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Reviews in Endocrine & Metabolic... Oct 2023Worldwide, far too many children and adolescents are living with the disease of obesity. Despite decades of public health initiatives, rates are still rising in many... (Review)
Review
Worldwide, far too many children and adolescents are living with the disease of obesity. Despite decades of public health initiatives, rates are still rising in many countries. This raises the question of whether precision public health may be a more successful approach to preventing obesity in youth. In this review, the objective was to review the literature on precision public health in the context of childhood obesity prevention and to discuss how precision public health may advance the field of childhood obesity prevention. As precision public health is a concept that is still evolving and not fully identifiable in the literature, a lack of published studies precluded a formal review. Therefore, the approach of using a broad interpretation of precision public health was used and recent advances in childhood obesity research in the areas of surveillance and risk factor identification as well as intervention, evaluation and implementation using selected studies were summarized. Encouragingly, big data from a multitude of designed and organic sources are being used in new and innovative ways to provide more granular surveillance and risk factor identification in obesity in children. Challenges were identified in terms of data access, completeness, and integration, ensuring inclusion of all members of society, ethics, and translation to policy. As precision public health advances, it may yield novel insights that can contribute to strong policies acting in concert that ultimately lead to the prevention of obesity in children.
Topics: Adolescent; Child; Humans; Pediatric Obesity; Public Health; Risk Factors
PubMed: 37055611
DOI: 10.1007/s11154-023-09802-8 -
Archives of Disease in Childhood.... Jun 2022Obesity is common among children and young people, with potential for significant clinical consequences. The physical and psychological comorbidities associated with...
Obesity is common among children and young people, with potential for significant clinical consequences. The physical and psychological comorbidities associated with childhood obesity persist into adult life, but many children do not have access to tailored obesity services. We present a framework for the identification, assessment and management of childhood obesity by the non-specialist. We also offer strategies to initiate discussions about weight and to communicate effectively with patients living with obesity.
Topics: Adolescent; Adult; Child; Comorbidity; Family; Humans; Pediatric Obesity; Referral and Consultation
PubMed: 33832962
DOI: 10.1136/archdischild-2020-321029 -
Frontiers in Endocrinology 2022
Topics: Child; Humans; Pediatric Obesity; Risk Factors
PubMed: 36093116
DOI: 10.3389/fendo.2022.1000597 -
Clinical Pediatrics Sep 2015Pediatric obesity is highly prevalent in developed countries globally (and worsening in developing countries) and threatens to shorten the lifespan of the current... (Review)
Review
Pediatric obesity is highly prevalent in developed countries globally (and worsening in developing countries) and threatens to shorten the lifespan of the current generation. At highest risk for weight-related comorbidities including Type 2 diabetes mellitus, non-alcoholic fatty liver disease and dyslipidemia is a sub-set of children with severe obesity, often defined as a body mass index (BMI) percentile ≥99 percentile for age and sex. The pathophysiology of severe obesity in childhood is complex, resulting from the dynamic interplay of a myriad of individual and societal factors including genetic predisposition and health behaviors contributing to energy imbalance. Approximately 4–6% of children have severe obesity, representing a common scenario encountered by providers, and intervention is critical to halt ongoing weight gain and, when possible, reverse the trend. Clinical approaches promoting behavioral weight loss may result in modest, albeit clinically significant, reductions in BMI; however, such changes are often difficult to maintain long-term. Data regarding the impact of targeted pharmacotherapy including agents such as orlistat are limited in the pediatric population and again only suggest modest results. However, increasing evidence suggest that surgical treatment, as an adjunct to ongoing lifestyle changes, may be a promising option in carefully-screened adolescents with severe obesity and weight-related comorbidities who are motivated to adhere to the long-term treatment needs.
Topics: Adolescent; Bariatric Surgery; Child; Child, Preschool; Humans; Pediatric Obesity; Young Adult
PubMed: 25567296
DOI: 10.1177/0009922814565886 -
Annals of Nutrition & Metabolism 2022The role of diet in the pediatric age for optimal development, achievement, and maintenance of a healthy status is well recognized. Increasing attention is nowadays also... (Review)
Review
BACKGROUND
The role of diet in the pediatric age for optimal development, achievement, and maintenance of a healthy status is well recognized. Increasing attention is nowadays also paid to reducing the burden of human nutrition on the planet's health for present and future generations.
SUMMARY
Beyond environmental sustainability, the transition to diets rich in animal and processed foods contributes to an overall unhealthy nutritional status leading to an increased prevalence of obesity- and diet-related noncommunicable diseases. Childhood overweight and obesity are a growing public health crisis worldwide. The aim of this narrative review was to summarize evidence of the nutritional status and dietary habits in children and the link with environmental sustainability.
KEY MESSAGE
Optimizing nutrition in infancy and establishing healthy lifestyles from the preschool years might help to reduce the risk of overweight, and all the disorders related, respecting the sustainability dimension.
Topics: Animals; Child; Child, Preschool; Diet; Feeding Behavior; Humans; Nutritional Status; Overweight; Pediatric Obesity
PubMed: 35679841
DOI: 10.1159/000524860 -
Pediatric Pulmonology Mar 2020Childhood obesity contributes to many diseases, including asthma. There is literature to suggest that asthma developing as a consequence of obesity has a nonallergic or...
Childhood obesity contributes to many diseases, including asthma. There is literature to suggest that asthma developing as a consequence of obesity has a nonallergic or non-T2 phenotype. In this review, obesity-related asthma is utilized as a prototype of non-T2 asthma in children to discuss several nonallergic mechanisms that underlie childhood asthma. Obesity-related asthma is associated with systemic T helper (Th)1 polarization occurring with monocyte activation. These immune responses are mediated by insulin resistance and dyslipidemia, metabolic abnormalities associated with obesity, that are themselves associated with pulmonary function deficits in obese asthmatics. As in other multifactorial diseases, there is both a genetic and an environmental contribution to pediatric obesity-related asthma. In addition to genetic susceptibility, differential DNA methylation is associated with non-T2 immune responses in pediatric obesity-related asthma. Initial investigations into the biology of non-T2 immune responses have identified the upregulation of genes in the CDC42 pathway. CDC42 is a RhoGTPase that plays a key role in Th cell physiology, including preferential naïve Th cell differentiation to Th1 cells, and cytokine production and exocytosis. Although these novel pathways are promising findings to direct targeted therapy development for obesity-related asthma to address the disease burden, there is evidence to suggest that dietary interventions, including diet modification, rather than caloric restriction alone, decrease disease burden. Adoption of a diet rich in micronutrients, including carotenoids and 25-OH cholecalciferol, a vitamin D metabolite, may be beneficial since these are positively correlated with pulmonary function indices, while being protective against metabolic abnormalities associated with the obese asthma phenotype.
Topics: Animals; Asthma; Child; Epigenomics; Humans; Lung; Metabolic Diseases; Pediatric Obesity
PubMed: 31912992
DOI: 10.1002/ppul.24600 -
The American Journal of Clinical... Apr 2021
Topics: Body Mass Index; Child; Female; Humans; Milk, Human; Obesity, Maternal; Pediatric Obesity; Pregnancy; Regression Analysis
PubMed: 33742200
DOI: 10.1093/ajcn/nqab009 -
Frontiers in Endocrinology 2020Childhood obesity is a modern worldwide epidemic with significant burden for health. It is a chronic metabolic disorder associated with multiple cardiovascular risk... (Review)
Review
Childhood obesity is a modern worldwide epidemic with significant burden for health. It is a chronic metabolic disorder associated with multiple cardiovascular risk factors such as dyslipidemia, hypertension, stroke, and insulin resistance. Many obese adolescents remain obese into adulthood, with increased morbidity and mortality. As childhood obesity is a risk factor for adult obesity, the childhood obesity-related disorders account for an increased risk of cardiovascular consequences in adults, in addition to the effects already exerted by the fat mass in adulthood. Several papers have already described the cardiovascular implications of idiopathic obesity, while few data are available about syndromic obesity, due to the small sample size, not homogeneous phenotypes, and younger age at death. The aim of this mini-review is to give a comprehensive overview on knowledge about cardiovascular implications of idiopathic and syndromic obesity to allow the reader a quick comparison between them. The similarities and differences will be highlighted.
Topics: Cardiovascular Diseases; Child; Humans; Pediatric Obesity
PubMed: 32582026
DOI: 10.3389/fendo.2020.00330 -
The American Psychologist 2020A growing body of research supports the potential importance of behavioral and social routines for children's health promotion and obesity risk reduction. Evidence in... (Review)
Review
A growing body of research supports the potential importance of behavioral and social routines for children's health promotion and obesity risk reduction. Evidence in support of this comes from multiple lines of research, which suggest that specific behavioral routines, namely, eating and sleep routines, may be protective against excessive weight gain and development of pediatric obesity. Emerging work also supports the potential importance of the timing of these behavioral routines. From a circadian perspective, alignment of behavioral and social routines with underlying circadian rhythms may be particularly important for enhancing children's weight regulation. Specifically, engaging in appropriately timed behavioral routines may serve to entrain circadian rhythms that affect metabolism and weight regulation. Thus, in addition to promoting healthier eating, activity, and sleep behaviors for prevention and treatment of pediatric obesity, it may also be important to consider promotion of consistency in, and optimal timing of, these behaviors in an effort to enhance extant prevention and treatment approaches. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Topics: Child; Child Behavior; Circadian Rhythm; Diet; Humans; Pediatric Obesity; Sleep; Social Behavior
PubMed: 32052991
DOI: 10.1037/amp0000599 -
Obesity Reviews : An Official Journal... Feb 2021The associations between built and food environments and childhood obesity have been studied extensively. However, the association between the natural environment and...
The associations between built and food environments and childhood obesity have been studied extensively. However, the association between the natural environment and childhood obesity has received too little scholarly attention. This study reviewed the literature published before 1 January 2019, which described associations between a full range of natural environmental factors (e.g., rainfall, temperature, sunlight, natural disasters, flood and drought) and weight-related behaviours and childhood obesity. Five cross-sectional studies and one longitudinal study were identified. Measures of natural environmental factors varied across six included studies, falling into five broad categories: weather conditions, altitude, natural disaster risk, air quality and day length. It was found that temperature was a significant weather indicator in most included studies and was associated with a reduction of daily physical activity. Children living in high-altitude areas were more likely to be shorter and heavier than their counterparts in low-altitude areas. Findings of this study will contribute to helping multiple stakeholders, including policy makers and urban planners, and formulate health policies and interventions to mitigate the detrimental impact of the natural environment on childhood obesity. More longitudinal studies should be designed to confirm these effects and explore the potential health effects of more natural environmental factors.
Topics: Air Pollution; Child; Cross-Sectional Studies; Exercise; Humans; Longitudinal Studies; Pediatric Obesity
PubMed: 32869468
DOI: 10.1111/obr.13097