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The Role of Obesogenic Dietary Behaviors in Children and Adolescents

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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 (15 February 2023) | Viewed by 38708

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Special Issue Editor

Dr. Laura C. Hopkins

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Department of Public Health and Prevention Science, Baldwin Wallace University, Berea, OH 44017, USA
Interests: childhood obesity prevention; summertime window of risk; food environments; child nutrition policy; food insecurity
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

You are invited to submit manuscripts to this Special Issue entitled “The Role of Obesogenic Dietary Behaviors in Children and Adolescents.”

Overweight and obesity continue to persist as an epidemic in developing and developed countries across the globe, including overweight and obesity among children and adolescents. Of concern are the negative consequences associated with overweight and obesity including developmental, physical, and mental health consequences, as well as academic performance that children and adolescents experience throughout childhood and the transition into adulthood. It is known that child and adolescent dietary behaviors including low fruit and vegetable consumption or high fat and added sugar consumption, among others, have been associated with increased risk for overweight and obesity. It is also known that childhood and adolescence are developmental phases that provide unique opportunities to shape food preferences, habits, and behaviors that could mitigate the risk of obesity and other noncommunicable disease development. An additional circumstantial concern is the current COVID-19 pandemic that has resulted in disruptions to routines that could contribute to obesogenic behaviors, including dietary behaviors. The objective of this issue is to showcase the latest research on child and adolescent obesogenic dietary behaviors including contributors, health impacts, disparities, and the role of the current COVID-19 pandemic. Original research and review articles will be accepted.

Dr. Laura C. Hopkins
Guest Editor

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Keywords

Overweight
Obesity
Chronic or noncommunicable diseases
Dietary habits
Dietary behaviors
Dietary patterns
Children
Adolescents
Food environment
COVID-19

Published Papers (12 papers)

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Research

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13 pages, 661 KiB

Open AccessArticle

The Influence of Relative Reinforcing Value of Food, Sensitization, Energy Intake and Diet Quality on zBMI Change over Two Years in Adolescents: A Longitudinal Cohort Study

by Jennifer L. Temple, Tegan Mansouri, Ana Letícia Pereira Andrade and Amanda M. Ziegler

Nutrients 2023, 15(9), 2179; https://doi.org/10.3390/nu15092179 - 03 May 2023

Viewed by 1353

Abstract

The relative reinforcing value (RRV) of food and sensitization are associated with zBMI and zBMI change over time, but the mechanisms underlying these relationships is unknown. The purpose of this study was to test the hypothesis that greater RRV and sensitization to HED food is associated with lower diet quality and greater energy intake at baseline and again at 24 months and that these relationships result in greater zBMI gain. The RRV of HED and LED food and dietary intake were measured at baseline and again after 24 months in a cohort of 202 boys and girls of 12–14 years old. The baseline RRV of HED food was associated with lower diet quality and lower energy intake at 24 months. zBMI gain was positively associated with the baseline energy intake but not baseline RRV of HED food or diet quality. However, diet quality moderated the relationship between baseline energy intake and zBMI change, with no difference in zBMI change as a function of energy intake when diet quality was high but significant and opposite relationships with energy intake when diet quality was low. This study suggests that high diet quality can reduce the negative impact of greater energy intake on zBMI change in adolescents. Full article

(This article belongs to the Special Issue The Role of Obesogenic Dietary Behaviors in Children and Adolescents)

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12 pages, 348 KiB

Open AccessArticle

Associations between Emotion Regulation, Feeding Practices, and Preschoolers’ Food Consumption

by Ana Filipa Santos, Carla Fernandes, Marília Fernandes, António J. Santos and Manuela Veríssimo

Nutrients 2022, 14(19), 4184; https://doi.org/10.3390/nu14194184 - 08 Oct 2022

Cited by 1 | Viewed by 2198

Abstract

Previous research identified emotion dysregulation, non-responsive feeding practices, and unhealthy food consumption as risk factors for childhood obesity. However, little is known about the relationships between these factors. This study examined associations between children’s emotion regulation, parental feeding practices, and children’s food consumption. The sample consisted of 163 mothers of children aged 3–5 years. Mothers completed the Emotion Regulation Checklist, the Child Feeding Questionnaire, and the Child Health Section from the Parent Interview of the Early Childhood Longitudinal Study-B to assess model variables. Results showed that healthy food consumption was associated with higher emotion regulation abilities, higher monitoring, and lower pressure to eat. For unhealthy food consumption, the associations were in opposite directions. Higher emotion regulation abilities were also associated with higher monitoring, lower pressure to eat, and lower restriction. For lability, the associations were in opposite directions. Regression analyses revealed that children’s lability, pressure to eat, and monitoring were significant predictors of children’s food consumption. These findings suggest that children’s emotion regulation and feeding practices are important determinants of children’s food consumption. Future longitudinal studies that examine bidirectional associations between children’s emotion regulation, parental feeding practices, children’s food consumption, and potential mechanisms accounting for these associations are needed. Full article

(This article belongs to the Special Issue The Role of Obesogenic Dietary Behaviors in Children and Adolescents)

16 pages, 593 KiB

Open AccessArticle

Online Pre-Order Systems for School Lunches: Insights from a Cross-Sectional Study in Primary Schools

by Nahlah Alkhunain, Jennifer Bernadette Moore and Hannah Ensaff

Nutrients 2022, 14(5), 951; https://doi.org/10.3390/nu14050951 - 23 Feb 2022

Cited by 1 | Viewed by 2328

Abstract

Schools are increasingly using online pre-order systems for children to select school meals in advance. This study aimed to explore how children use and interact with these systems. Using a combination of direct observation and an online questionnaire, the operation of these systems in four UK primary schools was examined. This included how the menu options were displayed, how these were selected by children (4–11 years), and the interactions between children and others when making food selections. Where possible, most children pre-ordered their school lunch in the classroom, and differences in the food choice process among children were observed. These apparently related to children’s ages; older children (8–11 years) showed more independence when making food selections, whereas younger children were often supported by others. Most parents reported that their child was the decision maker when pre-ordering the school lunch, and the role of children in the selection of school lunches was evident. This may be accentuated by the online pre-order systems, and given the likely expansion of these systems in schools, there is an opportunity to implement interventions to influence children towards specific or different meal options from the school menu. Full article

(This article belongs to the Special Issue The Role of Obesogenic Dietary Behaviors in Children and Adolescents)

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20 pages, 292 KiB

Open AccessArticle

Enabling Better Nutrition for Adolescents from Middle Eastern Backgrounds: Semi-Structured Interviews with Parents

by Nematullah Hayba, Yumeng Shi and Margaret Allman-Farinelli

Nutrients 2021, 13(11), 3918; https://doi.org/10.3390/nu13113918 - 01 Nov 2021

Cited by 3 | Viewed by 2413

Abstract

The unyielding obesity epidemic in adolescents from Middle Eastern (ME) backgrounds warrants culturally-responsive and co-designed prevention measures. This study aimed to capture the opinions of ME parents residing in Australia on the crisis and their enablers and barriers to healthy eating interventions given their influence on adolescent eating behaviors. Twenty-six semi-structured interviews were conducted with ME mothers, aged 35–59 years, and most residing in low socioeconomic areas (n = 19). A reflexive thematic analysis using the Capability, Opportunity, Motivation-Behaviour model and Theoretical Domain Framework was conducted. Parents expressed confidence in knowledge of importance of healthy eating, but were reluctant to believe behaviours were engaged in outside of parental influence. Time management skills are needed to support working mothers and to minimize reliance on nearby fast-food outlets, which was heightened during COVID-19 with home-delivery. Time constraints also meant breakfast skipping was common. A culture of feeding in light of diet acculturation and intergenerational trauma in this diaspora was also acknowledged. Parents pleaded for upstream policy changes across government and school bodies to support parental efforts in the form of increased regulation of fast-food and subsidization of healthy products. Opportunities for weight-inclusive programs including parenting workshops underpinned by culturally-responsive pedagogy were recommended. Full article

(This article belongs to the Special Issue The Role of Obesogenic Dietary Behaviors in Children and Adolescents)

15 pages, 304 KiB

Open AccessArticle

Did School Meal Programs and SNAP Participation Improve Diet Quality of US Children from Low-Income Households: Evidence from NHANES 2013–2014?

by Tzuan A. Chen, Lorraine R. Reitzel, Ezemenari M. Obasi and Jayna M. Dave

Nutrients 2021, 13(10), 3574; https://doi.org/10.3390/nu13103574 - 12 Oct 2021

Cited by 1 | Viewed by 2341

Abstract

Nutrition assistance programs such as school meals and the Supplemental Nutrition Assistance Program (SNAP) are designed to provide a safety net for the dietary intake of children from low-income families. However, compared with eligible non-participants, the relationship of diet quality with school meals only and school meals + SNAP is not well understood. The objectives of the study include: (1) To explore whether and to what extent nutrition assistance program participation (school meals only and school meals + SNAP) is related to diet quality; and (2) to examine the differences of diet quality between participating in school meals only, school meals + SNAP, or non-participation among American children. Children aged 5 to 18 years old from income eligible households who participated in the 2013–2014 National Health and Nutrition Examination Survey (NHANES) were included in this cross-sectional study (n = 1425). Diet quality was measured using the Healthy Eating Index (HEI)–2015 and its 13 subcomponents. A Rao-Scott Chi-square test, propensity scores approach, and Analysis of Covariance were performed. Covariates included age, sex, race/ethnicity, weight status, and family monthly poverty index. SAS survey procedures were used to incorporate the appropriate sample design weights. Participation in school meals + SNAP was not associated with higher diet quality compared to eligible non-participants or school meals-only participants. Participation in school meals + SNAP improved the intake of total dairy, but not added sugars or total vegetables compared to school meals only. Overall, school meal + SNAP participation did not significantly improve the overall diet quality of children in low-income households relative to comparable non-participants. Full article

(This article belongs to the Special Issue The Role of Obesogenic Dietary Behaviors in Children and Adolescents)

19 pages, 341 KiB

Open AccessArticle

Analysis of the Diet Quality and Nutritional State of Children, Youth and Young Adults with an Intellectual Disability: A Multiple Case Study. Preliminary Polish Results

by Michał Skrzypek, Wojciech Koch, Karolina Goral, Klaudia Soczyńska, Olga Poźniak, Klaudia Cichoń, Olga Przybysz and Marcin Czop

Nutrients 2021, 13(9), 3058; https://doi.org/10.3390/nu13093058 - 31 Aug 2021

Cited by 10 | Viewed by 3207

Abstract

(1) Background: Considering the limited amount of available data on the diet quality of children, adolescents, and young adults with an intellectual disability (ID) in Poland, as well as the higher incidence of nutritional disorders among people with ID in comparison to the general population, a study was conducted to assess the quality of diet in community-dwelling young individuals with ID. (2) Methods: A multiple-case study was carried out to obtain data on anthropometric parameters and food records over a three-day observation period for 18 subjects with ID. The nutritional value of the products and dishes consumed by the subjects was calculated using the commercial computer program Kcalmar.pro (Hermax, Poland), which contains the Polish database of the nutritional value of food products and dishes. The results presented here are those of a pilot study of a wider research project. (3) Results: The study group consisted of seven women (38.9%) and 11 men (61.1%) with an average age of 12.94 years (range 4.00–22.00) and an average BMI of 25.2 (range 14.5–35.4). The obtained results confirmed the suboptimal pattern of nutrition in children and adolescents with ID. Regarding energy intake and dietary macronutrients, only in 27.8% of cases, energy intake exceeded the Estimated Energy Requirement corresponding to age, sex, body weight, and height. Most of the respondents were characterized by correct intake of proteins, fats, and carbohydrates, and 83.3% showed excessive intake of saturated fatty acids. Excessive intake of vitamins B1, B2, and B6 was observed in all subjects, and that of vitamins B3 (niacin), B12, A, and C in the vast majority of subjects, while deficiency of vitamin D was observed in all individuals and folic acid in 22.2% of individuals. Excessive intake of minerals, such as sodium, phosphorus, and magnesium was noted among most of the respondents, while the intake of calcium and iodine was found to be insufficient. Compared to people with less severe ID (grades 1 and 2), people with grade 3 ID showed significantly lower intake/reference fulfillment of dietary components such as vitamin B6, potassium, phosphorus, iron, copper, iodine, magnesium, and zinc. No significant differences were noted in the nutritional reference fulfillment for various nutrients among the groups distinguished by sex, nutritional status, or the cause of ID. (4) Conclusion: Health supervision guidelines proposed for persons with ID should take into account the dietary practices of the families caring for them, with an emphasis on the prevention and correction of irregularities that may reduce the effectiveness of rehabilitation and deteriorate the health of the affected people. Caregivers/parents of each person with ID who took part in the study were given individualized dietary advice aimed at correcting the dietary abnormalities. Full article

(This article belongs to the Special Issue The Role of Obesogenic Dietary Behaviors in Children and Adolescents)

12 pages, 256 KiB

Open AccessArticle

Assessment of Food Quality in School Canteens: A Comparative Quantitative Study between Primary and Secondary Schools in Malaysia

by Leng Huat Foo and Ying Jing Tan

Nutrients 2021, 13(9), 3009; https://doi.org/10.3390/nu13093009 - 28 Aug 2021

Cited by 3 | Viewed by 12100

Abstract

Schools are an important food environment to cultivate and promote healthy food choices and practices among children and adolescents. The aim of the present study was to assess the type and quality of food and beverages sold in school canteens in public primary and secondary schools in Kelantan, Malaysia. Eligible schools were randomly selected from the list of all schools and detailed information of all food and beverage items sold in the school canteens were collected during school days. Food and beverages were classified based on food groups derived from the Malaysian Food Dietary Guideline and the Recommended Foods for Healthy Cafeteria Guideline. An assessment of the traffic-light nutrition food-labelling system of the total sugar content in all pre-packaged foods was also undertaken. A total of 568 food items were identified, with secondary school canteens selling a greater proportion of food items than the primary schools (55.5% vs. 44.5%). In terms of the main food groups, grains and cereal products represented the largest food group served (33–36%), followed by beverages (21–25%) and confectionary and sweet foods (12–13%). In contrast, the vegetable and fruit group represented the smallest proportion of food items sold (1–3%). Comparisons between primary and secondary schools showed a similar trend and pattern of food types and quality of foods sold, except for animal-based foods. A greater percentage of food items in this category was found among secondary schools (12.1%) versus primary schools (6.7%). When total sugar content of all pre-packaged foods was quantified based on the traffic-light nutrition-labelling system, almost one-third of foods and beverages were classified as high (29.1%). Confectionary (19.1%) and flavoured milk and fruit drinks (10.0%) both exceeded the recommended sugar levels of >22.5 g per 100 g and >11.25 mL per 100 m L, respectively. Only one of these packaged foods and beverages (0.9%) was classified as a healthy food choice. About a quarter of the food items available in school canteens were classified as prohibited based on a new revised list of prohibited food and beverage items. These findings indicate that, despite the Guidelines, a large number of unhealthy food items are being sold in school canteens. Hence, interventions such as sustainable healthy school canteen menus should be implemented to promote healthy food choices amongst school-aged children. Full article

(This article belongs to the Special Issue The Role of Obesogenic Dietary Behaviors in Children and Adolescents)

13 pages, 681 KiB

Open AccessArticle

Caregiver Feeding Practices as Predictors for Child Dietary Intake in Low-Income, Appalachian Communities

by Mikaela B. McIver, Sarah Colby, Melissa Hansen-Petrik and Elizabeth T. Anderson Steeves

Nutrients 2021, 13(8), 2773; https://doi.org/10.3390/nu13082773 - 13 Aug 2021

Cited by 6 | Viewed by 2099

Abstract

The Appalachian region of the U.S. is disproportionately impacted by poverty, obesity, and nutrition-related chronic diseases. Evidence suggests that caregiver feeding practices may promote healthful eating behaviors among children; however, this has not been examined in low-income, rural, Appalachian populations. This study examines caregiver feeding practices as predictors for child diet in low-income Appalachian families, using a cross-sectional analysis of 178 caregivers of young children (ages 2–10 years old), that were recruited from low-income, rural communities in East Tennessee, from November 2017 to June 2018. Caregivers self-reported measures of demographics, feeding practices, and child dietary intake. Multiple linear regression analyses were run, and found that higher use of caregiver modeling positively predicted child vegetable consumption (Beta = 1.02; p = 0.04). Higher caregiver intake of fruits and vegetables positively predicted child fruit consumption (Beta = 0.29; p = 0.02) and vegetable consumption (Beta = 1.56; p < 0.001), respectively. Higher home availability of healthier foods positively predicted child fruit consumption (Beta = 0.06; p = 0.002) and vegetable consumption (Beta = 0.09; p = 0.05). Higher home availability of less healthy foods positively predicted child consumption of high-sugar/high-fat snack foods (Beta = 0.59; p = 0.003). The findings of this study indicate that caregiver modeling, healthy caregiver dietary intake, and healthful home food availability are associated with healthier child dietary intake among young children in low-income, rural, Appalachian areas. Promoting these practices among caregivers may be an important strategy to enhancing dietary intake of children in this hard-to-reach, underserved population. Full article

(This article belongs to the Special Issue The Role of Obesogenic Dietary Behaviors in Children and Adolescents)

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11 pages, 715 KiB

Open AccessArticle

Social Representations of Drinking Water in Schoolchildren and Parents from Two Schools in Zapopan, Mexico

by Alejandra María Corona-Romero, María Fernanda Bernal-Orozco, Gabriela Alejandra Grover-Baltazar and Barbara Vizmanos

Nutrients 2021, 13(6), 1871; https://doi.org/10.3390/nu13061871 - 30 May 2021

Cited by 2 | Viewed by 2637

Abstract

Childhood obesity and children being overweight has increased recently; although they are multi-causal problems, an unhealthy diet is a critical component. In Mexico, drinking water consumption in children from 9 to 18 years only reaches 30% of total fluid consumption. The aim of our study was to describe the social representations (SR) of drinking water in school-children and parents of two schools in Zapopan, Mexico. Associative free listing was used as an information gathering technique. Schoolchildren aged 8 to 12 years (n = 50) and parents (n = 23) from two elementary schools were selected by a convenience sampling from April to June 2015. A similarity analysis was performed using the co-occurrence index; with this, a similarity graph was obtained. Prototypical analysis was performed to explore the structure of the SR. Three dimensions were described in the children’s SR: a functional dimension related to health and nutrition, a practical dimension that describes the instruments used for its consumption, and a theoretical dimension that specifies the characteristics of water and its relationship with nature. In the parents’ SR, a functional dimension was also found; another dimension was described regarding the integral well-being that drinking water provides. A practical dimension describes the features related to its consumption. The investigation describes the structure of the water SR, which help to contextualize and explain the actions of schoolchildren and their parents regarding drinking water consumption. Full article

(This article belongs to the Special Issue The Role of Obesogenic Dietary Behaviors in Children and Adolescents)

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32 pages, 781 KiB

Open AccessReview

Youth and Peer Mentor Led Interventions to Improve Biometric-, Nutrition, Physical Activity, and Psychosocial-Related Outcomes in Children and Adolescents: A Systematic Review

by Margaret A. Lavelle, Miriam Knopp, Carolyn W. Gunther and Laura C. Hopkins

Nutrients 2023, 15(12), 2658; https://doi.org/10.3390/nu15122658 - 07 Jun 2023

Cited by 1 | Viewed by 1602

Abstract

The utilization of youth (older) and peer (same age) mentor-led interventions to improve nutrition and physical activity has been an emerging trend in recent years. This systematic review is intended to synthesize the effectiveness of these intervention programs on participants and mentors based on biometric, nutrition, physical activity, and psychosocial outcomes of youth and peer mentor-led interventions among children and adolescents. Online databases, including PubMed, ScienceDirect, EBSCOhost and Google Scholar, were searched, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A three-step screening process was used to meet the proposed eligibility criteria, and the risk-of-bias tool for randomized trials (RoB 2) was used to assess bias for the included studies. Nineteen unique intervention programs and twenty-five total studies were deemed eligible when considering the criteria required for review. Multiple studies demonstrated positive evidence of the biometric and physical activity outcomes that were considered significant. The findings regarding the nutritional outcomes across the included studies were mixed, as some studies reported significant changes in eating habits while others did not find a significant change. Overall, the utilization of youth and peer mentor-led models in nutrition- and physical-activity-related interventions may be successful in overweight and obesity prevention efforts for those children and adolescents receiving the intervention and the youths and peers leading the interventions. More research is needed to explore the impact on the youths and peers leading the interventions and disseminating more detailed implementation strategies, e.g., training mentors would allow for advancements in the field and the replicability of approaches. Terminology: In the current youth- and peer-led nutrition and physical activity intervention literature, a varying age differential exists between the targeted sample and the peers, and varying terminology with regards to how to name or refer to the youth. In some instances, the youth mentors were individuals of the same grade as the target sample who either volunteered to serve in the peer role or were selected by their fellow students or school staff. In other cases, the youth mentors were slightly older individuals, either in high school or college, who were selected based upon their experience, leadership skills, passion for the project, or demonstration of healthy lifestyle behaviors. Full article

(This article belongs to the Special Issue The Role of Obesogenic Dietary Behaviors in Children and Adolescents)

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28 pages, 659 KiB

Open AccessReview

Improving Obesogenic Dietary Behaviors among Adolescents: A Systematic Review of Randomized Controlled Trials

by Elodie Nonguierma, Emily Lesco, Regan Olak, Hunter Welch, Nagina Zar Alam, Jamila Bonyadi and Laura Hopkins

Nutrients 2022, 14(21), 4592; https://doi.org/10.3390/nu14214592 - 01 Nov 2022

Cited by 4 | Viewed by 1771

Abstract

The overweight and obesity epidemic persists, and over 340 million children and adolescents aged 5–19 were classified as overweight or obese worldwide in 2020. Obesity intervention becomes crucial during the adolescent years due to the increased autonomy and adolescent motivation to oversee one’s own behaviors and lifestyle-related decisions. The objective of the current study was to conduct a systematic review of randomized controlled trials aimed at improving dietary intake and behaviors among adolescents. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were utilized. The key terms used in the searches referred to the study population and the topic of interest and included words and phrases such as “obesity or overweight and adolescents”, “dietary behaviors and adolescents”, “dietary intake and adolescents”, and “dietary habits and adolescents.” A tertiary screening process was employed, and the National Heart, Lung, and Blood Institute Quality Assessment of Controlled Intervention Studies quality scoring tool was utilized to assess the quality of research articles independently by n = 2 researchers. A total of 7441 articles were identified through the database search, and 36 were included in the current systematic review. The most common outcomes explored included dietary behaviors, anthropometric or biometric outcomes, and physical activity. Approximately half of the studies demonstrated significant improvements in the primary outcomes investigated. The majority of the high-impact studies where significant improvements in primary outcomes were demonstrated were conducted in school settings or were multicomponent or multilevel in nature. Thus, interventions targeting dietary behaviors in adolescents that are delivered in the school setting and are multicomponent or multilevel in nature are the most effective in terms of impact on dietary intake, anthropometric or biometric outcomes, and physical activity. Full article

(This article belongs to the Special Issue The Role of Obesogenic Dietary Behaviors in Children and Adolescents)

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Other

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16 pages, 735 KiB

Open AccessSystematic Review

Relation between Attachment and Obesity in Preschool Years: A Systematic Review of the Literature

by Ana F. Santos, Mariana C. Martins, Carla Fernandes, Kelly K. Bost and Manuela Veríssimo

Nutrients 2021, 13(10), 3572; https://doi.org/10.3390/nu13103572 - 12 Oct 2021

Cited by 4 | Viewed by 3144

Abstract

Increasing evidence suggests that attachment plays an important role in obesity. However, few studies examined this relationship in preschool children. This study aimed to systematically examine the empirical, peer-reviewed evidence regarding the relationship between attachment quality and obesity in the preschool years. Using established guidelines, relevant peer-reviewed literature published between 2000 and July 2021 was searched through EBSCO. This yielded a total of 1124 records for review. Established inclusion criteria comprised: empirical studies published in peer-review journals; include at least one anthropometric measure and/or food consumption measure. Exclusion criteria comprised: attachment measures not following Bowlby-Ainsworth conceptualization of the construct; children in institutionalized settings; context of severe mental illness, documented substance use disorders, or eating disorders; include only a measure of the psychological aspects of eating; intervention programs. After exclusions, eight studies with a total of 9225 participants met the inclusion criteria. Results support the role of attachment in weight-related outcomes, suggesting that considering attachment in the risk of obesity could contribute to the elaboration of effective prevention and intervention programs. Limitations included the small number of studies, predominately cross-sectional designs, the diversity of methodologies, most samples not including fathers, and lack of evidence about the developmental mechanisms underlying the association between attachment and obesity. More evidence is needed to determine how attachment and obesity are linked, and the potential underlying mechanisms accounting for this relationship. Full article

(This article belongs to the Special Issue The Role of Obesogenic Dietary Behaviors in Children and Adolescents)

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