Search Results (1,767)

Background: The prevalence of overweight and obesity in Chinese school-aged children has continued to rise, posing significant health risks. Rational nutrition knowledge and dietary behaviors are important for obesity prevention and control. The ‘Know Your Food’ campaign aimed to promote nutritious diets and empower informed food choices among Chinese children and young people. This study aims to assess both the implementation and effectiveness of the campaign in primary school settings. Methods: The monitoring framework was designed using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework and consisted of a series of social media advocacy and school-based nutrition sessions. A monitoring system based on the RE-AIM model was developed to assess the impact of the campaign. Observational data on reach, effectiveness, adoption, implementation, and maintenance were collected through media tracking, self-reported questionnaires, and focus group discussions. Results: Between 13 May and 15 June 2022, the campaign gained 77.13 million views and 291,029 interactions from social media. The campaign garnered positive feedback as it reached a wide audience through traditional media, social media and school sessions. 94.7% of the respondents were willing to share campaign information. After the session, more than two thirds of the students reported behavior change, with 70.0% reporting eating five vegetables a day, 67.7% reporting drinking fewer sugary drinks, 74.0% reporting replacing snacks with fruits/nuts, 76.9% reporting doing exercises, and 78.0% reporting getting sufficient sleep. Conclusions: The ‘Know Your Food’ campaign was able to reach and engage the target audience, increasing nutrition knowledge, and influencing behavior change within the short observation window. The findings exemplify the implementation and effectiveness of this campaign and highlight the importance of using a comprehensive assessment framework to assess such nutrition campaigns. Full article

Background: Over the past decades, the global onset of menarche has progressively advanced, driven by complex interactions between metabolic, psychosocial, and environmental factors. Beyond its reproductive significance, menarche represents a critical developmental milestone that coincides with increased vulnerability to mental health difficulties. Contemporary determinants such as childhood obesity, early-life adversity, and exposure to endocrine-disrupting chemicals (EDCs) may accelerate pubertal timing while simultaneously shaping adverse psychological trajectories during adolescence. Objectives: This review aims to provide a translational and clinically oriented synthesis of modern determinants of earlier menarche and their associations with mental health outcomes in girls and adolescents, highlighting implications for early identification, prevention, and integrated clinical care. Methods: We conducted a narrative review mapping a scoping literature search conducted using PubMed/Medline, Scopus, and PsycINFO, focusing on literature from the last decade (2016–2026), with emphasis on systematic reviews, meta-analyses, and longitudinal cohort studies. Evidence was synthesized across biological, psychosocial, and environmental domains. Results: Accumulating evidence indicates that higher childhood adiposity, psychosocial stress, and EDC exposure are consistently associated with advanced pubertal timing. Earlier menarche correlates with an elevated risk of depressive symptoms, anxiety, self-harm, and body image-related distress, although effect sizes vary across populations. Emerging longitudinal data suggest that the peri-menarcheal period represents a critical window for symptom exacerbation. These associations appear to be mediated by biological mechanisms (e.g., hormonal shifts, hypothalamic–pituitary–adrenal (HPA) axis reactivity) and social processes including peer-comparison dynamics and premature sexualization. Conclusions: Earlier menarche acts as a biopsychosocial sentinel event rather than an isolated gynecological milestone. Integrating mental health screening and anticipatory guidance into pediatric and gynecological care is essential for early risk detection. A multidisciplinary, equity-oriented approach is required to address both individual vulnerability and broader environmental determinants. Full article

Pediatric obesity is a complex, multifactorial pandemic with serious early-onset comorbidities, including prediabetes, type 2 diabetes, metabolic dysfunction-associated steatotic liver disease (MASLD), and cardiovascular disorders. While lifestyle modifications and the Mediterranean diet remain primary interventions, artificial intelligence (AI) is emerging as a critical tool for early diagnosis and personalized management. This review evaluates the current role of AI in predicting and treating childhood obesity and its complications. A literature search was conducted on PubMed and Google Scholar for English-language articles published from 2015 onward. Search terms included combinations of keywords related to “obesity”, “pediatric”, “comorbidities” (e.g., MASLD, diabetes), and “artificial intelligence” (e.g., machine learning, deep learning, multi-omics). Eligible study types ranged from original articles to systematic reviews and clinical guidelines. By integrating multi-omic data (genome, epigenome, transcriptome, metabolome, microbiota) with socio-psychological metrics, AI can predict obesity risk and early complications. Machine learning (ML) and deep learning have successfully identified specific metabolites, gut flora alterations, neurological pathways, and metabolic SNPs linked to obesity susceptibility. Furthermore, ML-driven prognostic models enable risk assessment for MASLD or diabetes progression, while specialized software supports remote lifestyle monitoring and tailored dietary interventions. AI has the potential to revolutionize pediatric obesity management through precision medicine. However, challenges regarding data privacy, digital literacy, and equitable access persist. Because current evidence relies heavily on limited and heterogeneous pediatric datasets, large-scale, well-characterized, and externally validated cohorts are essential to establish the clinical applicability of AI models before routine implementation. Full article

Background: Epidemiological patterns vary across populations and treatment centres worldwide, with obesity consistently reported as the main risk factor. The primary aim of this study was to characterise age- and sex-adjusted body mass index (BMI) z-scores in children with slipped capital femoral epiphysis (SCFE) treated in Bern, as well as to investigate their association with clinical characteristics. A secondary aim was to compare the observed characteristics with those reported internationally. Methods: This is a single-centre, retrospective cohort study conducted at the Department of Pediatric Surgery, University Children’s Hospital, Inselspital, University of Bern, and included patients under the age of 18 who were treated for SCFE between 2005 and 2025. Demographic, clinical, and anthropometric data were collected for all patients, including sex, age at the time of surgery, slip severity using the Southwick angle, intraoperative slip stability, symptom duration, as classified by Fahey/O’Brien, affected side of the hip, as well as height and weight at the time of surgery. The primary outcome was the age- and sex-adjusted BMI z-score at the time of surgery. Analyses stratified by sex, age, and slip severity were prespecified as secondary analyses. All other subgroup analyses were exploratory and hypothesis-generating. Results: The final cohort included 90 males (69.23%) and 40 females (30.77%). BMI data were available for 114 of the 130 patients. Two-thirds of the patients (62.3%) were overweight or obese. The median BMI z-score was 1.43 (interquartile range 0.72–2.19; mean 1.31 ± 1.11) and was significantly higher than the expected reference value of 0 (p < 0.001). There was no statistically significant difference in BMI z-scores between females and males (p = 0.288). A statistically significant association was observed between age at surgery and BMI z-score. Higher age at surgery was associated with lower BMI z-scores (p = 0.007). There was a trend towards lower BMI z-scores with increasing slip severity. However, this difference did not reach statistical significance (p = 0.158). In an exploratory, hypothesis-generating analysis, patients with stable slips had significantly higher BMI z-scores than those with unstable slips (p = 0.008). This association persisted after adjustment for age and after correction for multiple testing (p_adj = 0.032). A further exploratory, hypothesis-generating analysis showed that BMI z-scores also differed significantly across symptom duration, as classified by Fahey/O’Brien (p = 0.026). The lowest values were observed in the acute-on-chronic group. However, these differences just missed the threshold for statistical significance after adjustment for age and after correction for multiple testing (p_adj = 0.052). Conclusions: In Switzerland, children diagnosed with SCFE had a significantly higher BMI compared to the reference population. Our study revealed that two-thirds of the children were classified as overweight or obese, with obesity being approximately ten times more prevalent among this group compared to the overall Swiss paediatric population. A higher relative body weight was found to be independently associated with a younger age at surgery, consistent with obesity accelerating skeletal maturation and advancing the manifestation of SCFE. We identified a trend towards lower BMI z-scores with increasing slip severity; however, this finding did not reach statistical significance. Consequently, elevated body weight should be regarded as a marker of predisposition and earlier disease onset rather than of slip severity. Childhood obesity prevention may be relevant to SCFE prevention in Switzerland. Full article

Background/Objectives: Childhood and adolescent overweight and obesity are associated with adverse body composition and impaired glucose metabolism. Probiotic and synbiotic supplementation may modulate the gut microbiota and has been proposed as a potential adjunctive strategy for obesity management. This systematic review and meta-analysis aimed to evaluate the effects of probiotic and synbiotic supplementation on body composition and glucose metabolism in children and adolescents with overweight or obesity. Methods: This review was conducted according to the PRISMA 2020 statement. PubMed, Embase, Web of Science, the Cochrane Library, and CNKI were searched from inception to 5 May 2026. Randomized controlled trials evaluating probiotic or synbiotic supplementation in children and adolescents with overweight or obesity were included. Outcomes included BMI z-score, BMI, waist circumference, body fat percentage, fasting glucose, fasting insulin, and HOMA-IR. Random-effects meta-analyses, sensitivity analyses, and subgroup analyses according to intervention type (probiotic versus synbiotic supplementation) were performed using mean differences (MDs) and 95% confidence intervals (CIs). Risk of bias was assessed using RoB 2, and certainty of evidence was evaluated using GRADE. Results: Sixteen randomized controlled trials were included. Probiotic or synbiotic supplementation did not significantly reduce BMI z-score (MD = −0.03, 95% CI −0.11 to 0.05), waist circumference (MD = 0.60 cm, 95% CI −1.57 to 2.77), or body fat percentage (MD = −0.29 percentage points, 95% CI −1.64 to 1.06). A modest reduction in BMI was observed (MD = −0.91 kg/m², 95% CI −1.81 to −0.01), although this finding should be interpreted cautiously because no significant improvement was observed in BMI z-score. No significant effects were found for fasting glucose, fasting insulin, or HOMA-IR. Subgroup analyses showed no significant differences between probiotic and synbiotic supplementation for BMI, BMI z-score, or waist circumference, whereas a significant subgroup difference was observed for fasting glucose. Conclusions: Probiotic or synbiotic supplementation may be associated with a modest reduction in BMI; however, the certainty of this evidence was low, which limits confidence in its clinical implications. Current evidence does not support clear benefits for BMI z-score, waist circumference, body fat percentage, or glucose metabolism. The subgroup findings, particularly for fasting glucose, should be interpreted cautiously because they were based on a limited number of studies. Further high-quality randomized controlled trials are warranted. Full article

Background: Adolescence represents an essential stage of life for the prevention of metabolic changes associated with diseases, especially cardiovascular diseases. Objectives: The objectives of this study were to identify nutritional status and associate it with metabolic alterations in adolescent girls. Methods: We conducted a cross-sectional study that included adolescent 10–14-year-old girls from public schools. The research was undertaken with 79 girls. Results: We identified that over half of the girls were sedentary, excessively exposed to screens, physically inactive, and did not practice physical activities in sunlight. The menarche age was significantly lower in girls with overweight and obesity. Most girls skipped breakfast (53.1%) and watched television (84.8%). We observed a high percentage of adolescents with overweight (65.7%), hypovitaminosis D (78.4%) and high levels of triglycerides (69.6%). We did not find an association between hypovitaminosis D and some recorded metabolic parameters (glycemia, glycated hemoglobin, insulin, total cholesterol, HDL-c, LDL-c and triglycerides). However, insulin levels, HOMA-IR, HDL-c, and systolic blood pressure were significantly associated with overweight and obesity, and our results may reflect the characteristics of the study sample and suggest that obese children may already exhibit early signs and risk factors for these chronic diseases during childhood, consistent with national and international data. Conclusions: The identification of metabolic alterations, nutritional status and lifestyle enables early and directed interventions, which may lead to the present and future cardiometabolic health improvements relative to adolescents. Full article

Background: Childhood obesity is a growing health concern and added sugar intake has been associated with increased obesity risk. Emerging evidence suggests that miR-143-5p and miR-223-3p are involved in metabolic regulation. Therefore, this study evaluated their plasma expression according to added sugar intake and their association with cardiometabolic risk parameters. Methods: This cross-sectional study included 91 children aged 6–12 years, comprising 44 with normal weight and 47 with overweight/obesity. Anthropometric measurements, clinical characteristics, and dietary added sugar intake were assessed. Plasma expression of miR-143-5p and miR-223-3p was quantified by RT-qPCR. Results: Compared with low added sugar intake, high added sugar intake was associated with lower plasma miR-143-5p expression and higher miR-223-3p expression. Both miR-143-5p and miR-223-3p expression levels were higher in children with overweight/obesity and insulin resistance than in their respective counterparts. In adjusted analyses, neither miRNA was associated with cardiometabolic risk parameters. However, added sugar intake was positively associated with miR-223-3p expression (β = 0.188, 95% CI: 0.022, 0.354) and glucose levels (β = 1.944, 95% CI: 0.133, 3.755). Conclusions: These findings suggest that higher added sugar intake is associated with altered circulating miRNA expression and higher fasting glucose concentrations in school-aged children. Full article

Childhood obesity may be associated with an accelerated loss of thermogenic adipocytes, increasing the risk of progressive lipid accumulation and metabolic deterioration. Early detection of the loss of thermogenic adipocytes would allow improved intervention to abrogate childhood obesity, yet reliable markers of human thermogenic adipocytes remain limited. We previously identified expression of FAM153A (family with sequence similarity 153 member A) in the developing human adipose tissue. Here, we investigated the expression pattern and potential association of FAM153A with the thermogenic transcriptional program in the adipose tissue of infants, children, and adolescents. We found that adipocyte FAM153A expression was triggered by beta adrenergic receptor stimulation, a key signal of adipocyte thermogenesis. FAM153A protein was confined to preadipocyte and adipocyte nuclei, and FAM153A mRNA expression positively correlated with the mRNA levels of canonical thermogenic adipocyte markers including uncoupling protein 1 (UCP1), myogenic differentiation 1 (MYOD1), type II iodothyronine deiodinase (DIO2), transmembrane protein 26 (TMEM26), Lim Homeobox 8 (LHX8), beta adrenergic receptor 2 (ADRB2), and peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PPARGC1A). Importantly, FAM153A expression was positively associated not only with the expression of individual thermogenic genes but also with their coordinated co-expression. Collectively, our findings identify FAM153A as a novel mRNA biomarker of human thermogenic adipocytes that serves as a robust indicator of the thermogenic transcriptional network. Full article

Vaccinations are a cornerstone of primary prevention in pediatric otolaryngology and play a critical role in reducing the burden of pediatric infectious diseases, particularly acute otitis media (AOM) and HPV-related infections. The introduction and widespread use of pneumococcal conjugate vaccines (PCVs) have been associated with substantial changes in the epidemiology of pediatric AOM, particularly through reductions in vac-cine-serotype disease and complicated forms, while contributing to changes in pathogen distribution with an increased role of non-vaccine serotypes and non-pneumococcal bac-teria, requiring continuous epidemiological surveillance. Prophylactic human papillomavirus (HPV) vaccination in adolescents and young adults effectively prevents oral infection with vaccine-type high-risk HPV, a necessary step in the pathogenesis of HPV-related oropharyngeal carcinoma. Clinical and epidemiological studies demonstrate robust antibody responses and significant reductions in oral HPV prevalence among vaccinated individuals. Although direct evidence of a reduction in oropharyngeal cancer incidence is not yet available, vaccination may consequently reduce the future burden of HPV-related oropharyngeal cancers. Long-term surveillance remains essential to confirm this potential benefit. Barriers to optimal vaccine coverage include unequal access, incomplete vaccination uptake, and limited awareness of HPV-related oral disease. In conclusion, vaccinations provide direct and clinically relevant benefits in pediatric otolaryngology by reducing recurrent AOM, severe complications and surgical interventions. HPV vaccination also reduces vaccine-type oral HPV infection and may consequently contribute to reducing the future burden of HPV-related oropharyngeal cancers. Achieving high vaccination coverage, coupled with continuous epidemiological monitoring, is essential to maximize individual and public health benefits and to inform the development of vaccines with broader serotype coverage. Full article

Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as the most common chronic liver disorder in the pediatric population, closely paralleling the global rise in childhood obesity. Increasing evidence highlights the gut–liver axis as a key contributor to MASLD pathogenesis, with gut microbiota dysbiosis influencing hepatic steatosis through multiple interconnected mechanisms, including increased intestinal permeability, endotoxemia, altered bile acid metabolism, and modulation of host energy homeostasis. In children, the characterization of microbiota signatures associated with MASLD remains challenging due to heterogeneity across studies, age-related microbial dynamics, and methodological variability. This review synthesizes current evidence regarding the role of the gut microbiota in pediatric MASLD, focusing on pathogenetic pathways, reported microbial patterns, and microbiota-targeted therapeutic strategies, while incorporating relevant mechanistic evidence from adult studies where pediatric data remain limited. Although several taxa have been repeatedly associated with pediatric MASLD, findings are not yet sufficiently consistent for clinical application. Interventions such as probiotics, prebiotics, and dietary modulation show promising but still preliminary results, with limited high-quality pediatric trials available. A deeper mechanistic understanding and standardized study designs are needed to clarify causality and to support microbiota-based precision approaches in pediatric MASLD management. Full article

Background/Objectives: Childhood obesity is prevalent in the United States, and although food environments (FEs) may be related to child weight, findings remain inconsistent. This study evaluated neighborhood and home FEs’ associations with children’s weight and explored interactive effects of the neighborhood and home FEs on child weight. We hypothesized that children exposed to less healthy neighborhood and home FEs would have higher weight. Methods: This secondary analysis leveraged baseline data from caregiver–child dyads (n = 115) enrolled in an obesity intervention trial (HABITS). The Modified Retail Food Environment Index (mRFEI) was calculated as the proportion of healthy versus unhealthy food vendors within a 4-mile buffer of participants’ homes using food retailer data from business directories and geographic information systems software. Caregivers reported fruit, vegetable, and sugary beverage availability at home. Child weight was measured and used to determine weight-for-age z-scores (WAZs). Linear regression models were used to examine neighborhood FE, home FE, and their interactions as predictors of child WAZs. Results: Participants were majority non-Hispanic Black (77%) with household incomes of <$30,000/year (73%). Children were 3.0 ± 1.0 years old. Child WAZs were negatively associated with home fruit availability (β = −0.07, 95% CI: −0.14 to −0.01, p = 0.02), with no associations observed for the neighborhood FE or other home FE factors and no interaction between neighborhood and home FEs on weight. Conclusions: There were no significant associations between neighborhood FEs and weight among young children, while within the home FE, only the availability of fruit was associated with child weight. Full article

Overweight in childhood, adolescence and adulthood is now a world-wide epidemic. A variety of preventive and therapeutic measures are being developed with partial success. Since the pioneering studies of D.J. Barker linking maternal famine in pregnancy to long—term undesirable effects on the offspring—the “metabolic syndrome” that stems from long-lasting epigenetic changes, it became evident that there are many undesirable events which affect in-utero fetal growth and development. They often persist postnatally, through childhood and adulthood. The purpose of this review is to discuss the prenatal factors that may have long term effects on postnatal weight gain and obesity that are important contributors to the “obesity” epidemic. These prenatal undesired factors are pregestational and gestational diabetes, pre-pregnancy maternal obesity, excessive weight gain in pregnancy, placental dysfunction and maternal hormonal imbalances. They may affect fetal growth, generally causing excessive growth (macrosomia) and sometimes diminished growth (small for gestational age). These prenatal conditions are associated with epigenetic changes that may contribute to insulin resistance and subsequent metabolic alterations leading to increased food intake, overweight, and obesity. Studies also demonstrate that increased exposure in pregnancy to teratogens, like endocrine disruptors and cigarette smoking, may also affect prenatal and postnatal growth and adiposity. However, many the studies demonstrating the role of these factors are often weakened, as they mainly demonstrate associations and do not sufficiently consider possible confounding factors such as postnatal age, nutrition and lifestyle. Better understanding of these prenatal factors may support more effective prevention and management strategies for childhood overweight and obesity. Full article

Ultra-processed foods (UPFs) are increasingly prevalent in global diets and have been consistently associated with adverse health outcomes. Their consumption during sensitive life stages, such as pregnancy and early childhood, raises significant public health concerns due to potential intergenerational effects. This narrative review critically examines the impact of UPF consumption during pregnancy and early life, with a focus on maternal and child health outcomes, including alterations in gut microbiota composition. Accumulating evidence indicates that UPF consumption is linked to increased risks of obesity, type 2 diabetes, cardiovascular disease, and all-cause mortality. During pregnancy, high UPF intake is associated with poorer diet quality, excessive gestational weight gain, increased inflammation, and unfavorable neonatal outcomes, including altered microbiota transmission and impaired neurodevelopment. In early childhood, UPFs were linked to microbiota dysbiosis, obesity, micronutrient deficiencies, and allergic conditions. Notably, maternal dietary pattern strongly influences the early and sustained incorporation of UPFs into children’s diets. Overall, UPF consumption during pregnancy and early childhood represents a modifiable risk factor with far-reaching health implications. A deeper understanding of the dietary–microbiome–health axis is essential for developing effective nutritional strategies to optimize maternal and child health outcomes and reduce long-term disease risks. Full article

Background/Objectives: Despite existing guidelines on limiting screen time, children and adolescents are spending an increasing number of hours in front of digital devices. This increase raises concerns about long-term health consequences, particularly in the context of the growing prevalence in childhood overweight and obesity. The aim of this review is to present the current state of knowledge regarding the relationship between increased screen time and weight-related health outcomes in the pediatric population. It also highlights the need for health education targeting both children and parents, based primarily on developing skills to manage time spent in front of electronic screens. Methods: A narrative review of the literature was conducted in the MEDLINE (PubMed), Web of Science and Scopus databases, including studies published between 2015 and 2025. Results: Available evidence suggests that prolonged screen exposure may be associated with reduced physical activity, circadian rhythm disturbances, including sleep problems, increased stress levels, and adverse mental health outcomes. These factors may interact and reinforce one another, potentially contributing to a positive energy balance and an increased risk of overweight and obesity among young people. Conclusions: The evidence reviewed highlights the ongoing digitalisation of younger generations and the potential consequences of excessive screen use. The underlying mechanisms appear complex and multidirectional. However, methodological heterogeneity across studies underscores the need for well-designed longitudinal and intervention research. Full article

Background/Objectives: Early childhood is an important period when growth and adiposity patterns emerge and may persist into later childhood. Children enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) face elevated obesity risk. We characterized BMI-for-age z-score (BMIz) trajectories from 24 to 60 months and their child-, caregiver-, and household-level correlates. Methods: This was a secondary analysis of the WIC Infant and Toddler Feeding Practices Study-2 (ITFPS-2) public-use dataset. We analyzed 5,583 BMIz observations from 2,247 dyads; adjusted models used 4,314 observations from 1,738 children. Linear mixed-effects models tested individual, interpersonal, and household predictors. Restriction and pressure-to-eat were lagged, time-varying exposures. Results: Mean BMIz was elevated at all waves (0.46 to 0.56). Obesity prevalence rose from 15.4% to 18.5%. Unconditionally, BMIz was stable from 24 to 48 months and rose by 60 months. Adjusted models linked higher BMIz to higher birth weight, Hispanic or Latino ethnicity, birth complications, maternal overweight or obesity, paternal overweight, prenatal smoking, adolescent maternal age, and lower maternal education. Male sex was associated with lower BMIz. Prior-wave restriction was associated with higher, and pressure to eat with modestly lower, subsequent BMIz. Household indicators showed no independent association. Conclusions: Caregiver and perinatal characteristics and feeding practices were the most consistent modifiable correlates of late-preschool BMIz. These observational, complete-case findings warrant caution. The 48–60-month window may be a promising period to target for WIC-based obesity prevention. Full article