Search Results (294)

Background: Early childhood nutrition is strongly associated with neurodevelopmental outcomes, particularly in socially vulnerable settings. Limited evidence is available describing the relationship between nutritional status, food security, and neurodevelopment among preschool children in low-income urban areas of Colombia. This study aimed to evaluate nutritional status, household food insecurity, and neurodevelopmental outcomes in children attending early childhood centers in El Codito, Bogotá, and to explore the association between anthropometric indicators and neurodevelopmental performance. Methods: A cross-sectional study was conducted in children enrolled in community childcare centers. Nutritional status was assessed using anthropometric indicators according to World Health Organization growth standards, including weight for age, height for age, and body mass index for age. Neurodevelopment was evaluated using the Escala Abreviada de Desarrollo (EAD). Household food insecurity was measured through a validated questionnaire. Descriptive statistics were performed, and associations between variables were analyzed using correlation tests and group comparisons according to data distribution. Results: Most participants presented adequate nutritional status; however, a proportion of children showed risk of stunting or excess weight. Neurodevelopmental scores were generally within expected ranges, although variability was observed across developmental domains. Significant associations were identified between certain anthropometric indicators and neurodevelopmental outcomes. Moderate to severe household food insecurity was identified in 21.4% of participating households. Conclusions: Nutritional status and household food insecurity represent important contextual factors for child health in vulnerable urban populations. These findings highlight the importance of integrated nutritional and developmental monitoring strategies within early childhood programs. Further longitudinal studies are required to clarify causal pathways and to guide targeted public health interventions in similar contexts. Full article

Background/Objectives: Excess weight and dyslipidemia are health conditions growing worldwide in children, including indigenous populations. The concern is their related comorbidities, which could appear at an early age. Given limited information on Seri children, this study aimed to evaluate the prevalence of excess weight and dyslipidemia, and to identify factors associated with BMI-for-age Z-score and dyslipidemia. Methods: This cross-sectional study was conducted among Seri children aged 3–11 years. For prevalence analysis, the BMI-for-age Z-score was calculated as an indicator of excess weight. Dyslipidemia was assessed only in school-age children. Information was collected on potential associated variables, including maternal nutritional status, children’s sleep behaviors, physical activity, diet, and cardiovascular health, as well as household characteristics such as the modernity index and food insecurity. Results: A total of 154 Seri children were evaluated. Among preschoolers, 18.8% were classified at risk of overweight. In school-age children, the combined prevalence of overweight and obesity was 32.8%. Maternal BMI and weight, the modernity index, and being a boy were positively associated with the BMI-for-age Z-score, whereas having food insecurity, cardiovascular health score, and sleep time were negatively associated. Dyslipidemia prevalence was 46.1% among school-age Seri children. Having dyslipidemia was positively associated with maternal BMI, percentage of energy intake from ultra-processed products, paternal occupation as a merchant, and child age, and negatively associated with the number of remunerative maternal economic activities. Conclusions: These findings provide evidence on the prevalence of excess weight and dyslipidemia and their associated factors among Seri children and may inform future research and health strategies in Seri and other vulnerable populations. Full article

Background: Childhood obesity is a complex public health issue in which parental perceptions and family dietary behaviors are pivotal. This study assessed the feasibility of the Smart Family lifestyle counseling intervention in Greek primary care. It explored changes in children’s dietary behaviors relative to parental weight perception and Mediterranean diet adherence. Methods: A single-arm pretest–posttest pilot study was conducted in Patras, Greece, from Health4EUKids Joint Action. The intervention consisted of four monthly face-to-face counseling sessions using the Smart Family methodology. In total, 49 parent–child dyads (aged 2–12 years) completed the program. Data collection included child anthropometric measurements, validated food frequency questionnaires, parental perception of child weight status, and parental Mediterranean diet adherence. Results: Parents who underestimated their child’s weight status had significantly higher Mediterranean diet scores than those who overestimated (p = 0.032); those with low adherence tended to overestimate and those with moderate adherence to underestimate. The largest reduction was observed for sweets and desserts (median −2.35 servings/week), with significant reductions in sugar-sweetened beverages, grains and cereals, whole wheat products, and dairy. Fish and vegetable intake increased significantly, but fruit intake did not change. Changes in fast food and red meat differed significantly across Mediterranean diet score tertiles, with larger decreases in the lower tertiles. Conclusions: Smart Family counseling was feasible to deliver through trained healthcare professionals in Greek primary care over four months, with reductions in selected discretionary foods observed alongside the intervention. Parental weight perception and Mediterranean diet adherence emerged as potential barriers to change although the findings are exploratory and require confirmation in a future controlled trial. Full article

Background/Objectives: Empowered mothers are more likely to adopt recommended childcare practices, thereby contributing to reduced childhood undernutrition. However, the magnitude of the association between maternal empowerment and childhood undernutrition in Bangladesh has not been comprehensively assessed. This study aims to address this research gap. Methods: The Bangladesh Demographic and Health Survey (BDHS) 2017-18 and BDHS 2022 served as data sources. Maternal empowerment was assessed across three domains, e.g., attitude to violence, social independence, and decision making, using the Survey-based Women’s Empowerment (SWPER) index. The undernutrition status of children was assessed through z-score based indicators, including stunting (height-for-age z-score < −2 SD), wasting (weight-for-height z-score < −2 SD), and underweight (weight-for-age < −2 SD). Children with at least two and any of these undernutrition conditions were categorized as multiple undernutrition and any undernutrition, respectively. Multivariable logistic regression models were utilized to observe the survey-specific and pooled association between maternal empowerment and childhood undernutrition. Results: The analysis includes 11,647 mother–child pairs. The association between maternal empowerment and childhood undernutrition was consistent across individual surveys and the pooled sample, although the significance level varied by empowerment domains and undernutrition categories. Maternal social independence was found to be a significant protective factor against both multiple and any childhood undernutrition status in individual surveys and the pooled sample. For example, in the pooled sample, high maternal empowerment in the social independence domain was significantly associated with 18% (AOR: 0.82; 95% CI: 0.69, 0.98; p = 0.026) lower odds of multiple undernutrition statuses and 18% (AOR: 0.82; 95% CI: 0.71, 0.95; p = 0.009) lower odds of any undernutrition statuses than those of low maternal empowerment. Conclusions: Improving the status of maternal social independence can potentially result in reduced childhood undernutrition. The scope remains to cascade the benefits of the other two maternal empowerment domains, e.g., attitude to violence and decision making, to child nutrition in Bangladesh. Full article

Background: Parents of children with attention-deficit/hyperactivity disorder (ADHD) and sleep problems can experience challenges and negative health effects. The aim of this study was to explore parents’ own health-related experiences as their child with ADHD and sleep problems underwent a sleep intervention with a weighted blanket. Methods: A convergent mixed methods design was undertaken. Sociodemographic and questionnaire data were collected from 68 parents at baseline and at the 16-week follow-up. Paired-samples t-tests were used to analyze the data. An inductive qualitative content analysis was used to analyze interviews with 21 parents after the follow-up. An integrative analysis was performed and assessed for confirmation, expansion, or disconfirmation. Results: At the follow-up, parents reported improvements in their own health status (EQ-5D-3L—index 0.83 ± 0.15 vs. 0.87 ± 0.13; p = 0.034), in well-being (Outcome Rating Scale—individual 7.08 ± 2.22 vs. 7.55 ± 1.82; p = 0.045), and in family life (the Brief Child and Family Phone Interview—family comfort score 5.62 ± 1.62 vs. 5.14 ± 1.66; p = 0.003). Parents’ health-related experiences were described as: (1) having a sense of well-being, including being well rested, sustaining energy, reaching a state of calm, and finding hope, (2) balancing family life, including reclaiming personal sphere and nurturing relationships, and (3) managing everyday life, including keeping to the daily schedule and dealing with household chores. The integrative analysis resulted in the overarching themes of health through: (1) inner strength (confirmed), (2) recovery (expanded), (3) close relationships (confirmed), and (4) social engagements (expanded). Conclusions: The findings suggest that sleep interventions for children with ADHD and sleep problems may also be associated with positive changes in aspects of parents’ health, well-being, and family life. Full article

Background: School feeding programs aim to improve child nutrition, and they may influence weight outcomes insofar as program modalities and household responses alter children’s total energy intake. This is especially relevant in countries facing the double burden of malnutrition, where undernutrition and micronutrient deficiencies coexist with rising overweight and obesity. This study estimates the effect of Peru’s former National School Feeding Program on obesity and excess weight among children aged 36 to 59 months under a selection-on-observables identification strategy and assesses whether impacts differ across operational modalities, particularly breakfast-only versus breakfast plus lunch and ready-to-eat rations versus foods delivered for preparation. Methods: We use repeated cross-sectional microdata from the Demographic and Health Survey (ENDES) pooled over 2014 to 2018 and link them to administrative information. The sample includes 18,959 children aged 36 to 59 months. To improve comparability, we estimate propensity score weights targeting the average treatment effect on the treated (ATT) using a machine learning generalized boosted model (GBM), and assess covariate balance using standardized mean differences and Kolmogorov–Smirnov statistics. Identification assumes conditional independence given observed covariates and overlap (common support). Main estimates rely on weighted probit models with fixed effects, progressively adding exposure duration, modality indicators, and controls. Distributional effects are examined using quantile regression on the continuous weight-for-height z-score. Results: Without differentiating modalities, beneficiary status is not associated with a statistically significant change in obesity, while pooled baseline estimates indicate a statistically significant higher probability of excess weight. Modality-specific results show that obesity declines only when Qali Warma is delivered as breakfast plus lunch through products to be prepared (approximately −1.0 percentage point in parsimonious models and −0.4 percentage points after controls). Evidence for excess weight is directionally consistent by modality but less conclusive once controls are included. Conclusions: Qali Warma’s effects on early-childhood weight outcomes depend on implementation modality. Evaluations of school feeding programs should incorporate operational heterogeneity, particularly during program redesign. Full article

Background/Objectives: Children and adolescents exposed to criminal victimization are at increased risk for depression; however, the contribution of nutritional status to depressive symptom severity in this vulnerable population remains poorly understood. Therefore, we aimed to examine the associations between depression severity and nutritional parameters in child and adolescent victims of crime. Methods: This cross-sectional study included 72 children and adolescents (aged 10–16 years) referred to a forensic medicine department in Türkiye. Nutritional status was assessed using anthropometric measurements (body weight, body mass index [BMI], BMI-Z score, and body fat percentage), three-day dietary records, and the Mediterranean Diet Quality Index (KIDMED). Depression severity was evaluated using the Kutcher Adolescent Depression Scale (KADS). The associations were analyzed using Pearson’s rho correlation and forward stepwise linear regression. Potential confounding variables, including age, gender, socioeconomic status, and trauma-related characteristics, were recorded and considered during the analysis; however, due to the limited sample size and to avoid model overparameterization, they were not fully adjusted for in the final model. Results: Depression severity was positively correlated with the body weight, BMI, BMI-Z score, body fat percentage, and dietary energy, carbohydrate, protein, and fat intakes (all p < 0.05). In contrast, the vitamin C and dietary fiber intakes, breastfeeding duration, and KIDMED scores were negatively correlated with the KADS scores (p < 0.05). Regression analysis revealed that the lower KIDMED scores, higher body fat percentage, and greater body weight were significantly associated with depression severity, collectively explaining 82.2% of the variance in the KADS scores. Conclusions: Poor diet quality and adverse body composition are strongly associated with depression severity in child and adolescent victims of crime. These findings suggest that nutritional factors may be associated with depression severity in child and adolescent victims of crime; however, the results should be interpreted as preliminary and hypothesis-generating. Full article

Background and Objectives: The COVID-19 pandemic profoundly disrupted global healthcare systems, limiting access to diagnostic and therapeutic services for chronic diseases. Patients with decompensated liver cirrhosis were particularly vulnerable due to their fragile clinical status and dependence on continuous medical care. This study aimed to evaluate the temporal evolution of clinical, biological, and prognostic parameters in patients admitted emergently with decompensated liver cirrhosis across three distinct phases: pre-pandemic, pandemic, and post-pandemic. Materials and Methods: A retrospective, single-center study was conducted at the Department of Gastroenterology, Municipal Clinical Emergency Hospital, Timișoara, Romania, including 355 patients hospitalized between February 2018 and February 2024. Clinical, biochemical, and outcome data were collected and analyzed using univariate and multivariate logistic regression models to identify independent predictors of in-hospital mortality for each study period. Results: Significant temporal variations were observed in disease severity, management, and outcomes. The mean MELD score increased from 18.7 to 21.0 during the pandemic (p = 0.043), while endoscopic evaluations declined markedly (59.4% pre-pandemic vs. 42.7% pandemic, p = 0.037). Mortality rose from 21.7% to 30.2% during the pandemic (p = 0.044) and remained elevated post-pandemic (26.4%). Multivariate regression identified Child–Pugh, MELD, and Baveno scores as consistent mortality predictors, though their relative weight varied by period. During the pandemic, acute complications—particularly jaundice (OR = 294) and upper gastrointestinal bleeding (OR = 355)—became dominant determinants of death. Conclusions: The pandemic transformed cirrhosis from a chronic, manageable disease into an acutely unstable condition, primarily due to delayed presentation and restricted procedural access. Although post-pandemic recovery was evident, residual increases in mortality and severity indicate lasting effects of healthcare disruption, underscoring the need to strengthen system resilience and continuity of care for patients with chronic liver disease. Full article

Background and Objective: This study examines the factors associated with child undernutrition among children under five in Ethiopia, Kenya, Madagascar, and Tanzania. It uses the Composite Index of Anthropometric Failure to measure the full burden of undernutrition, combining weight-for-height (WHZ), weight-for-age (WAZ), and height-for-age (HAZ) indicators. This approach captures children facing multiple forms of failure that single indicators miss. Methods: The study analyzed 37,570 children using nationally representative Demographic and Health Survey (DHS) data for Ethiopia 2019, Kenya 2022, Madagascar 2021, and Tanzania 2022. A binary logistic regression model identified key predictors of child undernutrition across countries. Results: The prevalence of anthropometric failure ranged from 24% to 44%. Higher parental education, child’s age, socioeconomic status, child’s sex, and a postnatal checkup within 2 months were associated with a lower odds of anthropometric failure. Children of educated mothers in Ethiopia (AOR = 0.547) and Tanzania (AOR = 0.606) had better outcomes. Educated fathers in Kenya (AOR = 0.589) and Madagascar (AOR = 0.369) reduced the risk of child undernutrition. Children aged 13–24 months had a higher risk in all countries. In Madagascar (AOR = 0.309), children who received a postnatal checkup had a decreased risk of malnutrition. Children from rich households in Ethiopia (AOR = 0.645) and from middle (AOR = 0.683) and rich (AOR = 0.535) households in Kenya had significantly lower odds of undernutrition. In comparison, female children had lower odds of anthropometric failure in all four countries. Conclusions: Viewed through a nutrition equity lens, these findings underscore the importance of recognizing how the intersectionality of anthropometric failures disproportionately affects children from poorer households and communities with limited access to education and postnatal care. This study advances existing knowledge by using the Composite Index of Anthropometric Failure to show overlapping and hidden forms of undernutrition. The findings identify child age, parental education, postnatal checkup, child sex, and socioeconomic status as shared priorities for reducing undernutrition. The results provide country-specific insights for designing integrated, evidence-based nutrition interventions in Eastern Africa. Full article

Ensuring equitable and inclusive access to children’s extracurricular activity facilities represents a profound manifestation of educational equity and is crucial for promoting children’s holistic development and societal sustainability. However, the underlying spatial mechanisms shaping their equity remain insufficiently explored. Using Tianjin’s central urban area as a case study, this study examines the spatial accessibility and equity of such facilities under dual government–market provision systems. The multi-mode Huff two-step floating catchment area model (MM-Huff-2SFCA) was employed to assess accessibility across walking, e-bike, public transport, and private car modes, integrating facility quality, household preference, and time-based distance decay. Equity was further evaluated using Lorenz curves and Gini coefficients across multiple spatial scales, while geographically weighted regression (GWR) identified spatial heterogeneity in factors such as child population density, transport infrastructure, household economic status, and basic education coverage. Results indicate that macro-level spatial balance masks substantial micro-scale inequities, particularly among transport-disadvantaged groups. Government and market systems exhibit contrasting spatial logics, forming a compensation–complementarity pattern across urban space. These findings underscore the need for refined and differentiated governance in extracurricular activity facilities planning, integrating spatial planning, transport accessibility, and social equity to advance child-friendly urban development and equitable public service provision. Full article

Background/Objectives: Childhood obesity remains a major public health issue, particularly in Mediterranean countries such as Greece. Although parental influences on children’s weight have been extensively studied, fewer studies have jointly examined parental mental health, feeding practices, sociodemographic factors, and biological stress markers. This study aimed to investigate associations between psychological status, educational level, feeding behaviors, and children’s Body Mass Index (BMI) in a Greek sample. A pilot assessment of salivary cortisol was included in evaluating its feasibility as an objective biomarker of parental stress. Subjects and Methods: A total of 103 parent–child dyads participated in this cross-sectional study. Children’s BMI was classified using World Health Organization (WHO) growth standards. Parental stress, anxiety, and depressive symptoms were assessed using the Perceived Stress Scale-14 (PSS-14) and the Depression Anxiety Stress Scale-21 (DASS-21) questionnaires. Feeding practices were evaluated with the Comprehensive Feeding Practices Questionnaire (CFPQ). Statistical analyses included Pearson correlations, independent samples t-tests, one-way ANOVA, Mann–Whitney U, and Kruskal–Wallis tests. A subsample provided saliva samples for cortisol analysis to assess feasibility and explore the potential associations with parental stress indicators. Results: Parental BMI showed a strong positive association with child BMI (p = 0.002). Higher parental anxiety (p = 0.002) and depression (p = 0.009) were also associated with increased child BMI. Restrictive (p < 0.001) and emotion-driven (p < 0.001) feeding practices were associated with higher child BMI, whereas monitoring (p = 0.013) and health-promoting feeding practices (p = 0.001) appeared protective. Lower parental education was related to a higher BMI in both parents (p = 0.001) and children (p = 0.002) and to more frequent use of restrictive feeding strategies (p = 0.001). WHO charts identified a greater proportion of children as overweight or obese compared with the Centers for Disease Control and Prevention (CDC) criteria. The analysis showed statistically significant differences between the two classification systems (χ² (4) = 159.704, p < 0.001), indicating that BMI categorization varies considerably depending on the reference system used. No significant associations were observed with residential environment or salivary cortisol, likely due to the limited size of the pilot biomarker subsample. Conclusions: The findings highlight the combined effect of parental mental health status, educational level, and feeding practices on child BMI within the Greek context. The preliminary inclusion of a biological stress marker provides added value to the existing research in this area. These results underscore the importance of prevention strategies that promote parental psychological wellbeing and responsive feeding practices while addressing socioeconomic disparities to reduce the childhood obesity risk. Full article

Background: Streptococcus pneumoniae is a leading cause of child mortality in Nepal despite the introduction of the 10-valent pneumococcal conjugate vaccine (PCV10). Vaccine effectiveness is threatened by the emergence of non-vaccine serotypes (NVTs) and the multiple serotypes carriage which often fail to be detected by traditional methods. We aimed to study changes in serotype distribution before and after PCV10 immunization among infants, including serotype dominance in Nepalese infants in the post-vaccine era. Methods: We enrolled infants in a longitudinal cohort study (2020–2022) conducted in Bhaktapur, Nepal. Nasopharyngeal swabs were collected before PCV10 dose 1 (6 weeks) and at 9 and 12 months post-immunization. We used a sensitive nanofluidic qPCR platform to detect multiple serotypes and establish their hierarchy by quantifying the bacterial load of each strain. Inverse Probability Weighting (IPW) adjusted risk factor analysis was used to account for loss to follow-up. Results: PCV10 successfully reduced vaccine-type (VT) carriage, declining sharply from 32.8% at 6 weeks to 4.8% at 12 months. VTs were pushed from being the dominant strain to occupying subdominant roles in co-colonization. Conversely, NVTs rapidly filled the vacated niche, showing a significant increase in their dominant status (p < 0.001). The most common replacing NVTs that rose to dominance were 35B, 19A, 6C/6D, and 15B/15C. Significant risk factors for carriage included older infancy (aOR 3.4, 95%CI: 2.6–4.5 at 9 months), a household kitchen in the living area (aOR 1.4, 95%CI: 1.0–1.9), and winter (aOR 1.7, 95%CI: 1.5–2.7) and pre-monsoon seasons (aOR 2.0, 95%CI: 1.5–2.8). Conclusions: While PCV10 reduced overall VT circulation, the persistence of VTs in subdominant niches creates a continuous reservoir for potential re-emergence and antibiotic resistance. This clear hierarchical shift in dominance towards NVTs underscores the urgent need for a public health strategy that includes the adoption of a higher-valent PCV to provide broader protection, and interventions targeting environmental risk factors are essential to sustain long-term reductions in pneumococcal colonization. Full article

Background/Objectives: This study examines factors associated with child overweight/obesity (OW/OB), pre-COVID-19 and during the COVID-19 pandemic, among all U.S. children aged 10–17 years, with or without developmental disabilities (DD) and, separately, among the subgroup of children diagnosed with a DD. Methods: Using data from the National Survey of Children’s Health (NSCH, 2018–2021), we applied descriptive statistics and multivariate logistic regression analyses to estimate the odds ratios of associations between family resilience, screen time, and childhood overweight/obesity. Family resilience measures families’ communication and problem-solving behaviors. Screentime is time spent on TV, computer, cellphone or electronic devices. Results: In descriptive analyses, during COVID-19, 35.8% of all children were identified as OW/OB compared to 32.8% pre-COVID-19—a weighted increase of 3.0%. Among children with developmental disabilities, OW/OB increased from 37.4% to 39.3%. Children reporting ≥4 h of screentime use increased from pre-COVID-19 to during COVID-19 in both groups (All Children: pre-COVID: 33.5%, during COVID: 41.6%; Developmental Disabilities: pre-COVID: 39.9%, during COVID: 49.4%). Among all children, there was a positive and strong association between screentime use and OW/OB at both pre- and during COVID-19 years. Children belonging to households with low family resiliency had 1.31 times the odds of being overweight/obese (95% CI, 1.06–1.63, p < 0.05) before the pandemic. However, these results were not significant after the pandemic. Conclusions: Prevalence of overweight/obesity in all children and children with DD during the COVID-19 pandemic continued to rise. Screentime was found to be a key determinant in increased weight status. Contrary to our hypothesis, family resilience failed to emerge as a significant protective factor for OW/OB; additional research is needed to explore the protective role of family resiliency on childhood obesity. Study findings may provide insights into developing best practices and tailored interventions with early OW/OB screening and programs tailored towards the youngest group of children aged 10–12 years or below. Full article

Background: Childhood undernutrition and overnutrition continue to be major public health challenges in South Africa. There is limited evidence on how socio-economic factors and dietary behaviors influence nutritional outcomes among school-aged children, particularly in rural areas such as Thulamela Municipality. Objective: This study aimed to examine the socio-demographic determinants, dietary patterns, and nutritional status among school-aged children in Thulamela Municipality, Limpopo Province, South Africa. Methods: A cross-sectional survey was conducted with 347 children aged 8–12 years. Simple random sampling was used to select eight villages from a total of 227 within the municipality. A snowball sampling method was used to recruit eligible children. Data on socio-demographic characteristics, including the child’s sex, parental education level, marital status, and employment status, were collected. Additionally, their dietary habits and meal frequency patterns were collected using structured questionnaires. Anthropometric measurements including height, weight, and BMI-for-age were obtained following WHO growth standards. Associations between variables were assessed using chi-square tests, with p-values < 0.05 considered statistically significant. Results: The prevalence of severe and moderate stunting was 20.5% and 21.0%, respectively. Overweight conditions and obesity affected 32.6% and 16.2% of participants, respectively. Parental education (p = 0.027), marital status (p = 0.001), and household income (p = 0.043) showed significant associations with height-for-age and BMI-for-age Z-scores. Additionally, regular breakfast consumption and the frequent intake of vegetables and dairy products were positively associated with improved nutritional outcomes (p < 0.05). Conclusions: The nutritional profile of school-aged children in Thulamela Municipality reflects a double burden of malnutrition, with concurrent high rates of stunting, overweight conditions, and obesity. Interventions that promote balanced diets and address socio-economic disparities are crucial for improving child growth and overall health. Socio-economic factors, including parental education, marital status, and household income, were significantly associated with children’s height-for-age and BMI-for-age. Furthermore, the regular consumption of breakfast, vegetables, and dairy products was associated with better nutritional outcomes, highlighting the influence of both dietary behaviors and socio-demographic determinants on child growth and health. Implementing nutrition education programs within schools that emphasize the value of balanced diets and highlighting the significance of eating breakfast regularly and incorporating vegetables and dairy products into daily meals is important. These programs should include both children and their caregivers to support regular healthy eating behaviors at home and in school. Additionally, schools should carry out regular growth monitoring and nutritional assessments to identify early indications of undernutrition or overnutrition, enabling prompt referrals and interventions for children who may be at risk. Full article

Background: Maternal vitamin D status during pregnancy has been hypothesized to influence offspring neurodevelopment; however, the evidence remains inconsistent. Methods: We studied 66 mother–child pairs from the KLOTHO cohort with serum 25-hydroxyvitamin D [25(OH)D] measurements at delivery (maternal and umbilical cord). At 10 years of age, neurodevelopment was assessed using standardized questionnaires, generating composite z-scores for cognitive (cognitive, communication, motor) and psychosocial (social–sentimental, special interests) domains. Multivariable models were adjusted for sex, maternal body mass index and education, and neonatal birth weight and gestational age. Results: Maternal 25(OH)D deficiency (<50 nmol/L) was not associated with cognitive composite scores (p = 0.77). The psychosocial composite scores showed a non-significant negative trend (p = 0.29). Neonatal deficiency showed no consistent association with cognition (p = 0.99) or psychosocial outcomes (p = 0.30). Exploratory partial correlations suggested a positive association between maternal 25(OH)D and psychosocial development (r = 0.60, p = 0.038, n = 12). Seasonal variation in maternal vitamin D was observed (autumn: 56.0 ± 24.6 vs. winter: 32.0 ± 18.3 nmol/L; p < 0.0001), but did not translate into differences in 10-year outcomes. Conclusions: In this cohort of 66 pairs, perinatal vitamin D status was not a determinant of global cognition at 10 years of age. A potential link with psychosocial development requires replication in larger longitudinal studies. Due to the limited sample size, all findings should be interpreted as exploratory. Full article