Children and adolescents are increasingly exposed to processed food in China, however, its association with obesity has not been investigated.
Objectives
To assess the consumption of ultra-processed food (UPF) and its association with overweight/obesity among children and adolescents in China.
Methods
A total of 3437 children and adolescents aged 6–18 years, participating at least twice in the China Nutrition and Health Survey, were included. Food intake was collected using a 3-day 24-h dietary recall method at home visits. Body weight, height and waist circumference (WC) were measured during the survey. UPF was defined by food process levels using NOVA classification. Overweight/obesity was defined by the international age- and sex-specific BMI and WC cut-offs. The association between UPF consumption and overweight/obesity was assessed using mixed effect logistic regression analyses adjusted for socio-demographic, economic, behavioural, dietary and health factors.
Results
The mean daily UPF consumption of the study population (mean age 9.3 years) increased from 9.7 in 1997 to 60.0 grams in 2011. The adjusted odds ratios (OR) (95% CI) for overweight/obesity (using BMI) for UPF consumption of 0, 1–49, 50–99 and ≥ 100 g/day were 1.00, 1.38 (0.98–1.94), 2.01 (1.25–3.24) and 1.53 (0.82–2.86), respectively (p-trend =0.013). Similarly, the corresponding adjusted ORs (95% CI) for central obesity (using WC) were 1.00, 1.84 (1.30–2.60), 2.13 (1.30–3.48) and 2.15 (1.14–4.05) (p-trend<0.001).
Conclusions
Higher long-term UPF consumption was associated with an increased risk of overweight/obesity among children and adolescents in China.
{"title":"Ultra-processed food consumption and obesity among children and adolescents in China—Findings from China Health and Nutrition Survey","authors":"Ming Li, Zumin Shi","doi":"10.1111/ijpo.70012","DOIUrl":"10.1111/ijpo.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Children and adolescents are increasingly exposed to processed food in China, however, its association with obesity has not been investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the consumption of ultra-processed food (UPF) and its association with overweight/obesity among children and adolescents in China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 3437 children and adolescents aged 6–18 years, participating at least twice in the China Nutrition and Health Survey, were included. Food intake was collected using a 3-day 24-h dietary recall method at home visits. Body weight, height and waist circumference (WC) were measured during the survey. UPF was defined by food process levels using NOVA classification. Overweight/obesity was defined by the international age- and sex-specific BMI and WC cut-offs. The association between UPF consumption and overweight/obesity was assessed using mixed effect logistic regression analyses adjusted for socio-demographic, economic, behavioural, dietary and health factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean daily UPF consumption of the study population (mean age 9.3 years) increased from 9.7 in 1997 to 60.0 grams in 2011. The adjusted odds ratios (OR) (95% CI) for overweight/obesity (using BMI) for UPF consumption of 0, 1–49, 50–99 and ≥ 100 g/day were 1.00, 1.38 (0.98–1.94), 2.01 (1.25–3.24) and 1.53 (0.82–2.86), respectively (<i>p</i>-trend =0.013). Similarly, the corresponding adjusted ORs (95% CI) for central obesity (using WC) were 1.00, 1.84 (1.30–2.60), 2.13 (1.30–3.48) and 2.15 (1.14–4.05) (<i>p</i>-trend<0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Higher long-term UPF consumption was associated with an increased risk of overweight/obesity among children and adolescents in China.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 7","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612712","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}
Screen-based behaviours have brought great changes to our lifestyles over the last 50 years. There is limited data evaluating the effects of such alterations on the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) in adolescents. This study sets out to assess possible associations of excessive screen exposure with liver steatosis in a representative sample of US adolescents.
Methods
This cross-sectional analysis used data derived from the National Health and Nutrition Examination Surveys (NHANES) carried out in 2017–2018, including 731 subjects aged 12–17 years. Self-reported screen time (ST, hours/day) outside of school was recorded, including hours watching TV or videos and hours using the computer. Liver steatosis was identified according to the median controlled attenuation parameter (CAP) by transient elastography.
Results
Among the participants, 476 (65.0%, 95% CI: 60.7%–69.2%) experienced excessive screen time (EST, daily ST ≥ 5 h). The prevalence of liver steatosis was higher in adolescents with EST versus counterparts with modest ST (ST < 5 h) (27.0% vs. 16.1%, p < 0.001). EST was associated with increased odds of liver steatosis in adolescents after adjusting for covariates related to demographic background, metabolic variables, physical activity and diet quality (OR: 2.10, 95% CI: 1.34–3.29, p = 0.032). Body mass index partially mediated the effect of EST on liver steatosis risk (52.9%, p = 0.036).
Conclusion
Excessive screen time was associated with increased odds of liver steatosis in adolescents. Strategies to reduce screen time for youth may bring benefits for the management of MASLD.
{"title":"Association between excessive screen time and steatotic liver disease in adolescents: Findings from the 2017–2018 National Health and Nutrition Examination Survey","authors":"Shaoxun Li, Shuanghong Jin, Peipei Fang, Chenwei Pan, Shanshan Huang","doi":"10.1111/ijpo.70010","DOIUrl":"10.1111/ijpo.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Screen-based behaviours have brought great changes to our lifestyles over the last 50 years. There is limited data evaluating the effects of such alterations on the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) in adolescents. This study sets out to assess possible associations of excessive screen exposure with liver steatosis in a representative sample of US adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional analysis used data derived from the National Health and Nutrition Examination Surveys (NHANES) carried out in 2017–2018, including 731 subjects aged 12–17 years. Self-reported screen time (ST, hours/day) outside of school was recorded, including hours watching TV or videos and hours using the computer. Liver steatosis was identified according to the median controlled attenuation parameter (CAP) by transient elastography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the participants, 476 (65.0%, 95% CI: 60.7%–69.2%) experienced excessive screen time (EST, daily ST ≥ 5 h). The prevalence of liver steatosis was higher in adolescents with EST versus counterparts with modest ST (ST < 5 h) (27.0% vs. 16.1%, <i>p</i> < 0.001). EST was associated with increased odds of liver steatosis in adolescents after adjusting for covariates related to demographic background, metabolic variables, physical activity and diet quality (OR: 2.10, 95% CI: 1.34–3.29, <i>p</i> = 0.032). Body mass index partially mediated the effect of EST on liver steatosis risk (52.9%, <i>p</i> = 0.036).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Excessive screen time was associated with increased odds of liver steatosis in adolescents. Strategies to reduce screen time for youth may bring benefits for the management of MASLD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 7","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603278","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}
Hayley Christian, Andrea Nathan, Emma Adams, Stewart G. Trost, Jasper Schipperijn
Background
High levels of sedentary behaviour are associated with poor child health outcomes such as obesity. Early childhood education and care (ECEC) services are a key intervention setting. Most ECEC policy-based interventions focus on children's nutrition and physical activity with few aimed at children's sedentary behaviour.
Objective
To evaluate the effect of the Play Active ECEC policy intervention on educator adherence to sedentary behaviour policy recommendations, educator's practices and educator psychosocial influences related to children's sedentary behaviour.
Methods
Pragmatic cluster randomized trial in 81 ECEC services in Perth, Western Australia. Services implemented the Play Active policy over three months. Outcomes were educator-reported changes in adherence to sedentary behaviour policy recommendations, practices and psychosocial influences related to children's sedentary behaviour. Analysis involved descriptive statistics and generalized linear mixed-effects models.
Results
Adherence to sedentary behaviour policy recommendations and educator's practices and psychosocial influences related to children's sedentary behaviour was high at baseline and did not significantly change in response to the Play Active policy intervention.
Conclusions
Educators appeared to adhere to best-practice guidelines for children's sedentary behaviour in ECEC. Clear evidence informed policy, standards and legislation to maintain children's low levels of sedentary behaviours in ECEC is warranted.
{"title":"Impact of the Play Active policy intervention on early childhood educator's sedentary behaviour-related practices, psychosocial influences and meeting policy recommendations: Results from a pragmatic cluster randomized trial","authors":"Hayley Christian, Andrea Nathan, Emma Adams, Stewart G. Trost, Jasper Schipperijn","doi":"10.1111/ijpo.70005","DOIUrl":"10.1111/ijpo.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>High levels of sedentary behaviour are associated with poor child health outcomes such as obesity. Early childhood education and care (ECEC) services are a key intervention setting. Most ECEC policy-based interventions focus on children's nutrition and physical activity with few aimed at children's sedentary behaviour.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the effect of the Play Active ECEC policy intervention on educator adherence to sedentary behaviour policy recommendations, educator's practices and educator psychosocial influences related to children's sedentary behaviour.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pragmatic cluster randomized trial in 81 ECEC services in Perth, Western Australia. Services implemented the Play Active policy over three months. Outcomes were educator-reported changes in adherence to sedentary behaviour policy recommendations, practices and psychosocial influences related to children's sedentary behaviour. Analysis involved descriptive statistics and generalized linear mixed-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Adherence to sedentary behaviour policy recommendations and educator's practices and psychosocial influences related to children's sedentary behaviour was high at baseline and did not significantly change in response to the Play Active policy intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Educators appeared to adhere to best-practice guidelines for children's sedentary behaviour in ECEC. Clear evidence informed policy, standards and legislation to maintain children's low levels of sedentary behaviours in ECEC is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 6","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603279","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}
Yingan Chen, Curtis Tilves, Bruno Bohn, Myriam Doyon, Luigi Bouchard, Patrice Perron, Renee Guerin, Eric Masse, Marie-France Hivert, Noel T. Mueller
Objective
To examine gut microbiota diversity, composition and metabolites in relation to overall mass (OM), fat mass (FM) and lean soft tissue mass (LSTM) measured by dual x-ray absorptiometry (DXA) in 5-year-old children.
Methods
Mothers of the Gen3G cohort were enrolled prenatally in 2010–2013 in Quebec, Canada; 153 children from the cohort had data on gut microbiota and DXA scans at 5–6.4 years of age, and 140 also had plasma metabolite data. We characterized gut microbiota by 16S rRNA Illumina sequencing and metabolites by untargeted multiplatform mass spectrometry. We examined associations of microbial alpha diversity, beta diversity, composition (amplicon sequence variants; ASVs) and metabolites (microbial metabolites) with DXA measures, adjusting for age, sex, diet and drinking water.
Results
Of the 153 children, 43.1% were female, and 96.1% self-identified as white. The median BMI was the 52nd percentile. Microbial richness (alpha diversity) was positively associated with OM, FM and LSTM. Of the 542 ASVs tested, 7 were associated with OM, 5 with FM and 4 with LSTM. One Veillonella ASV and two Blautia ASVs were significantly associated with all outcomes. Among 278 microbial metabolites, no metabolites were associated with FM, while glycoursodeoxycholate was associated with OM, and glycoursodeoxycholate, 3-hydroxybutyrate and gamma-glutamylalanine were associated with LSTM.
Conclusions
In 5-year-old children, gut microbiota alpha diversity, richness and specific gut microbes were associated with OM, FM and LSTM. Many of the associations followed a similar pattern for FM and LSTM, suggesting they may not be specific to adiposity but rather reflect overall growth.
{"title":"Gut microbiota and microbial metabolites are associated with body composition in 5-year-old children: A cross-sectional study in the Gen3G cohort","authors":"Yingan Chen, Curtis Tilves, Bruno Bohn, Myriam Doyon, Luigi Bouchard, Patrice Perron, Renee Guerin, Eric Masse, Marie-France Hivert, Noel T. Mueller","doi":"10.1111/ijpo.70007","DOIUrl":"10.1111/ijpo.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine gut microbiota diversity, composition and metabolites in relation to overall mass (OM), fat mass (FM) and lean soft tissue mass (LSTM) measured by dual x-ray absorptiometry (DXA) in 5-year-old children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Mothers of the Gen3G cohort were enrolled prenatally in 2010–2013 in Quebec, Canada; 153 children from the cohort had data on gut microbiota and DXA scans at 5–6.4 years of age, and 140 also had plasma metabolite data. We characterized gut microbiota by 16S rRNA Illumina sequencing and metabolites by untargeted multiplatform mass spectrometry. We examined associations of microbial alpha diversity, beta diversity, composition (amplicon sequence variants; ASVs) and metabolites (microbial metabolites) with DXA measures, adjusting for age, sex, diet and drinking water.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 153 children, 43.1% were female, and 96.1% self-identified as white. The median BMI was the 52nd percentile. Microbial richness (alpha diversity) was positively associated with OM, FM and LSTM. Of the 542 ASVs tested, 7 were associated with OM, 5 with FM and 4 with LSTM. One <i>Veillonella</i> ASV and two <i>Blautia</i> ASVs were significantly associated with all outcomes. Among 278 microbial metabolites, no metabolites were associated with FM, while glycoursodeoxycholate was associated with OM, and glycoursodeoxycholate, 3-hydroxybutyrate and gamma-glutamylalanine were associated with LSTM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In 5-year-old children, gut microbiota alpha diversity, richness and specific gut microbes were associated with OM, FM and LSTM. Many of the associations followed a similar pattern for FM and LSTM, suggesting they may not be specific to adiposity but rather reflect overall growth.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 6","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584077","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}
Marylin Carino, Jonathan Nguyen, Ru Hui New, Renae Kirkham, Louise Maple-Brown, Shiree Mack, Diana MacKay, Angela Titmuss
Introduction
There is a high prevalence of type 2 diabetes (T2D) in First Nations populations worldwide, increasingly at younger ages. This review aims to identify interventions for the prevention of T2D in First Nations children and young people aged 4–25 years.
Methods
A systematic search of both published and unpublished literature until March 2024 was performed using 15 electronic databases, including MEDLINE, CINAHL, EMBASE, Scopus, Cochrane Library, ATSIHealth, OpenGrey and specific First Nations databases. Eligible studies included First Nations participants aged 4–25 years without T2D, exploring interventions to prevent T2D. Outcomes included knowledge of diabetes, anthropometry and physiology, diet and nutrition, physical activity, glycemic indicators and psychosocial indicators.
Results
Fourteen pre–post exposure non-controlled studies were included, evaluating nine programs. Programs were culturally adapted and primarily school-based, focusing on individual-level behaviour modification in nutrition and physical activity. Most studies assessing knowledge outcomes reported improvement. There were inconsistent findings regarding impacts on dietary intake and glycemia. One home-based program achieved improvements across a range of outcomes, including body mass index, physical activity and psychosocial scores.
Conclusion
Despite the increasing prevalence of T2D in First Nations children and young people, evidence of effective preventive strategies within these populations remains limited.
{"title":"A systematic review of prevention strategies for type 2 diabetes in First Nations children and young people","authors":"Marylin Carino, Jonathan Nguyen, Ru Hui New, Renae Kirkham, Louise Maple-Brown, Shiree Mack, Diana MacKay, Angela Titmuss","doi":"10.1111/ijpo.70009","DOIUrl":"10.1111/ijpo.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>There is a high prevalence of type 2 diabetes (T2D) in First Nations populations worldwide, increasingly at younger ages. This review aims to identify interventions for the prevention of T2D in First Nations children and young people aged 4–25 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of both published and unpublished literature until March 2024 was performed using 15 electronic databases, including MEDLINE, CINAHL, EMBASE, Scopus, Cochrane Library, ATSIHealth, OpenGrey and specific First Nations databases. Eligible studies included First Nations participants aged 4–25 years without T2D, exploring interventions to prevent T2D. Outcomes included knowledge of diabetes, anthropometry and physiology, diet and nutrition, physical activity, glycemic indicators and psychosocial indicators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen pre–post exposure non-controlled studies were included, evaluating nine programs. Programs were culturally adapted and primarily school-based, focusing on individual-level behaviour modification in nutrition and physical activity. Most studies assessing knowledge outcomes reported improvement. There were inconsistent findings regarding impacts on dietary intake and glycemia. One home-based program achieved improvements across a range of outcomes, including body mass index, physical activity and psychosocial scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite the increasing prevalence of T2D in First Nations children and young people, evidence of effective preventive strategies within these populations remains limited.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 6","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595908","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}
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}
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":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70002","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":"OA","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
<div> <section> <h3> Background</h3> <p>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> </section> <section> <h3> Objectives</h3> <p>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> </section> <section> <h3> Methods</h3> <p>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> </section> <section> <h3> Results</h3> <p>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, <i>p</i> < 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, <i>p</i> < 0.01). Spending three or more hours per day on screen time was linked to higher odds of obesity (odds ratio: 2.50, <i>p</i> < 0.01). Furthermore, being a short sleeper was associated with higher odds of overweight (odds ratio: 3.54, <i>p</i> < 0.01).</p> </section> <section> <h3> Conclusions</h3> <p>Children failing to meet none or only
{"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":"10.1111/ijpo.13208","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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, <i>p</i> < 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, <i>p</i> < 0.01). Spending three or more hours per day on screen time was linked to higher odds of obesity (odds ratio: 2.50, <i>p</i> < 0.01). Furthermore, being a short sleeper was associated with higher odds of overweight (odds ratio: 3.54, <i>p</i> < 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Children failing to meet none or only ","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 5","pages":""},"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}
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":"10.1111/ijpo.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 5","pages":""},"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":"10.1111/ijpo.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Limited insight exists into the weight development in children with obesity not receiving obesity treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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 <i>z</i>-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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 <i>z</i>-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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Higher BMI <i>z</i>-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>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70001","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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