Risk Of Childhood Obesity Research Articles

Is Serum Uric Acid to Creatinine Ratio Associated with Hypertension and Metabolic Syndrome in Children with Obesity?

Childhood obesity is a global health problem with increasing prevalence, leading to long-term cardiovascular complications. Research conducted on adults has established a correlation between serum uric acid to creatinine ratio (SUA/Cr) and metabolic syndrome (MetS) components. The study investigates the relationship between SUA/Cr and hypertension (HT) and MetS components in children with obesity.A total of 103 children with obesity who underwent ambulatory blood pressure measurement (ABPM) were included the study and patients were divided into two groups "HT" (n=60) and "Normal" (n=43). Demographic, anthropometric, and laboratory characteristics were retrospectively analyzed.The study included 103 children (42 female, 61 male) with a mean age of 13.7±2.9 years. HT prevalence was significantly higher in patients with severe obesity and dyslipidemia (p=0.045, p=0.01). Males exhibited significantly higher SUA/Cr than females (p<0.001). However, SUA/Cr showed no significant differences between patients with and without HT, MetS, dyslipidemia, or hyperglycemia (p=0.69, p=0.64, p=0.90, p=0.37). Furthermore, linear regression analysis did not establish a significant effect of SUA/Cr on ABPM parameters (p>0.05).In our cohort, no significant association was found between SUA/Cr and HT, as well as MetS components in children with obesity. These findings highlight the need for further investigation into the complex mechanisms regulating uric acid metabolism, obesity, and cardiovascular risk in children.

Dietary Lipid Profile in Spanish Children with Overweight or Obesity: A Longitudinal Study on the Impact of Children’s Eating Behavior and Sedentary Habits

Background: Dietary lipids, sedentary habits, and eating behaviors influence childhood obesity, but their interrelations remain unclear. Aim: To assess the relationships between young children’s dietary lipid profile and children’s eating behavior, as well as their sedentary habits, providing evidence-based insights that can help mitigate obesity risk in this vulnerable population. Design: A longitudinal randomized controlled trial conducted over 9 months, involving 90 children aged 2–6 years with overweight or obesity who were followed under a program that promoted healthy lifestyle habits for all participants and regularly monitored their parameters. Methods: The dietary lipid profile, eating behavior, and sedentary habits were assessed at baseline and after 9 months using validated tools, including 24 h recalls, the child eating behavior questionnaire (CEBQ), and screen time questionnaires. Results: Reductions in screen/sedentary time were significantly associated with decreased total fat (−11.1 g/day) and saturated fat (−4.3 g/day) intake, compared to smaller reductions in unchanged screen hours and increases with prolonged screen use. A positive correlation was observed between changes in dietary fat and the CEBQ domain “Desire to drink” (r = 0.528, p &lt; 0.001), with regression analysis confirming a direct relationship. Conclusions: Managing screen time and eating behavior is crucial for improving dietary lipid profile and reducing childhood obesity risk. Strategies should include reducing sedentary behaviors, limiting sugary drinks, and promoting water as the main beverage, alongside effective nutrition education for families.

Long-term exposure to fine particulate matter components with obesity in children and adolescents in China: The age-sex disparities and key effect modifiers.

Long-term fine particulate matter (PM2.5) exposure was associated with childhood obesity. However, the key PM2.5 components and whether PM2.5 effect may vary by obesity type, growth stage, sex, and individual/family characteristics have yet been examined. In this study, we investigated 213,907 Chinese children and adolescents aged 3-18 years in 2017-2019. Three-year average concentrations of PM2.5 and five major components were assigned to each participant's address. Multivariable mixed-effects model and weighted quantile sum regression were used to estimate the effect sizes of each component. Stratified analyses were performed by age and sex groups, with the interactive effects of a series of individual/family features evaluated. The odds ratio of childhood obesity was 1.28 (95 %CI: 1.15-1.43) for per interquartile range increase in PM2.5, with organic matter identified as the key contributor. General central obesity and mixed obesity were more sensitive to PM2.5 exposure than peripheral obesity. As children aged, the effect size of PM2.5 attenuated for general central obesity, remained unchanged for mixed obesity and increased for peripheral obesity. Females, children with obese parents, and those with lower levels of physical activity were more vulnerable than others. Other adverse effect modifiers for certain children included family with one child, low family income, and less sleep duration. Our findings emphasize that the influence of exposure to PM2.5 and its components on risk of obesity in children and adolescents should be considered comprehensively in developing adequate obesity prevention strategies.

Gestational Diabetes Mellitus: Mechanisms Underlying Maternal and Fetal Complications.

Gestational diabetes mellitus (GDM) affects over 10% of all pregnancies, both in Korea and worldwide. GDM not only increases the risk of adverse pregnancy outcomes such as preeclampsia, preterm birth, macrosomia, neonatal hypoglycemia, and shoulder dystocia, but it also significantly increases the risk of developing postpartum type 2 diabetes mellitus and cardiovascular disease in the mother. Additionally, GDM is linked to a higher risk of childhood obesity and diabetes in offspring, as well as neurodevelopmental disorders, including autistic spectrum disorder. This review offers a comprehensive summary of clinical epidemiological studies concerning maternal and fetal complications and explores mechanistic investigations that reveal the underlying pathophysiology.

Maternal Well-Being and Child Appetitive Traits at 5 Years Old: Findings from the ROLO Longitudinal Birth Cohort Study.

Background: Maternal depression has been linked with increased risk of childhood obesity. Furthermore, maternal negative affectivity in early childhood has been associated with food fussiness. We explored the relationship between longitudinal maternal well-being mid-pregnancy, at 2 years and 5 years postpartum and children's appetitive traits at 5 years of age. Methods: This is a secondary analysis of the ROLO (randomized control trial of low glycemic diet in pregnancy) longitudinal birth cohort study including pregnancy (n = 279), 2 years (n = 168), and 5 years (n = 295) postpartum. Maternal well-being was measured using the World Health Organization-Five Well-Being Index. Children's appetitive traits were measured at 5 years of age using the Children's Eating Behavior Questionnaire. Bivariate correlation and then linear regression, adjusted for potential confounders, were used to determine relationships between maternal well-being at each timepoint and offspring's appetitive traits at 5 years old. Results: Mean maternal well-being was higher at 5 years postpartum (63.3%) than mid-pregnancy (58.2%) or at 2 years postpartum (61.0%) (p = 0.001). No relationships were observed between maternal well-being mid-pregnancy and child's appetitive traits at 5 years. In adjusted regression, at 2 years postpartum, maternal well-being was negatively associated with "Emotional Overeating" (B = -0.029, p = 0.024), "Satiety Responsiveness" (B = -0.040, p = 0.014), "Slowness Eating" (B = -0.072, p = <0.001), and "Emotional Undereating" (B = -0.054, p = 0.010) and positively associated with "Enjoyment of Food" (B = 0.050, p = 0.007). Maternal well-being at 5 years postpartum was negatively associated with "Satiety Responsiveness" (B = -0.025, p = 0.033) and "Slowness Eating" (B = -0.031, p = 0.024). Conclusion: Maternal well-being in early childhood may influence children's appetitive traits; however, further research is required to fully explore this relationship.

RELAÇÃO ENTRE USO DE TELAS E ESTADO NUTRICIONAL DE CRIANÇAS EM HOSPITAL UNIVERSITÁRIO

Excessive use of electronic devices by children has become a growing concern due to its potential negative health impacts, particularly the increased risk of childhood obesity. This sedentary behavior, combined with prolonged screen time, can directly influence children's nutritional status, leading to weight gain and other health problems. This study aimed to investigate the association between nutritional status and average screen time in children aged 6 to 10 years attending a University Hospital in Recife, Pernambuco, Brazil. The research was conducted through a cross-sectional case-control study, where anthropometric parameters, screen time, and socioeconomic data of the participants were evaluated. Data collection took place over a year, using questionnaires administered in the General and Pediatric Endocrinology Clinics. The results revealed that 66.7% of the evaluated children were classified as eutrophic, while 33.3% were diagnosed with obesity. The average screen time in the control group was 2.074 hours per day, while in the case group (obese children), the average was 2.92 hours per day, reaching nearly 4 hours during weekends. The findings of this study indicate a strong association between prolonged screen time and childhood obesity, suggesting that time spent in front of electronic devices can be a significant risk factor for developing excess weight in children. Therefore, it is essential to raise awareness about the effects of excessive screen time on children's health and encourage further studies focused on this relationship, aiming at preventive and intervention strategies to mitigate the risks associated with excessive screen use.

Prenatal exposure to particulates and anthropometry through 9 years of age in a birth cohort.

Previous research observed links between prenatal air pollution and risk of childhood obesity but the timing of the exposure is understudied. We examined prenatal particulate matter (PM10, PM2.5) exposure and child anthropometry. Children's body mass index z-scores (zBMI) at 0-3 (N = 4370) and 7-9 (n = 1191) years were derived from reported anthropometry at paediatric visits. We ran linear mixed models for six windows, adjusting for maternal, child, and neighbourhood factors. PM10 exposure across pregnancy and at multiple windows was associated with higher zBMI in both early and middle childhood. For instance, one interquartile range increase in PM10 exposure during the first 2 weeks of pregnancy was associated with higher zBMI at 0-3 (0.05, 95% CI: 0.01, 0.10) and 7-9 (0.14, 95% CI: 0.02, 0.23). PM2.5 exposure during the final 2 weeks of gestation was associated with higher zBMI at 7-9 years (B: 0.12, 95% CI: 0.04, 0.22). Even at low levels of air pollution, prenatal PM10 exposure was associated with higher zBMI in childhood.

Subtypes of Gestational Diabetes Mellitus Are Differentially Associated With Newborn and Childhood Metabolic Outcomes.

Subtypes of gestational diabetes mellitus (GDM) based on insulin sensitivity and secretion have been described. We addressed the hypothesis that GDM subtypes are differentially associated with newborn and child anthropometric and glycemic outcomes. Newborn and child (age 11-14 years) outcomes were examined in 7,970 and 4,160 mother-offspring dyads, respectively, who participated in the Hyperglycemia and Adverse Pregnancy Outcome Study (HAPO) and Follow-Up Study. GDM was classified as insulin-deficient GDM (insulin secretion <25th percentile with preserved insulin sensitivity), insulin-resistant GDM (insulin sensitivity <25th percentile with preserved insulin secretion), or mixed-defect GDM (both <25th percentile). Regression models for newborn and child outcomes included adjustment for field center, maternal BMI, and other pregnancy covariates. Child models also included adjustment for child age, sex, and family history of diabetes. Compared with mothers with normal glucose tolerance, all three GDM subtypes were associated with birth weight and sum of skinfolds >90th percentile. Insulin-resistant and mixed-defect GDM were associated with higher risk of cord C-peptide levels >90th percentile. Insulin-resistant GDM was associated with higher risk of neonatal hypoglycemia. Insulin-resistant GDM was associated with higher risk of neonatal hypoglycemia and childhood obesity (odds ratio [OR] 1.53, 95% CI 1.127-2.08). The risk of child-impaired glucose tolerance was higher with insulin-resistant (OR 2.21, 95% CI 1.50-3.25) and mixed-defect GDM (OR 3.01, 95% CI 1.47-6.19). GDM subtypes are differentially associated with newborn and childhood outcomes. Better characterizing individuals with GDM could help identify at-risk offspring to offer targeted, preventative interventions early in life.

Prevalence of overweight and obesity among preschool children in Hainan: a cross-sectional study in China's largest free-trade zone.

Childhood obesity leads to significant health risks, emphasizing the critical need for effective preventive measures during the preschool years. However, there is a lack of comprehensive studies on overweight and obesity among preschool children in Hainan Island, China's largest free-trade zone. Our study assessed the prevalence of overweight and obesity among preschool children across Hainan Island using Chinese, World Health Organization (WHO), and International Obesity Task Force (IOTF) criteria. Additionally, the potential factors influencing overweight and obesity among preschool children in Hainan Island were further explored. We conducted a cross-sectional survey of children aged 3-6 years covering 18 cities and counties in China's largest free trade zone. The survey primarily involved anthropometric data collection and questionnaires on children's information and the sociodemographic characteristics of their parents or guardians. We recorded the height and weight of each child and calculated their body mass index (BMI). The z-score for BMI-for-age was calculated using the WHO-recommended Anthro and AnthroPlus software, and diagnoses of overweight and obesity were determined separately according to the Chinese, WHO, and IOTF criteria. The chi-squared test, t-test, or rank-sum test was applied to describe and statistically analyze the baseline characteristics of the participating children. Additionally, potential factors affecting overweight and obesity were analyzed using a multifactor binary logistic regression model. The prevalence of overweight and obesity among preschool children in Hainan Island was 11.30% based on the Chinese criteria, significantly higher than the rates of 5.80% and 5.40% observed according to the WHO and IOTF criteria, respectively (χ 2 = 12,870.368, P < 0.001). After multifactorial adjusted analyses, we found that according to the three growth criteria, having overweight fathers or mothers, family incomes of more than 100,000 Yuan, fully active eating, and higher birth weights increased the risk of overweight and obesity among preschool children in Hainan Island. The prevalence of overweight and obesity among preschool children in Hainan Island was lower compared to rates reported in other regions. Considering that the growth and development indicators for children under 7 years old in Hainan Island are generally lower than international standards, the use of Chinese standards may be more suitable for detecting overweight and obesity among preschool children in this area. Based on the risk factors identified in this study, preventive measures can be targeted in the future to reduce the risk of overweight and obesity in preschool children in Hainan Island.

Association Between Exposure to Particulate Matter Air Pollution with Risk of Obesity Among Children and Adolescents in Northern and Central Taiwan.

The present study investigated the relationship between air pollution, specifically PM2.5 and PM10, and childhood and adolescent obesity in northern and central Taiwan. Previous research has shown a positive correlation between air pollution and pediatric obesity, but no study has been conducted in Taiwan. We used data from the K-12 Education Administration, Ministry of Education, and the Taiwan Air Quality Monitoring Network to analyze the association between PM2.5 and PM10 exposures and obesity rates among elementary and junior high school students. Data on students' height and weight were combined with air pollution data obtained from monitoring stations to assess exposure. A multivariable model estimated the relative risk and 95% confidence intervals of obesity linked to PM2.5 and PM10 exposures. Cities were categorized into quartiles (Q1-Q4) based on pollutant accumulation to compare the obesity rates. Students living in areas with higher PM2.5 and PM10 exposures (Q4) had a significantly higher risk of obesity than those living in areas with lower exposures (Q1). The effect was more pronounced in girls and older students, with PM2.5 exhibiting a stronger relationship than PM10. PM2.5 and PM10 exposures are significantly associated with an increased obesity risk in children and adolescents, particularly in girls and older students. Further research is needed to explore the underlying mechanisms and to control for socioeconomic and demographic factors.

Anthropometric measures to identify the health risk of obesity among European adolescents (System review)

In the last decade, the share of obese adolescents in the European region has been steadily increasing, which is associated with a higher risk and earlier onset of a number of socially significant diseases with a complicated clinical course. Therefore, timely and rapid diagnosis of obesity in adolescents by applying cheap, convenient, non-invasive and reliable indirect methods such as anthropometric indices is crucial in health care settings. A systematic search and analysis of the available scientific literature was performed to identify relevant articles published over the period between January 2013 and December 2023 in Web of Science, Science Direct, Scopus, Research Gate and PubMed. Seventy full-text publications reporting the application of such anthropometric indices as Body Mass Index, Waist Circumference, Waist-to-Hip ratio and Waist-to-Height Ratio to identify the healthy risk of obesity among European adolescents were considered the most eligible and reviewed in detail. In order to generalize the results and obtain reliable statements, the method of meta-analyses (PRISMA) was applied. A systematic review covers seventy scientific studies involving 495,251 children and adolescents from twenty-six countries of the European continent. Body Mass Index (BMI) was established to be the leading, most commonly used anthropometric index to identify risk of obesity among adolescents in the European health setting and research. Waist Circumference (WC) and Waist-to-Height Ratio (WHtR) were the next popular indicators of obesity in European adolescents with increasing frequency of application in medical practice and population surveys. Surveys applying anthropometric measurements to determine obesity risk in children and adolescents turned out to be quite heterogenic in terms of sample characteristics, research methods and reported claims. Body Mass Index, Waist Circumference, Waist-to-Hip ratio and Waist-to-Height Ratio are simple indicators of obesity risk in European adolescents, but with greater practical advantages that determine their widespread use in medical and scientific settings. Until now, BMI has been the leading predictive indicator. In the last decade, the application of Waist Circumference and Waist-to-Height Ratio has grown significantly relying on the scientifically reported good discrimination capabilities. However, it is necessary to actualize and confirm universal international reference cutoff values of the considered anthropometric metrics determining the risk of obesity among European adolescents taking into account not only their age and sex but also stages of puberty and ethnicity, have yet to be actualized and confirmed.

The Effect of Maternal Diet and Lifestyle on the Risk of Childhood Obesity.

Background/Objectives: Childhood obesity is a global health problem that affects at least 41 million children under the age of five. Increased BMI in children is associated with serious long-term health consequences, such as type 2 diabetes, cardiovascular disease, and psychological problems, including depression and low self-esteem. Although the etiology of obesity is complex, research suggests that the diet and lifestyle of pregnant women play a key role in shaping metabolic and epigenetic changes that can increase the risk of obesity in their children. Excessive gestational weight gain, unhealthy dietary patterns (including the Western diet), and pregnancy complications (such as gestational diabetes) are some of the modifiable factors that contribute to childhood obesity. The purpose of this narrative review is to summarize the most important and recent information on the impact of the diet and lifestyle of pregnant women on the risk of childhood obesity. Methods: This article is a narrative review that aims to summarize the available literature on the impact of pregnant women's diet and lifestyle on the risk of obesity in their offspring, with a focus on metabolic and epigenetic mechanisms. Results/Conclusions: Current evidence suggests that a pregnant woman's lifestyle and diet can significantly contribute to lowering the risk of obesity in their offspring. However, further high-quality research is needed to understand better the metabolic and epigenetic relationships concerning maternal factors that predispose offspring to obesity.

The divergent association of diet intake, parental education, and nutrition policy with childhood overweight and obesity from low- to high-income countries: A meta-analysis.

It is unclear whether the effects of dietary intake, parental education, and nutrition policy on childhood overweight and obesity is consistent between high-income (HICs) and low- and middle-income (LMICs) countries. The objective of this meta-analysis was to investigate the association of diet, parental education and nutrition policy with childhood overweight and obesity when the economic levels were controlled. PubMed, Web of Science, Embase and Scopus were searched for observational studies published from January 1980 to October 2023 that examined the association of diet, parental education and nutrition policy with childhood overweight and obesity. Meta random effects model stratified by gross national income per capita was used to assess whether the associations were varied by economic levels. From 18 191 identified studies, 154 met the inclusion criteria. Meta-analysis revealed that higher sugar-sweetened beverage intake was a risk factor for childhood overweight and obesity in both HICs and LMICs countries/regions, whereas higher intake of fruit and/or vegetable was a protective factor only in LMICs countries/regions (odds ratio (OR) = 0.77; 95% confidence interval (CI) = 0.69-0.85). Moreover, lower parental education level increased the risk (OR = 1.46; 95% CI = 1.32-1.61) and nutrition policy implementation decreased the risk (OR = 0.96; 95% CI = 0.91-0.99) of childhood overweight and obesity only in HICs. Fruit and/or vegetable intake, parental education and nutritional policy exert different influences on childhood overweight and obesity in countries with varied economic levels. These findings will enhance the understanding of the complex interplay between these factors and their impact on childhood health.

Prospective relationship between family screen time rules, obesogenic behaviours, and childhood obesity.

Family screen use rules (FSRs) could plausibly protect against the development of childhood obesity, although the mechanisms underlying these protective effects remain largely unexplored. This research aimed to investigate prospectively the associations between exposure to FSRs at age 24 months, obesogenic behaviours (excessive screen time and short sleep duration) at age 45 months, and obesity at age 54 months. Additionally, a model proposing the mediating role of obesogenic behaviours in the association between FSRs and childhood obesity was tested. Data were obtained from 5733 children and their mothers participating in the 'Growing Up in New Zealand' study. Logistic regressions examined the association between three FSRs (rules on quality, quantity and timing of screen time, and different numbers of FSRs), obesogenic behaviours, and childhood obesity. Structural equation modelling (SEM) was applied to assess the potential mediating roles of obesogenic behaviours in the association between FSRs and zBMI. Neither exposure to individual nor all three FSRs was significantly associated with lower odds of obesity. However, protective effects of FSRs were observed concerning obesogenic behaviours. Exposure to individual or all three FSRs correlated with reduced odds of not meeting screen time and sleep duration recommendations. SEM analysis indicated no direct association between FSRs and zBMI; nevertheless, a significant indirect association was identified through the mediation of obesogenic behaviours. These findings suggest the potential benefits of promoting the adoption of FSRs as a promising population-based strategy to enhance child health behaviours and mitigate the risk of childhood obesity.

Health effects associated with measured contaminants in the Arctic: short communication

ABSTRACT The Arctic Monitoring Assessment Program Human Health Assessment report 2021 presents a summary of the presence of environmental contaminants in human populations across the circumpolar Arctic and related health effects. Based on this report the objective of this paper is giving a short summary of the health effects related to the current level of persistent organic pollutants (POP) and metals. The overall key findings are as follows: i. metals and POP (polychlorinated biphenyls, per- and polyfluoroalkyl substances (PFAS)) in the Arctic have known adverse health impacts on humans especially on developing foetuses and children. Lifestyle, diet and nutrition and genetics influence the risk; ii. POP and metals negatively impact the brain and immune system, increasing the risk of childhood obesity, type 2 diabetes later in life and negatively affect foetal growth and development: iii. marine food omega-3 fatty acids can diminish adverse effects of high mercury exposure on cardiovascular and neurological outcomes; iv. the interaction of genetic, lifestyle, nutrition status and contaminants can influence the risk of cancer, metabolic disease, nervous system disorders, disruption of reproduction and foetal and child growth. Future investigations must focus on genetically and effect modifiers and mixtures of POP exposures to explore the effect of chemical interaction on health outcomes.

Parental obesity, health determinants, and cardiometabolic risk according to sleep duration in schoolchildren: analysis through structural equations

Backgroundthe independent association between parental obesity, sleep and lifestyle habits with cardiometabolic risk factors in children and adolescents has been widely explored in the literature. Our study represents a novel approach to comprehensively investigate a complex model encompassing various aspects associated with cardiometabolic risk in youth. Thus, the aim of the present study was to verify the relationship between parental obesity and cardiometabolic risk in children and adolescents, considering the mediator role of health indicators according to sleep time.MethodsThis cross-sectional study was conducted on 3,973 children and adolescents aged 6 to 17 years attending public and private schools in a city located in Southern Brazil. Sleep duration, lifestyle, physical activity, natural food consumption, and parental obesity were evaluated through self-reported questionnaires. Physical fitness was evaluated according to the protocols of Projeto Esporte Brasil. The body fat percentage was evaluated through the measures of tricipital and subscapular folds, and the body mass index was calculated. The clustered metabolic risk score (cMetS) considered the summing z-scores of waist circumference, systolic blood pressure, triglycerides, total cholesterol/high-density lipoprotein cholesterol ratio, and fasting glucose, divided by five. A structural equation model was applied for statistical analysis. Results: The relationship between parental obesity and cardiometabolic risk was observed in children and adolescents with adequate sleep, being significant (p < 0.05) mediated by physical activity, natural food, physical fitness, and lifestyle. This was also observed when parental education was included in the inadequate sleep cluster model. Conclusion: Present findings underscore the importance of sufficient sleep duration as a critical factor in understanding the complex interplay between parental obesity and cardiometabolic risk in children and adolescents.

Association of Dietary Patterns, C-Reactive Protein, and Risk of Obesity Among Children Aged 9-17 Years in Guangzhou, China: A Cross-Sectional Mediation Study.

Childhood obesity is a major public health challenge in the 21st century, and diet is one of the key modifiable factors in its prevention. This study examined the link between dietary patterns of children and general and central obesity, including the role of C-reactive protein (CRP). This study enrolled 2413 children aged 9-17. Anthropometric measurements, CRP levels, and dietary data were collected. Factor analysis identified dietary patterns, and logistic regression examined the association between CRP levels and childhood obesity. Multiple linear regression determined the correlation between dietary patterns and CRP. Mediation analysis assessed the role of CRP in the link between dietary patterns and childhood obesity. Three dietary patterns were identified. The rice and meat pattern was significantly correlated to the risk of childhood obesity (OR = 1.166, 95%CI: 1.000, 1.359 for general obesity; OR = 1.215, 95%CI: 1.071, 1.377 for central obesity). CRP was positively correlated with childhood obesity risk (OR = 2.301, 95%CI: 1.776, 2.982 for general obesity; OR = 2.165, 95%CI: 1.738, 2.697 for central obesity). The fruit and vegetable pattern was inversely related to CRP (β= -0.059, 95%CI: -0.081, -0.036), while the snack pattern was positively correlated (β= 0.043, 95%CI: 0.020, 0.065). CRP had a suppressive effect on the association between the fruit and vegetable pattern and snack pattern with childhood obesity. This study revealed the rice and meat pattern as a risk factor for childhood obesity, and cross-sectional evidence linked the fruit and vegetable pattern and snack pattern to childhood obesity risk, mediated by CRP.

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.

The proportion of weight gain due to change in fat mass in infants with vs without rapid growth.

There is extensive evidence that rapid infant weight gain increases the risk of childhood obesity, but this is normally based on childhood body mass index (BMI) only and whether or not this is because infants with rapid weight gain accrue greater fat mass is unknown. The primary objective of our study was to test whether the proportion of infant weight gain due to concurrent increases in fat mass is greater in infants with rapid weight gain as compared to those with normal growth. Body composition was assessed by (1) air-displacement plethysmography (ADP) at 0 and 6 months in 342 infants from Australia, India, and South Africa and (2) deuterium dilution (DD) at 3 and 24 months in 555 infants from Brazil, Pakistan, South Africa, and Sri Lanka. Weight gain and length growth were each categorized as slow, normal, or rapid using cut-offs of <-0.67 or >+0.67 Z-scores. Regression was used to estimate and contrast the percentages of weight change due to fat mass change. Approximately 40% of the average weight gain between 0 and 6 months and 20% of the average weight gain between 3 and 24 months was due to increase in fat mass. In both samples, compared to the normal group, the proportion of weight gain due to fat mass was higher on average among infants with rapid weight gain and lower among infants with slow weight gain, with considerable individual variability. Conversely, slow and rapid length growth was not associated with differential gains in fat mass. Pediatricians should monitor infant growth with the understanding that, while crossing upward through the weight centiles generally is accompanied by greater adiposity gains (not just higher BMI), upward crossing through the length centiles is not.

A Digital Health Behavior Intervention to Prevent Childhood Obesity

Infant growth predicts long-term obesity and cardiovascular disease. Previous interventions designed to prevent obesity in the first 2 years of life have been largely unsuccessful. Obesity prevalence is high among traditional racial and ethnic minority groups. To compare the effectiveness of adding a digital childhood obesity prevention intervention to health behavior counseling delivered by pediatric primary care clinicians. Individually randomized, parallel-group trial conducted at 6 US medical centers and enrolling patients shortly after birth. To be eligible, parents spoke English or Spanish, and children were born after 34 weeks' gestational age. Study enrollment occurred between October 2019 and January 2022, with follow-up through January 2024. In the clinic-based health behavior counseling (clinic-only) group, pediatric clinicians used health literacy-informed booklets at well-child visits to promote healthy behaviors (n = 451). In the clinic + digital intervention group, families also received health literacy-informed, individually tailored, responsive text messages to support health behavior goals and a web-based dashboard (n = 449). The primary outcome was child weight-for-length trajectory over 24 months. Secondary outcomes included weight-for-length z score, body mass index (BMI) z score, and the percentage of children with overweight or obesity. Of 900 randomized children, 86.3% had primary outcome data at the 24-month follow-up time point; 143 (15.9%) were Black, non-Hispanic; 405 (45.0%) were Hispanic; 185 (20.6%) were White, non-Hispanic; and 165 (18.3%) identified as other or multiple races and ethnicities. Children in the clinic + digital intervention group had a lower mean weight-for-length trajectory, with an estimated reduction of 0.33 kg/m (95% CI, 0.09 to 0.57) at 24 months. There was also an adjusted mean difference of -0.19 (95% CI, -0.37 to -0.02) for weight-for-length z score and -0.19 (95% CI, -0.36 to -0.01) for BMI z score. At age 24 months, 23.2% of the clinic + digital intervention group compared with 24.5% of the clinic-only group had overweight or obesity (adjusted risk ratio, 0.91 [95% CI, 0.70 to 1.17]) based on the Centers for Disease Control and Prevention criteria of BMI 85th percentile or greater. At that age, 7.4% of the clinic + digital intervention group compared with 12.7% of the clinic-only group had obesity (adjusted risk ratio, 0.56 [95% CI, 0.36 to 0.88]). A health literacy-informed digital intervention improved child weight-for-length trajectory across the first 24 months of life and reduced childhood obesity at 24 months. The intervention was effective in a racially and ethnically diverse population that included groups at elevated risk for childhood obesity. ClinicalTrials.gov Identifier: NCT04042467.