Treatment Of Childhood Obesity Research Articles

Gut microbiota profiling in obese children from Southeastern China.

Childhood obesity not only has a negative impact on a child's health but is also a significant risk factor for adult obesity and related metabolic disorders, making it a major global public health concern. Recent studies have revealed the crucial role of gut microbiota in the occurrence and development of obesity, in addition to genetic and lifestyle factors. In this study, we recruited 19 normal-weight children and 47 children with varying degrees of obesity. A questionnaire survey was conducted to inquire about the family background, lifestyle habits and dietary composition of the 66 children. Findings indicate that fathers of obese children tend to be obese themselves, while children with highly educated mothers are more likely to maintain a normal weight. Furthermore, overweight children tend to spend more time on electronic devices and less time on physical activities compared to their normal-weight counterparts. Obese children exhibit significant differences in breakfast and dinner dietary composition when compared to children with normal weight. Additionally, the gut microbiota of these 66 children was analyzed using 16S rRNA sequencing. Analysis of gut microbiota composition showed similar compositions among children with varying degrees of obesity, but significant differences were observed in comparison to normal-weight children. Obese children exhibited a reduced proportion of Bacteroidota and an increased proportion of Firmicutes, resulting in an elevated Firmicutes/Bacteroidota ratio. Moreover, Actinobacteriota were found to be increased in the gut microbiota of children with varying degrees of obesity. PICRUSt analysis indicated significant metabolic differences in the microbiota functions between obese and normal-weight children, suggesting the composition of gut microbiota could be a crucial factor contributing to obesity. These findings provide valuable insights for the treatment of childhood obesity.

Prevalence of Adolescents Meeting Criteria for Metabolic and Bariatric Surgery.

The American Academy of Pediatrics endorses metabolic and bariatric surgery (MBS) as a safe and effective treatment of severe obesity in children with class 3 obesity or with class 2 obesity and qualifying comorbidities. The study objective was to determine eligibility and characteristics of adolescents who qualify for MBS based on American Academy of Pediatrics guidelines. This retrospective cohort study analyzed electronic health record data of 603 051 adolescents aged 13 to 17 years between January 1, 2018, and December 31, 2021. Centers for Disease Control and Prevention criteria were used to define obesity classes 2 and 3. Multivariable logistic regression was used to evaluate the factors associated with meeting MBS eligibility criteria. Of the 603 041 adolescents evaluated, 22.2% had obesity (12.9% class 1, 5.4% class 2, and 3.9% class 3). The most frequently diagnosed comorbid conditions were gastroesophageal reflux disease (3.2%), hypertension (0.5%), and nonalcoholic fatty liver disease (0.5%). Among adolescents with class 2 obesity, 9.1% had 1 or more comorbidities qualifying for MBS, and 4.4% of all adolescents met the eligibility criteria for MBS. In multivariable modeling, males, Black and Hispanic adolescents, and those living in more deprived neighborhoods were more likely to meet MBS eligibility criteria. Overall, 1 in 23 adolescents met the eligibility criteria for MBS. Demographic and social determinants were associated with a higher risk for meeting these criteria. The study suggests that the health care system may face challenges in accommodating the demand for MBS among eligible adolescents.

Treatment of childhood obesity based on the reduction of ultra-processed foods plus energy restriction: A randomised controlled trial based on the Brazilian guidelines.

Reducing ultra-processed foods (UPF) improves diet quality and may curb energy consumption. This study aimed to compare an intervention based on the reduction of UPF, according to the Dietary Guideline for the Brazilian Population (DGBP), with and without advice on energy intake. A parallel and randomised controlled trial was carried out with children with obesity from 7 to 12 years old. Both control (CG) and intervention groups (IG) participated monthly in 6 standardised educational activities based on the 10 steps of the DGBP. An individualised food plan was also provided to the IG. The rate of change for body mass index (BMI), waist circumference, body weight, and UPF consumption were investigated based on mixed-effect models. At the end of the study, the BMI declined in the IG (Δ = -0.27 kg/m2) compared to the CG (Δ = + 0.53 kg/m2) (p = .0002). Both groups showed a decline in grams of UPF until the fourth month and a gradual increase in the following months. Combining the qualitative approach of the DGBP with counselling on energy restriction through the diet plan proved to be effective in reducing childhood obesity. Clinical Trial Registration: This trial is registered at the Brazilian Registry of Clinical Trials (REBEC), under the RBR-3st5sn registry, available at http://www.ensaiosclinicos.gov.br/rg/RBR-3st5sn/. The datasets generated by the current study are not publicly available but are available from the corresponding author on reasonable request.

Adherence and dropout in exercise-based interventions in childhood obesity: A systematic review of randomized trials.

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

A family-based and mobile-assisted intervention for lifestyle behaviors in youths: A randomized controlled trial.

This randomized controlled trial was conducted to assess the effectiveness of a family-based and mobile-assisted lifestyle intervention in reducing weight gain among school-age children with overweight and obesity. A total of 164 school-age children with overweight or obesity and their parents were randomized to the treatment intervention (n = 82) or an attention-control group (n = 82). The treatment intervention included three face-to-face education sessions, augmented by monthly text messages sent to parents on their mobile devices. The primary outcome was child BMI-for-age z-score. Secondary outcomes included child BMI, percent body fat, and actigraphy-assessed sleep as well as parental sleep quality. Outcomes were assessed at baseline, 3, 6, and 12 months after the intervention, with treatment effects analyzed using general linear models for repeated measures. Our results showed that children in the treatment intervention group had significantly lower BMI-for-age z score, BMI, and percent body fat than did those in the control group, with an adjusted mean difference of 0.31 units (95% CI: -0.59 to -0.03; p = 0.03), 1.34 kg/m² (95% CI, -2.42 to -0.26; p = 0.01), and 3.12% (95% CI, -5.93 to -0.30; p = 0.03), respectively. No treatment effects were observed for child and parental sleep. Our findings suggest that family-based and mobile-assisted lifestyle intervention results in significant and sustained benefits to enhanced weight management for school-age children with overweight and obesity. Nurses planning and delivering childhood overweight and obesity treatment interventions should consider a family-based approach with the assistance of mobile devices.

FTO genotype and body mass index reduction in childhood obesity interventions: A systematic review and meta-analysis.

Numerous guidelines have called for personalized interventions to address childhood obesity. The role of fat mass and obesity-associated gene (FTO) in the risk of childhood obesity has been summarized. However, it remains unclear whether FTO could influence individual responses to obesity interventions, especially in children. To address this, we systematically reviewed 12,255 records across 10 databases/registers and included 13 lifestyle-based obesity interventions (3980 children with overweight/obesity) reporting changes in body mass index (BMI) Z-score, BMI, waist circumference, waist-to-hip ratio, and body fat percentage after interventions. These obesity-related outcomes were first compared between children carrying different FTO genotypes (rs9939609 or its proxy) and then synthesized by random-effect meta-analysis models. The results from single-group interventions showed no evidence of associations between FTO risk allele and changes in obesity-related outcomes after interventions (e.g., BMI Z-score: -0.01; 95% CI: -0.04, 0.01). The results from controlled trials showed that associations between the FTO risk allele and changes in obesity-related outcomes did not differ by intervention/control group. To conclude, the FTO risk allele might play a minor role in the response to obesity interventions among children. Future studies might pay more attention to the accumulation effect of multiple genes in the intervention process among children.

Dental implications of childhood obesity and prevention and management methods in dental office

Childhood obesity is a common chronic disease in childhood, and its prevalence and socioeconomic costs have increased worldwide over the past 40 years. The World Health Organization has designated obesity as a global epidemic, emphasizing the need for its treatment and management. The impacts of childhood obesity on dentistry include a higher risk of dental caries, advanced dental development, as well as psychological changes (anxiety, depression, attention deficit hyperactiv-ity disorder) and physical changes (increased complications, changes in drug metabolism) that should be considered when implementing preventive strategies, orthodontic treatment, behavior management and sedative procedures. Dentists should regularly check child’s body mass index and diet for every child visiting dental office. Parental obesity, consumption of sugar-sweetened beverages, poor dietary habits, and lack of exercise can be a risk factors for obesity in normal/overweight child. Diet counseling should be provided to high-risk children and their parents. Preventing childhood obesity is crucial, and the key point in treating childhood obesity is behavior modification therapy, which focuses on regulating daily eatinghabits and physical activity. Dentists should recognize the seriousness of childhood obesity and participate in the prevention and management of the obesity epidemic, thus enhancing oral and systemic health

The effectiveness of auricular neuromodulation in childhood and adolescent obesity

detrimental to a child's health. This condition predominantly stems from an interplay of genetic, environmental, and lifestyle factors. Key contributors include unhealthy dietary habits, insufficient physical activity, and prolonged engagement in sedentary activities, such as excessive use of mobile phones, computers, and television. Childhood obesity predisposes individuals to a spectrum of health complications, including cardiovascular diseases, type 2 diabetes, and respiratory disorders. Additionally, it is associated with various psychological and social challenges. The rising prevalence of childhood obesity underscores its seriousness as a growing public health concern, with long-term implications for the health and well-being of affected children. Results: The review identified four surveys that met the predefined outcomes. These studies provided substantial evidence supporting the use of auricular neuromodulation in addressing childhood obesity. Each of the four studies was a randomized clinical trial, focusing on children and adolescents who underwent auricular neuromodulation. This procedure involved the use of vaccaria (plant seeds), metal pellets and mustard seeds. The participants in this study were divided into two subgroups. The first group received intervention with the use of vaccaria and the second group was the control group where there was no intervention. This design facilitated the comparison of the given intervention against alternative treatments. The primary outcome measures included anthropometric parameters and assessments of body image, self-esteem, and depressive symptoms. Conclusion: Recent studies have demonstrated that auricular neuromodulation using vaccaria seeds, mustard seeds and metal pellets yields positive results in treating childhood obesity. This conclusion is based on anthropometric outcome measures. These findings suggest that such neuromodulation techniques can be a viable option in the physiotherapeutic treatment of obesity in children and adolescents.

A pragmatic trial of a family-centered approach to childhood obesity treatment: Rationale and study design

BackgroundFamily-based behavioral treatment (FBT) is an effective intensive health behavior and lifestyle treatment for obesity reduction in children and adolescents, but families have limited access. The purpose of this randomized, pragmatic, comparative effectiveness trial was to examine changes in child relative weight in a 12-month, enhanced standard of care (eSOC) intervention combined with FBT (eSOC+FBT) vs. eSOC alone. MethodsChildren aged 6 to 15 years with obesity, and their primary caregiver, were recruited from primary care clinics. Families were randomized 1:1 to eSOC, a staged approach led by the primary care provider that gradually intensified dependent on a child's response to care and aligns with the American Medical Association guidelines, or the eSOC+FBT arm, which included regular meetings with a health coach for healthy eating, physical activity, positive parenting strategies, and managing social and environmental cues. Both treatments align with the 2023 American Academy of Pediatrics clinical practice guidelines. Assessments occurred at baseline, midpoint (month 6), end-of-intervention (month 12), and follow-up (month 18). Primary outcome was change from baseline to 12 months in child percent overweight (percentage above the median body mass index in the general US population normalized for age and sex). Secondary outcomes were parent weight, child psychosocial factors, heterogeneity of treatment effects, and cardiometabolic risk factors. Exploratory outcomes assessed reach, effectiveness, adoption, implementation, and maintenance. ConclusionThis pragmatic trial will generate evidence for the comparative effectiveness of implementing two guidelines-based approaches in primary care for obesity reduction in children and adolescents.Trial registration:ClinicalTrials.gov Identifier: NCT03843424

Reframing interventions for optimal child nutrition and childhood obesity: the importance of considering psychological factors.

This review aims to emphasise the impact of poor nutrition on children's health and psychological well-being, urging those involved in childhood obesity or nutrition services to broaden their intervention approach. Poor nutrition and childhood obesity affect physical and psychological health. The stress of living with obesity further impacts quality of life, well-being and self-esteem. Children living with obesity may experience adverse childhood events and stress, and young people are able to recall the impact of psychosocial issues such as experiencing stigma and discrimination. Food is often a coping mechanism for managing negative emotions, perpetuating cycles of emotional coping and unhealthy eating behaviours. UK guidelines recommend family-based, multi-component weight management interventions for children living with obesity. Interventions mainly target health behaviours and utilise behaviour change techniques attempting to directly improve diet and physical activity as behavioural outcomes. Whilst these interventions may show some improvements in psychological well-being, there is limited consideration or understanding of the underlying mechanisms of action which indirectly influence engagement and the sustainability of the behaviour change. Lack of attention and inclusion of psychosocial variables in intervention implementation may help explain the variable effectiveness reported across childhood obesity interventions. In conclusion, enhancing the effectiveness of childhood obesity interventions requires a broader approach that fully incorporates psychosocial factors. Those responsible for commissioning, designing and implementing these interventions should adopt a holistic approach that addresses psychological and emotional needs while incorporating underlying mechanisms of action. This shift in focus could result in more sustainable and comprehensive treatment for childhood obesity.

Management of the child with obesity: Role and development of new medications

Childhood obesity continues to be a major health problem worldwide with the consequent associated comorbidities becoming apparent at very early ages and increasing throughout life. Although the prevention of obesity is essential, it is no less true that its treatment should be considered when prevention has failed and in specific cases of obesity. The treatment of obesity in children and adolescents continues to be based on a program for the reorganization of eating habits, physical activity, and eating behavior. Nevertheless, as a result of the enormous amount of investigation carried out in the past decade in search of efficient treatments for obesity, new drugs are gradually becoming available, including liraglutide, semaglutide, setmelanotide and phentermine/topiramate, among others. Although the treatments mentioned are now available, they are not applicable and/or accessible for every patient and we are all learning about the approach to using these new treatments and it is still early to interpret their effectiveness in the medium and long term. Furthermore, whether the use of these medications, once started, should be for life, remains to be clarified. Regarding bariatric surgery in children and adolescents, the available data are limited with scarce data regarding the long-term results. Thus, there have been important advances in the treatment of childhood obesity, but there are still much to be done.

A Narrative Review of Public Health Interventions for Childhood Obesity.

Public health interventions that intervene on macrolevel systems hold the promise of reducing childhood obesity at the population level through prevention. The purpose of this review is to highlight some of the recent and best scientific evidence related to public health interventions for the prevention of childhood obesity. We provide a narrative review of scientific evidence for six categories of public health interventions and their impact on childhood obesity: federal nutrition assistance programs, programs implemented in early care and education centers, interventions to support healthy nutrition and physical activity in schools, community-based programs and policies, labeling policies and marketing to children, and taxes on sugar sweetened beverages (SSB). Federal nutrition assistance programs have the strongest evidence to support reduction in childhood obesity and serve populations with the highest prevalence of childhood obesity. Other interventions including SSB taxes, community-wide interventions, and interventions at schools and early care and education centers also show significant improvements in child weight status. Overall public health interventions have strong evidence to support widespread implementation in service of reducing childhood obesity rates at the population level. To effectively address the recalcitrant childhood obesity epidemic, multi-pronged solutions are needed. The current evidence for public health obesity interventions is consistent with the paradigm that recognizes the importance of macrolevel systems influences on childhood obesity: interventions that are most effective intervene at macrolevels.

Nursing interventions in childhood obesity

Introduction: obesity is a chronic disease characterized by a high percentage of fat in the human body, caused mainly by endogenous (genetic), biological and exogenous causes (life habits), representing a serious public health problem. Objective: to know the nursing interventions in childhood obesity. Methods: a systemic review of scientific articles was carried out using the PICO strategy. The search was carried out according to PRISMA parameters where initially 40 articles were obtained, of which 18 were included under inclusion criteria such as: Original studies, clinical trials, systematic reviews and meta-analysis, free access, English and Spanish languages and that have been published. between the years 2019 and 2023; while, the exclusion criteria were: degree thesis and documents that did not meet the inclusion criteria. The databases were: ELSEVIER, MEDLINE, Redalyc, SCIELO, Latindex, Dialnet, Latin REV, Scopus using descriptors in health sciences (DECS) from Bireme and the Medical Subject Headings (MESH) from the National Library of Medicine in English, such as: (interventions) AND (childhood obesity AND (Nursing). Results: nursing interventions focused mainly on improving eating behaviors and reducing sedentary lifestyle. Those related to the family were more successful, because, by training adults the quality of life of the child is improved. Conclusions: The training of nursing staff is essential for the management and care of childhood obesity

Микробиота кишечника у детей с ожирением: особенности состава и роль в патогенезе

This review focuses on the composition of the gut microbiota in children with obesity. Studies demonstrating changes in the gut microbiota in obese children during the first year of life are presented: their association with maternal obesity and family dietary patterns. Numerous experimental and clinical studies have identified that the gut microbiota plays a key role in the development of obesity through the regulation of appetite, energy processes and metabolic mechanisms of fat accumulation. Obese children have a distinctive metabolic profile, including elevated levels of short-chain fatty acids and a high Firmicutes/Bacteroidetes ratio, which may serve as important biomarkers of this condition. The studies presented in this review expand our understanding of the relationship between the gut microbiota and obesity, providing new perspectives for further reference and comparative analyses, as well as for the development of innovative strategies for the prevention and treatment of obesity in children. Key words: obesity, gut microbiota, childhood obesity

Effectiveness of utilizing step-monitoring devices to prevent and treat obesity in children and adolescents: A systematic review and meta-analysis.

Children and adolescents who are overweight and obese represent a growing public health issue. The use of step-monitoring devices as an intervention tool may be a simple, cost-effective, and easily replicable solution for addressing obesity in children and adolescents. No prior systematic reviews have evaluated the effectiveness of utilizing step-monitoring devices as an intervention method for obesity in children and adolescents. Previous studies on using step-monitoring devices to prevent and treat obesity in children and adolescents were identified in the following databases: Web of Science, EMBASE, PubMed, Cochrane Library, SPORTDiscus, and SCOPUS. The search period for each database ranged from the year of their inception to 8 March 2023 (updated in June 2024). Meta-analyses were performed for mean differences (MDs) in body mass index (BMI), BMI z-score (BMI-Z), body fat, waist circumference, and body weight. From 12,907 relevant records, 23 studies were included in this meta-analysis. The included studies were mainly at low risk of bias, except for blinding. Step-monitoring device-based interventions had significant effects in reducing BMI-Z (MD -0.06; 95% CI -0.10 to -0.02), body fat (MD -0.95%; 95% CI -1.35 to -0.54), and body weight (MD -1.23 kg; 95% CI -2.36 to -0.10). However, there was no significant effect on BMI (MD -0.16 kg/m2; 95% CI -0.55 to 0.22) and waist circumference (MD -0.33 cm; 95% CI -1.23 to 0.58). Subgroup analyses indicated that participants who were overweight or obese showed greater intervention effects on BMI and BMI-Z compared to participants with normal weight. The programs with an intervention duration of ≤6 months presented a greater intervention effect on BMI-Z than those with an intervention duration of more than 6 months. The programs that established goals had a greater intervention effect on body fat than those that did not. Step-monitoring devices may be an effective and generalizable intervention tool for the prevention and treatment of obesity in children and adolescents. Future studies should further explore how to set step goals and the duration of interventions to achieve better intervention effects.

Outcome of BMI2+: Motivational Interviewing to Reduce BMI Through Primary Care AAP PROS Practices.

Pediatric obesity rates in the United States remain at an all-time high. Pediatric primary care clinicians and registered dietitians can help treat childhood obesity, and motivational interviewing (MI) has shown promising effects in prior trials. We randomized 18 pediatric primary care practices to receive the Brief Motivational Interviewing to Reduce BMI or BMI2+ intervention or continue with usual care (UC). Practices were recruited through the American Academy of Pediatrics Pediatric Research in Office Settings network. The intervention comprised 4 components1: in-person and telehealth MI counseling by pediatric clinicians; 4 recommended sessions,2 6 telephone MI counseling sessions from a registered dietitian,3 text message reminders and tailored motivational messages, and4 parent educational materials. The main outcome was the change in the percentage of the 95th percentile of BMI. The study was conducted 2017 through 2021. There was a significant treatment x time interaction (b = 0.017, 95% confidence interval: [0.0066-0.027]) for the main outcome, favoring the UC group, with youth in the intervention arm showing a greater relative increase in their percent of the 95th percentile. There was no overall benefit of the intervention and, contrary to expectations, youth in the intervention arm gained more weight, based on percent of the distance from the 95th percentile than matched youth from UC practices. The absolute excess weight gain among intervention relative to UC youth was small, approximately 0.5 BMI units and 1 kg over 2 years. We offer several potential explanations for these unexpected findings.

Значение исследования генетических маркеров в лечении и профилактике ожирения у детей и подростков

Aim. To consider the role of hereditary predisposition in the formation of obesity, and to analyze the importance of genetic marker studies in the treatment and prevention of obesity in children and adolescents. Key points. The increasing prevalence of obesity among children and adolescents over the past decades is one of the most important medical and social problems, since obesity contributes to the emergence of such non-infectious diseases as type 2 diabetes mellitus and arterial hypertension, which are rightly considered a non-infectious epidemic of the 21st century. At the same time, the role of hereditary predisposition in the formation of obesity is well known, and therefore the search for its genetic markers becomes relevant. Conclusion. Genetic markers help not only to identify patients at risk for obesity, but also to diagnose metabolic disorders at early stages: dyslipidaemia, disorders of carbohydrate metabolism, early manifestations of endothelial dysfunction, which will help to prevent the development of heart attacks, strokes, type 2 diabetes mellitus, and thus reduce disability and mortality from non-infectious diseases. Along with this, the isolation of certain genetic markers and their combinations will allow the creation of personalized obesity treatment and prevention programs. Keywords: obesity, children, adolescents, genetic markers, gene polymorphisms.

Current research status of non-pharmacological intervention for childhood obesity induced hypertension

Current research status of non-pharmacological intervention for childhood obesity induced hypertension

小儿肥胖症的中医临床治疗进展

小儿肥胖症的中医临床治疗进展

Public health risks of approving drugs for the treatment of childhood obesity in Brazil

Public health risks of approving drugs for the treatment of childhood obesity in Brazil