Impact Of Childhood Obesity Research Articles

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

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

Mendelian randomization analysis separated the independent impact of childhood obesity and adult obesity on socioeconomic status, psychological status, and substance use

BackgroundObesity is linked to a variety of psychosocial and behavioral outcomes but the causalities remain unclear yet. Determining the causalities and distinguishing between the separate effects of childhood and adult obesity is critical to develop more targeted strategies to prevent adverse outcomes. MethodsWith single nucleotide polymorphisms (SNPs) used as genetic variables, we employed univariable Mendelian randomization (UVMR) to explore the causalities between childhood and adult body mass index (BMI) and socioeconomic status, psychological status, and substance use. Genetic data for childhood and adult BMI came respectively from 47,541 children aged 10 years and 339,224 adult participants. The outcome data were obtained from corresponding consortia. The direct impact of childhood BMI and adult BMI was then examined using a multivariable MR (MVMR). ResultsUVMR found that higher childhood BMI was linked causally to lower household income (β = −0.06, 95 % CI = −0.08 ∼ −0.03, P = 4.86 × 10−5), decreased subjective well-being (β = −0.07, 95 % CI = −0.12 ∼ −0.03, P = 1.74 × 10−3), and an increased tendency of smoking regularly (OR = 1.12, 95 % CI = 1.04–1.20, P = 1.52 × 10−3). Similar results were observed in adult BMI. MVMR further revealed that after adjusting with adult BMI, childhood BMI remained an isolated impact on household income. The impacts of adult BMI on the outcomes were diminished when adjusting with childhood BMI. ConclusionThe findings indicate the impacts of childhood obesity on subjective well-being and smoking initiation are a result of higher BMI sustaining into adulthood, whereas the effect on household income is attributed to a lasting impact of obesity in early life. The results would help facilitate more targeted strategies for obesity management to prevent adverse outcomes.

Obese boys penile length: is it micropenis or just Buried?

Background Obesity in childhood is an escalating public health crisis with profound implications, including potential impacts on penile development. This study aimed to measure penile size in obese children and adolescents to detect the presence of micropenis and buried penis. Methods An observational cross-sectional study was conducted on 680 obese boys (BMI >95th percentile) aged 9.4±3.22 years. Stretched penile length (SPL) was measured using a conventional method. Anthropometric measurements, laboratory tests, and penile length categorization (normal, micropenis, buried penis) were performed. Results Sixty percent of participants had normal penile length, while 9.12% were diagnosed with micropenis, and 30.88% had buried penis. SPL positively correlated with age, weight, height, and BMI but negatively with height and BMI Z-scores. No significant correlations were found between SPL and glycated hemoglobin or impaired glucose tolerance diagnosis. Dyslipidemia and impaired glucose metabolism were observed. Conclusions and recommendations A high prevalence of micropenis and buried penis among obese boys underscores the profound impact of childhood obesity on penile development. Early screening and management strategies are crucial to mitigate long-term consequences. Adopting a multidisciplinary approach, involving pediatric endocrinologists, urologists, and psychologists, ensures a holistic treatment addressing both physical and psychological aspects of the condition. Furthermore, individualized treatment plans should be developed, potentially incorporating hormonal therapy, surgical interventions, or a combination of both.

Childhood Obesity: Insight into Kidney Involvement.

This review examines the impact of childhood obesity on the kidney from an epidemiological, pathogenetic, clinical, and pathological perspective, with the aim of providing pediatricians and nephrologists with the most current data on this topic. The prevalence of childhood obesity and chronic kidney disease (CKD) is steadily increasing worldwide, reaching epidemic proportions. While the impact of obesity in children with CKD is less pronounced than in adults, recent studies suggest a similar trend in the child population. This is likely due to the significant association between obesity and the two leading causes of end-stage renal disease (ESRD): diabetes mellitus (DM) and hypertension. Obesity is a complex, systemic disease that reflects interactions between environmental and genetic factors. A key mechanism of kidney damage is related to metabolic syndrome and insulin resistance. Therefore, we can speculate about an adipose tissue-kidney axis in which neurohormonal and immunological mechanisms exacerbate complications resulting from obesity. Adipose tissue, now recognized as an endocrine organ, secretes cytokines called adipokines that may induce adaptive or maladaptive responses in renal cells, leading to kidney fibrosis. The impact of obesity on kidney transplant-related outcomes for both donors and recipients is also significant, making stringent preventive measures critical in the pre- and post-transplant phases. The challenge lies in identifying renal involvement as early as possible, as it is often completely asymptomatic and not detectable through common markers of kidney function. Ongoing research into innovative technologies, such as proteomics and metabolomics, aims to identify new biomarkers and is constantly evolving. Many aspects of pediatric disease progression in the population of children with obesity still require clarification. However, the latest scientific evidence in the field of nephrology offers glimpses into various new perspectives, such as genetic factors, comorbidities, and novel biomarkers. Investigating these aspects early could potentially improve the prognosis of these young patients through new diagnostic and therapeutic strategies. Hence, the aim of this review is to provide a comprehensive exploration of the pathogenetic mechanisms and prevalent pathological patterns of kidney damage observed in children with obesity.

Childhood Obesity and Essential Micronutrients: Insights from India's Comprehensive National Nutrition Survey (2016-18).

Based on the long-term impact of childhood obesity, there is a compelling need to assess the burden of obesity and micronutrient deficiency and the interactions between the two. Thus, the aims of the study were to estimate the prevalence of overweight and obese children and adolescents to compare micro-nutrient levels in these children with normal and underweight categories and explore the factors affecting overweight and obesity in the presence of micronutrient deficiencies. Secondary data analysis of theComprehensive National Nutrition Survey-India (2017-2018) was done. The survey recorded information from 112,245 preschool children (6-60months), school age children (5-9years), and adolescents (10-19years). Half of these participants were invited for biochemical testing and were included in our analysis. The presence of overweight or obesity and micronutrient (serum erythrocyte folate; vitamin B12, A, and D; ferritin; zinc; and urinary iodine) deficiencies were the primary outcomes. The secondary outcome included the mean serum levels and predictors of overweight and obesity in the presence of micronutrient deficiencies. Of the 38,060, 38,355, and 35,830 preschool, school-age, and adolescent study participants, about 2.69, 4.18, and 4.99% were overweight or obese. We observed significant variations in the mean folate and vitamin B12 levels among the overweight and obese preschool and school-age children compared to the normal weight group. School-age children exhibited significant differences in all micronutrient levels. In contrast, adolescents only showed substantial differences in vitamin D and A and serum ferritin levels. The predictors of overweight and obesity included geographical locations, wealth quintiles, and societal castes. Iron, folate, vitamin D, and zinc levels significantly affect the odds of developing childhood overweight and obesity. It is vital to halt the growing burden of childhood overweight and obesity. Addressing micronutrient deficiencies can help us bring a sustainable and feasible approach to managing this menace.

Television viewing and body fat distribution among Bengali school children of Kolkata, India

Background: Childhood obesity is considered as a major concern since a couple of decades. The increasing prevalence of childhood obesity is clear and concerns about the future health impact of childhood obesity are currently well documented. Low level of physical activity, high quantity of fat rich junk food consumption and prolonged leisure time with television (TV) viewing were reported to be significantly associated with obesity.
 Objective: The present study aims to evaluate the association of body fat distribution with television watching among school going Bengali children of Kolkata, India.
 Sample and Methods: 200 girls (aged 10-15 years) from a very heterogeneous background were selected from one state school. Data on socio-demographic aspects, TV viewing, computer use, physical activity and dietary pattern were collected by pretested questionnaire after obtaining prior consent from competent persons. Anthropometric measurements were taken following standard techniques.
 Results: Most of the participants preferred fat rich junk food and a few practice regular exercises. One-way ANOVA showed significant differences of body mass index (BMI), waist circumference (WC) and mid upper arm circumference (MUAC) between groups depending on the duration of TV viewing. The adiposity related variables were standardized by standard deviation score before the inferential analyses. Adjusted multiple linear regression showed positive effects of the duration of TV viewing on BMI (R2=0.233) and MUAC (R2=0.277).
 Conclusion: Irrespective of economic status, prolonged television watching leads to an adverse body fat distribution among teenage girls of Kolkata.

The Effect of Childhood Obesity or Sarcopenic Obesity on Metabolic Syndrome Risk in Adolescence: The Ewha Birth and Growth Study.

The prevalence of obesity and metabolic syndrome (MetS) in the pediatric population has increased globally. We evaluated the impact of childhood obesity and sarcopenic obesity on the risk of MetS in adolescence using the Ewha Birth and Growth Cohort study data. In this study, we analyzed data from 227 participants who were followed up at the ages of 7-9 and 13-15 years. Overweight and obesity were defined as a body mass index of the 85th percentile or higher based on national growth charts, and sarcopenic obesity was defined using body composition data. Metabolic diseases in adolescence were identified by calculating the pediatric simple metabolic syndrome score (PsiMS), continuous metabolic syndrome score (cMetS), and single-point insulin sensitivity estimator (SPISE) as MetS indices. The prevalence of overweight was approximately 15% at both 7-9 and 13-15 years old, and that of sarcopenic obesity (7-9 years old) was 19.5%. Boys aged 13-15 years had a significantly larger waist circumference (WC) and higher systolic blood pressure (SBP) than girls. The MetS indices (PsiMS, cMetS, and SPISE) showed no significant differences by gender. Overweight and sarcopenic obese people have a higher overall risk of MetS components than normal people. The overweight group had a significantly higher prevalence of PsiMS and cMetS than the normal group, while the SPISE was significantly lower and the MetS indicator was worse in the overweight group than in the normal group. Similar results were obtained in the group with sarcopenic obesity. Both overweight and sarcopenic obesity remained significantly associated with MetS indicators, even after adjusting for covariates. Furthermore, metabolic health assessed by the cMetS in adolescence was affected not only by childhood overweight but also by adolescence, which showed an interaction effect. The results of this study emphasize the importance and need for early detection of childhood obesity and effective public health interventions.

PSAT113 Childhood obesity: a chance to prevent future male infertility?

Abstract Background Testicular volume (TV) is a fertility marker directly related to sperm count. About a quarter of young men aged 18-19 years have testicular hypotrophy and, therefore, their future fertility is at risk. Accordingly, meta-regression data have shown that the sperm count has halved in the past forty years worldwide for no apparent reason. Interestingly, the prevalence of childhood obesity has increased in parallel over the past few decades. However, the impact of childhood obesity and of obesity-related metabolic disorders on testicular growth is still unknown. Aim This study was undertaken toevaluate the impact of obesity, hyperinsulinemia, insulin-resistance, and type 2 diabetes mellitus (T2DM) on TV in pre-pubertal (<9 years), peri-pubertal (9-14 years), and post-pubertal (14-16 years) periods. Patients and Methods We collected data on TV, age, SDS of the body mass index (BMI), insulin, HOMA-index, fasting glycemia, glucose levels at 120 min following the oral glucose tolerance test (OGTT), and glycated hemoglobin of 264 children and adolescents followed-up for weight control. Patients with factors known capable of influencing TV (any acquired or congenital endocrine dysfunction, drug assumption, radiotherapy, major comorbidities) and patients with low BMI (SDS ≤-1) were excluded. Data distribution was analyzed by the Shapiro-Wilk test. Inter-group differences were evaluated using the two-way analysis of variance (ANOVA) of the log-transformed data. Significance was accepted for a p-value <0.05. Results The cohort was made of 61, 53, and 150 children/adolescents with normal weight, overweight, or obesity, respectively; 115 had insulin levels <20 µIU/ml and 45 ≥20 µIU/ml; 61 did not have (HOMA-index <2.5) and 97 had (HOMA-index ≥2.5) insulin-resistance; 139 did not have T2DM, 22 had pre-diabetes and 3 had T2DM. The boys of 9-14 years with normal weight had a significantly higher TV compared to those with overweight or obesity. No difference was found in the other age ranges when data were grouped according to the BMI. In contrast, both in pre-pubertal and in post-pubertal phases, children/adolescents with normal insulin levels had significantly higher TV compared to those with hyperinsulinemia. Conversely, peri-pubertal boys with hyperinsulinemia had significantly higher TV compared to those with normal insulin levels. In the post-pubertal phase, these adolescents with insulin-resistance had lower TV compared to those with HOMA-index <2.5, while no difference was found in the other age ranges. Finally, T2DM did not influence TV in any age range. Conclusion Children/adolescents with overweight/obesity, hyperinsulinemia, and insulin-resistance have lower TV compared to their age-matched controls. These findings help to understand the reason for the high prevalence of testicular hypotrophy in young men. We speculate that more careful control of body weight in childhood/adolescence could represent a prevention strategy to pursue the maintenance of testicular function later in life. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.

The causal impact of childhood obesity on bone mineral density and fracture in adulthood: A two-sample Mendelian randomization study.

Observational studies have indicated the associations between obesity with bone mineral density (BMD) and fracture but yield inconsistent results. The impact of childhood obesity on bone health in adulthood is even less clear. The present study adopted the Mendelian randomization methods to determine whether the genetically predicted childhood obesity was causally associated with BMD and the risk of fracture. Genetic variants were extracted from genome-wide association studies (GWAS) to identify childhood obesity loci [IEU open GWAS project: childhood obesity (ID: ieu-a-1096)] and single nucleotide polymorphisms (SNPs) as instrumental variables to investigate causality. We used two-sample univariable Mendelian randomization (MR) to estimate causal relationships between childhood obesity on BMD and fracture subtypes based on SNPs from European samples. To avoid bias, Cochran's Q test and leave-one-out variant analysis were performed. The MR analysis shows strong evidence that childhood obesity is causally associated with eBMD (OR 1.068, 95% CI 1.043–1.095, P < 0.001) and a weak decreased risk of leg fracture (OR 0.9990, 95% CI 0.9981–0.9999, P =0.033) based on the inverse variance weighting (IVW) method. After adjusting for diabetes and adult obesity, the results of eBMD remained the same. The MR analysis revealed sufficient evidence to indicate childhood obesity was causally associated with increased BMD and decreased risk of leg fracture in adults. Childhood obesity could be taken into consideration when assessing eBMD.

P-558 Childhood exposure to high-fat diets changes sperm small RNA content up to two unexposed generations of mice

Abstract Study question Is the adoption of high-fat diet from childhood associated with sperm small RNA content in mice? Are those changes inherited by the offspring and grand-offspring? Summary answer The adoption of high-fat diet during childhood changes sperm small RNA content up to the grand-offspring even after dietary correction. What is known already The prevalence of childhood obesity is increasing worldwide. The adoption of high-fat diet (HFD) from early age is a major factor for this trend. However, the long-lasting health effects of childhood obesity associated to HFD is unknown, particularly after dietary reversion. Multiple studies demonstrated that sperm small non-coding RNA (sncRNA) content changes in response to acute and chronic dietary factors. Also, sperm sncRNAs can transmit acquired traits such as metabolic syndrome. However, it is not known how the HFD-related sperm sncRNA fingerprints varies across generations, and how it relates with the phenotypes of the progeny. Study design, size, duration At weaning, 36 C57BL/6 mice were randomly divided into three groups (n = 12) feeding on 1) standard chow (CTRL) for 200 days, 2) HFD for 200 days, or 3) HFD for 60 days reverted to chow for 140 days (childhood HFD, CHFD). Subsequent generations (36 mice/generation, all fed on chow) were obtained by mating F0 and F1 males with same-age normoponderal females 120 days post-weaning and were assigned to the same experimental group as the progenitor. Participants/materials, setting, methods Mice were euthanized 200 days after weaning and tissues collected. Epidydimal sperm was collected, and concentration, viability, motility, and morphology were evaluated. Sperm RNA were extracted using the tri-reagent protocol, and sncRNAs sequenced by NGS RNA-seq. Sequences were annotated using SPORTS 1.1 and differential expression analysis performed using DESeq2. Targets of differently expressed sequences were estimated and Gene Ontology (GO) analysis of biological function performed using topGO. Main results and the role of chance HFD consumption during childhood is associated with poorer sperm parameters, even after dietary correction. No changes in sperm parameters were found between the offspring of HFD, CHFD and CTRL but, the grand-offspring of HFD and HFDt mice had lower sperm counts than the grand-offspring of CTRL. Regarding sperm sncRNA content, no changes were found between HFD and CTRL, but several mitochondrial transcription initiation RNAs (tiRNA) and repeat-derived RNAs (repRNAs) were differently expressed comparing to CTRL. Sperm sncRNA content of the offspring of HFD (piwi-interacting RNAs and repRNA) and CHFD (tRNA-derived fragments and repRNAs) displayed several differently expressed sequences comparing to CTRL. Only microRNAs (miRNAs) were differently expressed in the grandoffspring (CTRL vs. CHFD). GO analysis of biological function based on the targets of differently expressed sncRNAs showed a potential impact of childhood obesity in pathways related to sperm motility, chemotaxis and membrane integrity. These results suggest that sperm sncRNA content is altered due to childhood obesity even after two generations. This signature is not preserved across the male germline, but may influence the sperm sncRNA content of the progeny. This long-lasting, transgenerational signature of childhood obesity may explain the inheritance of the poor sperm quality phenotype from grand-sire to grand-offspring. Limitations, reasons for caution This model does not evaluate the impact of earlier dietary intervention, before sexual maturation. Also, it is not clear if the reported effects are exclusively due to childhood obesity or to excessive caloric intake. The estimates of biological impact using GO analysis of sperm sncRNA targets require further experimental evidence. Wider implications of the findings Our findings evidence the long-lasting effects of childhood obesity to sperm parameters, even after dietary reversion, and the potential transgenerational effects to the health of the progeny. Our results raise awareness about the impact of childhood obesity to reproductive health of future fathers and their progeny. Trial registration number 0421/000/000/2016

Vascular Alterations Preceding Arterial Wall Thickening in Overweight and Obese Children.

Background: Childhood obesity is linked to adverse cardiovascular outcomes in adulthood. This study aimed to assess the impact of childhood obesity on the vasculature and to investigate whether vascular alteration precedes arterial wall thickening in childhood. Methods: A total of 295 overweight (body mass index [BMI] 85th to 95th percentile, n = 30) and obese (BMI ≥ 95th percentile, n = 234) children aged 7–17 years and 31 normal-weight controls with similar age and gender were prospectively recruited. We assessed anthropometric data and laboratory findings, and measured the carotid intima–media thickness (IMT), carotid artery (CA) diameter, M-mode-derived arterial stiffness indices, and velocity vector imaging parameters, including the CA area, fractional area change, circumferential strain, and circumferential strain rate (SR). Results: The mean ± standard deviation age of the participants was 10.8 ± 2.1 years; 172 (58%) children were male. Regarding structural properties, there was no difference in the IMT between the three groups. The CA diameter was significantly increased in obese children, whereas the CA area showed a significant increase beginning in the overweight stage. Regarding functional properties, contrary to β stiffness and Young’s elastic modulus, which were not different between the three groups, the circumferential SR showed a significant decrease beginning in the overweight stage and was independently associated with BMI z-scores after adjusting for covariates. Conclusion: We have demonstrated that arterial stiffening and arterial enlargement precede arterial wall thickening, and that these vascular alterations begin at the overweight stage in middle childhood or early adolescence.

Evaluation of the impact of childhood obesity on retrobulbar hemodynamics and retinal microvasculature.

To evaluate changes in retrobulbar ocular blood flow parameters by using Colour Doppler Imaging (CDI) and changes in foveal microvasculature by using Optical Coherence Tomography Angiography (OCTA) in pediatric obese patients and to compare them with a group of healthy children. Children diagnosed with obesity without hypertension and diabetes (39 subjects, obese group) and age-matched healthy controls (26 subjects, control group) underwent CDI and OCTA imaging. Peak systolic velocity, end-diastolic velocity and resistivity index from ophthalmic, central retinal and posterior ciliary arteries on CDI; superficial and deep capillary plexus vascular density and foveal avascular zone area on OCTA imaging were obtained in each group. Central foveal and subfoveal choroidal thicknesses were also measured. CDI and OCTA parameters were compared between two groups. Peak systolic and end-diastolic velocities were found to be significantly lower in obese children than in controls in all three examined arteries (p < 0.05). Resistivity index values were similar between the groups. OCTA imaging did not reveal significant changes in superficial and deep capillary plexus vascular densities and foveal avascular zone area across analysed retinal regions between the groups. Subfoveal choroid was thicker in obese group than in control group (325.89 ± 52.77 µm vs. 304.52 ± 21.76 µm, p = 0.04). An apparent decrease was present in retrobulbar hemodynamics in obese children. This arises the possibility of early ocular macrovascular compromise rather than retinal microvascular impairment in childhood obesity.

Obesity and Cardiometabolic Risk Factors: From Childhood to Adulthood.

Obesity has become a major epidemic in the 21st century. It increases the risk of dyslipidemia, hypertension, and type 2 diabetes, which are known cardiometabolic risk factors and components of the metabolic syndrome. Although overt cardiovascular (CV) diseases such as stroke or myocardial infarction are the domain of adulthood, it is evident that the CV continuum begins very early in life. Recognition of risk factors and early stages of CV damage, at a time when these processes are still reversible, and the development of prevention strategies are major pillars in reducing CV morbidity and mortality in the general population. In this review, we will discuss the role of well-known but also novel risk factors linking obesity and increased CV risk from prenatal age to adulthood, including the role of perinatal factors, diet, nutrigenomics, and nutri-epigenetics, hyperuricemia, dyslipidemia, hypertension, and cardiorespiratory fitness. The importance of ‘tracking’ of these risk factors on adult CV health is highlighted and the economic impact of childhood obesity as well as preventive strategies are discussed.

Impact of Childhood Obesity and Psychological Factors on Sleep.

The aim of the study was to analyze sleep duration and behaviors in relation to psychological parameters in children and adolescents with obesity seeking inpatient weight-loss treatment in comparison to normal-weight children, and whether or not these variables would improve during the time course of treatment. Sixty children or adolescents with overweight and obesity (OBE) and 27 normal-weight (NW) peers (age: 9–17) were assessed for subjective sleep measures through self-reported and parent-reported questionnaires, as well as body weight, body composition, and psychological questionnaires. The OBE participants were assessed upon admission and before discharge of an inpatient multidisciplinary weight-loss program. NW participants' data were collected for cross-sectional comparison. In comparison to NW, children and adolescents with OBE had a shorter self-reported sleep duration and had poorer sleep behaviors and more sleep-disordered breathing as reported by their parents. No change in sleep measures occurred during the inpatient treatment. Psychological factors including higher anxiety, depression, and destructive-anger-related emotion regulation were moderate predictors for unfavorable sleep outcomes, independent of weight status. Children with obesity had less favorable sleep patterns, and psychological factors influenced sleep in children, independent of weight. More research is needed on the relationship and direction of influence between sleep, psychological factors, and obesity, and whether they can be integrated in the prevention and management of childhood obesity and possibly also other pediatric diseases.

Impact of Childhood Obesity in America

Impact of Childhood Obesity in America

The Impact of Childhood Obesity on Joint Alignment: A Systematic Review and Meta-Analysis.

It has been suggested that overweight/obesity (OW/OB) impairs the normal alignment of children and adolescents' musculoskeletal system. However, to date, no study has systematically reviewed or quantified the effect of OW/OB on the development of joint malalignments in children and adolescents. The purpose of this study was to systematically review the association between OW/OB and joint alignment in children and adolescents and to quantify the evidence on whether children and adolescents with OW/OB have a higher risk of developing joint malalignments than their peers of normal weight. PubMed and Web of Science databases were systematically searched from inception to March 9, 2020. Studies investigating the association between OW/OB and joint alignment in children and adolescents were selected. Nonoriginal articles, participants with movement pattern diseases, and adolescents studied while pregnant were excluded. Two independent reviewers conducted the study selection and data extraction. Qualitative synthesis of evidence and random effect meta-analyses (risk ratio [RR]) were performed. Seventy-three studies (5 longitudinal and 68 cross-sectional) met the inclusion criteria involving 1,757,107 children and adolescents. There was consistent evidence supporting associations of OW/OB with rounded shoulder, lumbar hyperlordosis, genuvalgum, and flatfoot. Our meta-analysis showed that children and adolescents with OW/OB had a significantly higher risk of lumbar hyperlordosis (RR=1.41), genu valgum (RR=5.92), flatfoot (RR=1.49), and any joint malalignment (RR=1.68) when compared with their peers of normal weight. The presence of genu valgum and flatfoot were the most robust results. Based on these findings, OW/OB is associated with the presence of joint malalignments in children and adolescents. This is the first study that has systematically reviewed the effect of OW/OB on the development of joint malalignments in children and adolescents.

A School Nurse Delivered Health Promotion Intervention on Diabetes Indices among overweight children

Globally, the rise in the prevalence of non-communicable illnesses is the most significant public health challengeof the 21st century, with childhood obesity playing a key role. Its well-known evidence that school-basedinterventions are effective in managing childhood obesity and diabetic profiles. The primary objective of this studywas to examine the school nurse delivered health promotion intervention on diabetes indices among overweightchildren.Methods: True experimental research design was carried out. A total of eight schools in all consented to take partin the investigation and the distribution of the schools were done randomly using the lottery technique. Childrenaged between 12 -18 participated in the intervention program and the children in the study group received aschool-based intervention for 16 weeks. The anthropometric measurements of weight, height and BMI wereassessed as primary outcomes and diabetes indices such as fasting and postprandial blood sugar were assessedas secondary outcomes. Comparison of baseline values band after the intervention was done through paired andunpaired t-tests.Results: Compared with the control group experimental group showed a decrease in weight (t=3.835 P&lt;0.001) andbody mass index (t=1.724 P&lt;0.001). Substantial changes in the fasting blood sugar (t=0.135, p=0.0893) and postprandial blood sugar (t=2.282, p=0.023). Additionally, there was a link between fasting sugar and BMI that wasfavourable. After a 16-week intervention program, the postprandial blood glucose level in the experimental groupshowed a significant positive connection (r=0.706 p0.001, r=0.628 p0.001, r=0.567 p0.00).Conclusion: Despite the fact that a lot of research has focused on the impact of childhood obesity and thesignificance of the diabetic profile. This study demonstrated that the physical activity-based intervention helped the obese children significantly in improving their physical health status and reducing complications on healthissues related to diabetes. In order to screen diabetic students and conduct screening procedures, additional policyand protocol need be implemented in school settings.

The pubertal growth spurt is diminished in children with severe obesity.

At the population level, there is a negative linear correlation between childhood body mass index (BMI) and pubertal height gain. However, in children with obesity, there are no studies showing whether the severity of obesity affects pubertal height gain. Moreover, how obesity in childhood affects pubertal timing is controversial, especially in boys. We aimed to investigate the impact of severe obesity in childhood on the pubertal growth spurt in both sexes. The study group consisted of 68 patients (32 boys) with childhood onset obesity followed in a Spanish university hospital. The QEPS growth model was used to calculate pubertal growth function estimates for each individual. The highest individual prepubertal BMI SDS value was related to the age at onset of pubertal growth and pubertal height gain. Results were compared to analyses from individuals in a community-based setting (n = 1901) with different weight status. A higher peak BMI in childhood was associated with less specific pubertal height gain in children with moderate-to-extreme obesity. For boys, the higher the BMI, the earlier the onset of pubertal growth. For girls with obesity, this correlation was not linear. Obesity in childhood impairs the pubertal growth spurt in a severity-related fashion. The higher the BMI in childhood, the lower the pubertal height gain in children with moderate-to-extreme obesity. For boys with obesity, the higher the BMI, the earlier the onset of pubertal growth. The results contribute to the research field of how weight status in childhood is related to pubertal timing and pubertal growth. The results have implications for understanding how childhood obesity is related to further growth.

Impact of Childhood Obesity on Bone Metabolism.

Childhood obesity is a considerable worldwide health problem and a major risk factor for several chronic diseases. Fat rich diets result in altered serum levels of lipids, cytokines and hormonal factors, which influence skeletal acquisition and promote microstructural and mechanical behavior changes in bone, especially to bone quality and quantity. However, the possible longterm implications of high-fat diets in childhood are controversial. Despite not fully understood, multiple signaling pathways which support bone tissue homeostasis are altered under hyperlipidic conditions, including RANKL/RANK/OPG, PPAR-γ/Alox5/5-LO, leptin/IGF-I/AGE, ApoE/Lrp-1, Thy-1, IL-6, TNFα, calcium, vitamin D and K metabolism. Moreover, the expression of reactive oxygen species is also modified. Considering the importance of this subject, the aim of this review was to explore the mechanisms of bone formation affected by obesity during childhood during childhood.

The impact of childhood obesity on human capital in high-income countries: A systematic review.

Current evidence of the impact of childhood obesity on human capital development does not point in a consistent direction, and its interpretation is challenging. We carried out a systematic review of studies from high-income countries that used robust causal inference approaches to assess the impact of childhood overweight and obesity on outcomes typically linked to human capital development in economics. Global Health, Medline and EconLit were used to search for peer-reviewed papers. Three reviewers independently assessed study quality using the Newcastle-Ottawa Scale. Nineteen papers representing 22 studies met the inclusion criteria. Included studies were categorized based on three components of human capital: cognitive performance (n = 18), measured through test scores; educational attainment (n = 3), through grade progression and college completion; and labour market outcomes (n = 1), through wages. We find that childhood overweight and obesity hinder education outcomes, with effects mostly observed at older ages of exposure measurement (12+ years). Girls with overweight and obesity experienced larger negative effects and more often than boys. Future research should elucidate the pathways through which childhood obesity impacts human capital development, to support policies that may mitigate those impacts, thus averting social costs that are currently widespread, increasing and unaccounted for.