurement Standards Manual and the shortened version of the Social Competence and Behavior Evaluation Scale (SCBE-30) were used to assess physical fitness and emotional competence, respectively. These assessments were conducted both before and after the ten-week intervention period. The analysis utilised a mixed-effects model for physical fitness and a mixed-model ANOVA for the SCBE data.ResultsThe HS group and OPE group demonstrated significantly improvement in the standing long jump, 10-m shuttle run and balance beam walking than the FP group; meanwhile, only anxious-withdrawal levels showed a significant grouping effect and group-by-time interaction effect. After the intervention, both the HS group and the FP group showed significantly lower scores for anxiety compared to the OPE group, with no significant difference observed between the HS and FP groups.ConclusionsThe results suggested that structured ball skills programmes may promote physical fitness and reduce anxiety. The integration of effective physical exercise programmes into preschool curricula holds the potential for promoting holistic development.

Lipidomics of infant mesenchymal stem cells associate with the maternal milieu and child adiposity.

Our objective was to interrogate mesenchymal stem cell (MSC) lipid metabolism and gestational exposures beyond maternal body mass that may contribute to child obesity risk. MSCs were cultured from term infants of mothers with obesity (n = 16) or normal weight (n = 15). In MSCs undergoing myogenesis in vitro, we used lipidomics to distinguish phenotypes by unbiased cluster analysis and lipid challenge (24-hour excess fatty acid [24hFA]). We measured MSC AMP-activated protein kinase (AMPK) activity and fatty acid oxidation (FAO), and a composite index of maternal glucose, insulin, triglycerides, free fatty acids, TNF-α, and high-density lipoprotein and total cholesterol in fasting blood from mid and late gestation (~17 and ~27 weeks, respectively). We measured child adiposity at birth (n = 29), 4-6 months (n = 29), and 4-6 years (n = 13). Three MSC clusters were distinguished by triacylglycerol (TAG) stores, with greatest TAGs in Cluster 2. All clusters increased acylcarnitines and TAGs with 24hFA, although Cluster 2 was more pronounced and corresponded to AMPK activation and FAO. Maternal metabolic markers predicted MSC clusters and child adiposity at 4-6 years (both highest in Cluster 3). Our data support the notion that MSC phenotypes are predicted by comprehensive maternal metabolic milieu exposures, independent of maternal BMI, and suggest utility as an at-birth predictor for child adiposity, although validation with larger longitudinal samples is warranted.

The invisible connection of mothers' BMI, emotional appetite, and food choices with childhood obesity.

This study examined the effects of mothers' body mass index (BMI), emotional appetite, and food choices on children's growth curves and adiposity. Data was collected from 492 mothers. The demographic characteristics and anthropometric measurements were obtained using a questionnaire. The mothers' food choices and emotional appetites were assessed using scales. BMI for age Z score and tripoderal index (TMI) were used in the evaluation of children's anthropometric measurements and adiposity. The mean age of mothers' was 39.10 ± 0.26 and BMI was 25.08 ± 0.21. Among the mothers, 54.5% were classified as normal, 28.4% as pre-obese, and 14.7% as obese. Among the children, 31.5% were overweight or obese. There was a strong positive correlation between the mean BMI of the mothers and the mean TMI and BMI of the children (p < 0.001). The "convenience" food choice factor of mothers had negative correlation with childiren's BMI for age (p < 0.005). This study emphasizes the invisible connection between mothers' emotional appetite and food choices and children's BMI and TMI and highlights the importance of paying attention to mothers' eating habits for children's health outcomes. These findings will be informative in the formulation of future health policies. This research revealed the relationship between mothers' food choices and emotional appetites, and their children's growth curves and adiposity. The study proposes the Triponderal Index as an alternative approach to evaluating growth, introducing a novel perspective in growth monitoring. By highlighting the impact of mothers' emotional appetites and food choices on children's dietary habits and weight status, the research emphasizes the significance of family eating habits. The findings support the promotion of healthy dietary practices within families as a crucial measure in preventing and managing childhood obesity, conveying a significant message to parents and healthcare professionals for a healthier future.

Study on the association between malnutrition, early childhood caries and caries activity among children aged 3–5 years

BackgroundThis study aims to investigate the association between malnutrition and early childhood caries (ECC) and caries activity among children aged 3–5 years, in order to provide a theoretical basis for preventing and blocking ECC and improving malnutrition.MethodsChildren aged 3–5 years from six kindergartens in Zhao Xian, China were enrolled in this study. The decayed, missing, filled teeth (dmft) of all children were examined and recorded. The Cariostat method was used to detect dental caries activity, collect anthropometric data and measure haemoglobin concentration. Parents were asked to complete a questionnaire on the general characteristics and oral health behaviour of the participants. The “Growth Standards for Chinese Children Under 7 Years Old” was used to assess the nutritional status of all participating children. Wilcoxon rank sum test and multivariate logistic regression analysis were used to analyse and evaluate the relationship between ECC, caries activity and malnutrition.ResultsA total of 635 children who met the criteria were included in this study. After adjusting for confounding factors, logistic regression showed that the risk of ECC was significantly increased in underweight children compared with normal children (OR = 5.43, P < 0. 05); compared with normal children, the risk of ECC decreased in overweight and obese children (OR = 0.31, P < 0.001); underweight children had higher caries severity than normal weight children, and the difference was statistically significant (OR = 2.69, P < 0. 05); stunted children had higher caries severity than normal weight children and the difference was statistically significant (OR = 2.28, P < 0.05); underweight was positively associated with caries activity and the association was statistically significant (OR = 2.33, P < 0. 05); stunting was positively associated with caries activity and the association was statistically significant (OR = 2.1, P < 0.05); overweight and obesity were negatively associated with caries activity and the association was statistically significant (OR = 0.61, P < 0.05).ConclusionsThe risk of ECC among children aged 3–5 years was positively associated with undernutrition and negatively associated with overnutrition. The severity of ECC among children aged 3–5 years was positively associated with undernutrition. The caries activity among children aged 3–5 years was positively associated with undernutrition and negatively associated with overnutrition.

Determination of plasma lysophosphatidylethanolamines (lyso-PE) by LC-MS/MS revealed a possible relation between obesity and lyso-PE in Japanese preadolescent children: The Hokkaido study.

Lysophosphatidylethanolamines (lyso-PEs) are the partial hydrolysis products of phosphatidylethanolamine. Although lyso-PEs are important biomarkers in various diseases, their determination is limited by the lack of simple and efficient quantification methods. This study aims to develop an improved quantitative method for the determination of lyso-PEs and its application to an epidemiological study. Single reaction monitoring channels by collision-induced dissociation for seven lyso-PEs were established using liquid chromatography-tandem mass spectrometry. Plasma lyso-PEs were extracted with a single-phase method using an isotopically labelled internal standard for quantification. The proposed method was adopted to define lyso-PEs in plasma samples of children aged 9-12years living in Sapporo, Japan. The limit of detection and limit of quantification for each lyso-PE ranged between 0.001-0.015 and 0.002-0.031pmol/μL, respectively. Recoveries were found to be > 91% for all the species. The analysis results of children's plasma showed that the total lyso-PE concentrations in boys (n = 181) and girls (n = 161) were 11.53 and 11.00pmol/μL (median), respectively. Participants were further classified by the percentage of overweight and subgrouped as underweight (n = 12), normal range (n = 292), or overweight (n = 38). Interestingly, the reduction of lyso-PE 16:0 and increased lyso-PE 22:6 were observed in overweight children compared with normal range (Fold change: 0.909 and 1.174, respectively). This study successfully established a simple quantitative method to determine lyso-PE concentrations. Furthermore, our method revealed the possible relation between plasma lyso-PEs and overweight status.

Varying optimal power for height-standardisation of childhood weight, fat mass and fat-free mass across the obesity epidemic.

Childhood adiposity markers can be standardised for height in the form of indices (marker/heightp) to make meaningful comparisons of adiposity patterns within and between individuals of differing heights. The optimal value of p has been shown to differ by birth year, sex, age, and ethnicity. We investigated whether height powers for childhood weight and fat mass (FM) differed by birth year, sex, or age over the period before and during the child obesity epidemic in Copenhagen. Population-based cross-sectional study of 391,801 schoolchildren aged 7 years, 10 years and 13 years, born between 1930 and 1996, from the Copenhagen School Health Records Register. Sex- and age-specific estimates of the height powers for weight and FM were obtained using log-log regression, stratified by a decade of birth. For weight, amongst children born 1930-39, optimal height powers at 7 years were 2.20 (95% CI: 2.19-2.22) for boys and 2.28 (95% CI: 2.26-2.30) for girls. These increased with birth year to 2.82 (95% CI: 2.76-2.87) and 2.92 (95% CI: 2.87-2.97) for boys and girls born in 1990-96, respectively. For FM, amongst those born 1930-39, powers at 7 years were 2.46 (95% CI: 2.42-2.51) and 2.58 (95% CI: 2.53-2.63) for boys and girls, respectively, and increased with birth year reaching 3.89 (95% CI: 3.75-4.02) and 3.93 (95% CI: 3.80-4.06) for boys and girls born 1990-96, respectively. Powers within birth cohort groups for weight and FM were higher at 10 years than at 7 years, though similar increases across groups were observed at both ages. At 13 years, height powers for weight and FM initially increased with the birth year before declining from the 1970s/80s. Due to increases in the standard deviation of weight and FM during the obesity epidemic, optimal height powers needed to standardise childhood weight and FM varied by birth year, sex, and age. Adiposity indices using a uniform height power mean different things for different birth cohort groups, sexes, and ages thus should be interpreted with caution. Alternative methods to account for height in epidemiological analyses are needed.

What is Needed for Parents to Work Together with Primary Care Physicians in Dealing with Childhood Obesity and Overweight?

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Effect of Indo-Mediterranean diet versus calorie-restricted diet in children with non-alcoholic fatty liver disease: A pilot randomized control trial.

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

P003 ASSOCIATION BETWEEN SERUM URIC ACID AND BLOOD PRESSURE IN BOYS, GIRLS AND ADOLESCENTS WITH OVERWEIGHT and OBESITY ATTENDED IN PEDIATRIC HOSPITALS IN THE AUTONOMOUS CITY OF BUENOS AIRES. “MULTICENTRIC STUDY

Introduction: Childhood overweight and obesity are modifiable risk factors for the development of Hypertension (HTN). Elevated serum uric acid (UA) is a known cardiovascular risk factor in adults. Objective: To evaluate whether there is an association between high serum UA values and elevated BP in overweight and obese children and adolescents. Methods: Multicenter prospective cross-sectional study. Overweight and obese patients aged 5 to 18 years attended in HTN outpatient clinics of three tertiary pediatric hospitals in Buenos Aires were included. Office BP control, 24-hours ambulatory BP monitoring (ABPM) and laboratory tests (metabolic and lipid profile and serum UA measurement) were performed. Results: 173 patients were enrolled, mean age 11.7±2.9 years, 63 women (36.4%), 50 were overweight (28.9%) and 123 obese (71.1%). 143 normotensive (NT) patients were registered, 14 with white-coat HTN, 11 with masked hypertension (MH) and 5 with sustained HTN. The mean value of serum UA was 5.1±1.2, 113 subjects were above the mean value and 24 were above 2SD. Taking serum UA higher than the average (n:113) according to BP we observed 89/143 in NT vs. 13/14 in white-coat HTN (OR 7.8 95% CI 1.1-62.1 p=0.04), 89/143 in NT vs. 8/11 in MH (OR 1.6 95% CI 0.4-6.3 p=0.7) and 89/143 in NT vs. 3/5 in sustained HTN (OR 0.9 95% CI 0.1-5.2 p=0.9). Using serum UA &gt;2SD (n:24) 14/143 above this value in NT vs. 7/14 in white-coat HTN (OR 9.2 95% CI 2.8-30.1 p&lt;0.001), 14/143 in NT vs. 3/11 MH (OR 3.4 95% CI 0.8-14.5 p=0.1) and no subject with sustained HTN had serum UA values &gt;2SD. Conclusions: Elevated serum UA was observed in subjects with white-coat HTN. The number of subjects with sustained HTN was not sufficient to evaluate the association with serum UA values. These findings emphasize the importance of the systematic implementation of 24-hours ABPM for detection of white-coat HTN in overweight and obese children and adolescents.

Prevalence and sociodemographic factors associated with double burden of malnutrition among children under 5: a cross-sectional analysis of NFHS-4 data in India

BackgroundThe double burden of malnutrition (DBM), characterised by the coexistence of undernutrition and overnutrition, poses a significant public health challenge, particularly in low- and middle-income countries. India, being one of...

The Effectiveness of Physical Activity Intervention at School on BMI and Body Composition in Overweight Children: A Pilot Study

(1) Background: Overweight children usually have lower levels of physical activity (PA) than their normal-weight peers. Low PA predisposes to an increase in body fat mass. The aim of this study was to evaluate the effectiveness of school-based PA intervention on the anthropometric indicators and body composition of overweight and obese children during a two-year observation period, from the age of 10 to 12. (2) Materials and methods: The research included 148 children with overweight or obesity who were born in 2007. There were two groups of children with standard and elevated PA at school (SPA and EPA; 4 and 10 h of physical education lessons a week, respectively). Anthropometric and body composition measurements were carried out. Body mass index (BMI), fat mass (FM), fat-free mass (FFM), skeletal muscle mass (SMM), and total body water (TBW) were estimated. In total, five measurements were conducted at intervals of 5–6 months. (3) Results: In EPA group, the percentage of obese children decreased from 46% to 35.25%, and in SPA group, this percentage increased from 42.75% to 46%. Only 3.33% of children in the standard PA group (one child) and 17.2% in the elevated PA group (six children) changed their BMI and FM categories from overweight to normal body mass. In EPA children, FM decreased from 28.65% to 26.41%, and in SPA children, it increased from 30.31% to 31.75%. The highest increase in FFM was in EPA boys, while SPA boys recorded the highest decrease. In SPA children, SMM increased by 0.43% from 38.85% to 39.28%, and in EPA children, it increased by 2.51% from 40.27% to 42.78%. In EPA children, TBW slightly increased from 53.26% to 53.59%, and in SPA children, it decreased from 50.70% to 49.93%. (4) Conclusions: Elevated PA at school has a positive effect on the BMI and body composition of children who are overweight or obese. Increasing the mandatory number of physical education lessons in school curricula is an efficient strategy for reducing obesity in school-aged children.

Reducing the Number of Times Eating Out Helps to Decrease Adiposity (Overweight/Obesity) in Children.

This cohort enrolled children and teens of any gender, 8-18 years old, and with a body mass index (BMI) z-score of ≥1 into "Sacbe", a comprehensive program to identify which eating habits could reduce BMI z-score. The sample size calculated was 110 participants. We recorded anthropometric measures, clinical history, and habits. A clinically relevant reduction in BMI z-score was defined as ≥0.5 over 12 months or its equivalent according to the months of follow-up. 58.2% were female, the median age was 12 years (range: 9.1-14.7), and the mean BMI z-score was 2.30 ± 0.83. The 82.7% achieved a reduced BMI z-score but 41.8% achieved a clinically relevant reduction with a median follow-up of 6.7 months. Eating out less than once per week was associated with this outcome, even after adjusting for energy intake, other eating patterns, sedentary screen time, physical activity, sleep duration, and sitting time (HR 2.12; 95% CI: 1.07-4.21). Eating out < once/week implicates less processed food exposition and better quality of food; this habit could be the most effective to reduce childhood adiposity.

The Role of Diet and Physical Activity in Obesity and Overweight in Children with Down Syndrome in Developed Countries.

Down's syndrome (DS), or Trisomy 21, represents the most common chromosomal abnormality in live births, characterized by an extra chromosome 21. Children affected by Down's syndrome are more susceptible to the development of obesity and of becoming overweight compared with other children. Furthermore, they seem to present a more unfavorable lipid profile than the non-DS obese pediatric population. Diet and physical activity are closely related to the development of overweight and obesity, and they can be assessed using questionnaires such as the Mediterranean Diet Quality Index in children and adolescents (KIDMED) and the Godin-Shephard Leisure-Time Physical Activity Questionnaire. This review aims to undertake a comprehensive analysis of the intricate interplay between diet and physical activity in children affected by Down's syndrome. Specifically, it seeks to deepen understanding regarding the question of how diet and exercise can influence and prevent the development of overweight and obesity in that special pediatric population.