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Diet and Lifestyle Interventions for Child Obesity

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

Deadline for manuscript submissions: 20 December 2025 | Viewed by 2993

Special Issue Editors


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Guest Editor
Department of Health Sciences, University of Milan, 20122 Milan, Italy
Interests: pediatric obesity; malnutrition; metabolic syndrome; inflammation; omega-3; body composition; nutritional status

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Guest Editor
1. Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20122 Milan, Italy
2. Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
Interests: obesity; lifestyle intervention; ketogenic diets; eating behaviors; nutritional status; body composition
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Guest Editor
Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy
Interests: pediatric obesity; metabolic syndrome; food allergy; celiac disease; autism spectrum disorders

Special Issue Information

Dear Colleagues,

Childhood obesity is a multifactorial and complex disease. Children with obesity can develop serious complications usually seen in adults (e.g., asthma, metabolic syndrome, NAFL-D). Breastfeeding during the first two years of life, together with complementary feeding, is known to have an impact on the later development of obesity. Dietary patterns, portion sizes, eating frequency, and family meals are critical characteristics to target for early interventions in childhood and adolescence. Physical activity should also be promoted to prevent noncommunicable diseases. Dietary and lifestyle interventions are promising for children and families coping with this complex condition. This Special Issue welcomes original research articles and reviews on diet and lifestyle interventions for preventing or treating childhood obesity.

Dr. Elisabetta Di Profio
Dr. Ramona Silvana De Amicis
Dr. Serena Coppola
Guest Editors

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Keywords

  • childhood obesity
  • nutritional status
  • metabolic syndrome
  • metabolic complications
  • metabolically unhealthy obesity
  • body composition
  • ultraprocessed foods consumption
  • diet and lifestyle intervention
  • eating behaviors
  • bioactive compounds
  • innovative preventive and therapeutic strategies

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Published Papers (5 papers)

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Research

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20 pages, 673 KiB  
Article
Parent and Child Choice of Sugary Drinks Under Four Labelling Conditions
by Zenobia Talati, Thomas McAlpine, Katlyn Mackenzie, Gael Myers, Liyuwork M. Dana, Jessica Charlesworth, Moira O’Connor, Caroline Miller, Barbara A. Mullan and Helen G. Dixon
Nutrients 2025, 17(11), 1920; https://doi.org/10.3390/nu17111920 - 3 Jun 2025
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Abstract
Background: The majority of Australian children exceed the World Health Organization’s recommended dietary intake of free sugar, particularly through the consumption of sugar-sweetened beverages. Front-of-pack nutrition labels increase perceived risk and deter the consumption of sugar-sweetened beverages. However, past studies of young children [...] Read more.
Background: The majority of Australian children exceed the World Health Organization’s recommended dietary intake of free sugar, particularly through the consumption of sugar-sweetened beverages. Front-of-pack nutrition labels increase perceived risk and deter the consumption of sugar-sweetened beverages. However, past studies of young children have focused almost exclusively on a parent’s choice of beverage for children. This study investigated the influence of four label designs (text-based warning, tooth decay pictorial, teaspoons of sugar, and Health Star Rating) on the beverage choices of N = 1229 Australian children (aged 4–11 years) and their parents. Methods: In an online vending machine scenario, parent–child dyads were separately asked to select which beverage they would choose for themselves before and after being randomised to one label condition. The beverages displayed included 100% fruit juice, soft drink, soft drink with a non-nutritive sweetener, flavoured milk, plain milk and bottled water. Beverage healthiness was determined by a 1–10 rating based on a review by a panel of experts (10 dietitians and nutritionists). Results: Mixed-model ANOVAs showed that for parents, each label design performed comparably; however, for children, small but significant differences were seen in the effectiveness of different label designs, with the teaspoons of sugar label, text-based warning, and tooth decay pictorial found to be more impactful in promoting healthier drink choices than the Health Star Rating. Conclusions: These findings can inform public health advocacy efforts to improve food labelling and could be incorporated into educational resources to help children understand the nutritional profiles of different sugary drinks. Full article
(This article belongs to the Special Issue Diet and Lifestyle Interventions for Child Obesity)
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13 pages, 401 KiB  
Article
Daily Eating Window and Obesity Markers in a Sample of Schoolchildren from Vienna: Insights from the EDDY Study
by Paula Moliterno, Victoria Donhauser and Kurt Widhalm
Nutrients 2025, 17(10), 1661; https://doi.org/10.3390/nu17101661 - 13 May 2025
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Abstract
Background/Objectives: The eating window concept has been understudied in children, with no reports from Austria. This study explored meal timing and its association with obesity-related variables in a sample of Viennese schoolchildren. The effect of a healthy intervention on obesity variables according to [...] Read more.
Background/Objectives: The eating window concept has been understudied in children, with no reports from Austria. This study explored meal timing and its association with obesity-related variables in a sample of Viennese schoolchildren. The effect of a healthy intervention on obesity variables according to the daily eating window was assessed. Methods: The EDDY study included 138 third-grade students from three Vienna schools. Baseline meal timing was assessed using self-administered questionnaires, and the daily eating window—the time between the first and last meal—was calculated and categorized into tertiles. Anthropometric and body fat measurements were taken at baseline and after 21 months. Baseline outcomes were compared between children with long (LEW; 3rd tertile) and short (SEW; 1st tertile) eating windows using adjusted linear regression analysis. Longitudinal changes were analyzed using mixed models for repeated measures. Results: The median age was 7.9 years, and 26.8% were classified with overweight/obesity. The children’s eating window spanned 11:40 h, from 7:00 to 19:00. More than half (52.2%) reported fasting 1–2 h before bed. Children had four daily meals; 16.4% skipped breakfast, while 51.5% ate it regularly. Meal timing variables did not differ by weight status. Children with a LEW (≥12:05 h) had lower BMI-SDS (−0.66) and fat mass index (−1.06) than those with a SEW (≤11:05 h). No longitudinal changes in BMI-SDS, fat mass index, or waist-to-height ratio were observed across eating window tertiles following the intervention. Conclusions: In a non-representative sample of Viennese children, the eating window ranged from 9:30 to 13:30 h, similar to Austrian adults but differing from other Western European countries. Full article
(This article belongs to the Special Issue Diet and Lifestyle Interventions for Child Obesity)
16 pages, 543 KiB  
Article
Associations of Academic Study- and Non-Study-Related Sedentary Behaviors with Incident Obesity in Children and Adolescents
by Tingyu Lu, Meng Li, Ruihang Zhang, Ruiqiang Li, Shaojun Shen, Qiuxia Chen, Rong Liu, Jiao Wang, Yabin Qu and Lin Xu
Nutrients 2025, 17(10), 1633; https://doi.org/10.3390/nu17101633 - 9 May 2025
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Abstract
Objective: To assess the associations between academic study- and non-study-related sedentary behaviors and the risk of overweight/obesity in children and adolescents, as well as their joint association with sugar-sweetened beverage (SSB) consumption. Methods: Sedentary behaviors and SSB consumption were assessed using [...] Read more.
Objective: To assess the associations between academic study- and non-study-related sedentary behaviors and the risk of overweight/obesity in children and adolescents, as well as their joint association with sugar-sweetened beverage (SSB) consumption. Methods: Sedentary behaviors and SSB consumption were assessed using self-reported questionnaires. Overweight/obesity were defined by age- and sex-specific body mass index cut-off values according to the criteria of “Screening for overweight and obesity among school-age children and adolescents” in China. Poisson regression with robust error variance was used to assess the associations of sedentary behaviors and/or SSB consumption with the risk of overweight/obesity, yielding relative risks (RRs) and 95% confidence intervals (CIs). The Shapley additive explanations (SHAP) method was used to rank the contribution of five specific sedentary behaviors to obesity risk. Results: Among 47,148 participants with a 3-year follow-up, longer durations of screen-related, academic study-related, and total sedentary time were each associated with a higher risk of overweight/obesity (adjusted RR (95% CI) per hour increment: 1.01 (1.00–1.02), 1.03 (1.01–1.06), and 1.02 (1.01–1.03)). After mutual adjustment, the associations of engaging in homework, attending tutorial classes, and using mobile electronic devices remained significantly associated with higher overweight/obesity risk. The SHAP summary plot shows that using mobile electronic devices, attending tutorial classes, and doing homework were the three most important sedentary obesogenic contributors. A significant interaction of age with sedentary time was found (p for interaction < 0.05). No significant interaction was found between SSB consumption and sedentary time. Conclusions: Excessive sedentary behaviors were associated with a higher risk of overweight/obesity, particularly due to mobile electronic device use, attending tutorial classes, and doing homework. Full article
(This article belongs to the Special Issue Diet and Lifestyle Interventions for Child Obesity)
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Review

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31 pages, 465 KiB  
Review
The Role of Nutraceuticals and Probiotics in Addition to Lifestyle Intervention in the Management of Childhood Obesity—Part 1: Metabolic Changes
by Maria Elisabeth Street, Federica Casadei, Erika Rita Di Bari, Francesca Ferraboschi, Anna Giuseppina Montani, Anna-Mariia Shulhai and Susanna Esposito
Nutrients 2025, 17(10), 1630; https://doi.org/10.3390/nu17101630 - 9 May 2025
Viewed by 686
Abstract
Childhood obesity is a growing global health issue. Its rising prevalence is linked to genetic, environmental, and lifestyle factors. Obesity in children could lead to different comorbidities and complications with an increased risk of metabolic disorders, such as insulin resistance, dyslipidemia, type 2 [...] Read more.
Childhood obesity is a growing global health issue. Its rising prevalence is linked to genetic, environmental, and lifestyle factors. Obesity in children could lead to different comorbidities and complications with an increased risk of metabolic disorders, such as insulin resistance, dyslipidemia, type 2 diabetes mellitus (T2DM), and metabolic dysfunction-associated steatotic liver disease (MASLD). First-line treatment involves dietary modifications and lifestyle changes; however, adherence is often poor and remains a significant challenge. Pharmacotherapy, while a potential option, has limitations in availability and can cause side effects, leading to growing interest in alternative treatments, such as nutraceutical compounds. Derived from natural sources, these compounds have different anti-inflammatory, antiallergic, antioxidant, antibacterial, antifungal, neuroprotective, antiaging, antitumor, insulin-sensitizing, glucose, and lipid-lowering effects. This review describes commonly used nutraceutical compounds, such as omega-3 fatty acids, vitamin D, polyphenols (such as resveratrol and curcumin), berberine, white mulberry leaves and others, and pre- and probiotics in the management of obesity, evaluating the evidence on their mechanisms of action and efficacy in metabolic comorbidities. The evidence suggests that the integration of nutraceuticals into the diet may positively influence body mass index, glucose metabolism, lipid profiles, and gut microbiota composition and reduce inflammation in obese individuals. These effects may provide future practical guidance for clinical practice, contribute to metabolic health improvement, and potentially prevent obesity-related complications. In this first part, we discuss the effects of nutraceutical compounds on insulin sensitivity and insulin resistance, T2DM, dyslipidemia, and MASLD in addition to diet and lifestyle interventions. Full article
(This article belongs to the Special Issue Diet and Lifestyle Interventions for Child Obesity)
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19 pages, 317 KiB  
Review
The Role of Nutraceuticals and Probiotics in Addition to Lifestyle Intervention in the Management of Childhood Obesity—Part 2: Comorbidities
by Maria Elisabeth Street, Federica Casadei, Erika Rita Di Bari, Francesca Ferraboschi, Anna Giuseppina Montani, Maria Concetta Mele, Anna-Mariia Shulhai and Susanna Esposito
Nutrients 2025, 17(9), 1487; https://doi.org/10.3390/nu17091487 - 28 Apr 2025
Viewed by 753
Abstract
Pediatric obesity is associated with a wide range of comorbidities beyond metabolic changes, affecting cardiovascular, endocrine, reproductive, musculoskeletal systems, and also mental health. Hypertension, commonly observed in children with obesity, increases the risk of long-term cardiovascular disease. Polycystic ovary syndrome (PCOS) presents another [...] Read more.
Pediatric obesity is associated with a wide range of comorbidities beyond metabolic changes, affecting cardiovascular, endocrine, reproductive, musculoskeletal systems, and also mental health. Hypertension, commonly observed in children with obesity, increases the risk of long-term cardiovascular disease. Polycystic ovary syndrome (PCOS) presents another significant endo-reproductive challenge that often develops during adolescence in females, leading to further comorbidities in adulthood. Additionally, excess adiposity can negatively impact bone health by modifying bone metabolism and increasing fracture risk. Obesity is also strongly linked to mental health disorders, including depression, anxiety, and low self-esteem, which can further exacerbate unhealthy lifestyle behaviors and disorders. Given the limitations and poor adherence of traditional treatment strategies, nutraceuticals have emerged as potential complementary therapies due to their bioactive properties. Various compounds have demonstrated antihypertensive, insulin-sensitizing, and anti-inflammatory effects, while others support bone metabolism and promote mental well-being. Herewith, we discuss the role of nutraceuticals in managing hypertension, PCOS, bone health, and mental health issues in individuals with obesity, evaluating their mechanisms of action and clinical relevance. Integrating nutraceutical compounds with dietary and lifestyle interventions may improve treatment outcomes and prevent obesity-related comorbidities. Further, we emphasize the need for further large-scale clinical studies, especially in pediatric patients. Full article
(This article belongs to the Special Issue Diet and Lifestyle Interventions for Child Obesity)
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