Research

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12 pages, 717 KiB

Open AccessArticle

Healthy Schoolhouse 2.0 Health Promotion Intervention to Reduce Childhood Obesity in Washington, DC: A Feasibility Study

by Melissa Hawkins, Sarah Irvine Belson, Robin McClave, Lauren Kohls, Sarah Little and Anastasia Snelling

Nutrients 2021, 13(9), 2935; https://doi.org/10.3390/nu13092935 - 25 Aug 2021

Cited by 7 | Viewed by 4101

Abstract

Childhood obesity prevalence trends involve complex societal and environmental factors as well as individual behaviors. The Healthy Schoolhouse 2.0 program seeks to improve nutrition literacy among elementary school students through an equity-focused intervention that supports the health of students, teachers, and the community. [...] Read more.

Childhood obesity prevalence trends involve complex societal and environmental factors as well as individual behaviors. The Healthy Schoolhouse 2.0 program seeks to improve nutrition literacy among elementary school students through an equity-focused intervention that supports the health of students, teachers, and the community. This five-year quasi-experimental study follows a baseline–post-test design. Research activities examine the feasibility and effectiveness of a professional development series in the first program year to improve teachers’ self-efficacy and students’ nutrition literacy. Four elementary schools in Washington, DC (two intervention, two comparison) enrolled in the program (N = 1302 students). Demographic and baseline assessments were similar between schools. Teacher participation in professional development sessions was positively correlated with implementing nutrition lessons (r = 0.6, p < 0.001, n = 55). Post-test student nutrition knowledge scores (W = 39985, p < 0.010, n = 659) and knowledge score changes (W = 17064, p < 0.010, n = 448) were higher among students in the intervention schools. Students who received three nutrition lessons had higher post knowledge scores than students who received fewer lessons (H(2) =22.75, p < 0.001, n = 659). Engaging teachers to implement nutrition curricula may support sustainable obesity prevention efforts in the elementary school environment. Full article

(This article belongs to the Special Issue Childhood Obesity: Nutrition and Lifestyle Determinants, Prevention and Management)

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12 pages, 303 KiB

Open AccessArticle

Breastfeeding and Overweight in European Preschoolers: The ToyBox Study

by Natalya Usheva, Mina Lateva, Sonya Galcheva, Berthold V. Koletzko, Greet Cardon, Marieke De Craemer, Odysseas Androutsos, Aneta Kotowska, Piotr Socha, Luis A. Moreno, Yannis Manios, Violeta Iotova and on behalf of the ToyBox-Study Group

Nutrients 2021, 13(8), 2880; https://doi.org/10.3390/nu13082880 - 21 Aug 2021

Cited by 6 | Viewed by 3572

Abstract

The benefits of breastfeeding (BF) include risk reduction of later overweight and obesity. We aimed to analyse the association between breastfeeding practices and overweight/obesity among preschool children participating in the ToyBox study. Data from children in the six countries, participating in the ToyBox-study [...] Read more.

The benefits of breastfeeding (BF) include risk reduction of later overweight and obesity. We aimed to analyse the association between breastfeeding practices and overweight/obesity among preschool children participating in the ToyBox study. Data from children in the six countries, participating in the ToyBox-study (Belgium, Bulgaria, Germany, Greece, Poland, and Spain) 7554 children/families and their age is 3.5–5.5 years, 51.9% were boys collected cross-sectionally in 2012. The questionnaires included parents’ self-reported data on their weight, height, socio-demographic status, and infant feeding practices. Measurements of preschool children’s weight and height were done by trained researchers using standard protocols and equipment. The ever breastfeeding rate in the total sample was 85.0% (n = 5777). Only 6.3% (n = 428) of the children from the general sample were exclusively breastfed (EBF) for the duration of the first six months. EBF for four to six months was significantly (p < 0.001) less likely among mothers with formal education < 12 years (adjusted Odds Ratio (OR) = 0.61; 95% Confidence interval (CI) 0.44–0.85), smoking throughout pregnancy (adjusted OR = 0.39; 95% CI 0.24–0.62), overweight before pregnancy (adjusted OR = 0.67; 95%CI 0.47–0.95) and ≤25 years old. The median duration of any breastfeeding was five months. The prevalence of exclusive formula feeding during the first five months in the general sample was about 12% (n = 830). The prevalence of overweight and obesity at preschool age was 8.0% (n = 542) and 2.8% (n = 190), respectively. The study did not identify any significant association between breastfeeding practices and obesity in childhood when adjusted for relevant confounding factors (p > 0.05). It is likely that sociodemographic and lifestyle factors associated with breastfeeding practices may have an impact on childhood obesity. The identified lower than desirable rates and duration of breastfeeding practices should prompt enhanced efforts for effective promotion, protection, and support of breastfeeding across Europe, and in particular in regions with low BF rates. Full article

(This article belongs to the Special Issue Childhood Obesity: Nutrition and Lifestyle Determinants, Prevention and Management)

10 pages, 495 KiB

Open AccessArticle

Effects of School-Based Interventions on Reducing Sugar-Sweetened Beverage Consumption among Chinese Children and Adolescents

by Zhenni Zhu, Chunyan Luo, Shuangxiao Qu, Xiaohui Wei, Jingyuan Feng, Shuo Zhang, Yinyi Wang and Jin Su

Nutrients 2021, 13(6), 1862; https://doi.org/10.3390/nu13061862 - 30 May 2021

Cited by 6 | Viewed by 3556

Abstract

We set up a series of school-based interventions on the basis of an ecological model targeting sugar-sweetened beverage (SSB) reduction in Chinese elementary and middle schools and evaluated the effects. A total of 1046 students from Chinese elementary and middle schools were randomly [...] Read more.

We set up a series of school-based interventions on the basis of an ecological model targeting sugar-sweetened beverage (SSB) reduction in Chinese elementary and middle schools and evaluated the effects. A total of 1046 students from Chinese elementary and middle schools were randomly recruited in an intervention group, as were 1156 counterparts in a control group. The interventions were conducted in the intervention schools for one year. The participants were orally instructed to answer all the questionnaires by themselves at baseline and after intervention. The difference in difference statistical approach was used to identify the effects exclusively attributable to the interventions. There were differences in grade composition and no difference in sex distribution between the intervention and control groups. After adjusting for age, sex, and group differences at baseline, a significant reduction in SSB intake was found in the intervention group post intervention, with a decrease of 35.0 mL/day (p = 0.034). Additionally, the frequency of SSB consumption decreased by 0.2 times/day (p = 0.071). The students in the elementary schools with interventions significantly reduced their SSB intake by 61.6 mL/day (p = 0.002) and their frequency of SSB consumption by 0.3 times/day (p = 0.017) after the intervention. The boys in the intervention group had an intervention effect of a 50.2 mL/day reduction in their SSB intake (p = 0.036). School-based interventions were effective in reducing SSB consumption, especially among younger ones. The boys were more responsive to the interventions than the girls. (ChiCTR, ChiCTR1900020781.) Full article

(This article belongs to the Special Issue Childhood Obesity: Nutrition and Lifestyle Determinants, Prevention and Management)

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15 pages, 457 KiB

Open AccessArticle

Associations between Children’s Genetic Susceptibility to Obesity, Infant’s Appetite and Parental Feeding Practices in Toddlerhood

by Claire Guivarch, Marie-Aline Charles, Anne Forhan, Ken K. Ong, Barbara Heude and Blandine de Lauzon-Guillain

Nutrients 2021, 13(5), 1468; https://doi.org/10.3390/nu13051468 - 26 Apr 2021

Cited by 7 | Viewed by 2975

Abstract

Previous findings suggest that parental feeding practices may adapt to children’s eating behavior and sex, but few studies assessed these associations in toddlerhood. We aimed to study the associations between infant’s appetite or children’s genetic susceptibility to obesity and parental feeding practices. We [...] Read more.

Previous findings suggest that parental feeding practices may adapt to children’s eating behavior and sex, but few studies assessed these associations in toddlerhood. We aimed to study the associations between infant’s appetite or children’s genetic susceptibility to obesity and parental feeding practices. We assessed infant’s appetite (three-category indicator: low, normal or high appetite, labelled 4-to-24-month appetite) and calculated a combined obesity risk-allele score (genetic risk score of body mass index (BMI-GRS)) in a longitudinal study of respectively 1358 and 932 children from the EDEN cohort. Parental feeding practices were assessed at 2-year-follow-up by the CFPQ. Three of the five tested scores were used as continuous variables; others were considered as binary variables, according to the median. Associations between infant’s appetite or child’s BMI-GRS and parental feeding practices were assessed by linear and logistic regression models, stratified on child’s sex if interactions were significant. 4-to-24-month appetite was positively associated with restrictive feeding practices among boys and girls. Among boys, high compared to normal 4-to-24-month appetite was associated with higher use of food to regulate child’s emotions (OR [95% CI] = 2.24 [1.36; 3.68]). Child’s BMI-GRS was not related to parental feeding practices. Parental feeding practices may adapt to parental perception of infant’s appetite and child’s sex. Full article

(This article belongs to the Special Issue Childhood Obesity: Nutrition and Lifestyle Determinants, Prevention and Management)

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12 pages, 272 KiB

Open AccessArticle

Physical Activity, Sedentariness, Eating Behaviour and Well-Being during a COVID-19 Lockdown Period in Greek Adolescents

by Ioannis D. Morres, Evangelos Galanis, Antonis Hatzigeorgiadis, Odysseas Androutsos and Yannis Theodorakis

Nutrients 2021, 13(5), 1449; https://doi.org/10.3390/nu13051449 - 24 Apr 2021

Cited by 36 | Viewed by 6584

Abstract

Adolescents’ daily life has dramatically changed during the COVID-19 era due to the social restrictions that have been imposed, including closures of schools, leisure centers and sport facilities. The purpose of this study was to examine levels of well-being and mood and their [...] Read more.

Adolescents’ daily life has dramatically changed during the COVID-19 era due to the social restrictions that have been imposed, including closures of schools, leisure centers and sport facilities. The purpose of this study was to examine levels of well-being and mood and their relations with physical (in)activity and eating behaviors in adolescents during a lockdown period in Greece. A total of 950 adolescents (Mean Age = 14.41 years ± 1.63) participated in a web-based survey while education was conducted online and organized sport activities were interrupted. Participants showed poor well-being, insufficient physical activity levels and moderate scores of healthy eating behavior. Hierarchical regression analysis showed that, after controlling for the effect of gender and body mass index, increased physical activity and healthier eating behavior predicted better well-being (b = 0.24, p < 0.01 and b = 0.19, p < 0.01, respectively), whereas sedentariness predicted worse well-being (b = −0.16, p < 0.01). Furthermore, it was revealed that days of physical activity per week was a stronger predictor of well-being than minutes of physical activity per week, and that both in-house and out-of-house physical activity were beneficial. Considering that well-being in our study was below the threshold recommended by the World Health Organization as indicative of possible depressive symptoms, measures to increase physical activity, decrease sedentariness and improve eating behavior should become a priority for communities and policy makers. Full article

(This article belongs to the Special Issue Childhood Obesity: Nutrition and Lifestyle Determinants, Prevention and Management)

15 pages, 1785 KiB

Open AccessArticle

Resting Energy Expenditure Is Not Altered in Children and Adolescents with Obesity. Effect of Age and Gender and Association with Serum Leptin Levels

by J. Karina Zapata, Victoria Catalán, Amaia Rodríguez, Beatriz Ramírez, Camilo Silva, Javier Escalada, Javier Salvador, Giuseppe Calamita, M. Cristina Azcona-Sanjulian, Gema Frühbeck and Javier Gómez-Ambrosi

Nutrients 2021, 13(4), 1216; https://doi.org/10.3390/nu13041216 - 07 Apr 2021

Cited by 11 | Viewed by 2587

Abstract

In children and adolescents, obesity does not seem to depend on a reduction of resting energy expenditure (REE). Moreover, in this young population, the interactions between either age and obesity or between age and gender, or the role of leptin on REE are [...] Read more.

In children and adolescents, obesity does not seem to depend on a reduction of resting energy expenditure (REE). Moreover, in this young population, the interactions between either age and obesity or between age and gender, or the role of leptin on REE are not clearly understood. To compare the levels of REE in children and adolescents we studied 181 Caucasian individuals (62% girls) classified on the basis of age- and sex-specific body mass index (BMI) percentile as healthy weight (n = 50), with overweight (n = 34), or with obesity (n = 97) and in different age groups: 8–10 (n = 38), 11–13 (n = 50), and 14–17 years (n = 93). REE was measured by indirect calorimetry and body composition by air displacement plethysmography. Statistically significant differences in REE/fat-free mass (FFM) regarding obesity or gender were not observed. Absolute REE increases with age (p < 0.001), but REE/FFM decreases (p < 0.001) and there is an interaction between gender and age (p < 0.001) on absolute REE showing that the age-related increase is more marked in boys than in girls, in line with a higher FFM. Interestingly, the effect of obesity on absolute REE is not observed in the 8–10 year-old group, in which serum leptin concentrations correlate with the REE/FFM (r = 0.48; p = 0.011). In conclusion, REE/FFM is not affected by obesity or gender, while the effect of age on absolute REE is gender-dependent and leptin may influence the REE/FFM in 8–10 year-olds. Full article

(This article belongs to the Special Issue Childhood Obesity: Nutrition and Lifestyle Determinants, Prevention and Management)

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12 pages, 295 KiB

Open AccessArticle

Complementary Feeding and Overweight in European Preschoolers: The ToyBox-Study

by Natalya Usheva, Sonya Galcheva, Greet Cardon, Marieke De Craemer, Odysseas Androutsos, Aneta Kotowska, Piotr Socha, Berthold V. Koletzko, Luis A. Moreno, Violeta Iotova, Yannis Manios and on behalf of the ToyBox-study Group

Nutrients 2021, 13(4), 1199; https://doi.org/10.3390/nu13041199 - 05 Apr 2021

Cited by 9 | Viewed by 3465

Abstract

Complementary feeding (CF) should start between 4–6 months of age to ensure infants’ growth but is also linked to childhood obesity. This study aimed to investigate the association of the timing of CF, breastfeeding and overweight in preschool children. Infant-feeding practices were self-reported [...] Read more.

Complementary feeding (CF) should start between 4–6 months of age to ensure infants’ growth but is also linked to childhood obesity. This study aimed to investigate the association of the timing of CF, breastfeeding and overweight in preschool children. Infant-feeding practices were self-reported in 2012 via a validated questionnaire by >7500 parents from six European countries participating in the ToyBox-study. The proportion of children who received breast milk and CF at 4–6 months was 51.2%. There was a positive association between timing of solid food (SF) introduction and duration of breastfeeding, as well as socioeconomic status and a negative association with smoking throughout pregnancy (p < 0.005). No significant risk to become overweight was observed among preschoolers who were introduced to SF at 1–3 months of age compared to those introduced at 4–6 months regardless of the type of milk feeding. Similarly, no significant association was observed between the early introduction of SF and risk for overweight in preschoolers who were breastfed for ≥4 months or were formula-fed. The study did not identify any significant association between the timing of introducing SF and obesity in childhood. It is likely that other factors than timing of SF introduction may have impact on childhood obesity. Full article

(This article belongs to the Special Issue Childhood Obesity: Nutrition and Lifestyle Determinants, Prevention and Management)

10 pages, 481 KiB

Open AccessArticle

Antenatal Determinants of Childhood Obesity in High-Risk Offspring: Protocol for the DiGest Follow-Up Study

by Danielle Jones, Emanuella De Lucia Rolfe, Kirsten L. Rennie, Linda M. Oude Griep, Laura C. Kusinski, Deborah J. Hughes, Soren Brage, Ken K. Ong, Kathryn Beardsall and Claire L. Meek

Nutrients 2021, 13(4), 1156; https://doi.org/10.3390/nu13041156 - 31 Mar 2021

Cited by 1 | Viewed by 3113

Abstract

Childhood obesity is an area of intense concern internationally and is influenced by events during antenatal and postnatal life. Although pregnancy complications, such as gestational diabetes and large-for-gestational-age birthweight have been associated with increased obesity risk in offspring, very few successful interventions in [...] Read more.

Childhood obesity is an area of intense concern internationally and is influenced by events during antenatal and postnatal life. Although pregnancy complications, such as gestational diabetes and large-for-gestational-age birthweight have been associated with increased obesity risk in offspring, very few successful interventions in pregnancy have been identified. We describe a study protocol to identify if a reduced calorie diet in pregnancy can reduce adiposity in children to 3 years of age. The dietary intervention in gestational diabetes (DiGest) study is a randomised, controlled trial of a reduced calorie diet provided by a whole-diet replacement in pregnant women with gestational diabetes. Women receive a weekly dietbox intervention from enrolment until delivery and are blinded to calorie allocation. This follow-up study will assess associations between a reduced calorie diet in pregnancy with offspring adiposity and maternal weight and glycaemia. Anthropometry will be performed in infants and mothers at 3 months, 1, 2 and 3 years post-birth. Glycaemia will be assessed using bloodspot C-peptide in infants and continuous glucose monitoring with HbA1c in mothers. Data regarding maternal glycaemia in pregnancy, maternal nutrition, infant birthweight, offspring feeding behaviour and milk composition will also be collected. The DiGest follow-up study is expected to take 5 years, with recruitment finishing in 2026. Full article

(This article belongs to the Special Issue Childhood Obesity: Nutrition and Lifestyle Determinants, Prevention and Management)

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11 pages, 253 KiB

Open AccessEditor’s ChoiceArticle

Lifestyle Changes and Determinants of Children’s and Adolescents’ Body Weight Increase during the First COVID-19 Lockdown in Greece: The COV-EAT Study

by Odysseas Androutsos, Maria Perperidi, Christos Georgiou and Giorgos Chouliaras

Nutrients 2021, 13(3), 930; https://doi.org/10.3390/nu13030930 - 13 Mar 2021

Cited by 120 | Viewed by 11805

Abstract

Previous studies showed that the coronavirus disease 2019 (COVID-19) lockdown imposed changes in adults’ lifestyle behaviors; however, there is limited information regarding the effects on youth. The COV-EAT study aimed to report changes in children’s and adolescents’ lifestyle habits during the first COVID-19 [...] Read more.

Previous studies showed that the coronavirus disease 2019 (COVID-19) lockdown imposed changes in adults’ lifestyle behaviors; however, there is limited information regarding the effects on youth. The COV-EAT study aimed to report changes in children’s and adolescents’ lifestyle habits during the first COVID-19 lockdown and explore potential associations between changes of participants’ lifestyle behaviors and body weight. An online survey among 397 children/adolescents and their parents across 63 municipalities in Greece was conducted in April–May 2020. Parents self-reported changes of their children’s lifestyle habits and body weight, as well as sociodemographic data of their family. The present study shows that during the lockdown, children’s/adolescents’ sleep duration and screen time increased, while their physical activity decreased. Their consumption of fruits and fresh fruit juices, vegetables, dairy products, pasta, sweets, total snacks, and breakfast increased, while fast-food consumption decreased. Body weight increased in 35% of children/adolescents. A multiple regression analysis showed that the body weight increase was associated with increased consumption of breakfast, salty snacks, and total snacks and with decreased physical activity. The COV-EAT study revealed changes in children’s and adolescents’ lifestyle behaviors during the first COVID-19 lockdown in Greece. Effective strategies are needed to prevent excessive body weight gain in future COVID-19 lockdowns. Full article

(This article belongs to the Special Issue Childhood Obesity: Nutrition and Lifestyle Determinants, Prevention and Management)

17 pages, 1855 KiB

Open AccessArticle

Characteristic-Grouped Adiposity Indicators for Identifying Metabolic Syndrome in Adolescents: Develop and Valid Risk Screening Tools Using Dual Population

by Yu-Ting Chin, Wei-Ting Lin, Pei-Wen Wu, Sharon Tsai, Chun-Ying Lee, David W. Seal, Ted Chen, Hsiao-Ling Huang and Chien-Hung Lee

Nutrients 2020, 12(10), 3165; https://doi.org/10.3390/nu12103165 - 16 Oct 2020

Cited by 8 | Viewed by 2262

Abstract

A simple, robust, and characterized adiposity indicator may be appropriate to be used as a risk screening tool for identifying metabolic syndrome (MetS) in adolescents. This study used dual adolescent populations to develop and validate efficient adiposity indicators from 12 characterized candidates for [...] Read more.

A simple, robust, and characterized adiposity indicator may be appropriate to be used as a risk screening tool for identifying metabolic syndrome (MetS) in adolescents. This study used dual adolescent populations to develop and validate efficient adiposity indicators from 12 characterized candidates for identifying MetS that may occur during the transition from adolescence to young adulthood. Data from the adolescent Nutrition and Health Survey in Taiwan (n = 1920, 12–18 years) and the multilevel Risk Profiles for adolescent MetS study (n = 2727, 12–16 years) were respectively used as training and validation datasets. The diagnostic criteria defined by the International Diabetes Federation for adolescents (IDF-adoMetS) and the Joint Interim Statement for adults (JIS-AdMetS) were employed to evaluate MetS. In the training dataset, principal component analysis converted 12 interrelated obesity indices into bodyfat-, lipid-, and body-shape-enhanced groups, with the first two characteristic-groups having a higher discriminatory capability in identifying IDF-adoMetS and JIS-AdMetS. In the validation dataset, abdominal volume index (AVI) among girls and waist circumference (WC) among boys were respectively validated to have a higher Youden’s index (0.740–0.816 and 0.798–0.884) in identifying the two MetS. Every 7.4 and 4.3 positive tests of AVI (cutoff = 13.96) had an accurate IDF-adoMetS and JIS-AdMetS, respectively, and every 32.4 total tests of WC (cutoff = 90.5 cm) had a correct identification for the two MetS. This study stresses the discriminatory capability of bodyfat- and lipid-enhanced adiposity indicators for identifying MetS. AVI and WC were, respectively, supported as a risk screening tool for identifying female and male MetS as adolescents transition to adulthood. Full article

(This article belongs to the Special Issue Childhood Obesity: Nutrition and Lifestyle Determinants, Prevention and Management)

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Review

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24 pages, 1754 KiB

Open AccessReview

Effects of L-Citrulline Supplementation and Aerobic Training on Vascular Function in Individuals with Obesity across the Lifespan

by Anaisa Genoveva Flores-Ramírez, Verónica Ivette Tovar-Villegas, Arun Maharaj, Ma Eugenia Garay-Sevilla and Arturo Figueroa

Nutrients 2021, 13(9), 2991; https://doi.org/10.3390/nu13092991 - 27 Aug 2021

Cited by 5 | Viewed by 4127

Abstract

Children with obesity are at higher risk for developing cardiometabolic diseases that once were considered health conditions of adults. Obesity is commonly associated with cardiometabolic risk factors such as dyslipidemia, hyperglycemia, hyperinsulinemia and hypertension that contribute to the development of endothelial dysfunction. Endothelial [...] Read more.

Children with obesity are at higher risk for developing cardiometabolic diseases that once were considered health conditions of adults. Obesity is commonly associated with cardiometabolic risk factors such as dyslipidemia, hyperglycemia, hyperinsulinemia and hypertension that contribute to the development of endothelial dysfunction. Endothelial dysfunction, characterized by reduced nitric oxide (NO) production, precedes vascular abnormalities including atherosclerosis and arterial stiffness. Thus, early detection and treatment of cardiometabolic risk factors are necessary to prevent deleterious vascular consequences of obesity at an early age. Non-pharmacological interventions including L-Citrulline (L-Cit) supplementation and aerobic training stimulate endothelial NO mediated vasodilation, leading to improvements in organ perfusion, blood pressure, arterial stiffness, atherosclerosis and metabolic health (glucose control and lipid profile). Few studies suggest that the combination of L-Cit supplementation and exercise training can be an effective strategy to counteract the adverse effects of obesity on vascular function in older adults. Therefore, this review examined the efficacy of L-Cit supplementation and aerobic training interventions on vascular and metabolic parameters in obese individuals. Full article

(This article belongs to the Special Issue Childhood Obesity: Nutrition and Lifestyle Determinants, Prevention and Management)

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15 pages, 1255 KiB

Open AccessReview

Management of Childhood Obesity—Time to Shift from Generalized to Personalized Intervention Strategies

by Mohamad Motevalli, Clemens Drenowatz, Derrick R. Tanous, Naim Akhtar Khan and Katharina Wirnitzer

Nutrients 2021, 13(4), 1200; https://doi.org/10.3390/nu13041200 - 06 Apr 2021

Cited by 22 | Viewed by 10253

Abstract

As a major public health concern, childhood obesity is a multifaceted and multilevel metabolic disorder influenced by genetic and behavioral aspects. While genetic risk factors contribute to and interact with the onset and development of excess body weight, available evidence indicates that several [...] Read more.

As a major public health concern, childhood obesity is a multifaceted and multilevel metabolic disorder influenced by genetic and behavioral aspects. While genetic risk factors contribute to and interact with the onset and development of excess body weight, available evidence indicates that several modifiable obesogenic behaviors play a crucial role in the etiology of childhood obesity. Although a variety of systematic reviews and meta-analyses have reported the effectiveness of several interventions in community-based, school-based, and home-based programs regarding childhood obesity, the prevalence of children with excess body weight remains high. Additionally, researchers and pediatric clinicians are often encountering several challenges and the characteristics of an optimal weight management strategy remain controversial. Strategies involving a combination of physical activity, nutritional, and educational interventions are likely to yield better outcomes compared to single-component strategies but various prohibitory limitations have been reported in practice. This review seeks to (i) provide a brief overview of the current preventative and therapeutic approaches towards childhood obesity, (ii) discuss the complexity and limitations of research in the childhood obesity area, and (iii) suggest an Etiology-Based Personalized Intervention Strategy Targeting Childhood Obesity (EPISTCO). This purposeful approach includes prioritized nutritional, educational, behavioral, and physical activity intervention strategies directly based on the etiology of obesity and interpretation of individual characteristics. Full article

(This article belongs to the Special Issue Childhood Obesity: Nutrition and Lifestyle Determinants, Prevention and Management)

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13 pages, 904 KiB

Open AccessEditor’s ChoiceReview

The Influence of Parental Dietary Behaviors and Practices on Children’s Eating Habits

by Lubna Mahmood, Paloma Flores-Barrantes, Luis A. Moreno, Yannis Manios and Esther M. Gonzalez-Gil

Nutrients 2021, 13(4), 1138; https://doi.org/10.3390/nu13041138 - 30 Mar 2021

Cited by 90 | Viewed by 25916

Abstract

Poor dietary habits established during childhood might persist into adulthood, increasing the risk of developing obesity and obesity-related complications such as Type 2 Diabetes Mellitus. It has been found that early modifications in eating habits, especially during childhood, might promote health and decrease [...] Read more.

Poor dietary habits established during childhood might persist into adulthood, increasing the risk of developing obesity and obesity-related complications such as Type 2 Diabetes Mellitus. It has been found that early modifications in eating habits, especially during childhood, might promote health and decrease the risk of developing diseases during later life. Various studies found a great influence of parental dietary habits on dietary behaviors of their children regardless of demographic characteristics such as gender, age, socioeconomic status and country; however, the exact mechanism is still not clear. Therefore, in this review, we aimed to investigate both parents’ and children’s dietary behaviors, and to provide evidence for the potential influence of parents’ dietary behaviors and practices on certain children’s eating habits. Family meals were found to contribute the most in modeling children’s dietary habits as they represent an important moment of control and interaction between parents and their children. The parental practices that influenced their children most were role modeling and moderate restriction, suggesting that the increase of parental encouragement and decrease of excessive pressure could have a positive impact in their children’s dietary behaviors. This narrative review highlights that parental child-feeding behaviors should receive more attention in research studies as modifiable risk factors, which could help to design future dietary interventions and policies to prevent dietary-related diseases. Full article

(This article belongs to the Special Issue Childhood Obesity: Nutrition and Lifestyle Determinants, Prevention and Management)

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27 pages, 1042 KiB

Open AccessReview

Impact of Strategies for Preventing Obesity and Risk Factors for Eating Disorders among Adolescents: A Systematic Review

by Ana Carolina B. Leme, Jess Haines, Lisa Tang, Karin L. L. Dunker, Sonia T. Philippi, Mauro Fisberg, Gerson L. Ferrari and Regina M. Fisberg

Nutrients 2020, 12(10), 3134; https://doi.org/10.3390/nu12103134 - 14 Oct 2020

Cited by 26 | Viewed by 8852

Abstract

An effective behavior change program is the first line of prevention for youth obesity. However, effectiveness in prevention of adolescent obesity requires several approaches, with special attention paid to disordered eating behaviors and psychological support, among other environmental factors. The aim of this [...] Read more.

An effective behavior change program is the first line of prevention for youth obesity. However, effectiveness in prevention of adolescent obesity requires several approaches, with special attention paid to disordered eating behaviors and psychological support, among other environmental factors. The aim of this systematic review is to compare the impact of two types of obesity prevention programs, inclusive of behavior change components, on weight outcomes. “Energy-balance” studies are aimed at reducing calories from high-energy sources and increasing physical activity (PA) levels, while “shared risk factors for obesity and eating disorders” focus on reducing disordered eating behaviors to promote a positive food and eating relationship. A systematic search of ProQuest, PubMed, PsycInfo, SciELO, and Web of Science identified 8825 articles. Thirty-five studies were included in the review, of which 20 regarded “energy-balance” and 15 “shared risk factors for obesity and eating disorders”. “Energy-balance” studies were unable to support maintenance weight status, diet, and PA. “Shared risk factors for obesity and eating disorders” programs also did not result in significant differences in weight status over time. However, the majority of “shared risk factors for obesity and eating disorders” studies demonstrated reduced body dissatisfaction, dieting, and weight-control behaviors. Research is needed to examine how a shared risk factor approach can address both obesity and eating disorders. Full article

(This article belongs to the Special Issue Childhood Obesity: Nutrition and Lifestyle Determinants, Prevention and Management)

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21 pages, 952 KiB

Open AccessReview

Adipose Tissue Development and Expansion from the Womb to Adolescence: An Overview

by Camila E. Orsso, Eloisa Colin-Ramirez, Catherine J. Field, Karen L. Madsen, Carla M. Prado and Andrea M. Haqq

Nutrients 2020, 12(9), 2735; https://doi.org/10.3390/nu12092735 - 08 Sep 2020

Cited by 42 | Viewed by 6965

Abstract

Prevalence rates of pediatric obesity continue to rise worldwide. Adipose tissue (AT) development and expansion initiate in the fetus and extend throughout the lifespan. This paper presents an overview of the AT developmental trajectories from the intrauterine period to adolescence; factors determining adiposity [...] Read more.

Prevalence rates of pediatric obesity continue to rise worldwide. Adipose tissue (AT) development and expansion initiate in the fetus and extend throughout the lifespan. This paper presents an overview of the AT developmental trajectories from the intrauterine period to adolescence; factors determining adiposity expansion are also discussed. The greatest fetal increases in AT were observed in the third pregnancy trimester, with growing evidence suggesting that maternal health and nutrition, toxin exposure, and genetic defects impact AT development. From birth up to six months, healthy term newborns experience steep increases in AT; but a subsequent reduction in AT is observed during infancy. Important determinants of AT in infancy identified in this review included feeding practices and factors shaping the gut microbiome. Low AT accrual rates are maintained up to puberty onset, at which time, the pattern of adiposity expansion becomes sex dependent. As girls experience rapid increases and boys experience decreases in AT, sexual dimorphism in hormone secretion can be considered the main contributor for changes. Eating patterns/behaviors and interactions between dietary components, gut microbiome, and immune cells also influence AT expansion. Despite the plasticity of this tissue, substantial evidence supports that adiposity at birth and infancy highly influences its levels across subsequent life stages. Thus, a unique window of opportunity for the prevention and/or slowing down of the predisposition toward obesity, exists from pregnancy through childhood. Full article

(This article belongs to the Special Issue Childhood Obesity: Nutrition and Lifestyle Determinants, Prevention and Management)

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