Overweight Children Research Articles

Registration and management of children with overweight by general practitioners in The Netherlands

Background General practitioners (GPs) form the gateway to healthcare in numerous European countries. Their role in addressing and managing overweight/obesity in children is crucial. In Dutch guidelines, GPs are encouraged to proactively address weight-related issues during patient consultations, regardless of the initial reason of the visit. Objective(s) To examine the frequency, management and follow-up of GP visits of children for overweight/obesity and the identification by GPs of these children presenting with other complaints. Methods A retrospective cohort study. Health records from 2012–2021 in the Rijnmond Primary Care Database (RPCD) of children aged 2–18 with overweight/obesity who visited the GP were analysed. Children were categorised into two groups: those visiting for weight-related issues (group 1) and those visiting for other complaints but identified as overweight or obese by GPs (group 2). Data on patient demographics, reasons for contact, and management strategies were extracted. Results From the 120,991 children, 3035 children with documented overweight or obesity were identified, 208 were excluded. The study population comprised 2827 individuals: 55% belonging to group 1, 45% to group 2. The frequency of first visits remained stable at approximately 0.5% visits per total person-years each year. Group 1 received more referrals (74%) and follow-up consultations (45.5%) than group 2 with 17% referrals and 19.7% follow-up consultations. Conclusion This study highlights a concerning difference in the management of the two groups. Strategies for effective management of overweight in children and the GP’s role, warrant further investigation. Especially when overweight is not the primary reason for visit.

Dosing of antidepressants in relation to body weight in children and adolescents with overweight.

Overweight and obesity in children and adolescents may impact pharmacokinetics and drug exposure. The aim of the present study was to evaluate doses of antidepressants in relation to body weight in children. We used data from the BMI Epidemiology Study (BEST) Gothenburg cohort and the National Prescribed Drug Register and included children and adolescents with a prescription of fluoxetine (n = 347) or sertraline (n = 733) and a weight measurement. For fluoxetine, individuals with overweight or obesity received slightly lower doses at first prescriptions, but not in iterated prescriptions. The weight-normalized dose was lower in individuals with overweight or obesity in first and iterated prescriptions, compared with normal weight (p < 0.01). For sertraline, there were no significant dose differences between individuals with overweight or obesity, compared with normal weight. However, pronounced differences were seen in dose per kilogram body weight in both first and iterated prescriptions (p < 0.01). We conclude that the doses of fluoxetine and sertraline were essentially similar in individuals with overweight or obesity, but the weight-normalized doses were clearly lower. Given the ongoing obesity epidemic, larger studies addressing optimal dosing in individuals with elevated weight are warranted.

Prevalence of childhood overweight and obesity in Malaysia: a systematic review and meta-analysis.

The incidence of childhood obesity is increasing worldwide. National surveys in Malaysia have shown similar trends. This review aimed to increase our understanding of the prevalence and associated factors of childhood overweight, obesity, and excess weight in Malaysia. A systemat-ic review and meta-analysis were conducted of studies reporting the prevalence of overweight and obesity in Malaysian children aged < 18 years. Systematic searches were conducted in Oc-tober 2023 and repeated in March 2024 of the PubMed, Scopus, and Web of Science databases. The grey literature was also included. Study selection, data extraction, and quality assessments were conducted by paired independent researchers. A meta-analysis of prevalence and 95% confidence interval (CI) using a random-effects model and heterogeneity (I2) was calculated. Publication bias was investigated using Egger's test. This review included 33 studies (N=273,710) conducted between 1996 and 2022. Overall, the childhood overweight, obesity and excess weight prevalence was 13.9% (95% confidence interval [CI], 13.0-14.8%), 11.8% (95% CI, 10.9-12.8%), and 24.0% (95% CI, 22.3-25.7%), respectively. Boys had a significant-ly higher proportion of obesity (12.5% [95% CI, 11.1-14.1%] vs. 9.1% [95% CI, 8.1-10.1%]) and excess weight (25.7% [95% CI, 23.5-28.1%] vs. 20.7% [95% CI, 18.8-22.8%]) than girls. Sarawak natives had a higher prevalence of obesity (17.7% [95% CI, 16.0-19.5%]). Annually, the obesity prevalence increased by 0.3% (95% CI, 0.1-0.6%; p=0.006) and excess weight prevalence increased by 0.6% (95% CI, 0.3-1.0%; p=0.002). Heterogeneity was high (I2>90%), and publication bias was possible (p<0.001). Variability was not significantly affected by the critical appraisal score or sample size. In conclusion, the prevalence of childhood overweight, obesity, and excess weight in Malaysia doubled over 26 years. Future studies of the prevalence of childhood excess weight should follow a standardized reference for body mass index by age to ease interstudy comparisons.

Consumption of Sugar-Sweetened Beverages by Polish Young Adults: A Preliminary Study on the Importance of Sugar Tax Familiarity and Health Effects

Consumption of sugar-sweetened beverages (SSBs) contributes to the risk of developing overweight and obesity in children and adults. Thus, reducing free sugar is a globally recognized public health priority. The implementation of a sugar tax is one way of achieving this goal. This study aimed to investigate the relationship between familiarity with the sugar tax and its importance in reducing obesity, the perceived health consequences of SSBs, situations and reasons for consumption, and the frequency of SSB consumption. A cross-sectional study was conducted in May 2022 among 216 Polish adults (age 18–45). Hierarchical cluster analysis was used to identify three homogeneous clusters with regard to the perceived health consequences of consuming SSBs. A logistic regression model was used to verify the relationship between the frequency of SSB consumption (dependent variable) and other variables. Respondents with higher familiarity with the sugar tax (OR: 0.594; 95% CI: 0.42–0.85) and those in the “Unaware of disease” (OR: 0.437; 95% CI: 0.18–0.94) and “Disease-conscious” (OR: 0.484; 95% CI: 0.24–0.97) clusters were less likely to consume SSBs at least once per week than those in the “Moderately disease-conscious” cluster. Both the place of SSB consumption (i.e., restaurant—OR: 1.847; 95% CI: 1.14–3.64, work or university—OR: 3.217; 95% CI: 1.51–6.88, family home—OR: 2.877; 95% CI: 1.50–5.53) as well as a preference for their taste (OR: 4.54; 95% CI: 1.66–12.45) increased the chance of consuming SSBs at least once a week. In conclusion, it is necessary to continue educating the public about the health consequences of SSB consumption. The use of legislative measures (i.e., sugar tax) also contributes to reducing SSB consumption and can thus counteract the increasing obesity rate.

Interventions for Managing Picky Eating in Preschool Children: Literature Review

Introduction: Picky eating in children is a widespread issue that can affect growth and development. Factors contributing to picky eating include parental influence, early feeding practices, and environmental conditions. Addressing picky eating behavior is crucial to prevent long-term negative effects on children's nutrition and health. Objective: This study aimed to evaluate the effectiveness of various interventions, such as sensory education, parent training, oral interventions, massage, and diet adjustments, in improving picky eating behavior in children. Method: A review of 15 studies published between 2013 and 2023 was conducted, focusing on intervention programs for children aged 1-6 years. The studies were selected from databases like PubMed, Science Direct, and Google Scholar. Result: Sensory education helped reduce food rejection by familiarizing children with new foods. Parent training, including cooking classes and the Baby Led Weaning (BLW) method, effectively reduced picky eating. Oral interventions, such as herbal remedies and appetite-enhancing supplements, showed positive outcomes. Massage techniques like Tui Na and tailored dietary plans also contributed to better eating habits in both underweight and overweight children. Conclusion: Interventions including sensory education, parental training, oral treatments, massage, and diet modifications can significantly improve eating behaviors in picky eater children, promoting healthier nutrition and growth.

Sovrappeso e obesità in età pediatrica: un intervento pragmatico nelle cure primarie

Paediatric clinics are in a unique position to detect chronic diseases, identify at-risk individuals, educate families and implement early preventive interventions. This article aims to provide evidence on how and with what strategies the AUSL of Reggio Emilia has built a programme to combat overweight and obesity in childhood by involving a network of services, starting with paediatricians. A variety of approaches have been taken to address the problem of promoting healthy lifestyles. The BMIF project (Very Fit Children) focuses on early detection and treatment of overweight children using motivational interviewing to help families change their lifestyles. First, second and third level interventions provide treatment for children with obesity according to defined care pathways. Anticipatory guides on responsive feeding and the BeBa (Children's Wellbeing) app promote healthy lifestyles. Effectiveness and equity were the guiding principles for the choices made. This required time and a significant effort, but it also resulted in greater support from both operators and decision-makers.

Effectiveness of a health promotion program on overweight in vulnerable children from primary schools (BeE-school): A cluster-randomized controlled trial.

Obesity is a complex, multifactorial disease with rising global prevalence. Considering its significant association with lower socioeconomic status, implementing obesity prevention programs in vulnerable school-age children is particularly pertinent. This cluster-randomized controlled trial aims to evaluate the effectiveness of a health promotion program on overweight in vulnerable children from primary schools. The BeE-school study involved 735 children (51.7% boys, average age 7.7 (1.2) years old) from 10 primary schools in the Northern region of Portugal, identified as Educational Territories for Priority Intervention. After the initial assessment, the schools were randomized into two groups: one receiving the intervention (4 schools, n = 353) and the other not (6 schools, n = 382). The intervention included education and training teachers for 16 weeks, their implementation in the classroom, and giving families challenges every two weeks during this length of time. The program's effectiveness was assessed short-term, immediately post-intervention (for 95.5% of participants) and long-term, one year after (for 50.8%). We considered the difference in BMI z-scores (BMIz), waist-to-height ratio and waist-to-weight ratio, from baseline to post-intervention and follow-up assessment. In post-intervention, intervened children presented a significant reduction in all the three measures of adiposity: BMIz (B = -0.098, 95% CI: -0.156 to -0.040, p = 0.001), waist-to-height ratio (B = -0.007, 95% CI: -0.010 to -0.003, p < 0.001) and waist-to-weight ratio (B = -0.121, 95% CI: -0.193 to -0.048, p = 0.001). One year after the intervention ended the decrease in BMIz remained significant (B = -0.114, 95% CI: -0.213 to -0.015, p = 0.023). Conclusion: The school-based intervention, focusing on teacher training in health promotion and involving families, proved to be effective in improving body composition in socially vulnerable children.

The joint effect of vitamin-D status and tobacco exposure on overweight and obesity in children.

This study aimed to explore the combined effects of serum vitamin-D level and tobacco exposure on the risk of overweight and obesity in children. This cross-sectional study analysed the data of 11636 children aged 2-17 years from the National Health and Nutrition Examination Surveys database between 2007 and 2018. Univariable and multivariate weighted logistic regression models were used to analyse the associations of serum vitamin-D or cotinine levels with overweight and obesity in children as well as the combined effects of serum vitamin-D and cotinine on the risk of overweight and obesity in children. Subgroup analysis was performed in terms of gender, age, race and household smokers. OR with corresponding 95 % CI was presented. The elevated risk of overweight and obesity in children was found in those with serum vitamin-D < 20 ng/ml (OR = 1·44, 95 % CI: 1·29, 1·61). Also, the odds of overweight and obesity in children was 1·14 (OR = 1·14, 95 % CI: 1·01, 1·29) in children with cotinine ≥ 0·05 ng/ml. Relative to participants with serum vitamin-D ≥ 20 ng/ml and cotinine < 0·05 ng/ml, increased risk of overweight and obesity was identified in those with serum vitamin-D < 20 ng/ml and cotinine < 0·05 ng/ml (OR = 1·45, 95 % CI: 1·26, 1·68) and serum vitamin-D < 20 ng/ml and cotinine ≥ 0·05 ng/ml (OR = 1·62, 95 % CI: 1·38, 1·91). Serum vitamin-D and cotinine exposure had combined effects on the risk of overweight and obesity in children.

Ambient air pollution, urban green space and childhood overweight and obesity: A health impact assessment for Barcelona, Spain

BackgroundThe burden of childhood overweight and obesity attributable to ambient air pollution and a lack of urban green spaces (UGS) remains unknown. This study aimed to estimate the attributable cases of childhood overweight and obesity due to air pollution and insufficient UGS exposure in Barcelona, Spain. MethodsWe applied a quantitative health impact assessment approach. We collected childhood overweight and obesity prevalence levels and exposure data from 69 spatial basic health zones in Barcelona. We estimated particulate matter (PM2.5) and nitrogen dioxide (NO2) levels using land use regression models, normalized difference vegetation index (NDVI) levels using remote sensing and percentage of green area (%GA) using land use. We estimated relative risks, population attributable fractions, and preventable overweight/obesity cases in children under following scenarios: Compliance of World Health Organization (WHO) air quality guidelines (AQGs) for (1) PM2.5 and (2) NO2; achieving (3) city-target NDVI levels and (4) 25% green area (%GA) recommendations. The analyses were stratified by socioeconomic deprivation index (in quintiles). Uncertainty was quantified using Monte Carlos simulations. ResultsCompliance of WHO AQGs could prevent 0.4% [253 (95%CI, −604; 1086)] and 4.2% [3000 (95%CI, 1009; 4943)] of childhood overweight/obesity cases due to excess PM2.5 and NO2 levels in Barcelona, respectively. Compliance of NDVI and %GA targeted levels could prevent 6% [4094 (95%CI, 1698; 6379)] and 10% [6853 (95%CI, 1440; 12779)] of childhood overweight/obesity cases respectively. The preventable burdens of childhood overweight/obesity cases were slightly higher in middle-class socioeconomic areas due to the higher adverse exposure levels at baseline (high air pollution, less UGS). DiscussionCompliance with WHO AQGs and achieving UGS targets can reduce childhood overweight and obesity levels in Barcelona, and potentially in other locations as well. This underscores the need for policies that foster healthier urban environments of high environmental quality in order to protect child health.

Measuring validity and reliability of the Italian version of Physical Activity Questionnaire for Older Children in overweight and obese children

The measure of daily physical activity (PA) is one of the most important topics in the field of health promotion. In addition, self-efficacy and enjoyment are significant factors that can foster adherence to physical activity during a person’s lifetime. The present study aims to assess the validity and reliability of Physical Activity Questionnaire for Older Children-Italian version (PAQ-C-It) in a sample of normal weight, overweight, and obese children. Three studies were conducted to assess the (1) general characteristics of PAQ-C-It, (2) model fit and construct validity between PA, self-efficacy, and enjoyment, and (3) reliability and construct validity of PAQ-C-It in normal weight, overweight, and obese children. The sample involved a total of 914, 500, and 600 children (male = 466, female = 448) attending first grade of secondary school (age = 11–13 years), in the first, second and third study, respectively. Children were asked to respond to three scales: Physical Activity Questionnaire for Older Children (PAQ-C-It), the Perceived Physical Ability Scale (PPAS), and Physical Activity Enjoyment Scale (PACES). Then, explorative and confirmatory factor analyses were conducted to assess the validity and reliability of the PAQ-C-It by relating results with those of the other scales. The analysis showed acceptable value and internal consistency of items for the subscales (α &amp;gt; 0.7), as well as the average variance extracted (&amp;gt;0.5) in both normal weight, overweight, and obese children. The results of the present study show that PAQ-C-It can be applied in the field of physical activity to measure adherence to physical activity and healthy behaviors. Moreover, self-efficacy and enjoyment are significant factors that can best promote adherence to PA. The present study can extend our knowledge about PAQ-C-It and open up new research avenues for driving interventions aimed at reducing sedentary behavior and improving PA in overweight and obese children.

The case for investment in nutritional interventions to prevent and reduce childhood and adolescent overweight and obesity in Peru: a modelling study

BackgroundBetween 2006 and 2016 the prevalence of overweight and obesity among children and adolescents aged 5–19 years in Peru increased from 22.7 to 27.0%. This investment case quantifies the economic impacts of childhood and adolescent overweight and obesity in Peru. It identifies and quantifies the potential impact of a set of new or expanded interventions that can strengthen current national efforts to prevent and reduce child and adolescent overweight and obesity.MethodsA deterministic Markov cohort model with a societal cost perspective estimated reductions in mortality and morbidity from implementing interventions to prevent and reduce child and adolescent overweight and obesity and the impact in savings in healthcare costs and gains in wages and productivity. Interventions identified through a review of published literature includes a school-based social marketing campaign, exclusive breastfeeding promotion and support, a healthy food and drink policy for school premises, and a 20% subsidy on fruits and vegetables for people living below the national poverty line. The return on investment (ROI) was calculated along with the estimated cost savings associated with the interventions. Analysis was conducted to test ROI sensitivity to changes in the key parameters and assumptions.ResultsBetween 2025 and 2092, the expected combined direct and indirect healthcare costs attributable to child and adolescent overweight and obesity in Peru are 210.6 billion USD. The direct healthcare costs are 1.8 billion USD, and the indirect costs are 208.8 billion USD. Expected savings for all interventions combined is 13.9 billion USD with a per-person savings of 12,089.8 USD. The expected ROI of the four interventions combined is 39.3 USD (30-years), 64.6 USD (50-years), and 164.1 USD (66-years) per one USD invested.ConclusionsThe overweight and obesity epidemic among children and adolescents in Peru requires wide-ranging and expanded implementation of policies to achieve long-term reductions in prevalence. This study’s findings show that the four priority interventions have high ROIs and can be used to guide policy to address the complex interplay of factors that contribute to the obesogenic environment.

Weight Status Change from Birth to Childhood and High Blood Pressure in Childhood

Background: While both high birth weight and childhood overweight/obesity have been associated with a heightened risk of high blood pressure (BP) during childhood, the association between weight status change from birth to childhood and the risk of high BP has not been fully explored. This study aimed to investigate how changes in weight status from birth to childhood influence the development of high BP in childhood. Methods: The data for this study were obtained from the baseline survey of the Huantai Childhood Cardiovascular Health Cohort Study, which included 1237 children aged 6 to 11. Children with a birth weight under 2500 g or a body mass index (BMI) below the fifth percentile for their age and sex during childhood were excluded. Based on birth weight (high birth weight [&gt;4000 g] vs. healthy [≤4000 g]) and childhood weight status (overweight [including obesity] vs. healthy weight), participants were categorized into four groups: consistently healthy weight, weight decrease, weight increase, and consistently excess weight. Results: Compared to children who maintained a healthy weight from birth to childhood, higher odds of childhood high BP was observed among those with consistently excess weight (odds ratio [OR] = 2.73, 95% confidence interval [CI] = 1.46–5.12) and those with a weight increase (OR = 2.77, 95% CI = 1.91–4.02). In contrast, children with a weight decrease did not exhibit significantly higher odds of childhood high BP (OR = 0.94, 95% CI = 0.36–2.45). Conclusion: Children who become overweight in childhood or who consistently had excess weight from birth were at higher risk of childhood high BP. However, the risk of high BP in childhood may be mitigated or eliminated in individuals with high birth weight who achieve a healthy weight by childhood.

Association of maternal 25(OH)D levels during pregnancy with fetal birth weight and preschooler growth status: A retrospective birth cohort study.

There is limited and conflicting evidence available regarding the correlation between maternal vitamin D status and childhood overweight and body mass index (BMI). The aim of this study was to investigate the following: (1) potential association between maternal 25-hydroxyvitamin D (25(OH)D) levels and newborn growth status; (2) relationship between maternal 25OHD levels and BMI and the risk of overweight with preschoolers being overweight. A cohort of 3213 eligible singleton mother-infant pairs were used to investigate the possible associations between maternal 25(OH)D levels and fetal growth status. Data of 1767 available singleton mother-infant pairs and 6-year-old preschoolers was applied to analyze the potential correlations between maternal 25(OH)D status and risk of childhood overweight. Compared with sufficient 25(OH)D in pregnancy group (≥75 nmol/L), there were no correlations between the maternal 25(OH)D deficiency (<50 nmol/L) and large gestational age (LGA) (p = 0.465), small gestational age (SGA) (p = 0.607), lower birth weight (LBW) (p = 0.725) or fetal macrosomia (p = 0.535). Moreover, no significant associations between insufficient maternal 25(OH)D (50-75 nmol/L) and LGA (p = 0.505), SGA (p = 0.816), LBW (p = 0.816), or fetal macrosomia (p = 0.413) were observed. We found statistically significant disparities between the fetal birth weight and height (p < 0.001), weight (p < 0.001), head circumference (p = 0.001) of 6-years preschooler. No significant associations were found between the maternal 25(OH)D levels and BMI and risk of overweight at 6-year-old preschoolers. There were no apparent correlation found between maternal 25(OH)D concentrations and fetal birth status. There was no evidence found to suggest the effect of maternal 25(OH)D level on overweight at 6-year-old preschoolers.

No association between the early-life gut microbiota and childhood body mass index and body composition.

The gut microbiota has been implicated in adult obesity, but the causality is still unclear. It has been hypothesized that an obesity-prone gut microbiota can be established in infancy, but only few studies have examined the early-life gut microbiota in relation to obesity in childhood, and no consistent associations have been reported. Here, we examine the association between the early-life gut microbiota and body mass index (BMI) development and body composition throughout childhood. Gut microbiota from stool were collected from 700 children in the Copenhagen Prospective Studies on Asthma in Childhood2010 (COPSAC2010) cohort at ages of 1week, 1month, 1 year, 4 years, and 6 years and analyzed by 16S rRNA gene sequencing. Outcomes included BMI World Health Organization (WHO) Z scores (zBMI), overweight (zBMI>1.04) and obesity (zBMI>1.64) (0-10 years), and adiposity rebound and body composition from dual-energy X-ray absorptiometry at 6 years. The early-life gut microbiota diversity, overall composition, and individual taxon abundances in unsupervised and supervised models were not consistently associated with either current or later BMI Z scores, overweight, obesity, adiposity rebound, or body composition in childhood. In a deeply characterized longitudinal birth cohort, we did not observe any consistent associations between the early-life gut microbiota and BMI or risk of obesity in later childhood. While this does not conclusively rule out a relationship, it suggests that if such associations exist, they may be more complex and potentially influenced by factors emerging later in life, including lifestyle changes. COPSAC is funded by private and public research funds (all listed on www.copsac.com).

The Estimation of Copper Serum Level Among Obese Children

Background: Obesity means an excess amount of body fat. No general agreement exists on the definition of obesity in children as it does adults. Most professionals use published guidelines based on the body mass index (BMI), or a modified BMI for age, to measure obesity in children. Others define obesity in children as body weight at least 20% higher than a healthy weight for a child of that height, or a body fat percentage above 25% in boys or above 32% in girls Objective: to estimate the serum level of copper among obese children. Methods: This comparative study was conducted on fifty of overweight and/or obese children (based on BMI) and thirty of clinically healthy, age and sex matched children's served as controls also, the cases and controls were selected randomly from the pediatrics outpatient clinic of Benha University Hospital and Sheben El Kom Educational hospital, in the period between 2013 to 2015. Parental consent was obtained for all children included in the study. Results: In the current study there were no significant difference found between patients and control group regarding age, sex and residence, but there was significant difference between the two groups regarding income and socioeconomic state. P=0.04. Also, there were no static difference in height in patient when compared to control group, and patients had a higher statically significant Weight, BMI and Skin fold thickness when compared to control group. Additionally, that there were significantly higher rate of frequent bad nutritional habits including shipping breakfast (p=0.022) consumption of energy- dense food and food consumption during TV watch in patients than controls. P&lt; 0.001 and the children's physical activity levels were lower in the patient’s group than the control group. P&lt;0.001. Conclusion: The obesity varied remarkably with different socioeconomic levels. Obese children had a characteristic nutritional pattern like skipping breakfast and consumption of energy dense food

Exploring the Link between the Obesity and ADHD

Obesity is a chronic, multifactorial and recurrent disease. ADHD is a chronic neurodevelopmental disorder in early childhood. The core symptoms include attention deficit, hyperactivity/impulsivity and oppositional defiance. Research shows that there is a significant correlation between obesity and ADHD, and the probability of overweight and obese children suffering from ADHD is significantly higher than that of normal weight children. This paper discusses the association mechanism between ADHD and obesity from the perspectives of genetics, eating disorders, intestinal flora and poor physical exercise. At the same time, in view of the prevention and intervention of the comorbidity of ADHD and obesity, this paper also puts forward various means such as diet intervention, exercise prevention intervention and drug treatment. However, the relationship between obesity and ADHD is complex, and the comorbidity problem needs to be solved urgently. Establishing an effective early screening system, implementing targeted prevention and intervention measures, and strengthening public awareness and understanding of comorbidities are important ways to improve the quality of life of this group. Further research is needed in the future.

Effects of aerobic exercise on executive function among overweight and obese children: a systematic review and meta-analysis.

Overweight and obesity are serious public health issues worldwide and significantly impair children's executive function (EF). However, there is no consensus regarding the benefits of aerobic exercise, on the EF of overweight and obese children. This study systematically evaluated the intervention effects of aerobic exercise on EF and its subcomponents (inhibitory control, working memory, and cognitive flexibility) in overweight and obese children. We searched six databases-PubMed, Web of Science, Cochrane Library, Embase, EBSCOhost, and China National Knowledge Infrastructure-until March 17, 2024 for randomized controlled trials examining the effects of aerobic exercise on the EF of overweight and obese children the Cochrane Risk of Bias Assessment Tool. Following heterogeneity testing, RevMan 5.4 and Stata 17.0 were used for meta-analysis and subgroup analysis of the three indicators. The standardized mean difference (SMD) and 95% confidence intervals (CI) were used as statistical measures for effect analysis with the SMD value as the effect size and a p-value of ≤0.05 indicating statistical significance. Eighteen studies involving 1,260 participants were included. Aerobic exercise significantly improved overall EF (SMD = -0.50, 95% CI [-0.68, -0.32], p < 0.01) with a moderate to high positive effect on inhibitory control (SMD = -0.52, 95% CI [-0.72, -0.31], p < 0.01) and working memory (SMD = -0.63, 95% CI [-1.06, -0.20], p < 0.01) but not on cognitive flexibility (SMD = -0.32, 95% CI [-0.71, 0.07], p = 0.11). These results suggest that EF in overweight and obese children is influenced by factors such as exercise characteristics and body mass index (BMI). Subgroup analysis revealed a significant moderating effect of exercise type, exercise intensity, session time, and individual BMI on EF. Aerobic exercise selectively improved EF in overweight and obese children. Subgroup analysis indicated that cognitive engagement in ball game interventions of at least moderate intensity and a single session of 25-40 min are more beneficial for improving EF in overweight and obese children. Extremely obese children (BMI > 25 kg/m2) do not benefit from the intervention, highlighting the need for a specific focus on intervention outcomes in future studies.

Predictors of high blood pressure in children from 6 to 11 years: The PREDI cohort study

Abstract Background Hypertension is an important cardiovascular disease (CVD) in Brazil that affects approximately 30% of the adult population and accounts for nearly 50% of CVD-related deaths in the country. Identifying the main predictors of high blood pressure (BP) during childhood will help prevent the development of other CVDs in adulthood and deaths. This study aimed to estimate the effect of biological, demographic, and socioeconomic characteristics on the child’s BP at 6, 9 and 11 years of age. Methods Cohort study conducted with 181 children in Joinville city, southeastern Brazil. Individual data were collected during three follow-ups (2016, 2021, and 2023) in a private room of the family’s home. BP was measured by the auscultatory method. Poisson regression analysis adjusted for important covariates was used to estimate the relative risk (RR) of maternal and child weight status, demographic, and socioeconomic characteristics on the child’s BP at ages 6, 9 and 11. Results The prevalence of high BP in children at ages 6, 9 and 11 was 26.5%, 20.4% and 3.0%, respectively. Pre-pregnancy body mass index (BMI) and the child’s BMI were associated with high BP over the period investigated. The risk of children having high diastolic BP from 6 to 11 years of age was 6% higher (RR = 1.06; 95%CI 1.01, 1.11) when mothers had pre-pregnancy BMI ≥25 kg/m2, even after adjusting for child BMI. For each one kg/m2 increase in child BMI, the risk of children having high systolic BP pressure increased by 14% (RR = 1.14; 95%CI 1.05, 1.23), even after adjusting for pre-pregnancy BMI. Conclusions Pre-pregnancy excess body weight and increased child BMI were associated with high BP in children from 6 to 11 years of age. Addressing pre-pregnancy excess body weight and overweight in childhood, combined with BP monitoring from the age of six, are actions that can prevent the development of CVDs in adulthood, thus reducing a serious global public health problem. Key messages • Encouraging parents to monitor their children’s BP is essential to prevent associated chronic diseases throughout life. • Identifying children with altered blood pressure is an important public health indicator.

Adipose Tissue Macrophages of the Human Fetus.

Prenatal adipose tissue development affects body composition and growth trajectory in early infancy, therefore it is a key determinant of adiposity in childhood. Childhood overweight and obesity increase the probability of being obese as an adult. After birth and in adulthood, adipose tissue macrophages (ATMs) are relevant constituents of the fat depots, and they are necessary for physiological adipose tissue development and fat metabolism. In obesity, however, ATMs may induce chronic inflammation leading to insulin resistance, pancreatic beta cell damage and self-immunity. Despite being relevant regulators of adipose tissue development and functioning, it is unknown whether ATMs are present in the fetal adipose tissue, therefore it is elusive whether they may affect the prenatal establishment of fat depots. Here we studied the distribution of ATMs in the human fetus between gestational weeks 17 and 38 and labeled ATMs in the early postnatal life. We found that CD45+/CD14+/CD68+ ATMs infiltrated the fetal adipose tissue from the 17th week of gestation and remained persistent throughout the second and third trimesters. ATMs were phagocytic in the neonate and expressed interleukin-6, along with other pro-inflammatory gene products. These findings show that ATMs colonize the adipose tissue early in gestation, raising the possibility that intrauterine ATM-adipocyte communication may exist, eventually allowing ATMs to affect prenatal adipose tissue development.

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.