Prevalence Of Childhood Obesity Research Articles

An examination of the predictors of change in BMI among 38026 school students in Makkah, Saudi Arabia.

The prevalence of childhood obesity has substantially increased in the Gulf Cooperation Council countries, including Saudi Arabia. The Rashaka initiative is a Saudi national school-based multicomponent intervention that was introduced in the school year 2016-2017 to address childhood overweight and obesity. This study aims to examine the effect of the Rashaka initiative on students' body mass index (BMI) for two academic years (2016-2017 and 2018-2019) and to analyse predictors of BMI change. Secondary data for this pre-post study was provided by the Ministry of Health for 38026 students from 89 intermediate and secondary schools that implemented the initiative in Makkah City, Saudi Arabia. It was analysed using non-parametric tests and multiple regressions at a 5% level of significance. Over 2y of implementation, BMI was reduced significantly across the schools (p < 0.001). Based on the regression modelling, school gender and education stage were found to be the only significant predictors of BMI change. Girls and intermediate schools had greater BMI reductions than boys and secondary schools (p < 0.001 and p = 0.031). This study provides tentative evidence for the effectiveness of the Rashaka intervention in Makkah City. In addition, our study has identified that the Rashaka initiative may require modification to improve its effect on boys and students in secondary schools.

Association between taste sensitivity, taste preference, and obesity: study of healthy snacks in children aged 9–14 years

Healthy eating habits are essential to prevent childhood obesity. Children’s eating habits are influenced by many factors, such as taste sensitivity and taste preferences. This study aimed to analyze the correlation between taste sensitivity, taste preference, and obesity in children. This cross-sectional study enrolled 101 healthy children aged 9–14(34 boys and 67 girls). Nutritional status was assessed based on age- and sex-specific BMI z-scores, following CDC Growth Charts. Taste sensitivity was measured using graded sucralose (sweet)/ saline (salty) solution of 0.1709, 0.3418, and 0.6837 mol/L with distilled water (blanks). Taste preferences were assessed using a self-reported questionnaire, the gradation of sugar and salt, and four healthy snacks (two sweet snacks and two salty snacks). Statistical analysis was performed using correlation test. A quarter of the subjects were overweight and obese (25.8%). Most subjects had good taste sensitivity, and it was easier to recognize salty than sweet taste (89.1% vs. 58.4%). Moreover, the sweet taste and sweet food were preferred by almost all subjects. Correlation test showed a correlation between sweet taste sensitivity (r = 0.213; p = 0.032) and sweet preference (r = 0.374; p = 0.029) especially in boys to nutritional status, but not for salty taste. Obesity in children was associated with taste sensitivity and taste preferences especially for sweetness. Presenting healthy foods that consider the daily limit of sugar intake is very important to support optimal nutritional status for children.Graphical

Comparison of body composition assessment tools in infancy

The prevalence of childhood obesity is increasing globally(1). While BMI is commonly used to define obesity, it is unable to differentiate between fat and muscle mass, leading to calls to measure body composition specifically(2). While several tools are available to assess body composition in infancy, it is unclear if they are directly comparable. Among a subset of healthy infants born to mothers participating in a randomised controlled trial of a preconception and antenatal nutritional supplement(3), measurements were made at ages 6 weeks (n = 58) and 6 months (n = 70) using air displacement plethysmography (ADP), whole-body dual-energy X-ray absorptiometry (DXA), and bioelectrical impedance spectroscopy (BIS). Estimates of percentage fat mass (%FM) were compared using Cohen’s kappa statistic (κ) and Bland-Altman analysis (4,5). There was none to weak agreement when comparing tertiles of %FM (κ = 0.15–0.59). When comparing absolute values, the bias (i.e., mean difference) was smallest when comparing BIS to ADP at 6 weeks (+1.7%). A similar bias was observed at 6 months when comparing DXA to ADP (+1.8%). However, when comparing BIA to DXA at both ages, biases were much larger (+7.6% and +4.7% at 6 weeks and 6 months, respectively). Furthermore, there was wide interindividual variance (limits of agreement [LOA] i.e., ± 1.96 SD) for each comparison. At 6 weeks, LOA ranged from ± 4.8 to ± 6.5% for BIA vs. DXA and BIA vs. ADP, respectively. At 6 months, LOA were even wider, ranging from ± 7.3 to ± 8.1% (DXA vs. ADP and BIA vs. DXA, respectively). Proportional biases were apparent when comparing BIS to the other tools at both ages, with BIS generally overestimating %FM more among infants with low adiposity. In addition to differences according to tool type, within-tool factors impacted body composition estimation. For ADP measurements, the choice of FFM density reference (Fomon vs. Butte) had minimal impact; however, choice of DXA software version (GE Lunar enCORE basic vs. enhanced) and BIS analysis approach (empirical equation vs. mixture theory prediction) led to very different estimates of body composition. In conclusion, when comparing body composition assessment tools in infancy, there was limited agreement between three commonly used tools. Therefore, researchers and clinicians must be cautious when conducting longitudinal analyses or when comparing findings across studies, as estimates are not comparable across tools.

Nutrition and physical activity in schools in Pacific Island Countries

The increasing rates of obesity among children and adolescents are significant issues worldwide and in the Pacific Island Nations(1). An energy imbalance between calorie intake and expenditure is linked to overweight and obesity for children and adolescents. Epidemiological, nutritional, and technological changes are linked to altered eating habits, including an increase in energy consumption. Conversely, technological advancements and market globalization are responsible for declines in physical activity (PA)(2). During COVID-19 outbreak a more sedentary lifestyle than before the outbreak has been adopted by children and adolescents as a result of lockdown measures, which include shutting of schools, restrictive travel outside the home, and limiting social interactions has made the issue worse(3). Studies have shown that 40% to 70 % of obese children become obese adults(4). Since children spend a large portion of their day in school and eat their main meals there, school settings are suitable for interventions aimed at preventing childhood obesity. Additionally, school environments will reduce the number of dropouts brought on by problems with accessibility or transit(5). The selection of primary school children is important for interventions as the dietary and physical activity habits acquired at this age are ingrained in children and continue into adulthood. So, it is important to have a robust nutrition and physical activity curriculum in all the primary schools. There are many challenges faced by the governments in implementing such curriculum which includes lack of trained in country staff, limited infrastructures in schools for physical activity, culturally relevant information which can be easily understood by local populations, proper monitoring, and evaluation of the existing guidelines. Community engagement and partnership with local health ministries and departments are crucial for the success of these curriculum (6). To fill this gap robust evidence on effectiveness and implementation of school-based wellness intervention programs in primary schools are in dire needs in Pacific Island nations. Given this, the project titled “Healthy Child Promising Future-Promoting health in primary school settings was conducted in all schools in Wallis &amp; Futuna and piloted in one urban school in Fiji. A knowledge, attitude, practice (KAP) questionnaire was used to evaluate the effectiveness of the intervention which was conducted for all the children (7-9 years) and their care takers. Intervention was conducted on 15 pre identified themes by face-to-face sessions every week and 30 minutes physical activity session was conducted every day in all the schools for children. For caretakers intervention was conducted around 5 themes. In both the countries the intervention had shown significant improvement in KAP scores both for caretakers and children related to the healthy diet consumption and promotion of physical activity. The results indicate that the developed intervention package had a positive impact on KAP.

DeepHealthNet: Adolescent Obesity Prediction System Based on a Deep Learning Framework.

The global prevalence of childhood and adolescent obesity is a major concern due to its association with chronic diseases and long-term health risks. Artificial intelligence technology has been identified as a potential solution to accurately predict obesity rates and provide personalized feedback to adolescents. This study highlights the importance of early identification and prevention of obesity-related health issues. To develop effective algorithms for the prediction of obesity rates and provide personalized feedback, factors such as height, weight, waist circumference, calorie intake, physical activity levels, and other relevant health information must be taken into account. Therefore, by collecting health datasets from 321 adolescents who participated in Would You Do It! application, we proposed an adolescent obesity prediction system that provides personalized predictions and assists individuals in making informed health decisions. Our proposed deep learning framework, DeepHealthNet, effectively trains the model using data augmentation techniques, even when daily health data are limited, resulting in improved prediction accuracy (acc: 0.8842). Additionally, the study revealed variations in the prediction of the obesity rate between boys (acc: 0.9320) and girls (acc: 0.9163), allowing the identification of disparities and the determination of the optimal time to provide feedback. Statistical analysis revealed that the performance of the proposed deep learning framework was more statistically significant (p 0.001) compared to the other general models. The proposed system has the potential to effectively address childhood and adolescent obesity.

IJCM_187A: Prevalence and risk factors of childhood obesity among school-going children in a metropolitan city of india.

Background: Childhood obesity is a grave public health concern in the 21st century. It is becoming a widespread problem in low and middle-income countries, particularly in urban areas. Childhood obesity is a precursor to metabolic syndrome, poor physical health, mental disorders, respiratory problems, and glucose intolerance, which can all continue into adulthood. Developing countries like India face a unique problem of a ‘double burden’, where undernutrition and obesity co-exist. Objectives: The study aimed to determine the prevalence of overweight/ obesity among school-going children and to identify the modifiable risk factors associated with it. Methodology: An epidemiological cross-sectional study was conducted in a private school located in the Western suburbs of Mumbai. The study included all students from the 1st to 10th standard of the secondary section, who were willing to participate. Before the study, necessary permissions were obtained from the school authorities and parental consent was taken. The study was conducted over 4 days in October 2023. Data was collected through interviews using a pre-structured questionnaire. The collected data will be analyzed using SPSS for descriptive and inferential statistics. Results: Among 521 participants, the Prevalence of Overweight is 14.77% and Obesity is 6.71% in our study. Statistical significance was found between BMI and Smartphone usage, BMI and Occupation of Mother. Conclusion: Dietary factors have always been associated with overweight &amp; obesity however our study reveals that other factors also play a pivotal role in development of obesity which is an important risk factor for Non- Communicable Diseases further in adulthood.

Prevalence and Determinants of Childhood Obesity among Primary School Pupils in Edo State: A Cross-Sectional Study

Childhood obesity is a global health concern associated with various adverse health outcomes. This cross-sectional study aims to determine the prevalence of childhood obesity and explore the factors contributing to obesity among primary school pupils in Edo State, Nigeria. A multistage sampling technique was employed to select 1,805 pupils from sixteen schools in Edo State. Data on body composition, including weight, height, arm circumference, and skin folds measurements, were collected by qualified nurses and research assistants. Additionally, a food frequency questionnaire (FFQ) and a food consumption pattern questionnaire (FCPQ) were administered to assess the pupils' food consumption patterns. Statistical analyses were conducted using SPSS version 23, including frequency distributions, percentage distributions, mean, standard deviations, chi-square and independent samples t-test statistics. The study found out that 14% of pupils in the state were obese, and that skipping lunch, eating alone and engaging in physical activities after school had a significant relationship with the prevalence of obesity (p = 0.049, 0.040 and 0.035 respectively). Also, children in urban areas had a higher likelihood of obesity compared to those from rural areas (p &lt; 0.000), while girls exhibited slightly higher prevalence of obesity compared to boys, though the difference is insignificant (p = 0.769). The study concluded that the prevalence of childhood obesity is high in Edo State of Nigeria, and that the determinants of this prevalence include dietary patterns, cultural factors, and gender. Keywords: Childhood obesity, prevalence, determinants, primary school pupils, Edo State, Nigeria

2023 Obesity Fact Sheet: Prevalence of Obesity and Abdominal Obesity in Adults, Adolescents, and Children in Korea from 2012 to 2021.

The 2023 Obesity Fact Sheet aims to present an updated overview of obesity prevalence across all age groups, including children and adolescents. This study included individuals aged ≥20 years (n=16,941,423 in 2021) who underwent health checkups provided by the Korean National Health Insurance Service between 2012 and 2021. The prevalence of obesity and abdominal obesity was standardized by age and sex using data from the 2010 population and housing census. For children and adolescents (6 to 18 years) (n=884 in 2021), we used the Korea National Health and Nutrition Examination Survey (2012 to 2021), and obesity was defined by the corresponding sex- and age-specific body mass index percentile of 95th or greater based on the 2017 Korean National Growth Chart for Children and Adolescents. The overall prevalence of obesity in 2021 is 38.4% (49.2% in men and 27.8% in women), which is a 1.27-fold increase from 30.2% in 2012. The prevalence of obesity has increased across all age groups, particularly among those aged 20, 30, and 80 years. The prevalence of class III obesity substantially increased from 0.35% (men) and 0.42% (women) in 2012 to 1.21% and 0.97% in 2021, with 3.46- and 2.31-fold increases, respectively. This increase was particularly pronounced in young adults. The prevalence of obesity in children and adolescents has surged from 9.7% in 2012 to 19.3% in 2021, with a greater increase among boys. Our study provides information on the current status of obesity prevalence based on the 2023 Obesity Fact Sheet, emphasizing the urgency of implementing timely strategies to reverse this increasing trend.

Childhood obesity prevention trials: A systematic review and meta-analysis on trial design and the impact of type 1 error.

Effect sizes from previously reported trials are often used to determine the meaningful change in weight in childhood obesity prevention interventions because information on clinically meaningful differences is lacking. Estimates from previous trials may be influenced by statistical significance; therefore, it is important that they have a low risk of type 1 error. A systematic review and meta-analysis were conducted to report on the design of child obesity prevention randomized controlled trials and effectiveness according to risk of type 1 error. Eighty-four randomized controlled trials were identified. A large range of assumptions were applied in the sample size calculations. The most common primary outcome was BMI, with detectable effect size differences used in sample size calculations ranging from 0.25 kg/m2 (followed up at 2years) to 1.1kg/m2 (at 9months) and BMI z-score ranging from 0.1 (at 4years) to 0.67 (at 3years). There was no consistent relationship between low risk of type 1 error and reports of higher or lower effectiveness. Further clarity of the size of a meaningful difference in weight in childhood obesity prevention trials is required to support evaluation design and decision-making for intervention and policy. Type 1 error risk does not appear to impact effect sizes in a consistent direction.

Positive Outliers: A Mixed Methods Study of Resiliency to Childhood Obesity in High-Risk Neighborhoods

ObjectiveDespite the high prevalence of obesity and the clustering of risk by neighborhood, few studies have examined characteristics which promote healthy child weight in neighborhoods with high obesity risk. We aimed to identify protective factors for children living in neighborhoods with high obesity risk. MethodsWe identified neighborhoods with high obesity risk using geolocated electronic health record data with measured body mass index (BMI) from well-child visits (2012–2017). We then recruited caregivers with children aged 5 to 13 years who lived in census tracts with mean child BMI percentile ≥72 (February 2020–August 2021). We used sequential mixed methods (quantitative surveys, qualitative interviews) to compare individual, interpersonal, and perceived neighborhood factors among families with children at a healthy weight (positive outliers [PO]) versus families with ≥1 child with overweight or obesity (controls). Regression models and comparative qualitative analysis were used to identify protective characteristics. ResultsSeventy-three caregivers participated in the quantitative phase (41% PO; 34% preferred Spanish) and twenty in the qualitative phase (50% PO; 50% preferred Spanish). The frequency of healthy caregiver behaviors was associated with being a PO (Family Health Behavior Scale Parent Score adjusted β 3.67; 95% CI 0.52–6.81 and qualitative data). Protective factors also included caregivers’ ability to minimize the negative health influences of family members and adhere to family routines. ConclusionsThere were few differences between PO and control families. Support for caregiver healthy habits and adherence to healthy family routines emerged as opportunities for childhood obesity prevention in neighborhoods with high obesity risk.

Lifestyle intervention in children with obesity and nonalcoholic fatty liver disease (NAFLD): study protocol for a randomized controlled trial in Ningbo city (the SCIENT study)

BackgroundThe increasing prevalence of childhood obesity has become an urgent public health problem, evidence showed that intervention for childhood obesity bring enormous health benefits. However, an effective individualized intervention strategy remains to be developed, and the accompanying remission of related complications, such as nonalcoholic fatty liver disease (NAFLD), needs to be assessed. This study aimed to develop an m-Health-assisted lifestyle intervention program targeting overweight/obese children and assess its effectiveness on indicators of adiposity and NAFLD.MethodsThis is a cluster-randomized controlled trial that conducted in children with overweight/obesity in Ningbo city, Zhejiang Province, China. Students in Grade 3 (8–10 years old) were recruited from six primary schools, with three be randomized to intervention group and three to usual practice group. The intervention program will last for one academic year and consists of health education, dietary guidance, and physical activity reinforcement. This program is characterized by encouraging four stakeholders, including School, Clinic, famIly, and studENT (SCIENT), to participate in controlling childhood obesity, assisted by m-Health technology. Assessments will be conducted at baseline and 3 months, 9 months, 24 months, and 36 months after baseline. The primary outcome will be the differences between the two groups in students’ body mass index and fatty liver index at the end of the intervention (9 months after baseline). During the implementation process, quality control methods will be adopted.DiscussionThe program will test the effectiveness of the m-Health-assisted lifestyle intervention on children with obesity and NAFLD. The results of this study will provide evidence for establishing effective lifestyle intervention strategy aimed at childhood obesity and NAFLD and may help develop guidelines for the treatment of obesity and NAFLD in Chinese children.Trial registrationClinicaltrials.gov NCT05482191. Registered on July 2022.

Preventing childhood obesity in general practice: a qualitative study of GPs, practice nurses, and practice managers.

General practitioners (GPs) in Australia have an important role to play in preventing childhood obesity. Activities such as growth monitoring and promotion of healthy behaviours can contribute to obesity prevention efforts; however, the practicalities of how this is done are poorly documented. Objectives were to understand current attitudes and practices regarding promoting healthy childhood growth and development and preventing childhood obesity in general practice, and identify practical barriers and enablers to routinely incorporating this into general practice based on the observations and personal experiences of general practice staff. A descriptive qualitative study was undertaken with Australian general practice staff. Barriers and enablers underwent thematic analysis and mapped to the ecological model. Interviews were conducted with 9 GPs, 4 nurses, and 2 practice managers. Participants agreed that growth monitoring and healthy behaviour promotion should be done for children with a healthy weight. However, the thematic analysis indicated that obesity prevention in clinics is not supported well by the broader general practice system, there are complexities associated with obesity prevention discussions, and the COVID-19 pandemic has intensified challenges in general practice. Two themes for obesity prevention enablers were identified; these related to bridging the implementation gap and the need for changes outside the clinic to support behaviour within the clinic. Ecological model mapping implicated multiple ecological levels for each theme. Childhood obesity prevention through growth monitoring and healthy behaviour promotion is relevant to general practice; however, more support is needed to enable implementation and embed these practices day-to-day.

Relation between Body Composition Trajectories from Childhood to Adolescence and Nonalcoholic Fatty Liver Disease Risk.

NAFLD has become the leading cause of chronic liver disease in children, as a direct consequence of the high prevalence of childhood obesity. This study aimed to characterize body composition trajectories from childhood to adolescence and their association with the risk of developing nonalcoholic fatty liver disease (NAFLD) during adolescence. The participants were part of the 'Chilean Growth and Obesity Cohort Study', comprising 784 children who were followed prospectively from age 3 years. Annual assessments of nutritional status and body composition were conducted, with ultrasound screening for NAFLD during adolescence revealing a 9.8% prevalence. Higher waist circumference measures were associated with NAFLD from age 3 years (p = 0.03), all skin folds from age 4 years (p < 0.01), and DXA body fat measurements from age 12 years (p = 0.01). The fat-free mass index was higher in females (p = 0.006) but not in males (p = 0.211). The second and third tertiles of the fat mass index (FMI) had odds ratios for NAFLD during adolescence of 2.19 (1.48-3.25, 95% CI) and 6.94 (4.79-10.04, 95% CI), respectively. Elevated waist circumference, skin folds, and total body fat were identified as risk factors for future NAFLD development. A higher FMI during childhood was associated with an increased risk of NAFLD during adolescence.

Impact of prenatal maternal dietary exclusion on childhood obesity and overweight risk.

Child birthweight is a measure of fetal nutrition that is primarily determined by prenatal maternal (PM) diet. Child birthweight and child obesity/overweight risk are well established to be linked. Nevertheless, no studies have investigated the impact of PM dietary exclusion on child obesity/overweight risk or body mass index z-score (BMIz). The study aimed to determine whether PM dietary exclusion affected the child's BMIz, obesity/overweight risk, whether child birthweight serves as a mediator of this, and whether PM use of dietary supplements can protect against this. Waves within the years 2004-2019 from the Longitudinal Study of Australian Children, a population-based cohort study, were analyzed. The participants were aged 0 to 15 years during these waves of the study. Analysis was conducted using logistic and linear models. A total of 5,107 participants were involved in the first wave of the study. The PM exclusion of fish was associated with a higher risk of being underweight at age 14 or 15 years and mild-to-moderate obesity at age 6 or 7 years. The PM exclusion of egg was associated with a higher risk of being overweight at age 14 or 15 years. The exclusion of dairy was associated with more mixed effects. Mediation effects did not reach statistical significance. Moderation effects involving PM dietary supplement use, when they did occur, were associated with higher child BMIz and usually a higher risk of obesity/overweight. Fish and eggs are likely important parts of PM diets for preventing childhood obesity and overweight. Further studies will be needed to determine reasons for this and the apparent adverse effects of dietary supplements on overweight/obesity risk.

ECLAMPSIA: PERSPECTIVE ON THE POSSIBLE REPERCUSSIONS ON THE CHILD'S HEALTH

Eclampsia is a serious complication of pre-eclampsia, which is characterized by high blood pressure, proteinuria and edema during pregnancy. Eclampsia can cause seizures, coma and maternal and fetal death, being one of the main causes of perinatal morbidity and mortality in the world. Furthermore, eclampsia can have repercussions on the child's health, such as prematurity, low birth weight, perinatal asphyxia, intracranial hemorrhage, cerebral palsy, delayed neuropsychomotor development and increased risk of cardiovascular and kidney diseases in adulthood. Despite the importance of the topic, there are few studies that address the consequences of eclampsia on child health in a comprehensive and up-to-date manner. Objective: was to identify and analyze scientific articles that investigated the effects of eclampsia on children's health, from birth to school age, considering clinical, neurological, cognitive, behavioral and social aspects. Methodology: A search was carried out in the PubMed, Scielo and Web of Science databases, using the following descriptors: eclampsia, child health, child development, child outcome and child morbidity. Articles published in the last 10 years, in Portuguese, English or Spanish, that evaluated children born to mothers with eclampsia, whether or not compared with children born to mothers without eclampsia or with pre-eclampsia, were included. Articles that did not address the outcomes of interest, that had insufficient samples, that presented selection bias or confusion, that were reviews, case reports or letters to the editor were excluded. The selection of articles was made according to the PRISMA checklist, following the steps of identification, screening, eligibility and inclusion. The data extracted from the articles were: authors, year, country, study design, sample size, children's age, evaluated outcomes and main results. Results: 16 studies were selected. The outcomes evaluated were: mortality, morbidity, growth, neuropsychomotor development, cognition, behavior, quality of life and risk factors for chronic diseases. The main results were: higher perinatal and neonatal mortality in children born to mothers with eclampsia; higher incidence of neonatal complications, such as asphyxia, hypoglycemia, jaundice, infection, hemorrhage and convulsions; higher frequency of prematurity, low birth weight, intrauterine growth restriction and small for gestational age; greater risk of delay in neuropsychomotor development, cognitive deficit, behavior problems, low quality of life and lower school performance; higher prevalence of hypertension, obesity, dyslipidemia and insulin resistance in childhood. Conclusion: Eclampsia is a condition that negatively affects a child's health, from the perinatal period to school age, compromising their growth and development potential. It is necessary to expand research on this topic, as well as implement prevention measures, early diagnosis and adequate treatment of pre-eclampsia and eclampsia, aiming to reduce their impacts on maternal and child health.

STEATOHEPATITIS IN OBESITY CHILDREN

Steatohepatitis is hepatic steatosis with inflammation and, in some cases, hepatocyte balloon degeneration and fibrosis [1]. Steatohepatitis is a form of non-alcoholic fatty liver disease (NAFLD), which includes a wide range of conditions: from non-alcoholic steatosis (NAS) -fat deposition in the liver of more than 5% of the parenchymal mass without signs of damage to hepatocytes to non-alcoholic steatohepatitis (NASH), which progresses with development fibrosis, cirrhosis and, in some patients, hepatocellular carcinoma [1]. The prevalence of steatohepatitis in the pediatric population, according to various sources, varies greatly. Thus, the recommendations of the North American Society of Pediatric Gastroenterologists, Hepatologists and Nutritionists (NASPGHAN) indicate that hypertransaminasemia occurs in 29-38% of obese children aged 2-4 years [1]. According to A. Sahota et al. [2], NASH was found in 12% of obese and overweight children. The joint recommendations for the diagnosis, treatment and preventionof obesity in children and adolescents of the Russian Association of Endocrinologists, the Russian Society for the Prevention of Non-Infectious Diseases, and the Association of Pediatric Cardiologists of Russia note that NASH is diagnosed in 12-26% of obese children and adolescents [3]. Obesity and overweight currently affect 25-30% of school-age children [4]. The situation is almost the same for preschool children. The COSI (Childhood Obesity Surveillance Initiative) study, conducted under the WHO programin Moscow in 2017-2018, summing up the dynamics of body weight for the entire preschool period, showed that among children aged 7 years, 27% of boys were overweight and 22% of girls, and obesity -in 10 and 6%, respectively [5]. Another Russian study assessing the physical development of children of middle and school age [6] also demonstrated a significant prevalence of obesity and overweight in this age group in Russian regions. Thus, at 11 years of age, obesity in boys was recorded in 18.6% of cases, ingirls -in 9.2%, and excess body weight -in 15.4 and 14.3%, respectively. At the age of 15, obesity was detected in 10% of cases among boys, in 3.6% of girls, and overweight in 11.5 and 10.5% of cases, respectively [6]. Based on these data, it can be assumed that the incidence of NASH in the pediatric population varies from 0.5 to 3%. It should be noted that the prevalence of obesity, and with it NAFLD, including NASH, is increasing throughout the world due to modern negative trends in the diet and physical activity of children [7].

Language Disparities in Caregiver Satisfaction with Physician Communication at Well Visits from 0-2 Years

ObjectiveThis study aimed to describe caregiver satisfaction with physician communication over the first two years of life and examine differences by preferred language and the relationship to physician continuity. MethodsLongitudinal data were collected at well visits (2 months to 2 years) from participants in a randomized controlled trial to prevent childhood obesity. Satisfaction with communication was assessed using the validated Communication Assessment Tool (CAT) questionnaire. Changes in the odds of optimal scores were estimated in mixed-effects logistic regression models to evaluate the associations between satisfaction over time and language, interpreter use, and physician continuity. ResultsOf 865 caregivers, 35% were Spanish-speaking. Spanish-speaking caregivers without interpreters had lower odds of an optimal satisfaction score compared with English speakers during the first 2 years, beginning at 2 months [OR 0.64 (95% CI: 0.43, 0.95)]. There was no significant difference in satisfaction between English-speaking caregivers and Spanish-speaking caregivers with an interpreter. The odds of optimal satisfaction scores increased over time for both language groups. For both language groups, odds of an optimal satisfaction score decreased each time a new physician was seen for a visit [OR 0.82 (95% CI: 0.69, 0.97)]. ConclusionCaregiver satisfaction with physician communication improves over the first two years of well-child visits for both English- and Spanish-speakers. A loss of physician continuity over time was also associated with lower satisfaction. Future interventions to ameliorate communication disparities should ensure adequate interpreter use for primarily Spanish-speaking patients and address continuity issues to improve communication satisfaction.

The Shaping Healthy Choices Program: Improving the impact through community partnerships

The high prevalence of childhood overweight and obesity demonstrates the need for effective intervention strategies. The Shaping Healthy Choices Program (SHCP) is a school-based intervention that promotes nutrition and physical education, develops family and community partnerships, and incorporates foods available on the school campus, with the goal of achieving sustainable student health outcomes. Partnerships developed through implementation of the SHCP were analyzed using the RE-AIM: Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework to assess the potential for adoption, scaling and sustainability of the program. The RE-AIM framework is a comprehensive approach to evaluating public health interventions through reach, effectiveness, adoption, implementation and maintenance. Partners of the SHCP include site staff (teachers, administration and health professionals), parents, peer teachers, and state and federal agencies, such as the Supplemental Nutrition Assistance Program Education (SNAP-Ed), which funds CalFresh Healthy Living, University of California (CFHL, UC), and UC Cooperative Extension. This analysis highlights how partnerships developed and sustained with the SHCP may serve as a model for other programs to expand, while also enabling programs to remain responsive to the diverse challenges and needs of local community partners.

Retraction: Barriers and facilitators of childhood obesity prevention policies: a systematic review and meta-synthesis.

[This retracts the article DOI: 10.3389/fped.2022.1054133.].

Creatine Acts as a Mediator of the Causal Effect of Obesity on Puberty Onset in Girls: Evidence from Mediation Mendelian Randomization Study.

Epidemiological studies have linked obesity to the onset of puberty, while its causality and the potential metabolite mediators remain unclear. We employed a two-sample Mendelian randomization (MR) design to evaluate the causal effects of obesity on puberty onset and its associated diseases including type 2 diabetes (T2D) and cardiovascular diseases (CVDs). The potential mediators in this pathway were further explored using a two-step MR design. The robustness of our findings was evaluated using sensitivity analyses. Our MR results revealed that childhood obesity/BMI were causally associated with an increased Tanner stage in girls, younger age at menarche, and increased risk of adulthood T2D and CVD. However, neither childhood BMI nor obesity had a causal effect on the Tanner stage in boys. Mediation analysis further indicated that increased creatine served as a mediator for the causal pathway from childhood obesity/BMI to the Tanner stage of girls, while early puberty onset in girls played a mediating role in the pathway linking childhood obesity to increased risk of adulthood T2D and CVD. This study indicated that the risk of early puberty onset in girls and its associated health issues can be potentially reduced by preventing childhood obesity. The involvement of creatine in this process needs to be further validated and explored.