INTRODUCTION:Previous studies suggest that children from lower socioeconomic status may be at higher risk of unhealthy eating. This study aims to examine the cumulative socioeconomic vulnerabilities and their association with dietary patterns and obesity levels in European children. METHODS:A total of 9664 parent-child dyads (79% mothers; 50.8% girls) from six European countries participated in the study. Families provided baseline information on energy balance-related behaviours and socioeconomic factors through questionnaires. Children's dietary habits were evaluated using semi-quantitative food frequency questionnaires, and anthropometric data were collected. Vulnerabilities were quantified through a composition of variables based on household income, parental education and employment. Multivariable and logistic regression analyses were performed. RESULTS:The study found significant associations between socioeconomic vulnerability and children's dietary habits and body mass index. Higher vulnerability was linked to a lower probability of fruit and vegetable intake, and a higher probability of consuming red meat, and energy-dense snacks. Children with the highest vulnerability had nearly four times higher odds of overweight/obesity (OR = 3.82, 95% CI: 3.05-4.76). CONCLUSIONS:The findings of this study indicate that European children from families with a high socioeconomic vulnerability tend to have an unhealthy dietary profile and a higher degree of obesity. Therefore, public health programs should prioritise families facing high socioeconomic vulnerabilities promoting healthy eating to prevent childhood obesity at early stages. TRIAL REGISTRATION:Clinical trials registry http://clinicaltrials.gov: NCT02393872.
INTRODUCTION:Obesity in infants is a growing problem in Mexico, affecting children's well-being and increasing long-term health risks. Evidence of the multilevel determinants during the first 1000 days is limited. This study aimed to examine the relationship between individual, maternal, household and the prevalence of overweight and obesity in children under 2 years of age. METHODS:A secondary analysis of the 2021 National Health and Nutrition Survey was conducted with a sample of 185 mother-infant binomials. To assess the combined prevalence of overweight and obesity (ow_ob) in infants, body mass index Z-scores were calculated by age and sex. By age group, multiple logistic regression models were adjusted to evaluate the association between childhood ow_ob and individual, maternal, household and place of residence variables. RESULTS:A combined prevalence of overweight and obesity of 29.7% was found. In infants aged 0-11 months, the highest probability of ow_ob (pr_ob = 0.87) was amongst infants of overweight mothers who worked outside the home. In infants aged 12-23 months, the highest likelihood of ow_ob (pr_ob = 0.885) was for children whose mothers had lower levels of education, were married, had a diagnosis of depression and experienced moderate or severe food insecurity. CONCLUSIONS:This study is one of the first in Mexico to analyse multiple risk factors simultaneously at the national level, as it had a representative sample of children under 2 years old. The findings underscore the importance of early intervention and a comprehensive approach considering family and socioeconomic factors in childhood obesity prevention.
BACKGROUND:The association between breastfeeding and adolescent obesity remains unclear because most previous studies included youth with obesity. We explored these associations from ages 9 to 12 amongst initially healthy weight youth. METHODS:The analytic sample included 4161 youth (10 586 observations across three assessments; all healthy weight at baseline; 50.7% female; 52% breastfed more than 6 months) from the Adolescent Brain Cognitive Development (ABCD) Study. Linear mixed-effects models examined breastfeeding × age × sex and breastfeeding × puberty × sex interactions on BMI trajectories (kg/m2). Logistic regression estimated the risk of unhealthy weight (BMI ≥ 85th percentile) by ages 11-12. All analyses were stratified by sex. RESULTS:Three-way interactions were not significant. Significant breastfeeding × age interactions (β = -0.005, p < 0.001) indicated that breastfed youth exhibited lower BMI trajectories, particularly when breastfed for more than 6 months (β = -0.006, p < 0.001). Significant breastfeeding × puberty interactions showed lower BMI trajectories across pubertal stages amongst breastfed youth (β = -0.06, p = 0.017), observed only in boys and especially in those breastfed beyond 6 months (β = -0.11, p = 0.005). Breastfeeding was associated with a reduced unhealthy weight risk at ages 11-12 (RR = 0.78, p = 0.002), exclusively in boys and amongst those breastfed more than 6 months (RR = 0.52, p < 0.001). No associations were found in girls. CONCLUSION:Amongst initially healthy weight youth, breastfeeding, especially beyond 6 months, was associated with healthier BMI trajectories and lower unhealthy weight risk in boys. Although these sex-specific patterns warrant further research, our findings suggest that the associations between breastfeeding and body weight development extend into adolescence.
BACKGROUND:Rising sedentary behaviour and consumption of sugar-sweetened beverages and ultra-processed foods have increased the risk and earlier onset of obesity in children. OBJECTIVES:To define controlled attenuation parameter (CAP) cut-off values in healthy children, assess the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) in children with overweight and obesity, and establish an appropriate starting age for MASLD screening in our population. METHODS:Healthy primary school children were recruited. Hepatic steatosis was assessed using CAP, and body composition data were collected during two periods: August 2020-March 2021 and February 2023-May 2024. RESULTS:Of 1653 participants (mean age 9.5 ± 1.7 years), 976 children with normal weight were used to establish reference intervals. Hepatic steatosis was defined as a CAP above 247 dB/m (97.5th percentile). The prevalences of MASLD in children with overweight and obesity were 0% and 16%, respectively, in school grade 1, which increased to 19% and 75% in school grade 6 (p < 0.001). CONCLUSIONS:Screening for hepatic steatosis associated with obesity should begin as early as school grade 1, while screening for children with overweight may be more appropriate by school grade 6. These findings emphasise the need for age- and weight-specific screening strategies for children with overweight and obesity.
BACKGROUND:While acute exercise has been shown to alter subsequent energy intake in adolescents with obesity, the role of the exercise-induced energy expenditure and substrate oxidation remains unknown. The present study investigates the effect of energy expenditure and substrate oxidation rates during an acute walking exercise on subsequent appetitive responses in adolescents with obesity. METHODS:Body composition and maximal aerobic capacities were assessed in 25 adolescents [8 males, 12-16 years] with obesity. They then realized a control condition without exercise [CON] and an exercise session [EX, 40-min walking at 4 km h-1] in a randomized order. Energy expenditure and substrate use were assessed at rest and during exercise using indirect calorimetry. Subsequent ad libitum energy intake, appetite sensations and food reward were assessed. RESULTS:Post-exercise energy intake was reduced on EX compared with CON [1083 ± 253 vs. 950 ± 226 kcal; p = 0.041], with reduced absolute protein intake [p = 0.011]. None of the appetite sensations differed between conditions. Pre-lunch explicit liking for fat decreased on EX compared with CON [p = 0.045], the implicit and explicit wanting for fat [p = 0.047 and p = 0.025 respectively] and explicit wanting for taste [p = 0.012] decreased from pre to post lunch after exercise. Energy Expenditure, fat and carbohydrate oxidation rates during exercise were not associated with subsequent appetitive measurements. CONCLUSION:Exercise-induced energy expenditure and substrate might not be associated with the short-term control of appetite and energy intake in adolescents with obesity, which remains to be confirmed by further studies evaluating the effect of various exercises inducing specific predominant fuel sources.
BACKGROUND:Low-carbohydrate (CHO) or ketogenic diets have been proposed as alternative interventions to caloric restriction to address the childhood obesity epidemic. However, empirical support for this dietary strategy has remained inconclusive in youth. The objective was to test the hypothesis that consumption of a meal lower in the proportion of CHO relative to fat acutely elicits greater satiety, and lower preference for sweet and high-fat foods and energy intake at the subsequent meal in adolescents with obesity. METHODS:In a randomised crossover trial, 15 adolescents with obesity (7 females; 13.2 ± 1.8 years) consumed 3 isocaloric lunch meals on 3 different occasions: (i) moderate (52%), (ii) low (24%) or (iii) very low (7%) in CHO with commensurately adjusted fat content and matched for protein. Adolescents rated their appetite sensations at regular intervals throughout each test day (visual analogue scales). Food reward was recorded before and after the lunch meal, and prior to an ad libitum dinner (French version of the Leeds Food Preference Questionnaire [LFPQ-fr]), from which energy and macronutrient intake was quantified. RESULTS:No significant differences in energy or macronutrient intake at dinner or daily appetite sensations were found between conditions. Similarly, the proportions of CHO and fat had no effect on liking or wanting for high-fat or sweet foods. Rather, choice frequency for sweet foods appeared to increase after consumption of each meal (p = 0.048). CONCLUSION:In the context of isocaloric meals, lowering the CHO content with a commensurate increase in fat, does not significantly alter satiety, food reward or subsequent energy intake during a test meal in adolescents with obesity.
BACKGROUND:Children born to mothers with obesity or gestational diabetes mellitus (GDM) face elevated risks of central adiposity and adverse cardiometabolic outcomes, including metabolic syndrome (MetS) and systemic inflammation. However, it remains unclear whether these risks are primarily driven by current adiposity or by in utero exposure. This study investigated associations between waist circumference (WC), waist-to-height ratio (WHtR), and continuous MetS (cMetS) scores in children, and evaluated whether in utero exposure to maternal obesity or GDM moderated these relationships. Associations between cMetS and cardiometabolic biomarkers were also examined. METHODS:Children were grouped by maternal early-pregnancy weight status and GDM diagnosis: (1) normal weight without GDM, (2) overweight/obesity without GDM, and (3) overweight/obesity with GDM. WC was classified as < 85th or ≥ 85th percentile; WHtR as < 0.5 or ≥ 0.5. cMetS scores were computed with and without the WC component. Group differences and associations were assessed using ANCOVA and correlation analyses. RESULTS:WC and WHtR were strong predictors of cMetS, independent of in utero exposure group. Children with WC ≥ 85th percentile or WHtR ≥ 0.5 had significantly higher cMetS scores (p < 0.0001), even when WC was excluded from the cMetS calculation. cMetS was inversely correlated with adiponectin and positively correlated with leptin, the leptin-to-adiponectin ratio, HOMA-IR, CRP, and IL-6 (all p < 0.01). CONCLUSIONS:Central adiposity-indexed by WC or WHtR-rather than in utero exposure, is the primary driver of cardiometabolic risk. Associations between cMetS and cardiometabolic biomarkers underscore insulin resistance and adipose tissue dysfunction as key mechanisms underlying MetS in children.
BACKGROUND:Diet may influence the subclinical inflammatory responses related to metabolic disorders. OBJECTIVE:To identify a dietary pattern associated with inflammatory biomarkers and to evaluate its association with metabolic, clinical and anthropometric indicators in Brazilian adolescents. METHODS:Data from Brazilian adolescents aged 12-17 years participating in the Study of Cardiovascular Risk in Adolescents (ERICA, 2013-2014) were analysed. Dietary intake was assessed using a 24-h dietary recall. A dietary pattern was derived using the Partial Least Squares regression in a subset (n = 3703) with C-reactive protein and adiponectin as intermediate variables and retaining food groups with factor loadings ≥ |0.15|. Associations between the pro-inflammatory dietary pattern and anthropometric indicators and metabolic biomarkers were examined in a subsample of adolescents (n = 36 956) using crude and adjusted multiple linear regression models. RESULTS:The pro-inflammatory dietary pattern was characterised by positive loadings for soft drinks, cakes, cheese, fats, pasta, snacks, sweets and bread, and with negative loadings for rice, milk-based dishes, poultry, fish and beans. The mean inflammatory dietary pattern score was 0.05 overall, and higher for girls (0.08) than boys (0.03). Significant associations (p < 0.05) were found between the pro-inflammatory dietary pattern and increased BMI (β = 0.07 kg/m2), fasting blood glucose (β = 0.20 mg/dL) and HOMA-IR (β = 0.03), after adjusting for sex, age, school type, diet report quality and daily energy intake. CONCLUSIONS:Among Brazilian adolescents, a pro-inflammatory dietary pattern was associated with higher body weight, fasting glucose and insulin resistance.
OBJECTIVE:To understand delivery features and intervention strategies of adolescent weight management interventions which may influence eating disorder risk. METHODS:Systematic searches in four databases and two trial registries to identify randomised controlled trials in adolescents with overweight/obesity measuring eating disorder risk pre- and post-intervention. Delivery features and intervention strategies were coded from published descriptions using a project-specific codebook, validated by trial investigators and narratively synthesised. RESULTS:Of 11 860 records screened, 23 trials, with 54 intervention arms, were included in the analysis. Most interventions focused on weight loss and maintenance (54%) and were informed by a cognitive behavioural framework (43%). Interventions commonly targeted an individual with a support person (70%). Median intervention duration was 26 weeks, with weekly (35%) or staged (e.g., weekly, then monthly) visit (41%) frequency. Interventions had a mean (SD) of 30 (16.1) intervention strategies. Most included healthy eating education (89%), physical activity education (89%) and problem-solving barriers to dietary change (80%). Few included mental health strategies (17%). Interventions included 'dietary prescription' (65%), and 78% promoted 'healthful/helpful eating behaviours'. CONCLUSION:Weight management interventions are complex and vary in delivery approach and strategies used to change behaviors. Characterising interventions is a critical first step to understanding how weight management interventions' influence eating disorder risk.
OBJECTIVES:Asian adults develop metabolic complications at lower body mass indices (BMIs) compared with other ethnic groups, leading to lower BMI cutoffs for overweight and obesity. However, it remains unclear whether such adjustments are warranted in Asian children and adolescents. We aimed to determine whether lower BMI percentile cutoffs should be considered for overweight and obesity among Asian children and adolescents in the United States. METHODS:We analysed nationally representative data from U.S. children and adolescents from NHANES, 2012-2020. Metabolic parameters-including truncal fat percentage, glycemic markers, lipid profiles and liver disease markers-were compared between Asian and non-Asian participants within the 85-95th percentile and ≥ 95th percentile ranges. Metabolic parameter-based matching analyses identified corresponding BMI percentiles between groups. RESULTS:Asian children had more pronounced metabolic abnormalities than non-Asians in the overweight and obesity groups. After matching for metabolic parameters, Asians had the same levels of metabolic dysfunction at lower BMI percentiles than non-Asians, with averaged differences of approximately 3-9 BMI percentiles across various BMI percentile ranges. CONCLUSIONS:Asian children and adolescents experience elevated metabolic risks at currently defined BMI percentiles. Lower BMI cutoffs targeting the 80th percentile for overweight and 90th percentile for obesity may improve early detection of metabolic risks in the Asian paediatric population.
BACKGROUND:Gestational diabetes (GDM) is associated with increased future obesity risk in affected mothers and children. OBJECTIVE:We assessed if dietary behaviours learnt during a GDM pregnancy positively impact maternal and child health 3 years postpartum. METHOD:In a secondary analysis, we included women with obesity recruited to the UPBEAT randomised controlled trial with 3-year follow-up postnatally (n = 441). Maternal and offspring anthropometry and dietary data were recorded antenatally and at follow-up. Data were assessed using linear/logistic regression, adjusting for confounders. RESULTS:Women with GDM (22%) had higher BMI (median 35.6 vs. 34.2 kg/m2; p = 0.049) and energy intake (1738.2 vs. 1551.6 kcal/day; p = 0.005) at ~16 weeks' gestation compared to unaffected women, but lower gestational weight gain (4.5 kg vs. 6.6 kg; p < 0.001). However, at 3 years postpartum BMI was similar between groups (35.8 vs. 35.2 kg/m2; p > 0.5). GDM-exposed infants had a higher birthweight (55.4 vs. 45.9th centile; p = 0.008) than unexposed infants and at 3 years of age were more likely to be overweight/obese (International Obesity Task Force, IOTF, standards; OR 2.32; 95% CI 1.38, 3.91) but with similar skinfold thicknesses and dietary patterns. CONCLUSION:Women with GDM demonstrated reduced gestational weight gain, and despite a higher BMI than women without GDM in early pregnancy, this difference was not evident at 3 years postpartum. However, while maternal and offspring dietary behaviours were comparable between groups, exposed offspring were at increased risk of overweight/obesity at 3 years of age.
BACKGROUND:Adolescents with youth-onset type 2 diabetes (YO-T2D) have an increased risk for cardiometabolic complications. The impact of vertical sleeve gastrectomy (VSG) on fat distribution and cardiac morphology/function in YO-T2D is unknown. OBJECTIVES:To evaluate changes in body composition, abdominal and cardiac fat depots, and cardiometabolic health in adolescents with YO-T2D undergoing VSG. METHODS:Anthropometrics, labs and imaging were used to assess participants pre-surgery and 3-12 months post-surgery. MRI quantified pericardial (PAT), epicardial (EAT), subcutaneous (SAT) and visceral adipose tissue (VAT), hepatic fat fraction (HFF) and cardiac morphology/function. Mixed-effects models assessed longitudinal changes. RESULTS:By 12 months, weight decreased from 134.3 ± 5.1 to 103.3 ± 5.2 kg, VAT 1943 ± 148 to 1248 ± 150 cm3, HFF 23.2% ± 2.3% to 5.3% ± 2.3% and PAT and EAT by 27% and 33% (all p < 0.01). Homeostatic model assessment of insulin resistance (HOMA-IR) improved (7.8 ± 1.2 to 1.7 ± 1.2 [p < 0.01]). BMI, SAT, resting heart rate (RHR), left ventricular (LV) mass and cardiac output (CO) also decreased (all p < 0.05). VAT decreases correlated with decreases in HFF (r = 0.70, p = 0.01), HOMA-IR (r = 0.60, p = 0.04) and CO (r = 0.70, p = 0.03). HFF decreases correlated with decreases in BMI (r = 0.70, p = 0.03), HOMA-IR (r = 0.90, p < 0.001), RHR (r = 0.90, p = 0.002), CO (r = 0.80, p = 0.007) and LV mass (r = 0.70, p = 0.02). CONCLUSIONS:VSG reduces ectopic and regional fat and improves associated insulin sensitivity and cardiac health in adolescents with YO-T2D.
BACKGROUND:Childhood obesity poses a global health threat, with emerging evidence suggesting distinct adipocyte senescence patterns compared to adult-onset obesity. We systematically explored whether childhood obesity may be causally associated with age-related diseases through a meta-analysis of Mendelian randomization (MR) evidence. METHODS:We screened six databases (MEDLINE, PubMed, EMBASE, Web of Science, Cochrane Library and CNKI) and identified 45 MR articles examining paediatric adiposity and major age-related diseases. For each disease, we performed a meta-analysis using results from published MR studies and conducted de novo analyses based on genetic data from UK Biobank (n = 453 169), FinnGen (n > 200 000) and other large consortiums. RESULTS:The meta-analysis examined 44 diseases across 9 systems, revealing suggestive associations between genetically determined childhood obesity and increased risk of 16 age-related diseases, including hypertension, atrial fibrillation, coronary artery disease, stroke and myocardial infarction; colorectal, endometrial and pancreatic cancers; nonalcoholic fatty liver disease, type 2 diabetes, diabetic nephropathy; multiple sclerosis and gout; Alzheimer's disease; depression and asthma. Three of these associations were marginal (p = 0.03-0.05). Paradoxical inverse associations emerged for breast cancer and ulcerative colitis. CONCLUSION:The findings from this meta-analysis underscore associations between childhood adiposity and multisystem age-related pathologies, underscoring the imperative for early obesity prevention.
BACKGROUND:During the COVID-19 pandemic, there was a rise in the incidence of type 2 diabetes (T2D) and prediabetes in children and teenagers. We investigated whether new risk factors for diabetes in children emerged during the pandemic period. METHODS:Using health records of a large, integrated health system, we evaluated the incidence of new-onset T2D and prediabetes in patients aged 0-19 years from 2020 to 2023. We utilised descriptive statistics, chi-square and multivariable logistic regressions to predict the risk of T2D and prediabetes. RESULTS:Compared to children with normal weight, children with obesity (p < 0.0001) and those overweight (p < 0.0001) were more likely to develop prediabetes, and children with obesity were more likely to develop T2D (p < 0.0001). Children aged 12-19 were more likely to develop prediabetes (p < 0.0001) and T2D (p < 0.0001) compared to younger children. Publicly insured children were more likely to develop T2D (p = 0.003). Black and Asian children were at higher risk than White individuals of developing both prediabetes (p < 0.0001) and T2D (p = 0.019 and p = 0.02, respectively). COVID-19 infection was not a meaningful risk factor for prediabetes or T2D. CONCLUSION:Risk factors for prediabetes and T2D in children remained the same during the pandemic as prior: adolescents, overweight/obese patients, publicly insured individuals and non-White individuals.
BACKGROUND:In Sweden, schoolwork pressure and adolescent overweight/obesity prevalence have increased in recent decades. This study investigates the relationship between schoolwork pressure and weight status, considering the moderating role of socioeconomic background. METHODS:We analysed pooled cross-sectional data from 12 154 adolescents in the nationally representative Swedish Health Behaviour in School-aged Children surveys (2013/14, 2017/18, 2021/22). Logistic regression models examined the association between schoolwork pressure and self-reported overweight/obesity status (standardised by IOTF cut-offs) across socioeconomic backgrounds assessed by the Family Affluence Scale (FAS) and perceived family wealth (PFW). We calculated population attributable fractions to quantify schoolwork pressure's contribution to overweight/obesity. RESULTS:37% of students reported high schoolwork pressure, and 14% had overweight or obesity. High schoolwork pressure was associated with increased odds of overweight/obesity (OR 1.17, 95% CI 1.03-1.32). Adolescents experiencing high pressure from low socioeconomic backgrounds FAS (OR 2.10, 95% CI 1.60-2.76) or PFW (OR 1.82, 95% CI 1.22-2.71) had the highest odds of overweight/obesity. Approximately 5% of overweight/obesity cases were attributable to high schoolwork pressure. CONCLUSIONS:High schoolwork pressure increases the likelihood of adolescent overweight/obesity, particularly for disadvantaged socioeconomic groups. Implementing policies to reduce academic stress and providing targeted support are essential for promoting healthier outcomes.
U.S. acculturation is associated with poor diet quality and obesity. This study examined the association of acculturation with added sugars among Mexican American adolescents, and whether added sugars mediate the association between acculturation and overweight/obesity. Data from NHANES 2009-2018 included 1317 Mexican American adolescents aged 12-19 years. Acculturation was measured by language spoken at home (English vs. Spanish) and birthplace of child and caregiver (United States vs. Mexico). Added sugars intake was assessed by 24-h dietary recall and categorised as 'high' (≥ 10% total energy intake) versus 'low' (< 10%). Multivariable logistic regressions tested associations between acculturation and added sugars, and path analysis evaluated the mediation of added sugars between acculturation and overweight/obesity (≥ 85th BMI percentile). Greater acculturation, indicated by primarily speaking English at home (OR: 1.6; 95% CI: 1.0, 2.5), caregiver being U.S.-born (2.2; 1.1, 4.2), both child and caregiver U.S.-born (2.8; 1.2, 6.5), or both U.S.-born + English at home (2.9; 1.1, 7.5), was associated with higher odds of high added sugars intake. Added sugars did not mediate the effect of acculturation on obesity/overweight status. These findings suggest that while higher acculturation is associated with excess added sugars intake, future research is needed to clarify how acculturation influences obesity risk.
BACKGROUND:The 2023 Clinical Practice Guideline for pediatric obesity recommends immediate, intensive treatment, including behavioral therapy, medications, and surgery when indicated. Understanding parental agreement with the guideline is critical for successful implementation. OBJECTIVE:To evaluate parental awareness of and agreement with the guideline. METHODS:Parents (n = 150; 62.9% female; 75.5% White; Mage = 37.6 ± 7.4 years) completed an online survey assessing guideline awareness and agreement. K-means cluster analysis identified parent subgroups based on agreement patterns. Linear regression examined predictors of agreement (e.g., parent age, BMI). Inductive content analysis explored underlying perspectives. RESULTS:Few parents (5.3%) were aware of the guideline before the survey. Cluster analysis identified three subgroups: Guideline Skeptics (34%; broadly disagreed), Selective Supporters (28%; mostly agreed but opposed medications and surgery), and Guideline Supporters (38%; broadly agreed). Higher parental BMI predicted lower agreement (β = -0.20, p = 0.018). Qualitative findings added nuance to parents' preference for lifestyle changes, highlighted concerns about mental health and eating disorders, and emphasized parental responsibility in the development and treatment of obesity. CONCLUSIONS:Parental agreement with the guideline varies widely. While most support behavioral treatment, many express concerns about medications and surgery, and a subset of "Guideline Skeptics" reject core principles such as the use of BMI. Tailored implementation strategies are needed to address these diverse views.
BACKGROUND:Children with overweight or obesity (OW/OB), relative to healthy weight (HW), have lower cognitive performance and hippocampal volumes. Whether this extends to children with HW at familial risk for future OW/OB is unknown. OBJECTIVES:To compare memory performance and hippocampal subfield volumes between HW children at high risk (HR) and low risk (LR) for OW/OB. METHODS:HW children (n = 95, aged 8-11), classified as HR (n = 43, both parents with OW/OB) or LR (n = 52, both parents with HW), underwent structural magnetic resonance imaging and memory testing (Verbal List Learning Test-Food-Child Version (VLLT-Food-C) and Child Memory Scale subtests: word pairs, dot locations). Linear models tested group differences in memory scores, hippocampal and subfield (CA1, CA3, dentate gyrus (DG), subiculum) volumes. RESULTS:Groups did not differ on demographics except body mass index (HR > LR, p = 0.003), despite all children being HW. LR children performed better on VLLT-Food-C short- ( β $$ \beta $$ = 0.34, p < 0.01) and long-delay cued recall ( β $$ \beta $$ = 0.21, p = 0.04) and word pairs delayed recall ( β $$ \beta $$ = 0.21, p = 0.04). Children with HR had smaller bilateral whole hippocampus, CA1, DG and right CA3 volumes (ps < 0.05); only the right DG remained significant ( β $$ \beta $$ = 0.15, p = 0.04) after intracranial volume adjustment. CONCLUSIONS:Memory and hippocampal volume differences may reflect underlying familial risk of OW/OB in HW children.
Parental communication plays a critical role in weight-related health of children and adolescents and requires a balanced, thoughtful and supportive approach. The European Childhood Obesity Group (ECOG) convened a panel of experts to discuss the topic of parental communication in the prevention and treatment of child and adolescent obesity, as summarised in this statement. Parental concern about weight is evident, but the lack of parental knowledge about obesity, the impact of weight bias and stigma on their children and adolescents' health behaviours, and the influences of culture, media, and advertising all make communication challenging and problematic for many families. Parents need support and skill building in order to provide a communication environment that is healthy and accepting. Healthcare professionals can model healthy communication styles by focusing on health, building family strengths and supports, asking youth about what words they prefer using to discuss their weight, and acknowledging the multifactorial causes of obesity that reside in the socioecological environment. While parental communication offers a powerful platform for promoting healthy behaviours in youth, it must be handled with care to avoid the harms of stigmatisation and oversimplification of obesity as a reflection of individual lifestyle choices. With appropriate tools, knowledge, skills, and support, parents can be better equipped to engage in supportive dialogue that empowers their children and promotes their health and wellbeing.
BACKGROUND:To prevent the development of obesity and related comorbidities, interventions must begin early in life. This study aimed to assess the impact of a home-based obesity prevention intervention on children's and parents' body mass index (BMI). METHODS:The Guelph Family Health Study is a randomised controlled trial of a 6-month obesity prevention intervention aimed at establishing healthful household routines regarding family meals, children's screen time, physical activity and sleep among 285 families with preschool-aged children. The control group received 6 emails on child health behaviours. The analytic sample included 376 children (3.6 ± 1.3 years old, 20.2% at risk for overweight, 8.2% with overweight/obesity) and 481 parents (58.2% with overweight/obesity). RESULTS:Compared to controls, the intervention had no significant impact on children's or parents' BMI at post-intervention and 1 year after the intervention. Children in both the intervention and control groups had a non-significant decrease in BMI from baseline to post-intervention [intervention; -0.23 kg/m2 (95% CI, -0.46, 0.002); control; -0.17 kg/m2 (95% CI, -0.40, 0.06)] and from baseline to 1-year follow-up [intervention, -0.29 kg/m2 (95% CI, -0.67, 0.08); control, -0.06 kg/m2 (95% CI, -0.42, 0.30)]. CONCLUSIONS:Compared to controls, this home-based obesity prevention intervention had no significant impact on children's or parents' BMI immediately after the intervention or after 1 year of follow-up, indicating that the intervention had no additional effect compared to the control group on children's or parents' BMI over time. Future data collection phases will allow for the examination of the intervention effect on BMI as children age. TRIAL REGISTRATION:This study is registered at clinicaltrial.gov identifier: NCT02939261.
