Search Results (433)

Childhood obesity increases chronic disease risk, but no comprehensive synthesis has evaluated the impact of school-based combined nutrition education and physical activity interventions on cardiometabolic biomarkers in children aged 3 to 12 years. This systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251085194). Five databases were systematically searched through June 2025. Twelve randomized controlled trials involving 18,231 children were included and assessed using the PEDro scale. Ten trials demonstrated significant improvements in at least one cardiometabolic biomarker. Blood pressure (8 studies) outcomes showed systolic reductions of 1.41–6.0 mmHg in six studies. Glucose metabolism (5 studies) improved in two studies with reductions of 0.20–0.22 mmol/L. Lipid profiles (7 studies) improved in three studies, including total cholesterol (−0.32 mmol/L). Insulin levels (5 studies) decreased significantly in two investigations. Anthropometric improvements included BMI and body fat. Physical activity increased by >45 min/week and dietary habits improved significantly. Programs with daily implementation (90-min sessions 4x/week), longer duration (≥12 months), family involvement (parent education), and curriculum integration (classroom lessons) showed superior effectiveness. Interventions targeting children with overweight/obesity demonstrated higher changes compared to the general population. However, methodological limitations included a lack of assessor blinding, absence of subject/therapist blinding, and inadequate retention rates. School-based interventions combining nutrition and physical activity can produce significant improvements in cardiometabolic biomarkers, supporting comprehensive, sustained multicomponent programs for early chronic disease prevention. Full article

Childhood obesity is a growing global health concern, with established links to physical activity, nutrition, and, increasingly, to prenatal and perinatal factors. Emerging evidence highlights the significant role of maternal conditions such as obesity, comorbidities, nutrition, and environmental exposures in predisposing offspring to long-term metabolic and cardiovascular diseases. The “Developmental Origins of Health and Disease” (DOHaD) paradigm provides a framework for understanding how early life environmental exposures, particularly during the periconceptional, fetal, and neonatal periods, can program future health outcomes through epigenetic mechanisms. Epigenetic modifications alter gene expression without changing the DNA sequence and are increasingly recognized as key mediators in the development of obesity. This narrative review summarizes current findings on the early determinants of childhood obesity, emphasizing the molecular and epigenetic pathways involved. A comprehensive literature search was conducted across multiple databases and international sources, focusing on recent studies from the past decade. Both human and animal research were included to provide a broad perspective. This review aims to consolidate recent insights into early life influences on obesity, underscoring the need for preventive strategies starting as early as the preconception period. Full article

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

Background/Objectives: Childhood obesity is a global epidemic. Addressing the modifiable risk factors with effective policies is crucial for both prevention and intervention. This scoping review aims to provide a situational analysis of childhood obesity in Greece by mapping the available evidence on the prevalence of obesity among Greek children and adolescents and exploring the existing policies implemented to address this issue. Methods: A systematic literature search was conducted on 15 September 2023, using the PubMed, Scopus, and IATROTEK-online databases to identify studies related to childhood obesity and policies in Greece. Keyword groups were developed for “childhood obesity,” “Greece,” and either “prevalence” or “policies”. Additional sources, including Google and Google Scholar, were screened to ensure comprehensiveness. Results: A total of 66 studies were included: 61 on obesity prevalence (≤18 years of age) and 5 on existing policies tackling childhood obesity, all in Greece. The collective prevalence was observed to lie within the subsequent range of values: 2.8–21.2%. Regarding both genders, the observed prevalence ranged from 2.8% to 26.7% in males, and between 1.3% and 33.7% in females. The policies adopted in Greece cover various domains (healthy nutrition, public preferences, physical activity, school policies, and programs related to childhood obesity). Conclusions: Childhood obesity in Greece is a major challenge. Greece currently uses some policies and strategies to combat childhood obesity. There is still work to be done: policies play a pivotal role as a key tool to influence lifestyle habits on a broad scale and exert a considerable impact on the reduction in this prevalent health concern. Full article

Background: Childhood obesity disproportionately affects Hispanic families in the U.S. Although parenting practices and interventions appear to be viable approaches to lower the risk of childhood obesity, there is limited information on which parenting practices would be relevant and culturally appropriate for Hispanic families. This study aimed to document the health-related factors that impact Hispanic parenting practices to inform evidence-based parenting interventions to improve child health outcomes and reduce the risk of childhood obesity. Methods: We conducted cross-sectional, formative research guided by the COREQ checklist. Hispanic parents of elementary school-aged children were recruited using purposive and snowball sampling. Eligible parents completed a brief sociodemographic survey, the Comprehensive Feeding Practices Questionnaire (CFPQ), and an individual semi-structured interview. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using a coding-based thematic approach. Results: Seventeen parents (88.2% female) participated in the study, and the majority reported Spanish as their preferred language (70.6%). According to parent-reported data, the children’s (52.9% female) mean age was 8.4 ± 1.5 years, and over half were classified as having overweight or obesity. The CFPQ analysis indicated that parents scored highest on subscales related to encouraging healthy eating and eating variety, a finding that was reinforced by interview data. Qualitative analysis identified four key themes: 1. parenting roles, routines, and strategies for promoting culturally appropriate and healthy meals; 2. beliefs of children’s health and weight; 3. beliefs on physical activity and screen time; and 4. environmental and social factors affecting access to healthy food and physical activity. Conclusions: Both quantitative and qualitative results emphasize that parents engage in healthy eating guidance and eating variety and are aware of the factors that impact parenting practices and their children’s health. To improve child health outcomes and reduce the risk of childhood obesity among Hispanic families, parenting interventions need to be culturally responsive and address the factors that influence parenting practices. The findings from this study highlight four key areas to prioritize when designing or adapting parenting interventions to lower the risk of childhood obesity among Hispanic families. Full article

Background: Childhood obesity is a growing global health concern, with an increasing prevalence of severe obesity among young children. This study aimed to determine the average age of severe obesity onset in Polish children and evaluate the time gap between diagnosis and referral for specialized care. Methods: This data analysis was conducted across four Polish pediatric endocrinology centers specializing in childhood obesity management (Szczecin, Cracow, Zabrze, Rzeszów) between July 2022 and November 2023. The study included 367 children and adolescents (186 boys, 181 girls) aged 0–18 years, diagnosed with severe obesity based on age-specific BMI criteria. Anthropometric measurements were performed during the patient’s inclusion into the study and based on past medical records. BMI and BMI Z-scores were calculated for all current and past measurements. Results: The median age of the study population at the moment of inclusion into the study was 13.7 ± 2.9 years (range: 2.2–18 years). The median BMI was 40.9 ± 5.1 kg/m² (range: 30.1–65.8 kg/m²), and the median BMI Z-score was 2.7 ± 0.4 (range: 2.3–6.2). Out of the 367 children included, 327 (89%) had entered puberty. An analysis of past measurements revealed that 83% of children had severe obesity at their earliest recorded BMI measurement, with n median onset age of 3.2 years. The median age of referral to specialized care was 10 ± 5.0 years, reflecting a delay of almost 7 years from diagnosis to targeted medical care. Conclusions: This study highlights a substantial delay between the onset of severe obesity and referral for specialized care, underscoring the need for earlier intervention strategies tailored to age, sex, and developmental stage. Full article

Background: Childhood obesity is a global health concern. Early development of fundamental movement skills (FMS) and adherence to the Mediterranean diet (MD) are key modifiable factors for prevention. This study assessed the effectiveness of a multidisciplinary, school-based intervention for childhood obesity prevention. Methods: Children aged 3–5 years from a preschool in Messina, Italy, participated in a 9-month intervention integrating nutritional education and physical activity. FMS were evaluated using the MOBAK test. Anthropometric measurements and MD adherence (through the Kid-Med questionnaire) were collected. Caregivers completed an online survey reporting lifestyle changes. Results: Significant improvements were observed in FMS: object control (score 1) increased from 2.67 ± 1.78 to 4.28 ± 1.82, locomotor skills (score 2) from 4.69 ± 1.96 to 5.83, 5.83 ± 1.70, and total MOBAK score (score 3) from 7.35 ± 3.09 to 10.11± 2.94. (p < 0.001 for all). Kid-Med scores significantly improved from (3.79 ± 2.31 vs. 5.03 ± 2.69) (p = 0.0027), indicating enhanced MD adherence. Post-intervention, adherence was classified as poor (27.4%), moderate (53.2%), and optimal (19.4%). Although only a minority of parents reported lifestyle changes, over 50% noted increased fruit and vegetable intake in their children. Males showed higher FMS scores and waist circumference compared to females. Conclusions: A school-based multidisciplinary intervention significantly improved motor competence and dietary habits in preschool children. These findings underscore the importance of early, integrated strategies involving families and educators to support healthy development and prevent childhood obesity. Full article

Background/Objectives: Childhood overweight/obesity status is a critical risk factor for adverse cardiometabolic outcomes. We aimed to evaluate the sex-specific associations between a maintained childhood overweight status and late-adolescent cardiometabolic risk factors using data from a Korean longitudinal study. Methods: We used data from the Korean Children-Adolescents Study, a prospective cohort of children enrolled at age 7 and followed annually from 2005 to 2020. Among participants who were followed at least once, a total of 899 children (438 boys, 461 girls) with consistent body mass index (BMI) status at ages 7–9 and 10–12 were included in the analysis. Participants were categorized into two groups on the basis of BMI: normal weight maintenance and overweight maintenance. Multivariable linear regression was used to examine the associations between BMI patterns and cardiometabolic risk factors, with adjustments for covariates. Results: Among the 899 children (mean age: 7.1 ± 0.4 years, 48.7% boys), 12.8% of boys and 5.9% of girls were classified into the overweight maintenance group. Boys in the overweight maintenance group had significantly greater BMIs, waist circumferences (WC), body fat percentages, trunk fat mass, and aspartate aminotransferase and alanine aminotransferase levels at ages 15 and 18. Girls in the same group had elevated BMI, WC, body fat percentage, trunk fat mass, and blood pressure and experienced earlier pubertal onset. Conclusions: Maintaining an overweight status during childhood is associated with adverse cardiometabolic profiles in adolescence, with sex-specific differences. These findings highlight the importance of early, sex-specific interventions to prevent long-term health risks associated with childhood obesity. Full article

Type II diabetes mellitus (T2D) is a metabolic disorder. Childhood overweight or obesity raises the risk for developing T2D later in life. Early identification of at-risk individuals is fundamental for disease prevention and patient management. The scope of this pilot study was to explore whether leukocyte protein O-GlcNAc modification is elevated in an overweight pediatric cohort. Eight overweight and eight normal-weight children aged 3–13 years were recruited at the Papardo General Hospital (Messina, Italy). Physical exams, complete blood tests, and determination of leukocyte protein O-GlcNAcylation were carried out. Protein O-GlcNAcylation was higher in leucocytes from overweight children compared to normal-weight children, and was significantly correlated with BMI, metabolic markers (LDL-cholesterol/triglycerides), and the inflammatory marker CRP. This study suggests that leukocyte protein O-GlcNAcylation may represent a novel biomarker for the early detection of metabolic abnormalities that may lead to the development of pre-diabetes or T2D later in life. Full article

Seaweeds represent a vital yet often understudied component of the diet and cultural heritage of many coastal communities globally. This study investigated seaweed consumption practices in coastal communities of Tawi-Tawi, Philippines, through one-to-one interviews (n = 280) and focus group discussions (n = 7). The study revealed that nearly all (99%) of the population consumes seaweeds, with women comprising the majority of consumers who have done so since childhood (68% female vs. 32% male). These consumers were predominantly married (79%), within the 21–40 age group (53%), with families of 5–7 members (43%), practicing Islam (97%), and belonging to the Sama tribe (71%). A significant portion (48%) had resided in the area for 21–30 years, attained elementary to high school education (66%), and had a monthly income ranging from 1000 to 10,000 Philippine pesos (72%). Seaweed consumption was a family-wide practice (88%), including children, who typically started around 4–8 years old (61%), driven by perceived nutritional benefits (43%), preferred flavor (80%), affordability (19%), ease of preparation (33%), and cultural integration (23%). The primary edible seaweeds identified were Kappaphycus alvarezii (63%), K. striatus (58%), Kappaphycus spp. (47%), Eucheuma denticulatum (57%), Caulerpa lentillifera (64%), Caulerpa spp. (51%), C. cf. macrodisca ecad corynephora (45%), C. racemosa (30%), and Solieria robusta (49%), with less frequent consumption of K. malesianus (8%), Chaetomorpha crassa (3%), Gracilaria spp. (0.72%), and Hydroclathrus clathratus (0.36%). Specific plant parts were preferred for certain species, and preparation predominantly involved raw (75%) or cooked (77%) salads with spices, primarily prepared by mothers (72%). Consumers generally avoided seaweeds showing signs of ice-ice disease (95%), pale coloration (91%), or epiphyte infestation (84%). Consumption frequency was typically 1–3 times per week (45%), with knowledge largely passed down through generations (95%). Seaweed salads were primarily consumed as a viand (92%) at home (97%), with locals perceiving seaweed consumption as contributing to a healthy diet (40%) and overall well-being [e.g., aiding hunger (76%), improving digestion (20%), preventing obesity (14%), and aiding brain development (3%)]. The study’s findings emphasize the significant yet often overlooked role of seaweeds in the food systems and cultural heritage of Tawi-Tawi’s coastal communities. Future efforts should prioritize the sustainable management of wild resources, explore the cultivation of diverse edible species, and enhance nutritional awareness. Further research into traditional seaweed knowledge holds broader value. Full article

Background/Objectives: Overweight children and childhood obesity are growing public health concerns influenced by early-life nutrition and lifestyle. Irregular eating patterns, sedentary behaviour, and maladaptive eating behaviours significantly contribute to excess weight gain in children. This cross-sectional study comprehensively assessed physical activity, sleep, anthropometric parameters, and eating behaviours in preschool children in Split, Croatia, examining associations between eating behaviours and nutritional status indicators. Methods: A total of 429 children aged 4 to 7 years were recruited from kindergartens in Split-Dalmatia County. Parents completed a lifestyle questionnaire and the Children’s Eating Behaviour Questionnaire (CEBQ). Anthropometric measurements (weight, height, middle upper arm circumference, waist circumference) were recorded and BMI-for-age z-scores calculated. Physical activity and sleep patterns were assessed based on parental reports. Results: A total of 66% of the children had a healthy body weight, 12.6% were underweight, and 21.4% were overweight or obese. Significant sex differences were found in the CEBQ subscale “Slowness in Eating” (p = 0.04). Overweight or obese children showed a higher food responsiveness, while underweight/normal-weight children had greater emotional undereating and slowness in eating. No significant sex differences were observed regarding physical activity. Girls exhibited significantly more frequent daytime napping than boys. Conclusions: This study shows a significant prevalence of overweight and obese preschool children in Split, Croatia. The results underline the importance of promoting healthy eating behaviours and physical activity from an early age. This is the first study applying CEBQ in the Croatian population and suggests that the interventions should target diet quality and unfavourable eating behaviours to prevent future health risks. Full article

This overview explores the complex relationship between environmental factors, particularly obesity, and the timing of puberty, with a focus on how hormonal and genetic interactions are influenced by external conditions. Puberty (gonadarche) is characterised by the activation of the hypothalamic–pituitary–gonadal (HPG) axis. The onset and progression of puberty vary significantly among individuals, primarily due to genetic factors, with key genes like kisspeptin 1 (KISS1) and makorin ring finger protein 3 (MKRN3) playing a crucial role. Cohesively, this paper emphasises that environmental factors, particularly obesity and exposure to endocrine-disrupting chemicals (EDCs), have become significant influences on the timing of puberty. Childhood obesity has risen significantly in recent decades and the age of pubertal onset has declined over the same period. Obesity greatly disrupts hormone regulation in pre-pubertal children. Leptin accelerates the onset of puberty in girls but not in boys. The underlying mechanism is proposed to be the increase in Kiss1/GnRH signalling. On the contrary, excess leptin in boys suppresses testosterone production by increasing oestrogen conversion. Low adiponectin in obese girls may contribute to earlier puberty due to a reduced inhibition of Kiss1/GnRH signalling. Low adiponectin in boys is linked to delayed puberty due to its role in maintaining insulin sensitivity and testosterone production. Hyperinsulinemia influences pubertal timing through central and peripheral mechanisms. Insulin acting synergistically with leptin promotes the earlier onset of puberty in girls but not in boys. The effects of exposure to certain EDCs—mostly obesogenic chemicals that mimic the action of natural hormones—on the timing of puberty remain unclear; hence, further research on this topic is needed. Addressing and preventing obesity in children could potentially mitigate these alterations in pubertal timing. Full article

Background: The rising prevalence of childhood obesity (CO) has been strongly linked to physical inactivity and sedentary behavior. Early development of functional movement skills (FMS) is crucial for fostering active lifestyles and preventing CO. Methods: We assessed the FMS of 102 children aged 3–5 using the MOBAK test battery. Parents completed a Likert-scale questionnaire evaluating their perception of their child’s motor competence. Results: A total of 102 children and 92 parents participated. Although 61.1% of children engaged in regular sports activities, only 20.5% reached a satisfactory MOBAK total score (Score 3). Significant gender differences emerged in locomotor skills (Score 2) and overall performance (Score 3), with p-values < 0.026 and <0.016, respectively. A significant negative correlation between BMI and Score 2 was observed (p < 0.030). Parents significantly overestimated their children’s FMS (p = 0.0001). Conclusions: Findings emphasize the importance of early interventions targeting FMS enhancement and parental education to effectively support CO prevention strategies and promote lifelong physical activity. Full article

Background/Objectives: Identifying the factors influencing compliance is essential to improve the effectiveness of interventions. However, no study has examined factors that influence the longitudinal patterns of obesity intervention compliance. We aim to identify the longitudinal trajectories of parental and child compliance using group-based trajectory modeling (GBTM) and assess the influencing factors. Methods: The Diet, ExerCIse, and CarDiovascular hEalth Children (DECIDE-Children) was a 9-month app-assisted obesity prevention intervention targeted 8–10-year-old children. Altogether, 684 child–parent pairs from the intervention group were included. Parents were required to use the mobile app to learn health knowledge, monitor children’s diet and exercise behaviors, manage children’s weight, and received the assessment results. Parental compliance was assessed as the monthly usage times and duration of the mobile app. For child compliance, we used data recorded by parents in the “behavior monitoring” module. We employed group-based trajectory modeling (GBTM) to identify distinct trajectories of parental and child compliance and examined their associations with childhood obesity outcomes. Univariate and multivariate logistic regressions were performed to identify the influencing factors associated with the identified compliance groups. Results: Distinct trajectory groups of parental and child compliance were identified. The compliance trajectories of parents and children are related to the extent of changes in the child’s obesity-related outcomes (waist circumference, waist-to-hip ratio, and body fat percentage. p < 0.05). A majority of parents were classified into the “relatively low compliance” group. Parents in this group was associated with having a daughter (OR: 1.95, 95% CI: 1.17, 3.31) and the father having a higher education level (OR: 1.65, 95% CI: 1.05, 2.60). For children, 20.2% were assigned to the “decreasing compliance” group. Children in this group were more likely to have a younger mother (OR: 1.05, 95% CI: 1.01, 1.10) and parents with poorer compliance (OR: 2.36, 95% CI: 1.16, 5.47). Conclusions: Both student and parental compliance were shown to influence the effectiveness of childhood obesity interventions, highlighting the need to prioritize the assessment and promotion of compliance in such interventions. Child sex, paternal educational level, and maternal age were identified as significant factors associated with compliance, while the level of family involvement was found to play a pivotal role in fostering healthy behaviors in children. These findings suggest that future intervention strategies should place greater emphasis on engaging families and providing targeted supervision and support for populations at risk of lower compliance in order to enhance intervention outcomes. Full article

Childhood obesity is a growing global health issue. Its rising prevalence is linked to genetic, environmental, and lifestyle factors. Obesity in children could lead to different comorbidities and complications with an increased risk of metabolic disorders, such as insulin resistance, dyslipidemia, type 2 diabetes mellitus (T2DM), and metabolic dysfunction-associated steatotic liver disease (MASLD). First-line treatment involves dietary modifications and lifestyle changes; however, adherence is often poor and remains a significant challenge. Pharmacotherapy, while a potential option, has limitations in availability and can cause side effects, leading to growing interest in alternative treatments, such as nutraceutical compounds. Derived from natural sources, these compounds have different anti-inflammatory, antiallergic, antioxidant, antibacterial, antifungal, neuroprotective, antiaging, antitumor, insulin-sensitizing, glucose, and lipid-lowering effects. This review describes commonly used nutraceutical compounds, such as omega-3 fatty acids, vitamin D, polyphenols (such as resveratrol and curcumin), berberine, white mulberry leaves and others, and pre- and probiotics in the management of obesity, evaluating the evidence on their mechanisms of action and efficacy in metabolic comorbidities. The evidence suggests that the integration of nutraceuticals into the diet may positively influence body mass index, glucose metabolism, lipid profiles, and gut microbiota composition and reduce inflammation in obese individuals. These effects may provide future practical guidance for clinical practice, contribute to metabolic health improvement, and potentially prevent obesity-related complications. In this first part, we discuss the effects of nutraceutical compounds on insulin sensitivity and insulin resistance, T2DM, dyslipidemia, and MASLD in addition to diet and lifestyle interventions. Full article