Pediatric Obesity最新文献

Introduction: Some studies suggest that meal timing is involved in obesity and metabolic health. However, little is known about children, so the aim was to assess whether meal timing patterns affect nutritional status and diet quality in children.

Methods: A cross-sectional study was conducted on 880 children (8-13 years). Participants were classified according to the median timing of their first meal, last meal and the length of their eating window (12 h). Adjusted linear regression was used to evaluate associations between first meal timing, last meal timing or eating window and anthropometric, biochemical and dietary variables.

Results: A later last meal was associated with lower scores on the Healthy Eating Index (HEI-2020), Mediterranean Diet Score (MDS) and DASH diet [β (95% CI): -1.139 (-2.258; -0.021), -0.207 (-0.408; -0.007) and - 0.582 (-1.072; -0.092), respectively]. A longer eating window was associated with higher glucose levels, LDL-c, and the ratio LDL-c/HDL-c [β (95% CI): 3.204 (1.876; 4.532), 4.725 (1.109; 8.342), and 0.090 (0.014; 0.166), respectively].

Conclusion: Later meal timing and a prolonged eating window were linked to poorer diet quality and unfavourable metabolic markers. It may be relevant to consider meal timing as a preventive health strategy in the development of future dietary guidelines.

Background: Individuals with autism spectrum disorder (ASD) may be at increased risk of both obesity and underweight.

Objective: To examine the association between ASD and weight status in children and adolescents, adjusting for individual- and neighbourhood-level sociodemographic factors.

Methods: We conducted a cross-sectional study of children and adolescents ≥2 and ≤18 years old using health administrative and demographic data from Ontario, Canada. Using growth measurements from a large primary care database between 2011 and 2016, we categorized weight status using World Health Organization definitions. We defined ASD based on a previously validated algorithm.

Results: We included 568 children and adolescents with ASD and 32 967 without ASD. Comparing those with ASD to those without ASD, prevalence of underweight was 3.5% versus 1.9%, overweight 19.0% versus 18.2%, obesity 12.9% versus 7.3%, and severe obesity 5.8% versus 2.2%. In the fully adjusted multinomial logistic regression model, ASD remained associated with underweight (adjusted odds ratio [aOR] 2.02; 95% confidence interval [CI] 1.27-3.20), obesity (aOR 1.87; 95% CI 1.44-2.43) and severe obesity (aOR 2.62; 95% CI 1.81-3.80).

Conclusion: Children and adolescents with ASD are at increased risk of underweight, obesity, and severe obesity, independent of sociodemographic characteristics. Strategies addressing growth and weight status are warranted in this population.

Background and objectives: To explore the relationship between constant exposure to phthalates (PAEs) and overweight/obesity and the role of lifestyle in children.

Methods: This study conducted five repeated follow-up visits with 829 children and analysed data from 740 children. Logistic regression models were used to evaluate the association between constant PAE exposure, lifestyle and overweight/obesity.

Results: The study found that constant high levels of PAEs exposure may increase the risk of obesity in girls, and the risk is higher in girls with an unhealthy lifestyle. In the unhealthy lifestyle group of girls, compared with the constant low (CL) exposure group of PAEs, the odds ratios (ORs) for overweight/obesity and obesity in the constant high (CH) exposure group were 2.99 (1.11, 8.05) and 11.58 (1.38, 96.87), respectively. In addition, an interaction effect between constant exposure to PAEs and lifestyle was observed on obesity in girls.

Conclusion: These results suggest the importance of reducing constant exposure to high levels of PAEs to reduce the risk of obesity, especially in individuals with unhealthy lifestyles. The government should strengthen the formulation of regulations and standards for PAEs while guiding parents to use fewer plastic products.

Objectives: This study examined the impact of hypothetical interventions on (i) early life factors (prenatal and early postnatal) on rapid weight gain during infancy, and (ii) early life factors and child energy balance-related behaviours (EBRB) on children's body mass index (BMI)-for-age at 5 and 8 years.

Methods: Data from the Norwegian Mother, Father, and Child Cohort Study included participants aged 2 (n = 48 109), 5 (n = 18 810) and 8 (n = 10 830) years. Early life intervention variables were maternal smoking during pregnancy, maternal weight before and during pregnancy, exclusive/partial breastfeeding for 6 months, and introduction of complementary food at 6 months. Child EBRB intervention variables for the 5-year outcome included screen time, fruit and vegetable intake, and sugar-sweetened soft drink intake assessed at 3 years. For the 8-year outcome, interventions included screen time, presence of a television in the child's bedroom, sleep hours and breakfast intake assessed at 5 years. The parametric g-formula was used for analysis.

Results and conclusions: The average population-level difference in rapid weight gain during infancy at 2 years under the intervention targeting the prenatal, early postnatal factors and these factors combined with 95% confidence intervals were -0.012 (-0.017, -0.007), -0.009 (-0.012, -0.005) and -0.020 (-0.025, -0.015), respectively. The average population-level differences in children's BMI-for-age z-score for interventions targeting early life factors, child EBRB and these factors combined were -0.225 (-0.244, -0.207), 0.02 (-0.021, 0.024) and -0.223 (-0.249, -0.196), respectively among 5-year-olds and -0.265 (-0.295, -0.236), -0.020 (-0.029, -0.011) and -0.285 (-0.315, -0.256), respectively among 8-year-olds. Our results suggested joint interventions on early life factors may reduce childhood BMI-for-age z-scores.

Background: Children and adolescents are increasingly exposed to processed food in China, however, its association with obesity has not been investigated.

Objectives: To assess the consumption of ultra-processed food (UPF) and its association with overweight/obesity among children and adolescents in China.

Methods: A total of 3437 children and adolescents aged 6-18 years, participating at least twice in the China Nutrition and Health Survey, were included. Food intake was collected using a 3-day 24-h dietary recall method at home visits. Body weight, height and waist circumference (WC) were measured during the survey. UPF was defined by food process levels using NOVA classification. Overweight/obesity was defined by the international age- and sex-specific BMI and WC cut-offs. The association between UPF consumption and overweight/obesity was assessed using mixed effect logistic regression analyses adjusted for socio-demographic, economic, behavioural, dietary and health factors.

Results: The mean daily UPF consumption of the study population (mean age 9.3 years) increased from 9.7 in 1997 to 60.0 grams in 2011. The adjusted odds ratios (OR) (95% CI) for overweight/obesity (using BMI) for UPF consumption of 0, 1-49, 50-99 and ≥ 100 g/day were 1.00, 1.38 (0.98-1.94), 2.01 (1.25-3.24) and 1.53 (0.82-2.86), respectively (p-trend =0.013). Similarly, the corresponding adjusted ORs (95% CI) for central obesity (using WC) were 1.00, 1.84 (1.30-2.60), 2.13 (1.30-3.48) and 2.15 (1.14-4.05) (p-trend<0.001).

Conclusions: Higher long-term UPF consumption was associated with an increased risk of overweight/obesity among children and adolescents in China.

Introduction: Screen-based behaviours have brought great changes to our lifestyles over the last 50 years. There is limited data evaluating the effects of such alterations on the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) in adolescents. This study sets out to assess possible associations of excessive screen exposure with liver steatosis in a representative sample of US adolescents.

Methods: This cross-sectional analysis used data derived from the National Health and Nutrition Examination Surveys (NHANES) carried out in 2017-2018, including 731 subjects aged 12-17 years. Self-reported screen time (ST, hours/day) outside of school was recorded, including hours watching TV or videos and hours using the computer. Liver steatosis was identified according to the median controlled attenuation parameter (CAP) by transient elastography.

Results: Among the participants, 476 (65.0%, 95% CI: 60.7%-69.2%) experienced excessive screen time (EST, daily ST ≥ 5 h). The prevalence of liver steatosis was higher in adolescents with EST versus counterparts with modest ST (ST < 5 h) (27.0% vs. 16.1%, p < 0.001). EST was associated with increased odds of liver steatosis in adolescents after adjusting for covariates related to demographic background, metabolic variables, physical activity and diet quality (OR: 2.10, 95% CI: 1.34-3.29, p = 0.032). Body mass index partially mediated the effect of EST on liver steatosis risk (52.9%, p = 0.036).

Conclusion: Excessive screen time was associated with increased odds of liver steatosis in adolescents. Strategies to reduce screen time for youth may bring benefits for the management of MASLD.

Background: High levels of sedentary behaviour are associated with poor child health outcomes such as obesity. Early childhood education and care (ECEC) services are a key intervention setting. Most ECEC policy-based interventions focus on children's nutrition and physical activity with few aimed at children's sedentary behaviour.

Objective: To evaluate the effect of the Play Active ECEC policy intervention on educator adherence to sedentary behaviour policy recommendations, educator's practices and educator psychosocial influences related to children's sedentary behaviour.

Methods: Pragmatic cluster randomized trial in 81 ECEC services in Perth, Western Australia. Services implemented the Play Active policy over three months. Outcomes were educator-reported changes in adherence to sedentary behaviour policy recommendations, practices and psychosocial influences related to children's sedentary behaviour. Analysis involved descriptive statistics and generalized linear mixed-effects models.

Results: Adherence to sedentary behaviour policy recommendations and educator's practices and psychosocial influences related to children's sedentary behaviour was high at baseline and did not significantly change in response to the Play Active policy intervention.

Conclusions: Educators appeared to adhere to best-practice guidelines for children's sedentary behaviour in ECEC. Clear evidence informed policy, standards and legislation to maintain children's low levels of sedentary behaviours in ECEC is warranted.

Objective: To examine gut microbiota diversity, composition and metabolites in relation to overall mass (OM), fat mass (FM) and lean soft tissue mass (LSTM) measured by dual x-ray absorptiometry (DXA) in 5-year-old children.

Methods: Mothers of the Gen3G cohort were enrolled prenatally in 2010-2013 in Quebec, Canada; 153 children from the cohort had data on gut microbiota and DXA scans at 5-6.4 years of age, and 140 also had plasma metabolite data. We characterized gut microbiota by 16S rRNA Illumina sequencing and metabolites by untargeted multiplatform mass spectrometry. We examined associations of microbial alpha diversity, beta diversity, composition (amplicon sequence variants; ASVs) and metabolites (microbial metabolites) with DXA measures, adjusting for age, sex, diet and drinking water.

Results: Of the 153 children, 43.1% were female, and 96.1% self-identified as white. The median BMI was the 52nd percentile. Microbial richness (alpha diversity) was positively associated with OM, FM and LSTM. Of the 542 ASVs tested, 7 were associated with OM, 5 with FM and 4 with LSTM. One Veillonella ASV and two Blautia ASVs were significantly associated with all outcomes. Among 278 microbial metabolites, no metabolites were associated with FM, while glycoursodeoxycholate was associated with OM, and glycoursodeoxycholate, 3-hydroxybutyrate and gamma-glutamylalanine were associated with LSTM.

Conclusions: In 5-year-old children, gut microbiota alpha diversity, richness and specific gut microbes were associated with OM, FM and LSTM. Many of the associations followed a similar pattern for FM and LSTM, suggesting they may not be specific to adiposity but rather reflect overall growth.

Introduction: There is a high prevalence of type 2 diabetes (T2D) in First Nations populations worldwide, increasingly at younger ages. This review aims to identify interventions for the prevention of T2D in First Nations children and young people aged 4-25 years.

Methods: A systematic search of both published and unpublished literature until March 2024 was performed using 15 electronic databases, including MEDLINE, CINAHL, EMBASE, Scopus, Cochrane Library, ATSIHealth, OpenGrey and specific First Nations databases. Eligible studies included First Nations participants aged 4-25 years without T2D, exploring interventions to prevent T2D. Outcomes included knowledge of diabetes, anthropometry and physiology, diet and nutrition, physical activity, glycemic indicators and psychosocial indicators.

Results: Fourteen pre-post exposure non-controlled studies were included, evaluating nine programs. Programs were culturally adapted and primarily school-based, focusing on individual-level behaviour modification in nutrition and physical activity. Most studies assessing knowledge outcomes reported improvement. There were inconsistent findings regarding impacts on dietary intake and glycemia. One home-based program achieved improvements across a range of outcomes, including body mass index, physical activity and psychosocial scores.

Conclusion: Despite the increasing prevalence of T2D in First Nations children and young people, evidence of effective preventive strategies within these populations remains limited.

The development of obesity in childhood is the result of interplay between a complex array of multi-level factors, one of which is dietary intake. However, dietary intake in childhood itself is impacted by many factors operating at different levels. This special issue brings together a collection of papers that examine various factors influencing children's dietary intake. Rather than issuing a call for papers, this collection came together organically based on regular submissions, highlighting the growing body of research dedicated to understanding how children's dietary habits can contribute to obesity risk. These papers represent studies that have focused on the external (e.g., fast-food environment, ongoing rapid proliferation of ultra-processed foods) and social (e.g., the role of parents and schools, stress and adversity) environment, behavioural factors (e.g., reward and gratification, sleeping behaviour) and genetic factors, as well as maternal factors that promote intra-generational transmission. This is summarized in Figure 1. In a time when obesity development continues to rise globally, these studies may shed light on the complexity of one of the main drivers, namely dietary intake. Below we summarize the latest research in these areas resulting from the papers in this Special Issue.