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Dietary Patterns and Lifestyle Promoting Healthy Weight Strategies in Children and Adolescents

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

Deadline for manuscript submissions: closed (27 October 2023) | Viewed by 21083

Special Issue Editor

Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
Interests: childhood obesity; maternal and infant nutrition; dietary pattern; lifestyle factors; birth cohort
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Obesity in children and adolescents continues to pose a serious threat to public health worldwide, and the COVID-19 pandemic has especially exacerbated this problem. Childhood obesity affects children's health and persists into adulthood, significantly increasing the risk of contracting chronic diseases, such as diabetes, hypertension, and coronary heart disease in adulthood. The World Health Organization has recommended comprehensive interventions to combat childhood obesity. Healthy lifestyles, including balanced dietary patterns, adequate physical activity and sleep, play an important role in obesity prevention. However, studies showed that the lifestyles of children and adolescents are far from optimal. Previous childhood obesity prevention that largely focused on schools and findings was inconsistent. More research is needed to implement healthy weight strategies in other settings, especially at home.

The goal of this Special Issue is to present the latest population-based evidence on dietary patterns and lifestyles, promoting healthy weight strategies in children and adolescents. We are particularly interested in studies conducted in family settings, as well as multiple other settings. Original research and review articles are equally welcome.

Dr. Li Cai
Guest Editor

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Keywords

  • dietary pattern
  • physical activity
  • sedentary behavior
  • sleep
  • lifestyles
  • childhood obesity
  • weight management
  • prevention

Published Papers (10 papers)

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Research

12 pages, 317 KiB  
Article
Association between Physical Activity, Diet Quality and Leisure Activities of Young Poles
by Marta Sajdakowska, Krystyna Gutkowska, Małgorzata Kosicka-Gębska, Jerzy Gębski and Andrzej Gantner
Nutrients 2023, 15(24), 5121; https://doi.org/10.3390/nu15245121 - 16 Dec 2023
Viewed by 1159
Abstract
The aim of this study was to determine the association between eating behaviours, sedentary behaviours and physical activity based on a self-reported survey conducted on a sample of the Polish population of adolescents aged 13–16. The field survey was conducted on a nationwide [...] Read more.
The aim of this study was to determine the association between eating behaviours, sedentary behaviours and physical activity based on a self-reported survey conducted on a sample of the Polish population of adolescents aged 13–16. The field survey was conducted on a nationwide group of 6818 respondents. The object of the statistical analysis was to develop a model regarding the influence of selected socio-demographic characteristics on engaging in physical activity and selected dietary behaviours. Due to the dichotomous nature of the dependent variable, logistic regression models were used in the model. It was found that the higher the level of physical activity, the more well-balanced the diet, including higher levels of fruit consumption, water consumption and protein-containing products, as well as the relatively less frequent occurrence of sedentary behaviour as a form of leisure activity. However, there is a constant need to develop, in cooperation with scientific and research institutions and educational establishments, mechanisms for influencing a change in the behaviour of young people towards a more pro-healthy lifestyle so that the effects of these educational activities are not only reflected in an increase in the level of knowledge in this area but also contribute to real changes in dietary behaviour. Full article
15 pages, 540 KiB  
Article
Influence of Food Habits and Participation in a National Extracurricular Athletics Program on Body Weight within a Pair-Matched Sample of Polish Adolescents after One Year of Intervention—#goathletics Study
by Dominika Głąbska, Dominika Guzek, Dominika Skolmowska, Jakub Grzegorz Adamczyk, Hanna Nałęcz, Blanka Mellová, Katarzyna Żywczyk, Joanna Baj-Korpak and Krystyna Gutkowska
Nutrients 2023, 15(24), 5106; https://doi.org/10.3390/nu15245106 - 14 Dec 2023
Cited by 1 | Viewed by 969
Abstract
The COVID-19 pandemic reduced the physical activity level and commitment in adolescents, which has resulted in a body weight increase, and the World Health Organization (WHO) emphasizes that this negative trend must be now counteracted. The aim of this study was to assess [...] Read more.
The COVID-19 pandemic reduced the physical activity level and commitment in adolescents, which has resulted in a body weight increase, and the World Health Organization (WHO) emphasizes that this negative trend must be now counteracted. The aim of this study was to assess the influence of food habits and participation in a national extracurricular athletics program (Athletics for All) on body weight within a pair-matched sample of Polish adolescents after one year of intervention. The #goathletics Study was conducted in a population of Polish adolescents within two pair-matched groups: 506 adolescents aged 10–14, including 281 female and 225 male adolescents, regularly participating in Athletics for All program for at least 9 months (one school year) (intervention group), and a pair-matched control group (matched taking into account city, gender, and age). The #goathletics Study included the assessment of the body weight, which was conducted based on the growth reference charts for Body Mass Index (BMI), and waist circumference to verify central fatness. Athletics for All participation and food habits were verified as determinants of body weight, while food habits were assessed using the validated Adolescents’ Food Habits Checklist (AFHC). While compared the intervention group and control group, statistically significant differences were observed for body weight, BMI, and waist circumference, both for crude and relative values, with adolescents participating in the Athletics for All program presenting a lower risk of excessive body weight and central fatness (p < 0.05), while, compared to sub-groups stratified by AFHC score, no statistically significant differences in general anthropometric characteristics were observed (p > 0.05). While the body weight centile, height centile, BMI centile and waist-to-height ratio (WHtR) were assessed as the resultant variables, it was revealed that participation in the Athletics for All program is the only influencing factor in multi-factor analysis of variance (ANOVA) for body weight centile (F = 21.44; p < 0.0001) and BMI centile (F = 47.98; p < 0.0001), but for height centile and WHtR, none of the assessed factors influenced these variables. It was concluded that regularly participating in the Athletics for All program for at least 9 months was the only determinant of a lower risk of excessive body weight in adolescents, with declared food habits and gender not being significant. Full article
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30 pages, 3293 KiB  
Article
The “Planning Health in School” Programme (PHS-pro) to Improve Healthy Eating and Physical Activity: Design, Methodology, and Process Evaluation
by Margarida Vieira and Graça S. Carvalho
Nutrients 2023, 15(21), 4543; https://doi.org/10.3390/nu15214543 - 26 Oct 2023
Viewed by 1768
Abstract
Few interventions have successfully promoted healthy eating and active living among children with effective changes in anthropometric health outcomes. Well-designed interventions involving multiple strategies to convert the knowledge already available into action are needed for preventing childhood obesity. In this study, an educational [...] Read more.
Few interventions have successfully promoted healthy eating and active living among children with effective changes in anthropometric health outcomes. Well-designed interventions involving multiple strategies to convert the knowledge already available into action are needed for preventing childhood obesity. In this study, an educational programme called “Planning Health in School” (PHS-pro) was designed, implemented and evaluated to contribute to the prevention of obesity in childhood. The PHS-pro aimed at improving the eating behaviours and lifestyles of Portuguese grade-6 children towards healthier nutritional status. This paper describes and evaluates the PHS-pro concerning: (i) the research design within the theoretical framework grounded on “The Transtheoretical Model” and the stages of change; (ii) the educational components and the application of the participatory methodology to engage children to meet their needs, as active participants in their change process; and (iii) the process evaluation of the intervention. The implementation of the PHS-pro took into account the views and inputs of the participants for evaluating the educational components that should be considered in the designing of interventions aiming to be effective strategies. From the health promotion perspective, this study is important because it examines new approaches and pathways to effectively prevent overweight and obesity in children. Full article
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14 pages, 360 KiB  
Article
Pediatric Overweight, Fatness and Risk for Dyslipidemia Are Related to Diet: A Cross-Sectional Study in 9-year-old Children
by Paulo Mascarenhas, José M. Furtado, Sílvia M. Almeida, Maria E. Ferraz, Fernando P. Ferraz and Pedro Oliveira
Nutrients 2023, 15(2), 329; https://doi.org/10.3390/nu15020329 - 9 Jan 2023
Cited by 6 | Viewed by 2154
Abstract
Pediatric overweight, dyslipidemia and insulin resistance can result from unhealthy lifestyle habits and increase morbidity and mortality in adulthood. Herein, we evaluated the relationship between diet and physical activity patterns with the metabolic health of 9-year-old school children. Measurements included anthropometry, adiposity, lipid, [...] Read more.
Pediatric overweight, dyslipidemia and insulin resistance can result from unhealthy lifestyle habits and increase morbidity and mortality in adulthood. Herein, we evaluated the relationship between diet and physical activity patterns with the metabolic health of 9-year-old school children. Measurements included anthropometry, adiposity, lipid, and glycemic profiles. Questionnaires evaluated diet and physical activity. Exploratory factor analysis (EFA) screened for diet patterns, and multilevel models evaluated diet and physical activity patterns against overweight, dyslipidemia, and insulin resistance markers across schools and children. EFA highlighted two diet patterns, Western and Traditional. Food rich in fat, salt, and sugar and fewer vegetables and fruits defined the Western pattern. The Traditional pattern, linked to healthier eating habits, had analogies to the Mediterranean diet. Overall, 39% of the children were overweight (including the obese), while 62% presented cardiovascular risk factors on their lipid profiles. Normal-weight children presented 60% high cholesterol incidence. Global insulin resistance incidence was 4.1%, but almost doubled among the overweight/obese. The Westernized diet consistently linked to worse cardiovascular risk markers, even independently of physical practice. Intensive or competitive physical activity was associated with decreased triglycerides (p = 0.003), regardless of diet. Future prospective studies are warranted to validate these results externally. Full article
11 pages, 618 KiB  
Article
Predictors of Effectiveness and Adherence in a Multimodal Obesity Treatment Program for Children and Adolescents in Routine Care
by Julius Lars Breinker, Anika Kaspar, Elena Sergeyev, Antje Körner, Wieland Kiess and Anja Hilbert
Nutrients 2023, 15(1), 136; https://doi.org/10.3390/nu15010136 - 28 Dec 2022
Viewed by 2365
Abstract
Multimodal obesity treatments for children and adolescents generally showed only small to modest treatment effects and high dropout rates. Potential variations by patients’ clinical and sociodemographic factors remain, however, largely unclear. For this reason, our study analyzed psychological, physical, and sociodemographic predictors of [...] Read more.
Multimodal obesity treatments for children and adolescents generally showed only small to modest treatment effects and high dropout rates. Potential variations by patients’ clinical and sociodemographic factors remain, however, largely unclear. For this reason, our study analyzed psychological, physical, and sociodemographic predictors of treatment success and adherence in a multimodal obesity treatment over 12 months. The intent-to-treat sample included n = 361 children and adolescents (ages 3–17 years), of which n = 214 or 59.28% of patients completed treatment. A younger age and, in the sensitivity analysis, additionally a greater eating disorder psychopathology and treatment initiation before COVID-19 pandemic predicted greater BMI-SDS reductions (Body Mass Index-Standard Deviation Score). In contrast, predictors of treatment adherence were not found. The results underline the importance of early treatment of juvenile obesity. Additionally, eating disorder psychopathology includes restrained eating, which implies the ability to self-regulate eating behavior and therefore may have a positive effect on the treatment goal of controlled food intake. Challenges from altered treatment procedures due to the COVID-19 pandemic nonetheless remain. Full article
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15 pages, 512 KiB  
Article
Household Food Insecurity, Anemia, Malnutrition and Unfavorable Dietary Diversity among Adolescents: Quadruple Whammies in the Era of Escalating Crises in Lebanon
by Maha Hoteit, Hala Mohsen, Nour Yazbeck, Sarah Diab, Jessica Sarkis, Yonna Sacre, Lara Hanna-Wakim and Khlood Bookari
Nutrients 2022, 14(24), 5290; https://doi.org/10.3390/nu14245290 - 12 Dec 2022
Cited by 2 | Viewed by 2917
Abstract
Adolescence is a transitional period between childhood and adulthood. Nowadays, adolescents in Lebanon are growing during a time of unprecedented health crises and political instability. This study aimed to determine the prevalence and correlates of malnutrition, dietary diversity in adolescents’ households, and adolescents’ [...] Read more.
Adolescence is a transitional period between childhood and adulthood. Nowadays, adolescents in Lebanon are growing during a time of unprecedented health crises and political instability. This study aimed to determine the prevalence and correlates of malnutrition, dietary diversity in adolescents’ households, and adolescents’ self-reported food insecurity in Lebanon. A national representative sample of 450 parent–adolescent dyads (parents: mean age ± standard deviation (SD) = 46.0 ± 7.0, mothers: 59.0%; adolescents: mean age ± SD = 15.0 ± 3.0, girls: 54.6%) were interviewed. Anthropometric and blood hemoglobin measurements were performed for adolescents. The Food Consumption Score, the Arab Family Food Security Scale and the Adolescent-Level Food-Security Scale were used. The overall prevalence of adolescent stunting, thinness, overweight, obesity and anemia was 6.7%, 4.7%, 19.3%, 12.9% and 16.7%, respectively. Almost 40.4% and 68% of adolescent’s households consumed undiversified diets and were food insecure, respectively. Food insecurity (FI) affected 54.0% of adolescents. Adolescents attending schools (vs. university) were eight times more likely to be stunted (p = 0.04). Boys had a 4.3 times higher thinness risk (p = 0.005) compared to girls. Households reporting an income decline since the start of the Lebanese economic crisis were three times more likely to have a thin adolescent (p = 0.01). Parental overweight/obesity (p = 0.002) and lower education level (p = 0.04) nearly doubled the risk of adolescent overweight or obesity. At a time when escalating crises in Lebanon are shifting diets for the youngest generations, the development of adolescent-responsive nutritional policies becomes a must. Full article
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17 pages, 337 KiB  
Article
The Role of Dietary Patterns and Dietary Quality on Body Composition of Adolescents in Chinese College
by Hongrui Li, Dajun Li, Xianyun Wang, Huini Ding, Qinghua Wu, Haojun Li, Xuan Wang, Kaifeng Li, Rong Xiao, Kang Yu and Yuandi Xi
Nutrients 2022, 14(21), 4544; https://doi.org/10.3390/nu14214544 - 28 Oct 2022
Cited by 3 | Viewed by 2075
Abstract
There is limited evidence regarding the effects of dietary pattern and dietary quality on the risk of unhealthy weight status and related body composition in Chinese adolescence. In particular, studies using bioelectrical impedance analyzer (BIA) in these subjects are rare. The aim of [...] Read more.
There is limited evidence regarding the effects of dietary pattern and dietary quality on the risk of unhealthy weight status and related body composition in Chinese adolescence. In particular, studies using bioelectrical impedance analyzer (BIA) in these subjects are rare. The aim of this study was to evaluate the role of diet in body composition, to find a healthy dietary pattern for Chinese youth, and to promote the application of BIA among this population. A total of 498 participants aged from 18 to 22 years old were included. Dietary patterns were identified by principal components analysis. Energy-adjusted dietary inflammatory index (DII) and diet balance index (DBI) were calculated based on semi-quantitative food frequency questionnaire. Multivariate linear regression and logistic regression analysis were used to examine the relationship of dietary patterns, dietary quality with body mass index (BMI), fat mass index (FMI), fat-free mass index (FFMI), and the effect of dietary factors on BMI levels. The majority of participants with overweight and obesity had abdominal obesity, and there was 3.7% abdominal obesity in normal BMI individuals. Four dietary patterns were detected in the subjects. The pattern with the higher energy intake, which was close to the Western diet, was positively correlated with BMI (β = 0.326, p = 0.018) and FMI (β = 0.201, p = 0.043), while being negatively correlated with FFMI (β = −0.183, p = 0.021). Individuals who followed the pattern similar to the Mediterranean diet had a higher basal metabolic rate (BMR), and the highest fat free mass, soft lean mass, and skeletal muscle mass (p < 0.05) but the lowest FMI, visceral fat area (VFA), waist–hip ratio, and FMI/FFMI ratio (p < 0.05). Higher energy-adjusted DII was associated with high BMI. Higher bound score (HBS) (β = −0.018, p = 0.010) and diet quality distance (DQD) (β = −0.012, p = 0.015) were both negatively correlated with FFMI. In conclusion, fat or muscle indexes, such as BMR, FMI, and FFMI, had an important role in predicting overweight and obesity, which suggested the importance of applying BIA among Chinese college students. Students who followed healthful dietary patterns or the high-quality diet that is similar to the Mediterranean diet but not close to the Western diet were more likely to have a healthy BMI and normal body composition. Full article
10 pages, 591 KiB  
Article
Does a Healthy Lifestyle Lower the Elevated Risk of Obesity Caused by Caesarian Section Delivery in Children and Adolescents?
by Rong Lian, Zheng-He Wang, Zhi-Yong Zou, Yan-Hui Dong, Yi-De Yang and Jun Ma
Nutrients 2022, 14(17), 3528; https://doi.org/10.3390/nu14173528 - 26 Aug 2022
Cited by 1 | Viewed by 1727
Abstract
Background: Both caesarean section (CS) and lifestyle were linked with child adiposity. This study aimed to investigate whether CS delivery is linked with elevated risk of child adiposity regardless of a healthy lifestyle. Methods: All the subjects in this study came from a [...] Read more.
Background: Both caesarean section (CS) and lifestyle were linked with child adiposity. This study aimed to investigate whether CS delivery is linked with elevated risk of child adiposity regardless of a healthy lifestyle. Methods: All the subjects in this study came from a baseline survey of a national school-based program on healthy lifestyle interventions against adiposity among Chinese children and adolescents. A questionnaire was used to collect the information on delivery mode and lifestyle. According to the weighted lifestyle score, subjects were categorized into healthy, intermediate, and unhealthy lifestyle. Results: A total of 44,961 children aged 6–18 years were enrolled in the current study. Overall, 41.9% (18,855/44,961) of children were delivered by CS. Compared with children delivered by vaginal delivery, children delivered by CS had a higher adiposity risk (OR = 1.56; 95%CI: 1.46–1.66; p < 0.001) after adjustment for age, sex, region, mother adiposity, ethnicity, and weighted lifestyle factors. Compared with children with a healthy lifestyle, children with an unhealthy lifestyle had a higher risk of child adiposity (OR = 1.31; 95%CI: 1.19–1.44). Children delivered by CS who had an unhealthy lifestyle had a 106% higher (OR = 2.06; 95%CI: 1.79–2.37) risk of child adiposity compared with children delivered by vaginal delivery who had a healthy lifestyle. However, keeping a healthy lifestyle in later life seems not to offset the increased risk of child adiposity caused by CS (OR = 1.59; 95%CI: 1.39–1.82). Conclusions: Both CS and unhealthy lifestyle were linked with child adiposity risk. Keeping a healthy lifestyle did not counteract the elevated risk of child adiposity caused by CS. Full article
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21 pages, 1754 KiB  
Article
Meeting 24-Hour Movement and Dietary Guidelines: Prevalence, Correlates and Association with Weight Status among Children and Adolescents: A National Cross-Sectional Study in China
by Yide Yang, Shuqian Yuan, Qiao Liu, Feifei Li, Yanhui Dong, Bin Dong, Zhiyong Zou, Jun Ma, Julien S. Baker, Xianxiong Li and Wei Liang
Nutrients 2022, 14(14), 2822; https://doi.org/10.3390/nu14142822 - 8 Jul 2022
Cited by 8 | Viewed by 2806
Abstract
China is confronted with a “double burden” of underweight and overweight/obesity in children and adolescents. This study aimed to investigate the prevalence and correlates of meeting 24 h movement and dietary guidelines among Chinese children and adolescents. Further, the study aimed to examine [...] Read more.
China is confronted with a “double burden” of underweight and overweight/obesity in children and adolescents. This study aimed to investigate the prevalence and correlates of meeting 24 h movement and dietary guidelines among Chinese children and adolescents. Further, the study aimed to examine the association of meeting 24 h movement and dietary guidelines with weight status in Chinese children and adolescents. A total of 34,887 Chinese children and adolescents were involved. Only 2.1% of participants met the 24 h movement guidelines. Compared to those who met all three 24 h movement guidelines, those who only met the sleep duration guideline was significantly associated with a higher risk of underweight (p < 0.05), and those who only met the moderate-to-vigorous physical activity, or screen time guidelines were significantly associated with a higher risk of overweight/obesity (p < 0.05). Compared with those meeting the dietary guidelines, those who did not meet the soft drink intake guideline had a significantly lower risk of underweight (p < 0.05), those who did not meet the fruit intake guideline had a significantly lower risk of overweight/obesity (p < 0.05), and those who did not meet the milk intake guideline showed a significantly higher risk of overweight/obesity (p < 0.001). These findings indicate a significant association between meeting the 24 h movement and dietary guidelines and weight status among Chinese children and adolescents. Full article
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13 pages, 2056 KiB  
Article
A 3-Year Longitudinal Study of Effects of Parental Feeding Practices on Child Weight Status: The Childhood Obesity Study in China Mega-Cities
by Lu Ma, Na Yan, Zumin Shi, Yixin Ding, Siran He, Zhengqi Tan, Bo Xue, Yating Yan, Cai Zhao and Youfa Wang
Nutrients 2022, 14(14), 2797; https://doi.org/10.3390/nu14142797 - 7 Jul 2022
Cited by 3 | Viewed by 1907
Abstract
This study examined the longitudinal associations between parental feeding practices and child weight status, and their potential modification effects by child sex, age, and maternal and paternal educations among children. Data were collected from 2015 to 2017 of 2139 children aged 6–17 years [...] Read more.
This study examined the longitudinal associations between parental feeding practices and child weight status, and their potential modification effects by child sex, age, and maternal and paternal educations among children. Data were collected from 2015 to 2017 of 2139 children aged 6–17 years and their parents in five Chinese mega-cities. Parental feeding practices were assessed using 11-items from Child Feeding Questionnaire. Waist-to-height ratio (WHtR), body mass index (BMI), and general and central obesity were measured and analyzed using a mixed-effects model. Three parental feeding patterns were identified by factor analysis including “concern”, “pressure to eat”, and “control”. Concern was associated with higher BMI z-score, WHtR (βs ranged from 0.01 to 0.16), and general obesity (ORs ranged from 1.29 to 6.41) among children aged ≤12 years and >12 years, regardless of child sex and parental educations. Pressure to eat was associated with lower BMI z-score (β = −0.08, p < 0.001), WHtR (β = −0.004, p < 0.01), and general (OR = 0.53, 95%CI = 0.42, 0.66) and central obesity (OR = 0.72, 95%CI = 0.58, 0.90) among children aged ≤12 years. Further analyses showed that significant associations were found for children with maternal or paternal education of college and above. Control was associated with increased risk of general and central obesity among children with maternal education of college and above, regardless of age. Our study indicates that higher concern and lower pressure to eat were associated with increased risk of obesity among children. Control was associated with increased risk of obesity among children with maternal education of college and above. Future childhood obesity preventions may optimize parental feeding practices. Full article
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