Jacqueline Muts, Stefanie M. P. Kouwenhoven, Nadja Antl, Marieke Abrahamse-Berkeveld, Britt J. van Keulen, Jos W. R. Twisk, Dewi van Harskamp, Chris H. P. van den Akker, Berthold Koletzko, Johannes B. van Goudoever
Introduction
Formula feeding is associated with an increased obesity risk compared to breastfeeding, possibly due to its higher protein content. We aimed to investigate the influence of feeding a modified, low-protein infant formula during the first 6 months of life on growth and body composition at 6 years.
Methods
Healthy term-born infants were randomised to receive a low-protein (mLP) infant formula with modified amino acid composition (n = 90; 1.7 g protein/100 kcal) or a control infant formula (CTRL) (n = 88; 2.1 g protein/100 kcal) up to 6 months. A breastfed (BF, n = 67) group served as a reference. At 6 years, anthropometry and body composition (air-displacement plethysmography) were measured.
Results
A total of 106 infants were measured at 6y follow-up, (n = 39 mLP; n = 33 CTRL; n = 34 BF). No significant differences were observed in mean weight, length, BMI, or fat mass percentage. However, the mean fat-free mass was lower in the mLP compared to the CTRL group (−1240 g; 95% CI: −1889 to −591, p < 0.001). Moreover, both formula groups had a higher absolute fat mass when compared to the breastfed group (p = 0.01).
Conclusions
Feeding a mLP formula during early life did not have beneficial effects on body composition in a subset of infants studied at age 6 year.
{"title":"Anthropometry and Body Composition in Childhood: Follow-Up of a Randomised, Double-Blinded Controlled Trial With a Modified, Low-Protein Infant Formula During Infancy","authors":"Jacqueline Muts, Stefanie M. P. Kouwenhoven, Nadja Antl, Marieke Abrahamse-Berkeveld, Britt J. van Keulen, Jos W. R. Twisk, Dewi van Harskamp, Chris H. P. van den Akker, Berthold Koletzko, Johannes B. van Goudoever","doi":"10.1111/ijpo.70038","DOIUrl":"10.1111/ijpo.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Formula feeding is associated with an increased obesity risk compared to breastfeeding, possibly due to its higher protein content. We aimed to investigate the influence of feeding a modified, low-protein infant formula during the first 6 months of life on growth and body composition at 6 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Healthy term-born infants were randomised to receive a low-protein (mLP) infant formula with modified amino acid composition (<i>n</i> = 90; 1.7 g protein/100 kcal) or a control infant formula (CTRL) (<i>n</i> = 88; 2.1 g protein/100 kcal) up to 6 months. A breastfed (BF, <i>n</i> = 67) group served as a reference. At 6 years, anthropometry and body composition (air-displacement plethysmography) were measured.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 106 infants were measured at 6y follow-up, (<i>n</i> = 39 mLP; <i>n</i> = 33 CTRL; <i>n</i> = 34 BF). No significant differences were observed in mean weight, length, BMI, or fat mass percentage. However, the mean fat-free mass was lower in the mLP compared to the CTRL group (−1240 g; 95% CI: −1889 to −591, <i>p <</i> 0.001). Moreover, both formula groups had a higher absolute fat mass when compared to the breastfed group (<i>p</i> = 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Feeding a mLP formula during early life did not have beneficial effects on body composition in a subset of infants studied at age 6 year.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144566864","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}
Sri Nikhita Chimatapu, Steven D. Mittelman, Alexandra Klomhaus, My H. Vu, Manal Habib, Lauren E. Wisk, David S. Black, Alaina P. Vidmar
Background
Continuous glucose monitors (CGM) offer real-time biofeedback that might support behavioural changes to reduce obesity in youth. However, the feasibility and acceptability of CGM in this population remain underexplored.
Methods
A 6-week crossover trial was conducted with youth aged 10–18 years with a body mass index above the 95th percentile. Participants experienced two phases in random order: (1) masked CGM (without data access) and (2) unmasked CGM (with real-time data access). The primary objective was to assess feasibility through recruitment, retention and adherence rates. Secondary measures included CGM-derived glucose metrics, sleep patterns, dietary intake, physical activity, eating behaviours and weight change. Descriptive analyses and mixed-effects regression models were used to examine between-condition differences on an intention-to-treat basis.
Results
Of 30 eligible participants, 27 were enrolled (90% recruitment rate; age: 14.5 ± 2.2 years, HbA1c: 5.5 ± 0.24%, 15/27 [55%] Hispanic, 16/27 [59%] female). Of the enrolled participants, 24 completed the protocol. Adherence averaged 35.1 days over 42 days (87% of days). The CGM was well tolerated, with no adverse effects reported. There was no significant difference in glycaemic variability metrics between masked and unmasked conditions over the 6-week period.
Conclusions
This trial supports the feasibility and acceptability of CGM use in youth with obesity. Given the exploratory nature of this study, longer-term research is needed to evaluate its effectiveness in modifying health behaviours and metabolic outcomes in this population.
{"title":"The effect of continuous glucose monitoring feedback on glycaemic variability in youth with obesity: A within-participant feasibility study","authors":"Sri Nikhita Chimatapu, Steven D. Mittelman, Alexandra Klomhaus, My H. Vu, Manal Habib, Lauren E. Wisk, David S. Black, Alaina P. Vidmar","doi":"10.1111/ijpo.70035","DOIUrl":"10.1111/ijpo.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Continuous glucose monitors (CGM) offer real-time biofeedback that might support behavioural changes to reduce obesity in youth. However, the feasibility and acceptability of CGM in this population remain underexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 6-week crossover trial was conducted with youth aged 10–18 years with a body mass index above the 95th percentile. Participants experienced two phases in random order: (1) masked CGM (without data access) and (2) unmasked CGM (with real-time data access). The primary objective was to assess feasibility through recruitment, retention and adherence rates. Secondary measures included CGM-derived glucose metrics, sleep patterns, dietary intake, physical activity, eating behaviours and weight change. Descriptive analyses and mixed-effects regression models were used to examine between-condition differences on an intention-to-treat basis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 30 eligible participants, 27 were enrolled (90% recruitment rate; age: 14.5 ± 2.2 years, HbA1c: 5.5 ± 0.24%, 15/27 [55%] Hispanic, 16/27 [59%] female). Of the enrolled participants, 24 completed the protocol. Adherence averaged 35.1 days over 42 days (87% of days). The CGM was well tolerated, with no adverse effects reported. There was no significant difference in glycaemic variability metrics between masked and unmasked conditions over the 6-week period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This trial supports the feasibility and acceptability of CGM use in youth with obesity. Given the exploratory nature of this study, longer-term research is needed to evaluate its effectiveness in modifying health behaviours and metabolic outcomes in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537598","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}
Jane Jacobs, Kathryn Backholer, Steven Allender, Vicki Brown, Liliana Orellana, Rachel Novotny, Luke Wolfenden, Marj Moodie, Melanie Nichols
Introduction
Community-based interventions (CBIs) to prevent childhood obesity show promise in reducing body mass index z-scores (zBMI). Assessing whether this approach produces equitable outcomes across socio-economic sub-groups is typically limited by inadequate sample size. This study aimed to assess the effectiveness of CBIs on zBMI and weight-related behaviours by socio-economic position (SEP).
Methods
Individual participant data meta-analysis using seven Australian childhood obesity prevention CBIs conducted between 2003 and 2022. Trials used consistent intervention approaches, objectively measured height and weight, and self- or parent-reported behaviours, and lasted 2–4 years. Area-level SEP was estimated using Australian Index of Relative Socio-economic Advantage and Disadvantage tertiles based on home or school postcodes. Multi-level linear and logistic models estimated the intervention effect on zBMI and behaviours across SEP levels.
Results
While zBMI scores increased across all groups, the increase was significantly greater in control compared to intervention students (difference: −0.036 [95%CI −0.065, −0.007]), among the 25 346 observations analysed. The effect of CBIs was greater in low compared to high SEP students (intervention effect difference = −0.10 [95%CI −0.18, −0.02]).
Discussion
Obesity prevention CBIs may have greater impacts among children from low SEP areas, potentially contributing to reducing health inequities. Further research is needed to understand barriers to improving weight-related behaviours across socio-economic groups.
{"title":"The impact of community-based childhood obesity prevention interventions in Australia by socio-economic position: An individual participant data meta-analysis","authors":"Jane Jacobs, Kathryn Backholer, Steven Allender, Vicki Brown, Liliana Orellana, Rachel Novotny, Luke Wolfenden, Marj Moodie, Melanie Nichols","doi":"10.1111/ijpo.70031","DOIUrl":"10.1111/ijpo.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Community-based interventions (CBIs) to prevent childhood obesity show promise in reducing body mass index z-scores (zBMI). Assessing whether this approach produces equitable outcomes across socio-economic sub-groups is typically limited by inadequate sample size. This study aimed to assess the effectiveness of CBIs on zBMI and weight-related behaviours by socio-economic position (SEP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Individual participant data meta-analysis using seven Australian childhood obesity prevention CBIs conducted between 2003 and 2022. Trials used consistent intervention approaches, objectively measured height and weight, and self- or parent-reported behaviours, and lasted 2–4 years. Area-level SEP was estimated using Australian Index of Relative Socio-economic Advantage and Disadvantage tertiles based on home or school postcodes. Multi-level linear and logistic models estimated the intervention effect on zBMI and behaviours across SEP levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>While zBMI scores increased across all groups, the increase was significantly greater in control compared to intervention students (difference: −0.036 [95%CI −0.065, −0.007]), among the 25 346 observations analysed. The effect of CBIs was greater in low compared to high SEP students (intervention effect difference = −0.10 [95%CI −0.18, −0.02]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Obesity prevention CBIs may have greater impacts among children from low SEP areas, potentially contributing to reducing health inequities. Further research is needed to understand barriers to improving weight-related behaviours across socio-economic groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332216","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}
Cara F Ruggiero, Dustin D French, Justin D Smith, Meghan E Perkins, Janice Liebhart, Jeanne Lindros, Jeremiah Salmon, Vincent Biggs, Allison J Wu, Davene R Wright, Elsie M Taveras, Lauren Fiechtner
Objective: This paper aims to describe the development and application of a cost tool to help predict return on investment and sustainability of the Healthy Weight Clinic Family Healthy Weight Program (FHWP) through insurance reimbursement.
Methods: Case studies to apply the cost tool were conducted with 3 sites to assess the break-even point for clinic patient volume (i.e., financial neutral point: operational costs = revenue) during implementation. Financial neutral points were based on average reimbursement rates per health centre.
Results: The annual fixed cost of the intervention ranged from $65 252 to $79 024. The average revenue ranged from $806-$1663 per patient through medical reimbursement, and the clinics needed to care for an average of 37-81 patients annually to break even.
Conclusions: Use of an adaptable cost tool that captures reimbursement of clinical provider time and a minimum stream of clinical volume can equip decision-makers in planning financially to implement and sustain a clinically based FHWP.
{"title":"Development and application of a cost tool for a primary care-based intensive health behaviour and lifestyle treatment.","authors":"Cara F Ruggiero, Dustin D French, Justin D Smith, Meghan E Perkins, Janice Liebhart, Jeanne Lindros, Jeremiah Salmon, Vincent Biggs, Allison J Wu, Davene R Wright, Elsie M Taveras, Lauren Fiechtner","doi":"10.1111/ijpo.70028","DOIUrl":"10.1111/ijpo.70028","url":null,"abstract":"<p><strong>Objective: </strong>This paper aims to describe the development and application of a cost tool to help predict return on investment and sustainability of the Healthy Weight Clinic Family Healthy Weight Program (FHWP) through insurance reimbursement.</p><p><strong>Methods: </strong>Case studies to apply the cost tool were conducted with 3 sites to assess the break-even point for clinic patient volume (i.e., financial neutral point: operational costs = revenue) during implementation. Financial neutral points were based on average reimbursement rates per health centre.</p><p><strong>Results: </strong>The annual fixed cost of the intervention ranged from $65 252 to $79 024. The average revenue ranged from $806-$1663 per patient through medical reimbursement, and the clinics needed to care for an average of 37-81 patients annually to break even.</p><p><strong>Conclusions: </strong>Use of an adaptable cost tool that captures reimbursement of clinical provider time and a minimum stream of clinical volume can equip decision-makers in planning financially to implement and sustain a clinically based FHWP.</p>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":" ","pages":"e70028"},"PeriodicalIF":2.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324028","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}
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.
{"title":"Racial and ethnic disparities in obesity trends among US children and adolescents aged 2-19, 2011-2023.","authors":"Kathy Hu, Renee A Underwood, Yun Shen","doi":"10.1111/ijpo.70032","DOIUrl":"10.1111/ijpo.70032","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":" ","pages":"e70032"},"PeriodicalIF":2.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273797","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}
Lauren Iacono, Paola Filigrana, Monica Batalha, Krista M. Perreira, Linda C. Gallo, Bharat Thyagarajan, Martha L. Daviglus, Amber Pirzada, Alan M. Delamater, Frank J. Penedo, Kelly R. Evenson, Carmen R. Isasi
Background
Although Hispanic/Latino youth experience a high burden of cardiometabolic risk factors, few studies address regional differences.
Objective
We assessed differences between urban areas in metabolic syndrome and cardiometabolic markers among US Hispanic/Latino youth and examined underlying factors explaining these differences.
Methods
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.
Results
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).
Conclusion
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.
{"title":"Differences across four major US urban areas in metabolic syndrome in the Hispanic Community Children's Health Study/Study of Latino Youth (SOL Youth)","authors":"Lauren Iacono, Paola Filigrana, Monica Batalha, Krista M. Perreira, Linda C. Gallo, Bharat Thyagarajan, Martha L. Daviglus, Amber Pirzada, Alan M. Delamater, Frank J. Penedo, Kelly R. Evenson, Carmen R. Isasi","doi":"10.1111/ijpo.70027","DOIUrl":"10.1111/ijpo.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although Hispanic/Latino youth experience a high burden of cardiometabolic risk factors, few studies address regional differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We assessed differences between urban areas in metabolic syndrome and cardiometabolic markers among US Hispanic/Latino youth and examined underlying factors explaining these differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional study of youth (<i>n</i> = 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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144091997","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}
Miguel Seral-Cortes, Gabin Drouard, Guiomar Masip, Leonie H. Bogl, Stefaan De Henauw, Ronja Foraita, Timm Intemann, Lauren Lissner, Denes Molnar, Rajini Nagrani, Valeria Pala, Catalina Picó, Paola Russo, Gianluca Tognon, Michael Tornaritis, Toomas Veidebaum, Marvin N. Wright, Pilar De Miguel-Etayo, Luis A. Moreno, Idoia Labayen, the IDEFICS/I.Family Consortia
Background and Objectives
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.
Methods
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.
Results
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.
Conclusions
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.
{"title":"Mediterranean diet and obesity polygenic risk interaction on adiposity in European children: The IDEFICS/I.Family Study","authors":"Miguel Seral-Cortes, Gabin Drouard, Guiomar Masip, Leonie H. Bogl, Stefaan De Henauw, Ronja Foraita, Timm Intemann, Lauren Lissner, Denes Molnar, Rajini Nagrani, Valeria Pala, Catalina Picó, Paola Russo, Gianluca Tognon, Michael Tornaritis, Toomas Veidebaum, Marvin N. Wright, Pilar De Miguel-Etayo, Luis A. Moreno, Idoia Labayen, the IDEFICS/I.Family Consortia","doi":"10.1111/ijpo.70023","DOIUrl":"10.1111/ijpo.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092008","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}
Yining Ma, Lisa Bailey-Davis, Amy M. Moore, Cara F. Ruggiero, Carolyn F. McCabe, Jennifer S. Savage
Background
Integrating health care and social care presents opportunities to deliver responsive parenting (RP) interventions for childhood obesity prevention.
Objectives
This analysis examined the effect of an integrated RP intervention on infant obesogenic risk behaviours.
Methods
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.
Results
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.
Conclusions
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.
背景：整合卫生保健和社会保健提供了提供响应性育儿（RP）干预儿童肥胖预防的机会。目的：本分析考察了综合RP干预对婴儿肥胖危险行为的影响。方法：这一次要分析包括228对妇女、婴儿和儿童增强婴儿早期健康生活方式（WEE Baby）护理研究中的母婴对，这是一项实用的随机临床试验，将儿科临床医生和妇女、婴儿和儿童特殊补充营养计划（WIC）营养学家之间的护理结合起来，以鼓励RP。母亲们被随机分为6个月RP干预组和标准护理组。在婴儿2个月和6个月时完成早期健康生活方式风险评估工具。逻辑回归检验了研究组对致肥风险行为的影响，而t检验评估了研究组对致肥风险行为总分的影响。模型调整牛奶类型和胎次。结果：RP母亲在2个月（调整优势比[aOR] 0.21, 95%可信区间[CI] 0.07-0.62）和6个月（aOR 0.36, 95%可信区间[CI] 0.16-0.81）时报告夜间喂养的可能性较小；压力完成奶瓶（aOR 0.53, 95% CI 0.30-0.93）和在2个月喂养/玩耍时使用屏幕（aOR 0.34, 95% CI 0.17-0.67）；并在6个月大时让婴儿在晚上8点后睡觉（aOR 0.46, 95% CI 0.21-0.97）。与标准护理相比，RP母亲在2个月时的肥胖风险行为评分显著降低（p = 0.009），但在6个月时则没有（p = 0.06）。结论：WEE婴儿护理干预降低了WIC母婴的某些肥胖危险行为。卫生和社会环境中的综合护理可用于提供以患者为中心的RP指导，以改善高危人群的早期致胖风险行为。
{"title":"Effect of a care-coordinated responsive parenting intervention on obesogenic risk behaviours among mother–infant dyads enrolled in WIC","authors":"Yining Ma, Lisa Bailey-Davis, Amy M. Moore, Cara F. Ruggiero, Carolyn F. McCabe, Jennifer S. Savage","doi":"10.1111/ijpo.70020","DOIUrl":"10.1111/ijpo.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Integrating health care and social care presents opportunities to deliver responsive parenting (RP) interventions for childhood obesity prevention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This analysis examined the effect of an integrated RP intervention on infant obesogenic risk behaviours.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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 <i>t</i>-tests assessed study group effects on a total obesogenic risk behaviour score. Models adjusted for milk type and parity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 (<i>p</i> = 0.009) but not at 6 months (<i>p</i> = 0.06) compared to standard care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075090","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}
Mostafa Salama, Kaitlin Leopold, Roland Hentz, Seema Kumar
Objective
To examine change in weight status following initiation of lisdexamfetamine in children with attention deficit hyperactivity disorder (ADHD) and overweight or obesity.
Study Design
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.
Results
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).
Conclusion
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.
{"title":"Weight loss following lisdexamfetamine in children and adolescents with attention deficit hyperactivity disorder and overweight and obesity","authors":"Mostafa Salama, Kaitlin Leopold, Roland Hentz, Seema Kumar","doi":"10.1111/ijpo.70024","DOIUrl":"10.1111/ijpo.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine change in weight status following initiation of lisdexamfetamine in children with attention deficit hyperactivity disorder (ADHD) and overweight or obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 <i>Z</i>-score decreased by −0.41 (95% confidence intervals [CI] [−0.57, −0.25], <i>p</i> < 0.001) and BMI percent of the 95th percentile decreased by −11.2% (95% CI [−15.8 to −6.7], <i>p</i> < 0.001). In the mild–moderate obesity group, BMI <i>Z</i>-score decreased by −0.44 (95% CI [−0.56, −0.31], <i>p</i> < 0.001) and BMI% of the 95th percentile decreased by −11.1% at 24 months (95% CI [−13.9 to −8.4], <i>p</i> < 0.001). In the mild–moderate obesity and overweight groups, younger children (ages 4–10) showed greater reduction in their BMI (<i>p</i> < 0.001 and <i>p</i> = 0.029, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075092","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}
Cristina Cadenas-Sanchez, Jorge R. Fernández-Santos, Mairena Sánchez-López, Natalia García-Corada, Diego Moliner-Urdiales, Nuria Romero-Parra, Manuel A. Rodriguez Perez, Pere Palou, Cecilia Dorado-García, German Vicente-Rodríguez, Francisco B. Ortega, David Jiménez-Pavón
Background and objectives
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.
Methods
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.
Results
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).
Conclusion
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.
{"title":"Geographic and ethnic inequalities in total and central obesity, and physical fitness among preschool children: Insights from the PREFIT project","authors":"Cristina Cadenas-Sanchez, Jorge R. Fernández-Santos, Mairena Sánchez-López, Natalia García-Corada, Diego Moliner-Urdiales, Nuria Romero-Parra, Manuel A. Rodriguez Perez, Pere Palou, Cecilia Dorado-García, German Vicente-Rodríguez, Francisco B. Ortega, David Jiménez-Pavón","doi":"10.1111/ijpo.70021","DOIUrl":"10.1111/ijpo.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 (<i>p</i> ≤ 0.017). However, they demonstrated greater levels of upper-limb muscular strength and balance (<i>p</i> < 0.001). Preschoolers from rural areas of Spain showed higher central obesity but better fitness performance compared to those from urban areas (<i>p</i> ≤ 0.004). White and African preschoolers showed lower levels of total and central obesity than Latin preschoolers (<i>p</i> ≤ 0.003) and performed better in upper-limb muscular strength and speed–agility compared to Asian or Latin preschoolers (<i>p</i> ≤ 0.037).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954312","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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