Obesity Prevention Research Articles

Advances in the molecular mechanisms of exercise biomechanics for interventions in adolescent obesity

The global epidemic of adolescent obesity is becoming increasingly severe, posing significant threats to both the physical health of adolescents and their psychological well-being and social adaptability. Exercise biomechanics, as an interdisciplinary field that integrates biology, mechanics, physics, and medicine, focuses on examining the mechanical behavior of organisms during physical activity and its implications for physiological and pathological processes. This paper aims to provide a comprehensive review of recent advancements in the research on molecular mechanisms related to exercise biomechanics in the context of adolescent obesity intervention to offer scientific theoretical support for the prevention and treatment of obesity. In recent years, researchers have elucidated the impact of exercise interventions on the expression and signaling of obesity-related genes by modulating critical pathways, including fat metabolism, inflammatory responses, and insulin sensitivity. This has been achieved through the application of advanced technologies such as high-throughput sequencing, proteomics, and metabolomics, thereby providing molecular-level insights into the mechanisms by which exercise contributes to the prevention and treatment of obesity in adolescents. Building upon this foundation, the present paper aims to further investigate future research directions and the potential applications of exercise biomechanics to enhance the optimization and development of intervention strategies for adolescent obesity.

Effect of the Intervention Dominated by Rational-Emotive Therapy on Obese Children’s Mental Health

Background: Due to economic development and lifestyle changes, childhood obesity and psychological problems are becoming increasingly prominent. However, only a few studies have investigated the available psychological interventions for obese children. In this study, an eight-week empirical research on obese children was conducted where rational-emotive therapy was combined with group exercise. Methods: A total of 110 obese children from 2 public primary schools in Fujian Province, China were selected via cluster random sampling. They were randomly divided into an experimental group and a control group, with 55 children in each group. The experimental group received an integrated intervention dominated by rational-emotive therapy, while the control group did not receive any intervention. After eight weeks of intervention, a comparative measurement was conducted on both groups. Results: The decrease in BMI observed in the experimental group was significantly greater than that observed in the control group, and such difference was statistically significant (P<0.05). The decrease in depression observed in the experimental group was greater than that observed in the control group, and such difference was statistically significant (P<0.05). The experimental group reported reductions in all eight factors of metal health after the intervention, and the differences were statistically significant (P<0.001). Conclusion: The proposed intervention model can effectively reduce obese children’s BMI and depression levels and improve their mental health. The results of this study provide scientific basis for the timely prevention of childhood obesity and negative psychological problems.

Human gut microbial aromatic amino acid and related metabolites prevent obesity through intestinal immune control.

Obesity affects millions of people in the world. The gut microbiome influences body fat accumulation, but the mechanisms remain to be investigated. Here, we show an association between microbial aromatic amino acid metabolites in serum and body fat accumulation in a large Chinese longitudinal cohort. We next identify that 4-hydroxyphenylacetic acid (4HPAA) and its analogues effectively protect male mice from high-fat-diet-induced obesity. These metabolites act on intestinal mucosa to regulate the immune response and control lipid uptake, which protects against obesity. We further demonstrate that T cells and B cells are not vital for 4HPAA-mediated obesity prevention, and innate lymphoid cells have antagonistic roles. Together, these findings reveal specific microbial metabolites as pivotal molecules to prohibit obesity through immune control, establishing mechanisms of host modulation by gut microbial metabolites.

Association between physical activity, trouble sleeping, and obesity among older Americans: a cross-sectional study based on NHANES data from 2007 to 2018

BackgroundAs the global population ages, obesity among older adults has become an increasing public health concern. Lifestyle factors, including physical activity (PA) and sleep, play a critical role in obesity prevention. These behaviors occur within a 24-hour cycle, yet research on the impact of different PA patterns, trouble sleeping, and their combination on obesity in older adults remains limited. This study aimed to explore: (1) the relationship between PA patterns, trouble sleeping, and obesity among older Americans; and (2) the combined effect of PA patterns and trouble sleeping on obesity in this population.MethodsA total of 10,891 participants aged 60 and older (55.0% female) from the National Health and Nutrition Examination Survey 2007–2018 were included. Trouble sleeping was assessed using the Sleep Disorder Questionnaire, and PA was measured using the Global Physical Activity Questionnaire. Body mass index (BMI) was calculated from objectively measured weight and height. Multivariate linear regression models were used to estimate the association between PA patterns, trouble sleeping, and BMI.ResultsCompared to the inactive group, participants in the insufficiently active group (β = -0.75; 95% CI = -1.27 to -0.23; P = 0.005), weekend warrior group (β = -1.08; 95% CI = -1.88 to -0.28; P = 0.009), and regularly active group (β = -1.58; 95% CI = -2.02 to -1.14; P < 0.001) had a significant negative association with BMI. Participants with trouble sleeping exhibited a positive association with BMI compared to those without trouble sleeping (β = 0.39; 95% CI = 0.02 to 0.75; P = 0.040). Conversely, among participants with trouble sleeping, those who were regularly active exhibited a negative association with BMI (β = -0.56; 95% CI = -1.05 to -0.07; P = 0.027). Additionally, compared to sufficiently active group, both the inactive and insufficiently active groups exhibited a positive association with BMI, regardless of the presence of trouble sleeping.ConclusionInsufficient PA and trouble sleeping in older adults are positively associated with obesity. Engaging in either a weekend warrior or regular PA lifestyle is negatively associated with obesity. Furthermore, adopting a regularly active lifestyle may mitigate the negative impact of trouble sleeping on obesity. However, regardless of the presence of trouble sleeping, insufficient PA remains positively associated with obesity in older adults.

Does income have a non-linear impact on residents’ BMI? Re-examining the obesity Kuznets curve

BackgroundAfter more than 40 years of growth, the income of Chinese residents has greatly increased; however, the problems of overweight and obesity among residents have become increasingly prominent.MethodsWe used data from the China Family Panel Studies (CFPS) to study the relationship between residents’ income and obesity using the instrumental variable (IV) method.ResultsThe impact of income on residents’ body mass index (BMI) is an inverted U-shape; that is, when income is low, BMI significantly rises with income, and when per capita income exceeds 57,066 yuan in 2023 prices (equivalent to 8,098 dollars), further increases in income will lead to a decrease in BMI.ConclusionsThe results suggest that the impact of income on resident obesity may be related to dietary behaviour and health investment. Although income increases the likelihood of health expenditure and exercise, it has an inverted U-shaped effect on whether residents consume fish, meat, fried or pickled foods, and dine out. That is, in the low-income stage, income mainly increases consumption of unhealthy foods such as fish, meat, and fried and pickled foods, leading to a significant increase in BMI. In the high-income stage, residents reduce consumption of large amounts of fish and meat, pay more attention to healthy diet and healthcare, and increase exercise, which leads to a decline in BMI and an overall inverted U-shaped impact of income on obesity. Further heterogeneous analysis showed that income has a greater impact on obesity among rural residents, those aged 50 years and older, and those with low education levels. Finally, this study provides relevant suggestions for the prevention and control (P&C) of obesity among urban and rural residents.

Adapting the Nutrition and Physical Activity Self-Assessment: A Cross-Country Case Study of Improving Early Childhood Health Environments in the United States, Australia, and the United Kingdom.

Background: Child overweight and obesity is a critical global health issue with substantial individual and societal impacts necessitating early intervention to establish healthy habits. Health promoting early childhood education (ECE) settings are important as most young children attend ECEs in high- and middle-income countries. Nutrition and Physical Activity Self-Assessment for Child Care (NAPSACC) is an evidence-based approach to support improvements to ECE environment for improving child health. While adapting proven child obesity prevention interventions from other countries offers efficiency, the process is frequently underreported and insufficiently documented. Methods: Guided by the ADAPT framework, this article describes the adaptation of NAPSACC in the United States (US), Australia (AU), and the United Kingdom (UK) from 2012 to 2023. Contextual differences in ECE systems in the US, AU, and UK and reflections on the process of adaptation were explored. Results: NAPSACC was successfully adapted, maintaining core theoretical components while allowing for implementation flexibility to meet varying contexts. The iterative adaptation process revealed that a flexible dynamic approach was essential for maintaining the relevance and effectiveness of the NAPSACC intervention in different contexts. Conclusions: Our experience highlights the importance of ongoing iteration, international collaboration, research, and responsiveness to evolving circumstances in adaptation processes. Strong and flexible leadership, such as that demonstrated by NAPSACC's founder, Dr. Dianne S. Ward, facilitates successful adaptation and continuous improvement of public health programs. Trial registration: This paper includes multiple registered trials - NCT02889198, ACTRN12619001158156, ISRCTN16287377, and ISRCTN33134697.

Key Gaps in the Prevention and Treatment of Obesity in Children and Adolescents: A Critical Appraisal of Clinical Guidelines

Background: The worldwide increase in the prevalence of childhood obesity necessitates effective prevention and treatment strategies. Clinical practice guidelines (CPGs) offer guidance, but significant heterogeneity or lack of practical application exists in their recommendations. The purpose of the present study is to provide an expert, comprehensive, and comparative analysis of gaps in current CPGs for the prevention and treatment of obesity in children and adolescents. Results: A total of 14 CPGs were identified, focusing on childhood obesity prevention (n = 11), treatment (n = 9), or both (n = 6). Prevention CPGs generally recommend body mass index (BMI) assessment, but specific measurement frequency is often absent. While some provide age-specific dietary recommendations, graphical tools are lacking. Recommendations for increased physical activity and reduced screen time are common, but age-stratified guidance is deficient. Furthermore, recommendations regarding mental health and sleep are notably absent. Treatment CPGs utilize BMI for obesity diagnosis, but inconsistencies in cut-off points persist. Comorbidity assessment is generally recommended, yet age-specific guidance remains lacking. Dietary recommendations are present in most CPGs, but many lack detailed specifications (e.g., meal frequency, portion sizes, macronutrient distribution, age-appropriate examples). Most CPGs advocate for 60 min of daily physical activity and limit screen time to 2 h per day. Recommendations concerning sleep are consistently absent. While parental involvement is acknowledged, specific guidance for active participation in prevention and treatment is deficient. Pharmacological treatment options are frequently outdated, and surgical intervention is reserved for exceptional cases of severe obesity. Conclusions: Standardizing BMI cut-off points and defining age groups across CPGs would improve consistency and comparability in the diagnosis, prevention, and treatment of childhood obesity. Tailoring recommendations for diet, physical activity, sedentary behavior, and sleep to specific age groups would ensure developmentally appropriate interventions. A stronger emphasis on early prevention strategies is needed to address the root causes of obesity. Clear guidance for parents and families would facilitate their active engagement in prevention and treatment. Up-to-date information regarding pharmacological and surgical treatments is imperative.

Sedentary behavior and sleep for children and adolescents with obesity: A systematic review.

Sedentary behavior and inadequate sleep are well-known lifestyle determinants of obesity that are linked to poor health outcomes, including into adulthood. This systematic review aims to synthesize evidence on how sedentary behavior (different durations, frequencies, patterns, or types) and improved sleep and/or sleep hygiene are related to improved health and functioning and reduced obesity-associated disability for the integrated management of obesity. We systematically searched electronic databases and trial registries for randomized trials and prospective cohort studies published between 2012 and 2023. The searches yielded 8990 records, 95 of which were read in full text by independent reviewers. No completed studies met the selection criteria. Only one ongoing study will likely meet the review's selection criteria, but data collection has not yet been completed. The lack of participants with obesity at baseline was the most common exclusion reason (51 studies, 53%), followed by ineligible exposures (12 studies, 12%) like dietary counseling or parenting interventions. As randomized trials and prospective cohort studies concerning sedentary behavior or sleep in children and adolescents have traditionally focused on the primary prevention of obesity, future research should include children and adolescents with obesity and present subgroup analyses for different degrees of obesity and comorbidities.

Modern problems of diagnosis and prevention of obesity in children

Background. Obesity in children is an important medical and social problem of our time. It is associated with a high risk of developing concomitant diseases, such as cardiovascular pathologies, endocrine disorders and exercise intolerance. An increase in the number of cases of obesity in the child population is a global trend that requires effective methods of diagnosis, prevention and treatment. The purpose of this article was to summarize current scientific data presented in publications from PubMed, Scopus, and Web of Science databases, as well as in international and national clinical guidelines in order to optimize approaches to the diagnosis and prevention of obesity in children. Results. Obesity in children remains a pressing problem that requires a comprehensive approach to its solution. It is necessary to pay special attention to the early detection of excess body weight and associated metabolic disorders, as they have a significant impact on the future health of children. It is important to develop and implement individualized preventive programs that take into account age, social and cultural characteristics. Integration of modern diagnostic methods and approaches to correcting children’s lifestyle will reduce the prevalence of obesity, reduce the risk of complications and improve the quality of life of the child population. The results of the analysis of modern sources indicate that the main diagnostic criteria for obesity in children are body mass index and waist circumference. Obesity in children negatively affects the quality of life, contributes to the development of chronic diseases and reduces exercise tolerance. Preventive measures include correction of eating behavior, increasing physical activity, monitoring metabolic indicators and using programs to teach a healthy lifestyle. ­Conclusions. Childhood obesity requires early diagnosis and individualized preventive measures. A comprehensive approach helps reduce the risk of complications and improve quality of life.

Comparative Hypothalamic Proteomic Analysis Between Diet-Induced Obesity and Diet-Resistant Rats

Obesity arises from a complex interplay of genetic and environmental factors. Even among individuals with the same genetic predisposition, diet-induced obesity (DIO) exhibits varying degrees of susceptibility, which are categorized as DIO and diet-induced obesity resistance (DR). The hypothalamus plays a pivotal role in regulating energy homeostasis. This study performed a comparative hypothalamic proteomic analysis in DIO and DR rats to identify differentially expressed proteins (DEPs) associated with alterations in body weight. Male Sprague Dawley rats were fed either a standard chow diet or a high-fat diet for 12 weeks. DIO rats exhibited the most rapid weight gain compared to both the control and DR rats. Despite consuming similar caloric intake, DR rats exhibited less weight gain relative to DIO rats. Proteomic analysis revealed 31 DEPs in the hypothalamus of DR rats compared to DIO rats (with a false discovery rate (FDR) &lt; 1%). Notably, 14 proteins were upregulated and 17 proteins were downregulated in DR rats. Gene ontology analysis revealed an enrichment of ion-binding proteins, such as those binding to Fe2+, Zn2+, Ca2+, and Se, as well as proteins involved in neuronal activity and function, potentially enhancing neuronal development and cognition in DR rats. The DEPs pathway analysis via the Kyoto Encyclopedia of Genes and Genomes (KEGG) implicated starch and sucrose metabolism, antigen processing and presentation, and the regulation of inflammatory mediator affecting TRP channels. Western blotting confirmed the proteomic findings for TRPV4, CaMKV, RSBN1, and BASP1, which were consistent with those obtained from Tandem Mass tag (TMT) proteomic analysis. In conclusion, our study highlights the hypothalamic proteome as a critical determinant in the susceptibility to DIO and provides novel targets for obesity prevention and treatment.

GLP-1 Receptor Agonists in Pediatric and Adolescent Obesity.

Obesity remains highly prevalent among children in the United States and is associated with an ever-increasing burden of obesity-related diseases. Effective pediatric obesity prevention and treatment will require both societal interventions and health care system innovation. One recent advancement is the approval of glucagon-like peptide-1 receptor agonists (GLP-1RAs) for use in adolescents. GLP-1RAs are notable for their effectiveness in weight management and in their ability to ameliorate obesity-related diseases. GLP-1RAs can be an important part of a comprehensive treatment plan for pediatric patients seeking obesity care, and we will review the pediatric clinician's considerations for their effective use. We discuss the history of obesity pharmacology and development of GLP-1RAs. We review the indications for use and common adverse reactions. We highlight the importance of mental health care for obesity treatment, with a focus on disordered eating behaviors and their intersection with obesity and pharmacologic treatment of obesity. Nutrition remains an important issue for obesity prevention and management, and we highlight nutritional concerns during GLP-1RA therapy. Finally, we discuss health inequities in obesity, the dangers of perpetuating these inequities if GLP-1RA access remains biased, and the opportunities for improvement.

Effect of a Behavioral Change Communication Strategy Coupled With Small-Quantity Lipid-Based or Micro-Nutrient Supplements on Stunting and Obesity in Children in Baja Verapaz, Guatemala: Results From a Cluster Randomized Controlled Trial.

The co-existence of childhood stunting and obesity is a public health problem in Guatemala and Latin America. The objective of this study was to assess the effects of unsweetened small-quantity lipid-based nutrient supplements (SQ-LNS) coupled with a behavior change communication (BCC) strategy on the double burden of malnutrition. We conducted a three-arm randomized-control trial with two-stage cluster sampling of households with children under 4.5 months or a mother in the third trimester of pregnancy at baseline from 76 communities in Baja-Verapaz, Guatemala. Some 1268 households were randomly assigned to SQ-LNS or micronutrient powders (MNPs) paired with a multilevel participatory-ludic BCC strategy, or to MNPs only. Measures of mothers' nutrition knowledge and practices were collected at baseline and endline. Children's height, weight, and hemoglobin concentration were measured at endline. Treatment effects were estimated using regression models. The BCC strategy boosted caregiver nutrition knowledge from 4.2 (95% CI: 2.7, 5.7) to 4.6 percentage points (95% CI: 3.1, 6.1). Significant effects on nutrition practices of 3.0 percentage points (95% CI: 1.2, 4.8) were found only for caregivers with children receiving SQ-LNS. We found no detectable treatment effects on stunting or anemia. However, children exposed to SQ-LNS and the BCC strategy were 2.6 percentage points (95% CI: -5.0, -0.2) less likely to be overweight or obese (54.1% lower than the group receiving MNPs only). An intervention coupling a multilevel participatory-ludic BCC strategy with the use of unsweetened SQ-LNS holds promise for the prevention of childhood overweight and obesity, yet complementary interventions are required to address non-nutritional factors related to stunting in Guatemala.

Monitoring and adaptation of a system dynamics approach to prevent childhood overweight and obesity: findings from the LIKE programme

BackgroundThere are few examples of public health programmes rooted in system dynamics methodology. The aim of this paper was to broaden the evidence-base on the implementation and evaluation of a system dynamics programme for obesity prevention, using the Lifestyle Innovations based on youth’s Knowledge and Experience (LIKE) Programme as a case study. In LIKE, system dynamics principles were operationalized around three central pillars: the action programme is (1) rooted in a system-based understanding; (2) integrated in the local context and (3) dynamic.MethodsThis study took place in an urban setting in Amsterdam, the Netherlands, as part of the LIKE programme. The action programme consisted of establishing thematic action groups around previously identified leverage points within the system of overweight-related behaviours among adolescents. An action monitoring register was used to monitor action development and implementation, including the targeted system level. To track action implementation and adaptation over time, we conducted an in-depth evaluation using ripple effects mapping and additional interviews for three action groups. This data was analysed by performing a thematic content analysis.ResultsDuring the 6-year course of LIKE, 63 action ideas were formulated by 12 action groups, and 22 of these actions were implemented. Most of these implemented actions targeted lower system levels. A total of 9 of the 22 implemented actions were incorporated in existing initiatives. We observed that operationalization of system dynamics principles influenced the form of the action programme. Action ideas were dynamic in the sense that they changed over time or were abandoned because of growing system insights and/or factors within the wider context. This required shifting the focus from individual actions to the programme as a whole and formulating action ideas in terms of their function in changing the system, instead of on its form.ConclusionsUsing LIKE as a case study, this study provides an example of the output of a system dynamics action programme. We show how leverage points can be used as a starting point to develop action ideas that target lower and higher system levels. This demands monitoring and evaluation that facilitates continuous customization of the programme.

Parental Perspectives on Pediatric Obesity Prevention and Management in Korea: Insights into Barriers and Facilitators.

Parental awareness and involvement are crucial in managing obesity in children and adolescents. Although awareness of obesity-related health risks is increasing, public understanding of specific aspects remains limited. This study examines parental perceptions and practices regarding pediatric obesity in Korea. An online survey was conducted from June 3 to 14, 2024, targeting 102 parents/guardians of children and adolescents who were overweight or obese according to the 2023 Student Health Examination results. The survey assessed experiences with medical consultations, awareness and management practices regarding obesity, awareness of related policies, and barriers and facilitators for obesity management. A significant gap exists between awareness and actual practice in managing pediatric obesity. Although 90.2% of the respondents recognized the importance of dietary and exercise management, the actual implementation rates were low (68.6% and 66.7%, respectively). Notably, 62.1% of respondents were unaware of any existing national policies or programs: 39.7% were aware of relevant policies, and only 35.3% were aware of related programs. Barriers to obesity management included a lack of awareness and motivation among children and adolescents, insufficient information for parents/guardians, and financial and time constraints. Facilitators of effective management include accurate diagnosis, coordination between schools and healthcare providers, and increased community support. Combating pediatric obesity will require improved awareness and education, reduced financial burden, and the promotion of national policies. Strengthening coordination among schools, healthcare providers, and community resources will facilitate the successful management of obesity.

The Familias Saludables Study: A Culturally Tailored Family-Centered Intervention for Childhood Obesity Prevention Among Hispanic Communities.

The Familias Saludables Study: A Culturally Tailored Family-Centered Intervention for Childhood Obesity Prevention Among Hispanic Communities.

Taurine promotes glucagon-like peptide-1 secretion in enteroendocrine L cells.

Taurine, an amino-sulfonic acid mainly sourced from food, suppresses blood glucose by stimulating insulin secretion from pancreatic β-cells. However, its relationship with glucagon-like peptide-1 (GLP-1) secretion from enteroendocrine L cells is unclear. This study aimed to determine the role of taurine in GLP-1 secretion from L cells. Taurine administration promoted GLP-1 secretion in enteroendocrine L cell line GLUTag cells and increased plasma GLP-1 in mice. Taurine uptake via the taurine transporter increased cytosolic ATP levels, resulting in higher intracellular Ca2+ concentrations and enhanced GLP-1 secretion through ATP-sensitive K+ channel closure. These findings may help identify new therapeutic targets for obesity and diet-related disease prevention.

A comparison of early childhood obesity prevention in Australian general practice and child and family health settings: A mixed methods study.

A comparison of early childhood obesity prevention in Australian general practice and child and family health settings: A mixed methods study.

Effects of high-calorie diet-induced obesity on molecular structures of lipids and proteins - A multi-organ study using FTIR spectroscopy.

Effects of high-calorie diet-induced obesity on molecular structures of lipids and proteins - A multi-organ study using FTIR spectroscopy.

Do the effects of interventions aimed at the prevention of childhood obesity reduce inequities? A re-analysis of randomized trial data from two Cochrane reviews.

Do the effects of interventions aimed at the prevention of childhood obesity reduce inequities? A re-analysis of randomized trial data from two Cochrane reviews.

Decoding the complex systems of obesity

Decoding the complex systems of obesity