Search Results (555)

Background: Childhood obesity represents the most common nutritional and metabolic disorder in industrialized countries and constitutes a major public health concern. In Italy, 20–25% of school-aged children are overweight and 10–14% are obese, with marked regional variability. Excess adiposity in childhood is frequently associated with hypertension, dyslipidemia, insulin resistance, and non-alcoholic fatty liver disease (NAFLD), predisposing to future cardiovascular disease (CVD). Objective: To investigate anthropometric indicators of cardiometabolic risk in 810 children and adolescents aged 7–17 years who underwent assessment for competitive sports eligibility at the Sports Medicine Unit of Modena, evaluate baseline knowledge of cardiovascular health aligned with ESC, AAP (2023), and EASO guidelines. Methods: 810 children and adolescents aged 7–17 years undergoing competitive sports eligibility assessment at the Sports Medicine Unit of Modena underwent evaluation of BMI percentile, waist circumference (WC), waist-to-height ratio (WHtR), and blood pressure. Cardiovascular knowledge and lifestyle habits were assessed via a previously used questionnaire. Anthropometric parameters, blood pressure (BP), and lifestyle-related knowledge and behaviors were assessed using standardized procedures. Overweight and obesity were defined according to WHO BMI-for-age percentiles. Elevated BP was classified based on the 2017 American Academy of Pediatrics age-, sex-, and height-specific percentiles. Statistical analyses included descriptive statistics, group comparisons, chi-square tests with effect size estimation, correlation analyses, and multivariable logistic regression models. Results: Overall, 22% of participants were overweight and 14% obese. WHtR > 0.5 was observed in 28% of the sample and was more frequent among overweight/obese children (p < 0.001). Elevated BP was detected in 12% of participants with available measurements (n = 769) and was significantly associated with excess adiposity (χ² = 7.21, p < 0.01; Cramér’s V = 0.27). In multivariable logistic regression analyses adjusted for age and sex, WHtR > 0.5 (OR 2.14, 95% CI 1.32–3.47, p = 0.002) and higher sedentary time (OR 1.41 per additional daily hour, 95% CI 1.10–1.82, p = 0.006) were independently associated with elevated BP, whereas BMI percentile lost significance when WHtR was included in the model. Lifestyle knowledge scores were significantly lower among overweight and obese participants compared with normal-weight peers (p < 0.01). Conclusions: WHtR is a sensitive early marker of cardiometabolic risk, often identifying at-risk children missed by BMI alone. Baseline cardiovascular knowledge was suboptimal. The observed gaps in cardiovascular knowledge underscore the importance of integrating anthropometric screening with structured educational interventions to promote healthy lifestyles and long-term cardiovascular prevention. Full article

Background/Objectives: Low back pain (LBP) is increasingly prevalent among children and adolescents and represents a growing public health concern due to its potential persistence into adulthood. Screen-based sedentary behavior has substantially increased in pediatric populations. However, evidence regarding its association with LBP remains inconsistent, and the existence of a dose–response relationship is not well established. Methods: A systematic review and meta-analysis of observational studies was conducted in accordance with PRISMA guidelines. Studies examining the association between screen-based sedentary behavior and LBP in children and adolescents aged 6–18 years were included. Random-effects meta-analyses were used to pool continuous exposure estimates, and a multivariate random-effects dose–response meta-analysis was performed to assess changes in LBP risk across increasing levels of daily screen time. Results: A total of 30 studies were included. The pairwise meta-analysis of continuous exposure showed no statistically significant association between screen time and LBP, with OR = 1.02 (95% CI 0.65 to 1.59). In contrast, the dose–response meta-analysis demonstrated a significant positive association, with a 26% (95% CI 8% to 48%) increase in the odds of LBP for each additional hour of daily screen time. High between-study heterogeneity was observed, and most studies relied on self-reported measures of screen exposure and LBP, which may have introduced recall and misclassification bias and warrants cautious interpretation of the findings. Conclusions: Higher levels of screen-based sedentary behavior were associated with an increased risk of LBP in children and adolescents when examined using a dose–response approach, whereas pairwise meta-analyses did not identify a significant association. Nevertheless, substantial between-study heterogeneity and high risk of bias limit causal inference and require cautious interpretation. Full article

Over 10% of US children and adolescents have attention-deficit hyperactivity disorder (ADHD), with a similar prevalence among youth athletes. While ADHD may confer certain athletic performance advantages such as heightened quickness, decision-making and periods of hyperfocus, it also poses some challenges including reduced concentration, frustration, and possible increased injury risk. Pharmacologic treatments, including stimulant-based medications, can improve attentiveness and athletic performance but could alter nutritional behaviors such as appetite suppression. This paper reviews the current literature on nutritional strategies to provide practical sports nutrition guidelines for children and adolescent athletes with ADHD. Evidence suggests that optimizing energy intake, emphasizing complex carbohydrates, improving fat quality intake, and consuming adequate amounts of micronutrients may support both athletic performance and ADHD symptom management. In contrast, excessive added sugars and saturated fats are associated with poorer outcomes and manifestation of ADHD symptoms. Although no research examining nutritional interventions in youth athletes with ADHD have been performed, applying established sports nutrition principles for youth athletes with ADHD offers a promising approach to enhance performance, reduce injury risk, and support the long-term health of the athlete. Full article

This paper is concerned with the sexual rights of homeless adolescents. After a brief presentation of the ethical foundation of these rights in the capabilities approach and noting the relevance of the concept of relational autonomy, an ethical analysis of a specific problem is performed, namely the risky sexual behavior of homeless adolescents. It is argued that although these young people have moral agency it is not fully developed and thus they cannot be held to the same standards of responsibility as are adults. Thus, we can see the importance of interventions that empower homeless youth to protect their own sexual health through risk-avoidance or harm reduction strategies. Full article

Background: Physical inactivity during adolescence remains a major public health concern, yet its multifactorial determinants are not fully understood in low- and middle-income settings. Objective: To identify and quantify the determinants of physical activity (PA) among Brazilian adolescents using a hierarchical logistic regression model that reflects the theoretical ordering of distal to proximal factors. Methods: A cross-sectional study was conducted with 856 adolescents (13–19 years). Data were obtained from the validated Brazilian Youth Risk Behavior Survey and the Brazilian Economic Classification Criteria (ABEP) socioeconomic questionnaire. PA was dichotomized according to World Health Organization recommendations. Hierarchical logistic regression examined five theoretical blocks: sociodemographic, anthropometric, substance use, weight/diet, and sedentary behavior. Results: Overall, 5 out of 17 predictors were significant in the full model. extended Body mass index (eBMI) was negatively associated with physical activity (OR = 0.331, 95% CI: 0.169–0.647, p = 0.001), while body mass was positively associated (OR = 2.078, 95% CI: 1.045–4.135, p = 0.037). Working status (OR = 1.235, 95% CI: 1.035–1.475, p = 0.019) and weight loss attempts (OR = 1.327, 95% CI: 1.042–1.690, p = 0.022) increased the odds of being active, whereas current smoking reduced it (OR = 0.715, 95% CI: 0.517–0.990, p = 0.043). Model discrimination improved progressively (AUC = 0.577 to 0.692). Conclusions: Physical activity among Brazilian adolescents was primarily influenced by behavioral and perceptual rather than demographic factors. These findings highlight the need for integrated interventions promoting muscle development, body positivity, and smoking prevention. Full article

Background: Parental burnout is a state of extreme exhaustion that is detrimental to family life. There is some evidence, albeit limited, that children of exhausted parents are at risk of neglect or abuse. The children’s lived experience remains an underinvestigated issue. This qualitative and participatory study aimed to explore children’s and adolescents’ perceptions and experience of parental burnout, as well as the resources they identify as available to assist them. Methods: We interviewed 24 children of exhausted parents, including children typically developing (n = 17), children with illness/disability (n = 3), and children with learning/behavioral difficulties (n = 4). We used interactive data collection tools, adapted to the participants’ age. The interviews were followed by a participatory validation seminar. Results: We evidenced a high emotional burden experienced by children exposed to parental burden. The children conveyed feeling insecure about what happens, perceiving a mismatch between their own needs and those of their parents, and being afraid both of and for their parents. Conclusions: Our results call for an increased recognition of parental burnout as not only a personal or family problem, but a possibly important societal and public health concern, with implications for child prevention and health promotion. Full article

Background/Objectives: Alternative Tobacco and Nicotine Products (ATNPs) have gained widespread popularity. Although they are often promoted as lower-risk alternatives to traditional tobacco products, concerns remain regarding their association with risky behaviors among adolescents and young adults. This study examines the relationship between dietary and lifestyle habits and both ATNP use and intention to use ATNP among Italian participants in the MINERVA (My changINg lifEstyles our Research and eVeryone heAlth) international project. Methods: MINERVA is an observational, international, prospective cohort study. A study-specific questionnaire was administered to participants, who were recruited through informal snowball sampling. The questionnaire collected information on sociodemographic characteristics, lifestyle factors, dietary habits, and the use of both traditional tobacco products and ATNPs. Predictors of ATNP use and intention to use were assessed using logistic regression models. Results: Data from 7535 Italian participants were analyzed. Overall, 48% reported having ever used ATNP, and 14% of non-smokers and non-users expressed an intention to try these products. Significant predictors of ATNP use and intention to use included prior smoking, lower age, and having family members who smoke. Lifestyle factors such as frequent consumption of fast food, junk food, and alcoholic beverages were positively associated with both ATNP use and intention to use. Conversely, daily fruit and vegetable consumption was inversely associated with these outcomes. Conclusions: ATNP use and intention to use were associated with unhealthy dietary and lifestyle patterns. These findings highlight the importance of integrated public health strategies addressing substance use alongside broader lifestyle behaviors among adolescents and young adults. Full article

Background: The rising prevalence and enduring impact of mental health problems in youth have intensified the call for population-level prevention. Low positive and high negative affect in childhood are vulnerability factors for mental health problems in adolescence. Supporting youth in managing affect during early adolescence may foster mental health preventively. Self-regulation training has shown promise in this regard. Moreover, its parallels with Behavioral Activation (BA) align with the recommendation to adapt evidence-based clinical interventions into scalable, accessible formats for prevention. Methods: This study examined whether a 12-day mobile-based self-regulation training, consistent with BA principles and delivered in an innovative digital format, could increase positive and decrease negative affect in a sample of 156 youths (M_age = 10.0). Results: No significant group differences emerged in affect change over time, and neither baseline levels of self-control nor emotion regulation strategies moderated the effects. Conclusions: The findings suggest that low-intensity mobile-based interventions may be insufficient to produce meaningful affect change in youth. The potential need to shift from universal prevention strategies to more selective approaches targeting at-risk youth is discussed. Full article

Background/Objectives: Sleep disorders represent a significant health burden among children and adolescents with autism spectrum disorder (ASD), affecting their core symptoms, behavior, and quality of life. While physical activity has shown promise in managing sleep disorders in the general pediatric population, its effectiveness for children and adolescents with ASD remains understudied. Methods: This retrospective cohort study analyzed electronic health records from 132 healthcare organizations, examining 155,860,529 individuals to determine sleep disorder prevalence in ASD populations and evaluate the impact of physical activity interventions. We identified 248,940 children and adolescents with ASD aged 5–18 years, of whom 38,976 had documented sleep disorders. Propensity score matching was performed to compare patients with ASD and sleep disorders who received physical activity interventions with matched controls. Primary outcomes included sleep disorder resolution and medication utilization changes at 1- and 5-year follow-up. Bonferroni correction was applied to secondary analyses to account for multiple comparisons. Results: The prevalence of sleep disorders was markedly higher in children and adolescents with ASD (19.25%) compared to non-ASD peers (3.37%), with risk ratios escalating from childhood (RR = 5.34, 95% CI: 5.28–5.40) to adolescence (RR = 6.12, 95% CI: 6.05–6.19). After matching, 3709 patients were included in each group. Physical activity interventions were associated with significantly higher sleep disorder resolution at 1 year (−59.9% vs. −5.05%, p = 0.001) and sustained benefit at 5 years (−49.83% vs. +7.26%, p = 0.001). After Bonferroni correction, improvement in sleep apnea at 1 year remained statistically significant (−62.26% vs. +9.39%, Bonferroni-adjusted p = 0.040). Improvements in parasomnia and insomnia did not survive correction and were considered exploratory. Age emerged as a key effect modifier: adolescents (12–18 years) demonstrated sustained improvements in overall sleep outcomes at both 1- and 5-year follow-up that met Bonferroni-corrected thresholds, whereas younger children (5–11 years) showed limited and inconsistent responses. Among comorbidity groups, anxiety-comorbid patients exhibited the strongest overall improvement (−58.7% vs. −12.4%, p < 0.01), while reductions in amphetamine use and changes in melatonin prescribing patterns should be interpreted as exploratory findings requiring prospective confirmation. Conclusions: This large-scale observational study suggests structured physical activity interventions are associated with sustained improvements in overall sleep disorders among children and adolescents with ASD. While subtype- and subgroup-specific associations were observed, many attenuate after multiple comparison adjustments, highlighting the need for cautious interpretation. Findings support exploring physical activity in comprehensive care plans, with prospective randomized trials needed to confirm causality, optimize protocols, and address multiplicity. Full article

Children and adolescents with mental illness are at increased risk of developing overweight and obesity, a relationship that is complex, bidirectional, and often exacerbated by the weight-related side effects of psychotropic medications. This review addressed the research question: How are overweight and obesity addressed in children and adolescents with mental illness? Following JBI and PRISMA-ScR guidelines, a systematic search of PubMed, CINAHL, EMBASE, and PsycINFO was conducted, including studies in English or Scandinavian languages, across all designs, that focused on non-pharmacological approaches for this population aged 0–19 years. The search was completed in May 2025. Nine studies met the inclusion criteria, comprising four qualitative studies, four cohort studies, and one cross-sectional study. Based on inductive content analysis, three overarching themes were developed: approaches to weight and health, showing a predominant focus on individual lifestyle modifications; roles, resources, and prioritization, reflecting how constrained resources influence healthcare professionals’ decisions; and critical repercussions and future directions, highlighting the consequences for children, adolescents, and their families. Overall, interventions mainly target behavior change, with limited attention to structural or systemic factors. These findings underscore the need for tailored guidance and clear clinical strategies to support healthcare professionals and families in addressing weight-related issues in child and adolescent mental health care. Full article

Background/Objectives: Early motherhood is a risk factor for the mother-child relationship during the perinatal period, implying that intrusive or withdrawn maternal behavior and possibly abusive behavior can have short- and long-term consequences for child development. Methods: This study aimed to evaluate the preliminary effectiveness of a short mentalization community video feedback intervention designed to improve maternal mentalization, maternal communication, and behavior quality of adolescent and young mothers. Twenty-six young and adolescent mother-infant dyads were recruited at an Italian outpatient hospital service for adolescent and young parents with a one-group pre-test/post-test design. The participants (n = 15) received four video feedback sessions focused on mentalization and affective communication. At 3 infant months, risk factors associated with young motherhood were assessed. At 3 infant months (pre-intervention) and 9 months (post-intervention), the quality of maternal communication and behavior has been evaluated with Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE), and maternal mind-mindedness was assessed. Results: At the end of the intervention, the results showed significant improvements in maternal communication quality and mind-mindedness, especially in decreasing disrupted maternal affective communication (p = 0.005) and non-attuned mind-mindedness comments (p = 0.005). Conclusions: This study highlighted good acceptance of the intervention in a public health context and the effectiveness of a short mentalization community video feedback intervention to improve maternal mind-mindedness and communication quality between young mothers and their infants. The preliminary findings of this pilot study could be useful for implementing similar interventions aimed at young parents in community contexts. Full article

Ureaplasma species are associated with various reproductive health issues, while human papillomavirus (HPV) is associated with cervical, vaginal and vulvar cancers. Data on the association between Ureaplasma species and HPV are limited in South Africa. This study investigated the prevalence of Ureaplasma urealyticum (U. urealyticum), Ureaplasma parvum (U. parvum), and HPV coinfection and their associated factors, among adolescent girls and young women (AGYW) in the Eastern Cape Province, South Africa. A total of 214 participants were retrospectively recruited, and secondary data on HPV, U. urealyticum, U. parvum, demographics, and sexual behavior were used. HPV was detected using the Roche Linear Array HPV Genotyping Test, while U. urealyticum and U. parvum were detected using Allplex™ sexually transmitted infection (STI) essential Assay. Statistical analyses were performed using GraphPad Prism Version 8.0.1.244. The prevalence of U. urealyticum was 43.9% (94/214) and increased significantly with age (p = 0.036, R² = 0.8497); while U. parvum prevalence was 68.7% (147/214) and was not influenced by age. Having four to six lifetime sexual partners (PR: 1.77, 95% CI: 1.04–3.00, p = 0.043) was associated with increased risk of U. urealyticum. A proportion of 36.3% (77/212) had HPV-U. urealyticum coinfection and its risk was increased among those with 3–6 lifetime sexual partners (PR: 1.59, 95% CI: 1.10–2.53, p = 0.017), 2–4 new partners past three months (PR: 2.14, 95% CI: 1.19–2.42, p = 0.021); vaginal sexual intercourse frequency past 1-month (2–3 vaginal intercourse: PR: 1.54, 95% CI: 1.06–2.53, p = 0.037; 4–10 vaginal intercourse: PR: 1.91, 95% CI: 1.83–1.91, p = 0.005) and alcohol consumption (PR: 1.85, 95% CI: 1.20–3.28, p = 0.004). U. urealyticum positives had a significantly higher risk of HPV types targeted by Cervarix^® HPV vaccine than negatives (PR: 2.56, 95% CI: 1.23–5.37, p = 0.013), Gardasil^®4 (PR: 2.16, 95% CI: 1.25–3.75, p = 0.006) and Gardasil^®9 (PR: 1.70, 95% CI: 1.25–2.32, p = 0.001). AGYW of Eastern Cape Province, South Africa had high prevalence of U. urealyticum-HPV and U. parvum-HPV coinfections. Ureaplasma species coinfection was associated with HPV prevalence and distribution of genotypes. The U. urealyticum prevalence and its coinfection with HPV were associated with sexual behavior. Data from this study could contribute to the design of sexual health and STI interventions and could serve as a baseline for future epidemiological studies, which include ongoing surveillance of HPV genotype prevalence to evaluate the impact and effectiveness of HPV vaccination programs in the population. Full article

Background: Childhood overweight and obesity represent growing public health challenges globally, driven by complex interactions between demographic, behavioral, and familial factors. This study assessed the prevalence and determinants of overweight and obesity among school-aged children and adolescents attending urban schools in the Aseer Region of Saudi Arabia (Abha and Khamis Mushait). Methods: A cross-sectional study was conducted among 413 urban school students aged 6–18 years. Anthropometric measurements were obtained using standardized procedures, and lifestyle behaviors were assessed through a structured questionnaire. Data were analyzed using descriptive statistics, Chi-square tests, and multivariate binary logistic regression. Variables with p < 0.05 in univariate analysis, alongside conceptually relevant predictors, were included in the final model. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. Results: The combined prevalence of overweight and obesity was high, particularly among older age groups and secondary-school students. Significant associations were found between BMI category and age, school level, parental education, and family history of obesity. Lifestyle behaviors including fast-food consumption, low fruit and vegetable intake, prolonged screen time, and short sleep duration showed strong relationships with overweight/obesity. In the adjusted model, key predictors included frequent fast-food intake (AOR = 2.74), low fruit/vegetable intake (AOR = 2.20), physical inactivity (AOR = 1.70), high screen time (AOR = 2.40), short sleep duration (AOR = 1.55), and positive family history of obesity (AOR = 3.10). Conclusions: Childhood overweight and obesity in the Aseer Region are influenced by both modifiable lifestyle behaviors and familial predisposition. Targeted interventions promoting healthy dietary habits, adequate physical activity, reduced screen time, and sufficient sleep are essential. Preventive strategies should prioritize adolescents and children with a family history of obesity to effectively reduce obesity risk. Full article

Background: Sedentary behavior in adolescents is a major pediatric health concern. Prolonged inactivity can negatively affect physical and mental health, potentially leading to body image distortion, especially among adolescents. This study aims to explore the relationship between sedentary behavior and body image distortion in adolescents, considering sedentary purpose and sex differences. Methods: This study analyzed data from the 2021–2023 Korea Youth Risk Behavior Survey (KYRBS), comprising 150,025 middle and high school students. Sedentary time was self-reported as the average daily sedentary duration over 7 days. Body image distortion was defined as a discrepancy between the body mass index and perceived body image of participants. Data analysis included descriptive statistics, chi-square tests, and logistic regression, stratified by sex and sedentary purpose. Increased sedentary behavior was significantly associated with body image distortion. Results: Among female adolescents, educational sedentary time had a stronger effect on body image distortion (odds ratio: 1.06, 95% confidence interval: 1.02–1.09). In contrast, male adolescents showed no significant association. Conclusions: This study highlights the significant association between sedentary behavior and body image distortion in adolescents. Future research should further explore the long-term effects of sedentary behavior on the physical and mental health of adolescents. Full article

Background: Survival among children and adolescents and young adults (AYA) with cancer has improved substantially over recent decades; however, dominant survivorship models remain reactive—activated post-treatment and anchored to static exposure- and organ-based screening. This design underuses the anticipatory window at diagnosis and overlooks environmental and social determinants that modulate outcomes across the life course. Methods: We narratively reviewed international frameworks including the Children’s Oncology Group (COG), the International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG), the Pan-European Network for Care of Survivors after Childhood and Adolescent Cancer (PanCare) and the National Comprehensive Cancer Network (NCCN), and synthesized evidence on environmental determinants, exposomics, toxicogenomics, and implementation. Building on two decades of real-world practice, we describe the evolution from the Pediatric Environmental History (PEHis) to the Ambiomic Health Compass (AHC), integrating genomic, exposomic, geospatial, clinical, and biomonitoring layers into routine care. In this framework, survivorship is conceptualized as beginning at the time of cancer diagnosis (“day 0”). Results: PEHis operationalizes guideline-based care with structured environmental and social assessment, personalized plans, and community integration, contributing to improved survival, healthier behaviors, reduced treatment-related mortality and stronger oncology–primary-care coordination. AHC extends PEHis with dynamic risk recalibration, contextual alerts, targeted biomonitoring, and toxicogenomic interpretation, enabling anticipatory decisions from day 0. The manuscript summarizes the paradigm shift (current vs. Ambiomic models), the domain-specific expansion over existing guidelines, the core clinical/system tools, and time-bound metrics (12, 24, 60 months) to support implementation and evaluation. Conclusions: Survivorship should move upstream—from late surveillance to ambiomic, exposure-aware care beginning at diagnosis. Integrating advanced exposomics, mutational epidemiology, and explainable analytics can reduce preventable events and chronicity, enhance equity, and align pediatric oncology with planetary health. The PEHis–AHC continuum offers a scalable blueprint for next-generation survivorship programs in Europe and beyond. Ambiomic medicine does not replace precision medicine—it completes and extends it by integrating exposomics, social context, and anticipatory analytics from day 0. Full article