Childhood obesity and cardiac risk in youth: Emerging challenges toward 2050.

To address the major public health problems of increased body weight and obesity, causing conditions such as hypertension and diabetes. Early obesity in childhood and adolescence has more severe long-term health consequences. The Developmental Origins of Health and Disease (DOHaD) concept examines how early overfeeding and other factors affect health throughout life. This study hypothesized that a short-term metformin treatment during puberty could reduce metabolic dysfunction caused by neonatal overfeeding. We investigated whether the same intervention would have a similar effect on metabolic programming in adulthood. Male Wistar rats raised in small (SL, three pups per mother) and normal (NL, 9 pups per mother) litters were used as models of early overfeeding. Some of the SL and NL animals received intraperitoneal injections of metformin (NL-M and SL-M), whereas the controls received saline (NL-C and SL-C) from days 35-42 (puberty) or 70-81 (adulthood). Two months after the intervention, at both puberty and adulthood, the SL animals exhibited metabolic dysfunction, and were significantly heavier with greater tissue fat accumulation than the NL animals (p <0.0001). SL-M animals treated during puberty exhibited significant reductions in white adipose tissue and liver weight, as well as lower weight gain (p <0.05). In contrast, metformin treatment in adulthood did not alter metabolism. These findings suggest that short-term metformin treatment in rats during puberty can mitigate adult metabolic dysfunction induced by neonatal overnutrition. However, this intervention in adulthood did not result in long-term metabolic changes, which confirms the DOHaD concept.

Seminars in pediatric sugery pediatric metabolic and bariatric surgery.

Clinical characteristics, treatment patterns, and healthcare utilization among children, adolescents, and young adults with obesity in the United States.

From air to adipose: Investigating PM2.5-bound chlorinated paraffins and overweight/obesity in Chinese children and adolescents.

Could Glucagon-Like Peptide-1 (GLP-1) receptor antagonists be used to treat obstructive sleep apnoea in children and adolescents with obesity?

Cardiovascular disease burden in children with obesity: A narrative review.

Pharmacotherapy in childhood obesity: Key points from the 2023 AAP clinical practice guideline.

The toddler milk intervention trial (ToMI): A randomized controlled trial on the effect of protein content in young child formula on BMI and growth.

To examine 4-year changes in Body Mass Index z-score (BMIz) among children and adolescents with overweight or obesity who participated in municipality-based interventions, and to assess whether effects varied by age, sex or baseline weight category. This matched cohort study included children aged 5-15 years. The intervention group received a municipality-based early treatment intervention. Controls (up to five) were matched on age, sex, baseline weight category and calendar year, and received school-based surveillance consisting of mandatory school health examinations with repeated anthropometric assessments. BMIz trajectories were analysed using mixed effects models with linear splines, adjusting for socioeconomic factors derived from national registries. Among 1274 children and adolescents (216 intervention, 1058 control), 56.9%-58.0% in both groups were living with overweight at baseline. No significant differences in BMIz trajectories were observed over the 4-year period. Both groups showed an initial decrease in BMIz during the first 6 months (intervention: -0.18; control: -0.28), followed by an increase from 6 to 12 months (intervention: 0.12; control: 0.21) and a plateau from 12 to 48 months (intervention: -0.01; control: -0.03). Municipality-based interventions did not result in greater long-term BMIz reductions than matched controls. Both groups had modest short-term improvements, which may reflect beneficial effects of both the structured interventions and the active school-based surveillance received by controls. The similar BMIz trajectories suggest system-level equivalence within the Danish school health system. These findings underscore the need for understanding the mechanisms behind these early changes and how to support long-term maintenance.

Poor sleep and emotional wellbeing, which often decline during puberty, are associated with declines in metabolic health and are key determinants of childhood obesity. The aim of the study was to explore bidirectional associations between sleep, emotional wellbeing and obesity from ages 8 to 14 using the Growing Up in Scotland cohort. Secondary analyses were conducted on data from sweeps 7-10 (ages 8-14). Sleep duration was caregiver-reported at age 8 and self-reported at 14. Obesity was assessed using BMI percentiles (BMIp), derived from objective height and weight at ages 8, 10, 12 and 14. Emotional wellbeing was assessed using the Strengths and Difficulties Questionnaire caregiver-report at 10 and 12 years, and self-report at 14 years. Pearson correlations and adjusted regressions examined associations between sleep, BMIp and emotional wellbeing from ages 8 to 14. Analyses included 4157 participants (50.2% male). Shorter sleep at 8 years was associated with higher BMIp at 12 years (β = -0.172, CI (95%) = -0.335, -0.116, p < 0.001) and poorer emotional wellbeing at 10 (β = -0.120, CI (95%) = -0.179, -0.034, p < 0.001) and 12 years (β = -0.101, CI (95%) = -0.164, -0.026, p < 0.001). Poorer emotional wellbeing at 10 (β = -0.116, CI (95%) = -0.232, -0.093, p < 0.001) and 12 years (β = -0.194, CI (95%) = -0.328, -0.174, p < 0.001) predicted shorter sleep at 14 years. Higher BMIp at 8 years was associated with shorter sleep at 14 years (β = -0.182, CI (95%) = -0.359, -0.111, p < 0.001). Poorer emotional wellbeing at 10 years was associated with higher BMIp at 14 years (β = 0.142, CI (95%) = 0.074, 0.629, p = 0.13). Bidirectional associations emerged between short sleep and emotional wellbeing and higher BMIp. Poor emotional wellbeing was associated with subsequent obesity; but not bidirectionally. These interactions should inform the design of health interventions for 8-14-year-olds.

Dietary probiotic intervention for childhood obesity management: a systematic review and meta-analysis

Obesity care education in Canadian medical schools: A multi-site qualitative study.

Glucagon-like peptide-1 analog, liraglutide, alters blood-testis barrier permeability in juvenile healthy rats.

The aim of this scoping review is to provide a comprehensive overview of existing research exploring the potentially triadic relation between obesity, OSA, and MASLD in children. A systematic literature search of PubMed and Web of Science was conducted in accordance with the PRISMA Extension for Scoping Review (PRISMA-ScR) guidelines. Following title and abstract screening, eligible studies were subjected to full-text assessment, resulting in the inclusion of 15 studies in the final review. The initial search identified 263 studies, of which 15 met the inclusion criteria following title and abstract screening and full-text review. Data extraction enabled a comprehensive synthesis of current evidence on the pairwise associations and the potential triadic relationship between obesity, OSA, and MASLD in children. The findings suggest that oxidative stress and inflammation are key underlying mechanisms contributing to this triadic interplay. Key causative factors identified for the triad between pediatric obesity, OSA, and MASLD encompass adipocyte dysfunction, hypoxia-induced IR, and inflammation. However, certain ambiguities remain. Future research should clarify the underlying mechanisms, including fat distribution and the gut-liver axis, and investigate the impact of intermittent hypoxia on adipose tissue to inform treatment strategies targeting all components of the triad.

Abstract Introduction Digital formats have the potential to enhance access and engagement of obesity treatment programs, yet little is known about how parents experience them. This qualitative study aimed to explore how parents of children aged 2–6 years perceived and experienced the digital delivery of a well-established and evidence-based parent support program (More and Less, ML) as treatment. The study was part of a larger randomized controlled trial (RCT) within the EU-funded STOP project, which compared the digital intervention with standard care. The treatment included a 10-week online version of the ML parent support program, followed by six months of continued support via a smartphone app. The ML program constituted the active treatment, while the follow-up app was introduced afterwards as a supportive tool to help families maintain changes. Methods Semi-structured interviews were conducted with 14 parents from 13 families (12 mothers and 2 fathers, mean age 38 years, range 30–47) in Sweden. Nine held a university degree. Their children (9 girls and 4 boys) were aged 2–6 years; 9 had obesity and 4 had overweight. Interviews were recorded, transcribed, and analyzed using thematic analysis guided by the COM-B model, which focuses on the capability, opportunity, and motivation required for behavior change. Results Two main themes were identified: Supporting each other (with subthemes Group support and Group learning ) and Support through digital programs (with subthemes Digital vs in-person engagement and Staying on track ). Parents highlighted the value of connecting with peers during group sessions, which fostered a sense of community and emotional safety. Although many preferred in-person meetings, the digital format was appreciated for its convenience. Motivation to use the app as follow-up varied; some found it helpful, while others expressed a desire for a more interactive and personalized format. Conclusion Parents managing childhood obesity benefit from supportive, nonjudgmental environments. Peer support—even when delivered digitally—enhances their confidence and engagement. Digital tools may also serve as a valuable complement to group-based treatment by extending support beyond the sessions. These findings suggest that future interventions should combine flexible digital components with peer support to enhance engagement and sustainability.

Dysregulated inflammation during pregnancy can result in an adverse intrauterine environment, potentially disrupting fetal growth and development and increasing the risk of childhood obesity. This study aimed to assess the association between maternal inflammation during the second trimester of pregnancy and childhood adiposity at ages 7 and 13 years. Utilizing the Seychelles Child Development Study Nutrition Cohort 2 (SCDS NC2), we measured maternal inflammatory markers (IL-1β, IL-2, IFN-γ, TNF-α, IL-4, IL-5, IL-10, IL-6, CRP, MCP-1, sFlt-1, and VEGF-D) at 28 weeks gestation and childhood body mass index (BMI)-for-age z-scores, waist-to-hip circumference ratios, and the odds of overweight and obesity at ages 7 and 13 years. The associations between maternal inflammatory markers and childhood adiposity measures were analyzed using linear regression for BMI-for-age z-scores and waist-to-hip ratios and multinomial logistic regression for weight status. Potential effect modification by child sex was explored using interaction terms. Among the 1,351 mother-child pairs, 57.1% of mothers, 12.3% of children at age 7 years, and 15.0% of children at age 13 years were classified with obesity. Few associations between gestational inflammatory markers and any adiposity outcome were statistically significant, and all beta coefficients were close to the null. Several associations had statistically significant sex interaction terms (p < 0.05), however most of these associations were not statistically significant. Overall, there was no evidence of an association between second trimester maternal inflammatory markers and childhood adiposity at age 7 or 13 years in this cohort.

The global epidemic of overweight and obesity threatens gynecological and reproductive health, necessitating effective therapeutic strategies to improve maternal and fetal long-term health outcomes. This review provides an overview of weight loss interventions and discusses their use in the context of gestation, such as surgical interventions and anti-obesity medications. As the interest in incretin-based therapies has risen substantially, we discuss how incretin-based therapies, including glucagon-like peptide-1 (GLP-1) receptor agonists and GLP-1 receptor agonists and glucose-dependent insulinotropic polypeptide (GIP) dual agonists, might improve reproductive function and could interact with the physiological metabolic changes ensuring a healthy pregnancy. These metabolic adaptations during pregnancy arise from the integration of insulin signaling, lipid metabolism, placental endocrine function, mitochondrial remodeling and inflammatory regulation. Furthermore, we consider not only short-term consequences of maternal overweight and obesity but also focus on fetal long-term health trajectories following pregnancy-related metabolic disorders, as maternal obesity and gestational weight gain are considered risk factors for childhood obesity and overweight.

This study investigated the longitudinal associations between adherence to the 24-h Movement Guidelines (24-HMG), specifically, meeting the recommendations for moderate-to-vigorous physical activity (MVPA) (≥ 60min/day), recreational screen time (≤ 2h/day), and sleep (9-11h/night), and one-year changes in physical fitness and body composition among overweight and obese children. Particularly, the study identified whether the number and specific combinations of 24-HMG adherence were associated with more favorable health outcomes in this high-risk pediatric group. A prospective cohort of 337 children aged 6-12 years from six public schools in China was followed for one year. Physical activity, sedentary screen time, and sleep were assessed using triaxial accelerometers, validated questionnaires, and parental reports. Physical fitness was evaluated via the Chinese National Student Physical Fitness Battery, while body composition i.e., body fat percentage (BFP), fat-free mass(FFM), and skeletal muscle mass (SMM), was measured using bioelectrical impedance analysis. Covariates included demographic characteristics and parental support for healthy movement behaviors. Over the follow-up, sleep duration decreased and sedentary time increased, while MVPA showed no significant change. All physical fitness and body composition indicators increased over the one-year period. Adherence to two guidelines, especially those including MVPA, was associated with reductions in BFP and gains in FFM. Combinations of MVPA with reduced sedentary time or adequate sleep showed the strongest associations with improvements in physical fitness and FFM and decreases in BFP. Full adherence to all three guidelines was associated only with improvements in physical fitness and FFM. This study demonstrates that adherence to the 24-HMG, particularly combinations involving MVPA, is associated with improved physical fitness and body composition in overweight and obese children. The underlying mechanisms and intervention evidence warrant further investigation.Level of evidence Level III-well-designed cohort study.

Tackling childhood obesity represents a significant public health challenge associated with several adverse health and psychological outcomes, with increased prevalence in ethnically diverse populations. Early intervention is required to promote healthy weight from early childhood and reduce health inequalities. A systematic review was conducted to synthesise evidence from randomised trials of behavioural interventions that target obesity prevention among young ethnic minority children aged 0-5 years in high-income countries. Medline, PsycINFO, Scopus and PubMed were searched for articles published between 1995 and 2023 to examine the theoretical and cultural adaptation strategies associated with the most effective interventions. A narrative synthesis using SWiM guidelines was conducted to summarise the data. Forty-four articles reporting on thirty-eight unique RCT intervention studies are reported. Around one-third of the interventions resulted in a difference in weight, which favoured the intervention when compared to the control. Behavioural interventions that utilise deep and tailored cultural adaptation strategies may be more effective in changing dietary practices and weight outcomes but may be less important in increasing physical activity levels. The theoretical domains and behaviour change techniques associated with the most promising success are reported. Collaborative partnerships with diverse families alongside wider community stakeholders may offer a more effective solution to ensure obesity prevention interventions remain tailored to the local context and provide sustainable solutions that can deliver increased impact.