Natalie B. Lister, Rabia Khalid, Isabelle R. Jardine, Samantha Pryde, Hannah Melville, Anna L. Seidler, Kylie E. Hunter, Amy L. Ahern, Louise A. Baur, Caroline Braet, Sarah P. Garnett, Andrew J. Hill, Sarah Maguire, Dasha Nicholls, Susan J. Paxton, Milan K. Piya, Amanda Sainsbury, Katharine Steinbeck, Denise E. Wilfley, Kelly Cooper, Genevieve Dammery, Alicia M. Grunseit, Faith Anne N. Heeren, Rebecca A. Jones, Theodore K. Kyle, Fiona Quigley, Molly Robbins, Jacqlyn Yourell, Melanie K. Bean, Maxine P. Bonham, Kerri N. Boutelle, Michelle I. Cardel, Katherine E. Darling, Aimee L. Dordevic, Dawn M. Eichen, Leonard H. Epstein, Andrea B. Goldschmidt, Elissa Jelalian, Mara Cristina Lofrano-Prado, Tiffany Naets, Wagner L. Prado, Hanna F. Skjåkødegård, Yngvild Sørebø Danielsen, Richard I. Stein, Marian Tanofsky-Kraff, Annelies Van Eyck, Alaina P. Vidmar, Jack A. Yanovski, Brittany J. Johnson, Hiba Jebeile, the EDIT Collaboration
Objective
To understand delivery features and intervention strategies of adolescent weight management interventions which may influence eating disorder risk.
Methods
Systematic searches in four databases and two trial registries to identify randomised controlled trials in adolescents with overweight/obesity measuring eating disorder risk pre- and post-intervention. Delivery features and intervention strategies were coded from published descriptions using a project-specific codebook, validated by trial investigators and narratively synthesised.
Results
Of 11 860 records screened, 23 trials, with 54 intervention arms, were included in the analysis. Most interventions focused on weight loss and maintenance (54%) and were informed by a cognitive behavioural framework (43%). Interventions commonly targeted an individual with a support person (70%). Median intervention duration was 26 weeks, with weekly (35%) or staged (e.g., weekly, then monthly) visit (41%) frequency. Interventions had a mean (SD) of 30 (16.1) intervention strategies. Most included healthy eating education (89%), physical activity education (89%) and problem-solving barriers to dietary change (80%). Few included mental health strategies (17%). Interventions included ‘dietary prescription’ (65%), and 78% promoted ‘healthful/helpful eating behaviours’.
Conclusion
Weight management interventions are complex and vary in delivery approach and strategies used to change behaviors. Characterising interventions is a critical first step to understanding how weight management interventions' influence eating disorder risk.
{"title":"Components of Adolescent Behavioural Interventions With Eating Disorder Outcomes: Systematic Review With Intervention Mapping","authors":"Natalie B. Lister, Rabia Khalid, Isabelle R. Jardine, Samantha Pryde, Hannah Melville, Anna L. Seidler, Kylie E. Hunter, Amy L. Ahern, Louise A. Baur, Caroline Braet, Sarah P. Garnett, Andrew J. Hill, Sarah Maguire, Dasha Nicholls, Susan J. Paxton, Milan K. Piya, Amanda Sainsbury, Katharine Steinbeck, Denise E. Wilfley, Kelly Cooper, Genevieve Dammery, Alicia M. Grunseit, Faith Anne N. Heeren, Rebecca A. Jones, Theodore K. Kyle, Fiona Quigley, Molly Robbins, Jacqlyn Yourell, Melanie K. Bean, Maxine P. Bonham, Kerri N. Boutelle, Michelle I. Cardel, Katherine E. Darling, Aimee L. Dordevic, Dawn M. Eichen, Leonard H. Epstein, Andrea B. Goldschmidt, Elissa Jelalian, Mara Cristina Lofrano-Prado, Tiffany Naets, Wagner L. Prado, Hanna F. Skjåkødegård, Yngvild Sørebø Danielsen, Richard I. Stein, Marian Tanofsky-Kraff, Annelies Van Eyck, Alaina P. Vidmar, Jack A. Yanovski, Brittany J. Johnson, Hiba Jebeile, the EDIT Collaboration","doi":"10.1111/ijpo.70074","DOIUrl":"https://doi.org/10.1111/ijpo.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To understand delivery features and intervention strategies of adolescent weight management interventions which may influence eating disorder risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Systematic searches in four databases and two trial registries to identify randomised controlled trials in adolescents with overweight/obesity measuring eating disorder risk pre- and post-intervention. Delivery features and intervention strategies were coded from published descriptions using a project-specific codebook, validated by trial investigators and narratively synthesised.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 11 860 records screened, 23 trials, with 54 intervention arms, were included in the analysis. Most interventions focused on weight loss and maintenance (54%) and were informed by a cognitive behavioural framework (43%). Interventions commonly targeted an individual with a support person (70%). Median intervention duration was 26 weeks, with weekly (35%) or staged (e.g., weekly, then monthly) visit (41%) frequency. Interventions had a mean (SD) of 30 (16.1) intervention strategies. Most included healthy eating education (89%), physical activity education (89%) and problem-solving barriers to dietary change (80%). Few included mental health strategies (17%). Interventions included ‘dietary prescription’ (65%), and 78% promoted ‘healthful/helpful eating behaviours’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Weight management interventions are complex and vary in delivery approach and strategies used to change behaviors. Characterising interventions is a critical first step to understanding how weight management interventions' influence eating disorder risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145706285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Claire Singleton, Danqi Zhuang, Kimberley Kavanagh, Kathyrn V. Dalrymple, Angela C. Flynn, Lucilla Poston, Claire L. Meek, Sara L. White
Background
Gestational diabetes (GDM) is associated with increased future obesity risk in affected mothers and children.
Objective
We assessed if dietary behaviours learnt during a GDM pregnancy positively impact maternal and child health 3 years postpartum.
Method
In a secondary analysis, we included women with obesity recruited to the UPBEAT randomised controlled trial with 3-year follow-up postnatally (n = 441). Maternal and offspring anthropometry and dietary data were recorded antenatally and at follow-up. Data were assessed using linear/logistic regression, adjusting for confounders.
Results
Women with GDM (22%) had higher BMI (median 35.6 vs. 34.2 kg/m2; p = 0.049) and energy intake (1738.2 vs. 1551.6 kcal/day; p = 0.005) at ~16 weeks' gestation compared to unaffected women, but lower gestational weight gain (4.5 kg vs. 6.6 kg; p < 0.001). However, at 3 years postpartum BMI was similar between groups (35.8 vs. 35.2 kg/m2; p > 0.5). GDM-exposed infants had a higher birthweight (55.4 vs. 45.9th centile; p = 0.008) than unexposed infants and at 3 years of age were more likely to be overweight/obese (International Obesity Task Force, IOTF, standards; OR 2.32; 95% CI 1.38, 3.91) but with similar skinfold thicknesses and dietary patterns.
Conclusion
Women with GDM demonstrated reduced gestational weight gain, and despite a higher BMI than women without GDM in early pregnancy, this difference was not evident at 3 years postpartum. However, while maternal and offspring dietary behaviours were comparable between groups, exposed offspring were at increased risk of overweight/obesity at 3 years of age.
妊娠期糖尿病（GDM）与受影响的母亲和儿童未来肥胖风险增加有关。目的评估妊娠期GDM患者饮食行为对产后3年母婴健康的积极影响。方法在二次分析中，我们将肥胖妇女纳入了乐观随机对照试验，产后随访3年（n = 441）。在产前和随访时记录母体和后代的人体测量和饮食数据。使用线性/逻辑回归评估数据，调整混杂因素。结果：妊娠16周时，GDM患者（22%）的BMI（中位数35.6 vs 34.2 kg/m2, p = 0.049）和能量摄入（1738.2 vs 1551.6 kcal/day, p = 0.005）高于未受影响的女性，但妊娠体重增加较低（4.5 kg vs 6.6 kg, p < 0.001）。然而，在产后3年，两组之间的BMI相似（35.8 vs. 35.2 kg/m2; p > 0.5）。gdm暴露的婴儿比未暴露的婴儿出生体重更高（55.4比45.9,p = 0.008），并且在3岁时更容易超重/肥胖（国际肥胖工作组，IOTF，标准；OR 2.32; 95% CI 1.38, 3.91），但皮肤折叠厚度和饮食模式相似。结论GDM妇女妊娠期体重增加减少，尽管妊娠早期BMI高于非GDM妇女，但产后3年差异不明显。然而，虽然两组之间的母亲和后代的饮食行为是相似的，但暴露的后代在3岁时超重/肥胖的风险增加。
{"title":"Beyond Gestational Diabetes: Maternal and Offspring Health and Lifestyle 3 Years Postnatally in a Secondary Analysis of the UPBEAT Trial Cohort","authors":"Claire Singleton, Danqi Zhuang, Kimberley Kavanagh, Kathyrn V. Dalrymple, Angela C. Flynn, Lucilla Poston, Claire L. Meek, Sara L. White","doi":"10.1111/ijpo.70076","DOIUrl":"https://doi.org/10.1111/ijpo.70076","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gestational diabetes (GDM) is associated with increased future obesity risk in affected mothers and children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We assessed if dietary behaviours learnt during a GDM pregnancy positively impact maternal and child health 3 years postpartum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>In a secondary analysis, we included women with obesity recruited to the UPBEAT randomised controlled trial with 3-year follow-up postnatally (<i>n</i> = 441). Maternal and offspring anthropometry and dietary data were recorded antenatally and at follow-up. Data were assessed using linear/logistic regression, adjusting for confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Women with GDM (22%) had higher BMI (median 35.6 vs. 34.2 kg/m<sup>2</sup>; <i>p</i> = 0.049) and energy intake (1738.2 vs. 1551.6 kcal/day; <i>p</i> = 0.005) at ~16 weeks' gestation compared to unaffected women, but lower gestational weight gain (4.5 kg vs. 6.6 kg; <i>p</i> < 0.001). However, at 3 years postpartum BMI was similar between groups (35.8 vs. 35.2 kg/m<sup>2</sup>; <i>p</i> > 0.5). GDM-exposed infants had a higher birthweight (55.4 vs. 45.9th centile; <i>p</i> = 0.008) than unexposed infants and at 3 years of age were more likely to be overweight/obese (International Obesity Task Force, IOTF, standards; OR 2.32; 95% CI 1.38, 3.91) but with similar skinfold thicknesses and dietary patterns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Women with GDM demonstrated reduced gestational weight gain, and despite a higher BMI than women without GDM in early pregnancy, this difference was not evident at 3 years postpartum. However, while maternal and offspring dietary behaviours were comparable between groups, exposed offspring were at increased risk of overweight/obesity at 3 years of age.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145706286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luana S. Blaudt, Taís de S. Lopes, Amanda de M. Souza, Geisa Gabriela B. Rodrigues, Iuna A. Alves, Rosangela A. Pereira
Background
Diet may influence the subclinical inflammatory responses related to metabolic disorders.
Objective
To identify a dietary pattern associated with inflammatory biomarkers and to evaluate its association with metabolic, clinical and anthropometric indicators in Brazilian adolescents.
Methods
Data from Brazilian adolescents aged 12–17 years participating in the Study of Cardiovascular Risk in Adolescents (ERICA, 2013–2014) were analysed. Dietary intake was assessed using a 24-h dietary recall. A dietary pattern was derived using the Partial Least Squares regression in a subset (n = 3703) with C-reactive protein and adiponectin as intermediate variables and retaining food groups with factor loadings ≥ |0.15|. Associations between the pro-inflammatory dietary pattern and anthropometric indicators and metabolic biomarkers were examined in a subsample of adolescents (n = 36 956) using crude and adjusted multiple linear regression models.
Results
The pro-inflammatory dietary pattern was characterised by positive loadings for soft drinks, cakes, cheese, fats, pasta, snacks, sweets and bread, and with negative loadings for rice, milk-based dishes, poultry, fish and beans. The mean inflammatory dietary pattern score was 0.05 overall, and higher for girls (0.08) than boys (0.03). Significant associations (p < 0.05) were found between the pro-inflammatory dietary pattern and increased BMI (β = 0.07 kg/m2), fasting blood glucose (β = 0.20 mg/dL) and HOMA-IR (β = 0.03), after adjusting for sex, age, school type, diet report quality and daily energy intake.
Conclusions
Among Brazilian adolescents, a pro-inflammatory dietary pattern was associated with higher body weight, fasting glucose and insulin resistance.
{"title":"Inflammatory Dietary Pattern Associated With Metabolic Biomarkers, Blood Pressure and Anthropometric Indicators in Brazilian Adolescents","authors":"Luana S. Blaudt, Taís de S. Lopes, Amanda de M. Souza, Geisa Gabriela B. Rodrigues, Iuna A. Alves, Rosangela A. Pereira","doi":"10.1111/ijpo.70079","DOIUrl":"https://doi.org/10.1111/ijpo.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diet may influence the subclinical inflammatory responses related to metabolic disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify a dietary pattern associated with inflammatory biomarkers and to evaluate its association with metabolic, clinical and anthropometric indicators in Brazilian adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from Brazilian adolescents aged 12–17 years participating in the Study of Cardiovascular Risk in Adolescents (ERICA, 2013–2014) were analysed. Dietary intake was assessed using a 24-h dietary recall. A dietary pattern was derived using the Partial Least Squares regression in a subset (<i>n</i> = 3703) with C-reactive protein and adiponectin as intermediate variables and retaining food groups with factor loadings ≥ |0.15|. Associations between the pro-inflammatory dietary pattern and anthropometric indicators and metabolic biomarkers were examined in a subsample of adolescents (<i>n</i> = 36 956) using crude and adjusted multiple linear regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The pro-inflammatory dietary pattern was characterised by positive loadings for soft drinks, cakes, cheese, fats, pasta, snacks, sweets and bread, and with negative loadings for rice, milk-based dishes, poultry, fish and beans. The mean inflammatory dietary pattern score was 0.05 overall, and higher for girls (0.08) than boys (0.03). Significant associations (<i>p</i> < 0.05) were found between the pro-inflammatory dietary pattern and increased BMI (<i>β</i> = 0.07 kg/m<sup>2</sup>), fasting blood glucose (<i>β</i> = 0.20 mg/dL) and HOMA-IR (<i>β</i> = 0.03), after adjusting for sex, age, school type, diet report quality and daily energy intake.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among Brazilian adolescents, a pro-inflammatory dietary pattern was associated with higher body weight, fasting glucose and insulin resistance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145706346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ghamdi Zainab, Moore Halim, Siroux Julie, Beraud Duane, Shaea Alkahtani, Abdullah F. Alghannam, Pereira Bruno, Masurier Julie, Finlayson Graham, Julian Valérie, Isacco Laurie, Thivel David
Background
Low-carbohydrate (CHO) or ketogenic diets have been proposed as alternative interventions to caloric restriction to address the childhood obesity epidemic. However, empirical support for this dietary strategy has remained inconclusive in youth. The objective was to test the hypothesis that consumption of a meal lower in the proportion of CHO relative to fat acutely elicits greater satiety, and lower preference for sweet and high-fat foods and energy intake at the subsequent meal in adolescents with obesity.
Methods
In a randomised crossover trial, 15 adolescents with obesity (7 females; 13.2 ± 1.8 years) consumed 3 isocaloric lunch meals on 3 different occasions: (i) moderate (52%), (ii) low (24%) or (iii) very low (7%) in CHO with commensurately adjusted fat content and matched for protein. Adolescents rated their appetite sensations at regular intervals throughout each test day (visual analogue scales). Food reward was recorded before and after the lunch meal, and prior to an ad libitum dinner (French version of the Leeds Food Preference Questionnaire [LFPQ-fr]), from which energy and macronutrient intake was quantified.
Results
No significant differences in energy or macronutrient intake at dinner or daily appetite sensations were found between conditions. Similarly, the proportions of CHO and fat had no effect on liking or wanting for high-fat or sweet foods. Rather, choice frequency for sweet foods appeared to increase after consumption of each meal (p = 0.048).
Conclusion
In the context of isocaloric meals, lowering the CHO content with a commensurate increase in fat, does not significantly alter satiety, food reward or subsequent energy intake during a test meal in adolescents with obesity.
{"title":"The Appetitive Responses to a Meal Are Not Affected by Its Carbohydrate Content in Adolescents With Obesity: A Pilot Study","authors":"Ghamdi Zainab, Moore Halim, Siroux Julie, Beraud Duane, Shaea Alkahtani, Abdullah F. Alghannam, Pereira Bruno, Masurier Julie, Finlayson Graham, Julian Valérie, Isacco Laurie, Thivel David","doi":"10.1111/ijpo.70077","DOIUrl":"10.1111/ijpo.70077","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Low-carbohydrate (CHO) or ketogenic diets have been proposed as alternative interventions to caloric restriction to address the childhood obesity epidemic. However, empirical support for this dietary strategy has remained inconclusive in youth. The objective was to test the hypothesis that consumption of a meal lower in the proportion of CHO relative to fat acutely elicits greater satiety, and lower preference for sweet and high-fat foods and energy intake at the subsequent meal in adolescents with obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a randomised crossover trial, 15 adolescents with obesity (7 females; 13.2 ± 1.8 years) consumed 3 isocaloric lunch meals on 3 different occasions: (i) moderate (52%), (ii) low (24%) or (iii) very low (7%) in CHO with commensurately adjusted fat content and matched for protein. Adolescents rated their appetite sensations at regular intervals throughout each test day (visual analogue scales). Food reward was recorded before and after the lunch meal, and prior to an ad libitum dinner (French version of the Leeds Food Preference Questionnaire [LFPQ-fr]), from which energy and macronutrient intake was quantified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant differences in energy or macronutrient intake at dinner or daily appetite sensations were found between conditions. Similarly, the proportions of CHO and fat had no effect on liking or wanting for high-fat or sweet foods. Rather, choice frequency for sweet foods appeared to increase after consumption of each meal (<i>p</i> = 0.048).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In the context of isocaloric meals, lowering the CHO content with a commensurate increase in fat, does not significantly alter satiety, food reward or subsequent energy intake during a test meal in adolescents with obesity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asian adults develop metabolic complications at lower body mass indices (BMIs) compared with other ethnic groups, leading to lower BMI cutoffs for overweight and obesity. However, it remains unclear whether such adjustments are warranted in Asian children and adolescents. We aimed to determine whether lower BMI percentile cutoffs should be considered for overweight and obesity among Asian children and adolescents in the United States.
Methods
We analysed nationally representative data from U.S. children and adolescents from NHANES, 2012–2020. Metabolic parameters—including truncal fat percentage, glycemic markers, lipid profiles and liver disease markers—were compared between Asian and non-Asian participants within the 85–95th percentile and ≥ 95th percentile ranges. Metabolic parameter-based matching analyses identified corresponding BMI percentiles between groups.
Results
Asian children had more pronounced metabolic abnormalities than non-Asians in the overweight and obesity groups. After matching for metabolic parameters, Asians had the same levels of metabolic dysfunction at lower BMI percentiles than non-Asians, with averaged differences of approximately 3–9 BMI percentiles across various BMI percentile ranges.
Conclusions
Asian children and adolescents experience elevated metabolic risks at currently defined BMI percentiles. Lower BMI cutoffs targeting the 80th percentile for overweight and 90th percentile for obesity may improve early detection of metabolic risks in the Asian paediatric population.
{"title":"BMI Percentile Cutoffs for Overweight and Obesity Are Set Too High in Terms of Adiposity and Metabolic Markers for Asian Children and Adolescents","authors":"Suk-Jin Hong, Xinlian Zhang, Phillipp Hartmann","doi":"10.1111/ijpo.70075","DOIUrl":"https://doi.org/10.1111/ijpo.70075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Asian adults develop metabolic complications at lower body mass indices (BMIs) compared with other ethnic groups, leading to lower BMI cutoffs for overweight and obesity. However, it remains unclear whether such adjustments are warranted in Asian children and adolescents. We aimed to determine whether lower BMI percentile cutoffs should be considered for overweight and obesity among Asian children and adolescents in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed nationally representative data from U.S. children and adolescents from NHANES, 2012–2020. Metabolic parameters—including truncal fat percentage, glycemic markers, lipid profiles and liver disease markers—were compared between Asian and non-Asian participants within the 85–95th percentile and ≥ 95th percentile ranges. Metabolic parameter-based matching analyses identified corresponding BMI percentiles between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Asian children had more pronounced metabolic abnormalities than non-Asians in the overweight and obesity groups. After matching for metabolic parameters, Asians had the same levels of metabolic dysfunction at lower BMI percentiles than non-Asians, with averaged differences of approximately 3–9 BMI percentiles across various BMI percentile ranges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Asian children and adolescents experience elevated metabolic risks at currently defined BMI percentiles. Lower BMI cutoffs targeting the 80th percentile for overweight and 90th percentile for obesity may improve early detection of metabolic risks in the Asian paediatric population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145706287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel O. Mensah, Alysha B. Everett, Amelia E. Fouts, Gretchen L. Hoelscher, Samantha L. Martin, Jessica S. Bahorski, Priscilla H. Mensah, Makenzie L. Callahan, W. Timothy Garvey, Paula C. Chandler-Laney
Background
Children born to mothers with obesity or gestational diabetes mellitus (GDM) face elevated risks of central adiposity and adverse cardiometabolic outcomes, including metabolic syndrome (MetS) and systemic inflammation. However, it remains unclear whether these risks are primarily driven by current adiposity or by in utero exposure. This study investigated associations between waist circumference (WC), waist-to-height ratio (WHtR), and continuous MetS (cMetS) scores in children, and evaluated whether in utero exposure to maternal obesity or GDM moderated these relationships. Associations between cMetS and cardiometabolic biomarkers were also examined.
Methods
Children were grouped by maternal early-pregnancy weight status and GDM diagnosis: (1) normal weight without GDM, (2) overweight/obesity without GDM, and (3) overweight/obesity with GDM. WC was classified as < 85th or ≥ 85th percentile; WHtR as < 0.5 or ≥ 0.5. cMetS scores were computed with and without the WC component. Group differences and associations were assessed using ANCOVA and correlation analyses.
Results
WC and WHtR were strong predictors of cMetS, independent of in utero exposure group. Children with WC ≥ 85th percentile or WHtR ≥ 0.5 had significantly higher cMetS scores (p < 0.0001), even when WC was excluded from the cMetS calculation. cMetS was inversely correlated with adiponectin and positively correlated with leptin, the leptin-to-adiponectin ratio, HOMA-IR, CRP, and IL-6 (all p < 0.01).
Conclusions
Central adiposity—indexed by WC or WHtR—rather than in utero exposure, is the primary driver of cardiometabolic risk. Associations between cMetS and cardiometabolic biomarkers underscore insulin resistance and adipose tissue dysfunction as key mechanisms underlying MetS in children.
{"title":"Central Adiposity, Rather Than in Utero Exposure to Maternal Obesity or Gestational Diabetes, Predicts Metabolic Syndrome Risk in Children Aged 4–10 Years","authors":"Daniel O. Mensah, Alysha B. Everett, Amelia E. Fouts, Gretchen L. Hoelscher, Samantha L. Martin, Jessica S. Bahorski, Priscilla H. Mensah, Makenzie L. Callahan, W. Timothy Garvey, Paula C. Chandler-Laney","doi":"10.1111/ijpo.70066","DOIUrl":"10.1111/ijpo.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Children born to mothers with obesity or gestational diabetes mellitus (GDM) face elevated risks of central adiposity and adverse cardiometabolic outcomes, including metabolic syndrome (MetS) and systemic inflammation. However, it remains unclear whether these risks are primarily driven by current adiposity or by in utero exposure. This study investigated associations between waist circumference (WC), waist-to-height ratio (WHtR), and continuous MetS (cMetS) scores in children, and evaluated whether in utero exposure to maternal obesity or GDM moderated these relationships. Associations between cMetS and cardiometabolic biomarkers were also examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Children were grouped by maternal early-pregnancy weight status and GDM diagnosis: (1) normal weight without GDM, (2) overweight/obesity without GDM, and (3) overweight/obesity with GDM. WC was classified as < 85th or ≥ 85th percentile; WHtR as < 0.5 or ≥ 0.5. cMetS scores were computed with and without the WC component. Group differences and associations were assessed using ANCOVA and correlation analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>WC and WHtR were strong predictors of cMetS, independent of in utero exposure group. Children with WC ≥ 85th percentile or WHtR ≥ 0.5 had significantly higher cMetS scores (<i>p</i> < 0.0001), even when WC was excluded from the cMetS calculation. cMetS was inversely correlated with adiponectin and positively correlated with leptin, the leptin-to-adiponectin ratio, HOMA-IR, CRP, and IL-6 (all <i>p</i> < 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Central adiposity—indexed by WC or WHtR—rather than in utero exposure, is the primary driver of cardiometabolic risk. Associations between cMetS and cardiometabolic biomarkers underscore insulin resistance and adipose tissue dysfunction as key mechanisms underlying MetS in children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tyler J. Dobbs, Linnea Gutierrez, Houchun Harry Hu, Kendall S. Hunter, Brian Fonseca, Lorna Browne, David Winter, Melanie G. Cree, Laura Pyle, Jonathan L. Hills-Dunlap, Jane E. B. Reusch, Megan M. Kelsey, Thomas H. Inge, Petter Bjornstad, Kristen J. Nadeau
Background
Adolescents with youth-onset type 2 diabetes (YO-T2D) have an increased risk for cardiometabolic complications. The impact of vertical sleeve gastrectomy (VSG) on fat distribution and cardiac morphology/function in YO-T2D is unknown.
Objectives
To evaluate changes in body composition, abdominal and cardiac fat depots, and cardiometabolic health in adolescents with YO-T2D undergoing VSG.
Methods
Anthropometrics, labs and imaging were used to assess participants pre-surgery and 3–12 months post-surgery. MRI quantified pericardial (PAT), epicardial (EAT), subcutaneous (SAT) and visceral adipose tissue (VAT), hepatic fat fraction (HFF) and cardiac morphology/function. Mixed-effects models assessed longitudinal changes.
Results
By 12 months, weight decreased from 134.3 ± 5.1 to 103.3 ± 5.2 kg, VAT 1943 ± 148 to 1248 ± 150 cm3, HFF 23.2% ± 2.3% to 5.3% ± 2.3% and PAT and EAT by 27% and 33% (all p < 0.01). Homeostatic model assessment of insulin resistance (HOMA-IR) improved (7.8 ± 1.2 to 1.7 ± 1.2 [p < 0.01]). BMI, SAT, resting heart rate (RHR), left ventricular (LV) mass and cardiac output (CO) also decreased (all p < 0.05). VAT decreases correlated with decreases in HFF (r = 0.70, p = 0.01), HOMA-IR (r = 0.60, p = 0.04) and CO (r = 0.70, p = 0.03). HFF decreases correlated with decreases in BMI (r = 0.70, p = 0.03), HOMA-IR (r = 0.90, p < 0.001), RHR (r = 0.90, p = 0.002), CO (r = 0.80, p = 0.007) and LV mass (r = 0.70, p = 0.02).
Conclusions
VSG reduces ectopic and regional fat and improves associated insulin sensitivity and cardiac health in adolescents with YO-T2D.
{"title":"MRI Analysis of Cardiac Fat, Abdominal Adiposity and Cardiac Function After Vertical Sleeve Gastrectomy in Youth With Type 2 Diabetes","authors":"Tyler J. Dobbs, Linnea Gutierrez, Houchun Harry Hu, Kendall S. Hunter, Brian Fonseca, Lorna Browne, David Winter, Melanie G. Cree, Laura Pyle, Jonathan L. Hills-Dunlap, Jane E. B. Reusch, Megan M. Kelsey, Thomas H. Inge, Petter Bjornstad, Kristen J. Nadeau","doi":"10.1111/ijpo.70068","DOIUrl":"10.1111/ijpo.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adolescents with youth-onset type 2 diabetes (YO-T2D) have an increased risk for cardiometabolic complications. The impact of vertical sleeve gastrectomy (VSG) on fat distribution and cardiac morphology/function in YO-T2D is unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate changes in body composition, abdominal and cardiac fat depots, and cardiometabolic health in adolescents with YO-T2D undergoing VSG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Anthropometrics, labs and imaging were used to assess participants pre-surgery and 3–12 months post-surgery. MRI quantified pericardial (PAT), epicardial (EAT), subcutaneous (SAT) and visceral adipose tissue (VAT), hepatic fat fraction (HFF) and cardiac morphology/function. Mixed-effects models assessed longitudinal changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>By 12 months, weight decreased from 134.3 ± 5.1 to 103.3 ± 5.2 kg, VAT 1943 ± 148 to 1248 ± 150 cm<sup>3</sup>, HFF 23.2% ± 2.3% to 5.3% ± 2.3% and PAT and EAT by 27% and 33% (all <i>p</i> < 0.01). Homeostatic model assessment of insulin resistance (HOMA-IR) improved (7.8 ± 1.2 to 1.7 ± 1.2 [<i>p</i> < 0.01]). BMI, SAT, resting heart rate (RHR), left ventricular (LV) mass and cardiac output (CO) also decreased (all <i>p</i> < 0.05). VAT decreases correlated with decreases in HFF (<i>r</i> = 0.70, <i>p</i> = 0.01), HOMA-IR (<i>r</i> = 0.60, <i>p</i> = 0.04) and CO (<i>r</i> = 0.70, <i>p</i> = 0.03). HFF decreases correlated with decreases in BMI (<i>r</i> = 0.70, <i>p</i> = 0.03), HOMA-IR (<i>r</i> = 0.90, <i>p</i> < 0.001), RHR (<i>r</i> = 0.90, <i>p</i> = 0.002), CO (<i>r</i> = 0.80, <i>p</i> = 0.007) and LV mass (<i>r</i> = 0.70, <i>p</i> = 0.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>VSG reduces ectopic and regional fat and improves associated insulin sensitivity and cardiac health in adolescents with YO-T2D.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145538156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeralyn B. Jacobs, Haihong Hu, Seohyun Kim, Yi-shin Sheu, R. Clayton Bishop, Karen Chesbrough, Nancy S. Weinfield
Background
During the COVID-19 pandemic, there was a rise in the incidence of type 2 diabetes (T2D) and prediabetes in children and teenagers. We investigated whether new risk factors for diabetes in children emerged during the pandemic period.
Methods
Using health records of a large, integrated health system, we evaluated the incidence of new-onset T2D and prediabetes in patients aged 0–19 years from 2020 to 2023. We utilised descriptive statistics, chi-square and multivariable logistic regressions to predict the risk of T2D and prediabetes.
Results
Compared to children with normal weight, children with obesity (p < 0.0001) and those overweight (p < 0.0001) were more likely to develop prediabetes, and children with obesity were more likely to develop T2D (p < 0.0001). Children aged 12–19 were more likely to develop prediabetes (p < 0.0001) and T2D (p < 0.0001) compared to younger children. Publicly insured children were more likely to develop T2D (p = 0.003). Black and Asian children were at higher risk than White individuals of developing both prediabetes (p < 0.0001) and T2D (p = 0.019 and p = 0.02, respectively). COVID-19 infection was not a meaningful risk factor for prediabetes or T2D.
Conclusion
Risk factors for prediabetes and T2D in children remained the same during the pandemic as prior: adolescents, overweight/obese patients, publicly insured individuals and non-White individuals.
{"title":"Risk Factors for Development of Type 2 and Prediabetes in Children During the COVID-19 Pandemic","authors":"Jeralyn B. Jacobs, Haihong Hu, Seohyun Kim, Yi-shin Sheu, R. Clayton Bishop, Karen Chesbrough, Nancy S. Weinfield","doi":"10.1111/ijpo.70070","DOIUrl":"10.1111/ijpo.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>During the COVID-19 pandemic, there was a rise in the incidence of type 2 diabetes (T2D) and prediabetes in children and teenagers. We investigated whether new risk factors for diabetes in children emerged during the pandemic period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using health records of a large, integrated health system, we evaluated the incidence of new-onset T2D and prediabetes in patients aged 0–19 years from 2020 to 2023. We utilised descriptive statistics, chi-square and multivariable logistic regressions to predict the risk of T2D and prediabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to children with normal weight, children with obesity (<i>p</i> < 0.0001) and those overweight (<i>p</i> < 0.0001) were more likely to develop prediabetes, and children with obesity were more likely to develop T2D (<i>p</i> < 0.0001). Children aged 12–19 were more likely to develop prediabetes (<i>p</i> < 0.0001) and T2D (<i>p</i> < 0.0001) compared to younger children. Publicly insured children were more likely to develop T2D (<i>p</i> = 0.003). Black and Asian children were at higher risk than White individuals of developing both prediabetes (<i>p</i> < 0.0001) and T2D (<i>p</i> = 0.019 and <i>p</i> = 0.02, respectively). COVID-19 infection was not a meaningful risk factor for prediabetes or T2D.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Risk factors for prediabetes and T2D in children remained the same during the pandemic as prior: adolescents, overweight/obese patients, publicly insured individuals and non-White individuals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Childhood Obesity and Age-Related Diseases: A Systematic Review and Meta-Analysis of Mendelian Randomization Evidence","authors":"Haoxue Zhu, Xinghao Yi, Mengyu He, Siyi Wu, Ming Li, Shan Gao","doi":"10.1111/ijpo.70071","DOIUrl":"10.1111/ijpo.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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 (<i>n</i> = 453 169), FinnGen (<i>n</i> > 200 000) and other large consortiums.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 (<i>p</i> = 0.03–0.05). Paradoxical inverse associations emerged for breast cancer and ulcerative colitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings from this meta-analysis underscore associations between childhood adiposity and multisystem age-related pathologies, underscoring the imperative for early obesity prevention.</p>\u0000 \u0000 <div>\u0000 \u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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。
{"title":"The Association Between Schoolwork Pressure and Overweight/Obesity in Swedish Schoolchildren Across Different Socioeconomic Groups","authors":"Cassandra Comey, Kenisha Russell Jonsson, Maria Corell","doi":"10.1111/ijpo.70067","DOIUrl":"10.1111/ijpo.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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