Early Childhood Obesity Research Articles

Trajectory of Obesity and the Impact of Eating Behaviors on Obesity in Preschool Children: A Nationwide Population-Based Cohort Study in Korea

Background: Early childhood obesity is highly associated with obesity in adolescents and adults. However, studies on specific eating behaviors that have a decisive effect on obesity in early childhood (aged 3–5 years) are scarce. We hypothesized that critical risk factors associated with eating behaviors leading to obesity at ages of 3–5 years may be different. To confirm this hypothesis, we conducted a study on the risk factors of obesity related to eating behaviors in preschool children. Methods: Using the National Health Screening Program for Infants and Children (NHSPIC) in Korea’s general population cohort, we found the obesity trends in 3–5-year-olds. The risk factors of obesity in 3–5-year-olds were analyzed through logistic regression. Results: Among children with obesity at 3 years old, but without obesity at 4 years old, only 10.1% (107/1063) transitioned to obesity at 5 years old, whereas among children with obesity at 3–4 years old, 62.7% (398/635) transitioned to obesity at 5 years old. The risk factors for obesity at 3 years old were inclusion of meat in complementary food, prolonged breastfeeding, and consumption of sweetened beverages; at ages 4–5 years, the risk factors were the inclusion of meat in complementary food and consumption of sweetened beverages. Conclusions: Obesity at 4 years is more likely to lead to obesity in the following year than obesity at 3 years. The dietary factor with the greatest impact on obesity in children aged 3–5 years has been found to be consumption of sweetened beverages.

Sharing the motherload: A review and development of the CO-Parent conceptual model for early childhood obesity prevention.

Fathers remain under-represented in early childhood obesity prevention research and interventions, despite growing evidence that paternal biopsychosocial factors and behaviors from pre- and post-conception can influence lifelong offspring health. Informed by a literature review of high-quality evidence, "CO-Parent" (childhood obesity-Parent) is a new conceptual model underpinned by couple interdependence theory and a socioecological framework. Literature was searched for the concepts parental AND weight-related behaviors AND child weight or weight-related behaviors, in databases including MEDLINE, PsycINFO, Global Health, Scopus, and SocINDEX. Prior evidence syntheses were prioritized as source data to inform model development. "CO-Parent" illustrates the interdependent and independent effects of maternal and paternal weight, weight-related behaviors, and well-being, across preconception, pregnancy, postpartum, and the early years on child weight-related behaviors and weight up to age five. The influences of public policy, social, environmental, economic, community, and other complex modifiable mediating factors are included in the model. The "CO-Parent" conceptual model paves the way for a paradigm shift by recognizing fathers as key figures in early childhood obesity prevention initiatives, encouraging them to "share the motherload." It highlights both the independent and interdependent roles fathers play in the epidemiology of obesity starting from preconception. CO-Parent also provides the foundations necessary to guide future theory and research to be more inclusive of fathers to further understanding of the independent and interdependent influences of parents in early childhood obesity prevention.

A randomized controlled trial to test the efficacy of a brief Triple P discussion group to increase healthy feeding practices and reduce risk factors for infant obesity.

Test the efficacy of a brief 2-hr parenting intervention in increasing protective factors against and reducing risk factors for infant obesity. A 2 (Baby Healthy Living Triple P vs. care-as-usual) × 3 (baseline, postintervention, 6-month follow-up) design was used. Eighty-two parents of 4- to 18-month-old infants meeting at least two risk factors for early childhood obesity (e.g., parent/child overweight, low education level) were randomized to intervention (n = 42) or control group (n = 40). Parents questionnaires and child weight status was measured. Results showed an intervention effect on a primary outcome, early feeding practices (restrictive: d = 0.44, 95% CI [-0.01,0.88], pressuring: d = 0.11, 95% CI [-0.32,0.54], nonresponsive behaviors: (d = 0.32, 95% CI [-0.11,0.75]), and on a secondary outcome, feeding beliefs (d = 0.29, 95% CI [-0.14,0.73]). No beneficial impact was found on other primary outcomes (responsiveness in feeding: quantity d = 0.50, 95% CI [-0.03,1.03]) and nutritive d = 0.52, 95% CI [-0.03,1.07], mealtime environment: d = 0.35, 95% CI [-0.78,0.08], self-efficacy in responsive feeding: d = 0.21, 95% CI [-0.22,0.64]), or secondary outcomes (parental self-efficacy: d = 0.08, 95% CI [-0.50,0.35]), parent emotional eating (d = 0.01, 95% CI [-0.43,0.43]), food restraint (d = 0.42, 95% CI [-0.85,0.02]), and body satisfaction (d = 0.01, 95% CI [-0.43,0.43]) and child weight status (d = 0.11, 95% CI [-0.54,0.32]). Promising though limited support was demonstrated for a brief, low-intensity program to help parents in the prevention of obesity for infants at risk.

Childhood Obesity, Weight Change, and Pediatric Immune-Mediated Skin Diseases.

Whether childhood obesity or weight gain leads to the development of pediatric immune-mediated skin diseases remains unclear. We aimed to determine the associations between body mass index or body mass index changes and the development of 3 main immune-mediated skin diseases-alopecia areata, atopic dermatitis (AD), and psoriasis-by analyzing a longitudinal cohort of 2,161,900 Korean children from 2009 to 2020. The findings indicated that children who were obese had a higher risk of pediatric immune-mediated skin diseases than those with normal weight (P for trend < .01). An increase in body mass index was associated with a higher risk of AD, whereas a decrease in body mass index was correlated with a reduced risk of AD. Children who gained weight, transitioning from normal to overweight, exhibited a higher AD risk than those who maintained a normal weight (adjusted hazard ratio= 1.15, 95% confidence interval= 1.11-1.20). However, those who shifted from being overweight to achieving a normal weight (adjusted hazard ratio= 0.87, 95% confidence interval= 0.81-0.94) had a lower AD risk than children who were overweight who maintained their weight. In summary, early childhood obesity may increase the risk of pediatric immune-mediated skin diseases. Weight gain may increase AD risk, whereas weight loss may lower the risk.

Placental DNA Methylation Associated with Early Childhood Growth Trajectories and Obesity Risk

Placental DNA Methylation Associated with Early Childhood Growth Trajectories and Obesity Risk

Placental Gene Expression Associated with Early Childhood Growth Trajectories and Obesity Risk

Placental Gene Expression Associated with Early Childhood Growth Trajectories and Obesity Risk

219 - Identifying primary health professionals’ training needs to support early childhood obesity prevention in Australia

219 - Identifying primary health professionals’ training needs to support early childhood obesity prevention in Australia

218 - A comparison of early childhood obesity prevention in Australia between general practice and child and family health nursing services: a mixed methods study

218 - A comparison of early childhood obesity prevention in Australia between general practice and child and family health nursing services: a mixed methods study

Umbilical miRNAs Stratify Risk of Early Childhood Obesity Among Offspring of Mothers with Pre-Pregnancy Overweight/Obesity

Umbilical miRNAs Stratify Risk of Early Childhood Obesity Among Offspring of Mothers with Pre-Pregnancy Overweight/Obesity

208 - How can evidence-based early childhood obesity prevention programs achieve adoption, integration and scale-up: A comparative case study

208 - How can evidence-based early childhood obesity prevention programs achieve adoption, integration and scale-up: A comparative case study

The Gut Microbiome in Early Childhood Obesity: Exploring the Role of Diet and Probiotics - An Observational Study in Palembang, Indonesia

Introduction: Early childhood obesity is a growing public health concern, with the gut microbiome emerging as a potential contributing factor. Diet and probiotics hold promise in modulating the gut microbiome and potentially influencing obesity risk. This study investigated the associations between dietary patterns, gut microbiome composition, and the use of probiotics in early childhood obesity in Palembang, Indonesia. Methods: An observational study was conducted in Palembang, involving 150 children aged 2-5 years, categorized into obese and non-obese groups based on WHO growth standards. Dietary intake was assessed using a 3-day food record, gut microbiome composition was analyzed via 16S rRNA sequencing of fecal samples, and probiotic use was documented through questionnaires. Statistical analyses, including multivariate regression and microbiome diversity metrics, were employed to explore associations. Results: Obese children displayed significantly lower gut microbiome diversity compared to non-obese children (p &lt; 0.05). Dietary patterns rich in processed foods and sugary drinks were associated with altered gut microbiome composition, characterized by increased abundance of Firmicutes and decreased Bacteroidetes (p &lt; 0.01). Probiotic use was associated with improved gut microbiome diversity and a trend towards reduced obesity risk (p = 0.07). Conclusion: This study provides evidence linking dietary patterns, gut microbiome composition, and probiotic use to early childhood obesity in Palembang, Indonesia. Promoting healthy dietary choices and considering probiotic supplementation may offer potential strategies for obesity prevention in this population. Further research is warranted to establish causality and explore the long-term impact of interventions targeting the gut microbiome in early childhood obesity.

Centre-based childcare in early childhood and child obesity: systematic review and meta-analysis protocol

ObjectivesCentre-based childcare has been identified as a promising environment for obesity prevention in early childhood, but the longitudinal relationships between attending centre-based childcare and child obesity are not well understood....

Validation of Variables for Use in Pediatric Obesity Risk Score Development in Demographically and Racially Diverse United States Cohorts

ObjectiveTo evaluate the performance of childhood obesity prediction models in four independent cohorts in the United States, using previously validated variables obtained easily from medical records as measured in different clinical settings. Study designData from four prospective cohorts, Latinx, Eating, and Diabetes (LEAD); Stress in Pregnancy Study (SIPS); Project Viva; and Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) were used to test childhood obesity risk models and predict childhood obesity by ages 4 through 6, using five clinical variables (maternal age, maternal pre-pregnancy body mass index, birth weight Z-score, weight-for-age Z-score change, and breastfeeding), derived from a previously validated risk model and as measured in each cohort’s clinical setting. Multivariable logistic regression was performed within each cohort, and performance of each model was assessed based on discrimination and predictive accuracy. ResultsThe risk models performed well across all four cohorts, achieving excellent discrimination. The area under the receiver operator curve (AUROC) was 0.79 for CHAMACOS and Project Viva, 0.83 for SIPS, and 0.86 for LEAD. At a 50th percentile threshold, the sensitivity of the models ranged from 12 to 53%, and specificity was greater than or equal to 90%. The negative predictive values (NPV) were ≥ 80% for all cohorts, and the positive predictive values (PPV) ranged from 62-86%. ConclusionAll four risk models performed well in each independent and demographically diverse cohort, demonstrating the utility of these five variables for identifying children at high risk for developing early childhood obesity in the United States.

Laparoscopic sleeve gastrectomy in a 2-year-old child with morbid obesity: A case report with a 2-year follow-up.

Morbid obesity in infancy or early childhood is a challenging disease to manage. Here, we present the case report of the successful management of a 2-year-old girl child with morbidly obesity who was bedridden and had sleep apnoea and underwent laparoscopic sleeve gastrectomy. Bariatric surgery in this age group comes with a lot of decision-making challenges and technical and ethical considerations, and literature is scant on paediatric bariatric surgery. We describe the case and associated challenges in detail in this report.

Maternal Serum Metabolomics in Mid-Pregnancy Identifies Lipid Pathways as a Key Link to Offspring Obesity in Early Childhood.

Maternal metabolism during pregnancy shapes offspring health via in utero programming. In the Healthy Start study, we identified five subgroups of pregnant women based on conventional metabolic biomarkers: Reference (n = 360); High HDL-C (n = 289); Dyslipidemic-High TG (n = 149); Dyslipidemic-High FFA (n = 180); Insulin Resistant (IR)-Hyperglycemic (n = 87). These subgroups not only captured metabolic heterogeneity among pregnant participants but were also associated with offspring obesity in early childhood, even among women without obesity or diabetes. Here, we utilize metabolomics data to enrich characterization of the metabolic subgroups and identify key compounds driving between-group differences. We analyzed fasting blood samples from 1065 pregnant women at 18 gestational weeks using untargeted metabolomics. We used weighted gene correlation network analysis (WGCNA) to derive a global network based on the Reference subgroup and characterized distinct metabolite modules representative of the different metabolomic profiles. We used the mummichog algorithm for pathway enrichment and identified key compounds that differed across the subgroups. Eight metabolite modules representing pathways such as the carnitine-acylcarnitine translocase system, fatty acid biosynthesis and activation, and glycerophospholipid metabolism were identified. A module that included 189 compounds related to DHA peroxidation, oxidative stress, and sex hormone biosynthesis was elevated in the Insulin Resistant-Hyperglycemic vs. the Reference subgroup. This module was positively correlated with total cholesterol (R:0.10; p-value < 0.0001) and free fatty acids (R:0.07; p-value < 0.05). Oxidative stress and inflammatory pathways may underlie insulin resistance during pregnancy, even below clinical diabetes thresholds. These findings highlight potential therapeutic targets and strategies for pregnancy risk stratification and reveal mechanisms underlying the developmental origins of metabolic disease risk.

Sex-Specific Associations of Ultra-Processed Food Intake With Obesity in Early-Childhood

Sex-Specific Associations of Ultra-Processed Food Intake With Obesity in Early-Childhood

Child Care Center Staff Readiness to Change in an Early Childhood Obesity Prevention Program.

The childcare center (CCC) setting has the potential to be a strong foundation that supports the introduction of sustainable healthy lifestyle behaviors to prevent childhood obesity. It is important to assess barriers and facilitators to healthy weight development initiatives via program evaluation, including measuring CCC staff readiness to change. The overall goal of this study was to assess the readiness level over 1 school year among CCC staff who participated in "Healthy Caregivers-Healthy Children" (HC2), a cluster randomized controlled trial that evaluated the effectiveness of a childhood obesity prevention program from 2015 to 2018 in 24 low-income, racially/ethnically diverse centers. A secondary outcome was to assess how a CCC's stage of readiness to change was associated with CCC nutrition and physical activity environment, measured via the Environment and Policy Assessment and Observation (EPAO) tool. Mixed-models analysis with the CCC as the random effect assessed the impact of readiness to change over time on EPAO outcomes. Eighty-eight CCC teachers and support staff completed the HC2 readiness to change survey in August 2015 and 68 in August 2016. Only teachers and staff randomized to the treatment arm of the trial were included. Readiness to change and the EPAO. Results showed the majority of CCC staff in advanced stages of readiness to change at both time points. For every increase in readiness to change stage over 1 year (eg, precontemplation to contemplation), there was a 0.28 increase in EPAO nutrition scores (95% confidence interval [CI], 0.04-0.53; P = .02) and a 0.52 increase in PA score (95% CI, 0.09-0.95; P = .02). This analysis highlights the importance between CCC staff readiness to change and the CCC environment to support healthy weight development. Future similar efforts can include consistent support for CCC staff who may not be ready for change to support successful outcomes.

Infant Feeding Outcomes From a Culturally-Adapted Early Obesity Prevention Program for Immigrant Chinese American Parents

ObjectiveTo examine whether a cultural adaptation of an early childhood obesity prevention program promotes healthy infant feeding practices. MethodsProspective quasi-experimental study of a community-engaged multiphasic cultural adaptation of an obesity prevention program set at a federally qualified health center serving immigrant Chinese American parent-child dyads (N = 298). In a group of historical controls, we assessed early infant feeding practices (breastfeeding, sugar-sweetened beverage intake) in 6-month-olds and then the same practices alongside early solid food feeding practices (bottle weaning, fruit, vegetable, sugary or salty snack consumption) in 12-month-olds. After implementation, we assessed these practices in an intervention cohort group at 6 and 12 months. We used cross-sectional groupwise comparisons and adjusted regression analyses to evaluate group differences. ResultsAt 6 months, the intervention group had increased odds of no sugar-sweetened beverage intake (aOR: 5.69 [95% confidence interval (CI): 1.65, 19.63], P = .006). At 12 months, the intervention group also had increased odds of no sugar-sweetened beverage intake (aOR: 15.22 [95% CI: 6.33, 36.62], P < .001), increased odds of bottle weaning (aOR: 2.34 [95% CI: 1.05, 5.23], P = .03), and decreased odds of sugary snack consumption (aOR: 0.36 [0.18, 0.70], P = .003). We did not detect improvements in breastfeeding, fruit, vegetable, or salty snack consumption. ConclusionsA cultural adaptation of a primary care-based educational obesity prevention program for immigrant Chinese American families with low income is associated with certain healthy infant feeding practices. Future studies should evaluate cultural adaptations of more intensive interventions that better address complex feeding practices, such as breastfeeding, and evaluate long-term weight outcomes.

Mapping The Landscape of Childhood Obesity Research: Insights from A Comprehensive Bibliometric Analysis in Scopus Journals

This study aims to determine the development of scientific publications, mapping the scope and theme of publications related to obesity in early childhood published in Scopus-indexed journals from 2013-2023. This study uses the Scopus database which is retrieved using the publish or perish application. From the results of data extraction, 200 articles were obtained with keywords in the article titled Childhood Obesity. This research uses keyword co-occurrence analysis to identify and explore the main fields and topics that appear in publications. The application used to analyze the data is Vos Viewer. Based on the results of the analysis, 7 clusters were obtained. This study provides information to researchers, especially researchers in Indonesia about publication trends related to Childhood obesity. It is hoped that this research can be a foundation for further research, scientific development, and implementation in the fields of early childhood, health, and physical education. Keywords: childhood obesity, early childhood education, bibliometrics.

Examination of community-level interventions addressing early childhood obesity in Los Angeles County

ObjectiveTo help inform decisions regarding the equitable implementation of obesity interventions, we examined whether interventions were equitably reaching the most vulnerable communities, identified communities that received fewer interventions than expected, and estimated the effect of ‘dose’ of interventions on obesity prevalence. MethodsWe created a database to identify and characterize obesity-related interventions implemented in Los Angeles County from 2005 to 2015 linked to community-level sociodemographic and obesity prevalence data. We ran generalized linear models with a Gamma distribution and log link to determine if interventions were directed toward vulnerable communities and to identify communities that received fewer interventions than expected. We ran fixed-effects models to estimate the association between obesity prevalence and intervention strategy count among preschool-aged children enrolled in the Special Supplemental Nutrition Assistance Program for Women Infants and Children. ResultsWe found that interventions targeted vulnerable communities with high poverty rates and percentages of minority residents. The small cluster of communities that received fewer interventions than expected tended to have poor socioeconomic profiles. Communities which received more intervention strategies saw greater declines in obesity prevalence (β = -0.023; 95 % CI: −0.031, −0.016). ConclusionsIt is important to determine if interventions are equitably reaching vulnerable populations as resources to tackle childhood obesity become available. Evaluating the population impact of multiple interventions implemented simultaneously presents methodological challenges in measuring intervention dose and identifying cost-effective strategies. Addressing these challenges must be an important research priority as community-wide interventions involve multiple intervention strategies to reduce health disparities.