Search Results (33)

Background/Objectives: Body Mass Index (BMI) is a widely used indicator of children’s nutritional status and helps identify risks of being underweight and overweight during development. Understanding how BMI classifications evolve over time is crucial for early intervention and public health planning. This study aimed to determine the scope and direction of changes in BMI classification among children between the ages of 6 and 10. Methods: This longitudinal study included 1026 children (497 boys and 529 girls) from Gdansk, Poland. Standardized anthropometric measurements were collected at ages 6 and 10. BMI was calculated and classified using international reference systems (IOTF and OLAF). BMI classification changes were analyzed using rank transformations and Pearson correlation coefficients (p < 0.05) to explore relationships between body measurements. Results: Most children (76.51%) retained their BMI classifications over the four-year period. However, 23.49% experienced changes, with boys more often moving to a higher BMI category (15.29%) and girls more frequently shifting to a lower category (14.03%). The prevalence of children classified as living with obesity declined between ages 6 and 10, while both overweight and underweight classifications slightly increased. Strong correlations were observed between somatic features and BMI at both ages. Conclusions: The stability of BMI classification over time underscores the importance of early identification and sustained monitoring of nutritional status. The sex-specific patterns observed highlight the importance of targeted health promotion strategies. In this context, incorporating dietary interventions—such as promoting balanced meals and reducing unhealthy food intake—could play a significant role in maintaining healthy BMI trajectories and preventing both obesity and undernutrition during childhood. Full article

Background/Objectives: Overweight and obesity (OW/OB) in immigrant children is a complex multifactorial issue. This work aims to present the OW/OB profile and lifestyle habits of immigrant children and compare them with their native counterparts. Methods: A cross-sectional study (ASOMAD) was conducted in a representative sample of children aged 8–12 years in Madrid from 2020 to 2023. Parental origin, physical activity (PA), screen time, adherence to Mediterranean Diet, sleep, and body composition were assessed by validated methods. OW/OB was determined according to IOTF guidelines. T-tests, chi-square tests, and two-way ANOVA tests were applied based on the variables’ characteristics. Results: A total of 587 children (54% boys, aged 9.54 ± 1.19 y), 33.2% immigrants, were studied. OW/OB rate was higher in immigrants (39.7% boys and 37.4% girls) than in natives (18.0% boys and 17.7% girls) (p < 0.05). Immigrant boys were 30.64 ± 8.39 min/day less active than natives (p < 0.001). Both male and female immigrant children devoted considerably more weekday hours to screen time than natives (2.76 ± 2.75; 2.02 ± 2.47 vs. 2.09 ± 2.29; 1.32 ± 1.38; p < 0.05, respectively). Immigrant children consumed significantly less fish and olive oil and more pasta or rice almost every day (5 or more/week), ate at fast-food restaurants, consumed fewer dairy products and baked goods or pastries for breakfast (p < 0.05), and exhibited worse diet quality compared to Spanish ones. Conclusions: Immigrant children exhibited a higher prevalence of OW/OB, higher screen time, lower PA time, and ate less fish and olive oil and more pasta than natives. Additional research is required to explore the causes of these issues and enhance the lifestyle within this group. Full article

The aim of this work was to analyze the trend of overweight, obesity, and body fat distribution of children and adolescents in Catamarca, northwest Argentina, in the last four decades. A data series obtained between 1982 and 2019 in the province of Catamarca was analyzed. The sample of 5596 individuals (46.41% female), between 5 and 14 years old, was grouped into four decades: 1980, 1990, 2000, and 2010. The categories of overweight and obesity, based on body mass index (BMI), were defined from the international reference IOTF. The fat distribution was defined according to the subscapular tricipital index (STI). Between 1980 and 2010, BMI increased by 2.35 kg/m², overweight varied between 13.9% and 21.0%, and obesity varied between 3.4% and 19.2%. The centralized fat distribution varied from 3.9% in 1990 to 27.3% in 2010. In the cohort analysis, and after forty years, an increase in excess weight and body fat centralization was observed in children and adolescents in Catamarca. This trend was inversely proportional to the indicators of unsatisfied basic needs (UBN). It can be concluded that improvements in economic, educational, and housing conditions were not reflected in a better nutritional status. Full article

(1) Background: Obesity and overweight are defined as an abnormal or excessive accumulation of fat that can be harmful to health. These are conditions that can lead to a lifetime of diseases, including cancer, diabetes, and heart disease. The diagnosis of overweight and obesity in children and adolescents depends on the international reference used. (2) Objectives: In this study aimed to determine the level of concordance of the prevalence of underweight, normal weight, overweight, and obesity were estimated with three international references in Mexican children and adolescents between 2 and 18 years of age. (3) Methods: We used specific the body mass index (BMI) cut-off points of the ENSANUT Continua 2022 database. The weight category was measured using the World Health Organization (WHO) criteria (<−2 standard deviation (SD), underweight; −2 and +0.99 SD, normal weight; +1 and +1.99 SD, overweight; and ≥+2 SD, obesity); Centers for Disease Control and Prevention (CDC) criteria (<percentile 5, underweight; percentile 5 and <percentile 85, normal weight; ≥percentile 85, overweight; and ≥percentile 95, obesity); and the Obesity Task Force (IOTF) criteria (specific limit values). To determine agreement among these three criteria, Cohen’s Kappa index was used. (4) Results: There were differences in the estimation of weight categories according to the international reference used. Substantial (WHO-IOTF: 0.639; CDC-IOTF: 0.785) and almost perfect (WHO-CDC: 0.806) levels of agreement were found between the references used; however, agreement varied according to age. (5) Conclusions: The weight category depends on the reference used, so each one should be used with caution since the results inform our actions of prevention, surveillance, and the control of nutrition in childhood and adolescence for the timely detection of chronic health problems and effects of social deficiencies. Full article

Background/Objectives: The pediatric definition of severe obesity (OB) depends on the body mass index (BMI) references. We evaluated different BMI-derived metrics of the World Health Organization (WHO) system to define which cut-off is associated with the highest cardiometabolic risk (CMR); Methods: In this multicentric study, data were retrieved for 3727 youths (1937 boys; 2225 children, 1502 adolescents). OB was defined as BMI > 97th percentile (BMI_97th), severe OB was defined as BMI > 99th percentile (BMI_99th), BMI ≥ 120% of the 97th percentile (120% BMI_97th), or BMI Z-score > 3 (WHO tables), or BMI ≥ the International Obesity Task Force (IOTF) value crossing a BMI of 35 kg/m² at the age of 18 (IOTF₃₅). The continuous CMR Z-score (sum of residual standardized for age and sex of waist-to-height ratio, systolic and diastolic blood pressure, triglycerides, and HDL-cholesterol x −1) and the cluster of at least two CMR factors (hypertension, high triglycerides, low HDL-cholesterol, and high waist-to-height ratio) were calculated. Results: Continuous CMR Z-score was significantly higher both in children or adolescents with severe OB defined by 120% BMI_97th compared to BMI_99th (p < 0.0001), while it was lower only in adolescents with severe OB defined by 120% BMI_97th compared to BMI Z-score >3 (p < 0.0001). Compared to 120% BMI_97th, BMI Z-score > 3 and IOTF₃₅ had higher specificity, but lower sensitivity in identifying children and adolescents with clustered CMR factors. Conclusions: The definition of severe OB based on 120% BMI_97th is superior to BMI_99th but it is inferior to BMI Z score > 3 as far as the association between severe OB and CMR factors is concerned. Pediatricians should take into consideration the implication of the use of different BMI metrics in those countries that recommend the WHO system. WHO BMI Z-score > 3 and IOTF₃₅ can be used interchangeably to predict cardiometabolic risk. Full article

Background/Objectives: Childhood obesity is one of the most challenging contemporary public health problems. Children and adolescents with obesity experience multiple psychosocial difficulties, such as low self-esteem, depression, anxiety, and behavioral problems, which persist for a long time. The aim of the study was to assess the effect of a multidisciplinary personalized lifestyle intervention for depressive and anxiety symptoms, as evaluated by psychometric questionnaires, and their effect and association with cardiometabolic parameters in children and adolescents with overweight and obesity before and after the intervention. Methods: Six hundred and eleven (n = 611) children and adolescents (mean age ± SE: 10.39 ± 0.10 years; 51.5% females, 46.6% pubertal) were studied prospectively. Subjects were classified as being obese (50.2%), overweight (33.5%), or having a normal BMI (16.2%) according to IOTF criteria. All participants entered a 1-year lifestyle intervention program; laboratory investigations were obtained at the beginning and end of the study and two psychometric questionnaires were completed, the CDI and SCARED, which evaluate symptoms of depression and anxiety, respectively. Results: Following the lifestyle intervention, a significant decrease was noted in anxiety scores in all subjects and in depression scores in youth with obesity, as well as in adolescents with obesity, while females displayed a reduced response to the intervention. Insulin resistance and metabolic syndrome parameters, cortisol, PRL, and LH concentrations were positive predictors for depressive and anxiety symptoms. Conclusions: The implementation of a multidisciplinary personalized lifestyle intervention program in the management of childhood obesity is associated with a significant decrease in cardiometabolic and psychosocial comorbidities in children with and without excess adiposity. The improvement in mental health is likely mediated by an improvement in energy metabolism with subsequent improvement in neuroinflammation owing to lifestyle changes. Full article

Background: Obesity in childhood and adolescence represents a major public health problem, mostly attributed to dietary and physical activity factors. We aimed to determine the dietary and physical activity habits of participants before and after the implementation of a personalized, multidisciplinary, lifestyle intervention program for the management of obesity in the context of the Horizon Research Project ‘BigO: Big Data against Childhood Obesity’. Methods: Three hundred and eighty-six (n = 386) children and adolescents (mean age ± SD: 12.495 ± 1.988 years, 199 males and 187 females) participated in the study prospectively. Based on body mass index (BMI), subjects were classified as having obesity (n = 293, 75.9%) and overweight (n = 93, 24.1%) according to the International Obesity Task Force (IOTF) cut-off points. We implemented a personalized, multidisciplinary, lifestyle intervention program providing guidance on diet, sleep, and exercise, and utilized the BigO technology platform to objectively record data collected via a Smartphone and Smartwatch for each patient. Results: Following the intervention, a statistically significant decrease was noted in the consumption of cheese, cereal with added sugar, savory snacks, pasta, and fried potatoes across both BMI categories. Also, there was an increase in daily water intake between meals among all participants (p = 0.001) and a reduction in the consumption of evening snack or dinner while watching television (p < 0.05). Boys showed a decrease in the consumption of savory snacks, fried potato products, and pasta (p < 0.05), an increase in the consumption of sugar-free breakfast cereal (p < 0.05), and drank more water between meals daily (p < 0.001). Conclusions: Our findings suggest that a personalized, multidisciplinary, lifestyle intervention improves the dietary habits of children and adolescents. Full article

Background/Objective: Secreted frizzled-related protein 5 (Sfrp5) is an anti-inflammatory adipokine that has been implicated in the pathophysiology of obesity and its metabolic complications. Despite the fact that numerous studies have been carried out in adults, limited data on Sfrp5 exist for youth, especially in relation to overweight and obesity. Methods: In our study, we assessed the concentrations of Sfrp5, total oxidative (TOS) and antioxidative (TAS) status, high-sensitivity C-reactive protein (hs-CRP), and several cytokines (IL-1α, IL-1β, IL-2, IL-6, IL-8, IL-12, TNF-α) in 120 children and adolescents (mean age ± SE: 11.48 ± 0.25 years; 48 prepubertal, 72 pubertal; 74 males and 46 females) before and 1 year after the implementation of a personalized, structured, lifestyle intervention program of healthy diet, sleep, and physical exercise. Results: Based on the body mass index (BMI), participants were categorized as having morbid obesity (n = 63, 52.5%), obesity (n = 21, 17.5%), overweight (n = 22, 18.33%), or normal BMIs (n = 14, 11.67%), based on the International Obesity Task Force (IOTF) cut-off points. Following the 1-year lifestyle intervention program, a significant improvement in anthropometric measurements (BMI, BMI-z score, diastolic blood pressure, WHR, and WHtR), body-composition parameters, hepatic enzymes, lipid profile, inflammation markers, and the insulin-sensitivity profile (HbA1C, HOMA index) was observed in all subjects. Sfrp5 decreased in subjects with obesity (p < 0.01); however, it increased significantly (p < 0.05) in patients with morbid obesity. Linear regression analysis indicates that TNF-α and systolic blood pressure were the best positive predictors and hs-CRP was the best negative predictor for Sfpr5 concentration at initial assessment and glucose concentration for ΔSfrp5, while TNF-α and TAS were the best positive predictors for Sfpr5 concentration at annual assessment. Conclusions: These results indicate that Sfrp5 is associated with severe obesity and is increased following weight loss in children and adolescents with morbid obesity. It is also related to metabolic homeostasis, as well as inflammation and oxidative status. Full article

Thyroid hormones regulate metabolism and have a major impact in maintaining cardiovascular homeostasis. The purpose of our study was to examine the relation of thyrotropin (TSH) and thyroid hormones with cardiometabolic parameters in children and adolescents with obesity, overweight, and normal body mass index (BMI) before and after the implementation of a comprehensive, multidisciplinary, personalized, lifestyle intervention program for 1 year. One thousand three hundred and eleven (n = 1311) children and adolescents aged 2 to 18 years (mean age ± SD: 10.10 ± 2.92 years) were studied prospectively. Patients were categorized as having obesity (n = 727, 55.45%), overweight (n = 384, 29.29%) or normal BMI (n = 200, 15.26%) according to the International Obesity Task Force (IOTF) cutoff points. All patients received personalized guidance on diet, sleep, and physical activity at regular intervals throughout the 1-year period. Detailed clinical evaluation and hematologic, biochemical and endocrinologic investigations were performed at the beginning and the end of the study. Subjects with obesity had a more adverse cardiometabolic risk profile than subjects with overweight and normal BMI on both assessments. At initial evaluation, total T3 concentrations were positively associated with uric acid and HbA1C, and free T4 concentrations were negatively associated with insulin concentrations, while there was no association between TSH concentrations and cardiometabolic risk parameters. Following the 1 year of the multidisciplinary, lifestyle intervention program, the concentrations of lipids, HbA1C, ALT, and γGT improved significantly in all subjects. Changes in TSH concentrations were positively associated with changes in systolic blood pressure (SBP), glucose, triglycerides, and cholesterol concentrations. Changes in free T4 concentrations were negatively associated with changes in cholesterol and insulin concentrations. Furthermore, changes in T3 concentrations were positively associated with changes in HbA1C, glucose, uric acid, and triglyceride concentrations. These findings indicate that in children and adolescents with overweight and obesity, thyroid hormones are associated with indices conferring cardiometabolic risk. Full article

Background/Objectives: Obesity is currently considered a public health problem in both developed and developing countries. Gender- and age-specific body mass index (BMI) growth standards or references are particularly effective in monitoring the global obesity pandemic. This study aimed to report disparities in age-, gender- and ethnic-specific statistical estimates of overweight and obesity for 2–18 years aged Pakistani children and adolescents using the World Health Organization (WHO), the Center for Disease Control (CDC) 2000 references, the International Obesity Task Force (IOTF) and Pakistani references for BMI. Methods: The study used secondary data of 10,668 pediatric population, aged 2–18 years. Demographic information like age (years), gender, city and anthropometric examinations, i.e., height (cm) and weight (kg) were used in this study. The recommended age- and gender-specific BMI cut-offs of the WHO, CDC 2000 and the IOTF references were used to classify the children sampled as overweight and obese. For the Pakistani reference, overweight and obesity were defined as BMI-for-age ≥ 85th percentile and BMI-for-age ≥ 95th percentile, respectively. Cohen’s κ statistic was used to assess the agreement between the international references and local study population references in the classification of overweight/obesity. Results: The statistical estimates (%) of the participants for overweight and obesity varied according to the reference used: WHO (7.4% and 2.2%), CDC (4.9% and 2.1%), IOTF (5.2% and 2.0%) and Pakistan (8.8% and 6.0%), respectively; suggesting higher levels of overweight and obesity prevalence when local study references are used. The Kappa statistic shows a moderate to excellent agreement (κ ≥ 0.6) among three international references when classifying child overweight and obesity and poor agreement between local references and the WHO (0.45, 0.52), CDC (0.25, 0.50) and IOTF references (0.16, 0.31), for overweight and obesity, respectively. Conclusions: The results of the study showed a visible difference in the estimates of excess body weight after applying the WHO, CDC, IOTF and local BMI references to the study population. Based on the disparity results and poor agreement between international references and the local study reference, this study recommends using local BMI references in identifying children with overweight and obesity. Full article

Childhood overweight and obesity is a worldwide problem and to treat it parents’ detection has to be improved. The MapMe Body Image Scales (BIS) are a visual tool developed to improve parental perception of child weight in the United Kingdon (UK) based on British growth reference criteria. The aim of this study was to make a transcultural adaptation and validation of the MapMe BIS in Spain based on International Obesity Task Force (IOTF) cut offs A descriptive cross-sectional study was done. First, a translation and cultural adaptation was carried out. A total of 155 10–11-year-old children and their parents participated in this study. Children were measured to calculate their weight status, Body Mass Index (BMI), Body Fat Percentage (BFP) and Waist Circumference (WC), and their parents completed a purpose designed questionnaire about their perception and satisfaction of child’s body weight status using the adapted BIS. Test-retest reliability, criterion validity and concurrent validity of the adapted BIS were analyzed. This study shows that the adapted MapMe BIS has good psychometric properties and is a suitable visual scale to assess parental perception of weight status in 10 and 11-year-old children in Spain. Full article

Background: Parents’ own dietary habits have an impact on the diet quality and health of their children. Yet, the relationship between parental self-perceived health consciousness and health in preschool-aged children is not known. Thus, the aim was to study the relation of self-perceived dietary behavior of parents with their pre-school aged children’s dietary quality and body adiposity. Methods: Parents of 2–6-year-old children (n = 738) were recruited from child health clinics across Finland. Parents were divided into health-conscious (HC, n = 396) and non-health-conscious (non-HC, n = 342) according to a self-perceived report of following a healthy diet. Semi-structured questionnaires on parental views on their child’s diet were collected. Children’s diet quality was evaluated with the Children’s Index of Diet Quality (CIDQ). Anthropometrics of the children were recorded during the child’s health clinic visit. BMI was converted to a BMI standard deviation score (BMI-SDS) and categorized according to the Finnish growth reference curves as well as the categories of the International Task Force (IOTF). Results: Children of HC parents had better diet quality compared to children of non-HC parents (11.4 ± 2.6 vs. 10.6 ± 2.6, p = 0.01). They also presented lower BMI-SDS values compared to children of non-HC parents (−0.02 ± 1.12 vs. 0.19 ± 1.09 p = 0.015). Categories of BMI-SDS according to the Finnish growth charts did not differ between the children of HC and non-HC parents. Yet, the categories of BMI-SDS according to cut-offs defined by the IOTF differed significantly between the HC and non-HC parents: the number of children with underweight was 44 (13.6%), normal weight 233 (72.1%), overweight 30 (9.3%) and obese 16 (5.0%), while the number of children of HC parents who were underweight was 69 (18.6%), normal weight 255 (68.7%), overweight 44 (11.9%) and obese 3 (0.8%). Conclusion: Parental self-perceived health consciousness in terms of healthy eating is related to adiposity and diet quality in children. Self-perceived healthy eating in parents could be one factor to consider when monitoring a child’s health in health clinics. Full article

Thinness is used to denote low BMI in children and may be a marker of undernutrition. However, despite prevalence rates of up to 10%, thinness in children is highly overlooked in high-income countries, and we have little knowledge about the diet and nutrient status among these children. We investigated if dietary intake and biomarkers of nutrient status, including iron, n-3 LCPUFA and vitamin D, differed in Danish schoolchildren with thinness compared to children with normal and overweight. We also investigated if intakes of important micronutrients were adequate across weight groups. We used cross-sectional data from 815 Danish 8–11-year-old children collected during the period August–November 2011. Measurements included 7-day dietary records, anthropometry and analysis of nutritional biomarkers in fasting blood samples. We defined thinness using the age- and sex-specific IOTF BMI cut-offs. In total, 10.2% of the children had thinness (boys: 8.9%; girls: 11.6%). These children had lower intake of energy, protein and red meat and higher intake of added sugar compared to children with normal and overweight. Thinness was also associated with higher fish intake compared to overweight, but we found no group differences in whole-blood EPA+DHA. Furthermore, thinness was associated with lower intake of iron and zinc than the other groups and lower intake of selenium versus normal weight, but with no group differences in iron biomarkers, serum ferritin or hemoglobin. The proportions of children with adequate intake of zinc and selenium were lower in the thin (56.5% and 50.7%) compared to the normal-weight children (72.5% and 63.9%) (p < 0.05), but the intake of these micronutrients as well as vitamin B12 and calcium were generally high across all weight groups. In contrast, intake of vitamin D and iron were low across groups, and there were no group differences in serum 25(OH)D. Danish children with thinness had different dietary intake than children with normal and overweight, but thin children did not generally have a poorer diet than normal-weight children. We also found comparable nutrient status and intakes of important micronutrients except for iron, zinc and selenium, which were lower in thin children and should be explored further. Full article

Unhealthy diets, physical inactivity and high body mass index (BMI) are preventable risk factors for non-communicable diseases throughout a person’s lifespan. The higher prevalence of these risk factors in children from lower socio-economic groups has been generally observed. The aim of this study is to explore the effect of parents’ socio-economic conditions on children’s consumption of fruit, vegetables and sugar-sweetened drinks, and inactivity, sedentary behaviour, overweight and obesity. This study used data from the sixth cross-sectional survey of the surveillance “OKkio alla Salute” (Italian COSI), involving 2467 schools and 53,275 children in 2019. All the information was collected through four questionnaires addressed to parents, children, teachers and head teachers. The weights and heights of the children were measured with standard techniques and equipment to classify overweight/obesity according to the WOF-IOTF cut-offs. The results showed a high percentage of children who do not adhere to health recommendations and a high prevalence of overweight and obesity. In particular, “less healthy” behaviours and higher BMI were more frequent in children from families with a lower socio-economic status and those residing in Southern Italy. These findings highlight the need for effective interventions that address the differences in these health-related behaviours. Full article

Background: Early detection tools for eating disorders play an essential role in their prevention. The aim of this study was to analyze different variables associated with the risk of eating disorders and their relation to anthropometric parameters, nutritional status and body self-image. Methods: The Eating Disorder Invetory-3 Referral Form (EDI-3 RF) and the Body Shape Questionnaire (BSQ) were administered to 809 adolescents (413 boys and 396 girls), aged 11 to 17 years, from three randomly chosen schools in a big Mediterranean city. Anthropometric measurements were taken following standardized methods. Overweight and obesity were determined according to the International Obesity Task Force (IOTF). Results: Overweight (23%) prevailed over obesity (9.37%). Girls registered a higher score in the Obsession for Thinness EDI-3 RF subscale and in the body dissatisfaction section of the BSQ. The only statistically significant differences in the Obsession for Thinness and Body Dissatisfaction levels among the different ages were seen in boys. In this series, body dissatisfaction assessed by the EDI-3 RF was not correlated with BSQ body dissatisfaction. Sex and age in adolescence determine the relationship between eating disorder attitudes and body shape dissatisfaction. Conclusions: It is necessary to look for other parameters to investigate to determine body dissatisfaction. Full article