Introduction: early infant feeding practices play a crucial role in shaping long-term dietary behaviors and health outcomes. However, validated instruments to assess these practices in infants under six months are scarce, particularly in low -and middle- income countries. The Feeding Practices and Structure Questionnaire for Infants - Milk Feeding version (FPSQ-M) was originally developed in Australia, but its applicability in diverse cultural contexts requires validation. Objective: to translate, culturally adapt, and validate the FPSQ-M for use among Mexican mothers with infants under six months of age. Methods: this cross-sectional study involved 197 Mexican mothers. The FPSQ-M underwent translation, cultural adaptation, and psychometric validation. Construct validity was evaluated through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Internal consistency was assessed using Cronbach's alpha, and measurement invariance by maternal education level was tested using multigroup analysis. Results: the EFA identified a four-factor structure, explaining 56.49 % of the variance, aligning with the original FPSQ-M. CFA, after removing two low-loading items, showed improved model fit (GFI = 0.901, CFI = 0.916, RMSEA = 0.063). Measurement invariance confirmed that the FPSQ-M is equivalent across maternal educational groups. Internal consistency was acceptable across all dimensions. Conclusions: the FPSQ-M demonstrated strong psychometric properties in this Mexican sample, making it a reliable tool for assessing feeding practices. Its use is recommended in future research and public health interventions aimed at promoting responsive feeding and preventing early childhood obesity.

It is unclear how early childhood obesity treatment affects metabolic risk. This study assessed long-term metabolic health in children with obesity aged 4-6 years and examined associations with weight status. This prospective cohort study pooled data from the Sweden-based More and Less randomized controlled trial, which compared a parent support program with standard care in 2012-2016. Children met the International Obesity Task Force (IOTF) criteria for obesity. Anthropometrics and metabolic risk factors were collected at baseline, 12 and 48 months. Associations between metabolic markers and weight status were examined using linear mixed models. Data from 106/177 (60%) children, mean age at baseline 5.3 years, were analysed. At baseline, 33/90 (36.6%) had elevated metabolic risk markers. At 48 months, one unit of body mass index standard deviation score (BMI SDS) was associated with higher glycosylated haemoglobin (HbA1c IFCC) (0.99 mmol/mol), higher fasting insulin (2.72 mIU/L) and lower high-density lipoprotein (HDL) (-0.16 mmol/L or -6.2 mg/dL). A BMI SDS reduction ≥ 0.25 was associated with lower HbA1c and triglycerides at 12 months, and a reduction ≥ 0.5 with lower total cholesterol at 48 months. Improved weight status may reverse metabolic disturbances present in early childhood.

Impact of a home-based obesity prevention intervention on children's eating behaviours: Findings from the Guelph Family Health Study randomised controlled trial.

Environmental phenotypes for healthy weight in children using population-based linked environment and health data: a cross-sectional observational study.

Gendered perceptions can shape parental beliefs, behaviours and practices relevant to childhood obesity prevention during the critical early life period from pregnancy to infancy. We explored how pregnant women, mothers and healthcare providers in maternal child health in Shanghai, China, perceive the influences of gender within an overweight and obesity prevention context. We conducted a qualitative descriptive study integrated into the intervention arm of an ongoing early childhood obesity prevention trial. Individual interviews and focus group discussions with pregnant women and mothers participating in the intervention and healthcare providers involved in the delivery of the intervention were conducted (n = 59). We documented perceptions on gender in relation to parental beliefs, behaviours and practices in the context of overweight and obesity prevention. Interviews were audio recorded, transcribed and analyzed using thematic analysis. Three main themes were identified. First, participants shared expectations for children's bodies, emphasizing that health was a priority for both boys and girls, but that expectations regarding body figure were generally stricter for girls than for boys. Second, regarding parenting expectations and health behaviours, few gender differences were reported other than boys being expected to engage in more physical activity compared to girls. Third, participants shared their views on gender roles and involvement in parenting, highlighting mothers' central role in overweight and obesity prevention during pregnancy and early childhood, alongside a desire for greater paternal involvement in parenting and in modelling healthy lifestyle behaviours. Findings underscore the importance of integrating gender‑related perceptions into early childhood overweight and obesity prevention efforts, beginning prenatally and extending through early childhood. Increasing awareness of these perceptions early in the life course could contribute to more gender-sensitive care and support childhood obesity prevention from the earliest stages of life. The SCHeLTI protocol was registered on the Chinese registry ChiCTR1800017773 on 2018-08-13 (https://www.chictr.org.cn/hvshowproject.html?id=93827%26v=1.3).

Nutritional problems among children under five remain a major public health concern in Indonesia, including both undernutrition and the increasing prevalence of overweight and obesity in early childhood. Parenting practices influenced by local wisdom are still widely applied in rural communities and may affect children’s dietary patterns and nutritional outcomes. This study aimed to analyze the role of local wisdom-based parenting practices in supporting the nutritional status of children under five in rural communities. This study employed a quantitative approach with a cross-sectional design. The research was conducted in Sumbersekar Village, Dau District, Malang Regency, from November 2025 to February 2026. A total of 34 mothers with children aged 6-59 months were selected using stratified random sampling. Data were collected through structured questionnaires assessing local wisdom-based parenting practices and anthropometric measurements to determine children’s nutritional status. Data were analyzed using descriptive statistics, Chi-square tests, and multinomial logistic regression. The results showed that most respondents applied local wisdom-based parenting practices in the good category (55.9%). The majority of children had normal nutritional status (61.8%), while 14.7% were undernourished, 17.6% were overweight, and 5.9% were obese. Statistical analysis indicated a significant association between local wisdom-based parenting practices and children’s nutritional status (p = 0.032). In conclusion, local wisdom-based parenting practices play an important role in determining children’s nutritional status. Integrating cultural values with balanced nutrition education may improve healthy feeding practices in rural communities.

Maternal prepregnancy body mass index (ppBMI) and gestational weight gain (GWG) are risk factors for overweight and obesity (OWO) in childhood. However, a better understanding of the magnitude, timing, and mediating mechanisms of these associations can inform interventions to improve maternal and child health. We conducted a prospective cohort study of 2899 mother-child dyads in northern Virginia (2012-2019). Maternal ppBMI was self-reported and GWG was calculated and categorized as excess (EGWG) using 2009 Institute of Medicine guidelines. Child weight was reported by parents every six months from birth to 24 months, and annually thereafter. Childhood OWO was defined as >85th percentile of WHO growth charts at 36 months. Generalized linear and mixed models estimated maternal OWO status and GWG as predictors of children's body weight Z-score and growth velocity, adjusted for covariate. Causal mediation analysis was used to quantify birth weight and early growth velocity as intervening factors. Mothers self-reported Hispanic (32.08%) and non-Hispanic (51.98%) ethnicity (15.94% missing). Mean ± SD ppBMI was 25.5 ± 5.4 kg/m² (35.46% with obesity) and GWG was 14.2 ± 6.8 kg (40.8% EGWG). At 36 months, 25.4% of children had overweight and 10.5% had obesity. Higher ppBMI (RR = 1.04 per 1.00 kg/m2; 95% CI: 1.03-1.06) and GWG was associated with childhood risk of OWO among non-Hispanic but not Hispanic mothers (interaction P = 0.02). Similarly, maternal obesity status (RR = 1.64; 95% CI: 1.26-2.13) and EGWG (RR = 1.38; 95% CI: 1.09-1.74) were associated with childhood OWO risk. Approximately 26.8% (95% CI: 14.9%-55.9%) of the ppBMI-OWO association could be attributed to birth weight. Maternal ppBMI and GWG were independently associated with risk of OWO in early childhood OWO, with variations by child age and ethnicity, highlighting the potential of pre- and perinatal interventions to reduce childhood obesity risk.

Childhood obesity remains a critical public health concern among Hispanic families in Mexico and the United States. Healthy Change, a brief peer-led programme delivered in childcare centres, was designed to increase mothers' awareness of child weight status and support healthier feeding practices. Embedded within a cluster randomized trial, this qualitative study examined experiences of Mexican and Mexican American mothers in the intervention arm. Four post-intervention focus groups were conducted at intervention sites (n= 25), and transcripts were analysed using inductive content analysis. Mothers reported favourable impressions, emphasizing practical advice, relatable peer facilitators, and a supportive group atmosphere. Many described initial shock or discomfort on learning that their child was overweight, followed by greater recognition of risk and intentional changes in family diet, routines, and opportunities for physical activity. Participants also identified needs for broader content, clearer communication, and some professional involvement to complement peer support. Family encouragement and involvement facilitated change, whereas competing schedules and communication gaps hindered participation. Findings suggest that peer-led programmes in childcare settings are feasible, acceptable, and capable of supporting healthier family lifestyles. Such interventions may offer a resource-efficient approach to strengthening maternal awareness and advancing early childhood obesity prevention in diverse communities.

Early childhood obesity is an increasing public health problem with long-term consequences. Identifying risk factors is essential for effective prevention strategies. To evaluate prenatal, perinatal, and postnatal influences; breastfeeding and nutritional practices, lifestyle and daily habits; household, sociocultural, and economic conditions; and parental anthropometric characteristics to better elucidate the determinants of obesity in early childhood. This cross-sectional study included 210 children aged 12-60 months, comprising 104 children with obesity and 106 non-obese controls. Standardized anthropometric assessments were performed in all participants. Parents completed a structured questionnaire capturing perinatal characteristics, infant feeding practices, dietary intake, medical history, lifestyle behaviors, and household-level factors. A total of 210 children (113 females) were included (106 obese and 104 non-obese), with comparable age between groups (3.4 ± 1.3 vs. 3.3 ± 1.3 years). Both maternal and paternal BMI values were significantly higher in the obese group, and maternal employment (27.4% vs. 5.8%) and maternal obesity (42.5% vs. 21.2%) were more prevalent. Maternal smoking during pregnancy (23.6% vs. 7.7%) and gestational diabetes (22.6% vs. 9.6%) were also more frequent. Feeding practices and current dietary patterns did not differ significantly between groups. In multivariable analysis, maternal employment (aOR 3.74), sibling obesity (aOR 2.21), and extended family obesity burden (aOR 1.19) independently predicted childhood obesity. Familial obesity burden showed the strongest associations with obesity, highlighting the need for early identification of high-risk children and family-centered preventive strategies focusing on physical activity, diet, and daily routines.

To assess whether a novel parent stress with nutrition vs nutrition alone intervention decreases early childhood obesity risk. A prospective, parallel, 12-week randomized controlled trial with parents who were overweight (114 dyads body mass index [BMI]: 34.7 ± 6.6) and their young children (aged 2-5years) was conducted between November 2018 and July 2022. Parenting Mindfully for Health (PMH+N) was compared with the control (CTL+N) weekly group intervention, each with nutrition and physical activity (N) psychoeducation. Changes in child BMI and parent stress were coprimary outcomes, whereas observed parenting in an established laboratory-based parent-child Toy-Wait Task (TWT) and child food intake were secondary outcomes. Child BMI z score significantly increased by 0.41 ([0.13, 0.69], P < .005) in the CTL+N, but PMH+N remained unchanged (0.20 [-0.49, 0.09], P > .17) over the 3-month follow-up, and parent stress decreased (3.17 [-5.19, -1.15] points, P < .003) only in the PMH+N arm. Significant time main effects indicated increased TWT positive parenting (2.82 [1.24, 4.4], P < .001) and reduced unhealthy child food intake (-1.78 [-3.02, -0.54]), driven by the PMH+N arm (P values <.02). Parent stress interacted with PMH+N vs CTL+N intervention to predict lower TWT positive parenting and child healthy food intake in the CTL+N arm (-1.74 [-3.26, -0.22] and -3.41 [-7.25, 0.42], respectively). Targeting parent stress with healthy nutrition is effective in preventing short-term early childhood obesity risk and in improving positive parenting and child healthy food intake. Further assessment of long-term effects of the PMH+N intervention on early childhood risk is warranted. (Clinical Trials Registration: NCT03950453).

Early childhood physical activity and sedentary behavior influence long-term health, yet evidence on interventions targeting how these behaviors are accumulated - rather than just total time - is limited. This study examined the impact of a parent-focused early childhood obesity prevention intervention on preschoolers' physical activity and sedentary behavior patterns. This study is a secondary analysis of data from the Melbourne Infant Feeding, Activity and Nutrition Trial [InFANT] clustered randomized control trial (2008-2013). Physical activity and sedentary behavior data were gathered using ActiGraph™ GT1M accelerometers. To capture insights beyond total time and examine accumulation patterns, the duration and frequency of sedentary bouts [≤100 counts per minute (cpm)], light-intensity physical activity (101-1,680 cpm) bouts, and moderate- to vigorous-intensity physical activity (≥1,681 cpm) bouts, each lasting ≥1 min, as well as the total number of sedentary breaks, were calculated at each time point. The ≥1 min cut-offs for bout durations were defined based on the medians observed in this sample (0.50 min for sedentary, 0.47 min for light-, 0.25 min for moderate- to vigorous-intensity physical activity). Multilevel regression analyses were fitted to examine intervention effects at 19 months (T3), and 3.5 (T4) and 5 (T5) years of age. In total, 296, 144 and 140 participants had valid accelerometry data and were included in the analytical sample at T3, T4 and T5, respectively. The intervention had a significant and beneficial effect on the total amount of sedentary breaks at 3.5 (β[95%CI] = 10.9[2.98,18.91) and 5 years (β[95%CI] = 7.94[0.03,15.86). The intervention effects on all other outcomes were small and not significant. Whilst only effects on sedentary breaks were observed, this study suggests that interventions may impact accumulation patterns in children under five. The Melbourne Infant Feeding, Activity and Nutrition Trial was registered with the International Standard Randomized Controlled Trial Number Register (ISRCTN81847050; 7/11/2007).

Parents, as the most proximal influence on young children, play an important role in shaping toddler behaviors. Yet, evidence on how parents shape toddler screen use is limited. Little is also known about the relationship between toddler screen use and BMI. Given existing disparities in screen use and early childhood obesity, a focus on Mexican American families with toddlers is warranted. This study aimed to evaluate the independent contributions of both maternal screen use and screen-related parenting practices with toddler screen use duration, for both TV viewing and mobile device use, and examine the relationship between toddler screen use duration and BMI. This cross-sectional study enrolled 384 Mexican American mother-toddler dyads recruited from safety net clinics. Enrolled mothers completed 7-day screen use diaries and surveys on screen-related parenting practices, and toddler anthropometrics were obtained. Negative binomial regression models estimated the relationships between screen-related parenting practices and maternal screen use (predictors) with child duration of daily TV use and mobile device use (outcomes). Spearman correlations were calculated to estimate the relationship between toddler screen use duration and age- and sex-specific BMI z scores. Maternal duration of daily TV and mobile device use were associated with toddler duration of daily TV (adjusted rate ratios [aRRs] 1.27-1.28; all P<.001) and mobile device use (aRRs 1.17-1.18; all P<.001), respectively, even after adjusting for maternal screen-related parenting practices. Specific parenting practices, including restriction of TV time (aRR=0.86; P=.01), restriction of mobile device time (aRR=0.80; P=.02), use of TV (aRR=1.27; P=.003) and mobile devices (aRR=1.78; P<.001) for child behavior regulation, and coviewing of mobile devices (aRR=1.51; P<.001), were associated with toddler duration of daily screen use, adjusted for maternal duration of daily screen use. Neither toddler duration of daily TV viewing nor daily mobile device use was correlated with toddler BMI z scores. Both the duration of maternal screen use and screen-related parenting practices, for both TV and mobile devices, should be considered when promoting healthy screen use in toddlers in Mexican American families. Interventionists should consider the family ecology when designing interventions promoting healthy screen use in early childhood.

This community service program aims to enhance the capacity of parents at TK Melati Indah, Pekanbaru, in implementing balanced nutrition based on local food to address early childhood obesity and unhealthy lunch box patterns. The method was conducted in four stages: identification and pre-testing, interactive education on "Isi Piringku" (My Plate) menu management, cooking demonstrations using local ingredients (such as catfish), and online mentoring.The results showed a significant increase in parents' knowledge, with average scores rising from 55 (fair) to 88 (excellent). Furthermore, there was a notable behavioral shift, characterized by a decrease in the use of double carbohydrates and improved compliance in including animal protein and vegetables in children's lunch boxes. This program demonstrates that nutritional literacy effectively optimizes local food potential to support children's growth and development during the golden age.

Practice guidelines for Australian primary health professionals (PHPs) highlight their crucial role in preventive care. However, PHPs report a lack of knowledge and skills regarding early childhood obesity prevention. This study aimed to identify the training needs of Australian PHPs - including child and family health nurses (CFHNs), general practitioners, general practice nurses and other community-based health professionals - to support early childhood health promotion and obesity prevention. From August 2022 to July 2023, PHPs were recruited to participate in an online survey and semi-structured interviews. Quantitative data was analysed descriptively and qualitative data analysed using reflexive thematic analysis. 227 PHPs returned a survey (46% CFHNs) and 28 were interviewed (13 CFHNs). Almost a quarter (23%) of participants had not received any continuing education regarding early childhood health behaviours and obesity prevention, with general practice professionals less likely to have participated in such education. PHPs identified a need to develop skills in growth assessment and working with children at risk of obesity. Digital and visual parent-facing resources were required to support PHPs' discussions of child health behaviours. Important components of education were case studies, self-paced learning, and live interactive discussions (37-46% of PHPs rated as highly important). PHPs sought interactive education activities from reputable service providers and reported time and cost were barriers to education. Australian PHPs require access to evidence-based education and resources to support early childhood health promotion and obesity prevention. Professional education providers should prioritize interactive and flexible modes of delivery.

Associations between 24-hour movement behaviors and overweight/obesity risk among children aged 2-6years.

Obesity in early childhood has become an increasing health issue that significantly affects children’s physical, cognitive, and emotional development. This condition results from an imbalance between energy intake and physical activity and is influenced by dietary patterns, family environment, parenting, technology exposure, and biological factors. Childhood obesity disrupts not only physical health but also impacts attention, memory, focus, and emotional regulation. This study uses a literature review method by analyzing various research related to childhood obesity and its developmental effects. Findings reveal that obesity reduces brain activity, decreases learning performance, and increases risks of anxiety and low self-esteem. Prevention strategies include monitoring dietary intake, increasing physical activity, applying healthy parenting styles, and strengthening collaboration between families and educational institutions. In conclusion, obesity poses a serious threat to children’s development and requires strong parental involvement in early prevention.

This review summarises evidence from cohort and intervention studies on the relationships between nutrition in early life, epigenetics and lifelong health. Established links include maternal diet quality with conception rates, micronutrient sufficiency before and during pregnancy with preterm birth prevention, gestational vitamin D intake with offspring bone health, preconception iodine status with child IQ, adiposity with offspring obesity and maternal stress with childhood atopic eczema. Animal studies demonstrate that early-life environmental exposures induce lasting phenotypic changes via epigenetic mechanisms, including DNA methylation, histone modifications and non-coding RNA, with DNA methylation of non-imprinted genes most extensively studied. Human data show that nutrition during pregnancy induces epigenetic changes associated with childhood obesity risk, such as Antisense long Non-coding RNA in the INK4 Locus (ANRIL, a long non-coding RNA) methylation variations linked to obesity and replicated across multiple populations. Emerging insights reveal that paternal nutrition and lifestyle also modify sperm epigenomics and influence offspring development. Although nutritional-randomised trials in pregnancy remain limited, findings from the NiPPeR trial showed widespread preconception micronutrient deficiencies and indicated that maternal preconception and pregnancy nutritional supplementation can reduce preterm birth and early childhood obesity. The randomised trials UPBEAT and MAVIDOS have shown that nutritional intervention can impact offspring epigenetics. Postnatal nutritional exposures further influence offspring epigenetic profiles, exemplified by ALSPAC cohort findings linking rapid infant weight gain to later methylation changes and increased obesity risk. Together, these studies support a persistent impact of maternal and early-life nutrition on child health and development, underpinned by modifiable epigenetic processes.

Childhood obesity already affects ~8-9 % of 2 to 5 year‑olds and predicts later cardiometabolic disease. This review a) clarifies current diagnostic criteria for preschool obesity; b) maps key environmental and behavioral drivers; and c) assesses nutrition‑focused interventions delivered at family, preschool and policy levels. BMI for age still underpins WHO, CDC and IOTF charts; severe obesity cut offs and waist measures refine risk. Obesogenic pressures arise from energy‑dense home diets, fast food outlets, poor produce access and persuasive digital marketing. Roughly 40 RCTs show that high‑intensity (≥25 h) family programs pairing parental skill‑building with home food restructuring lower BMI‑z by up to -0.59 and maintain ≈ -0.20 after 2 y. Preschool curricula shave -0.10 to -0.12 BMI‑z across populations. Fiscal levers sugar‑sweetened‑beverage taxes, meal standards, front‑of‑pack warnings and advertising restrictions produce small but often equity‑enhancing shifts and act synergistically with micro‑environmental changes. Evidence favors early, layered action: precise growth surveillance, intensive family‑centered treatment, healthy preschool food policies and equity‑oriented regulation. Scaling integrated bundles with high fidelity and long follow‑up could curb the projected 42 % rise in early childhood obesity by 2035. Research needs include cost‑effectiveness of digital adjuncts, natural experiment tests of zoning and marketing reforms, and systems models quantifying interactive impacts of combined policy packages.

Purpose This study aimed to evaluate national trends in central precocious puberty (CPP) incidence in Korean children and to examine the association between early childhood obesity and CPP using linked population-based datasets.Methods Data were obtained from the National Health Insurance Service (NHIS, 2012–2020) and the Infant/Toddler Health Check-up Program (2013–2016). CPP was defined operationally as having an International Classification of Diseases, 10th Revision code for precocious puberty, NHIS registration for CPP, and at least one year of gonadotropin-releasing hormone agonist treatment initiated before age 8 in girls and 9 in boys. Children with at least 3 health screenings before 6 years of age were included for body mass index (BMI) analysis. Multivariable logistic regression was used to estimate odds ratios (ORs) for CPP across BMI categories.Results A total of 195,892 CPP cases were identified. The incidence of CPP increased steadily from 2012 to 2020 in both sexes. In BMI analysis (n=35,766), CPP risk was significantly higher in the overweight (85th–94th percentile) and obese (≥95th percentile) groups compared to the normal-weight group (5th–84th percentile). The association was strongest in obese boys (OR, 2.573; 95% confidence interval, 2.417–2.739). Underweight status (<5th percentile) was associated with reduced CPP risk.Conclusions CPP incidence in Korea has increased in recent years. Early childhood obesity is a strong, independent risk factor for CPP, particularly in boys. Early weight management strategies may help reduce CPP risk.a

Aim: Childhood obesity is an escalating global health concern. Identifying modifiable risk factors is crucial to inform effective prevention strategies. This study explored lifestyle behaviors, including chrono-nutrition and sedentary behaviors, associated with overweight/obesity among Saudi pre-school children. Methods: This cross-sectional study of 450 children aged 3-6 years from 20 pre-schools assessed chrono-nutrition, sedentary, and sleep behaviors through questionnaires filled by parents/guardians. Height, weight, and skinfold thickness were measured. BMI was calculated using International Obesity Task Force classifications for children aged 2-18. Results: Overweight/obesity prevalence in preschoolers was 22.67%. Weight, skinfold, and body fat percentage were significantly higher among the overweight/obese group (p&lt;0.001). A significant association (p=0.009) was observed between sleeping time and BMI. However, insignificant associations were observed between BMI and chrono-nutrition or physical activity. Logistic regression analysis revealed that evening (OR=0.142, 95%CI: 0.024-0.834, p=0.031) and irregular screen time (OR=0.162, 95%CI: 0.036-0.730, p=0.018) as well as more than two hours of napping (OR=0.268, 95%CI: 0.073-0.987, p=0.048) were associated with lower odds of overweight or obesity status. Conclusions: Selected lifestyle behaviors exhibited significant associations with lower overweight/obesity among preschoolers. Future studies on pre-school children's lifestyle behaviors are warranted to enhance preventive health education and health promotion among young children.