This brief report examined obesity prevalence among US youth from 2011 to 2023 using National Health and Nutrition Examination Survey data. Obesity prevalence significantly increased overall, particularly among non-Hispanic Black children and adolescents. Findings highlighted worsening racial disparities and underscored an urgent need for targeted early childhood obesity prevention efforts.
Although Hispanic/Latino youth experience a high burden of cardiometabolic risk factors, few studies address regional differences.
We assessed differences between urban areas in metabolic syndrome and cardiometabolic markers among US Hispanic/Latino youth and examined underlying factors explaining these differences.
Cross-sectional study of youth (n = 1466, aged 8–16 years) in four US urban areas (Chicago, Bronx, Miami and San Diego) of the Hispanic Community Children's Health Study/Study of Latinos. Metabolic syndrome was ascertained following the International Diabetes Federation criteria. Socio-demographics, perceived environmental characteristics and diet quality were collected through questionnaires. Physical activity was measured using accelerometry. Survey regression models assessed the association between urban areas and metabolic syndrome.
There were differences across urban areas in socio-demographic, behavioural and perceived environmental characteristics. Relative to youth in the four urban areas, youth in Chicago (odds ratios [OR]: 2.39, 95% confidence interval [CI]: 1.29, 4.42), but not Bronx and San Diego, had higher odds of metabolic syndrome, while youth in Miami had lower odds of this syndrome (OR: 0.32, 95% CI: 0.12, 0.85).
We found differences across US urban areas in metabolic syndrome in Hispanic/Latino youth. Although behavioural and environmental characteristics partially explained these differences, future research is needed to understand persistent differences.
To examine whether changes in the Mediterranean Diet (MD) or any of its MD food groups modulate the genetic susceptibility to obesity in European youth, both in cross-sectional and longitudinal analyses.
For cross-sectional analysis, 1982 participants at baseline, 1649 in follow-up 1 (FU1) and 1907 in follow-up 2 (FU2), aged 2–16 years of the IDEFICS/I.Family studies were considered. For the longitudinal design, 1254 participants were included. Adherence to MD was assessed using the Mediterranean Diet Score (MDS), and genetic susceptibility to high BMI was assessed with a polygenic risk score (BMI-PRS). Multiple linear regression models were fitted to estimate gene × MD effects on markers of obesity.
In cross-sectional analyses, at baseline, higher MDS was associated with higher BMI in children with high genetic susceptibility (β = 0.12; 95% CI = [0.01, 0.24]). However, 6 years later, at FU2, higher MDS was associated with lower BMI (β = −0.19; 95% CI = [−0.38, −0.01]) in children with high genetic susceptibility, showing an attenuating MDS effect. Also in FU2, vegetables and legumes (V&L) showed inverse associations with BMI (β = −0.01; CI = [−0.02, −0.00]) and WC (β = −0.02; CI = [−0.03, −0.00]) regardless of the obesity genetic risk, although the effect sizes were small. In the longitudinal analyses, no MDS-obesity associations or gene × diet interaction effects were observed.
In cross-sectional analysis (baseline and FU2), the MD modulated the association between obesity susceptibility and adiposity indicators in European youth, having an exacerbating effect in children measured during infancy years and an attenuating effect in early adolescent years.
Integrating health care and social care presents opportunities to deliver responsive parenting (RP) interventions for childhood obesity prevention.
This analysis examined the effect of an integrated RP intervention on infant obesogenic risk behaviours.
This secondary analysis included 228 mother–infant dyads in the Women, Infants, and Children Enhancements to Early Healthy Lifestyles for Baby (WEE Baby) Care study, a pragmatic randomized clinical trial that integrated care between paediatric clinicians and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) nutritionists to encourage RP. Mothers were randomized to a 6-month RP intervention or standard care. The Early Healthy Lifestyle risk assessment tool was completed at infant ages 2 and 6 months. Logistic regression examined study group effects on obesogenic risk behaviours, while t-tests assessed study group effects on a total obesogenic risk behaviour score. Models adjusted for milk type and parity.
RP mothers were less likely to report nighttime feedings at 2 (adjusted odds ratio [aOR] 0.21, 95% confidence interval [CI] 0.07–0.62) and 6 months (aOR 0.36, 95% CI 0.16–0.81); pressure to finish the bottle (aOR 0.53, 95% CI 0.30–0.93) and using screens when feeding/playing at 2 months (aOR 0.34, 95% CI 0.17–0.67); and putting their infant to bed after 8:00 PM at 6 months (aOR 0.46, 95% CI 0.21–0.97). RP mothers had significantly lower obesogenic risk behaviour scores at 2 months (p = 0.009) but not at 6 months (p = 0.06) compared to standard care.
The WEE Baby Care intervention decreased some obesogenic risk behaviours among WIC mother–infant dyads. Integrated care in health and social settings can be used to provide patient-centred RP guidance to improve early obesogenic risk behaviours in high-risk populations.
To examine change in weight status following initiation of lisdexamfetamine in children with attention deficit hyperactivity disorder (ADHD) and overweight or obesity.
A retrospective chart review included children aged 2 to <18 years treated with lisdexamfetamine for ADHD. Body mass index (BMI) data for up to 2 years after initiation of lisdexamfetamine were analysed using linear mixed effects models with autoregressive-1 correlation structure on time of follow-up per patient.
The analysis included 330 children ≤18 years, median age 10 years (interquartile range 8.1–13) comprising 55 children with severe obesity, 88 with mild-moderate obesity, 131 with overweight and 56 with healthy weight, 68% male and 32% female. At 2 years after initiation of lisdexamfetamine in the severe obesity group, the BMI Z-score decreased by −0.41 (95% confidence intervals [CI] [−0.57, −0.25], p < 0.001) and BMI percent of the 95th percentile decreased by −11.2% (95% CI [−15.8 to −6.7], p < 0.001). In the mild–moderate obesity group, BMI Z-score decreased by −0.44 (95% CI [−0.56, −0.31], p < 0.001) and BMI% of the 95th percentile decreased by −11.1% at 24 months (95% CI [−13.9 to −8.4], p < 0.001). In the mild–moderate obesity and overweight groups, younger children (ages 4–10) showed greater reduction in their BMI (p < 0.001 and p = 0.029, respectively).
Reduction in BMI for age was noted for up to 2 years following initiation of lisdexamfetamine in children with ADHD and overweight and obesity. Further studies are warranted to study the weight loss effect of lisdexamfetamine in children with obesity.
Obesity and physical fitness are known to be influenced by various geographic factors and ethnicity in children. However, there is limited evidence on the level to which these factors can influence very early in life, at preschool age. This study aimed to describe and compare total and central obesity and physical fitness according to geographic factors and ethnicity in preschoolers.
This cross-sectional study included 3179 preschoolers (4.6 ± 0.9y, 52.8% boys). Geographic factors (location and type of area: rural/urban) were assessed based on the school setting, while ethnicity was determined through parental self-report. Total and central obesity and physical fitness (cardiorespiratory fitness, muscular strength, speed-agility, balance) were assessed using the PREFIT battery.
Preschoolers from southern regions of Spain presented higher total obesity along with lower performance in cardiorespiratory fitness and lower-limb muscular strength compared to their northern peers (p ≤ 0.017). However, they demonstrated greater levels of upper-limb muscular strength and balance (p < 0.001). Preschoolers from rural areas of Spain showed higher central obesity but better fitness performance compared to those from urban areas (p ≤ 0.004). White and African preschoolers showed lower levels of total and central obesity than Latin preschoolers (p ≤ 0.003) and performed better in upper-limb muscular strength and speed–agility compared to Asian or Latin preschoolers (p ≤ 0.037).
This study highlights significant physical health inequalities among preschoolers based on geographical factors and ethnic backgrounds. These findings underscore the need for targeted public health strategies to address socioeconomic and environmental determinants of early-life health disparities.
To explore the association between adverse childhood experiences (ACEs) and appetitive traits in adolescence.
Participants were 4118 children from the Generation XXI cohort. ACEs were assessed at age 10 with a self-administered questionnaire covering 15 different experiences and analysed by exposure categories (0, 1–3, 4–5 and ≥6) and dimensions identified through component analysis. Appetitive traits at age 13 were measured with the Children's Eating Behaviour Questionnaire, completed by parents. Multivariable linear regression analysis, adjusted for sociodemographic factors, was used.
Ninety-six percent reported at least one ACE, with 26% reporting ≥6. Those who reported at least one ACE had higher scores on food approach traits, indicative of an avid appetite. A dose–response relationship was observed between the number of ACEs and Food Responsiveness, Emotional Overeating and Desire to Drink. Participants with ≥6 ACEs scored higher on Enjoyment of Food (= 0.19, 95% confidence interval [CI] [0.06, 0.31]) and Emotional Undereating (= 0.13, 95% CI [0.01, 0.25]), and lower on Slowness in Eating ( = −0.19, 95%CI [−0.32, −0.06]). Analysis by ACEs dimensions revealed more consistent associations with food approach traits.
Greater ACE exposure was associated with appetitive traits that increase obesity risk, suggesting that these traits may contribute to explaining the association between ACEs and obesity.
High adiposity in children can predict cardiometabolic risk in adulthood. This study investigated if changes in dietary quality, measured by the Healthy Eating Index (HEI), are associated with changes in anthropometric measurements in children.
This secondary analysis used data from TX Sprouts, a cluster randomized controlled trial that investigated the effects of a 1-year school nutrition program on child diet and obesity. 24-hour dietary recalls were used to measure HEI-2020 at baseline and post-intervention. Anthropometric outcomes were BMI, waist circumference, and body fat percentage via bioelectrical impedance. Linear regression models assessed associations between changes in HEI-2020 total and component scores and anthropometrics.
Participants (n = 424) were 53% male, 56% Hispanic, and the average age was 9.3 years. A 10-point increase in total HEI-2020 score was associated with a 0.4% (95% CI: 0.1%–0.6%) decrease in body fat percentage. Increases in whole grain and decreases in refined grain component scores were associated with decreases in body fat percentage. Changes in total or component scores were not associated with changes in BMI, BMI-Z, or waist circumference.
This study found associations between increased diet quality and decreased body fat percentage in a primarily low-income, multi-ethnic population of children.
Metabolic dysfunction-associated steatotic liver disease (MASLD) has become a prevalent liver condition in children and teenagers with obesity. Unfortunately, there is no standardized treatment.
To examine the connection between apolipoprotein B (apoB), apolipoprotein A1 (apoA1), and the apoB/apoA1 ratio with the occurrence of MASLD in this population.
A retrospective study was made on children and adolescents with obesity in a children's hospital between the period 2020 and 2022. Anthropometric data, ultrasound results, and blood biochemistry were analysed to assess the connection between apoB, apoA1, and the presence of MASLD.
Of the 916 participants included, 313 were diagnosed with MASLD. The level of serum apoB reflected a substantial dose–response correlation with the odds of having MASLD. When apoB levels exceeded the 50th percentile, the risk increased significantly, and at the 95th percentile, the odds were 4.83 times higher than at the 50th percentile (95% CI: 2.02–11.56). The ratio of apoB/apoA1 at the 95th percentile was connected to a 2.41-fold higher prevalence compared to the 50th percentile (95% CI: 1.33–4.37). No significant correlation was found between the levels of apoA1 and MASLD prevalence.
Elevated levels of apoB and the apoB/apoA1 ratio have been strongly connected to increased MASLD prevalence in children and adolescents with obesity; hence, signifying their potential usefulness as biomarkers for early detection and intervention.
Previous studies have demonstrated an inverse relationship between socioeconomic status and childhood obesity in affluent nations, with parental education as a key factor. However, the meaning of socioeconomic indicators may vary by race and country, and research on this topic in Asian countries is limited.
We investigated the association between parents' educational status and childhood obesity in Japan.
We utilized data from Japan's birth cohort, recruiting participants from 2011 to 2014, and included 49 564 children. Parental educational status was categorized into four groups: both parents with lower education (LM-LF), mothers with higher education and fathers with lower education (HM-LF), mothers with lower education and fathers with higher education (LM-HF), and both parents with higher education (HM-HF). Multivariable logistic regression analyzed the association between parental education and overweight/obesity among 4-year-old children.
Of the participants, 17.9%, 16.9%, 16.2% and 15.4% were overweight/obese; and 5.5%, 4.6%, 4.4% and 3.8% were obese in LM-LF, HM-LF, LM-HF and HM-HF groups, respectively. When the reference group was defined as children born to parents with HM-HF, the adjusted odds ratios for overweight/obesity in LM-LF, HM-LF and LM-HF were 1.13 (95% confidence intervals [CI]: 1.06–1.21), 1.08 (95% CI: 1.01–1.15) and 1.03 (95% CI: 0.95–1.12); and those for obesity were 1.34 (95% CI: 1.20–1.50), 1.16 (95% CI: 1.04–1.31) and 1.11 (95% CI: 0.96–1.28), respectively.
Lower educational status in both parents was associated with overweight/obesity among 4-year-old children in Japan. Public policies might target parents with lower education to prevent childhood obesity.
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