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Effects of Nutrition and Physical Activity Lifestyle Interventions on Childhood 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 (5 February 2025) | Viewed by 17531

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Prof. Dr. Ahmad Alkhatib

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College of Life Sciences, Birmingham City University, Edgbaston, Birmingham B15 3TN, UK
Interests: diets or nutritional supplements across the lifespan; lifestyle interventions, especially to prevent diabetes and cardiovascular disease; obesity prevention strategies in children and adolescents; cellular physiological mechanisms determining adaptations to exercise training or nutritional supplementation
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Dear Colleagues,

Childhood obesity continues to increase globally in both developed and developing countries, leading to debilitating chronic diseases. Chilldhood obesity has quadrupled in the last four decades, and obesity complications and comorbidities are no longer adult diseases, but are becoming highly prevalent among children and adolescents, especially diabetes, hypertension, fatty liver and cardiorespiratory diseases. Interventions at all levels are needed, especially lifestyle-related interventions.

This Special Issue aims to bring research on lifestyle obesity interventions to the forefront. Nutritional eating behaviour and physical activity are the two modifiable factors towards a disease-free life. Interventions aimed at modifying diets, nutritional supplementation, alone or with modifying physical activity or exercise, are a contemporary scientific issue across the lifespan from childhood to older age. Therefore, we welcome submissions in any of these areas, including understanding obesity determinants in early years and intervention physical activity/exercise approaches.

Childhood obesity-preventative interventionsions the home, school, healthcare and community settings can be effective. Evidence suggests that interventions must target the appropriate developmental stage and ideally include multiple components (e.g, nutrition and physical activity) and settings or levels (e.g., family, school, policy, neighbourhood environment). Obesity interventions help ameliorate physiological-based risks of obesity, including metabolic, hormonal and immunological adversities.

All study types (clinical and randomised trials, physiological, behavioural and psycho-social) and designs (interventions, epidemiology, cross-sectional, modelling) are welcome.

Prof. Dr. Ahmad Alkhatib
Guest Editor

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Keywords

obesity
weight loss
nutrition
supplement
diet
children and adolescents
health behavior
lifestyle
school
intervention
diabetes
cardiovascular
metabolic
disease
chronic disease

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Published Papers (9 papers)

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Research

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18 pages, 281 KiB

Open AccessArticle

Integrating Physical Activity into a Nutrition and Exercise Science Middle School Curriculum: The THINK Program

by Arlette Perry, Joseph Bonner, Sophia Williams, Wei Xiong, Alejandro Garcia, Carolina Velasquez, Alexis Friedman, Debbiesiu L. Lee, Ingrid de Lima Hernandes, Ji Shen, Marisol Meyer and Lucia Fernandez

Nutrients 2025, 17(9), 1538; https://doi.org/10.3390/nu17091538 - 30 Apr 2025

Viewed by 354

Abstract

Background/Objectives: Recent interest has emerged in novel initiatives that focus on the “whole child” to improve the health and well-being in youth. The purpose of this study was to determine whether a translational health in nutrition and kinesiology (THINK) program addressing physical, psychological, and educational well-being could improve personal health and lifestyle behaviors in youth. Methods: A total of 81 adolescents (44 males, 37 females, 12.50 + 0.62 years) were evaluated at the beginning and end of the spring semester across three different years: 2019, 2021, and 2023. The physical literacy measures included the Physical Activity Enjoyment Scale (PAES) and the Physical Activity Perception Scale (PAPS), along with knowledge-based tests in nutrition and exercise science. Social emotional learning (SEL), STEM education, and nutrition habits were evaluated using standard surveys and questionnaires. The physical evaluations included measures of body composition and physical fitness. Results: At the completion of the spring semester of each year, evaluations were compiled for all three years, with decreases found for % body fat (p < 0.001) and increases found for lean body mass (p < 0.001). The physical fitness components, including muscular strength (p < 0.001), cardiorespiratory fitness (p < 0.001), power (p < 0.001), and flexibility (p < 0.01), all improved. The physical literacy components, including the PACES (p < 0.001), PAPS (p < 0.001), exercise (p < 0.05), and nutrition science knowledge (p < 0.05) results, also improved. There were no significant changes in any other variables. Conclusions: A novel in-school academic curriculum integrating the physical, psychological, and educational well-being of the whole child could lead to improved body composition, physical fitness, and physical literacy. Full article

(This article belongs to the Special Issue Effects of Nutrition and Physical Activity Lifestyle Interventions on Childhood Obesity)

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19 pages, 981 KiB

Open AccessArticle

Diabetes Therapeutics of Prebiotic Soluble Dietary Fibre and Antioxidant Anthocyanin Supplement in Patients with Type 2 Diabetes: Randomised Placebo-Controlled Clinical Trial

by Chompoonut Teparak, Juntanee Uriyapongson, Jatuporn Phoemsapthawee, Orathai Tunkamnerdthai, Ploypailin Aneknan, Terdthai Tong-un, Charnchai Panthongviriyakul, Naruemon Leelayuwat and Ahmad Alkhatib

Nutrients 2025, 17(7), 1098; https://doi.org/10.3390/nu17071098 - 21 Mar 2025

Cited by 1 | Viewed by 955

Abstract

Background: Antioxidants and prebiotics are popular functional foods known for their distinct physiological ameliorating benefits on type 2 diabetes mellitus (T2DM). Whether and how a combined antioxidant-prebiotic supplement affects primary and secondary T2DM outcomes is not known. Objectives: We investigated the therapeutic effects of an antioxidant (anthocyanin from riceberry rice) combined with prebiotics (dietary fibre from rice bran and Jerusalem artichoke) on glucose control, lipid profile, oxidative stress, inflammation, and cardiorespiratory fitness in T2DM patients. Methods: A total of 60 T2DM patients were randomly assigned to receive antioxidant/prebiotic (supplement group, SG) or maltodextrin (control group, CG), (two capsules (350 mg)/meal after three meals and before bedtime, 2.8 g/day), for 60 days. Venous blood samples were collected at baseline and after 60 days intervention to assess blood metabolic variables (glucose, insulin, and lipid profiles, renal and liver functions, oxidative stress, inflammation). Nutrition status, anthropometry, body composition (DEXA) and cardiorespiratory fitness were also measured. Results: Analysis of co-variance showed superior effects on T2DM’s glucose and lipid profiles in the SG compared with the CG including reduced fasting blood glucose (p = 0.01 within-group effects, p = 0.03 interaction effects), reduced glycated haemoglobin (p = 0.004 within-group effects, p = 0.002 interaction), and reduced low density lipoprotein (p = 0.006 within-group effects, p = 0.02 interaction effects). No significant change was found within the CG for any of these parameters. Kidney function’s glomerular filtration rate was also improved in the SG (p = 0.01 within-group effects), but not in the placebo CG. Intermediatory biomarkers of oxidative stress, inflammation, and cardiorespiratory fitness were not significantly affected in either group with no interaction effects. No adverse effects were detected following the 60-day supplementation intervention. Conclusions: The findings suggest that a combined anthocyanin-fibre may be promoted as an adjacent therapy in patients with T2DM, but the intermediary mechanisms of action require further research. Full article

(This article belongs to the Special Issue Effects of Nutrition and Physical Activity Lifestyle Interventions on Childhood Obesity)

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21 pages, 314 KiB

Open AccessArticle

Analysis of Nutrition Knowledge After One Year of Intervention in a National Extracurricular Athletics Program: A Cross-Sectional Study with Pair-Matched Controls of Polish Adolescents

by Dominika Skolmowska, Dominika Głąbska, Dominika Guzek, Jakub Grzegorz Adamczyk, Hanna Nałęcz, Blanka Mellová, Katarzyna Żywczyk and Krystyna Gutkowska

Nutrients 2025, 17(1), 64; https://doi.org/10.3390/nu17010064 - 27 Dec 2024

Viewed by 1203

Abstract

Background: Nutrition knowledge may be translated into adequate dietary intake and proper eating habits, so adolescent education programs focusing on improving eating habits and nutrition knowledge are needed. The aim of the cross-sectional study with pair-matched controls was to assess the Consumer Nutrition Knowledge Scale (CoNKS) results and its determinants after one year of intervention in a national extracurricular athletics program within a pair-matched sample of Polish adolescents. Methods: The #goathletics Study evaluated a Polish national extracurricular athletics program, ‘Athletics for all’, being a voluntary and free-of-charge physical activity program organized by the Polish Athletics Association. The study allowed comparing the intervention group of adolescents aged 10–14 years, participating in the program for at least 9 months (a school year) and a pair-matched group not participating in it, while the matching was based on city, gender, and age (each group: n = 506 adolescents, n = 281 females and n = 225 males). The nutrition knowledge was assessed using a Consumer Nutrition Knowledge Scale (CoNKS), and during the analysis, the following factors were taken into account: body weight, height, Body Mass Index (BMI), waist circumference, and waist-to-height ratio (WHtR). Results: The ‘Athletics for all’ program participation influenced not only the total CoNKS score (p < 0.0001) but also the scores in all studied areas—within procedural nutrition knowledge (p = 0.0002), declarative nutrition knowledge on nutrients (p = 0.0001), and declarative nutrition knowledge on calories (p < 0.0001), and program participants revealed a stronger understanding of all the studied areas compared to non-participating individuals. Gender, BMI, and central obesity tendency were not associated with the total CoNKS score (p > 0.05), or any of the studied areas (p > 0.05). The statistically significant differences in the number of correct answers were observed for four items within procedural nutrition knowledge, for four items within declarative nutrition knowledge on nutrients, and for four items within declarative nutrition knowledge on calories (p < 0.05), while for all of them, ‘Athletics for all’ program participants revealed a stronger understanding. Conclusions: One year of intervention in a national extracurricular athletics program significantly influenced the nutrition knowledge of the studied group of adolescents aged 10–14 years. While compared with the pair-matched control group of Polish adolescents, they were characterized by a stronger understanding of all areas of nutrition knowledge. Full article

(This article belongs to the Special Issue Effects of Nutrition and Physical Activity Lifestyle Interventions on Childhood Obesity)

16 pages, 322 KiB

Open AccessArticle

Correlates of Overweight and Obesity in German Primary School Children

by Anna Reißner, Olivia Wartha, Jens Dreyhaupt and Susanne Kobel

Nutrients 2024, 16(23), 3987; https://doi.org/10.3390/nu16233987 - 21 Nov 2024

Viewed by 1570

Abstract

Background/Objectives: Childhood obesity is a consistent public health issue, which often persists into adulthood. This study determined risk factors of childhood obesity and associated comorbidities in German school children. Methods: Data of 1956 primary school children (7.1 ± 0.6 years) were analysed. Anthropometrics were taken on site, other (health) parameters were assessed using a parental questionnaire. Binary logistic regression models were calculated, controlling for age, gender, family education level, and migration background. Results: Father’s physical illness (OR 1.092 [1.177; 3.073], p = 0.009) and a child’s chronic illness (OR 1.687 [1.077; 2.644], p = 0.022), maternal and paternal overweight (OR 2.180 [1.492; 3.185]; OR 2.494 [1.547; 4.022], p < 0.001, respectively), as well as maternal and paternal smoking (OR 1.942 [1.306; 2.889]; OR 1.972 [1.334; 2.917], p = 0.001, respectively) were significantly associated with the child being overweight. Also associated with the child being overweight were physical activity, regular screen media use (OR 0.605 [0.408, 0.896], p = 0.012; OR 2.029 [1.306; 3.152], p = 0.002, respectively), the mother and/or father thinking their child is too fat (OR 2.213 [1.504; 3.258], p < 0.001; OR 1.537 [1.048; 2.253], p = 0.028), the father’s physical inactivity (OR 1.69 [1.133; 2.521], p = 0.010), and if the child has not been breastfed (OR 1.632 [1.056; 2.521], p = 0.027), the mother smoked during pregnancy (OR 1.992 [1.224; 3.246], p = 0.006) as well as if the mother and/or father admonished their child about their weight (OR 25.521 [14.578; 44.680]; OR 19.448 [11.865; 31.877], p < 0.001, respectively). Children of unemployed mothers and in low-income households had an increased risk of being overweight (OR 4.811 [1.642; 14.096], p = 0.004; OR 2.203 [1.360; 3.568], p = 0.001, respectively). Conclusions: This study shows that parental health, lifestyle, and social behaviours matter in determining childhood obesity. Understanding those is essential to promoting a healthy lifestyle. Full article

(This article belongs to the Special Issue Effects of Nutrition and Physical Activity Lifestyle Interventions on Childhood Obesity)

14 pages, 605 KiB

Open AccessArticle

Effects of Responsiveness and Responsibility Parenting Factors on Family Mealtime Outcomes in Overweight African American Adolescents

by Haylee Loncar, Allison M. Sweeney, Taylor White, Mary Quattlebaum and Dawn K. Wilson

Nutrients 2024, 16(22), 3874; https://doi.org/10.3390/nu16223874 - 13 Nov 2024

Viewed by 939

Abstract

Background/Objectives: Family meals have been shown to be an important protective factor for positive health outcomes. This study assessed the associations of parenting factors with family mealtime among overweight African American adolescents over a period of 4 months. It was hypothesized that increases in warm and responsive parenting (parental responsiveness, parental responsibility) would be associated with increased frequency and quality of family mealtimes, while more demanding and controlling parenting (parental demandingness, parental monitoring) would be associated with a reduced frequency and quality of family mealtimes over time. Methods: Data from baseline to 16 weeks were collected from 241 African American adolescent–parent dyads (adolescent: M_age = 12.8 ± 1.7 years; 64% female; M_BMI%= 96.6 ± 4.2) that participated in the Families Improving Together (FIT) for Weight Loss randomized controlled trial. Results: Multilevel models revealed significant positive main effects of parental responsiveness and parental responsibility (p < 0.05) on the increased frequency of family meals (p < 0.01). Significant two-way interactions also showed that parental responsiveness (p < 0.05) predicted improved quality of family mealtimes, whereas parental demandingness (p < 0.01) predicted reduced quality of family mealtimes from baseline to 16 weeks. Conclusions: Results from this study have important implications for African American adolescent obesity prevention and future family-based intervention program guidelines. Full article

(This article belongs to the Special Issue Effects of Nutrition and Physical Activity Lifestyle Interventions on Childhood Obesity)

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20 pages, 1865 KiB

Open AccessArticle

Lifestyle Behaviours in Pre-Schoolers from Southern Spain—A Structural Equation Model According to Sex and Body Mass Index

by Gracia Cristina Villodres, Rosario Padial-Ruz, José-Antonio Salas-Montoro and José Joaquín Muros

Nutrients 2024, 16(21), 3582; https://doi.org/10.3390/nu16213582 - 22 Oct 2024

Viewed by 1585

Abstract

Objectives: The present study aimed to examine the relationship between screen time (ST), sleep time (SLT), physical fitness (PF), Mediterranean diet (MD) adherence, eating behaviours, and body mass index (BMI) in a sample of pre-schoolers from Granada (Spain). In order to address this aim, an explanatory model was developed to examine existing relationships between ST, SLT, PF, MD, pro-intake (PRO-I) and anti-intake (ANT-I) behaviours, and BMI. Further, the proposed structural model was examined via multi-group analysis as a function of sex and BMI. Methods: A cross-sectional study was conducted with 653 three- to six-year-old pre-schoolers attending 18 different schools invited to take part in the present study. Structural equation modelling (SEM) was employed to analyse relationships between study variables as a function of sex and BMI. Results: SEM analysis revealed negative associations between ST and PF (p < 0.005), ST and MD adherence (p < 0.005), ST and SLT (p < 0.005), MD adherence and ANT-I behaviours (p < 0.005), and MD adherence and BMI (p = 0.033). In contrast, positive associations emerged between SLT and MD adherence (p < 0.005), and PRO-I behaviours and BMI (p < 0.005). SEM revealed differences according to sex and BMI. Conclusions: The study highlights significant relationships between lifestyle behaviours and physical and dietary outcomes in pre-schoolers from southern Spain, with variations based on sex and BMI. These findings suggest the need for interventions aimed at reducing ST and promoting better sleep, PF, and dietary habits in order to limit weight-related and general health risks in pre-schoolers from southern Spain. Full article

(This article belongs to the Special Issue Effects of Nutrition and Physical Activity Lifestyle Interventions on Childhood Obesity)

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17 pages, 2164 KiB

Open AccessArticle

A Randomized Controlled Trial Comparing Loss versus Gain Incentives to Improve Adherence to an Obesity Treatment Intervention in Adolescents

by Robert M. Siegel, Christopher Kist, Shelley Kirk, Roohi Kharofa, Kristin Stackpole, Amanda Sammons, Linda Dynan, Meghan E. McGrady, JangDong Seo, Elaine Urbina and Nadine A. Kasparian

Nutrients 2024, 16(19), 3363; https://doi.org/10.3390/nu16193363 - 3 Oct 2024

Cited by 3 | Viewed by 2117

Abstract

Background/Objectives: Adherence to pediatric obesity treatment can be challenging. Monetary incentives improve adherence to lifestyle interventions, with incentives framed as loss often more effective than those framed as gain. The objectives of this study were to determine if monetary incentives in the form of gift cards would improve adherence to an obesity treatment intervention and whether framing the incentive as either loss or gain affected adherence. Methods: Sixty adolescents with obesity (body mass index of ≥95th percentile for age and sex) were recruited from our pediatric obesity treatment program. They were randomized into one of three groups and given a monthly adherence score (AS) of up to 100 points. These points were based on completing a medical visit, reporting on diet intake, and measuring daily steps on a wearable tracker. The Gain Group (GG), N = 20, started each month with USD 0 in a virtual account and increased their monetary reward up to USD 100 depending on AS. The Loss Group (LG), N = 21, began each month with USD 100 in their virtual account, which decreased based on adherence. The Control Group (CG), N = 19, received USD 10 monthly. Results: Adherence was highest in the GG, with 66.0 points, compared to the LG, with 54.9 points, and CG, with 40.6 points, with p < 0.01. The GG had greater adherence to their step goal (14.6) and dietary reporting (18.7) compared to the LG (10.0 and 13.9) and the CG (3.9 and 8.1), p < 0.005. Conclusions: Gain-framed incentives are superior to loss-framed ones in improving adherence to pediatric obesity treatments. Full article

(This article belongs to the Special Issue Effects of Nutrition and Physical Activity Lifestyle Interventions on Childhood Obesity)

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Review

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28 pages, 944 KiB

Open AccessReview

Orthorexia as an Eating Disorder Spectrum—A Review of the Literature

by Izabela Łucka, Artur Mazur, Anna Łucka, Izabela Sarzyńska, Julia Trojniak and Marta Kopańska

Nutrients 2024, 16(19), 3304; https://doi.org/10.3390/nu16193304 - 29 Sep 2024

Cited by 1 | Viewed by 3776

Abstract

Background: The purpose of this study is to compare and analyze research studies focused on orthorexia nervosa (ON) as a spectrum of eating disorders, and to summarize potential risk factors in different age and social groups. ON is characterized by an obsession with healthy eating, which leads to a restrictive diet and health problems. Methods: Due to a lack of comprehensive analyses, this review re-examined studies from 2006 to 2023, initially retrieving 53,134 articles. Upon refining the criteria and risk factors for eating disorders, 34 notable records were identified. These studies employed diagnostic tools such as ORTO and BOT, focusing on risk factors for ON. Results: Results indicate that individuals suffering from eating disorders, losing weight, exercising heavily, developing relationship problems, and suffering from body dysmorphic disorder are at high risk of developing ON. A significant correlation was found between ON, BMI, and gender, but not between ON and OCD. Interestingly, ON symptoms appear to overlap with those of other eating disorders, such as anorexia and bulimia, especially in terms of obsessive control over dieting and fear of gaining weight, indicating a close relationship between the two. Conclusions: Interestingly, orthorexia nervosa may serve as a coping mechanism for anorexia, providing a sense of control. However, further research on its long-term effects is required. Full article

(This article belongs to the Special Issue Effects of Nutrition and Physical Activity Lifestyle Interventions on Childhood Obesity)

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18 pages, 976 KiB

Open AccessReview

Childhood Obesity and Its Comorbidities in High-Risk Minority Populations: Prevalence, Prevention and Lifestyle Intervention Guidelines

by Ahmad Alkhatib and George Obita

Nutrients 2024, 16(11), 1730; https://doi.org/10.3390/nu16111730 - 31 May 2024

Cited by 12 | Viewed by 3965

Abstract

The prevalence of childhood obesity and its associated comorbidities is a growing global health problem that disproportionately affects populations in low- and middle-income countries (LMICs) and minority ethnicities in high-income countries (HICs). The increased childhood obesity disparities among populations reflect two concerns: one is HICs’ ineffective intervention approaches in terms of lifestyle, nutrition and physical activity in minority populations, and the second is the virtually non-existent lifestyle obesity interventions in LMICs. This article provides guidelines on childhood obesity and its comorbidities in high-risk minority populations based on understanding the prevalence and effectiveness of preventative lifestyle interventions. First, we highlight how inadequate obesity screening by body mass index (BMI) can be resolved by using objective adiposity fat percentage measurements alongside anthropometric and physiological components, including lean tissue and bone density. National healthcare childhood obesity prevention initiatives should embed obesity cut-off points for minority ethnicities, especially Asian and South Asian ethnicities within UK and USA populations, whose obesity-related metabolic risks are often underestimated. Secondly, lifestyle interventions are underutilised in children and adolescents with obesity and its comorbidities, especially in minority ethnicity population groups. The overwhelming evidence on lifestyle interventions involving children with obesity comorbidities from ethnic minority populations shows that personalised physical activity and nutrition interventions are successful in reversing obesity and its secondary cardiometabolic disease risks, including those related to cardiorespiratory capacity, blood pressure and glucose/insulin levels. Interventions combining cultural contextualisation and better engagement with families are the most effective in high-risk paediatric minority populations but are non-uniform amongst different minority communities. A sustained preventative health impact can be achieved through the involvement of the community, with stakeholders comprising healthcare professionals, nutritionists, exercise science specialists and policy makers. Our guidelines for obesity assessment and primary and secondary prevention of childhood obesity and associated comorbidities in minority populations are fundamental to reducing global and local health disparities and improving quality of life. Full article

(This article belongs to the Special Issue Effects of Nutrition and Physical Activity Lifestyle Interventions on Childhood Obesity)

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