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Nutritional Intervention and Physical Activity in Adolescents and Children with Obesity

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Obesity".

Deadline for manuscript submissions: closed (25 September 2025) | Viewed by 15096

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Special Issue Editors

Dr. Cristina Romero-Blanco

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Guest Editor

1. Department of Nursing, Ciudad Real, University of Castilla-La Mancha, 13001 Ciudad Real, Spain
2. PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha-Toledo Campus, 45004 Toledo, Spain
Interests: physical activity; obesity; active commuting; behavioral habits

Dr. Susana Aznar

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Guest Editor

PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha-Toledo Campus, 45004 Toledo, Spain
Interests: physical activity; obesity; active commuting; behavioral habits
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Dear Colleagues,

Childhood and adolescent obesity pose significant global health challenges with enduring impacts on physical health, psychosocial well-being, and healthcare costs. The alarming prevalence of obesity in these age groups demands urgent attention from researchers, policymakers, and healthcare professionals.

Obesity's multifactorial nature is well documented and influenced by genetic, environmental, and behavioral factors. Key among these are dietary habits and physical activity, which significantly affect obesity susceptibility from an early age. Understanding the complex interactions between nutrition, physical activity, and obesity is crucial for developing effective interventions.

Research highlights the need to investigate the efficacy of interventions targeting nutrition and physical activity to mitigate obesity's adverse health outcomes. These interventions hold the promise of improving quality of life for young individuals and reducing the burden on healthcare systems globally.

This Special Issue aims to synthesize current research findings and insights into effective strategies for preventing and managing obesity in children and adolescents. This aligns with the journal's scope by exploring the intersection of nutrition, physical activity, and public health. It will contribute valuable evidence-based recommendations for healthcare practices, policy development, and future research directions, ensuring a comprehensive understanding of the topic and its broader implications.

Dr. Cristina Romero-Blanco
Dr. Susana Aznar
Guest Editors

Manuscript Submission Information

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Keywords

nutrition
physical activity
intervention
obesity
children
adolescents
dietary modification
exercise programs
public health

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Published Papers (6 papers)

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Research

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19 pages, 1535 KB

Open AccessArticle

Evaluating the Impact of an 8-Week Family-Focused E-Health Lifestyle Program for Adolescents: A Retrospective, Real-World Evaluation

by Susan Hulland, Oluwadurotimi Obatoki, Isabella Giardino, Caley Kirkman, Monica van Dam, Cecilia Airth, Lucy Quin, Brendan Goodger and Zoe E. Davidson

Nutrients 2025, 17(22), 3509; https://doi.org/10.3390/nu17223509 - 10 Nov 2025

Viewed by 664

Abstract

Background/objectives: Overweight and obesity in adolescents is a significant public health concern, yet limited interventions exist in Australia to promote healthy behavior change in families and young people. This retrospective, real-world evaluation aimed to describe the impact of an 8-week e-Health program (Think, Eat And Move, [TEAM]) on anthropometric, behavioral and wellbeing outcomes in adolescents. Methods: Eligible TEAM program participants were aged 13–17 years, resided in Central or Eastern Sydney, Australia, had overweight/obesity, were at risk of or had a chronic health condition and/or required healthy lifestyle support. Retrospective program data were used to assess the impact of TEAM on weight, height and BMI z-score, dietary intake, physical activity and wellbeing indices. Results: Of 567 registered participants, 313 completed the TEAM program and were included in the analysis (median age 14.4 years, 56.2% female). The median (interquartile range) BMI z-score reduced from 1.8 (1.4–2.2) pre-program to 1.6 (1.1–2.1) post-program (p < 0.001, n = 262). Significant improvements in health behaviors following the program were observed, including increased consumption of fruit, vegetables and water; reduced consumption of confectionery and take-away foods; increased days of physical activity; and reduced sedentary time. Significant positive changes were also observed in knowledge and wellbeing measures. Conclusions: Adolescents completing the TEAM program demonstrated clinically important changes in anthropometry and improved nutrition and physical activity behaviors. E-Health modalities for promoting behavior change should be considered in public health strategies for adolescents. Full article

(This article belongs to the Special Issue Nutritional Intervention and Physical Activity in Adolescents and Children with Obesity)

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14 pages, 741 KB

Open AccessArticle

Association Between Adiposity Rebound and the Frequency of Balanced Meals Among Japanese Preschool Children: A Cross-Sectional Study

by Yuki Tada, Kemal Sasaki, Tomomi Kobayashi, Yasuyo Wada, Daisuke Fujita and Tetsuji Yokoyama

Nutrients 2025, 17(19), 3183; https://doi.org/10.3390/nu17193183 - 9 Oct 2025

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Abstract

Background: The Healthy Japan 21-Phase III dietary recommendations comprise a staple food, main dish, and side dish to maintain nutritional balance and support healthy child growth. The relationship between the frequency of such balanced meals and early adiposity rebound (AR), a predictor of obesity, remains unclear. Objective: This study aimed to examine the association between the frequency of balanced meals (staple food, main dish, and side dish) and early AR in preschool children. Methods: In this cross-sectional secondary analysis of nationwide online survey data of 688 mothers of children aged 3–6 years, dietary habits were assessed using a validated NutriSTEP-based 22-item Japanese Nutrition Screening Questionnaire. AR constituted a body mass index (BMI) increase from the 18- to 36-month health checkups recorded in the Maternal and Child Health Handbook. Risk scores reflecting lower frequency of balanced meals were calculated for staple foods, main dishes, and side dishes. Logistic regression evaluated associations between dietary risk scores and AR, adjusting for the child’s sex, age, gestational age, birth weight, daycare attendance, and parental obesity. Results: Among 688 children, 193 (28.1%) exhibited early AR and had significantly higher BMI at age 3 and the most recent measurement (both p < 0.01). A higher total dietary risk score was independently associated with AR (adjusted odds ratio; 2.58 [95% CI: 1.08–6.16]). In addition, the absolute risk difference between high- and low-risk groups was 8.5% (95% CI: 1.7–15.2%). Conclusions: A lower frequency of balanced meals is associated with early AR. These findings suggest that a simple, meal-balance screening tool could potentially aid in the early identification of the risk of later obesity and timely nutritional guidance. Full article

(This article belongs to the Special Issue Nutritional Intervention and Physical Activity in Adolescents and Children with Obesity)

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16 pages, 1802 KB

Open AccessArticle

Screen Time as a Determinant of Chosen Aspects of Lifestyle: A Cross-Sectional Study of 10- to 12-Year-Old Schoolchildren in Poland

by Joanna Myszkowska-Ryciak, Jadwiga Hamulka, Ewa Czarniecka-Skubina, Jerzy Gębski, Agata Chmurzynska and Krystyna Gutkowska

Nutrients 2025, 17(17), 2891; https://doi.org/10.3390/nu17172891 - 7 Sep 2025

Viewed by 1782

Abstract

Objective: The study aimed to analyze the relationship between screen time (ST) duration, body weight status (BWS), and selected lifestyle behaviors in children aged 10–12. Methods: A cross-sectional study of 7763 (50.8% girls) Polish schoolchildren was conducted in 2023–2024. Data on ST, physical activity (PA), sleep duration (SD), frequency of consumption of unhealthy foods, family meals (FM), and sociodemographic data were collected using a paper questionnaire. Anthropometric data were obtained from measurements; body mass index (BMI) was used to assess BWS, and the waist-to-height ratio to measure central obesity. A logistic regression model was performed to assess the effect of unhealthy food consumption, FM, BWS, PA level, and SD on the odds of excessive ST (>2 h/day). Results: Girls were less likely to extend ST than boys (OR: 0.78; 95% CI: 0.70–0.86). Increased PA had a limiting effect on the dependent variable (moderate OR: 0.64; 95% CI: 0.53–0.77; vigorous OR: 0.37; 95% CI: 0.31–0.45). Sleeping 6–8 h per day was associated with a 41.6% increase in prolonged ST (OR: 1.42; 95% CI: 1.27–1.57). Overweight/obese individuals were 39.6% more likely to exceed ST compared to normal-weight peers (OR: 1.40; 95% CI: 1.16–1.68). Living in a village and a smaller city increased the odds of excessive ST (OR: 1.12; 95% CI: 1.07–1.41 and OR: 1.18; 95% CI: 1.03–1.34). Conclusions: Excessive body mass and unhealthy dietary habits, particularly sugary beverages, have been identified as significant risk factors for excessive ST. Optimal SD, high PA, and regular FM might have a protective effect on ST. This knowledge will contribute to designing more tailored and effective educational interventions promoting healthy lifestyles in children. Full article

(This article belongs to the Special Issue Nutritional Intervention and Physical Activity in Adolescents and Children with Obesity)

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12 pages, 258 KB

Open AccessArticle

The Effectiveness of Novel e-Health Applications for the Management of Obesity in Childhood and Adolescence During the COVID-19 Outbreak in Greece

by Eleni Ramouzi, George Paltoglou, Diamanto Koutaki, Maria Manou, Christos Papagiannopoulos, Athanasia Tragomalou, Aikaterini Vourdoumpa, Penio Kassari and Evangelia Charmandari

Nutrients 2025, 17(13), 2142; https://doi.org/10.3390/nu17132142 - 27 Jun 2025

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Abstract

Background/Objectives: The prevalence of childhood obesity has recently increased, particularly during the COVID-19 pandemic, owing to lifestyle changes as a result of public health regulations and guidelines introduced by governments worldwide. The aim of our study was to evaluate the impact of novel e-Health applications in addressing childhood obesity prior to and during the COVID-19 pandemic. Methods: The study was conducted as part of the four-year European project BigO (Horizon2020, No.727688). A total of 86 children and adolescents with overweight and obesity (mean age ± standard error of the mean: 11.82 ± 0.25 years; 49 males, 37 females; 31 prepubertal, 55 pubertal) were studied prospectively for 1 year prior to the pandemic (non-COVID-19 group, n = 50) and during the pandemic (COVID-19 group, n = 36). Based on the body mass index (BMI), subjects were classified as having morbid obesity (n = 40, 46,51%) obesity (n = 21, 24.42%), overweight (n = 22, 25.58%), and normal ΒΜΙ (n = 3, 3.49%) according to the International Obesity Task Force cut-off points. The data collection system utilized the BigO technology platform, which connects to a smartphone and smartwatch to objectively record each patient’s diet, sleep, and physical activity. Participants used the BigO system continuously for 4 weeks and wore the smartwatch for specific periods during the week. Subsequently, they entered a personalized, multidisciplinary lifestyle intervention program for 4 months and used the system again for 4 weeks. Results: The key finding was a significantly higher improvement rate in BMI category among children and adolescents during the COVID-19 pandemic (58.3%) compared to before the pandemic (36%). Both groups showed significant reductions in BMI, BMI z-score, insulin resistance indices (homeostatic model assessment and quantitative insulin sensitivity check index), blood pressure, gamma-glutamyl transferase, and insulin concentrations, alongside increases in high-density lipoprotein cholesterol (p < 0.01). Notably, the COVID-19 group experienced a significantly greater reduction in BMI z-score at 12 months compared to the non-COVID-19 group (p < 0.05). Conclusions: Our results reveal that the COVID-19 group demonstrated better compliance with lifestyle interventions and experienced more significant improvements in cardiometabolic risk factors. This suggests that the innovative e-Health applications were successful in managing childhood obesity despite the challenges caused by the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Nutritional Intervention and Physical Activity in Adolescents and Children with Obesity)

22 pages, 917 KB

Open AccessArticle

Why Do Adolescents Skip Breakfast? A Study on the Mediterranean Diet and Risk Factors

by Cristina Romero-Blanco, Evelyn Martín-Moraleda, Iván Pinilla-Quintana, Alberto Dorado-Suárez, Alejandro Jiménez-Marín, Esther Cabanillas-Cruz, Virginia García-Coll, María Teresa Martínez-Romero and Susana Aznar

Nutrients 2025, 17(12), 1948; https://doi.org/10.3390/nu17121948 - 6 Jun 2025

Viewed by 8575

Abstract

Background/Objectives: Skipping breakfast is increasingly common among adolescents and has been associated with adverse health and academic outcomes. The average prevalence of breakfast skipping among adolescents is around 16%, although worldwide, it varies greatly across studies, ranging from 1.3 to 74.7%. This study aimed to assess the frequency of daily breakfast consumption and explore the factors associated with its omission in a stratified sample of Spanish adolescents. Methods: A cross-sectional study was conducted among 547 third-year secondary school students (aged 14–15) from both urban and rural areas in Castilla-La Mancha. Self-reported questionnaires were used to gather sociodemographic, psychosocial, and lifestyle data, including adherence to the Mediterranean diet (via the Kidmed questionnaire) and breakfast habits during school days. Descriptive, bivariate (Chi-square), and multivariate (binary logistic regression) analyses were conducted separately for boys and girls. Results: Findings showed a high prevalence of breakfast skipping one or more days (33.46%), with a significantly higher rate among girls (43.27%) than among boys (24.42%). Also, girls were more likely than boys to skip breakfast every day (14.18% vs. 6.87%, p < 0.001). In both groups, low adherence to the Mediterranean diet was strongly associated with skipping breakfast, along with higher screen time, shorter sleep duration, and being overweight/obese. Among girls, low olive oil consumption (OR 0.145 (CI 0.03–0.67) p 0.014) and poor Mediterranean diet adherence (OR 0.140 (CI 0.06–0.34) p < 0.001) were significant predictors. For boys, being overweight/obese (OR 2.185 (CI 1.06–4.52) p 0.035), low Mediterranean diet adherence (OR 0.136 (CI 0.06–0.32) p < 0.001), and not eating industrial pastries were associated factors (OR 0.413 (CI 0.20–0.88) p 0.022). Predictive models demonstrated good discriminatory power (AUC = 0.807 for girls; 0.792 for boys). Conclusions: Skipping breakfast is prevalent among adolescents, particularly girls, and is linked to poor dietary patterns and excess weight. These findings underscore the need for gender-specific nutritional interventions to promote regular breakfast consumption and improve dietary habits in adolescents. Full article

(This article belongs to the Special Issue Nutritional Intervention and Physical Activity in Adolescents and Children with Obesity)

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Review

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24 pages, 757 KB

Open AccessReview

School-Based Interventions to Prevent Overweight in Latin America: A Scoping Review and Policy Analysis

by Analí Morales-Juárez, Norma Alfaro, Yvette Fautsch-Macías, Maaike Arts, Paula Veliz and María F. Kroker-Lobos

Nutrients 2025, 17(21), 3435; https://doi.org/10.3390/nu17213435 - 31 Oct 2025

Viewed by 1278

Abstract

Overweight, including its severe form obesity, among children and adolescents has risen rapidly in Latin America. Schools play a critical role in addressing this growing public health challenge, as they offer a structured setting to implement preventive interventions targeting nutrition literacy, physical activity, and the food environment. The aim of this article is to describe the effectiveness of school-based interventions for preventing overweight in Latin America and whether existing policies, programs and other initiatives in the region align with the best available evidence. Among the 27 interventions included, most were conducted in Chile (41%), used a pre–post design (41%), adopted a preventive approach (85%), and reported positive effects (52%). Effective interventions included activities on nutrition literacy, physical activity, nutritious foods and diets, provision of free and safe drinking water (e.g., water that is free from microbial contamination and suitable for drinking), and healthy food environment. Experimental studies showed that the duration of effective interventions ranged from two months to two years and were primarily directed at primary school students including parents and teachers. Argentina, Chile, Colombia, Mexico, Peru, and Uruguay had multi-component policies and programs under a regulatory framework (e.g., laws or regulations passed by a government) based on the best available evidence to prevent overweight in school-aged children and adolescents. Only a limited number of countries have implemented these interventions. Ensuring program sustainability is critical to inform evidence-based childhood overweight prevention policies in the region. Policymakers should use the best scientific evidence to guide childhood overweight prevention strategies. Full article

(This article belongs to the Special Issue Nutritional Intervention and Physical Activity in Adolescents and Children with Obesity)

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