Obesity Prevention Research Articles

Improving Evidence-Synthesis for School-Based Obesity Prevention Interventions. Comment on Ginell et al. Unreliable Findings Due to Miscalculations and Errors. Comment on "Nally et al. The Effectiveness of School-Based Interventions on Obesity-Related Behaviours in Primary School Children: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Children 2021, 8, 489".

As researchers with substantial experience in the child obesity field [...].

Combating obesity in Southeast Asia countries: current status and the way forward

Obesity is gaining prominence as a serious public health challenge in the Southeast Asia (SEA) region, with an alarming rate of increase in its prevalence. Countries in the region have shown commitment to curbing the rise of obesity by establishing policies, strategies, and action plans. This paper summarises the current situation and strategies undertaken to combat obesity and related chronic diseases. Although a range of policies and strategies have been developed, including national nutrition action plans, community intervention programmes, fiscal measures, nutrition labelling to promote healthier choices, countries in the region are struggling to make significant progress toward halting the scourge of obesity. It is imperative to strengthen existing health systems with a paradigm shift from a focus on “sick care” to and enhancing nutrition initiatives to support obesity prevention. A comprehensive and coordinated approach is essential, one that emphasises high-level coordination across all levels of government and multiple sectors, and a unified plan rather than fragmented initiatives. For strategies to be effective and sustainable, they must address the fundamental environmental determinants of poor dietary choices and nutritional inequalities. A more holistic approach is clearly needed to improve the entire food environment, which in SEA countries must include the multitude of eating places where large segments of the population “eat out” everyday to meet their energy and nutrient needs. There is a recognised need for more comprehensive measures to promote healthy eating among school children and ensure a supportive environment for lifelong healthy habits. This paper calls for a whole-of-government, whole-of-society approach that combines changes to the fundamental food environment and accompanied by systematic monitoring and surveillance systems to achieve long-lasting health outcomes.

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

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

Effects of outdoor activity time, screen time, and family socioeconomic status on physical health of preschool children.

Experienced 3 years of pandemic-induced home life, in the post-epidemic period, preschoolers in China are falling short of the World Health Organization's standards for screen time and outdoor activities. This notably impacts their physical well-being. The study aims to probe the associations between screen time, outdoor activities, and the physical health of preschoolers, offering insights to shape interventions targeting myopia and obesity prevention in children. A cross-sectional study was conducted in Guangdong Province, involving a representative sample of 23,992 preschoolers and their caregivers recruited through proportional stratified cluster sampling. Data collection utilized the Chinese Early Human Capability Index (CHeHCI, eHCi), a questionnaire on children's media use in daily family life, and Body Mass Index (BMI). Linear regression and binary logistic regression models were employed to analyze the impact of screen time and outdoor activity duration on the physical health of preschoolers. In the high family socioeconomic status (SES) group, children had significantly less screen time compared to those in the medium and low SES groups. Outdoor activity time varied significantly based on SES, with higher SES linked to extended outdoor engagement. Additionally, children's eHCi health dimension score exhibited significant SES-related differences, showcasing higher scores for children in higher SES groups. In terms of gender differences, boys dedicated significantly more time to outdoor activities than girls, yet boys had a notably higher overweight rate. Furthermore, girls demonstrated better health outcomes based on eHCi health scores. A significant association emerged between overweight and screen time in children with high SES, indicating that prolonged screen time was linked to a higher likelihood of overweight based on BMI. Additionally, a substantial negative correlation was observed between children's eHCi health dimension score and screen time. Furthermore, children's outdoor activity time exhibited a significant positive correlation with eHCi health dimension score. Regression analysis revealed that screen time could significantly negatively predict children's physical health score, while outdoor activity time could significantly positively predict children's eHCi physical health score. The current study highlights that family SES, age, and gender play pivotal roles in influencing preschoolers' screen time and outdoor activity duration, with family SES being particularly influential. Higher family SES correlates with reduced screen time, increased outdoor activity, and elevated health levels among children. Importantly, children's screen time negatively predicts their health status, while outdoor time positively predicts their health status.

The Inhibitory Effects of Maclurin on Fatty Acid Synthase and Adipocyte Differentiation.

Obesity is a complex health condition characterized by excessive adipose tissue accumulation, leading to significant metabolic disturbances such as insulin resistance and cardiovascular diseases. Fatty acid synthase (FAS), a key enzyme in lipogenesis, has been identified as a potential therapeutic target for obesity due to its role in adipocyte differentiation and lipid accumulation. This study employed a multidisciplinary approach involving in silico and in vitro analyses to investigate the anti-adipogenic properties of maclurin, a natural phenolic compound derived from Morus alba. Using SwissDock software (ChEMBL version 23), we predicted protein interactions and demonstrated a high probability (95.6%) of maclurin targeting FAS, surpassing the interaction rates of established inhibitors like cerulenin. Docking simulations revealed maclurin's superior binding affinity to FAS, with a binding score of -7.3 kcal/mol compared to -6.7 kcal/mol for cerulenin. Subsequent in vitro assays confirmed these findings, with maclurin effectively inhibiting FAS activity in a concentration-dependent manner in 3T3-L1 adipocytes, without compromising cell viability. Furthermore, maclurin treatment resulted in significant reductions in lipid accumulation and the downregulated expression of critical adipogenic genes such as PPARγ, C/EBPα, and FAS, indicating the suppression of adipocyte differentiation. Maclurin shows potential as a novel FAS inhibitor with significant anti-adipogenic effects, offering a promising therapeutic avenue for the treatment and prevention of obesity.

Social Jetlag on Obesity-Related Outcomes in Spanish Adolescents: Cross-Sectional Evidence from the EHDLA Study.

This study aimed to investigate the association between social jetlag (SJL) and obesity-related outcomes among adolescents from Valle de Ricote (Region of Murcia, Spain). We explored the relationship between SJL and body mass index (BMI) z-score, waist circumference, and body fat percentage, as well as the odds of having excess weight, obesity, and abdominal obesity in a sample of Spanish adolescents. A cross-sectional study was conducted using data from the Eating Healthy and Daily Life Activities (EHDLA) project, which included 847 Spanish adolescents aged 12-17 years. SJL was assessed based on the differences in sleep patterns between weekdays and weekends. Obesity-related indicators such as BMI z-score, waist circumference, body fat percentage, excess weight, obesity, and abdominal obesity were measured. Generalized linear models with a Gaussian or binomial distribution were used to analyze the associations between SJL and obesity-related outcomes, adjusting for potential confounders. The analysis revealed significant associations between SJL and BMI z-score (unstandardized beta coefficient [B] = 0.15, 95% CI: 0.05 to 0.25, p = 0.003), waist circumference (B = 1.03, 95% CI: 0.39 to 1.67, p = 0.002), and body fat percentage (B = 0.83, 95% CI: 0.31 to 1.43, p = 0.008). Additionally, the odds ratios (ORs) for excess weight (OR = 1.35, 95% CI: 1.16 to 1.57; p < 0.001), obesity (OR = 1.59, 95% CI: 1.26 to 2.00; p < 0.001), and abdominal obesity (OR = 1.46, 95% CI: 1.23 to 1.72; p < 0.001) increased significantly with each 60 min increment in SJL. This study pointed out that the misalignment of sleeping times during weekdays and weekends (SJL) is significantly associated with higher BMI z-scores, waist circumference, body fat percentage, and higher odds of excess weight, obesity, and abdominal obesity among adolescents, being more significant in boys than in girls. These findings highlight the importance of addressing circadian misalignment in the prevention and management of obesity and its related metabolic disorders in this population.

Childhood obesity and comorbidities-related perspective and experience of parents from Black and Asian minority ethnicities in England: a qualitative study.

Preventing childhood obesity and associated comorbidities is often hampered by disproportionate disparity in healthcare provision in minority ethnic populations. This study contextualized factors influencing childhood obesity and related comorbidity from the perspectives and experiences of parents of ethnic minority populations. Following ethical approval, families (n = 180) from ethnic minority populations in the Northeast of England were contacted through flyers, community social groups and online forum. Of the 180 families contacted, 22 expressed interests, of whom 12 parents were eligible to participate in the study, and one family dropped out due to time constraints. Therefore 11 parents from ethnic minority communities living with at least one child with obesity were interviewed. Each family was separately visited at home and took part in a semi-structured interview based on the study's qualitative, descriptive phenomenological design. Nine of the families had one child who was diagnosed with an obesity-related comorbidity (non-alcoholic fatty liver disease, musculoskeletal problems or respiratory disorder). Semi-structured interviews were standardized around parents' perspective and experience on how their children were impacted by obesity and comorbidities, healthcare preventative interventions including lifestyle physical activity and nutrition, and views on tackling obesity impact on their lives. All interviews were analyzed using qualitative thematic analysis. Parents' perspectives revealed 11 themes centered around experience of living with a child with obesity, risks, and impact of obesity related Non-Communicable Diseases; and access to support, and barriers unique to minority ethnic groups. Parents revealed social disadvantages, fear of victimization by social services, perceptions on their cultural and religious traditions, and racial stigmatization related to their child's weight. Parents reported closer bonding with their children to protect them from the untoward consequences of overweight, and little awareness of healthcare obesity prevention programs. Work pressure, lack of time, absence of guidance from professionals were seen as barriers to healthy lifestyle, while support from friends and closer family bond in adopting healthy lifestyle behaviors were facilitators. However, there was little awareness or access to current healthcare obesity preventive offerings. Minority ethnic communities' perspective on childhood obesity prevention does not match the healthcare system preventative offerings. Community and family-oriented obesity preventative approaches, especially lifestyle interventions are needed beyond those administered by the primary healthcare system.

Comparison of In-Person and Virtual Implementations of an Obesity Prevention and Culinary Nutrition Education Program for Family Care Providers

Start Strong, a 4-week culinary nutrition education and obesity prevention program designed for rural family care providers in low-income areas of Minnesota, was initially an in-person training program and was recently adapted into a virtual version. Using a quasi-experimental design, this study examined within-group and between-group (in-person versus virtual) changes in culinary skill confidence and familiarity with food assistance programs after Start Strong participation. Additionally, we examined post-program participant experiences. The in-person program (n = 12, mean age of 45 years, September 2019) took place at community locations. The virtual program (n = 27, mean age of 41 years, Fall 2021–Winter 2022) used online learning and videoconferencing. Following data collection pre- and post-program, we used t-tests to examine within-group changes after Start Strong participation, repeated measures analysis of variance tests to compare outcomes between the in-person and virtual implementations, and Fisher’s exact test to compare post-survey outcomes. The in-person and virtual programs demonstrated similar improvements in cooking skill confidence and familiarity with food assistance programs. Compared to the virtual program, in-person participants reported significantly greater connection with other providers. This evaluation is relevant to addressing disparities in obesity prevention and provides an initial model for public health and community partnerships with ECE providers.

Key Players in the Complex Pathophysiology of Obesity: A Cross-Talk Between the Obesogenic Genes and Unraveling the Metabolic Pathway of Action of Capsaicin and Orange Peel.

Obesity is a widespread prevailing health concern with multifactorial causes. Among the various defined molecular targets associated with obesity, peroxisome proliferator activated receptor gamma, leptin, ghrelin, and adiponectin play crucial roles in fundamental processes including energy balance, adipose tissue biology, and metabolic health, making them particularly significant in the study of obesity.Capsaicin and orange peel exhibit promising anti-obesity properties through their thermogenic, metabolic, and anti-inflammatory effects. Potential pathways for therapeutic approaches in the management of obesity are provided by these targets. The lipid-lowering and anti-obesity benefits of specific plant species have been highlighted in Asian medicine. Due to the potential anti-obesity qualities, capsaicin, which is derived from chilli peppers, and orange peel extract has been focused in this review. Capsaicin causes apoptosis in preadipocytes and adipocytes and suppresses adipogenesis. Citrus fruits area significant source of bioactive substances, primarily flavonoids. Due to their ability to reduce adipocyte development and cellular lipid content, citrus polyphenols are helpful in the control of obesity. This extensive analysis offers insights into new treatment approaches for the prevention and management of obesity and metabolic syndrome by examining the interactions of molecular variables in obesity as well as the possible anti-obesity advantages of capsaicin and orange peel extract.

Discovery of Curcuminoids as Pancreatic Lipase Inhibitors from Medicine-and-Food Homology Plants.

Researchers are increasingly interested in discovering new pancreatic lipase inhibitors as anti-obesity ingredients. Medicine-and-food homology plants contain a diverse set of natural bioactive compounds with promising development potential. This study screened and identified potent pancreatic lipase inhibitors from 20 commonly consumed medicine-and-food homology plants using affinity ultrafiltration combined with spectroscopy and docking simulations. The results showed that turmeric exhibited the highest pancreatic lipase-inhibitory activity, and curcumin, demethoxycurcumin, and bisdemethoxycurcumin were discovered to be potent pancreatic lipase inhibitors within the turmeric extract, with IC50 values of 0.52 ± 0.04, 1.12 ± 0.05, and 3.30 ± 0.08 mg/mL, respectively. In addition, the enzymatic kinetics analyses demonstrated that the inhibition type of the three curcuminoids was the reversible competitive model, and curcumin exhibited a higher binding affinity and greater impact on the secondary structure of pancreatic lipase than found with demethoxycurcumin or bisdemethoxycurcumin, as observed through fluorescence spectroscopy and circular dichroism. Furthermore, docking simulations supported the above experimental findings, and revealed that the three curcuminoids might interact with amino acid residues in the binding pocket of pancreatic lipase through non-covalent actions, such as hydrogen bonding and π-π stacking, thereby inhibiting the pancreatic lipase. Collectively, these findings suggest that the bioactive compounds of turmeric, in particular curcumin, can be promising dietary pancreatic lipase inhibitors for the prevention and management of obesity.

Nutritional Management and Physical Activity in the Treatment of Sarcopenic Obesity: A Review of the Literature.

The prevalence of sarcopenic obesity among adults aged ≥65 years is increasing worldwide. It is a condition that describes the concomitant presence of sarcopenia and obesity, but it appears to be associated with greater increases in the risks for disability, morbidity, and mortality than the two conditions combined. The current review aims to summarize the available literature data on the effectiveness of lifestyle modification for the management of this high-risk geriatric syndrome. We conducted a comprehensive search across multiple databases, including PubMed, Scopus, Web of Science, and Cochrane Library, for publications published from January 1950 to June 2024. The detection of early preventive and therapeutic approaches to combat sarcopenic obesity is essential for healthy aging. There is ample evidence that suggests that poor dietary habits and physical inactivity are the main reasons for the development of sarcopenic obesity and should thus be the main targets for intervention. In the absence of effective pharmacological interventions, the best effect on sarcopenic obesity is achieved by combination with proper dietary intervention and regular physical activity according to the individual's health condition. Further research is needed to discover the most effective strategy for the prevention and treatment of sarcopenic obesity, as well as potential pharmacological options to improve muscle mass and function in older populations with physical restrictions.

The Effects of Testosterone on Hypothalamic and Serum Oxytocin Levels Are Affected by the Estrogen Milieu in Female Rats.

Previous studies have suggested that the effects of androgens on body weight (BW) and appetite are affected by the estrogen milieu in females; however, the mechanism underlying these effects remains unclear. We hypothesized that androgens may affect endogenous oxytocin (OT), which is a hypothalamic anorectic factor, and that these effects of androgens may be altered by the estrogen milieu in females. To investigate this hypothesis, in the present study, we examined the effects of testosterone on peripheral and central OT levels in ovariectomized female rats that did or did not receive estradiol supplementation. Ovariectomized female rats were randomly divided into non-estradiol-supplemented or estradiol-supplemented groups, and half of the rats in each group were concurrently supplemented with testosterone (i.e., rats were divided into four groups, n = 7 per each group). We also measured peripheral and central OT receptor (OTR) gene expression levels. As a result, we found that testosterone increased serum and hypothalamic OT levels and OT receptor mRNA levels in non-estradiol-supplemented rats, whereas it had no effects on these factors in estradiol-supplemented rats. In addition, testosterone reduced food intake, BW gain, and fat weight in non-estradiol-supplemented rats, whereas it did not have any effects on BW, appetite, or fat weight in estradiol-supplemented rats. These findings indicate that the effects of androgens on OT may be affected by the estrogen milieu, and elevated OT levels may be related to the blunting of appetite and prevention of obesity under estrogen-deficient conditions.

The Prevention of Childhood Obesity Is a Priority: The Preliminary Results of the "EpPOI: Education to Prevent Childhood Obesity" Project.

The increase in childhood obesity rates represents a serious public health problem. The project "EpPOI: Education to prevent childhood obesity" is aimed at a multidisciplinary approach to raise awareness of the importance of preventing childhood obesity through lifestyle education. Two actions by experts were performed: an intervention with children in schools and a meeting for both parents and school staff. Participants completed a questionnaire structured as a Likert scale. The sample size was 96 people, and awareness of the childhood obesity problem as well as the need for obesity prevention was high among respondents. We also found great interest among participants in having more information on pediatric nutrition and physical activity, with a positive correlation with age. Furthermore, the multivariate regression model configured interest in having more information on nutrition and physical activity as an independent and statistically significant predictor of awareness of childhood obesity as a current issue. The results highlight the need to act on childhood obesity through lifestyle prevention strategies early in life.

Polycystic ovary syndrome and the risk of asthma in reproductive-age women: Insights from 2 real-world large cohorts

Clinicians should consider screening women of childbearing age with Polycystic Ovary Syndrome (PCOS) for asthma symptoms to avoid delays in diagnosis and management. In addition, weight management and obesity prevention in PCOS patients should be prioritized to reduce the risk of asthma. Future studies should assess the role of hormonal supplementation/therapy in this patient population to improve asthma severity and outcomes.

Effectiveness of a nurse-led mHealth approach in preventing obesity in adolescents: an intervention study.

Obesity prevention in adolescents is a public health priority given its increasing prevalence and health impact of obesity. To evaluate the effectiveness of an educational intervention in overweight and obesity using a mHealth app in improving nutritional and sports knowledge, adherence to the Mediterranean diet, physical activity and anthropometric measurements in adolescents. A randomised controlled trial with parallel groups that included 305 adolescents. The app includes the use of effective behavioural strategies to achieve habit change. Primary outcome variables were nutritional and sports knowledge score (GeSNK), adherence to a Mediterranean diet (KidMed) and level of physical activity (PAQ-A). The study included 154 participants in the mHealth group and 151 in the control group. The level of nutritional and sports knowledge was significantly higher in the mHealth group, 47 points versus 42 points. Adherence to the Mediterranean diet improved in both groups, 9 points in the mHealth group versus 8 points in the control group. Physical activity was statistically higher in the intervention group, 160 minutes/week versus 120 minutes/week. The mHealth intervention showed a significant improvement in the level of nutritional and sports knowledge, adherence to the Mediterranean diet and time spent on physical activity.

Applying the family stress model to responsive feeding and early obesity prevention

Applying the family stress model to responsive feeding and early obesity prevention

ω-6 and ω-3 Polyunsaturated Fatty Acids: Inflammation, Obesity and Foods of Animal Resources.

Obesity, as defined by the World Health Organization (WHO), is excessive fat accumulation that can pose health risks and is a disorder of the energy homeostasis system. In typical westernized diets, ω-6 polyunsaturated fatty acids (PUFAs) vastly exceed the amount of ω-3 PUFAs, with ω-6/ω-3 ratios ranging from 10:1 to 25:1. ω-6 PUFAs, such as arachidonic acid, have pro-inflammatory effects and increase obesity. On the other hand, ω-3 PUFAs, including eicosapentaenoic acid and docosahexaenoic acid, have anti-inflammatory and anti-obesity effects. Linoleic acid (LA) and alpha-linolenic acid (ALA) are synthesized in almost all higher plants, algae, and some fungi. However, in humans and animals, they are essential fatty acids and must be consumed through diet or supplementation. Therefore, balancing LA/ALA ratios is essential for obesity prevention and human health. Monogastric animals such as pigs and chickens can produce meat and eggs fortified with ω-3 PUFAs by controlling dietary fatty acid (FA). Additionally, ruminant animals such as feeder cattle and lactating dairy cows can opt for feed supplementation with ω-3 PUFAs sources and rumen-protected microencapsulated FAs or pasture finishing. This method can produce ω-3 PUFAs and conjugated linoleic acid (CLA) fortified meat, milk, and cheese. A high ω-6/ω-3 ratio is associated with pro-inflammation and obesity, whereas a balanced ratio reduces inflammation and obesity. Additionally, probiotics containing lactic acid bacteria are necessary, which reduces inflammation and obesity by converting ω-6 PUFAs into functional metabolites such as 10-hydroxy-cis-12-octadecenoic acid and CLA.

Enactment, Evaluation, and Expansion of a Healthy Living Club in an Out of School Setting: A Community-Academic Partnership.

Interventions in community settings, where children spend substantial out of school time, may enhance access to evidence-based lifestyle interventions. The Boys and Girls Club of Lawrence (BGCL) and New Balance Foundation Obesity Prevention Center at Boston Children's Hospital partnered to revise, enact, and evaluate BGCL's existing Healthy Living Club and then flexibly expand the program to increase access. The BGCL is within walking distance of three public housing communities and easily accessible to members, of whom 90% identify as Hispanic. The interventions comprised nutrition sessions and either fitness activity sessions (N+FA Cycle 1, n = 63, 26 hours; N+FA Cycle 2, n = 94, 27 hours) or academic basketball practices (N+AB Cycle 2, n = 99, 72-80 hours), leveraging time already in the schedule where fitness could be intentionally promoted by coaches. Among children aged 8-15 years, mean [95% confidence interval (CI)] changes (beginning to end) in percentage above the BMI median were significant [N+FA Cycle 1: -2.4 (-4.1, -0.8); N+FA Cycle 2: -4.3 (-5.4, -3.1); N+AB Cycle 2: -5.5 (-6.9, -4.1)]. Lifestyle interventions, implemented with flexibility in existing programs, had beneficial impact, indicating potential of community-academic partnerships.

Dietary patterns associated with obesity and its comorbidities

Obesity is a major public health challenge, in Spain the prevalence of excess of weight and obesity and is 56 % and 19 %, respectively, and it is linked to numerous preventable chronic diseases. Nutritional epidemiology focused on nutrients has evolved towards the study of dietary patterns that consider synergistic interactions between foods and nutrients. This study aims to investigate the relationship between obesity and its treatment by healthy dietary patterns. The Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH), based on plant products, whole grains and low levels of salt, sugars and red meat, have been shown to promote weight loss and reduce comorbidities associated with obesity. Although vegetarian and vegan diets are adequate options for disease management and prevention, they require planning to avoid nutritional deficiencies. In conclusion, healthy dietary patterns such as the Mediterranean diet, DASH and vegetarian options are effective in both the prevention and treatment of obesity, highlighting the importance of considering the synergy between foods and nutrients in the management of this health condition.

Impact of the Physical Activity Environment on Change in Body Mass Index Percentile in Child Care Centers Serving Children with Disabilities.

Childcare centers (CCCs) can provide opportunities to implement physical activity (PA) via health promotion interventions to prevent obesity and associated chronic disease risk factors in young children. This study evaluated the impact of the Healthy Caregivers-Healthy Children (HC2) intervention on body mass index percentile (PBMI) and the PA environment in CCCs serving children with disabilities (CWD) over one school year. Ten CCCs were cluster-randomized to either (1) an intervention arm that received the HC2 curriculum adapted for CWD or (2) an attention control arm. Mixed-effect linear regression models analyzed the relationship between change in child PBMI and CCC childcare center PA environment by experimental condition and child disability status over one school year. Findings showed a significant decrease in PBMI among children in the HC2 centers (-6.74, p = 0.007) versus those in control centers (-1.35, p = 0.74) over one school year. Increased PA staff behaviors (mean change 3.66, p < 0.001) and PA policies (mean change 6.12, p < 0.001) were shown in intervention centers during the same period. Conversely, there was a significant increase in sedentary opportunities (mean change 4.45, p < 0.001) and a decrease in the portable play environment (mean change -3.16, p = 0.03) and fixed play environment (mean change -2.59, p = 0.04) in control centers. No significant differences were found in PBMI changes between CWD and children without disabilities (beta = 1.62, 95% CI [-7.52, 10.76], p = 0.73), suggesting the intervention's efficacy does not differ by disability status. These results underscore the importance of (1) including young CWD and (2) PA and the supporting environment in CCC health promotion and obesity prevention interventions.