Prevention Of Pediatric Obesity Research Articles

A Scoping Review of Tailoring in Pediatric Obesity Interventions.

Background: Families with children who have or are at risk for obesity have differing needs and a one-size-fits-all approach can negatively impact program retention, engagement, and outcomes. Individually tailored interventions could engage families and children through identifying and prioritizing desired areas of focus. Despite literature defining tailoring as individualized treatment informed by assessment of behaviors, intervention application varies. This review aims to exhibit the use of the term "tailor" in pediatric obesity interventions and propose a uniform definition. Methods: We conducted a scoping review following PRISMA-ScR guidelines among peer-reviewed pediatric obesity prevention and management interventions published between 1995 and 2021. We categorized 69 studies into 6 groups: (1) individually tailored interventions, (2) computer-tailored interventions/tailored health messaging, (3) a protocolized group intervention with a tailored component, (4) only using the term tailor in the title, abstract, introduction, or discussion, e) using the term tailor to describe another term, and (5) interventions described as culturally tailored. Results: The scoping review exhibited a range of uses and lack of explicit definitions of tailoring in pediatric obesity interventions including some that deviate from individualized designs. Effective tailored interventions incorporated validated assessments for behaviors and multilevel determinants, and recipient-informed choice of target behavior(s) and programming. Conclusions: We urge interventionists to use tailoring to describe individualized, assessment-driven interventions and to clearly define how an intervention is tailored. This can elucidate the role of tailoring and its potential for addressing the heterogeneity of behavioral and social determinants for the prevention and management of pediatric obesity.

The prevalence and prevention strategies of pediatric obesity: a narrative review.

Pediatric obesity has rapidly increased globally over the past few decades, including in Korea. We aimed to discuss trends in the prevalence of pediatric obesity and effective prevention strategies. Its prevalence has markedly increased in most high-income nations. According to recent reports, this increase has slowed in developed countries, but the levels remain alarmingly high. In Korea, the rate of pediatric obesity has surged notably since the 1990s; however, since the 2000s, this increase has become more gradual. According to recently published 2017 growth charts, the prevalence of pediatric obesity in Korea varies slightly depending on the data source. The National School Health Examination data showed that pediatric obesity gradually increase from 11.5% in 2014 to 15.1% in 2019, and after the coronavirus disease 2019 pandemic, it sharply increased to 19% in 2021. Based on data from the Korea National Health and Nutrition Examination Survey, the prevalence of pediatric obesity gradually increased from 10.8% in 2017 to 13.6% in 2019. This trend, which accelerated sharply to 15.9% in 2020 and 19.3% in 2021, was especially severe in boys and older children. Pediatric obesity not only affects health during childhood but also increases the risk of developing obesity and associated health conditions in adulthood. Despite ongoing research on treatment options, obesity prevention and control remain challenging. Hence, prioritizing early intervention and prevention of pediatric obesity through healthy eating habits and lifestyles is crucial. This requires intervention at the individual, family, school, and community levels.

The Effect of an Obesity Prevention Intervention Among Specific Subpopulations: A Heterogeneity of Treatment Effect Analysis of the Greenlight Trial.

Background: Understanding how different populations respond to a childhood obesity intervention could help optimize personalized treatment strategies, especially with the goal to reduce disparities in obesity. Methods: We conducted a secondary analysis of the Greenlight Cluster Randomized Controlled Trial, a health communication focused pediatric obesity prevention trial, to evaluate for heterogeneity of treatment effect (HTE) by child biological sex, caregiver BMI, caregiver reported race and ethnicity, primary language, and health literacy. To examine HTE on BMI z-score from 2 to 24 months of age, we fit linear mixed effects models. Results: We analyzed 802 caregiver-child pairs, of which 52% of children were female, 58% of households reported annual family income of <$20,000, and 83% did not have a college degree. We observed evidence to suggest HTE by primary language (p = 0.047 for Spanish vs. English) and the combination of primary language and health literacy (p = 0.01). There was insufficient evidence to suggest that the Greenlight intervention effect differed by biological sex, caregiver BMI, or by race/ethnicity. Conclusions: This HTE analysis found that the Greenlight obesity prevention intervention had a more beneficial effect on child BMI z-score over 2 years for children of caregivers with limited health literacy and for caregivers for whom Spanish was the primary language.

Virtual Nutrition Counseling in Pediatric Primary Care: An Integrated Approach to the Prevention and Management of Pediatric Obesity.

Given the rising prevalence of pediatric obesity, new approaches to the delivery of targeted nutrition counseling to not only prevent but also treat pediatric obesity are needed. The integration of a dietitian virtually was a successful quality improvement measure in this academic pediatric primary care clinic. The virtual dietitian provided age-appropriate nutrition counseling at well-child visits from 9 months to 6 years of age. Dietary counseling was also provided for children with overweight and obesity regardless of age. Vegetable, fruit, snack, and dairy intake was assessed in children who received counseling versus those who had traditional well childcare. Improved dairy habits were noted in the counseling cohort. A decrease in body mass index was not demonstrated in the patients with obesity or overweight; however, patient and provider satisfaction was quite high with this novel quality improvement measure. Virtual nutrition counseling can be easily integrated to facilitate a comprehensive pediatric medical home.

Prenatal and Pediatric Primary Care-Based Child Obesity Prevention: Effects of Adverse Social Determinants of Health on Intervention Attendance and Impact.

Background: Adverse social determinants of health (SDoHs), specifically psychosocial stressors and material hardships, are associated with early childhood obesity. Less is known about whether adverse SDoHs modify the efficacy of early childhood obesity prevention programs. Methods: We conducted a secondary analysis of publicly insured birthing parent-child dyads with Latino backgrounds participating in a randomized controlled trial of the Starting Early Program (StEP), a child obesity prevention program beginning in pregnancy. We measured baseline adverse SDoHs categorized as psychosocial stressors (low social support, single marital status, and maternal depressive symptoms) and material hardships (food insecurity, housing disrepair, and financial difficulties) individually and cumulatively in the third trimester. Logistic regression models tested effects of adverse SDoHs on StEP attendance. We then tested whether adverse SDoHs moderated intervention impacts on weight at age 2 years. Results: We observed heterogeneous effects of adverse SDoHs on outcomes in 358 parent-child dyads. While housing disrepair decreased odds of higher attendance [adjusted odds ratio (aOR) 0.52, 95% confidence interval (CI): 0.29-0.94], high levels of psychosocial stressors doubled odds of higher attendance (aOR 2.36, 95% CI: 1.04-5.34). Similarly, while certain adverse SDoHs diminished StEP impact on weight (e.g., housing disrepair), others (e.g., high psychosocial stress) enhanced StEP impact on weight. Conclusions: Effects of adverse SDoHs on intervention outcomes depend on the specific adverse SDoH. Highest engagement and benefit occurred in those with high psychosocial stress at baseline, suggesting that StEP components may mitigate aspects of psychosocial stressors. Findings also support integration of adverse SDoH assessment into strategies to enhance obesity prevention impacts on families with material hardships. Trial Registration: This study is registered on clinicaltrials.gov: Starting Early Obesity Prevention Program (NCT01541761); https://clinicaltrials.gov/ct2/show/NCT01541761.

Nutrition Interventions for Pediatric Obesity Prevention: An Umbrella Review of Systematic Reviews.

Nutrition interventions to prevent pediatric obesity can help to establish healthy habits to improve current and future health. The objective of this umbrella review of systematic reviews (SRs) is to examine the impact of obesity prevention interventions with a nutrition component on body mass index measures, overweight/obesity prevalence, and cost-effectiveness in participants 2-17 years old. Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods were used, and this umbrella review was registered on PROSPERO (CRD42023443033). Included SRs were required to search ≥2 databases and to assess the risk of bias (RoB) of primary studies, and they were published 2017-June 2023. Database searches identified 4776 articles, and 31 SRs were included. In all age groups combined, interventions with both nutrition and physical activity were effective and cost-effective in all settings combined, and in the community setting specifically. In children ≤5 years old, interventions in the home and family, community, and healthcare settings demonstrated some efficacy, whereas in children 6-12 years old, school interventions were most effective. Evidence with individuals 13-17 years was limited. The certainty of evidence was generally low due to RoB in included studies, inconsistency, and imprecision. Pediatric obesity prevention interventions with nutrition should be tailored to the developmental stage to ensure appropriateness and efficacy.

Applications of artificial intelligence in the management of childhood obesity.

Childhood obesity has emerged as a significant public health challenge, with long-term implications that often extend into adulthood, increasing the susceptibility to chronic health conditions. The objective of this review is to elucidate the applications of artificial intelligence (AI) in the prevention and treatment of pediatric obesity, emphasizing its potential to complement and enhance traditional management methods. We undertook a comprehensive examination of existing literature to understand the integration of machine learning and other AI techniques in childhood obesity management strategies. The findings from numerous studies suggest a strong endorsement for AI's role in addressing childhood obesity. Particularly, machine learning techniques have shown considerable efficacy in augmenting current therapeutic and preventive approaches. The intersection of AI with conventional obesity management practices presents a novel and promising approach to fortify interventions targeting pediatric obesity. This review accentuates the transformative capacity of AI, thereby advocating for continued research and innovation in this rapidly evolving domain.

Exergames to Limit Weight Gain and to Fight Sedentarism in Children and Adolescents with Obesity

Exergames are defined as digital games that require bodily movements to play, stimulating an active gaming experience to function as a form of physical activity (PA). The players interact with the game through whole-body movements improving energy expenditure. Exergames may be effective in improving physical and psychological aspects of children and adolescents with obesity. In this narrative review, we synthesized the current evidence regarding the role of exergames in modifying body composition and weight and in promoting changes in sedentary behavior to define the benefits of active video games as useful tools for fighting sedentarism and to outline the future directions of exergaming as a supplementation exercise rather than a replacement in educational programs for pediatric obesity. Data from the literature indicate that exergames may offer an interesting impact on childhood obesity and may be considered a potential strategy for controlling weight gain and body composition, promote PA, and decrease time spent on sedentary behavior in children and adolescents with obesity. However, exergame use also has some limits, such as children’s poor self-regulation and poor structuring of exergame use. Therefore, a prudent approach should be maintained, and additional high-quality research is needed to determine if exergames can be effectively used in the treatment of childhood obesity and if new digital media, as a supplementation of exercise rather than a replacement, could be considered to combat sedentary behavior in educational programs for pediatric obesity prevention.

The Role of Physical Therapists in Pediatric Health Promotion and Obesity Prevention: Comparison of Attitudes: Erratum.

The Role of Physical Therapists in Pediatric Health Promotion and Obesity Prevention: Comparison of Attitudes: Erratum.

Insights in paediatric virology during the COVID-19 era (Review).

The present article provides an overview of the key messages of the topics discussed at the '7th Workshop on Paediatric Virology', which was organised virtually on December 20, 2021 by the Institute of Paediatric Virology, located on the Island of Euboea in Greece. The workshop's plenary lectures were on: i) viral pandemics and epidemics in the ancient Mediterranean; ii) the impact of obesity on the outcome of viral infections in children and adolescents; and iii) COVID-19 and artificial intelligence. Despite the scarcity of evidence from fossils and remnants, viruses have been recognised as significant causes of several epidemics in the ancient Mediterranean. Paediatric obesity, a modifiable critical health risk factor, has been shown to impact on the development, progression and severity of viral infections. Thus, the prevention of paediatric obesity should be included in formulating public health policies and decision-making strategies against emerging global viral threats. During the current COVID-19 pandemic, artificial intelligence has been used to facilitate the identification, monitoring and prevention of SARS-CoV-2. In the future, it will play a fundamental role in the surveillance of epidemic-prone infectious diseases, in the repurposing of older therapies and in the design of novel therapeutic agents against viral infections. The collaboration between different medical specialties and other diverse scientific fields, including archaeology, history, epidemiology, nutritional technologies, mathematics, computer technology, engineering, medical law and ethics is essential for the successful management of paediatric viral infections. The current COVID-19 pandemic has underscored this need, which should be further encouraged in modern medical education.

The role of the physiotherapist in pediatric obesity prevention: comparing experiences.

Background. Obesity is an emerging issue with serious health consequences. It is preventable in pediatric settings through prevention projects and education about healthy lifestyles. The aim of the study is to analyze the problem and the methods of intervention, through the involvement of physiotherapists throughout Italy, and to explore the interest and sensitivity of Italian physiotherapists to the issue.&#x0D; Study design. A cross-sectional survey of physiotherapists was conducted using a self-completed online questionnaire, from January to March 2020.&#x0D; Materials and Methods. Literature analysis searching for national and international prevention strategies. Administration of a cognitive questionnaire to the pediatric GIS group.&#x0D; Results. Ninety-five point seven percent of the interviewees had never taken part in projects dedicated to pediatric obesity. Three experiences emerged, but only two respondents made themselves available for interview. Ninety-four point four percent of the operators considered the contribution to the health problem useful and 82.2% of them expressed a real interest in the topic.&#x0D; Conclusions. Physiotherapists should play an active role in planning interventions aimed at promoting and supporting healthy lifestyles from early childhood to early adulthood, starting even earlier during the prenatal and perinatal periods.

Association of maternal obesity and gestational diabetes mellitus with overweight/obesity and fatty liver risk in offspring

BACKGROUNDChildhood obesity and fatty liver are associated with adverse outcomes such as diabetes, metabolic syndrome, and cardiovascular diseases in adulthood. It is very important to identify relevant risk factors and intervene as early as possible. At present, the relationship between maternal and offspring metabolic factors is conflicting.AIMTo estimate the association of maternal obesity and gestational diabetes mellitus (GDM) with overweight/obesity and fatty liver risk in offspring at 8 years of age.METHODSThe prospective study included mothers who all had a 75-g oral glucose tolerance test at 24-28 wk of gestation and whose offspring completed follow-up at 8 years of age. Offspring birth weight, sex, height, weight, and body mass index (BMI) were measured and calculated. FibroScan-502 examination with an M probe (Echosens, Paris, France) was prospectively conducted in offspring aged 8 years from the Shanghai Prenatal Cohort Study.RESULTSA total of 430 mother-child pairs were included in the analysis. A total of 62 (14.2%) mothers were classified as obese, and 48 (11.1%) were classified as having GDM. The mean age of the offspring at follow-up was 8 years old. Thirty-seven (8.6%) offspring were overweight, 14 (3.3%) had obesity, and 60 (14.0%) had fatty liver. The prevalence of overweight, obesity and fatty liver in offspring increased significantly across maternal BMI quartiles (all P < 0.05). Among offspring of mothers with GDM, 12 (25.0%) were overweight, 4 (8.3%) were obese, and 12 (25.0%) had fatty liver vs. 25 (6.5%), 10 (2.6%) and 48 (12.6%), respectively, for offspring of mothers without GDM (all P < 0.05). In multiple logistic regression, after adjustment for variables, the OR for fatty liver in offspring was 8.26 (95%CI: 2.38-28.75) for maternal obesity and GDM.CONCLUSIONThis study showed that maternal obesity can increase the odds of overweight/obesity and fatty liver in offspring, and GDM status also increases the odds of overweight/obesity in offspring. Weight management and glycemic control before and during pregnancy need to be highlighted in primary prevention of pediatric obesity and fatty liver.

Prevention of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews

This Academy of Nutrition and Dietetics Position Paper reports current evidence on pediatric overweight and obesity prevention interventions and discusses implications for registered dietitian nutritionists (RDNs). An overview of current systematic reviews provided evidence-based results from a range of nutrition interventions according to developmental age group (ages 2 to 5, 6 to 12, and 13 to 17 years). Twenty-one current systematic reviews of nutrition interventions demonstrated a beneficial effect of nutrition and physical activity interventions on body mass index measures and no adverse events were identified. RDNs impart nutrition expertise in a wide range of settings to provide comprehensive care for children and adolescents as their nutrition and developmental needs change over time. This Position Paper outlines the current roles of, and proposed directions for, RDNs engaged in pediatric overweight and obesity prevention. Prevention of pediatric overweight and obesity requires comprehensive strategies ranging from policy-level to individual-level interventions in settings that will have the most beneficial impact for children according to their developmental stage. This Position Paper advocates for increased availability of nutrition and food access programs and interventions to reduce risk of pediatric obesity and associated adverse health outcomes both now and for future generations.

Sedentary behavior and physical activity are independently associated with obesity in Brazilian adolescents: a quantile regression analysis

Objective: to test the association of SB and moderate to vigorous physical activity (MVPA) with body mass index (BMI) in a representative sample of Brazilian young people. Methods: This is a cross-sectional school-based study (n = 1,023), including adolescents (14-21y; 54% female) from public and private schools in a Brazilian city. The survey was conducted in 2015 and the adolescents self-reported SB (screen time) and MVPA. Height and body mass were measured to calculate BMI. Quantile regression was used to investigate the association between SB, MVPA and BMI distribution percentiles (P10 ..., P90; statistical significance p &lt;.01). Results: SB and MVPA were associated with higher and lower BMI values, respectively. Quantile regression revealed that the associations were nonlinear and stronger in the upper BMI percentiles. Also, in the adjusted models (SB and MVPA in the same model), the associations were enhanced for MVPA. For example, each additional hour of MVPA at P10 was associated with −0.05 (p &lt;.01) lower BMI value, against −0.09 at P50 (p &lt;.01) and even lower at P90, −0.24 (p &lt;.01). Conclusion: SB and MVPA were independently and nonlinearly associated with BMI in our sample of Brazilian youth. The associations were more notable in the higher percentiles of the BMI distribution. Our findings suggest that nonlinearity between exposures and outcome should be considered when proposing future strategies for pediatric obesity prevention.

Role of physiotherapist in the pediatric obesity: pooled experiences

Objectives: To study the problem of pediatric obesity and the engagement of Italian physiotherapists, laying the foundations for a future health education project of the Specialist Interest Group (GIS) PEDIATRIC PHYSIOTHERAPY AIFI.Methodology: Administration of an insight survey/questionnaire to the Pediatric GIS Group.Results: 95.7% of respondents have never taken part in projects dedicated to pediatric obesity. Three experiences emerged, but only two respondents became available for the interview. 94.4% of the operators considered useful the physiotherapist's contribution to the healthcare problem and 82.2% of them expressed a real interest in the subject.Conclusions: Physiotherapists should play an active role in planning interventions aimed at promoting and supporting correct lifestyles from early childhood to young adulthood, starting even sooner during the prenatal and perinatal periods. This study confirmed the awareness and feeling of Italian pediatric physiotherapists towards the issue: The bases are therefore laid for future involvement of pediatric GIS in educational projects for the prevention of pediatric obesity.

Prevalence of Obesity and Hypertension among Rural School Adolescents: A School Based Pilot Study in Kerala, India

Aim: The prevalence of hypertension and obesity is increasing worldwide. Recent data on sustained hypertension and obesity among school-going children and adolescents from the state of Kerala, India are limited. The aim of the present study was to estimate the prevalence of obesity and hypertension among apparently healthy school going adolescents.&#x0D; Methodology: A cross-sectional survey was conducted among 252 school going adolescents aged 11-16 years (173 boys and 79 girls) selected from two private aided rural schools of Thrissur, District, Kerala, India. Measurements like height, weight, and blood pressure were done using standard guidelines. Guidelines of Indian Academy of Pediatrics and standard guidelines of blood pressure measurement using gender height specific blood pressure percentile charts were used to identify the overweight/obese and pre-hypertensive/ hypertensive adolescents respectively. Analysis was done using SPSS version 27.0. Gender wise differences were checked using chi-square and t-test.&#x0D; Results: Among 252 adolescents, 83 (20.7%) were either overweight or obese and pre-hypertensive or hypertensive. The overall prevalence of obesity and overweight was found to be 9.5% and 15.1% respectively. The overall prevalence of hypertension and prehypertension was found to be 15 (6.0%) and 24 (9.5%) respectively. Systolic blood pressure and diastolic blood pressure was found to be statistically lower (P&lt;0.001) among those with normal BMI, than those with overweight or obesity. The mean systolic and diastolic BP was slightly more among boys than girls and it was not statistically significant.&#x0D; Conclusion: The high prevalence of hypertension, obesity and the strong association between obesity and high blood pressure seen among school-going adolescents necessitates immediate attention. Strategies should be designed and implemented for prevention, early identification, and treatment of pediatric obesity and hypertension in forestalling the morbidity/mortality from non communicable diseases and its complications.

Assessment of Pediatric Resident Knowledge and Comfort in Addressing Childhood Obesity in Clinical Practice

Background: Recent data estimate the prevalence of pediatric obesity at 19.3%. Emphasis on primary prevention and early identification is needed to avoid development of serious medical and psychosocial sequelae. The objective of this initiative is to assess baseline knowledge and comfort among trainees at an inner-city pediatric residency program in identifying children with overweight/obesity, evaluating associated risk factors and comorbidities, and providing effective counseling. Methods: Key topics from 2 major guidelines on pediatric obesity assessment, prevention, and treatment were incorporated into the development of a resident questionnaire, which consisted of 12 knowledge-based questions and a Likert scale evaluating self-perceived knowledge and comfort on 7 skills. Results: Forty-six percent of eligible residents completed the questionnaire (n = 28). The mean score on the objective knowledge-based section was 44% ± 13%, with no differences by training year. The percentage of residents with correct responses by topic ranged from 14% to 79%. The mean self-perceived knowledge rating was 3.56 ± 0.86. The mean self-perceived comfort rating was 3.53 ± 0.89. Neither the self-perceived knowledge nor comfort rating was a significant predictor of performance on the objective knowledge-based section when controlling for postgraduate year status. Conclusions: Significant gaps in knowledge were discovered among pediatric residents with regard to appropriate screening, assessment, and counseling practices related to pediatric overweight/obesity. These deficits were not consistently reflected in residents' self-perceived knowledge and comfort ratings. The results of this initiative highlight the need for incorporation of standardized curricula on childhood overweight/obesity into pediatric resident education.

P29 Interest and Acceptability of a Clinic Based EFNEP Intervention in English and Spanish Speaking Parents for Pediatric Obesity Prevention

<h3>Objective</h3> Obesity continues to disproportionately impact low-income, ethnically diverse youth. Existing government-funded nutrition education programs and pediatric medical clinics can collaborate to target and deliver relevant interventions. The objective was to explore interest and acceptability of community nutrition intervention collocated in medical clinics. <h3>Use of Theory</h3> Social Cognitive (SCT) and goal setting theories. <h3>Target Audience</h3> Low-income English and Spanish-speaking parents with young children. <h3>Program Description</h3> Physicians referred parents of pediatric patients to the intervention. The intervention consisted of 8-weekly, 1.5 hour nutrition, activity and food-related parenting content anchored with guided goal setting, SCT constructs, and story telling. Existing Expanded Food and Nutrition Education (EFNEP) educators delivered the intervention in medical clinics. <h3>Evaluation Methods</h3> To assess interest and acceptability, referral, enrollment, and attendance data were collected and parent focus group interviews were conducted. Descriptive statistics and chi-square analysis were conducted on the quantitative data and interviews were recorded, transcribed and organized for content analysis. <h3>Results</h3> Twenty intervention series were conducted in English (n = 12) and Spanish (n = 8) at 5 medical clinics by 4 EFNEP educators. More than 1/3 of the parents (37%; n=709) expressed interest in the intervention after physician referral and 74% (n = 195) enrolled in the intervention. A greater proportion of referred Spanish-speaking parents expressed interest (<i>P</i> < 0.001) and completed 4 or more intervention sessions (<i>P</i> < 0.0001) compared to English-speaking parents. A total of 26 focus group interviews (n = 65) were conducted with the 97% of the parents said they enjoyed participating in the intervention. The intervention component most commonly mentioned as useful was guided goal setting. <h3>Conclusion</h3> Results from this study indicated that parents referred to the intervention were interested and attended with greater appeal to Spanish-speaking parents. Acceptability of the intervention can be attributed to the tailoring of the content and delivery by culturally competent educators.

Leveraging Emergent Social Networks to Reduce Sedentary Behavior in Low-Income Parents With Preschool-Aged Children.

This study tested the hypothesis that parents participating in a pediatric obesity intervention who formed social network ties with a parent in the intervention arm would engage in more daily physical activity and less sedentary behavior (after controlling for participant covariates). Data were collected at baseline, 12 months, and 36 months from 610 low-income parent-child pairs participating in an obesity prevention intervention for 3- to 5-year-old children. A network survey was used to identify social network ties among parents and accelerometers were used to measure parental physical activity and sedentary time. Longitudinal regression analyses tested effects of social network ties on parents' physical activity and sedentary behavior. Compared with parents without a social network tie, having a tie with an intervention group participant was associated with a clinically meaningful 11.04 min/day decrease in parental sedentary behavior that approached statistical significance (95% confidence interval [Cl] = [-22.71, 0.63], p = .06). Social network ties among parents in a pediatric obesity prevention intervention were not clearly associated with reduced sedentary behavior among those parents at the traditional level of p = .05. The large effect size (over 77min per week improvement) suggests there might be potential importance of promoting new social networks in community-based health promotion interventions to elicit and support behavior change, but further examination is needed.

Overview of pediatric obesity: diagnosis, epidemiology, and significance

Background: The prevalence of pediatric obesity has increased over the past several decades worldwide and in Korea. Childhood obesity has become a serious social problem.Current Concepts: Diagnosis of obesity is based on body mass index (BMI) in children and adolescents aged ≥2 years. Overweight and obese are defined as BMI ≥85th percentile to &lt;95th percentile and BMI ≥95th percentile, respectively, corresponding to sex and age. Obesity is further classified as Class I (BMI ≥95th percentile to &lt;120% of 95th percentile), Class II (BMI ≥120% of 95th percentile to &lt;140% of 95th percentile), and Class III (BMI ≥140% of 95th percentile). Waist circumference and waist-height ratio are used to evaluate abdominal obesity. Pediatric obesity can cause childhood comorbidities, including type 2 diabetes, dyslipidemia, non-alcoholic fatty liver disease, and hypertension. Adult obesity, cardiovascular diseases, and other adult comorbidities, together with increased medical costs are additional consequences of pediatric obesity.Discussion and Conclusion: Prevention, diagnosis, and proper management of pediatric obesity are important.