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European Journal of Pediatrics Nov 2023Obesity represents a major health problem in the pediatric population with an increasing prevalence worldwide, associated with cardiovascular and metabolic disorders,... (Review)
Review
Obesity represents a major health problem in the pediatric population with an increasing prevalence worldwide, associated with cardiovascular and metabolic disorders, and due to both genetic and environmental factors. Rare forms of obesity are mostly monogenic, and less frequently due to polygenic influence. Polygenic form of obesity is usually the common obesity with single gene variations exerting smaller impact on weight and is commonly non-syndromic.Non-syndromic monogenic obesity is associated with variants in single genes typically related to the hypothalamic leptin-melanocortin signalling pathway, which plays a key role in hunger and satiety regulation, thus body weight control. Patients with these genetic defects usually present with hyperphagia and early-onset severe obesity. Significant progress in genetic diagnostic testing has recently made for early identification of patients with genetic obesity, which guarantees prompt intervention in terms of therapeutic management of the disease. What is Known: • Obesity represents a major health problem among children and adolescents, with an increasing prevalence worldwide, associated with cardiovascular disease and metabolic abnormalities, and it can be due to both genetic and environmental factors. • Non-syndromic monogenic obesity is linked to modifications in single genes usually involved in the hypothalamic leptin-melanocortin signalling pathway, which plays a key role in hunger and satiety regulation. What is New: • The increasing understanding of rare forms of monogenic obesity has provided significant insights into the genetic causes of pediatric obesity, and our current knowledge of the various genes associated with childhood obesity is rapidly expanding. • A useful diagnostic algorithm for early identification of genetic obesity has been proposed, which can ensure a prompt intervention in terms of therapeutic management of the disease and an early prevention of the development of associated metabolic conditions.
Topics: Child; Adolescent; Humans; Pediatric Obesity; Leptin; Genetic Testing; Melanocortins
PubMed: 37607976
DOI: 10.1007/s00431-023-05159-x -
The Lancet. Global Health Aug 2023
Topics: Humans; Child; Pediatric Obesity; Risk Factors
PubMed: 37474221
DOI: 10.1016/S2214-109X(23)00284-X -
Trends in Endocrinology and Metabolism:... Jan 2024Exercise has systemic health benefits through effects on multiple tissues, with intertissue communication. Recent studies indicate that exercise may improve breastmilk... (Review)
Review
Exercise has systemic health benefits through effects on multiple tissues, with intertissue communication. Recent studies indicate that exercise may improve breastmilk composition and thereby reduce the intergenerational transmission of obesity. Even if breastmilk is considered optimal infant nutrition, there is evidence for variations in its composition between mothers who are normal weight, those with obesity, and those who are physically active. Nutrition early in life is important for later-life susceptibility to obesity and other metabolic diseases, and maternal exercise may provide protection against the development of metabolic disease. Here we summarize recent research on the influence of maternal obesity on breastmilk composition and discuss the potential role of exercise-induced adaptations to breastmilk as a kick-start to prevent childhood obesity.
Topics: Child; Infant; Humans; Female; Pregnancy; Milk, Human; Pediatric Obesity; Lactation
PubMed: 37735048
DOI: 10.1016/j.tem.2023.08.019 -
Pediatric Obesity Oct 2023Lifestyle behaviours related to diet and physical activity are associated with increased risk of obesity and evidence suggests that associations might be stronger when a... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Lifestyle behaviours related to diet and physical activity are associated with increased risk of obesity and evidence suggests that associations might be stronger when a synergetic effect is examined.
OBJECTIVE
To examine the cross-sectional and longitudinal associations between diet, screen time (ST) and step recommendations and risk of overweight and obesity in European preschoolers participating in the ToyBox-study.
METHODS
In this cluster-randomized clinical trial, 718 children (51.4% boys) from six European countries participated. Parents filled out questionnaires with information on socio-demographic status, step recommendations and ST.
RESULTS
Longitudinal results indicate that participants having a low Diet Quality Index (DQI), not meeting ST and step recommendations at T0 and T1 had higher odds of having overweight/obesity at T1 (odds ratio [OR] = 1.116; 95% confidence interval [CI] = 1.104-2.562) than those children having a high DQI and meeting ST and step recommendations at T0 and T1. Similarly, participants having a high DQI, but not meeting ST and step recommendations at T0 and T1 had increased odds of having overweight/obesity (OR = 2.515; 95% CI = 1.171-3.021).
CONCLUSIONS
The proportion of participants having a low DQI, not adhering to both step and ST recommendations was very high, and it was associated with a higher probability of having overweight and obesity.
Topics: Male; Humans; Child, Preschool; Female; Overweight; Sedentary Behavior; Cross-Sectional Studies; Obesity; Diet; Exercise; Pediatric Obesity
PubMed: 37525363
DOI: 10.1111/ijpo.13068 -
BMC Public Health Aug 2023Multi-component psychological interventions may mitigate overweight and obesity in children and adolescents. Evidence is, however, scattered on the effectiveness of such... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Multi-component psychological interventions may mitigate overweight and obesity in children and adolescents. Evidence is, however, scattered on the effectiveness of such interventions. This study aims to review the available evidence on the effectiveness of multi-component psychological interventions on anthropometric measures of school-aged children with overweight or obesity.
METHODS
We systematically searched international databases/search engines including PubMed and NLM Gateway (for MEDLINE), Web of Science, SCOPUS, and Google Scholar up to November 2022 for relevant articles pertaining to psychological weight-loss interventions targeting school-aged children. Two reviewers screened and extracted pertinent data. The quality of included studies was assessed using the Cochrane Risk of Bias Tool for Randomized Trials. Random effect meta-analysis was used to calculate, and pool standardized mean differences (SMD). We distinguished between intervention and maintenance effects. Intervention effects were defined as the mean change in outcome measurement detected between baseline and post-treatment. Maintenance effects were defined as the mean change in outcome measurement between post-treatment and last follow-up.
RESULTS
Of 3,196 studies initially identified, 54 and 30 studies were included in the qualitative and quantitative syntheses, respectively. Most studies reported on group-based interventions. The significant effects of intervention on BMI z-score (SMD -0.66, 95% CI: -1.15, -0.17) and WC (SMD -0.53, 95% CI: -1.03, -0.04) were observed for interventions that centered on motivational interviewing and cognitive behavioral therapy, respectively. Mean BMI and WC did not differ significantly between post-treatment and last follow-up measurement (maintenance effect), indicating that an initial weight loss obtained through the intervention period could be maintained over time.
CONCLUSIONS
Findings indicate that motivational interviewing and cognitive behavioral therapy as interventions to reduce BMI z-score (generalized obesity) and waist circumference (abdominal obesity) are effective and durable. However, detailed analyses on individual components of the interventions are recommended in future effectiveness studies.
Topics: Adolescent; Child; Humans; Pediatric Obesity; Overweight; Psychosocial Intervention; Cognitive Behavioral Therapy; Schools
PubMed: 37537523
DOI: 10.1186/s12889-023-16339-7 -
Health Promotion International Dec 2023Low- and middle-income countries are increasingly faced with a triple burden of malnutrition: endemic underweight, micronutrient deficiencies and rising prevalence of...
Low- and middle-income countries are increasingly faced with a triple burden of malnutrition: endemic underweight, micronutrient deficiencies and rising prevalence of overweight. This study aimed to address existing knowledge gaps and to identify priority policy options in Mongolia, the Philippines and Vietnam. A landscape analysis approach was adopted using methods set out in a UNICEF global toolkit. Quantitative and qualitative data were compiled from a range of global and national sources on childhood overweight and obesity, risk factors and policy responses. Key informant interviews and validation workshops were undertaken with key food and nutrition stakeholders from government and non-government organizations to identify priority policy options for the prevention of overweight and obesity among children. Overweight and obesity among children are increasing in all three countries. Associated risk factors are related to maternal nutrition, birthweight, breastfeeding, as well as diets and physical activity shaped by increasingly obesogenic environments. Key informants identified undefined policy approaches, poor community understanding and food and beverage industry influence as barriers to addressing overweight and obesity. Key policy priorities include restricting the marketing of unhealthy food and beverages, unhealthy food and beverage taxation, introduction of front-of-pack nutrition labels and improving school nutrition environments. Mongolia, the Philippines and Vietnam are all facing an increasing burden of childhood overweight and obesity. Despite differing national contexts, similar environmental factors are driving this rise. A suite of evidence-based policies can effectively be introduced to address obesogenic environments.
Topics: Child; Humans; Pediatric Obesity; Overweight; Philippines; Vietnam; Mongolia; Nutrition Policy; Malnutrition
PubMed: 38156876
DOI: 10.1093/heapro/daad187 -
The Science of the Total Environment Feb 2024Childhood overweight and obesity is a global problem. 38 million children under five years old were reported as being overweight/obese in 2019. However, current evidence... (Meta-Analysis)
Meta-Analysis Review
Childhood overweight and obesity is a global problem. 38 million children under five years old were reported as being overweight/obese in 2019. However, current evidence regarding the effects of air pollution on children weight status remains scarce and inconsistent. This study aimed to determine the association between air pollutants and the weight status of children and adolescents. Four databases were searched up to August 9, 2023. Adjusted merged odds ratios (ORs), regression coefficients (β), and their 95 % confidence intervals (95 % CIs) were calculated and pooled. A total of 27 studies were included. The results showed that air pollutants had adverse effects on the body weight of children and adolescents. Exposure to PM, PM, PM, and PM were associated with increased risk of overweight/obesity, with pooled ORs (95 % CI) of 1.23 (1.09, 1.40), 1.18 (1.10, 1.28), 1.04 (1.03, 1.05) and 1.11 (1.06, 1.17) per 10 μg/m increment, respectively. Individuals with higher exposure levels to NO, O, SO and CO (per 10 μg/m increment) were associated with 12 %, 6 %, 28 % and 1 % increased odds of being overweight/obese, respectively. With respect to the level of body mass index, the pooled β (95 % CIs) for each 10 μg/m increase in PM, PM, PM, and NO exposure were 0.15 (0.12, 0.18), 0.11 (0.06, 0.16), 0.07 (0.03, 0.10), and 0.03 (0.01, 0.04), respectively. PM has relatively strong adverse effects on body weight status. The subgroup analysis revealed a significantly increase in the risk of overweight/obesity when the concentrations of PM, PM, and NO exceeded 35 μg/m, 50 μg/m, and 40 μg/m, respectively. Exposure to PM, PM and NO increased the risk of overweight/obesity, especially in Asia. This study provides evidence of the association between air pollution and being overweight/obese in children and adolescents.
Topics: Child; Humans; Adolescent; Child, Preschool; Pediatric Obesity; Overweight; Air Pollution; Air Pollutants; Particulate Matter; Environmental Exposure; Nitrogen Dioxide
PubMed: 37984657
DOI: 10.1016/j.scitotenv.2023.168589 -
Obesity Reviews : An Official Journal... May 2024Obstructive sleep apnea (OSA) is a prevalent complication that affects up to 60% of children and adolescents with obesity. It is associated with poorer cardiometabolic... (Review)
Review
Screening for obstructive sleep apnea (OSA) in children and adolescents with obesity: A scoping review of national and international pediatric obesity and pediatric OSA management guidelines.
Obstructive sleep apnea (OSA) is a prevalent complication that affects up to 60% of children and adolescents with obesity. It is associated with poorer cardiometabolic outcomes and neurocognitive deficits. Appropriate screening and intervention for OSA are crucial in the management of children with obesity. We performed a scoping review of international and national pediatric obesity (n = 30) and pediatric OSA (n = 10) management guidelines to evaluate the recommendations on OSA screening in pediatric obesity. Sixteen (53%) of the pediatric obesity guidelines had incorporated OSA screening to varying extents, with no consistent recommendations on when and how to screen for OSA, and subsequent management of OSA in children with obesity. We provide our recommendations that are based on the strength and certainty of evidence presented. These include a clinical-based screening for OSA in all children with body mass index (BMI) ≥ 85th percentile or those with rapid BMI gain (upward crossing of 2 BMI percentiles) and the use of overnight polysomnography to confirm the diagnosis of OSA in those with high clinical suspicion. We discuss further management of OSA unique to children with obesity. An appropriate screening strategy for OSA would facilitate timely intervention that has been shown to improve cardiometabolic and neurocognitive outcomes.
Topics: Adolescent; Humans; Child; Pediatric Obesity; Sleep Apnea, Obstructive; Body Mass Index; Polysomnography; Cardiovascular Diseases
PubMed: 38355893
DOI: 10.1111/obr.13712 -
JAMA Network Open Jul 2023Soft drink consumption is associated with weight gain in children and adolescents, but little is known about the association between soft drink consumption and...
IMPORTANCE
Soft drink consumption is associated with weight gain in children and adolescents, but little is known about the association between soft drink consumption and prevalence of the overweight and obesity in adolescents.
OBJECTIVE
To investigate the association of soft drink consumption with overweight and obesity in adolescents enrolled in school (hereafter, school-going adolescents) using country-level and individual-level data.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional study used data from 3 cross-sectional studies including 107 countries and regions that participated in the Global School-Based Student Health Survey (2009-2017), the European Health Behavior in School-Aged Children study (2017-2018), and the US Youth Risk Behavior Survey (2019).
EXPOSURE
Daily soft drink consumption (consuming soft drinks 1 or more times per day or not).
MAIN OUTCOME AND MEASURE
Overweight and obesity defined by the World Health Organization Growth Reference Data.
RESULTS
Among the 107 countries and regions, 65 were low- and middle-income, and 42 were high-income countries and regions, with a total of 405 528 school-going adolescents (mean [SD] age, 14.2 [1.7] years; 196 147 [48.4%] males). The prevalence of overweight and obesity among adolescent students varied from 3.3% (95% CI, 2.6 to 4.1) in Cambodia to 64.0% (95% CI, 57.0 to 71.6) in Niue, and the prevalence of adolescent students consuming soft drinks 1 or more times per day varied from 3.3% (95% CI, 2.9 to 3.7) in Iceland to 79.6% (95% CI, 74.0 to 85.3) in Niue. There was a positive correlation between the prevalence of daily soft drink consumption and the prevalence of overweight and obesity (R, 0.44; P < .001). The pooled analysis using individual-level data also showed a statistically significant association between daily soft drink consumption and overweight and obesity (daily soft drink consumption vs nondaily soft drink consumption), with an odds ratio of 1.14 (95% CI, 1.08 to 1.21) among school-going adolescents.
CONCLUSIONS AND RELEVANCE
In this study of 107 countries and regions, the prevalence of daily consumption of soft drinks was associated with the prevalence of overweight and obesity among adolescent students. Our results, in conjunction with other evidence, suggest that reducing soft drink consumption should be a priority in combating adolescent overweight and obesity.
Topics: Male; Child; Humans; Adolescent; Female; Overweight; Pediatric Obesity; Cross-Sectional Studies; Carbonated Beverages; Surveys and Questionnaires
PubMed: 37486630
DOI: 10.1001/jamanetworkopen.2023.25158 -
Journal of Pediatric Nursing 2023This study was conducted to determine the relationship between child and parents' health behaviors and childhood obesity. In addition, an adaptation of the Turkish... (Review)
Review
PURPOSE
This study was conducted to determine the relationship between child and parents' health behaviors and childhood obesity. In addition, an adaptation of the Turkish version of the Family Health Behavior Scale (FHBS) was performed in this study.
DESIGN AND METHODS
This is a descriptive and methodological study. The research sample consisted of 358 parents who have a child between the ages of 5 and 12 studying in one of the seven state schools at the kindergarten, primary, and secondary school levels in Istanbul. Data were collected between February 2022 to May 2022 using the Parent and Child Descriptive Information Form, the Family Nutrition and Physical Activity (FNPA) Screening Tool, and the FHBS. IBM SPSS 25.0 (IBM, Armonk, NY, USA) and SPSS AMOS 21.0 software were used to analyze the data.
RESULTS
It was found that the confirmatory factor analysis result of FHBS confirmed the original structure of the scale, and Cronbach's Alpha coefficient was calculated as 0.80. A positive correlation was found between the parents' total scores of FNPA and FHBS (r:0.511, p < 0.001).
CONCLUSIONS
It is recommended to evaluate the child and their parents holistically in preventing and managing childhood obesity. School health nurses should plan family-centered interventions to improve health behaviors and carry out these interventions with a multidisciplinary team. Moreover, it has been determined that FHBS is a valid and reliable measurement tool for the Turkish population.
Topics: Child; Humans; Child, Preschool; Pediatric Obesity; Health Behavior; Parents; Exercise; Nutritional Status; Reproducibility of Results; Surveys and Questionnaires; Psychometrics
PubMed: 37494855
DOI: 10.1016/j.pedn.2023.07.010