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Childhood and Adolescent Obesity and Weight Management: 2nd Edition

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A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Global and Public Health".

Deadline for manuscript submissions: closed (25 September 2022) | Viewed by 44491

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Dr. Flora Bacopoulou

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Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, 1 Thivon Street, 11527 Athens, Greece
Interests: adolescent medicine; pediatrics; endocrinology; pediatric adolescent gynecology; stress; mental health; obesity; metabolic syndrome; learning disabilities; childhood cancer survivors
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Flora Bacopoulou

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Guest Editor

Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, 1 Thivon Street, 11527 Athens, Greece
Interests: adolescent medicine; pediatrics; endocrinology; pediatric adolescent gynecology; stress; mental health; obesity; metabolic syndrome; learning disabilities; childhood cancer survivors
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Obesity is a leading preventable cause of morbidity and mortality worldwide, with rapidly and unrelentingly increasing rates in children and adolescents. Obesity, especially that starting from an early age, increases the risk of metabolic, cardiovascular, reproductive, orthopedic, mental, allergic/autoimmune, and neoplastic diseases and curtails life expectancy. It is strongly related to chronic stress and associated with insulin resistance, metabolic syndrome, type 2 diabetes mellitus, hypertension, polycystic ovary syndrome, obstructive sleep apnea, osteoarthritis, and depression. Obesity and its accompanying manifestations also negatively affect specific populations, such as childhood cancer survivors and children with developmental and behavioral disorders. There is an urgent need to understand all of the factors contributing to childhood and adolescent obesity in order to best implement effective treatment and prevention approaches, both of which have proven to be elusive so far.

Considering the success and popularity of the Special Issue "Childhood and Adolescent Obesity and Weight Management" previously published in the journal Children (https://www.mdpi.com/journal/children/special_issues/Obesity_Weight_Management), we now release a Second Issue aimed to gather original research papers and review articles focused on Childhood and Adolescent Obesity and Weight Management.

This Special Issue of Children is an update on recent data pertaining to the diagnosis, prevalence, etiology, treatment, and prevention of childhood and adolescent obesity and its short- and long-term sequelae. We also encourage submissions that explore how chronic stress and physical, cognitive, developmental, behavioral and mental health conditions may impact on childhood and adolescent body weight and relate to obesity complications.

I look forward to receiving your contributions.

Dr. Flora Bacopoulou
Prof. Dr. Flora Bacopoulou
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

obesity
children
adolescents
insulin resistance
type 2 diabetes mellitus
metabolic syndrome
polycystic ovary syndrome
cancer survivors
stress
developmental

Published Papers (11 papers)

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Research

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9 pages, 1277 KiB

Open AccessArticle

Perceived Difficulties in Physical Tasks and Physical Fitness in Treatment- and Non-Treatment-Seeking Youths with Obesity

by Giada Ballarin, Maria Rosaria Licenziati, Olivia Di Vincenzo, Luca Scalfi and Giuliana Valerio

Children 2022, 9(9), 1351; https://doi.org/10.3390/children9091351 - 04 Sep 2022

Viewed by 1184

Abstract

Youths with obesity are more likely to experience physical and psychosocial distress which strongly limits physical activity, with consequences on the quality of life. Most evidence of lower physical fitness and physical activity levels has been reported in treatment-seeking samples, while few data are available in community samples. Our aim was to assess whether perceived difficulties in physical tasks and physical fitness performance differed between treatment- and non-treatment-seeking youths with obesity, enrolled from a hospital (H) and a school (S). Three hundred fifty-one youths (269 from H and 82 from S) were enrolled. Sports participation, sedentary habits and perceived difficulties in physical tasks were assessed by interview. Six-minute walk test (SMWD) and long jump (LJ) were performed. BMI Z-score, sedentary time and perceived difficulties were higher in H vs. S. In addition, youths from H scored worse in SMWD and LJ. For the same BMI Z-score, the perceived difficulties and physical fitness were poorer in the H compared to the S group. The setting (H) was the stronger predictor of perceived difficulties and lower performance. Our findings underline that physical aspects imposed by obesity are more evident in treatment-seeking youths. Counseling related to perceived difficulties in physical tasks and performance is useful to treat youth with obesity with appropriate and personalized modalities. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 2nd Edition)

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11 pages, 1058 KiB

Open AccessEditor’s ChoiceArticle

Maternal Pre-Pregnancy Obesity and Gestational Diabetes Mellitus Increase the Risk of Childhood Obesity

by Mi Jin Choi, Juyoun Yu and Jimi Choi

Children 2022, 9(7), 928; https://doi.org/10.3390/children9070928 - 21 Jun 2022

Cited by 11 | Viewed by 2895

Abstract

Previous studies have shown inconsistent results regarding the effects of maternal gestational diabetes mellitus (GDM) and pre-pregnancy obesity (PPO) on childhood obesity. This study aimed to determine the risk for early childhood obesity based on maternal GDM and PPO. This nationwide study used data obtained from the National Health Information Database in South Korea. The participants were divided into four groups based on maternal GDM and PPO, and 1:1 matching was performed. Each group had 1319 participants. A generalized estimating equation model was used to analyze the changes in body mass index percentile of children with age, and simple and multiple conditional logistic regression models were used to compare the prevalence of childhood obesity at 5 years. Children whose mothers had both PPO and GDM, only PPO, or only GDM had a 4.46 (95% CI: 3.28–6.05, p < 0.001), 3.11 (95% CI: 2.27–4.26, p < 0.001), or 1.58 (95% CI: 1.12–2.23, p = 0.010) times higher risk, respectively, of developing childhood obesity than children whose mothers had neither PPO nor GDM. Maternal PPO increases the risk for childhood obesity to a higher degree than maternal GDM, and the presence of both increases the risk even further. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 2nd Edition)

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10 pages, 809 KiB

Open AccessArticle

Trends in BMI Percentile and Body Fat Percentage in Children 12 to 17 Years of Age

by Pat R. Vehrs, Gilbert W. Fellingham, Angela McAferty and Laurel Kelsey

Children 2022, 9(5), 744; https://doi.org/10.3390/children9050744 - 19 May 2022

Cited by 6 | Viewed by 3014

Abstract

This study evaluates the cross-sectional trends in body fat percentage (BF%) and body mass index (BMI) percentile rank, and the relationship between the two in 332 (177 boys, 155 girls) 12- to 17-year-old children. Body mass index (BMI) was calculated using measured height and body mass, and sex-specific BMI for age percentile rank was determined using CDC growth charts. Body fat percentage (BF%) was measured with DEXA. Fat mass index (FMI) and fat-free mass index (FFMI) were calculated by normalizing the fat mass and fat-free mass for height. Compared to boys of the same age, girls had significantly higher BF% and FMI values and lower FFMI values. Compared to boys, at a given BMI percentile rank, females had a higher BF% and FMI, and a lower FFMI. In both boys and girls, there was an exponential increase in adiposity above the 70th percentile rank. BMI percentile rank is not an equivalent indicator of body fatness in boys and girls. Other measures of body composition can further inform the practitioner of a child’s adiposity. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 2nd Edition)

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15 pages, 1399 KiB

Open AccessArticle

Influence of an Educational Intervention on Eating Habits in School-Aged Children

by María José Menor-Rodriguez, Jonathan Cortés-Martín, Raquel Rodríguez-Blanque, María Isabel Tovar-Gálvez, María José Aguilar-Cordero and Juan Carlos Sánchez-García

Children 2022, 9(4), 574; https://doi.org/10.3390/children9040574 - 17 Apr 2022

Cited by 4 | Viewed by 3259

Abstract

A health promotion intervention directed at preventing unhealthy habits in relation to physical exercise, hygiene habits, diet and personal relationships can lead to a decrease in diseases during adulthood and obtaining a better quality of life. The intervention had a participative and multidisciplinary nature, and it was developed by health professionals, teachers and parents for school children. It promoted healthy lifestyle habits around food by working on four areas through video lessons, interactive talks, practical and theoretical–practical classes and an individual project on behalf of the student where they had to design healthy menus. We randomly selected, by stratified multistage sampling, three public primary education schools. A sample of 479 students registered during the 2014/2015 academic year aged between 6–12 years were included in the study. After the educational intervention, we found a significant reduction in the BMI of the students (p < 0.001). For breakfast, the overweight or obese children modified their usual food consumption after the intervention for a healthier breakfast based on fruit juice and bread instead of sugary snacks (p < 0.001). Regarding eating habits during the mid-morning break, there was a decrease in the consumption of sugary snacks (p < 0.001) and an increase in the consumption of fruits and sandwiches. We found that, after the intervention, the excessive consumption of pasta for the main meal reduced in favor of an increase in the consumption of proteins and different beans and pulses (p > 0.001). Educational interventions on healthy lifestyle habits carried out in children during their early years improve and correct unhealthy habits. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 2nd Edition)

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24 pages, 712 KiB

Open AccessEditor’s ChoiceArticle

The Eating Healthy and Daily Life Activities (EHDLA) Study

by José Francisco López-Gil

Children 2022, 9(3), 370; https://doi.org/10.3390/children9030370 - 07 Mar 2022

Cited by 20 | Viewed by 6794

Abstract

Background: Childhood obesity is one of the greatest public health concerns facing advanced societies, Spain being one of the countries with the highest incidence. In this sense, the Region of Murcia has been pointed out as the Spanish autonomous community with the highest prevalence of excess weight among young people. More specifically, the Valle de Ricote has shown an even greater proportion of excess weight among young people. Several sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors are related to excess weight. Based on the lack of information, this research project will try to provide relevant information to design intervention programs, as well as to implement effective public policies to try and reverse this alarming situation. Therefore, this research project aims (1) to obtain cross-sectional and longitudinal data on the excess weight and their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated among adolescents from the Valle de Ricote (Region of Murcia, Spain) (aged 12–17 years), and (2) to examine the association between excess weight and their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated among this population. Methods: A cross-sectional study and follow-up study will be performed. This research project will involve adolescents using a simple random sampling technique. A total of three secondary schools from the Valle de Ricote (Region of Murcia, Spain) will be included in this project. The minimum sample size will be 1138, establishing a 95% confidence interval, a 40% prevalence of excess weight, a 3% margin of error, and a non-response rate of 10%. Primary outcome measures will be: (1) anthropometric measurements, (2) sociodemographic factors, (3) environmental factors, (4) lifestyle factors, (5) health-related factors, (6) cognitive factors, and (7) psychological factors. Conclusion: This research project will aim to determine the prevalence of excess weight and interrelate their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated. The obtained results will help to manage and propose possible multidisciplinary interventions and strategies in order to prevent and reduce the excess weight in adolescents from the Valle de Ricote. Furthermore, orientations will be given to transfer the obtained results to the public sector to evaluate or change the adopted policies. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 2nd Edition)

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19 pages, 333 KiB

Open AccessEditor’s ChoiceArticle

Prevalence of Overweight and Obesity and Associated Diet-Related Behaviours and Habits in a Representative Sample of Adolescents in Greece

by Rafaela Makri, Michail Katsoulis, Anastasios Fotiou, Eleftheria Kanavou, Myrto Stavrou, Clive Richardson, Afroditi Kanellopoulou, Philippos Orfanos, Vassiliki Benetou and Anna Kokkevi

Children 2022, 9(1), 119; https://doi.org/10.3390/children9010119 - 17 Jan 2022

Cited by 10 | Viewed by 4653

Abstract

Excessive body weight during adolescence represents a significant public health problem worldwide. Identifying factors associated with its development is crucial. We estimated the prevalence of overweight and obesity in a representative sample of 11, 13 and, 15-year-olds living in Greece and explored the association with diet-related behaviours and habits. Self-reported data on weight, height, diet-related behaviours and habits were used from 3816 students (1898 boys, 1918 girls) participants in the Greek arm of the international Health Behaviour in School-Aged Children (HBSC) study during 2018. Overweight and obesity were defined using the 2007 WHO growth charts classification. Prevalence of overweight was 19.4% in the total sample, 24.1% for boys and 14.7% for girls, and prevalence of obesity was 5.3% in the total sample, 7.3% for boys and 3.4% for girls, respectively. In the total sample, overweight (including obesity) was positively associated with male gender, low family affluence, skipping breakfast, and being on a diet, and inversely associated with age and being physically active. Eating rarely with the family was positively associated with overweight only among boys and eating snacks/meals in front of screens only among girls. No association was noted for eating in fast-food restaurants, consuming vegetables, fruits, sweets, and sugar-sweetened beverages. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 2nd Edition)

10 pages, 388 KiB

Open AccessArticle

Comparison of Hospital Consultation and Summer Camp Lifestyle Intervention Programs for Sustained Body Weight Loss in Overweight/Obese Greek Children

by Anna L. Papageorgiou, Vasiliki Efthymiou, Aikaterini Giannouli, Paraskevi Xekouki, Christina C. Kranioti and George P. Chrousos

Children 2022, 9(1), 86; https://doi.org/10.3390/children9010086 - 08 Jan 2022

Cited by 3 | Viewed by 1976

Abstract

Two lifestyle intervention programs of a health initiative named “Evrostia” were conducted at (a) an outpatient obesity clinic of a children’s hospital and (b) summer camp (SC), respectively. Thirty overweight/obese children were randomly selected to participate in each intervention arm to assess the efficacy of the SC intervention and its possible superiority over usual hospital consultation (HC) practice. There was a statistically significant decrease in body weight (BW), and body mass index (BMI) in both programs. A higher duration of reduced BW was observed in the SC compared to HC intervention. Regarding the nutritional behavior, there was a significant increase in the consumption of breakfast, fruit and vegetables, and a reduction in the consumption of beverages and sweets in the SC group. A significant increase in the hours of weekly physical activity was also observed in children of the SC program. The comparison between the two lifestyle intervention programs showed that the SC program improved nutritional behaviors and physical activity and promoted longer preservation of BW loss than that of the HC program. Thus, the holistic and experiential approach of the SC program was more successful in the treatment of overweight and obesity in children than a conventional HC program. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 2nd Edition)

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Review

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16 pages, 781 KiB

Open AccessReview

Risk Factors, Clinical Consequences, Prevention, and Treatment of Childhood Obesity

by Mossad Abdelhak Shaban Mohamed, Merna Mahmoud AbouKhatwa, Abdul Aziz Saifullah, Muhammad Hareez Syahmi, Mohamed Mosaad, Mahmoud E. Elrggal, Inderpal Singh Dehele and Mohamed Hassan Elnaem

Children 2022, 9(12), 1975; https://doi.org/10.3390/children9121975 - 16 Dec 2022

Cited by 6 | Viewed by 11892

Abstract

Obesity might adversely affect the health and well-being of children and their families. Childhood obesity has crucial implications for health, both during childhood and as they age. It is highly associated with many acute problems and is commonly present during childhood, making visits and hospital admissions polarized in this group of children. The problems that may affect these children can be medical, such as asthma, chronic inflammation, orthopedic abnormalities, liver disease, diabetes mellitus or dyslipidemia. Long-term consequences of cardiovascular risk factors, the persistence of obesity and premature mortality are common among adults who had obesity during their early lives. Additionally, they could also suffer from psychological issues, such as low self-esteem, which puts them at risk of a much more serious psychosocial problem that may lead to depression, as well as a disruption in educational achievements and social relationships. A healthy diet, physical activity, adequate sleep, and limited screen time are all preventive measures that should be implemented at the family and community levels, preferably through well-structured programs. Furthermore, pharmacological management of childhood obesity is limited and only used after non-pharmacological interventions have failed or in the late stages of obesity. However, recent guidelines advocate the early use of medical interventions. Approved pharmacotherapeutic options include orlistat, phentermine/topiramate combination and liraglutide. There are several other options approved primarily for other specific forms of obesity or for other indications, including setmelanotide, metformin, lisdexamfetamine, zonisamide and fluoxetine. Bariatric surgery is a safe and effective option in cases with extreme obesity and comorbidities considering the need for long-term monitoring and support for cases and their families post-surgery. This review aims to discuss and highlight the recent evidence regarding risk factors, clinical consequences, prevention, and treatment of childhood obesity. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 2nd Edition)

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11 pages, 1648 KiB

Open AccessReview

Systematic Review and Meta-Analysis of the Efficacy and Safety of Metformin and GLP-1 Analogues in Children and Adolescents with Diabetes Mellitus Type 2

by Elisabeth Carydias, Andoneta Tasho, Chara Kani, Flora Bacopoulou, Charikleia Stefanaki and Sophia L. Markantonis

Children 2022, 9(10), 1572; https://doi.org/10.3390/children9101572 - 18 Oct 2022

Viewed by 2850

Abstract

Diabetes mellitus type 2 (DMT2) is one of the most frequent glucose metabolism disorders, in which serum glucose concentrations are increased. In most cases, changes in lifestyle and diet are considered as the first step in addressing its therapy. If changes in lifestyle and diet fail, drugs, such as metformin, must be added. Lately, apart from metformin or insulin, the FDA has approved the use of glucagon-like peptide-1 (GLP-1) analogues for children and adolescents. Little is known about their efficacy and safety at this young age. The main aim of this systematic review/meta-analysis was to assess the safety and efficacy of metformin and GLP-1 analogues, exenatide and liraglutide, compared with placebos or other antidiabetic drugs used for DMT2 in children and adolescents. Metformin did not seem to demonstrate pharmacologic superiority, while GLP-1 analogues were found superior to placebos. GLP-1 analogues may be considered a useful alternative for the treatment of DMT2 in children and adolescents. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 2nd Edition)

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10 pages, 637 KiB

Open AccessReview

Difference in Hair Cortisol Concentrations between Obese and Non-Obese Children and Adolescents: A Systematic Review

by Rosa Anna Kitani, Konstantina Letsou, Ioulia Kokka, Christina Kanaka-Gantenbein and Flora Bacopoulou

Children 2022, 9(5), 715; https://doi.org/10.3390/children9050715 - 12 May 2022

Cited by 5 | Viewed by 2128

Abstract

Childhood obesity has been linked to physical and psychological comorbidities that can be carried into adulthood. A bidirectional link between body weight and the stress system appears to exist, as cortisol may affect the regulation of appetite, while adiposity can affect cortisol secretion. Among the biological tissues used to evaluate cortisol concentrations, scalp hair can provide retrospective measures. The aim of this systematic review was to investigate the difference in hair cortisol concentrations between obese and non-obese minors ≤ 19 years of age. Children and adolescents with genetic, somatic or psychiatric comorbidities were excluded. The work was conducted following the PRISMA guidelines, using prespecified search terms in the Pubmed database. The initial search yielded 56 studies, while the last step of the screening procedure concluded in 9 observational studies. Among them, the results could be characterized as inconclusive. Five of them demonstrated significantly higher hair cortisol concentrations in obese children and adolescents than normal weight subjects. On the contrary, the remaining four found no statistically significant differences in hair cortisol concentrations between obese and non-obese subjects. Different methodologies applied, and confounding factors could explain the inconsistency in the findings. Further research is needed to provide more solid results. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 2nd Edition)

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Other

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6 pages, 216 KiB

Open AccessCommentary

Could COVID-19′s Aftermath on Children’s Health Be Felt into the 22nd Century?

by Alexios-Fotios A. Mentis, George Paltoglou, Panayotes Demakakos, Faheem Ahmed and George P. Chrousos

Children 2022, 9(4), 482; https://doi.org/10.3390/children9040482 - 01 Apr 2022

Cited by 2 | Viewed by 1944

Abstract

The COVID-19 pandemic has massively affected people’s health, societies, and the global economy. Our lives are no longer as they were before COVID-19, and, most likely, will never be the same again. We hypothesize that the effect of the COVID-19 pandemic on population health and the economy will last for a very long time and will still be felt in the 22nd century. Our hypothesis is based on evidence from the 1918–1919 influenza pandemic, the Dutch famine during the Second World War, and the 2007–2008 economic crisis, as well as from the rationally predicted impact of COVID-19 on human development. We expect that the COVID-19 pandemic, including the mitigation measures taken against it, will affect children’s development in multiple ways, including obesity, both while in utero and during critical and sensitive windows of development, including the early childhood years and those of puberty and adolescence. The psychosocial and biological impact of this effect will be considerable and unequally distributed. The implications will last at least a lifetime, and, through inter-generational transmission, will likely take us to future generations, into the 22nd century. We argue for the urgent need of designing and initiating comprehensive longitudinal cohort studies to closely monitor the long-term effects of COVID-19 on children conceived, born, and raised during the pandemic. Such an approach requires a close and effective collaboration between scientists, healthcare providers, policymakers, and the younger generations, and it will hopefully uncover evidence necessary to understand and mitigate the impact of the pandemic on people’s lives in the 21st and 22nd centuries. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 2nd Edition)

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