Childhood Obesity最新文献

Objective: This study examined the association between neighborhood food swamp environments and sugar-sweetened beverage (SSB) consumption in quick-service restaurants (QSRs) and whether ethnicity and race moderated this association. Methods: Observational data were collected from parent-child dyads patronizing four QSRs in Massachusetts (n = 82 dyads) and New Hampshire (n = 67 dyads), including children's SSB consumption (measured by plate waste) categorized as high (>25 g) versus lower sugar. The neighborhood food environment of each QSR was categorized as food swamp versus nonfood swamp based on the ratio of unhealthy to total food outlets in the neighborhood. Logistic regression analysis was used to test the relationship between food swamps, ethnicity/race, and SSB consumption. Results: Of the 149 children (49% Latinx, 58% between the ages of 7 and 12), most visited QSRs located in food swamps (63%). All children consumed a beverage in QSRs, and 83% consumed high-sugar SSBs. Children patronizing QSRs in food swamps did not differ significantly in the likelihood of consuming high SSBs relative to children in QSRs in nonfood swamps [82% vs. 83%, adjusted odds ratio (aOR) = 0.8, 95% confidence interval (CI): 0.3-2.2]. However, Latinx children were more likely than non-Latinx children to consume high-sugar SSBs in QSRs (93% vs. 72%, aOR = 3.4, 95% CI: 1.1-10.5). SSB consumption did not differ significantly between racial minority and White children. SSB consumption in food swamps did not differ by ethnicity/race. Conclusions: Regardless of the neighborhood food environment, children consume high-sugar SSBs in QSRs. Latinx children had higher odds of consuming high-sugar SSBs in QSRs. These findings support incentives promoting healthier beverage options for children across all food outlets.

Background: Despite the rapid increase in glucagon-like peptide-1 receptor agonist (GLP-1) use for management of weight among adolescents (ages 12-18 years), there is limited guidance on associated behavioral health considerations. Adolescents on GLP-1 therapy represent a potentially vulnerable population at risk of experiencing medical and psychosocial effects of obesity and comorbidities, as well as side effects and behavioral implications of the medications. Method: This perspective discusses behavioral and psychosocial considerations for adolescents seeking GLP-1s. The limited and developing literature on the use of GLP-1s for pediatric obesity treatment was reviewed to evaluate key aspects of psychosocial functioning and health behavior engagement and to stimulate discussion, research, clinical innovation, and advocacy to support best practices for youth seeking GLP-1s to address weight concerns. Results: There is currently sparse research on the effects of GLP-1s on adolescents' psychosocial functioning. In the context of clinical practice, it may be important to assess for symptoms of eating disorders/disordered eating behaviors, mood instability, and general psychosocial functioning as well as quality of life, social support, health behaviors, and readiness to change prior to the initiation of and throughout the course of GLP-1 treatment. Conclusions: This perspective serves as a call to action for research and clinical innovation to address the psychosocial effects of GLP-1s on adolescents. Screening, monitoring, and future research will be key to ensuring safe and effective use of GLP-1 therapy as well as optimal psychosocial outcomes for youth utilizing GLP-1 medications for obesity treatment.

Background: This study explored whether baseline body esteem predicted changes in eating behaviors, physical activity (PA), and health-related quality of life (QoL) over a 24-month period among youth with obesity enrolled in weight management programs. Methods: Utilizing data from the CANadian Pediatric Weight Management Registry, the study included 415 participants (n = 221 girls, n = 194 boys) aged 10-17 years (mean = 13.2, standard deviation = 2.2). Baseline assessments included a measure of body esteem, while QoL, eating behaviors, and PA were reported at baseline, 12 months, and 24 months. Multilevel modeling was applied to examine the relationships between baseline body esteem and changes in outcomes over time. Results: Higher baseline body esteem was associated with higher initial QoL scores (β = 0.70, p < 0.001) and healthier eating behavior scores (β = -0.57, p < 0.001). Individuals with lower baseline body esteem exhibited greater improvements in QoL (β = -0.12, p = 0.010) and eating behaviors (β = 0.12, p = 0.004) over time. However, baseline body esteem did not significantly predict changes in PA. Conclusions: These findings highlight the prospective relationship of body esteem with future health behaviors and outcomes, providing evidence for weight management programs to consider addressing body esteem within pediatric obesity research and treatment.

Background: The objective of this study was to test the association of Pro-Inflammatory/Anti-Inflammatory Food Intake Score (PAIFIS) and inflammatory biomarkers: C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 levels in a sample of Brazilian children. Methods: This cross-sectional study included children aged 5-8 years. Levels of inflammatory biomarkers and habitual food intake were measured using a quantitative food frequency questionnaire (FFQ) to estimate PAIFIS and anthropometric and socioeconomic data. The Mann-Whitney test, Spearman's correlation test, and nonparametric regression models with Kernel effects were used for analysis. Results: PAIFIS showed an association with increased TNF-α in the univariate analysis [β = 0.53, 95% confidence interval (CI) 0.05-1.15] and the multivariate analysis adjusted for the sum of skinfolds (ΣSF) and income (β = 0.31, 95% CI 0.00-1.11). ΣSF was associated with an increase in TNF-α (β = 15.0, 95% CI 3.16-36.1) and CRP (β = 0.013, 95% CI 0.004-0.022). Conclusions: The PAIFIS shows a positive association with TNF-α. Adiposity was also identified as an important risk factor for inflammation.

Recent literature proposed an association between physical activity (PA) and carotenoid status due to their overlapping role in mediating oxidative stress. However, this relationship has yet to be explored in young children. This study examined the relationship between objectively measured PA (ActiGraph triaxial accelerometry) and skin carotenoid levels (pressure-mediated reflection spectroscopy) in a sample of 3- to 5-years-old. Fourteen children (44 ± 7 months old, 71% male) from a single child care center were included in this cross-sectional analysis. Linear regression modeling indicated more time spent in PA was associated with higher skin carotenoid scores (β = 3.448, p = 0.032). These findings from our pilot study indicate a potential cross-sectional link between physical activity and carotenoid status in young children.

Background: While studies have described poorer health-related quality of life (HRQOL) among youth with obesity, less is known about health factors contributing to this perception. The study aims were to link patient-reported outcomes (PROs) data to electronic health record (EHR) data to describe the association between PROs and obesity-related health factors. Methods: Youth and parents of youth receiving care from weight management programs at eight PEDSnet sites completed PROMIS® measures assessing global health, fatigue, stress, and family relationships. EHR data were extracted, including demographics, anthropometrics, diagnoses, medications, and visits for the period encompassing 12 months prior to and after the date of survey. Linear regression analyses describe the association between PROMIS® scores and the diagnosis of obesity-related comorbidities, medications for obesity-related comorbidities, and health care utilization. Results: In total, 1249 youth (56% with severe obesity) of diverse backgrounds (60% public insurance, 24% non-Hispanic Black, 24% Hispanic) were included. The diagnosis of many obesity-related comorbidities and use of medications for obesity-related conditions were associated with worse global health fatigue and stress scores. The strongest associations that were consistent across many of the PROMIS® measures included number of chronic medications, number of comorbidities, having a neuropsychological diagnosis, and body mass index percentile trajectory. Conclusions: This study details the association of the health issues experienced by youth with obesity and PROs, offering targets in weight management treatment to improve youth and family perception of overall health and well-being.

Background: Maternal depression has been linked with increased risk of childhood obesity. Furthermore, maternal negative affectivity in early childhood has been associated with food fussiness. We explored the relationship between longitudinal maternal well-being mid-pregnancy, at 2 years and 5 years postpartum and children's appetitive traits at 5 years of age. Methods: This is a secondary analysis of the ROLO (randomized control trial of low glycemic diet in pregnancy) longitudinal birth cohort study including pregnancy (n = 279), 2 years (n = 168), and 5 years (n = 295) postpartum. Maternal well-being was measured using the World Health Organization-Five Well-Being Index. Children's appetitive traits were measured at 5 years of age using the Children's Eating Behavior Questionnaire. Bivariate correlation and then linear regression, adjusted for potential confounders, were used to determine relationships between maternal well-being at each timepoint and offspring's appetitive traits at 5 years old. Results: Mean maternal well-being was higher at 5 years postpartum (63.3%) than mid-pregnancy (58.2%) or at 2 years postpartum (61.0%) (p = 0.001). No relationships were observed between maternal well-being mid-pregnancy and child's appetitive traits at 5 years. In adjusted regression, at 2 years postpartum, maternal well-being was negatively associated with "Emotional Overeating" (B = -0.029, p = 0.024), "Satiety Responsiveness" (B = -0.040, p = 0.014), "Slowness Eating" (B = -0.072, p = <0.001), and "Emotional Undereating" (B = -0.054, p = 0.010) and positively associated with "Enjoyment of Food" (B = 0.050, p = 0.007). Maternal well-being at 5 years postpartum was negatively associated with "Satiety Responsiveness" (B = -0.025, p = 0.033) and "Slowness Eating" (B = -0.031, p = 0.024). Conclusion: Maternal well-being in early childhood may influence children's appetitive traits; however, further research is required to fully explore this relationship.

Background: Prebiotic fiber has been examined as a way to foster gut bacteria less associated with obesity. Tests of prebiotic fiber in reducing obesity have occurred mainly in animals, adults, and Caucasians when the highest obesity rates are in African American and Latinx youth. Response to prebiotic fiber is determined by the pre-existing intestinal microbiota. The type of microbiota varies based on diet and physical activity (PA), so it is important to examine acceptability and response to prebiotic fiber in those most at risk for obesity. Methods: This cluster randomized controlled feasibility trial included an online program designed to improve diet and PA along with administration of prebiotic fiber for 12 weeks in 123 4th and 5th grade students where 98% were eligible for free or reduced fee lunch. Of these 56% were male; 71% Latinx; 15% African American; and 14% Other. Results: A decrease in body fat (BF) was associated with higher pre-test BF. Lower BMI was associated with a decrease in fecal Tenericutes and an increase in Actinobacteria. Conclusion: Prebiotic fiber was evaluated in additional studies. Determining those most responsive to prebiotic fiber can also permit individual recommendations for greater inclusion in usual diet choices.

Background: Head Start (HS) is the largest federally funded early childhood education program in the United States. It prepares children socially, emotionally, and academically and sets the foundation for school readiness and academic success. In 2024, the Head Start Program Performance Standards were updated to provide enhanced support and workforce stability, including improvements in health and wellness. This study assessed the availability, participation, satisfaction, and interest in Workplace Wellness Programs (WWPs) for HS educators. Methods: An electronic survey was sent to nearly 74,000 HS grantees and educators; 2,611 complete surveys were included in the analysis. Descriptive analyses examined the availability, participation, satisfaction, and interest in WWPs, and multivariate regression analyses identified factors associated with WWP participation. Results: Approximately 71% of HS educators reported access to at least one WWP. The most common programs available were health education and promotion (51%), stress management (25%), and healthy lunch and snack options (20%). Participation rates for available programs ranged from 6% to 93%, and interest in unavailable programs ranged from 40% to 93%. Job dissatisfaction was associated with lower odds of participating in any WWP or in health education and wellness programs. Receipt of community food assistance was associated with lower odds of participating in nutrition and stress management programs. Conclusions: There is considerable variability in availability, participation, and interest in WWPs among HS educators. Research is needed to understand if expression of interest would translate into take-up of WWPs, identify strategies to reduce barriers, and increase participation.