Michael I. Goran, Alexandra Descarpentrie, Shana Adise
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.
{"title":"Factors that shape dietary intake in children in the context of increasing risk for obesity development","authors":"Michael I. Goran, Alexandra Descarpentrie, Shana Adise","doi":"10.1111/ijpo.70004","DOIUrl":"10.1111/ijpo.70004","url":null,"abstract":"<div>\u0000 \u0000 <p>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.</p>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571624","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}
Introduction: Rapid shifts in dietary patterns, marked by increased consumption of ultra-processed foods (UPFs), are increasingly impacting the health and wellbeing of infants and toddlers in low- and middle-income countries.
Methods: Utilizing data from the Demographic and Health Surveys, other national surveys, NCD-RisC data and Euromonitor sales data, we examine changes in stunting and overweight/obesity prevalence alongside the latest data on UPF consumption trends.
Results: The prevalence of overweight/obesity among children and mothers is increasing rapidly while stunting rates decline slowly. Simultaneously, there is a significant increase in consumption of UPFs, especially among preschool-aged children. Increasingly, poorer households are experiencing faster rates of increase in overweight and obesity prevalence compared to wealthier households. Results highlight the early socialization of infants and toddlers to unhealthy discretionary foods including UPFs, potentially setting the stage for long-term dietary preferences that favour food with high sugar or excess sodium.
Conclusion: There is an urgent need to address the rapid increases in UPF consumption among infants and toddlers. Options include expanding the WHO Code on marketing to protect 0-3-year-olds; creating front-of-package warning labels focusing on products for children ages 0-3 years to remove all added sugar and limit sodium in foods and beverages they consume.
{"title":"Nutrition transition's latest stage: Are ultra-processed food increases in low- and middle-income countries dooming our preschoolers' diets and future health?","authors":"Barry M Popkin, Amos Laar","doi":"10.1111/ijpo.70002","DOIUrl":"10.1111/ijpo.70002","url":null,"abstract":"<p><strong>Introduction: </strong>Rapid shifts in dietary patterns, marked by increased consumption of ultra-processed foods (UPFs), are increasingly impacting the health and wellbeing of infants and toddlers in low- and middle-income countries.</p><p><strong>Methods: </strong>Utilizing data from the Demographic and Health Surveys, other national surveys, NCD-RisC data and Euromonitor sales data, we examine changes in stunting and overweight/obesity prevalence alongside the latest data on UPF consumption trends.</p><p><strong>Results: </strong>The prevalence of overweight/obesity among children and mothers is increasing rapidly while stunting rates decline slowly. Simultaneously, there is a significant increase in consumption of UPFs, especially among preschool-aged children. Increasingly, poorer households are experiencing faster rates of increase in overweight and obesity prevalence compared to wealthier households. Results highlight the early socialization of infants and toddlers to unhealthy discretionary foods including UPFs, potentially setting the stage for long-term dietary preferences that favour food with high sugar or excess sodium.</p><p><strong>Conclusion: </strong>There is an urgent need to address the rapid increases in UPF consumption among infants and toddlers. Options include expanding the WHO Code on marketing to protect 0-3-year-olds; creating front-of-package warning labels focusing on products for children ages 0-3 years to remove all added sugar and limit sodium in foods and beverages they consume.</p>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":" ","pages":"e70002"},"PeriodicalIF":2.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514303","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}
Moazzam Tanveer, Yujun Cai, Georgian Badicu, Ejaz Asghar, Alexios Batrakoulis, Luca Paolo Ardigò, Serge Brand
<p><strong>Background: </strong>Overweight and obesity among children and adolescents poses a significant public health challenge. In Pakistan, the prevalence of childhood overweight and obesity continues to rise, leading to long-term adverse effects on health. Various external influences shape children's health behaviours and outcomes, with parents, peers, schools, and communities playing crucial roles, particularly during formative years.</p><p><strong>Objectives: </strong>This cross-sectional study aimed to investigate the associations between 24-h movement behaviour and overweight/obesity among school-aged children and adolescents, focusing on the intrapersonal, interpersonal, community, and school levels from a Social-Ecological Perspective.</p><p><strong>Methods: </strong>A population-based cross-sectional study was conducted from 15 January to 15 March 2023, using a representative multistage random cluster sampling method. The study enrolled 4200 participants aged 9-17 years and 3371 parents from 62 schools in central Punjab, Pakistan. Participants' body mass index (BMI) was classified based on CDC US 2000 BMI percentiles. Socio-ecological factors were analyzed using chi-square tests, binary logistic regression, and stepwise logistic regression to examine their associations with overweight and obesity.</p><p><strong>Results: </strong>The results of this study revealed that boys had 18.7% overweight and 9% obesity, while girls had 20.5% overweight and 13.2% obesity. Gender exhibited a significant association with weight status. A considerable proportion of participants did not meet recommended guidelines for junk food consumption (31.5% boys, 33.3% girls), physical activity (70% boys, 83.8% girls), screen time (37.7% boys, 41.1% girls), and sleep (55.7% boys, 54% girls). Individuals engaging in certain 24-h movement behaviours exhibited higher odds of obesity. Specifically, consuming fast food three or more days per week was associated with higher odds of obesity (odds ratio: 9.95, p < 0.01). Engaging in physical activity for less than 60 min per day, twice a week or less, was associated with higher odds of obesity (odds ratio: 3.47, p < 0.01). Spending three or more hours per day on screen time was linked to higher odds of obesity (odds ratio: 2.50, p < 0.01). Furthermore, being a short sleeper was associated with higher odds of overweight (odds ratio: 3.54, p < 0.01).</p><p><strong>Conclusions: </strong>Children failing to meet none or only one guideline faced increased overweight/obesity risk compared to those meeting all recommendations. Individual-level factors such as eating habits, physical activity, sedentary behaviour, sleep patterns, and unhealthy lifestyle choices significantly influenced body weight status. Urgent interventions are needed to enhance physical education resources and sports facilities in schools to create healthier environments and reduce overweight/obesity prevalence among students, promoting lifelong habits of p
{"title":"Associations of 24-h movement behaviour with overweight and obesity among school-aged children and adolescents in Pakistan: An empirical cross-sectional study.","authors":"Moazzam Tanveer, Yujun Cai, Georgian Badicu, Ejaz Asghar, Alexios Batrakoulis, Luca Paolo Ardigò, Serge Brand","doi":"10.1111/ijpo.13208","DOIUrl":"https://doi.org/10.1111/ijpo.13208","url":null,"abstract":"<p><strong>Background: </strong>Overweight and obesity among children and adolescents poses a significant public health challenge. In Pakistan, the prevalence of childhood overweight and obesity continues to rise, leading to long-term adverse effects on health. Various external influences shape children's health behaviours and outcomes, with parents, peers, schools, and communities playing crucial roles, particularly during formative years.</p><p><strong>Objectives: </strong>This cross-sectional study aimed to investigate the associations between 24-h movement behaviour and overweight/obesity among school-aged children and adolescents, focusing on the intrapersonal, interpersonal, community, and school levels from a Social-Ecological Perspective.</p><p><strong>Methods: </strong>A population-based cross-sectional study was conducted from 15 January to 15 March 2023, using a representative multistage random cluster sampling method. The study enrolled 4200 participants aged 9-17 years and 3371 parents from 62 schools in central Punjab, Pakistan. Participants' body mass index (BMI) was classified based on CDC US 2000 BMI percentiles. Socio-ecological factors were analyzed using chi-square tests, binary logistic regression, and stepwise logistic regression to examine their associations with overweight and obesity.</p><p><strong>Results: </strong>The results of this study revealed that boys had 18.7% overweight and 9% obesity, while girls had 20.5% overweight and 13.2% obesity. Gender exhibited a significant association with weight status. A considerable proportion of participants did not meet recommended guidelines for junk food consumption (31.5% boys, 33.3% girls), physical activity (70% boys, 83.8% girls), screen time (37.7% boys, 41.1% girls), and sleep (55.7% boys, 54% girls). Individuals engaging in certain 24-h movement behaviours exhibited higher odds of obesity. Specifically, consuming fast food three or more days per week was associated with higher odds of obesity (odds ratio: 9.95, p < 0.01). Engaging in physical activity for less than 60 min per day, twice a week or less, was associated with higher odds of obesity (odds ratio: 3.47, p < 0.01). Spending three or more hours per day on screen time was linked to higher odds of obesity (odds ratio: 2.50, p < 0.01). Furthermore, being a short sleeper was associated with higher odds of overweight (odds ratio: 3.54, p < 0.01).</p><p><strong>Conclusions: </strong>Children failing to meet none or only one guideline faced increased overweight/obesity risk compared to those meeting all recommendations. Individual-level factors such as eating habits, physical activity, sedentary behaviour, sleep patterns, and unhealthy lifestyle choices significantly influenced body weight status. Urgent interventions are needed to enhance physical education resources and sports facilities in schools to create healthier environments and reduce overweight/obesity prevalence among students, promoting lifelong habits of p","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":" ","pages":"e13208"},"PeriodicalIF":2.7,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481814","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}
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), is understudied among US adolescents despite rising obesity rates.
Methods: This study analysed the prevalence and trends of obesity and MASLD among US adolescents aged 12-17 using data from the National Health and Nutrition Examination Survey (NHANES). We developed a new screening model utilizing FibroScan-measured controlled attenuation parameter (CAP) scores, body measurements and blood chemistry data from 2017 to 2020 to assist in analysing MASLD trends from 1999 to 2020.
Results: Between 2017 and 2020, the prevalence of obesity and MASLD was approximately 20%, with about 70% of obese adolescents affected by MASLD. The condition was more common in boys, particularly among Mexican American adolescents. Additionally, 97.2% of those with NAFLD also had MASLD. Adolescents with MASLD had significantly higher body weight, waist circumference, triglyceride levels and alanine transaminase (ALT) levels, along with lower high-density lipoprotein (HDL) cholesterol and an increased risk of liver fibrosis. Insufficient physical activity and poor diet quality were key risk factors for developing MASLD. From 1999 to 2020, the prevalence of MASLD rose significantly, paralleling the increasing rates of obesity.
Conclusions: The study underscores the pressing need to screen at-risk adolescents for metabolic issues associated with steatotic liver diseases, given the rising obesity rates among adolescents. The high overlap between MASLD and NAFLD diagnoses indicates that the transition from NAFLD to MASLD can be effectively integrated into paediatric practice.
{"title":"Recent prevalence and trends of obesity and metabolic dysfunction-associated steatotic liver disease (MASLD) among US adolescents: 1999 to 2020.","authors":"Michael Sun, Hongbing Sun","doi":"10.1111/ijpo.70003","DOIUrl":"https://doi.org/10.1111/ijpo.70003","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), is understudied among US adolescents despite rising obesity rates.</p><p><strong>Methods: </strong>This study analysed the prevalence and trends of obesity and MASLD among US adolescents aged 12-17 using data from the National Health and Nutrition Examination Survey (NHANES). We developed a new screening model utilizing FibroScan-measured controlled attenuation parameter (CAP) scores, body measurements and blood chemistry data from 2017 to 2020 to assist in analysing MASLD trends from 1999 to 2020.</p><p><strong>Results: </strong>Between 2017 and 2020, the prevalence of obesity and MASLD was approximately 20%, with about 70% of obese adolescents affected by MASLD. The condition was more common in boys, particularly among Mexican American adolescents. Additionally, 97.2% of those with NAFLD also had MASLD. Adolescents with MASLD had significantly higher body weight, waist circumference, triglyceride levels and alanine transaminase (ALT) levels, along with lower high-density lipoprotein (HDL) cholesterol and an increased risk of liver fibrosis. Insufficient physical activity and poor diet quality were key risk factors for developing MASLD. From 1999 to 2020, the prevalence of MASLD rose significantly, paralleling the increasing rates of obesity.</p><p><strong>Conclusions: </strong>The study underscores the pressing need to screen at-risk adolescents for metabolic issues associated with steatotic liver diseases, given the rising obesity rates among adolescents. The high overlap between MASLD and NAFLD diagnoses indicates that the transition from NAFLD to MASLD can be effectively integrated into paediatric practice.</p>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":" ","pages":"e70003"},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447555","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}
Rasmus Møller Jørgensen, Jens Meldgaard Bruun, Mette Fogh, Iris Iglesia Altaba, Luis A Moreno, Henrik Støvring, Jane Nautrup Østergaard
Introduction: Limited insight exists into the weight development in children with obesity not receiving obesity treatment.
Methods: This cohort study included 467 Danish children aged 5-10 years with obesity (iso-BMI >30 kg/m2) not receiving treatment. Data from mandatory health check-ups on school-children's height and weight (converted to BMI z-scores) were merged with the Danish National Registries. A multivariable logistic regression weighted for the duration of follow-up was used to estimate odds ratios (OR) for normalization of BMI (iso-BMI 18.5-25 kg/m2) and obesity remission (iso-BMI 18.5-30 kg/m2).
Results: During a median follow-up of more than 6 years, 7.9% of the children normalized their BMI, while 45.4% obtained obesity remission. BMI z-score at inclusion acted as a strong inverse predictor for normalizing BMI (OR 0.14 per one-unit SD, CI: 0.03-0.53) and for obesity remission (OR 0.17 per one-unit SD, CI: 0.08-0.37). No other significant predictors were observed in the weighted multivariable models.
Conclusion: Higher BMI z-scores inversely predict normalizing BMI and achieving obesity remission in untreated children. Given that many children naturally achieve obesity remission or weight normalization, resources should focus on understanding barriers of obesity maintenance and to develop effective strategies for those who do not experience improvement.
{"title":"Weight development in children with obesity without treatment: A Danish cohort study with long-term follow-up.","authors":"Rasmus Møller Jørgensen, Jens Meldgaard Bruun, Mette Fogh, Iris Iglesia Altaba, Luis A Moreno, Henrik Støvring, Jane Nautrup Østergaard","doi":"10.1111/ijpo.70001","DOIUrl":"https://doi.org/10.1111/ijpo.70001","url":null,"abstract":"<p><strong>Introduction: </strong>Limited insight exists into the weight development in children with obesity not receiving obesity treatment.</p><p><strong>Methods: </strong>This cohort study included 467 Danish children aged 5-10 years with obesity (iso-BMI >30 kg/m<sup>2</sup>) not receiving treatment. Data from mandatory health check-ups on school-children's height and weight (converted to BMI z-scores) were merged with the Danish National Registries. A multivariable logistic regression weighted for the duration of follow-up was used to estimate odds ratios (OR) for normalization of BMI (iso-BMI 18.5-25 kg/m<sup>2</sup>) and obesity remission (iso-BMI 18.5-30 kg/m<sup>2</sup>).</p><p><strong>Results: </strong>During a median follow-up of more than 6 years, 7.9% of the children normalized their BMI, while 45.4% obtained obesity remission. BMI z-score at inclusion acted as a strong inverse predictor for normalizing BMI (OR 0.14 per one-unit SD, CI: 0.03-0.53) and for obesity remission (OR 0.17 per one-unit SD, CI: 0.08-0.37). No other significant predictors were observed in the weighted multivariable models.</p><p><strong>Conclusion: </strong>Higher BMI z-scores inversely predict normalizing BMI and achieving obesity remission in untreated children. Given that many children naturally achieve obesity remission or weight normalization, resources should focus on understanding barriers of obesity maintenance and to develop effective strategies for those who do not experience improvement.</p>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":" ","pages":"e70001"},"PeriodicalIF":2.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187539","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}
I Gusti Ngurah Edi Putra, Michael Daly, Eric Robinson
Background
There is limited evidence on how changes in obesity from childhood to adolescence are associated with adolescent mental health. We examined the associations between childhood obesity trajectories, obesity episodes, and mental health at age 17.
Methods
Data were from the UK Millennium Cohort Study. Obesity trajectory groups at ages 7 and 17 (n = 8306) and previous obesity episodes (number of sweeps with obesity) at ages 7, 11 and 14 (n = 7246) were examined. Caregiver and self-reported internalising and externalising symptoms at age 17 were used to measure mental health. Linear regression models were used.
Results
Relative to never developing obesity, obesity development (β = 1.01; 95% CI = 0.71, 1.32) and persistence (β = 1.18; 95% CI = 0.74, 1.61) were associated with higher internalising symptoms at age 17 and worsening (increase in scores) of these symptoms between ages 7 and 17 (β = 0.87; 95% CI = 0.57, 1.17 and β = 0.86; 95% CI = 0.56, 1.26 for development and persistence, respectively). Obesity development was associated with higher externalising symptoms at age 17 (β = 0.52; 95% CI = 0.25, 0.80) and worsening of these symptoms over time (β = 0.30; 95% CI = 0.07, 0.53). Having multiple past obesity episodes was not associated with worsening mental health independent of follow-up weight status. There were no differences in mental health outcomes between children who reversed versus never developed obesity.
Conclusions
Obesity development or persistence from ages 7 to 17 are associated with worsening mental health. If childhood obesity is reversed, there appears to be no evidence of a negative association between previous obesity and mental health at age 17.
{"title":"Childhood obesity trajectories and adolescent mental health: A UK cohort study","authors":"I Gusti Ngurah Edi Putra, Michael Daly, Eric Robinson","doi":"10.1111/ijpo.13206","DOIUrl":"10.1111/ijpo.13206","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is limited evidence on how changes in obesity from childhood to adolescence are associated with adolescent mental health. We examined the associations between childhood obesity trajectories, obesity episodes, and mental health at age 17.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were from the UK Millennium Cohort Study. Obesity trajectory groups at ages 7 and 17 (<i>n</i> = 8306) and previous obesity episodes (number of sweeps with obesity) at ages 7, 11 and 14 (<i>n</i> = 7246) were examined. Caregiver and self-reported internalising and externalising symptoms at age 17 were used to measure mental health. Linear regression models were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Relative to never developing obesity, obesity development (<i>β</i> = 1.01; 95% CI = 0.71, 1.32) and persistence (<i>β</i> = 1.18; 95% CI = 0.74, 1.61) were associated with higher internalising symptoms at age 17 and worsening (increase in scores) of these symptoms between ages 7 and 17 (<i>β</i> = 0.87; 95% CI = 0.57, 1.17 and <i>β</i> = 0.86; 95% CI = 0.56, 1.26 for development and persistence, respectively). Obesity development was associated with higher externalising symptoms at age 17 (<i>β</i> = 0.52; 95% CI = 0.25, 0.80) and worsening of these symptoms over time (<i>β</i> = 0.30; 95% CI = 0.07, 0.53). Having multiple past obesity episodes was not associated with worsening mental health independent of follow-up weight status. There were no differences in mental health outcomes between children who reversed versus never developed obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Obesity development or persistence from ages 7 to 17 are associated with worsening mental health. If childhood obesity is reversed, there appears to be no evidence of a negative association between previous obesity and mental health at age 17.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.13206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062808","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}
Lucia V Torres-Lopez, Abel Plaza-Florido, Jose J Gil-Cosano, Jairo H Migueles, Francisco B Ortega, Cristina Cadenas-Sanchez
Objectives: To investigate the association of sleep-disordered breathing (SDB) severity with cardiometabolic and inflammatory markers independently of the adiposity levels; and to explore the role of cardiorespiratory fitness in these associations in children with overweight/obesity.
Methods: A total of 109 children aged 8-11 years with overweight/obesity were included in this cross-sectional study. SDB was assessed using a scale of the reduce version of the Paediatric Sleep Questionnaire. Cardiometabolic markers included fasting blood lipids biomarkers (i.e., low- and high-density lipoprotein cholesterol, and triglycerides), blood pressure, insulin, glucose, and the homeostatic model assessment index. Inflammatory markers (i.e., interleukin-6, interleukin-1β, C-reactive protein [CRP], and tumour necrosis factor alpha) were analysed. Cardiorespiratory fitness was assessed by the 20 m shuttle-run test.
Results: No significant associations were found between SDB severity and most of the cardiometabolic markers after correcting for adiposity and multiple comparisons (all p's >0.05). SDB severity was positively related to CRP (β = 0.352, p = 0.002), yet not with the remaining inflammatory markers analysed. The interaction effect of cardiorespiratory fitness presented a positive trend in the association of SDB with CRP (p = 0.1). When stratified analyses by cardiorespiratory fitness levels were conducted, a positive relation was found between SDB and CRP in the low cardiorespiratory fitness group (β = 0.465, p = 0.014), but not in the high cardiorespiratory fitness group (β = 0.236, p = 0.108).
Conclusion: SDB severity was positively associated with CRP independently of the adiposity levels, but not with other inflammatory or cardiometabolic risk factors in children with overweight/obesity. Moreover, our results suggest that higher levels of cardiorespiratory fitness may attenuate the adverse effect of SDB severity on systematic inflammation in children with overweight/obesity.
目的：探讨睡眠呼吸障碍（SDB）严重程度与独立于肥胖水平的心脏代谢和炎症指标的关系；并探讨在超重/肥胖儿童中，心肺健康在这些关联中的作用。方法：本横断面研究共纳入109例8-11岁超重/肥胖儿童。使用儿科睡眠问卷的简化版量表评估SDB。心脏代谢标志物包括空腹血脂生物标志物（即低、高密度脂蛋白胆固醇和甘油三酯）、血压、胰岛素、葡萄糖和稳态模型评估指标。分析炎症标志物（即白细胞介素-6、白细胞介素-1β、c反应蛋白[CRP]和肿瘤坏死因子α）。采用20米穿梭跑试验评价心肺功能。结果：校正肥胖和多重比较后，SDB严重程度与大多数心脏代谢指标之间无显著相关性（p < 0.05）。SDB严重程度与CRP呈正相关（β = 0.352, p = 0.002），但与其余炎症标志物分析无关。在心肺适能的交互作用下，SDB与CRP呈正相关（p = 0.1）。按心肺适能水平分层分析时，低心肺适能组SDB与CRP呈正相关（β = 0.465, p = 0.014），高心肺适能组不呈正相关（β = 0.236, p = 0.108）。结论：在超重/肥胖儿童中，SDB严重程度与CRP呈正相关，独立于肥胖水平，但与其他炎症或心脏代谢危险因素无关。此外，我们的研究结果表明，较高的心肺健康水平可能会减轻SDB严重程度对超重/肥胖儿童系统性炎症的不利影响。
{"title":"Sleep-disordered breathing and cardiometabolic and inflammatory markers in children with overweight/obesity: The role of cardiorespiratory fitness.","authors":"Lucia V Torres-Lopez, Abel Plaza-Florido, Jose J Gil-Cosano, Jairo H Migueles, Francisco B Ortega, Cristina Cadenas-Sanchez","doi":"10.1111/ijpo.13207","DOIUrl":"https://doi.org/10.1111/ijpo.13207","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association of sleep-disordered breathing (SDB) severity with cardiometabolic and inflammatory markers independently of the adiposity levels; and to explore the role of cardiorespiratory fitness in these associations in children with overweight/obesity.</p><p><strong>Methods: </strong>A total of 109 children aged 8-11 years with overweight/obesity were included in this cross-sectional study. SDB was assessed using a scale of the reduce version of the Paediatric Sleep Questionnaire. Cardiometabolic markers included fasting blood lipids biomarkers (i.e., low- and high-density lipoprotein cholesterol, and triglycerides), blood pressure, insulin, glucose, and the homeostatic model assessment index. Inflammatory markers (i.e., interleukin-6, interleukin-1β, C-reactive protein [CRP], and tumour necrosis factor alpha) were analysed. Cardiorespiratory fitness was assessed by the 20 m shuttle-run test.</p><p><strong>Results: </strong>No significant associations were found between SDB severity and most of the cardiometabolic markers after correcting for adiposity and multiple comparisons (all p's >0.05). SDB severity was positively related to CRP (β = 0.352, p = 0.002), yet not with the remaining inflammatory markers analysed. The interaction effect of cardiorespiratory fitness presented a positive trend in the association of SDB with CRP (p = 0.1). When stratified analyses by cardiorespiratory fitness levels were conducted, a positive relation was found between SDB and CRP in the low cardiorespiratory fitness group (β = 0.465, p = 0.014), but not in the high cardiorespiratory fitness group (β = 0.236, p = 0.108).</p><p><strong>Conclusion: </strong>SDB severity was positively associated with CRP independently of the adiposity levels, but not with other inflammatory or cardiometabolic risk factors in children with overweight/obesity. Moreover, our results suggest that higher levels of cardiorespiratory fitness may attenuate the adverse effect of SDB severity on systematic inflammation in children with overweight/obesity.</p>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":" ","pages":"e13207"},"PeriodicalIF":2.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142997132","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}
Georgios K. Baxevanis, Iris Iglesia, Miguel Seral-Cortes, Sergio Sabroso-Lasa, Paloma Flores-Barrantes, Frédéric Gottrand, Aline Meirhaeghe, Anthony Kafatos, Kurt Widhalm, Nele Hockamp, Dénes Molnár, Ascensión Marcos, Esther Nova, Marcela González-Gross, Eva Gesteiro, Ángel Gutiérrez, Yannis Manios, Costas A. Anastasiou, Gerardo Rodríguez, Luis A. Moreno, the HELENA Study Group
Background
Although the genetic interplay with the environment has a major impact on obesity development, little is known on whether breastfeeding could modulate the genetic predisposition to obesity.
Objectives
To investigate whether breastfeeding attenuates the effect of an obesity genetic risk score (GRS) on adiposity in European adolescents.
Methods
Totally 751 adolescents from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study were included, divided according to breastfeeding status into never breastfed, 1–3 months and ≥4 months. Adjusting by socioeconomic status and lifestyle factors multiple linear regression models were used to assess (1) the main effect of breastfeeding duration and (2) its interaction effect with an obesity GRS, to predict different adiposity measures.
Results
A significant negative association between ≥4 months of breastfeeding and waist circumference (WC) z-score was observed [β (95% confidence interval), p-value] = [β = −0.189 (−0.37, −0.00), p = 0.044]. Also, significant interaction effects were observed for 1–3 and ≥4 months of breastfeeding and obesity GRS regarding body mass index (BMI) z-score [β = 0.155 (0.06, 0.24), p = 0.001] and [β = 0.108 (0.01, 0.18), p = 0.020, respectively] and fat mass index (FMI) z-score [β = 0.134 (0.04, 0.22), p = 0.003] and [β = 0.100 (0.01, 0.18), p = 0.026, respectively].
Conclusions
Breastfeeding modulates the association between the obesity GRS and body composition in adolescents.
背景：虽然遗传与环境的相互作用对肥胖的发展有重大影响，但母乳喂养是否能调节肥胖的遗传易感性尚不清楚。目的：研究母乳喂养是否会减弱欧洲青少年肥胖遗传风险评分（GRS）对肥胖的影响。方法：采用欧洲青少年营养健康生活方式（HELENA）横断面研究纳入751名青少年，按母乳喂养状况分为从不母乳喂养、1-3个月和≥4个月。经社会经济地位和生活方式因素调整后，采用多元线性回归模型评估(1)母乳喂养时间的主要影响以及(2)其与肥胖GRS的交互作用，以预测不同的肥胖措施。结果：≥4个月母乳喂养与腰围（WC） z-score呈显著负相关[β（95%可信区间），p值]= [β = -0.189 (-0.37, -0.00), p = 0.044]。此外，1-3个月和≥4个月母乳喂养与肥胖GRS在体重指数（BMI） z-score [β = 0.155 (0.06, 0.24), p = 0.001]和脂肪质量指数（FMI） z-score [β = 0.134 (0.04, 0.22), p = 0.003]和[β = 0.100 (0.01, 0.18), p = 0.026]方面存在显著交互作用。结论：母乳喂养调节了青少年肥胖GRS与体成分的关系。
{"title":"Interaction between breastfeeding duration and an obesity genetic risk score to predict body fat composition in European adolescents: The HELENA study","authors":"Georgios K. Baxevanis, Iris Iglesia, Miguel Seral-Cortes, Sergio Sabroso-Lasa, Paloma Flores-Barrantes, Frédéric Gottrand, Aline Meirhaeghe, Anthony Kafatos, Kurt Widhalm, Nele Hockamp, Dénes Molnár, Ascensión Marcos, Esther Nova, Marcela González-Gross, Eva Gesteiro, Ángel Gutiérrez, Yannis Manios, Costas A. Anastasiou, Gerardo Rodríguez, Luis A. Moreno, the HELENA Study Group","doi":"10.1111/ijpo.13205","DOIUrl":"10.1111/ijpo.13205","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although the genetic interplay with the environment has a major impact on obesity development, little is known on whether breastfeeding could modulate the genetic predisposition to obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate whether breastfeeding attenuates the effect of an obesity genetic risk score (GRS) on adiposity in European adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Totally 751 adolescents from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study were included, divided according to breastfeeding status into never breastfed, 1–3 months and ≥4 months. Adjusting by socioeconomic status and lifestyle factors multiple linear regression models were used to assess (1) the main effect of breastfeeding duration and (2) its interaction effect with an obesity GRS, to predict different adiposity measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A significant negative association between ≥4 months of breastfeeding and waist circumference (WC) z-score was observed [β (95% confidence interval), <i>p</i>-value] = [β = −0.189 (−0.37, −0.00), <i>p</i> = 0.044]. Also, significant interaction effects were observed for 1–3 and ≥4 months of breastfeeding and obesity GRS regarding body mass index (BMI) z-score [β = 0.155 (0.06, 0.24), <i>p</i> = 0.001] and [β = 0.108 (0.01, 0.18), <i>p</i> = 0.020, respectively] and fat mass index (FMI) z-score [β = 0.134 (0.04, 0.22), <i>p</i> = 0.003] and [β = 0.100 (0.01, 0.18), <i>p</i> = 0.026, respectively].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Breastfeeding modulates the association between the obesity GRS and body composition in adolescents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.13205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142997128","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}
Anna M Dieberger, Mireille N M van Poppel, Gernot Desoye, David Simmons, Jürgen Harreiter, Roland Devlieger, Carmen Medina, Deborah A Lawlor, Ahmed Elhakeem
Background: Obesity during pregnancy is related to fetal overgrowth. Effective interventions that can mitigate this risk are needed.
Objectives: This study aimed to investigate the effect of a lifestyle intervention for pregnant women with obesity on fetal growth trajectories.
Methods: In the DALI trial, pregnant women with a body mass index ≥29.0 kg/m2 and without gestational diabetes at baseline were randomized to counselling on physical activity (PA), healthy eating (HE) or a combination (PA + HE), or to usual care (UC). Fetal growth trajectories were modelled based on a combination of estimated fetal weight (EFW) from repeated ultrasound scans and weight measured at birth. Differences in fetal growth trajectories between groups were assessed.
Results: Three hundred eighty-four women were included. Those in the PA + HE intervention had slower EFW gain from 32 weeks onwards, with differences (PA + HE vs. UC) at 32, 36 and 40 weeks of -54.1 g (-146.7 to 38.9 g), -84.9 g (-194.0 to 24.7 g), and -99.8 g (-227.1 to 28.1 g), respectively. Effects appeared stronger in males, with a difference at 40 weeks of -185.8 g (-362.5 g to -9.2 g) versus -23.4 g (-190.4 g to 143.5 g) in females.
Conclusions: A lifestyle intervention for pregnant women with obesity resulted in attenuated fetal growth, which only reached significance in male offspring. Future larger trials are needed to confirm these findings and elucidate underlying pathways.
{"title":"Effect of a physical activity and healthy eating lifestyle intervention in pregnancy on fetal growth trajectories: The DALI randomised controlled trial.","authors":"Anna M Dieberger, Mireille N M van Poppel, Gernot Desoye, David Simmons, Jürgen Harreiter, Roland Devlieger, Carmen Medina, Deborah A Lawlor, Ahmed Elhakeem","doi":"10.1111/ijpo.13199","DOIUrl":"https://doi.org/10.1111/ijpo.13199","url":null,"abstract":"<p><strong>Background: </strong>Obesity during pregnancy is related to fetal overgrowth. Effective interventions that can mitigate this risk are needed.</p><p><strong>Objectives: </strong>This study aimed to investigate the effect of a lifestyle intervention for pregnant women with obesity on fetal growth trajectories.</p><p><strong>Methods: </strong>In the DALI trial, pregnant women with a body mass index ≥29.0 kg/m<sup>2</sup> and without gestational diabetes at baseline were randomized to counselling on physical activity (PA), healthy eating (HE) or a combination (PA + HE), or to usual care (UC). Fetal growth trajectories were modelled based on a combination of estimated fetal weight (EFW) from repeated ultrasound scans and weight measured at birth. Differences in fetal growth trajectories between groups were assessed.</p><p><strong>Results: </strong>Three hundred eighty-four women were included. Those in the PA + HE intervention had slower EFW gain from 32 weeks onwards, with differences (PA + HE vs. UC) at 32, 36 and 40 weeks of -54.1 g (-146.7 to 38.9 g), -84.9 g (-194.0 to 24.7 g), and -99.8 g (-227.1 to 28.1 g), respectively. Effects appeared stronger in males, with a difference at 40 weeks of -185.8 g (-362.5 g to -9.2 g) versus -23.4 g (-190.4 g to 143.5 g) in females.</p><p><strong>Conclusions: </strong>A lifestyle intervention for pregnant women with obesity resulted in attenuated fetal growth, which only reached significance in male offspring. Future larger trials are needed to confirm these findings and elucidate underlying pathways.</p>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":" ","pages":"e13199"},"PeriodicalIF":2.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142997124","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}
Rachael W. Taylor, Barbara C. Galland, Anne-Louise M. Heath, Andrew R. Gray, Kim A. Meredith-Jones, Sarah A. Fortune, Trudy A. Sullivan, Taiwo Adebowale, Deborah McIntosh, Rosie F. Jackson, Barry J. Taylor
Objective
To determine whether BMI differences observed at 5 years of age, from early intervention in infancy, remained apparent at 11 years.
Methods
Participants (n = 734) from the original randomized controlled trial (n = 802) underwent measures of body mass index (BMI), body composition (DXA), sleep and physical activity (24-h accelerometry, questionnaire), diet (repeated 24-h recalls), screen time (daily diaries), wellbeing (CHU-9D, WHO-5), and family functioning (McMaster FAD) around their 11th birthday. Following multiple imputation, regression models explored the effects of two interventions (‘Sleep’ vs. ‘Food, Activity and Breastfeeding’ [FAB]) using a 2 × 2 factorial design.
Results
Five hundred twelve children (48% female, mean [SD] age 11.1 [0.1] years) returned for the 11-year assessment (63% of original sample). Significant differences in BMI z-score (mean difference; 95% CI: −0.16; −0.41, 0.08) or the risk of overweight (including obesity) (odds ratio; 95% CI: 0.85; 0.56, 1.29) were no longer observed between children who had received the sleep intervention compared with those who had not. By contrast, children who had received the FAB intervention had greater BMI z-scores (0.24; 0.01, 0.47) and a higher risk of obesity (1.56; 1.03, 2.36) than children not enrolled in FAB. No significant differences were observed in any lifestyle variables nor wellbeing measures across all groups.
Conclusions
Sustained reductions in BMI and obesity risk from an early sleep intervention were not apparent 9 years later, whereas a more traditional lifestyle intervention resulted in increased rates of obesity, not explained by any differences in lifestyle behaviours measured.
Clinical Trial Registry
ClinicalTrials.gov number NCT00892983, https://clinicaltrials.gov/study/NCT00892983.
{"title":"Long-term follow-up of the impact of brief sleep and lifestyle interventions in infancy on BMI z-score at 11 years of age: The POI randomized controlled trial","authors":"Rachael W. Taylor, Barbara C. Galland, Anne-Louise M. Heath, Andrew R. Gray, Kim A. Meredith-Jones, Sarah A. Fortune, Trudy A. Sullivan, Taiwo Adebowale, Deborah McIntosh, Rosie F. Jackson, Barry J. Taylor","doi":"10.1111/ijpo.13204","DOIUrl":"10.1111/ijpo.13204","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine whether BMI differences observed at 5 years of age, from early intervention in infancy, remained apparent at 11 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants (<i>n</i> = 734) from the original randomized controlled trial (<i>n</i> = 802) underwent measures of body mass index (BMI), body composition (DXA), sleep and physical activity (24-h accelerometry, questionnaire), diet (repeated 24-h recalls), screen time (daily diaries), wellbeing (CHU-9D, WHO-5), and family functioning (McMaster FAD) around their 11th birthday. Following multiple imputation, regression models explored the effects of two interventions (‘Sleep’ vs. ‘Food, Activity and Breastfeeding’ [FAB]) using a 2 × 2 factorial design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five hundred twelve children (48% female, mean [SD] age 11.1 [0.1] years) returned for the 11-year assessment (63% of original sample). Significant differences in BMI <i>z</i>-score (mean difference; 95% CI: −0.16; −0.41, 0.08) or the risk of overweight (including obesity) (odds ratio; 95% CI: 0.85; 0.56, 1.29) were no longer observed between children who had received the sleep intervention compared with those who had not. By contrast, children who had received the FAB intervention had greater BMI <i>z</i>-scores (0.24; 0.01, 0.47) and a higher risk of obesity (1.56; 1.03, 2.36) than children not enrolled in FAB. No significant differences were observed in any lifestyle variables nor wellbeing measures across all groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Sustained reductions in BMI and obesity risk from an early sleep intervention were not apparent 9 years later, whereas a more traditional lifestyle intervention resulted in increased rates of obesity, not explained by any differences in lifestyle behaviours measured.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Trial Registry</h3>\u0000 \u0000 <p>ClinicalTrials.gov number NCT00892983, https://clinicaltrials.gov/study/NCT00892983.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142997131","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}
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