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Childhood Obesity and Age-Related Diseases: A Systematic Review and Meta-Analysis of Mendelian Randomization Evidence 儿童肥胖和年龄相关疾病:孟德尔随机化证据的系统回顾和荟萃分析。
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-11-14 DOI: 10.1111/ijpo.70071
Haoxue Zhu, Xinghao Yi, Mengyu He, Siyi Wu, Ming Li, Shan Gao

Background

Childhood obesity poses a global health threat, with emerging evidence suggesting distinct adipocyte senescence patterns compared to adult-onset obesity. We systematically explored whether childhood obesity may be causally associated with age-related diseases through a meta-analysis of Mendelian randomization (MR) evidence.

Methods

We screened six databases (MEDLINE, PubMed, EMBASE, Web of Science, Cochrane Library and CNKI) and identified 45 MR articles examining paediatric adiposity and major age-related diseases. For each disease, we performed a meta-analysis using results from published MR studies and conducted de novo analyses based on genetic data from UK Biobank (n = 453 169), FinnGen (n > 200 000) and other large consortiums.

Results

The meta-analysis examined 44 diseases across 9 systems, revealing suggestive associations between genetically determined childhood obesity and increased risk of 16 age-related diseases, including hypertension, atrial fibrillation, coronary artery disease, stroke and myocardial infarction; colorectal, endometrial and pancreatic cancers; nonalcoholic fatty liver disease, type 2 diabetes, diabetic nephropathy; multiple sclerosis and gout; Alzheimer's disease; depression and asthma. Three of these associations were marginal (p = 0.03–0.05). Paradoxical inverse associations emerged for breast cancer and ulcerative colitis.

Conclusion

The findings from this meta-analysis underscore associations between childhood adiposity and multisystem age-related pathologies, underscoring the imperative for early obesity prevention.

背景:儿童肥胖是一个全球性的健康威胁,新出现的证据表明,与成人发病的肥胖相比,儿童肥胖的脂肪细胞衰老模式不同。通过对孟德尔随机化(MR)证据的荟萃分析,我们系统地探讨了儿童肥胖是否与年龄相关疾病有因果关系。方法:我们筛选了6个数据库(MEDLINE、PubMed、EMBASE、Web of Science、Cochrane Library和CNKI),筛选了45篇探讨儿童肥胖和主要年龄相关疾病的MR文章。对于每种疾病,我们使用已发表的MR研究结果进行了荟萃分析,并基于来自UK Biobank (n = 453169)、FinnGen (n = 20000)和其他大型财团的遗传数据进行了从头分析。结果:荟萃分析检查了9个系统的44种疾病,揭示了遗传决定的儿童肥胖与16种年龄相关疾病风险增加之间的暗示关联,包括高血压、心房颤动、冠状动脉疾病、中风和心肌梗死;结直肠癌、子宫内膜癌和胰腺癌;非酒精性脂肪肝、2型糖尿病、糖尿病肾病;多发性硬化症和痛风;阿尔茨海默病;抑郁症和哮喘。其中三个相关性为边缘相关性(p = 0.03-0.05)。在乳腺癌和溃疡性结肠炎中出现了矛盾的负相关。结论:这项荟萃分析的发现强调了儿童肥胖与多系统年龄相关病理之间的联系,强调了早期预防肥胖的必要性。
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引用次数: 0
The Association Between Schoolwork Pressure and Overweight/Obesity in Swedish Schoolchildren Across Different Socioeconomic Groups 瑞典不同社会经济群体学童学业压力与超重/肥胖的关系
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-11-12 DOI: 10.1111/ijpo.70067
Cassandra Comey, Kenisha Russell Jonsson, Maria Corell

Background

In Sweden, schoolwork pressure and adolescent overweight/obesity prevalence have increased in recent decades. This study investigates the relationship between schoolwork pressure and weight status, considering the moderating role of socioeconomic background.

Methods

We analysed pooled cross-sectional data from 12 154 adolescents in the nationally representative Swedish Health Behaviour in School-aged Children surveys (2013/14, 2017/18, 2021/22). Logistic regression models examined the association between schoolwork pressure and self-reported overweight/obesity status (standardised by IOTF cut-offs) across socioeconomic backgrounds assessed by the Family Affluence Scale (FAS) and perceived family wealth (PFW). We calculated population attributable fractions to quantify schoolwork pressure's contribution to overweight/obesity.

Results

37% of students reported high schoolwork pressure, and 14% had overweight or obesity. High schoolwork pressure was associated with increased odds of overweight/obesity (OR 1.17, 95% CI 1.03–1.32). Adolescents experiencing high pressure from low socioeconomic backgrounds FAS (OR 2.10, 95% CI 1.60–2.76) or PFW (OR 1.82, 95% CI 1.22–2.71) had the highest odds of overweight/obesity. Approximately 5% of overweight/obesity cases were attributable to high schoolwork pressure.

Conclusions

High schoolwork pressure increases the likelihood of adolescent overweight/obesity, particularly for disadvantaged socioeconomic groups. Implementing policies to reduce academic stress and providing targeted support are essential for promoting healthier outcomes.

背景:在瑞典,近几十年来,学业压力和青少年超重/肥胖患病率有所增加。本研究探讨学业压力与体重状况的关系,并考虑社会经济背景的调节作用。方法:我们分析了全国代表性瑞典学龄儿童健康行为调查(2013/14、2017/18、2021/22)中12154名青少年的汇总横截面数据。逻辑回归模型检验了家庭富裕量表(FAS)和感知家庭财富(PFW)评估的社会经济背景下,学业压力与自我报告的超重/肥胖状况(由IOTF截止值标准化)之间的关系。我们计算了人口归因分数来量化学业压力对超重/肥胖的贡献。结果:37%的学生报告了高中学业压力,14%的学生超重或肥胖。高中学业压力与超重/肥胖的几率增加相关(OR 1.17, 95% CI 1.03-1.32)。来自低社会经济背景(FAS) (OR 2.10, 95% CI 1.60-2.76)或PFW (OR 1.82, 95% CI 1.22-2.71)的高压力青少年超重/肥胖的几率最高。大约5%的超重/肥胖病例可归因于高中学业压力。结论:高中学业压力增加了青少年超重/肥胖的可能性,特别是对社会经济弱势群体。实施减轻学业压力的政策和提供有针对性的支持对于促进更健康的结果至关重要。
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引用次数: 0
Prenatal Exposure to Gestational Diabetes Mellitus Is Associated With Greater Pre-Pubertal BMI Growth and Faster Post-Pubertal Cortical Thinning During Peri-Adolescence 产前暴露于妊娠期糖尿病与青春期前较大的BMI增长和青春期后更快的皮质变薄有关
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-11-12 DOI: 10.1111/ijpo.70069
Eustace Hsu, Trevor A. Pickering, Shan Luo

Background

The longitudinal trajectory of body mass index (BMI) and brain structure development during peri-adolescence is not clearly defined in offspring prenatally exposed to gestational diabetes mellitus (GDM) versus unexposed offspring.

Methods

Participants between age 9 and 10 years (N = 9583) were included from the Adolescent Brain and Cognitive Development (ABCD) Study and followed yearly through 4-year follow-up. GDM and puberty status were self-reported. BMI was calculated yearly, and MRI assessed brain structure biennially. Mixed-effects models analysed trajectories of BMI and brain structural measures between groups controlling for sociodemographic covariates, and linear spline was defined with a knot at the onset of puberty.

Results

There was an interaction of exposure by age in change in BMI [β (95% CI) = 0.032 (0.008, 0.056), p = 0.009] and mean cortical thickness [β (95% CI) = −0.038 (−0.071, −0.004), p = 0.027]. The former was driven by greater pre-pubertal increases in BMI [β (95% CI) = 0.051 (0.002, 0.100), p = 0.043], whereas the latter was driven by faster post-pubertal declines in cortical thickness among GDM-exposed offspring [β (95% CI) = −0.051 (−0.095, −0.007), p = 0.046].

Conclusion

Prenatal GDM exposure is associated with greater pre-pubertal increases in BMI and faster post-pubertal cortical thinning in youth aged between 9 and 15.

背景:产前暴露于妊娠期糖尿病(GDM)的后代与未暴露于妊娠期糖尿病(GDM)的后代在青春期前后身体质量指数(BMI)和大脑结构发育的纵向轨迹尚不清楚。方法:从青少年大脑和认知发展(ABCD)研究中纳入年龄在9至10岁之间的参与者(N = 9583),每年随访4年。GDM和青春期状态均为自我报告。BMI每年计算一次,MRI每两年评估一次脑结构。混合效应模型分析了控制社会人口协变量的组间BMI和脑结构测量的轨迹,线性样条被定义为青春期开始时的一个结。结果:暴露与年龄之间存在交互作用,影响BMI [β (95% CI) = 0.032 (0.008, 0.056), p = 0.009]和平均皮质厚度[β (95% CI) = -0.038 (-0.071, -0.004), p = 0.027]。前者是由青春期前较大的BMI增加引起的[β (95% CI) = 0.051 (0.002, 0.100), p = 0.043],而后者是由gdm暴露后代青春期后皮质厚度下降更快引起的[β (95% CI) = -0.051 (-0.095, -0.007), p = 0.046]。结论:在9 - 15岁的青少年中,产前GDM暴露与青春期前BMI增加和青春期后皮质变薄有关。
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引用次数: 0
Associations of Acculturation With Added Sugars Intake and Weight Status Among Mexican American Adolescents in the United States, NHANES, 2009–2018 美国墨西哥裔美国青少年中添加糖摄入与体重状况的文化适应关系,NHANES, 2009-2018。
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-10-28 DOI: 10.1111/ijpo.70063
Euisun Pyo, Regine Haardörfer, Liliana Aguayo, Miriam Vos, Mary Beth Weber, Jean A. Welsh

U.S. acculturation is associated with poor diet quality and obesity. This study examined the association of acculturation with added sugars among Mexican American adolescents, and whether added sugars mediate the association between acculturation and overweight/obesity. Data from NHANES 2009–2018 included 1317 Mexican American adolescents aged 12–19 years. Acculturation was measured by language spoken at home (English vs. Spanish) and birthplace of child and caregiver (United States vs. Mexico). Added sugars intake was assessed by 24-h dietary recall and categorised as ‘high’ (≥ 10% total energy intake) versus ‘low’ (< 10%). Multivariable logistic regressions tested associations between acculturation and added sugars, and path analysis evaluated the mediation of added sugars between acculturation and overweight/obesity (≥ 85th BMI percentile). Greater acculturation, indicated by primarily speaking English at home (OR: 1.6; 95% CI: 1.0, 2.5), caregiver being U.S.-born (2.2; 1.1, 4.2), both child and caregiver U.S.-born (2.8; 1.2, 6.5), or both U.S.-born + English at home (2.9; 1.1, 7.5), was associated with higher odds of high added sugars intake. Added sugars did not mediate the effect of acculturation on obesity/overweight status. These findings suggest that while higher acculturation is associated with excess added sugars intake, future research is needed to clarify how acculturation influences obesity risk.

美国文化的适应与饮食质量差和肥胖有关。本研究考察了墨西哥裔美国青少年的文化适应与添加糖之间的关系,以及添加糖是否介导了文化适应与超重/肥胖之间的关系。NHANES 2009-2018年的数据包括1317名12-19岁的墨西哥裔美国青少年。文化适应是通过家庭使用的语言(英语vs.西班牙语)和孩子和照顾者的出生地(美国vs.墨西哥)来衡量的。通过24小时饮食回忆评估添加糖摄入量,并将其分为“高”(≥10%的总能量摄入)和“低”(
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引用次数: 0
Memory Performance and Hippocampal Volumes in Healthy Weight Children at High- and Low-Familial Risk for Obesity 高、低家族性肥胖风险健康体重儿童的记忆表现和海马体体积
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-10-26 DOI: 10.1111/ijpo.70061
Melanie A. Dratva, Zoe L. Lanman, Amanda Bischoff-Grethe, Dawn M. Eichen, David R. Strong, Christina E. Wierenga, Kerri N. Boutelle
<div> <section> <h3> Background</h3> <p>Children with overweight or obesity (OW/OB), relative to healthy weight (HW), have lower cognitive performance and hippocampal volumes. Whether this extends to children with HW at familial risk for future OW/OB is unknown.</p> </section> <section> <h3> Objectives</h3> <p>To compare memory performance and hippocampal subfield volumes between HW children at high risk (HR) and low risk (LR) for OW/OB.</p> </section> <section> <h3> Methods</h3> <p>HW children (<i>n</i> = 95, aged 8–11), classified as HR (<i>n</i> = 43, both parents with OW/OB) or LR (<i>n</i> = 52, both parents with HW), underwent structural magnetic resonance imaging and memory testing (Verbal List Learning Test-Food-Child Version (VLLT-Food-C) and Child Memory Scale subtests: word pairs, dot locations). Linear models tested group differences in memory scores, hippocampal and subfield (CA1, CA3, dentate gyrus (DG), subiculum) volumes.</p> </section> <section> <h3> Results</h3> <p>Groups did not differ on demographics except body mass index (HR > LR, <i>p</i> = 0.003), despite all children being HW. LR children performed better on VLLT-Food-C short- (<span></span><math> <semantics> <mrow> <mi>β</mi> </mrow> <annotation>$$ beta $$</annotation> </semantics></math> = 0.34, <i>p</i> < 0.01) and long-delay cued recall (<span></span><math> <semantics> <mrow> <mi>β</mi> </mrow> <annotation>$$ beta $$</annotation> </semantics></math> = 0.21, <i>p</i> = 0.04) and word pairs delayed recall (<span></span><math> <semantics> <mrow> <mi>β</mi> </mrow> <annotation>$$ beta $$</annotation> </semantics></math> = 0.21, <i>p</i> = 0.04). Children with HR had smaller bilateral whole hippocampus, CA1, DG and right CA3 volumes (<i>p</i>s < 0.05); only the right DG remained significant (<span></span><math> <semantics> <mrow> <mi>β</mi> </mrow> <annotation>$$ beta $$</annotation> </semantics></math> = 0.15, <i>p</i> = 0.04) after intracranial volume adjustment.</p> </section> <section> <h3> Conclusions</h3> <p>Memory and hippocampal volume differences may reflect underlying familial
背景:与健康体重(HW)相比,超重或肥胖儿童(OW/OB)的认知能力和海马体积较低。这是否适用于有家族性OW/OB风险的HW患儿尚不清楚。目的:比较OW/OB高风险(HR)和低风险(LR) HW儿童的记忆表现和海马亚区体积。方法:HW儿童(n = 95,年龄8-11岁),分为HR组(n = 43,父母双方均患有OW/OB)和LR组(n = 52,父母双方均患有HW),采用结构磁共振成像和记忆测试(言语表学习测试-食物-儿童版(VLLT-Food-C)和儿童记忆量表子测试:单词对、点位置)。线性模型测试各组在记忆评分、海马和子区(CA1、CA3、齿状回(DG)、丘下)体积方面的差异。结果:各组在人口统计学上没有差异,除了身体质量指数(HR > LR, p = 0.003),尽管所有儿童都是高体重。LR儿童在VLLT-Food-C短记忆(β $$ beta $$ = 0.34, p β $$ beta $$ = 0.21, p = 0.04)和单词对延迟回忆(β $$ beta $$ = 0.21, p = 0.04)上表现较好。颅内容积调整后,HR患儿双侧海马全区、CA1、DG、右侧CA3体积减小(ps β $$ beta $$ = 0.15, p = 0.04)。结论:记忆和海马体积的差异可能反映了HW儿童OW/OB的潜在家族风险。
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引用次数: 0
Parent Perspectives on the 2023 Clinical Practice Guideline for Pediatric Obesity: A Mixed-Methods Study of Acceptance and Concerns 家长对2023年儿童肥胖临床实践指南的看法:一项接受和关注的混合方法研究
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-10-26 DOI: 10.1111/ijpo.70065
Brooke E. Wagner, Annika B. Kruse, Sarah C. Armstrong, Asheley C. Skinner, Karen A. Scherr

Background

The 2023 Clinical Practice Guideline for pediatric obesity recommends immediate, intensive treatment, including behavioral therapy, medications, and surgery when indicated. Understanding parental agreement with the guideline is critical for successful implementation.

Objective

To evaluate parental awareness of and agreement with the guideline.

Methods

Parents (n = 150; 62.9% female; 75.5% White; Mage = 37.6 ± 7.4 years) completed an online survey assessing guideline awareness and agreement. K-means cluster analysis identified parent subgroups based on agreement patterns. Linear regression examined predictors of agreement (e.g., parent age, BMI). Inductive content analysis explored underlying perspectives.

Results

Few parents (5.3%) were aware of the guideline before the survey. Cluster analysis identified three subgroups: Guideline Skeptics (34%; broadly disagreed), Selective Supporters (28%; mostly agreed but opposed medications and surgery), and Guideline Supporters (38%; broadly agreed). Higher parental BMI predicted lower agreement (β = −0.20, p = 0.018). Qualitative findings added nuance to parents' preference for lifestyle changes, highlighted concerns about mental health and eating disorders, and emphasized parental responsibility in the development and treatment of obesity.

Conclusions

Parental agreement with the guideline varies widely. While most support behavioral treatment, many express concerns about medications and surgery, and a subset of “Guideline Skeptics” reject core principles such as the use of BMI. Tailored implementation strategies are needed to address these diverse views.

背景:2023儿科肥胖临床实践指南建议立即进行强化治疗,包括行为治疗、药物治疗和必要时的手术治疗。理解家长同意指导方针是成功实施的关键。目的:评价家长对该指南的认知度和认同程度。方法:150名家长(女性62.9%,白人75.5%,年龄37.6±7.4岁)完成在线问卷调查,评估家长对指南的认知和认同。K-means聚类分析根据一致性模式确定父子组。线性回归检验了一致性的预测因子(如父母年龄、体重指数)。归纳性内容分析探究了潜在的观点。结果:调查前很少有家长知晓该指南(5.3%)。聚类分析确定了三个亚组:指南怀疑论者(34%;广泛不同意),选择性支持者(28%;大部分同意但反对药物和手术)和指南支持者(38%;广泛同意)。父母BMI越高,一致性越低(β = -0.20, p = 0.018)。定性研究发现,父母对改变生活方式的偏好有细微差别,强调了对心理健康和饮食失调的关注,并强调了父母在肥胖发展和治疗中的责任。结论:家长对指南的认同差异很大。虽然大多数人支持行为治疗,但许多人表达了对药物和手术的担忧,还有一部分“指南怀疑论者”拒绝使用BMI等核心原则。需要量身定制的实施战略来处理这些不同的观点。
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引用次数: 0
Parental Communication in the Prevention and Treatment of Child and Adolescent Obesity: A Position Statement of the European Childhood Obesity Group 父母沟通在预防和治疗儿童和青少年肥胖:欧洲儿童肥胖小组的立场声明。
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-10-22 DOI: 10.1111/ijpo.70052
Rebecca Puhl, Sandra Hassink, Julia Lischka, Gabriel Torbahn, Susanne Ring-Dimitriou, Caroline Braet, Elpis Vlachopapadopoulou, Teodora Handjieva-Darlenska, Andrea Vania, Edyta Łuszczki, Dénes Attila Molnár, David Thivel, Daniel Weghuber, Paulina Nowicka

Parental communication plays a critical role in weight-related health of children and adolescents and requires a balanced, thoughtful and supportive approach. The European Childhood Obesity Group (ECOG) convened a panel of experts to discuss the topic of parental communication in the prevention and treatment of child and adolescent obesity, as summarised in this statement. Parental concern about weight is evident, but the lack of parental knowledge about obesity, the impact of weight bias and stigma on their children and adolescents' health behaviours, and the influences of culture, media, and advertising all make communication challenging and problematic for many families. Parents need support and skill building in order to provide a communication environment that is healthy and accepting. Healthcare professionals can model healthy communication styles by focusing on health, building family strengths and supports, asking youth about what words they prefer using to discuss their weight, and acknowledging the multifactorial causes of obesity that reside in the socioecological environment. While parental communication offers a powerful platform for promoting healthy behaviours in youth, it must be handled with care to avoid the harms of stigmatisation and oversimplification of obesity as a reflection of individual lifestyle choices. With appropriate tools, knowledge, skills, and support, parents can be better equipped to engage in supportive dialogue that empowers their children and promotes their health and wellbeing.

父母的沟通在儿童和青少年的体重相关健康中起着至关重要的作用,需要一种平衡、周到和支持的方法。欧洲儿童肥胖小组(ECOG)召集了一个专家小组,讨论父母沟通在预防和治疗儿童和青少年肥胖方面的主题,总结在本声明中。父母对体重的关注是显而易见的,但父母对肥胖缺乏了解,体重偏见和污名对儿童和青少年健康行为的影响,以及文化、媒体和广告的影响,都使许多家庭的沟通充满挑战和问题。父母需要支持和技能培养,以提供一个健康和包容的交流环境。医疗保健专业人员可以通过关注健康,建立家庭力量和支持,询问年轻人他们更喜欢用什么词来讨论他们的体重,并承认存在于社会生态环境中的肥胖的多因素原因来塑造健康的沟通方式。虽然父母的沟通为促进青少年的健康行为提供了一个强有力的平台,但必须谨慎处理,以避免将肥胖污名化和过度简化为个人生活方式选择的反映。有了适当的工具、知识、技能和支持,父母就能更好地参与支持性对话,增强孩子的权能,促进他们的健康和福祉。
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引用次数: 0
Impact of a Home-Based Obesity Prevention Intervention on Children's and Parents' BMI: Findings From the Guelph Family Health Study Randomised Controlled Trial 基于家庭的肥胖预防干预对儿童和父母BMI的影响:来自圭尔夫家庭健康研究随机对照试验的发现
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-10-22 DOI: 10.1111/ijpo.70062
Raphaëlle Jacob, Andrea C. Buchholz, Gerarda Darlington, Alison M. Duncan, Lori Ann Vallis, Jean-Philippe Chaput, Angela Annis, Madeline Nixon, Jennifer D. Irwin, Don Morrow, David W. L. Ma, Jess Haines

Background

To prevent the development of obesity and related comorbidities, interventions must begin early in life. This study aimed to assess the impact of a home-based obesity prevention intervention on children's and parents' body mass index (BMI).

Methods

The Guelph Family Health Study is a randomised controlled trial of a 6-month obesity prevention intervention aimed at establishing healthful household routines regarding family meals, children's screen time, physical activity and sleep among 285 families with preschool-aged children. The control group received 6 emails on child health behaviours. The analytic sample included 376 children (3.6 ± 1.3 years old, 20.2% at risk for overweight, 8.2% with overweight/obesity) and 481 parents (58.2% with overweight/obesity).

Results

Compared to controls, the intervention had no significant impact on children's or parents' BMI at post-intervention and 1 year after the intervention. Children in both the intervention and control groups had a non-significant decrease in BMI from baseline to post-intervention [intervention; −0.23 kg/m2 (95% CI, −0.46, 0.002); control; −0.17 kg/m2 (95% CI, −0.40, 0.06)] and from baseline to 1-year follow-up [intervention, −0.29 kg/m2 (95% CI, −0.67, 0.08); control, −0.06 kg/m2 (95% CI, −0.42, 0.30)].

Conclusions

Compared to controls, this home-based obesity prevention intervention had no significant impact on children's or parents' BMI immediately after the intervention or after 1 year of follow-up, indicating that the intervention had no additional effect compared to the control group on children's or parents' BMI over time. Future data collection phases will allow for the examination of the intervention effect on BMI as children age.

Trial Registration

This study is registered at clinicaltrial.gov identifier: NCT02939261

背景:为了预防肥胖和相关合并症的发展,干预措施必须在生命早期开始。本研究旨在评估以家庭为基础的肥胖预防干预对儿童和父母体重指数(BMI)的影响。方法:圭尔夫家庭健康研究是一项为期6个月的肥胖预防干预的随机对照试验,目的是在285个有学龄前儿童的家庭中建立健康的家庭常规,包括家庭膳食、儿童屏幕时间、身体活动和睡眠。对照组收到6封关于儿童健康行为的电子邮件。分析样本包括376名儿童(3.6±1.3岁,20.2%有超重危险,8.2%有超重/肥胖)和481名家长(58.2%有超重/肥胖)。结果:与对照组相比,干预对干预后及干预后1年儿童及家长的BMI均无显著影响。干预组和对照组儿童的BMI从基线到干预后均无显著下降[干预;-0.23 kg/m2 (95% CI, -0.46, 0.002);控制;-0.17 kg/m2 (95% CI, -0.40, 0.06)],从基线到1年随访[干预],-0.29 kg/m2 (95% CI, -0.67, 0.08);对照组为-0.06 kg/m2 (95% CI, -0.42, 0.30)。结论:与对照组相比,这种以家庭为基础的肥胖预防干预在干预后立即或随访1年后对儿童或父母的BMI没有显著影响,这表明与对照组相比,干预对儿童或父母的BMI没有额外的影响。未来的数据收集阶段将允许检查干预对儿童年龄BMI的影响。试验注册:本研究在clinicaltrial.gov注册,识别码:NCT02939261。
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引用次数: 0
First 1000 Days Strategies to Prevent Childhood Obesity: A Narrative Review and Recommendations From the EndObesity Consortium 预防儿童肥胖的前1000天策略:来自肥胖联盟的叙述回顾和建议。
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-10-17 DOI: 10.1111/ijpo.70060
Mireille C. Schipper, Anna Manshanden, Kaat Philippe, Natàlia Ferré, Veronica Luque, Marion Lecorguillé, Adrien M. Aubert, Kathrin Guerlich, Camille Le Gal, Shweta Feher, Ester Parada-Ricart, Joaquin Escribano, Veit Grote, Berthold Koletzko, Teresa Primavesi-Poggio, Katharina Reiss, Jaap C. Seidell, Sandrine Lioret, Catherine M. Phillips, Barbara Heude, Romy Gaillard

Childhood obesity remains a major global public health challenge, leading to significant short- and long-term adverse health outcomes and imposing substantial societal costs. Recognising the critical importance of early intervention, the Horizon2020 EU-funded JPI Consortium EndObesity has prioritised the first 1000 days of life, from preconception to 2 years of age, as a key window for obesity prevention strategies. This narrative review synthesises findings from the EndObesity Consortium, summarising evidence from large multi-cohort studies on the influence of family-based health behaviours in the first 1000 days on offspring obesity risk, the potential of childhood obesity prediction models in the first 1000 days, and strategies to enhance prenatal and postnatal interventions to prevent childhood obesity development. Finally, we present recommendations for research, practice, and policy to address the complex, multifaceted challenges of childhood obesity prevention in the first 1000 days.

儿童肥胖仍然是一项重大的全球公共卫生挑战,导致严重的短期和长期不良健康后果,并造成巨大的社会成本。意识到早期干预的重要性,欧盟资助的Horizon2020 JPI Consortium endobesobesity将生命的前1000天(从孕前到两岁)作为预防肥胖策略的关键窗口。这篇叙述性综述综合了来自肥胖联盟的研究结果,总结了来自大型多队列研究的证据,这些研究涉及前1000天家庭健康行为对后代肥胖风险的影响,前1000天儿童肥胖预测模型的潜力,以及加强产前和产后干预以预防儿童肥胖发展的策略。最后,我们提出了研究、实践和政策方面的建议,以解决儿童肥胖预防在头1000天面临的复杂、多方面的挑战。
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引用次数: 0
Relative Fat Mass as an Estimator of Abdominal Adiposity in Youth Across the BMI Spectrum from Normal Weight to Obesity 相对脂肪量作为从正常体重到肥胖的BMI谱中青少年腹部肥胖的估计。
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-10-15 DOI: 10.1111/ijpo.70059
Wonhee Cho, Joon Young Kim, Silva Arslanian

Background

Relative fat mass (RFM) has been used to estimate whole-body fat percentage (%BF). However, whether RFM can mirror abdominal adiposity is unknown.

Objective

In youth, we examined if RFM reflects abdominal adiposity, if there are age/race/sex differences in the relationships between RFM and abdominal adiposity, and if our present-youth-cohort-derived RFM (RFM-Y) improves the prediction of %BF and abdominal adiposity.

Methods

In 358 youth (aged 10–19 years; 168 black/198 white) with normal weight and overweight/obesity (without secondary or syndromic obesity), visceral (VAT), subcutaneous (SAT) and total abdominal adipose tissue (TAT) were assessed by MRI/CT and %BF with DXA. RFM was calculated for ages 10–14 years as [74 − (22 × height/waist circumference [WC]) + (5 × sex)] and 15–19 years as [64 − (20 × height/WC) + (12 × sex)]; sex = 0 for boys, 1 for girls. To develop and validate RFM-Y, linear regression, concordance correlation coefficient, Bland–Altman plots and intraclass correlation coefficient were conducted.

Results

RFM associated with VAT, SAT and TAT (r = 0.66, 0.79, 0.79, respectively; all p < 0.001). The slope was significantly greater in (a) younger versus older youth for VAT, SAT and TAT; (b) whites versus blacks for VAT; and (c) girls versus boys for SAT and TAT. RFM-Y versus traditional RFM showed improved predictive ability for %BF (R 2 = 0.83 vs. 0.77) and abdominal adiposity (R 2 ranging from 0.51 to 0.80 vs. 0.37 to 0.63).

Conclusions

RFM reflects abdominal adiposity besides %BF and could be used in longitudinal/interventional youth trials, obviating the need for expensive imaging to assess changes in total and abdominal adiposity.

背景:相对脂肪量(RFM)已被用来估计全身脂肪百分比(%BF)。然而,RFM是否能反映腹部肥胖尚不清楚。目的:在年轻人中,我们研究了RFM是否反映了腹部肥胖,RFM和腹部肥胖之间的关系是否存在年龄/种族/性别差异,以及我们现在的青年队列衍生的RFM (RFM- y)是否改善了BF %和腹部肥胖的预测。方法:对358例体重正常、超重/肥胖(无继发性或综合征性肥胖)的青年(10-19岁;黑人168例/白人198例),采用MRI/CT和%BF结合DXA对内脏(VAT)、皮下(SAT)和腹部总脂肪组织(TAT)进行评估。10-14岁的RFM为[74 - (22 ×身高/腰围[WC]) + (5 ×性别)],15-19岁的RFM为[64 - (20 ×身高/腰围)+ (12 ×性别)];性别=男孩0,女孩1。采用线性回归、一致性相关系数、Bland-Altman图和类内相关系数等方法对RFM-Y进行开发和验证。结果:RFM与VAT、SAT和TAT (r分别为0.66、0.79、0.79;p均为0.83 vs. 0.77)和腹部肥胖相关(R2为0.51 ~ 0.80 vs. 0.37 ~ 0.63)。结论:RFM除反映BF %外还反映腹部脂肪,可用于纵向/介入性青年试验,无需昂贵的成像来评估总脂肪和腹部脂肪的变化。
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引用次数: 0
期刊
Pediatric Obesity
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