Prevalence Of Childhood Obesity Research Articles

Weight status and psychosomatic complaints in Swedish adolescent boys and girls: does family support play a buffering role?

BackgroundPsychosomatic complaints have increased among adolescents in recent decades, as have overweight and obesity rates. Both of these trends are regarded as public health concerns. However, the associations between weight status and psychosomatic complaints are not yet clear, necessitating further research. The aim of the present study was to investigate the associations between weight status and psychosomatic complaints in Swedish adolescent boys and girls, as well as to explore the potential buffering effect of family support.MethodsThe data was obtained from the cross-sectional Swedish Health Behaviour in School-aged Children (HBSC) study conducted in 2017/18, which involved 3,135 students aged 11, 13, and 15 years. Weight status was based on self-reported information on weight and height, which allowed for the calculation of body mass index (BMI) and the categorisation of participants into three groups: non-overweight, overweight, and obese. Psychosomatic complaints were assessed based on information regarding the frequency of eight different complaints, which were summed into an index. Family support was measured using three items describing the level of perceived emotional support, and an index was created, which was dichotomised into low and high family support. Gender stratified linear regression models were run to examine the associations between weight status and psychosomatic complaints. Age and family affluence were included as covariates. Interaction terms were included to evaluate whether family support moderated the main association.ResultsObesity was associated with higher levels of psychosomatic complaints in both boys and girls when compared to being non-overweight (boys: b = 2.56, 95% CI 0.32, 4.79; girls: b = 3.35, 95% CI 0.77, 5.94), while being overweight did not show any statistically significant associations with the outcome (boys: b = 0.21, 95% CI -0.72, 1.15; girls: b = 0.78, 95% CI -0.42, 1.98). In girls, a statistically significant interaction effect between family support and weight status was observed (p = 0.031), indicating that family support buffered against psychosomatic complaints in girls with obesity. No statistically significant interaction was found for boys (p = 0.642).ConclusionsThe findings of this study highlight the importance of public health initiatives aimed at preventing childhood obesity. They also underscore the significant role of family support in reducing psychosomatic complaints among adolescents with obesity. Further research is necessary to gain a deeper understanding of these relationships.

The association of vitamin D insufficiency with the prevalence of obesity in children: implications for serum calcium levels, alkaline phosphatase activity, and bone maturation

BackgroundVitamin D deficiency has been identified as a potential risk factor for various adverse health outcomes. However, its specific role in metabolic regulation and skeletal development in school-aged children is not fully understood. This study aimed to explore the correlation between vitamin D deficiency and childhood obesity rates, and its impact on serum calcium, alkaline phosphatase, and bone age in children.MethodsThe study analyzed clinical data from 159 school-aged children who underwent medical examinations. Participants were divided into the 25-hydroxyvitamin D3 (25(OH)D3) deficiency group and the 25(OH)D3 normal group based on their serum levels. We compared body mass index (BMI), total cholesterol (TC), triglycerides (TG), Ca, ALP, bone age, fasting blood glucose (FBG), and hemoglobin A1c (HbA1c) between the two groups. Logistic regression and Spearman correlation analyses were performed to further investigate relationships between 25(OH)D3 levels and metabolic and bone-related markers.ResultsThis study showed that the 25(OH)D3 deficiency cohort exhibited significantly higher BMI, TC, TG, and ALP levels, with lower Ca levels and delayed bone age compared to the normal group. Logistic regression analysis identified Ca, ALP, and bone age as significant predictors of 25(OH)D3 deficiency. Subgroup analysis showed that in the 25(OH)D3 deficient group, children with higher BMI had elevated TC, ALP levels, and delayed bone age, while Ca levels were lower. Correlation analysis confirmed the predictive value of these markers for 25(OH)D3 deficiency.ConclusionOur findings demonstrate that 25(OH)D3 deficiency is strongly associated with obesity in school-aged children and may negatively affect normal skeletal development. Regular monitoring of 25(OH)D3 levels in school-aged children is essential for ensuring proper growth and development, especially in those at risk for obesity.

THE ROLE OF NURSING IN THE PREVENTION AND CONTROL OF CHILDHOOD OBESITY

Research on nursing interventions in the prevention and control of childhood obesity has addressed three main determinants: sedentary lifestyles, poor diet, and psychosocial and environmental factors. Through an integrative literature review, negative points associated with each determinant were identified, such as increased risk of obesity, nutritional deficiencies, social stigma, and lack of emotional support. However, several nursing interventions have been highlighted as effective in addressing these problems, including nutritional education, promotion of physical activity, psychosocial support, and advocacy for healthy environments. Authors such as Jardim (2017), Borfe et al. (2017), Serra et al. (2018), among others, have contributed significantly to the development of these strategies. The research highlights the role of nurses in promoting child health, highlighting the importance of a multidimensional and collaborative approach to prevent and control childhood obesity. In summary, the results obtained provide valuable insights to improve nursing practices, promoting healthy lifestyle habits, and combating the childhood obesity epidemic.

Health promotion at local level in Portugal: is childhood obesity a concern in municipal programs?

Abstract Health promotion programs targeted at distinct health outcomes such as childhood obesity, at local level are increasingly used worldwide. There is a need to better understand the role of local governments (municipalities) as key public health promoters namely in the prevention of obesity in children. This study aims to provide some input regarding this issue in Portugal. In order to achieve this goal, health enhancing programs promoted by Portuguese municipalities in which children could participate were identified. The search of such programs was limited to the municipalities that were part of the Portuguese Network of Healthy Municipalities in 2021 (N = 57). A subsequent document analysis was conducted to describe how municipalities conceptualized children’s health by retrieving information on which topics the programs were focused on, or acted upon, and identify which socio-ecological model levels of health determinants were addressed (or not) by each program. The 77 identified programs were promoted by 30 municipalities and only 11 programs addressed childhood obesity. Most programs focused on the individual health determinants (N = 27) and provided limited information overall, which hindered a more in-depth analysis. The findings suggest that Portuguese municipalities seem to disregard their potential as public health promoters. Childhood obesity is a major public health concern at national level, as reflected in the National Health Plans, but not perceived as such locally. Municipalities are the closest government entities to the population, and it is their responsibility to ensure the population’s quality of life, by addressing the social and environmental determinants of health. Hence, municipalities should instill health concerns in all their actions/interventions, taking in consideration the most recent evidence, specifically in the case of childhood obesity. Key messages • This study findings suggest that, despite childhood obesity being a major public health concern at national level, as reflected in the National Health Plans, it is not perceived as such locally. • There is a need to better understand the role of municipalities as key public health promoters considering they are responsible to intervene on the social and environmental determinants of health.

Effects of a multidisciplinary program with physical exercise in pediatric obesity

Abstract Background Childhood obesity is a growing public health concern worldwide, with prevalence rates increasing in recent decades. This epidemic not only predisposes children to immediate health risks such as cardiovascular disease and musculoskeletal problems but also significantly increases their risk of obesity-related comorbidities in adulthood. Recognizing the multifactorial nature of pediatric obesity, interventions targeting lifestyle modifications are crucial to its control. Among these interventions, physical exercise emerges as a cornerstone in combating pediatric obesity. Purpose Our study examines the effectiveness of a twelve-week online physical exercise program on body composition and functional capacity in children and adolescents with obesity. Methods The sample consists of 30 participants (9 girls and 21 boys, aged 11-17 y) from the Pediatrics Department of Senhora da Oliveira Hospital in Guimarães (HSOG). Using standardized protocols, anthropometric measures (body weight and waist circumference) were measured. Functional capacity was assessed through squats, push-ups, and elbow plank tests (maximum repetitions in 60 seconds). All analyses were done using SPSS software, and the alpha level was 5%. Results Significant impacts of the exercise program were observed in body weight and waist circumference variables. Multivariate tests indicated a statistically significant interaction between the Moment*Groups factors (weight p = 0.040; waist circumference p = 0.007). Moreover, functional capacity was also influenced by the exercise program (squat p = 0.034; push-ups p = 0.013; and elbow plank p = 0.025). Conclusions Our results underscore the significant public health impact of integrating physical exercise into a multidisciplinary program for pediatric obesity. Innovative use of online interventions facilitated broader reach and accessibility, resulting in measurable improvements in body weight, waist circumference, and functional capacity among participants. Key messages • Integrating exercise into multidisciplinary programs improves pediatric obesity outcomes. • Online interventions broaden accessibility and effectiveness in preventing childhood obesity.

Declining trends of overweight and obesity in 4-year-olds during 2007-2022 in Northern Sweden

Abstract Background Overweight among preschool children is a huge public health issue. The prevalence of both childhood overweight and obesity increased during the COVID-19-pandemic. Our aim was to study the development of overweight and obesity among 4-year-olds in Västerbotten, Sweden, from 2007 until 2022 with special focus on the COVID-19-pandemic and the year after. Methods This is a repeated cross-sectional study that utilized individual data from most 4-year-old children living in Västerbotten County, Sweden in 2007-2022, implying that the children were born 2003-2108. We included encrypted and anonymized individual anthropometrical data from the routine 4-year-old Child Health Care visit. There were 47 004 4-year-old children living in the county and we included data from 42 584 children, 21 966 boys and 20 618 girls at the age of 46-51 months. Results Overweight and obesity decreased over the study period. In 2007 the prevalence of overweight was 13.4% for boys and 14.9% for girls and obesity 3.7% for boys and 2.7% for girls. In 2022 the prevalence of overweight had declined to 9.5% for boys and 12.1% for girls and the prevalence of obesity to 1.8% and 2.1%, respectively. During the COVID-19-pandemic the prevalence of overweight and obesity for both boys and girls increased and then rapidly returned to the pre-pandemic level in 2022. Conclusions In a setting with free standardized Child Health Care, we present a clear decline in the prevalence of overweight and obesity among Swedish preschool children over time. As in other settings the prevalence of overweight and obesity increased during the COVID-19-pandemic, but we also report a rapid decline in overweight and obesity after the pandemic. It is essential to understand the underlying mechanisms responsible for this favorable trend. Key messages • We present clear decline in the prevalence of overweight and obesity in preschool children over time in a setting with free standardized Child Health Care. • It is important to understand the possible mechanisms of the favorable trend of decrease of the prevalence of overweight and obesity in children pre- and post-pandemic.

The Effect of a Multidisciplinary Lifestyle Intervention Program on Apelin-12, Vaspin and Resistin Concentrations in Children and Adolescents with Overweight and Obesity

Background: Obesity in childhood and adolescence has reached epidemic proportions in recent decades. Methods: In the present study, we determined the concentrations of apelin-12, vaspin and resistin in 106 children and adolescents with overweight or obesity before and after the implementation of a multidisciplinary, personalized lifestyle intervention program of diet, sleep and exercise for 1 year. All subjects attended our Center for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence. Results: Following the lifestyle intervention, there were significant decreases in BMI (p < 0.01), apelin-12 (p < 0.05) and resistin (p < 0.01) concentrations, and an increase in vaspin (p < 0.01) concentration. Glucose was the best positive predictor of apelin-12 (b = 0.236, p < 0.05), and osteopontin was the best negative predictor of changes in apelin-12 (b = −0.299, p < 0.05). Vaspin correlated positively with adiponectin (b = 0.29, p < 0.05), while vitamin D (b = 0.621, p < 0.05) was the best positive predictor of vaspin. BMI z score (b = −0.794, p < 0.05), HDL (b = −0.284, p < 0.05) and HbA1C (b = −0.262, p < 0.05) were the best negative predictors of changes in vaspin. BMI z score was the best positive predictor of resistin (b = 0.437, p < 0.05). Conclusions: These findings suggest that apelin-12, vaspin and resistin correlate with indices of obesity, glucose, lipids and bone metabolism, while interaction with other proteins, such as osteopontin and adiponectin, was also noted. Therefore, apelin-12, vaspin and resistin may be used as biomarkers in children and adolescents with overweight and obesity.

Parenting Practices to Prevent Childhood Obesity Among Hispanic Families: A Systematic Literature Review.

Background: Childhood obesity disproportionately affects Hispanic families and remains an unresolved public health concern. Interventions to enhance health-related parenting practices may be a promising strategy to lower the risk for childhood obesity. However, there are scarce data on which parenting practices would be culturally relevant and contribute to lower the risk for childhood obesity among Hispanic families in the United States. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. An electronic database search of records was carried out in PubMed, CINAHL, PsycINFO, and Scopus to synthesize studies assessing associations or intervention effects of parenting practices on child BMI or other anthropometric measure among Hispanic parent-child dyads aged ≥18 and 2-12 years, respectively. Results: Of 1055 unique records identified, 17 studies were included. Most of these studies used a cross-sectional design (n = 10) and child BMI z-scores or BMI-for-age-sex percentiles as the outcome variable. Parenting practices to lower the risk for child overweight/obesity among Hispanic families included setting limits and providing routines (e.g., limited screentime), supporting a healthy lifestyle and physical activity (e.g., providing transportation to places for children's physical activities), and parenting feeding or diet-related practices (e.g., control the foods that children eat). Conclusion: Parenting practices that support healthy behaviors may be components of interventions to lower the risk for childhood obesity among Hispanic families.

Planning policies to restrict fast food and inequalities in child weight in England: a quasi-experimental analysis.

England has one of the highest childhood obesity rates in Europe. To promote a healthier food environment in 2015, Gateshead Council in North East England introduced planning guidelines effectively banning any new fast-food outlets. Our aim was to investigate whether this policy led to any reductions in childhood overweight and obesity prevalence and the inequalities in these outcomes. We used data from the National Child Measurement Programme, the Food Standards Agency Food Hygiene Rating Scheme data, and the Office of National Statistics between 2012 and 2020. We estimated a difference-in-differences model employing propensity score matching to identify a control group. We found no significant change in population-level childhood overweight and obesity in Gateshead compared with control areas. In subgroup analysis by area-level deprivation, we found that the quintile of deprivation with the highest proportion of fast-food outlets had a statistically significant reduction of 4.8% in the prevalence of childhood overweight and obesity compared with control areas. Restricting fast-food outlets in areas with a high concentration of such outlets as part of a package of policies to reduce childhood obesity may help to reduce prevalence and inequalities in childhood overweight and obesity.

Obesity in childhood - literature review and educational recommendations

Introduction and purpose Childhood obesity is a major global health concern. The World Health Organization reports that the prevalence of obesity in children and adolescents has increased significantly from 4% in 1975 to over 18% in 2016. The aim of the study is to conduct a comprehensive review of the literature on obesity among children and adolescents, emphasizes the importance of prevention, identification and effective management of childhood obesity. Materials and methods An extensive examination of articles published in scientific journals was carried out through online research platforms PubMed and Google Scholar. We searched articles by entering keywords in appropriate configuration: “childhood obesity”, “pediatric overweight”, “physical activity”, “activity and health”, “diet and obesity", "bariatric surgery" and "obesity medication". State of knowledge Treating childhood obesity requires following a personalized weight loss program, as well as adopting healthy eating habits and lifestyle practices. Improvements in metabolic and anthropometric indices can be achieved through complex interventions including dietary modification and physical activity, behavioral therapy, health promotion education, pharmacological treatment and bariatric surgery A step-by-step approach to managing weight is recommended, considering the child's age, the severity of obesity, and any accompanying health conditions. Dietary interventions focus on promoting a balanced, nutrient-rich diet that is calorie-appropriate for the child's age and gender. Summary Further research is still necessary to develop additional pharmaceutical options, refine surgical techniques, and better understand long-term outcomes in this patient population.To effectively prevent this disease, a comprehensive approach is necessary, considering both education and changes in the social environment.

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.

Challenging Childhood Obesity: The Influence of Education and Close Monitoring on Obesity-Related Behaviors.

We aimed to evaluate the role of nutrition and behavior education intervention in the prevention and treatment of childhood obesity by comparing changes in obesity-related characteristics among obese children during a follow-up period of 12 months. This study was designed as a prospective cohort study in children aged between 6 and 18 years, with exogenous obesity who applied to Istanbul Research and Training Hospital, Pediatrics Department, between January 2018 and July 2019. Beginning at the sixth month, a program for nutrition and behavior education for obesity prevention and treatment was initiated and continued during the second half of the study period. The mean age of 59 children (29 females, 30 males) was 11.73 ± 2.78. BMI levels did not show a significant difference in the first 6 months, but decreased significantly during the second 6 months of the study. Screen time, fast eating behavior, overeating behavior and food score index scores also demonstrated significant improvements during the intervention period of the study, between 6 and 12 months. It was concluded that nutrition and behavior education for the prevention and treatment of childhood obesity could be a successful intervention with close follow-up.

Advanced lipid testing in children: a call for pediatric reference intervals

Abstract Introduction Abnormal serum lipid levels in childhood are associated with dyslipidemia and increased risk of cardiovascular disease in adulthood. High prevalence of childhood obesity in the US has increased concerns about the adverse effects of abnormal lipids in children, prompting recommendations for universal lipid screening in adolescents. While specialized analysis of lipoproteins by nuclear magnetic resonance (NMR) has been predominately used in adults with risk factors for CVD, our laboratory also receives pediatric samples for NMR testing, most commonly associated with diagnostic codes for hyperlipidemia and/or abnormal weight gain. Currently adult-based reference ranges for the NMR lipoprotein measurements are used in children. The objective of this pilot study was to compare lipoprotein profiles of healthy adults and children and to assess the impact of reference intervals for children on clinical interpretation of pediatric results. Methods Serum samples were collected from 60 healthy children, ages 1 – 17 years, and 148 healthy adults, ages 19 – 64 years old. NMR lipoprotein analysis was performed using the Axinon lipoFIT by NMR assay on a 600 MHz NMR (Bruker). Statistical analysis was conducted in Excel and GraphPad Prism. Reference intervals (RIs) were determined in EP Evaluator as the central 95% interval. Results The levels of atherogenic low-density lipoprotein particle number (LDL-P) and small LDL-P (sLDL-P) were significantly lower in children compared to adults: 783±222 vs 1212±412 nmol/L and 302±142 vs 498±306 nmol/L, respectively (p<0.00001). Additionally, LDL size (LDL-s) was significantly larger in children than adults (21.23±0.29 vs 21.06±0.44 nm, p=0.006), reflecting prevalence of less dense LDL-P in the former group. Pediatric samples also had lower number of anti-atherogenic high-density lipoprotein particles (HDL-P) compared to adults: 29.4±4.6 vs 33.5±4.6 µmol/L, p<0.00001. The significant differences in the number and size of lipoprotein particles between adults and children implies that currently used adult reference intervals might not be appropriate for evaluating pediatric NMR samples. Therefore, we estimated RIs for our heathy pediatric and adult cohorts and applied these RIs to our retrospective data of 618 samples from children 1-17 years old, which were submitted for NMR lipoprotein testing in recent years. The analysis showed that using the adult RIs, 37% and 27% of pediatric samples would not flag for abnormally elevated LDL-P and sLDL-P, respectively; but they would be flagged based on the RI derived from our pediatric cohort. Moreover, 12% pediatric samples flagged for low HDL-P would have normal HDL-P levels if pediatric RIs are used instead of adult RIs. Conclusions Use of adult reference intervals in children may result in misclassification of lipid status and underestimation or overestimation of dyslipidemia and CVD risk in children. This pilot study highlights the need for pediatric reference intervals to guide interpretation of advanced lipid testing in children.

Pre-pregnancy and gestational interventions to prevent childhood obesity.

Childhood obesity is a significant global health issue with complex and multifactorial origins, often beginning before conception and influenced by both maternal and paternal health. The increased prevalence of pre-pregnancy obesity and gestational diabetes mellitus in women of reproductive age contributes to a heightened risk of metabolic dysfunction in offspring. Current clinical practices often implement lifestyle interventions after the first trimester, and have limited success, implying that they miss a critical window for effective metabolic adjustments. This review examines the limitations of lifestyle interventions during pregnancy in improving perinatal outcomes and highlights the importance of initiating such interventions before conception to positively impact parental health and fetal development. A re-evaluation of strategies is needed to enhance the metabolic health of prospective parents as a preventive measure against childhood obesity.

Origins of obesity in the womb: Fetal adiposity and its determinants.

Birth weight is an important predictor of perinatal complications and long-term health outcomes of offspring. Fetal programming influenced by maternal obesity, overnutrition, and hyperglycemia has been proposed as the fuel overload hypothesis. Recent investigations related with fetal body composition have revealed that neonatal adiposity can be predicted by fetal fat mass, and that maternal insulin resistance and serum leptin level are indicators of fetal adiposity. Based on the current evidence, the origins of obesity can partly be traced back into the fetal life. Further clarification of the determinants of fetal fat mass may lead to the clinical interventions and treatment strategies for fetal growth and development. This effort potentially leads to the elucidation of pathological conditions related with long-term health outcomes and the primary prevention of childhood obesity and early onset metabolic syndrome.

A-227 One Step Toward Implementation of Advanced Lipoprotien Testing in Children: A Pilot Study on Pediatric Reference Ranges

Abstract Background Abnormal serum lipid levels in childhood are associated with dyslipidemia and increased risk of cardiovascular disease in adulthood. High prevalence of childhood obesity in the US has increased concerns about the adverse effects of abnormal lipids in children, prompting recommendations for universal lipid screening in adolescents. While specialized analysis of lipoproteins by nuclear magnetic resonance (NMR) has been predominately used in adults with risk factors for CVD, our laboratory also receives pediatric samples for NMR testing, most commonly associated with diagnostic codes for hyperlipidemia and/or abnormal weight gain. Currently adult-based reference ranges for the NMR lipoprotein measurements are used in children. The objective of this pilot study was to compare lipoprotein profiles of healthy adults and children and to assess the impact of reference intervals for children on clinical interpretation of pediatric results. Methods Serum samples were collected from 60 healthy children, ages 1 - 17 years, and 148 self-identified healthy adults, ages 19 - 64 years old. NMR lipoprotein analysis was performed using the Axinon lipoFIT by NMR assay on a 600 MHz NMR (Bruker). Statistical analysis was conducted in Excel and Graph Pad Prism. Reference intervals (RIs) were determined in EP Evaluator as the central 95% interval. Results The levels of atherogenic low-density lipoprotein particle number (LDL-P) and small LDL-P (sLDL-P) were significantly lower in children compared to adults: 783±222 vs 1212±412 nmol/L and 302±142 vs 498±306 nmol/L, respectively (p<0.00001). Additionally, LDL size (LDL-s) was significantly larger in children than adults (21.23±0.29 vs 21.06±0.44 nm, p=0.006), reflecting prevalence of less dense LDL-P in the former group. Pediatric samples also had lower number of anti-atherogenic high-density lipoprotein particles (HDL-P) compared to adults: 29.4±4.6 vs 33.5±4.6 µmol/L, p<0.00001. The significant differences in the number and size of lipoprotein particles between adults and children implies that currently used adult reference intervals might not be appropriate for evaluating pediatric NMR samples. Therefore, we estimated RIs for our heathy pediatric and adult cohorts and applied these RIs to our retrospective data of 618 samples from children 1-17 years old, which were submitted for NMR lipoprotein testing in recent years. The analysis showed that using the adult RIs, 37% and 27% of pediatric samples would not flag for abnormally elevated LDL-P and sLDL-P, respectively; but they would be flagged based on the RI derived from our pediatric cohort. Moreover, 12% pediatric samples flagged for low HDL-P would have normal HDL-P levels if pediatric RIs are used instead of adult RIs. Conclusions Use of adult reference intervals in children may result in misclassification of lipid status and underestimation or overestimation of dyslipidemia and CVD risk in children. This pilot study highlights the need for pediatric reference intervals to guide interpretation of advanced lipid testing in children.

NUTRIÇÃO E PREVENÇÃO DA OBESIDADE INFANTIL: UMA REVISÃO ABRANGENTE DA LITERATURA

Childhood obesity is a global public health problem due to its high epidemic levels. Many overweight children have easy access to sugary foods and pasta, and consume little vegetables and fruits, resulting in an imbalance between energy intake and expenditure. In order to explore this topic, the general objective of this study is to review the literature on nutritional interventions for preventing childhood obesity. The methodology corresponds to a narrative literature review, where 16 scientific publications were selected for analysis from the PubMed, Scielo, PubMed and Bireme databases. The evidence indicates that childhood obesity is caused by a combination of genetic, environmental, socioeconomic and behavioral factors, constituting a multifactorial cause. This contributes to a sedentary lifestyle, chronic diseases such as diabetes and cardiovascular diseases. It is concluded that nutritional interventions are essential to prevent pediatric obesity and include healthy eating habits associated with physical activity. The role of schools, families and educational programs in this process is also highlighted.

Good Friends and Good Neighbors: Social Capital and Food Insecurity in Families with Newborns

To examine the association between social capital and household food insecurity among US families with newborns. This cross-sectional analysis used enrollment data from 881 newborn-caregiver dyads at six geographically-diverse US academic sites enrolled in the Greenlight Plus Trial, a comparative effectiveness trial to prevent childhood obesity. Ordinal proportional-odds models were used to characterize the associations of two self-reported measures of social capital: 1) caregiver social support and 2) neighborhood social cohesion, with household food insecurity after controlling for sociodemographic characteristics. Among 881 newborn-caregiver dyads (49% Hispanic, 23% non-Hispanic white, 17% non-Hispanic Black; 49% with annual household income <$50,000), food security was high for 75%, marginal for 9%, low for 11% and very low for 4%. In covariate-adjusted analyses, caregivers with a low social support score of 18 had five times the odds (aOR=5.03 95%CI=3.28-7.74) of greater food insecurity compared with caregivers with a high social support score of 30. Caregivers with a low neighborhood social cohesion score of 10 had nearly three times the odds (aOR=2.87 95%CI 1.61-5.11) of greater food insecurity compared with caregivers with a high neighborhood social cohesion score of 20. These associations remained robust when both social capital measures were included in one model. Caregiver social support and neighborhood social cohesion each appear to be inversely associated with food insecurity among US families with newborns. Longitudinal research is needed to determine the directionality of these relationships and whether improving social capital for families with young children reduces household food insecurity.

Recreational screen time and obesity risk in Korean children: a 3-year prospective cohort study

BackgroundStudies have shown that prolonged television watching increases obesity risk among children. However, few studies examined the associations with other types of screen time, such as computer and smartphone use, using a prospective cohort study design. Further, little is known about the specific non-screen time activity that may yield the most benefits when reallocating screen time to other activities.MethodsWe conducted a prospective cohort analysis using 3-year follow-up data from the Korean Children and Youth Panel Survey 2018 (n = 2,023; 4th grade elementary students who were not obese at baseline). Average time spent watching television, using computer and smartphone, and other after-school activities were self-reported at baseline. Weight and height were also self-reported at baseline and follow-up surveys through 2021. We performed multivariable logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between screen time and obesity incidence, adjusting for potential confounders. We also performed isotemporal substitution models to examine the associations of reallocating screen time to other non-screen time activities (physical activity, sleeping, hanging out with friends, reading, studying, and chatting with parents) in an equal time-exchange manner.ResultsLonger combined screen time (≥ 240 vs. <120 m/d) was statistically significantly associated with an increased obesity risk (OR [95% CI] = 1.68 [1.03, 2.73]). The direction of associations with television watching (≥ 180 vs. <60 m/d: OR [95% CI] = 2.86 [1.58, 5.20]), computer use (≥ 120 vs. <60 m/d: 1.38 [0.52, 3.64]), and smartphone use (≥ 180 vs. <60 m/d: 1.42 [0.76, 2.65]) were all positive, although the association was most apparent and statistically significant for television watching only. The associations did not change after additional adjustment for other lifestyle factors, including physical activity, sleep, and breakfast skipping. In the isotemporal substitution models, reallocating 1-hour of screen time to reading (OR [95% CI] = 0.67 [0.48, 0.93]) was associated with a decreased obesity risk. Reallocating 1-hour of screen time to physical activity was only marginally significantly associated with obesity risk (0.79 [0.62, 1.01]).ConclusionsOur data suggest that more efforts should focus on reducing screen time and increasing time for other non-screen time activities, particularly reading, for obesity prevention in children.

Study protocol for Early Tracking of Childhood Health determinants (ETCHED): A longitudinal observational life course study

BackgroundThe prevalence of childhood obesity and diabetes continues to rise in the United States (US), especially among minority populations. The objective of the Early Tracking of Childhood Health Determinants (ETCHED) study is to investigate the role of adverse fetal and early-life risk exposures that contribute to the development of childhood obesity and metabolic risk.MethodsETCHED is a longitudinal observational study of American Indian/Alaska Native (AI/AN) and Hispanic pregnant woman and their offspring. Pregnant mothers ≥ 18 years old are enrolled at a large public hospital system in the southwestern US. Enrolled mothers are followed through pregnancy, delivery, and the maternal/offspring dyad will be followed until the child’s 18th birthday. At each maternal visit, questionnaires assessing medical history, diet, physical activity, sleep, perceived stress, and socioeconomic and sociocultural information are obtained. Standard laboratory tests during maternal visits include glycemic measures, lipids, and renal function. Additional bio samples obtained include venous blood samples and cord blood for obesity/metabolic biomarkers and genetic/epigenetic testing, urinalysis, placental tissue for examining functional pathways, breast milk for metabolomics, and stool for metabolites and microbiome analysis. The offspring will have 6 infant/toddler visits at 6–12 weeks, 4 months, 6 months, 18 months, 2 and 3 years respectively. Thereafter, they will undergo comprehensive research visits (major visits) at 4–5 years, 6–9 years, 10–13 years, and 14–17 years. The major visits in children include detailed medical history, anthropometry, developmental assessment, socioeconomic and environmental assessments (food insecurity, family structure, and childcare), feeding and activity, biochemical tests, genetics/epigenetic testing, and ultrasound elastography. Electronic health records will be reviewed for additional clinical information. The primary analysis will constitute estimation of correlation coefficients between continuous variables. The planned study duration in this ongoing study is 23-years.DiscussionThis is a life course study that that will examine biological and environmental risk factors for obesity and cardiometabolic risk from the intrauterine period to early childhood and adolescence in a population with high-risk of obesity and type 2 diabetes in the United States. The ETCHED study would also provide a unique opportunity to combine multi-omics and clinical data to create novel integrative models to predict the cardiometabolic risk associated with childhood obesity and possibly identify etiopathogenetic mechanisms and future targets of intervention.Trial registration numberClinicalTrials.gov identifier: NCT03481829. Updated July 19, 2024, https://clinicaltrials.gov/study/NCT03481829?cond=ETCHED&rank=1.