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Purpose: This manuscript performed a meta-analysis to compare the effects of a low-fat diet (LFD) and a low-carbohydrate diet (LCD) on body weight and lipid levels in adolescents with overweight and obesity. Patients and Methods: PubMed and other databases were searched for the full-text literature comparing LFD and LCD up to November 2023 using a subject plus free word strategy, with search terms such as "low-fat diet", "low-carbohydrate diet", "obesity", "weight", "adolescents", "RCT", and so on. Two independent reviewers selected promising candidate trials, collected the data, and assessed the quality of the trials. RevMan 5.3 software was utilized to conduct a meta-analysis of the randomized controlled trials (RCTs) that were included. Results: 5 RCTs with 192 participants were included in this meta-analysis. Weight (mean difference − 2.81; 95% CI − 5.38 to − 0.25), Body Mass Index (BMI) (− 1.13; 95% CI − 2.14 to − 0.11) and Triglyceride (TG) (− 0.36; 95% CI − 0.46 to − 0.27) of the LCD were significantly lower than that of the LFD. At the same time, the high-density lipoprotein cholesterol (HDL) levels of the LCD were significantly higher than those of the LFD (0.08; 95% CI 0.04 to 0.12) (P < 0.05). However, there was no significant difference in the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), percent body fat, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL) between the two groups (P> 0.05). Conclusion: According to this study, LCD is more helpful in improving weight loss, HDL and TG. Thus, LCD may serve as an effective intervention for weight management in adolescents with overweight and obesity, although further research is needed to determine its long-term effects. [ABSTRACT FROM AUTHOR]

Background & aims: Obesity has been linked to various detrimental health consequences. While there is established evidence of a negative correlation between seafood consumption and obesity in adults, the current research on the association between seafood intake in childhood/adolescence and the risk of obesity is lacking. Our aim was to evaluate the association between seafood intake in childhood/adolescence and the risk of obesity in a Chinese nationwide cohort. Methods: We utilized data from the China Health and Nutrition Survey (CHNS) from the year of 1997 to 2015. Seafood consumption was evaluated through 3-day 24-hour recalls. In our study, overweight/obesity status was determined based on the Chinese Criteria of Overweight and Obesity in School-age Children and Adolescents (WS/T 586–2018), while abdominal obesity status was determined according to the Chinese Criteria of Waist Circumference Screening Threshold among Children and Adolescents (WS/T 611–2018). Results: During an average follow-up of 7.9 years, 404 cases developed overweight/obesity among 2206 participants in the seafood-overweight/obesity analysis, while 381 cases developed abdominal obesity among 2256 participants in the seafood-abdominal-obesity analysis. The high-consumer group was associated with 35% lower risk of overweight/obesity risk and 26% lower risk of abdominal obesity after fully adjusting for sociodemographic and lifestyle factors, compared with the non-consumer group. Considering different cooking methods, boiled seafood consumption was associated with 43% lower risk of overweight/obesity and 23% lower risk of abdominal obesity in the fully adjusted model, while stir-fried seafood did not demonstrate a statistical significance. Conclusion: Higher intake of seafood in childhood/adolescents, particularly in a boiled way, was associated with lower obesity risk. [ABSTRACT FROM AUTHOR]

Background: Fasting levels of glucagon are known to be elevated in youth and adults with type 2 diabetes mellitus (T2D). Children and adolescents with obesity were previously reported to show increasing fasting and post-glucose-challenge hyperglucagonemia across the spectrum of glucose tolerance, while no data are available in those with impaired fasting glucose (IFG). Materials and methods: Individuals from the Beta-JUDO study population (Uppsala and Salzburg 2010-2016) (n=101, age 13.3 ± 2.8, m/f=50/51) were included (90 with overweight or obesity, 11 with normal weight). Standardized OGTT were performed and plasma glucose, glucagon and insulin concentrations assessed at baseline, 5, 10, 15, 30, 60, 90 and 120 minutes. Patients were grouped according to their glycemic state in six groups with normal glucose metabolism (NGM) and normal weight (NG-NW), NGM with obesity or overweight (NG-O), impaired glucose tolerance (IGT), impaired fasting glucose (IFG), IGT+IFG and T2D, and in two groups with NGM and impaired glucose metabolism (IGM), for statistical analysis. Results and conclusion: Glucagon concentrations were elevated in young normoglycemic individuals with overweight or obesity (NG-O) compared to normoglycemic individuals with normal weight. Glucagon levels, fasting and dynamic, increased with progressing glycemic deterioration, except in IFG, where levels were comparable to those in NG-O. All glycemic groups showed an overall suppression of glucagon during OGTT. An initial increase of glucagon could be observed in T2D. In T2D, glucagon showed a strong direct linear correlation with plasma glucose levels during OGTT. Glucagon in adolescents, as in adults, may play a role in the disease progression of T2D. [ABSTRACT FROM AUTHOR]

Purpose: Motor competence is negatively associated with body mass index (BMI) in young people. However, it is still unclear whether motor competence is linked to the risk of obesity in adolescents and longitudinal evidence is missing. The main purpose of this study was to assess the association between motor competence and risk of obesity across adolescence. Methods: A 2-year follow-up study was conducted with a total of 122 adolescents (59.8% girls) aged 12 to 13 years at baseline. Motor competence (KTK), weight status (BMI) and physical activity (questionnaire) were assessed at three time points. Generalized estimating equation and logistic regression models were conducted to examine the relationships between motor competence and weight status, adjusting for potential confounders (i.e. age, sex and physical activity). Results: Motor competence and BMI were inversely related over time. The chance to have overweight/obesity decreased by 6.5% and 8% with a 10-point increase in motor competence across time. In addition, adolescents had 6.4 to 8.2 greater chance to have low motor competence with a 1-point increase in BMI across time. Conclusion: Motor competence is inversely associated with the risk of overweight/obesity across adolescence. Therefore, the development of motor competence can be a protection factor against excessive weight gain. As such, we recommend the development of motor competence as a strategy to prevent pediatric obesity through diversified types of physical activities such as sports, active play and physical education classes. [ABSTRACT FROM AUTHOR]

Background: Adolescent obesity is a global challenge with serious health impacts. This study aimed to explore the application of the Health Belief Model (HBM) in the context of preventing obesity in adolescents. Subjects and Method: This research uses an observational analytical design with a cross sectional approach. The population consists of teenagers aged 15-19 years in the city of Surakarta, with a sample of 200 teenagers chosen randomly. The dependent variable is obesity prevention behavior. The independent variable is the HBM construct (perceived vulnerability, perceived seriousness, perceived benefits, perceived barriers, cues to action, and self-efficacy). Data was collected using a questionnaire, and analyzed using multiple linear regression. Results: There is a positive and statistically significant relationship between perceived vulnerability (b= 0.08; 95% CI= 0.03 to 0.13; p = 0.004), perceived seriousness (b= 0.37; 95% CI= 0.29 to 0.46; p<0.001), perceived benefits (b= 0.22; 95% CI= 0.14 to 0.29; p<0.001), cues to action (b= 0.15; 95% CI= 0.05 to 0.25; p= 0.005) and self-efficacy (b= 0.05; 95% CI = 0.01 to 0.10; p= 0.027) on obesity prevention behavior. Adjusted R-squared= 72.15%. This means that the HBM construct includes perceptions of vulnerability, perceptions of severity, perceptions of benefits, cues to action, and self-efficacy, together they are able to explain variations in obesity preventive behavior in adolescents by 72.15%. Conclusion: The results of this study indicate that the Health Belief Model construct includes perceptions of vulnerability, perceptions of seriousness, perceptions of benefits, cues to action, and self-efficacy, which play a role together in shaping obesity prevention behavior in adolescents. [ABSTRACT FROM AUTHOR]

Background: The immunological mechanisms behind the clinical association between asthma and obesity in adolescence are not fully understood. This study aimed to find new plasma protein biomarkers associated specifically with coincident asthma and obesity in adolescents. Methods: This was a cross‐sectional study in children and adolescents 10–19 years old (N = 390). Relative plasma concentrations of 113 protein biomarkers related to inflammation and immune response were determined by proximity extension assay (Target 96; Olink, Uppsala, Sweden). Differences in protein concentrations between healthy controls (n = 84), subjects with asthma (n = 138), subjects with obesity (n = 107), and subjects with both asthma and obesity (AO; n = 58) were analyzed by ANCOVA, adjusting for age and sex, and in a separate model adjusting also for the sum of specific IgE antibody concentrations to a mix of food allergens (fx5) and aeroallergens (Phadiatop). Proteins elevated in the AO group but not in the obesity or asthma groups were considered specifically elevated in asthma and obesity. Results: Five proteins were elevated specifically in the AO group compared to controls (here sorted from largest to smallest effect of asthma and obesity combined): CCL8, IL‐33, IL‐17C, FGF‐23, and CLEC7A. The effects of adjusting also for specific IgE were small but IL‐33, IL‐17C, and FGF‐23 were no longer statistically significant. Conclusion: We identified several new potential plasma biomarkers specifically elevated in coincident asthma and obesity in adolescents. Four of the proteins, CCL8, IL‐33, IL‐17C, and CLEC7A, have previously been associated with viral mucosal host defense and Th17 cell differentiation. [ABSTRACT FROM AUTHOR]

In an inpatient treatment center for pediatric obesity, the effectiveness of an emotion regulation (ER) training on top of the multidisciplinary obesity treatment (MOT) was tested by means of an RCT. The ER training was evaluated on primary outcomes: ER and emotional eating, and secondary outcomes: well-being and weight loss, taking into account pre, post, and follow-up measurements. Of the 115 10- to-14-year old adolescents with obesity (52.2% girls), 65 were allocated to the ER training. Physicians measured their height and weight objectively (4 times). Participants also filled out questionnaires on ER competencies (ER abilities and ER strategies), emotional eating and well-being (3 times). Significant pre-post interactions were found for "emotional awareness," "problem solving," and "evoking a positive mood." Moreover, the positive effects of the ER training on emotion regulation strategies were maintained at follow-up. Concerning well-being, no significant pre-post interaction effects were found but a significant interaction effect was found when comparing pre with follow-up. Analyses show a significant main effect of time on weight loss, but this was not qualified by a Time × Condition interaction effect. The current RCT study shows limited but promising effects of adding an ER training to the MOT. Further research should investigate whether the positive short-term effects will be maintained. [ABSTRACT FROM AUTHOR]

The brain derived‐neurotrophic factor (BDNF) Val66Met polymorphism causes functional changes in BDNF, and is associated with obesity and some psychiatric disorders, but its relationship to health‐related quality of life (HRQoL) remains unknown. This study examined, in youth with obesity, whether carriers of the BDNF Val66met polymorphism Met‐alleles (A/A or G/A) differed from noncarriers (G/G) on HRQoL. The participants were 187 adolescents with obesity. Ninety‐nine youth were carriers of the homozygous Val/Val (G/G) alleles, and 88 were carriers of the Val/Met (G/A) or Met/Met (A/A) alleles. Blood samples were drawn in the morning after an overnight fast for genotyping. HRQoL was measured using the Pediatric‐Quality of Life core version. Compared to carriers of the Val66Met Val (G/G) alleles, carriers of the Met‐Alleles reported significantly higher physical –HRQoL (p = 0.02), school‐related HRQoL, (p = 0.05), social‐related HRQoL (p = 0.05), and total HRQoL (p = 0.03), and a trend for Psychosocial‐HRQoL. Research is needed to confirm our findings and determine whether carriers of the BDNF Val66Met homozygous Val (G/G) alleles may be at risk of diminished HRQoL, information that can influence interventions in a high‐risk population of inactive youth with obesity. [ABSTRACT FROM AUTHOR]

Four glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been used in children and adolescents with obesity or overweight. This network meta-analysis was conducted to compare the efficacy and safety of these regimens. Embase, PubMed, and Scopus were searched on March 2023 and updated in June 2024 for eligible randomized controlled trials (RCTs). The primary efficacy outcomes were mean difference in actual body weight, BMI (body mass index), BMI z score, and waist circumference. Safety outcomes included nausea, vomiting, diarrhea, abdominal pain, injection-site reaction, and hypoglycemia. Eleven RCTs with 953 participants were eligible. Semaglutide exhibited greater effects in reducing weight, BMI, and BMI z score versus the placebo. Semaglutide was associated with greater weight loss and BMI z score reduction in comparison with exenatide, liraglutide, and dulaglutide. Semaglutide also significantly decreased BMI than exenatide. None of the four GLP-1 RAs were associated with higher risks of diarrhea, headache, and abdominal pain versus the placebo. Liraglutide was more likely to cause nausea, vomiting, hypoglycemia, and injection-site reactions than the placebo. Liraglutide also had higher odds of causing injection-site reactions than other GLP-1 RAs. Semaglutide appeared to be the most effective and safe option among four GLP-1 RAs in children and adolescents with obesity or overweight. [ABSTRACT FROM AUTHOR]

Obesity is a worldwide increasing concern. Although in adults this is easily estimated with the body mass index, in children, who are constantly growing and whose bodies are changing, the reference points to assess weight status are age and gender, and need corroboration with complementary data, making their quantification highly difficult. The present review explores the interaction spectrum of oxidative stress, selenium status, and obesity in children and adolescents. Any factor related to oxidative stress that triggers obesity and, conversely, obesity that induces oxidative stress are part of a vicious circle, a complex chain of mechanisms that derive from each other and reinforce each other with serious health consequences. Selenium and its compounds exhibit key antioxidant activity and also have a significant role in the nutritional evaluation of obese children. The balance of selenium intake, retention, and metabolism emerges as a vital aspect of health, reflecting the complex interactions between diet, oxidative stress, and obesity. Understanding whether selenium status is a contributor to or a consequence of obesity could inform nutritional interventions and public health strategies aimed at preventing and managing obesity from an early age. [ABSTRACT FROM AUTHOR]

The global prevalence of childhood and adolescent obesity, exacerbated by the coronavirus disease 2019 pandemic, affects school-aged children and preschoolers. Early-onset obesity, which carries a high risk of metabolic complications, may contribute to a lower age at the onset of cardiovascular disease. As metabolic diseases such as diabetes, dyslipidemia, and nonalcoholic fatty liver disease observed in adulthood are increasingly recognized in the pediatric population, there is an emphasis on moving disease susceptibility assessments from adulthood to childhood to enable early detection. However, consensus is lacking regarding the definition of metabolic diseases in children. In response, various indicators such as the pediatric simple metabolic syndrome score, continuous metabolic syndrome score, single-point insulin sensitivity estimator, and fatty liver index have been proposed in several studies. These indicators may aid the early detection of metabolic complications associated with pediatric obesity, although further validation studies are needed. Obesity assessments are shifting in perspective from visual obesity to metabolic health and body composition considerations to fill the gap in health impact assessments. Sarcopenic obesity, defined as the muscle- to-fat ratio, has been proposed in pediatric populations and is associated with metabolic health in children and adolescents. The National Health Screening Program for Children in Korea has expanded but still faces limitations in laboratory testing. These tests facilitate timely intervention by identifying groups at a high risk of metabolic complications. Early detection and intervention through comprehensive health screening are critical for mitigating long-term complications of childhood obesity. [ABSTRACT FROM AUTHOR]

Background Over 18% of children and adolescents worldwide, aged 5-19 years old, are now considered overweight or obese. It is important to note that being overweight or obese can have a negative impact on the selfesteem and mental health of children and adolescents. Objectives The purpose of this study was to evaluate the levels of self-esteem, depression and their association with obesity/ overweight among a sample of Moroccan adolescents, aged between 12 and 17 years old. Method To achieve these aims, a cross-sectional survey was conducted, with a sample of students from 16 middle schools in Casablanca. The criteria for determining overweight and obesity were based on age and gender-specific BMI according to WHO reference standards. The Rosenberg Self-Esteem Scale was used to evaluate self-esteem, and the Beck Inventory for depression assessment. Results A sample of 410 adolescents consisted of 51.2% females and 55.1% participants aged between 13-15 years old. In the obesity category, girls had a significantly lower self-esteem score compared to boys. However, in the overweight category, although girls had a lower mean of self-esteem score compared to boys, there were no significant association in self-esteem scores based on Body Mass Index (BMI) categories and eating habits, specifically related to eating meals with family. Additionally, there was no association found between physical activity and self-esteem. However, a strong association was found between depression and both obesity/overweight and low self-esteem. Conclusion According to the results, when assessing the outcomes of obese adolescents, it is important to consider the variables of BMI, Rosenberg self-esteem scale, and depression. Therefore, it is recommended to implement psychological and psychiatric interventions in order to minimize these consequences. [ABSTRACT FROM AUTHOR]

Overweight and obesity represent major public health issues that affect more than 12.7 million children and adolescents. Health behavior change plays a critical role in self-managing obesity and overweight and can set the foundation for lifelong health for children and adolescents. Despite the potential of digital health technologies (DHTs) to help children and adolescents self-manage obesity and overweight, user engagement with DHTs, which plays a critical role in driving health behavior changes and improving health outcomes, remains low. One way to enhance user engagement with DHTs involves leveraging virtual characters through inducing self-presence among users. However, it is unclear how one can design virtual characters to achieve self-presence in DHTs to help children and adolescents self-manage obesity and overweight. The current study draws relevant data from a larger user-centered design science project to design a DHT that targets obese and overweight adolescents. We first derived relevant affordances pertinent to designing virtual characters through the self-presence perspective and then constructed design guidelines based on our findings. Further, we reviewed existing studies to determine potential support to further generalize our design guidelines. Based on our evidence, we propose design principles that can inform future efforts to design and assess virtual characters in DHTs. Developers and researchers who want to make DHTs more impactful in fostering healthier lifestyles among the youth should find our results useful. [ABSTRACT FROM AUTHOR]

Obesity has reached epidemic proportions, emphasizing the importance of reliable biomarkers for detecting early metabolic alterations and enabling early preventative interventions. However, our understanding of the molecular mechanisms and specific lipid species associated with childhood obesity remains limited. Therefore, the aim of this study was to investigate plasma lipidomic signatures as potential biomarkers for adolescent obesity. A total of 103 individuals comprising overweight/obese (n = 46) and normal weight (n = 57) were randomly chosen from the baseline ORANGE (Obesity Reduction and Noncommunicable Disease Awareness through Group Education) cohort, having been followed up for a median of 7.1 years. Plasma lipidomic profiling was performed using the UHPLC-HRMS method. We used three different models adjusted for clinical covariates to analyze the data. Clustering methods were used to define metabotypes, which allowed for the stratification of subjects into subgroups with similar clinical and metabolic profiles. We observed that lysophosphatidylcholine (LPC) species like LPC.16.0, LPC.18.3, LPC.18.1, and LPC.20.3 were significantly (p < 0.05) associated with baseline and follow-up BMI in adolescent obesity. The association of LPC species with BMI remained consistently significant even after adjusting for potential confounders. Moreover, applying metabotyping using hierarchical clustering provided insights into the metabolic heterogeneity within the normal and obese groups, distinguishing metabolically healthy individuals from those with unhealthy metabolic profiles. The specific LPC levels were found to be altered and increased in childhood obesity, particularly during the follow-up. These findings suggest that LPC species hold promise as potential biomarkers of obesity in adolescents, including healthy and unhealthy metabolic profiles. [Display omitted] • Understanding the molecular mechanisms and specific lipid species associated with childhood obesity remains limited. • Lysophosphatidylcholine - LPC.16.0, LPC.18.3, LPC.18.1, and LPC.20.3 were associated with baseline and follow-up BMI. • Metabotyping revealed the presence of subclusters within both the normal and overweight/obese groups. • LPCs hold promise as potential biomarkers of obesity in adolescents, including healthy and unhealthy metabolic profiles. [ABSTRACT FROM AUTHOR]

Background: Being overweight is a significant public health problem. Due to the complexity of obesity in adolescence, the treatment in health recovery must be interdisciplinary. Goals: the present study aimed to investigate the effects of an interdisciplinary intervention program in overweight adolescents on the consumption of inflammatory and anti-inflammatory foods. Methods: the project lasted 14 weeks and was divided into three stages: recruitment of participants and initial assessments; interdisciplinary interventions, which included the simultaneous participation of their parents and, finally, the reassessments. Food intake was measured at the beginning and end of the interventions using a three-day food record. The average values of calories and nutrients were used to generate the Dietary Inflammatory Index (DII®), a numerical score that assesses a diet for its effect on several biomarkers linked to inflammation. For the categorization of the DII®, high values (+1) for the pro-inflammatory effect and lower values (-1) for the anti-inflammatory effect were considered. For all analyses, a p<0.05 was considered. Results: The consumption of carbohydrates, lipids, total cholesterol, and saturated fat was reduced ( p<0.05). On the other hand, there was an increase in the consumption of fiber, proteins, and vitamins A, D, E, B3, B6, B9, B12, and C, in addition to an increase in the consumption of iron, selenium, magnesium and zinc ( p<0.05). The level of inflammation in IBD was significantly decreased for saturated fat, vitamins B6, B9, and C, as well as magnesium ( p<0.05). Conclusion: Based on the results, the interdisciplinary intervention promoted a positive response with reduced lipids, total cholesterol, saturated fat, and reduced inflammatory food. New interventions with large groups and different samples are recommended to encourage possible extrapolation of our findings. [ABSTRACT FROM AUTHOR]

Introduction: Due to the increasing prevalence of obesity in recent years, the treatment of excess weight has become necessary and a global public health problem, especially in childhood and adolescence. Objective: The present study aimed to analyze the effects of an interdisciplinary intervention on the processing and food consumption behavior of overweight and obese adolescents. Methods: This is a pre-experimental, analytical, and interventional study. Sixty-four adolescents (65% females and 35% males), with a mean age of 13.72 ± 2.46 years, who were overweight or obese, were included in the study. The interdisciplinary interventions took place over 12 weeks, three times a week, with the participation of an interdisciplinary team composed of physical education professionals (three times a week), nutritionists (twice a week), and psychologists (twice a week). To analyze the level of food processing, a 3-day food record was applied before and after the 12 weeks of intervention. Foods were calculated in grams, calories, and % of total energy value (TEI). Data were expressed as mean and standard deviation. Subsequently, the normality of the data was tested using the Kolmogorov-Smirnov test. After this confirmation, a paired t-test was performed to compare the preand post-intervention moments. Results: significant reduction in processed and ultraprocessed foods and increased consumption of fresh foods in grams and calories ( p<0.05). However, no significant differences were observed for consuming minimally processed foods (p>0.05). In addition, there were significant results in the domain portion size and quantity ( p<0.01) and consumption of fruits and vegetables ( p<0.05). Conclusion: 12 weeks of interdisciplinary interventions provided positive impacts on the level of food processing and consumption behavior of overweight and obese adolescents, contributing to the fight against obesity in adolescence. [ABSTRACT FROM AUTHOR]

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To our knowledge, no systematic review with meta-analysis has separately synthesized the effects of Mediterranean diet-based interventions in children and adolescents in relation to the effects on anthropometric measures. A better understanding of the effects of Mediterranean diet-based interventions on anthropometric variables could facilitate their implementation in efforts to prevent obesity in the young population. The aim of the present meta-analysis was to evaluate the effects of Mediterranean diet-based interventions on anthropometric and obesity indicators among children and adolescents. Four databases were systematically searched (PubMed, Scopus, Web of Science, and Cochrane Database of Systematic Reviews), including all studies up until 15 March, 2023. Eligible articles were randomized controlled trials measuring the effect of an intervention based on the promotion of the Mediterranean diet and obesity-associated parameters. The effect size of each study was estimated by Cohen's d for continuous variables or risk difference for categorical variables. Compared to the control group, the Mediterranean diet-based interventions showed small and significant reductions in body mass index (d = −0.14; 95% CI: −0.26, −0.01; I2 = 77.52%). Participants in the Mediterranean diet-based interventions had a significant reduction in the percentage of obesity (risk difference = 0.12; 95% CI: 0.01, 0.23; I2 =84.56%) in comparison with the control group. Interventions had greater effects when aiming at participants with excess weight (that is, overweight or obesity), both for body mass index, waist circumference, waist-to-height ratio, percentage of obesity, and percentage of abdominal obesity. Mediterranean diet-based interventions have a significant effect on reducing the body mass index as well as reducing obesity in children and adolescents (aged 3–18 y). This trial was registered at PROSPERO as CRD42023386789. [ABSTRACT FROM AUTHOR]

Context Steatotic liver disease is common but overlooked in childhood obesity; diagnostic methods are invasive or expensive. Objective We sought to determine the diagnostic accuracy of vibration-controlled transient elastography (VCTE) compared with magnetic resonance imaging (MRI) in adolescents with obesity and high risk for hepatosteatosis. Methods Baseline data in 3 clinical trials enrolling adolescents with obesity were included (NCT03919929, NCT03717935, NCT04342390). Liver fat was assessed using MRI fat fraction and VCTE-based controlled attenuation parameter (CAP). Hepatosteatosis was defined as MRI fat fraction ≥5.0%. The area under the receiver-operating characteristic curves (AUROCs) for CAP against MRI was calculated, and optimal CAP using the Youden index for hepatosteatosis diagnosis was determined. Results Data from 82 adolescents (age 15.6 ± 1.4 years, body mass index 36.5 ± 5.9 kg/m2, 81% female) were included. Fifty youth had hepatosteatosis by MRI (fat fraction 9.3% ; 95% CI 6.7, 14.0), and 32 participants did not have hepatosteatosis (fat fraction 3.1%; 95% CI 2.2, 3.9; P <.001). The hepatosteatosis group had higher mean CAP compared with no hepatosteatosis (293 dB/m; 95% CI 267, 325 vs 267 dB/m; 95% CI 248, 282; P =.0120). A CAP of 281 dB/m had the highest sensitivity (60%) and specificity (74%) with AUROC of 0.649 (95% CI 0.51-0.79; P =.04) in the entire cohort. In a subset of participants with polycystic ovary syndrome (PCOS), a CAP of 306 dB/m had the highest sensitivity (78%) and specificity (52%) and AUROC of 0.678 (95% CI 0.45-0.90; P =.108). Conclusion CAP of 281 dB/m has modest diagnostic performance for hepatosteatosis compared with MRI in youth with significant obesity. A higher CAP in youth with PCOS suggests that comorbidities might affect optimal CAP in hepatosteatosis diagnosis. [ABSTRACT FROM AUTHOR]

Background: Mental health plays a major role in children and adolescents with obesity. The aim of this study was (1) to compare mental health in children with obesity with the background population and (2) to investigate if mental health changed during one year in an obesity treatment program. Methods: Data on self-reported mental health was collected in 107 children and adolescents (mean age 13.2 years) with obesity at first visit in an obesity treatment program and at one year follow-up (n = 47). Mental health was assessed by eight questions from the Danish Health Behaviour in School-aged Children (HBSC) questionnaire: (1) self-rated health (2) life satisfaction (3) feeling low (4) body-image (5) loneliness (6) self-esteem (7) self-efficacy and (8) social competence. Data was compared to a reference population based on HBSC data. BMI-SDS was based on Danish reference values. Results: Children and adolescents with obesity had significantly higher odds of reporting negative body image and feeling low and lower odds of reporting high self-rated health and high self-esteem compared to a reference population. There was no difference between the groups regarding life-satisfaction, social competence, self-efficacy or feeling lonely. There were no significant changes in mental health from first visit to one-year follow-up. Conclusion: Our findings highlight the mental health difficulties in children and adolescents with obesity, and the importance of addressing these issues in obesity treatment. The results also indicate that children with obesity have psychosocial resources that should be exploited in treatment protocols. [ABSTRACT FROM AUTHOR]

Social media platforms and online gaming sites play a pervasive role in facilitating peer interaction and social development for adolescents, but they also pose potential threats to health and safety. It is crucial to tackle cyberbullying issues within these platforms to ensure the healthy social development of adolescents. Cyberbullying has been linked to adverse mental health outcomes among adolescents, including anxiety, depression, academic underperformance, and an increased risk of suicide. While cyberbullying is a concern for all adolescents, those with disabilities are particularly susceptible and face a higher risk of being targets of cyberbullying. Our research addresses these challenges by introducing a personalized online virtual companion guided by artificial intelligence (AI). The web-based virtual companion's interactions aim to assist adolescents in detecting cyberbullying. More specifically, an adolescent with ASD watches a cyberbullying scenario in a virtual environment, and the AI virtual companion then asks the adolescent if he/she detected cyberbullying. To inform the virtual companion in real time to know if the adolescent has learned about detecting cyberbullying, we have implemented fast and lightweight cyberbullying detection models employing the T5-small and MobileBERT networks. Our experimental results show that we obtain comparable results to the state-of-the-art methods despite having a compact architecture. [ABSTRACT FROM AUTHOR]

Background: Many studies have demonstrated the beneficial health effects of caffeine. However, its association with obesity prevalence and caffeine intake remains controversial. Notably, the impact of caffeine on children and adolescents needs to be more adequately represented in large-scale epidemiological investigations. Objective: This study examines the association between caffeine intake and obesity prevalence in children and adolescents aged 2 to 19. Methods: This study used the database from the National Health and Nutrition Examination Survey (NHANES, 2011–2020 March) to perform a cross-sectional study. A total of 10,001 classified children and adolescents were included in this analysis. All data were survey-weighted, and corresponding logistic regression models were performed to examine the associations between caffeine intake and the prevalence of obesity. Results: In a fully adjusted model, a per-quartile increase in caffeine intake was associated with a 0.05% increased prevalence of obesity. In the subgroup analysis, the multivariate-adjusted ORs (95% CIs) of the prevalence of obesity for per-quartile 1.3497 (1.2014, 1.5163) increments in caffeine intake were 1.5961 (1.3127, 1.9406) for boys and 1.4418 (1.1861, 1.7525) for girls, 1.5807 (1.3131, 1.9027) for white race and 1.3181 (1.0613, 1.6370), 1.0500 (0.6676, 1.6515) for the age of 2–5, 1.4996 (1.1997, 1.8745) for the age of 6–12, and 1.2321 (0.9924, 1597) for the age of 13–19. Conclusion: The study suggested that higher caffeine intake may have a protective effect against obesity in specific subgroups, particularly among no overweight individuals. However, the association was not significant in other groups, indicating the need for a nuanced understanding of caffeine's impact on obesity in diverse populations. [ABSTRACT FROM AUTHOR]

Obesity in adolescents is associated with non-communicable risk factors and diseases like metabolic-associated fatty liver disease (MAFLD), which is the liver manifestation of metabolic syndrome. L-citrulline is a non-protein amino acid that has shown positive effects on the degree of steatosis in animals with non-alcoholic fatty liver disease (NAFLD). The aim of the study was to evaluate the effect of oral L-citrulline supplementation on liver function and cardiovascular risk factors in adolescents with abdominal obesity and MAFLD. A prospective, double-blind clinical trial in adolescents with abdominal obesity was randomized into two groups: forty-two adolescents were supplemented with L-citrulline (6 g of L-citrulline/day) (n = 22) and placebo (n = 20) for eight weeks. The variables evaluated were anthropometry, blood pressure, glucose, insulin, HOMA-IR, L-citrulline, L-arginine, malondialdehyde, lipid profile, liver profile, urea, uric acid, and hepatic steatosis by ultrasound. After supplementation, the L-citrulline group had a decrease in liver fat accumulation (p = 0.0007); increases in body weight (p = 0.02), glucose (p = 0.03), and HOMA-IR (p = 0.03); and decreases in BMI (p = 0.002), total cholesterol (p = 0.001), HDL-C (p = 0.01), LDL-C (p = 0.002), and alkaline phosphatase (p = 0.05). L-citrulline for eight weeks decreases hepatic fat accumulation and LDL-C levels in adolescents with abdominal obesity and MAFLD. [ABSTRACT FROM AUTHOR]

Our objective was to systematically examine the characteristics of exercise interventions on adherence and dropout in children and adolescents with obesity. PubMed, Embase, PsycINFO, Lilacs, Scielo, and The Cochrane Central Register of Controlled Trials and reference lists of relevant articles were searched. We included randomized controlled trials with exercise interventions for pediatric patients with obesity presenting data on dropout and/or adherence. Two reviewers screened the records independently for eligibility with disagreements being resolved by a third reviewer. Twenty‐seven studies with 1268 participants were included. Because of high heterogeneity and poor reporting of adherence, it was not possible to perform a meta‐analysis. Dropout prevalence was calculated, and subgroup analyses comparing different types of exercise and a meta‐regression with potential moderators were performed. We found a dropout rate of 13%. Subgroup analyses did not identify significant differences. The duration of the exercise presented a moderating effect on dropout, suggesting that longer exercise sessions may lead to higher dropout in children and adolescents with obesity. Because of the poor adherence data, it is not clear which exercise characteristics may moderate adherence. To improve the quality of childhood obesity care, it is mandatory that future studies present adherence data. Systematic review registration: PROSPERO CRD42021290700. [ABSTRACT FROM AUTHOR]

This study systematically identified the effects of physical activity (PA) on depression, anxiety and weight-related outcomes among children and adolescents with overweight/obesity. EMBASE, The Cochrane Library, Web of Science, and PubMed were searched from January 1, 2000 to August 1, 2022 for peer-reviewed papers. Meta-analyses were conducted to ascertain the effect of physical activity on symptoms of anxiety, depression and weight-related outcomes in overweight/obese children and adolescents. Twenty-five studies representing 2188 participants, with median age 12.08 years old (8.3 to 18.44 years) were included. Depressive and anxiety symptoms, BMI, BMI z-scores, weight, waist circumference and height were evaluated. After incorporating the effects of PA interventions on children and adolescents with overweight/obesity, PA could improve depressive and anxiety symptoms, but not obesity indexes except waist circumference. While, PA combined with other interventions have a significant effect both on anxiety symptoms and BMI compared to pure PA intervention. In terms of intervention duration, we observed that durations falling within the range of 8 to 24 weeks exhibited the most positive effects on reducing depressive symptoms. We included 25 articles on the effects of physical activity on psychological states such as depression and anxiety, weight, BMI and other weight-related indicators in children and adolescents with overweight/obesity. We attempted to determine the most appropriate type of physical activity intervention for children and adolescents with overweight/obesity, as well as the most appropriate population characteristics and duration by combining the outcome data from each article. This has a great enlightening effect for health workers to carry out corresponding strategies in the future. • Physical activity is important for overweight/obese children and adolescents. • Physical activity was strongly associated with improvement in psychological symptoms. • We need more holistic, integrated forms of physical activity. [ABSTRACT FROM AUTHOR]

Background: Reduced central sensitivity to thyroid hormones (THs) has been observed in euthyroid adults with reduced renal function. This topic is unexplored in young people with overweight or obesity (OW/OB). Objective: The aim of this study was to evaluate the association between sensitivity to TH and mild reduced estimated glomerular filtration rate (MReGFR) in euthyroid children and adolescents with OW/OB. Methods: Data of 788 euthyroid children and adolescents with OW/OB (aged 6–16 years), recruited from seven Italian centers for the care of OW/OB, were evaluated. Peripheral sensitivity to TH was estimated through the FT3/FT4 ratio, while central sensitivity was assessed by estimating TSH index (TSHI), thyrotroph T4 resistance index, thyroid feedback quantile-based index (TFQI), parametric thyroid feedback quantile-based index (PTFQI). MReGFR was defined by an eGFR value ≥60 and <90 mL/min/1.73 m2. Results: Subjects with MReGFR had significantly lower levels of FT3/FT4 ratio (0.43 ± 0.09 vs. 0.44 ± 0.10; p = 0.028) and higher levels of TSH (2.89 ± 1.00 vs. 2.68 ± 0.99; p = 0.019), TSHI (2.95 ± 0.45 vs. 2.85 ± 0.55; p = 0.031), TFQI [1.00 (0.98–1.00) versus 1.00 (0.97–1.00); p = 0.046], and PTFQI (0.66 ± 0.17 vs. 0.60 ± 0.23; p = 0.006) compared with individuals with normal eGFR. Odds ratio of MReGFR raised of 1.2–3.2-fold for each increase of 1 mIU/L in TSH, 1 unit in TSHI, and PTFQI, but not for FT3/FT4 ratio. Conclusion: MReGFR is associated with reduced indices of central sensitivity to TH in euthyroid children and adolescents with OW/OB. This preliminary observation should be confirmed in prospective studies. [ABSTRACT FROM AUTHOR]

Introduction: Increasingly, research groups have been studying the association of serum vitamin D and metabolic health indicators, especially in patients with obesity. We compared the serum 25-hydroxyvitamin D (25(OH)D) concentrations in children and adolescents who had obesity and hepatosteatosis with children and adolescents who had obesity without hepatosteatosis and investigated the relationship between serum 25(OH)D concentrations and severity of hepatosteatosis. We also aimed to assess the effect of vitamin D treatment after 6 months on hepatosteatosis and liver biochemistry. Methods: One hundred thirty-three patients with obesity (body mass index [BMI] >+2 standard deviations [SDs] for their age and gender) and vitamin D deficiency (serum 25(OH)D <12 ng/mL) were recruited. Anthropometric measurements, biochemical parameters (serum calcium, phosphate, alkaline phosphatase, parathyroid hormone, 25(OH)D, glucose and insulin concentrations), and ultrasonographic findings of hepatosteatosis were recorded before and 6 months after Vitamin D treatment. χ2, Student's t tests, and multivariate analysis were performed. Results: Grade 1, 2, and 3 hepatosteatosis at baseline was present in 51 (38.4%), 43 (32.3%), and 10 (7.5%) subjects, respectively. Mean (± SD) serum 25(OH)D concentrations were significantly lower in those with hepatosteatosis (8.4 ± 2.4 ng/mL) compared with those without hepatosteatosis (9.9 ± 2.4 ng/mL, p < 0.005). Multivariable logistic regression analysis showed serum 25(OH)D concentration was the independent predictor for hepatosteatosis (p < 0.005), whereas age, sex, weight SD, BMI SD, and homeostasis model of assessment (HOMA)-insulin resistance (IR) were not (p > 0.05). There was no significant difference in BMI SD, HOMA-IR, and liver enzymes between subjects with and without hepatosteatosis (p > 0.05). Despite improvement in serum 25(OH)D concentrations at 6 months post-treatment (34.7 ± 10.6 ng/mL vs. 8.7 ± 2.4 ng/mL; p < 0.0001), there was no significant difference in the proportion of patients with different severity of hepatosteatosis as compared to before treatment (p = 0.88). Conclusion: Serum 25(OH)D concentrations were lower in children and adolescents with obesity and hepatic steatosis as compared to those without hepatic steatosis, with an inverse association between the severity of hepatosteatosis and serum 25(OH)D concentrations. Vitamin D treatment in children and adolescents with obesity and hypovitaminosis D did not improve severity of hepatic steatosis on ultrasonography at 6 months. Mini-Summary: What Is Known? Obesity is a significant risk factor for hepatosteatosis. Insulin resistance is considered a primary mechanism in the development of hepatosteatosis. Recent evidence suggests that the low serum 25-hydroxyvitamin D concentrations are associated with insulin resistance, and hence, may have a role in pathogenesis of non-alcoholic fatty liver disease (NAFLD). Randomized trials have not yet shown clear benefits of oral vitamin D supplementation on NAFLD. What Is New? We demonstrated a significant inverse relationship between low serum 25-hydroxyvitamin D concentrations and hepatosteatosis, in a large cohort of obese children and adolescents. Vitamin D treatment in obese children and adults with hypovitaminosis D did not improve severity of hepatic steatosis on ultrasonography at 6 months. [ABSTRACT FROM AUTHOR]

Context Pediatric obesity is characterized by insulin resistance, yet it remains unclear whether insulin resistance contributes to abnormalities in glucagon and incretin secretion. Objective To examine whether fasting and stimulated glucagon, glucagon-like peptide-1 (GLP-1), and glucose-dependent insulinotropic polypeptide (GIP) concentrations differ between children and adolescents with obesity and insulin resistance (OIR), obesity and normal insulin sensitivity (OIS), and controls with normal weight (NW). Methods 80 (34 boys) children and adolescents, aged 7-17 years with OIR (n = 22), OIS (n = 22), and NW (n = 36) underwent an oral glucose tolerance test with measurements of serum insulin, plasma glucose, glucagon, total GLP-1, and total GIP. Homeostatic model assessment of insulin resistance (HOMA-IR), single point insulin sensitivity estimator (SPISE), Matsuda index, insulinogenic index (IGI), and oral disposition index (ODI) were calculated. Results Fasting concentrations of glucagon and GLP-1 were higher in the OIR group, with no significant differences for GIP. The OIR group had higher glucagon total area under the curve (tAUC0-120) and lower GLP-1 incremental AUC (iAUC0-120), with no significant differences in GIP iAUC0-120. Higher fasting glucagon was associated with higher HOMA-IR, lower Matsuda index, lower SPISE, higher IGI, and higher plasma alanine transaminase, whereas higher fasting GLP-1 was associated with higher HOMA-IR, lower Matsuda index, and lower ODI. Higher glucagon tAUC0-120 was associated lower SPISE and lower Matsuda index, whereas lower GLP-1 iAUC0-120 was associated with a higher HOMA-IR, lower Matsuda index, and lower ODI. Conclusion Children and adolescents with OIR have elevated fasting concentrations of glucagon and GLP-1, higher glucagon and lower GLP-1 responses during an OGTT compared to those with OIS and NW. In contrast, individuals with OIS have similar hormone responses to those with NW. [ABSTRACT FROM AUTHOR]

A recent study examined the relationship between asthma and obesity in children and adolescents. The study found no evidence that asthma hindered physical activity, but the exact mechanism linking obesity and asthma remains unclear. Another study identified specific volatile organic compounds that were significantly linked to the early onset of the "obese-asthma" phenotype, suggesting common risk factors for both conditions. A new study in this issue identified five plasma proteins that were significantly elevated in individuals with both obesity and asthma, suggesting a potential role for viral defense at mucosal barriers in obesity-related asthma. These findings provide valuable insights into the complex relationship between asthma and obesity and may contribute to a better understanding of the underlying mechanisms. [Extracted from the article]

Background: Childhood and adolescent obesity are major, preventable public health concerns. Studies to date are inconclusive regarding an association between caesarean section (CS) delivery and offspring obesity, with fewer studies conducted in late adolescence. This study examined the association between CS delivery, with a specific focus on planned CS, and induction of labour and adolescent body mass index (BMI) and body fat percentage (BF%) at age 17 years. Methods: Data on 8,880 mother-child pairs from the United Kingdom Millennium Cohort Study were analysed. The exposures were mode of delivery (normal vaginal delivery (VD) (reference), assisted VD, planned CS and emergency CS) and mode of delivery by induction of labour status. Crude and adjusted binary logistic regression and linear regression models were fitted examining BMI and BF% at age 17 years respectively, adjusting for several potential confounders. Results: Adolescents born by CS did not have an elevated BMI or BF% compared to those born by normal VD. The fully adjusted results for overweight and obesity in children born by planned CS, compared to VD, were 1.05 (95% CI: 0.86–1.28) and 0.94 (95% CI: 0.72–1.23), respectively. The results were similar for the associations between CS and BF%, and between induction of labour and BMI. Conclusion: Overall, this large longitudinal study did not support an association between CS or induction of labour and overweight, obesity or BF%. It is possible that previously reported associations are due to residual or unmeasured confounding and/or underlying indications for CS delivery. [ABSTRACT FROM AUTHOR]

Sociodemographic and lifestyle factors (sleep, physical activity, and sedentary behavior) may predict obesity risk in early adolescence; a critical period during the life course. Analyzing data from 2971 participants (M = 11.94, SD = 0.64 years) wearing Fitbit Charge HR 2 devices in the Adolescent Brain Cognitive Development (ABCD) Study, glass box machine learning models identified obesity predictors from Fitbit-derived measures of sleep, cardiovascular fitness, and sociodemographic status. Key predictors of obesity include identifying as Non-White race, low household income, later bedtime, short sleep duration, variable sleep timing, low daily step counts, and high heart rates (AUCMean = 0.726). Findings highlight the importance of inadequate sleep, physical inactivity, and socioeconomic disparities, for obesity risk. Results also show the clinical applicability of wearables for continuous monitoring of sleep and cardiovascular fitness in adolescents. Identifying the tipping points in the predictors of obesity risk can inform interventions and treatment strategies to reduce obesity rates in adolescents. [ABSTRACT FROM AUTHOR]

Background: To target public health obesity prevention, we need to predict who might become obese i.e. predictors of increasing Body Mass Index (BMI) or obesity incidence. Predictors of incidence may be distinct from more well-studied predictors of prevalence, therefore we explored parent, child and sociodemographic predictors of child/adolescent BMI z-score and obesity incidence over 5 years in Malaysia. Methods: The South East Asia Community Observatory in Segamat, Malaysia, provided longitudinal data on children and their parents (n = 1767). Children were aged 6–14 years at baseline (2013-14) and followed up 5 years later. Linear multilevel models estimated associations with child BMI z-score at follow-up, adjusting for baseline BMI z-score and potential confounders. Predictors included parent cardiometabolic health (overweight/obesity, central obesity, hypertension, hyperglycaemia), and socio-demographics (ethnicity, employment, education). Logistic multilevel models explored predictors of obesity incidence. Results: Higher baseline BMI z-score predicted higher follow-up BMI z-score both in childhood to late adolescence (0.60; 95% CI: 0.55, 0.65) and early to late adolescence (0.76; 95% CI: 0.70, 0.82). There was inconsistent evidence of association between child BMI z-score at follow-up with parent cardiometabolic risk factors independent of baseline child BMI z-score. For example, maternal obesity, but not overweight, predicted a higher BMI z-score in childhood to early adolescence (overweight: 0.16; 95% CI: -0.03, 0.36, obesity: 0.41; 95% CI: 0.20, 0.61), and paternal overweight, but not obesity, predicted a higher BMI z-score in early to late adolescence (overweight: 0.22; 95% CI: 0.01, 0.43, obesity: 0.16; 95% CI: -0.10, 0.41). Parental obesity consistently predicted five-year obesity incidence in early to late adolescence, but not childhood to early adolescence. An adolescent without obesity at baseline with parents with obesity, had 3–4 times greater odds of developing obesity during follow-up (incidence OR = 3.38 (95% CI: 1.14–9.98, mother) and OR = 4.37 (95% CI 1.34–14.27, father) respectively). Conclusions: Having a higher BMI z-score at baseline was a stronger predictor of a higher BMI z-score at follow-up than any parental or sociodemographic factor. Targeting prevention efforts based on parent or sociodemographic factors is unwarranted but early childhood remains a key period for universal obesity prevention. [ABSTRACT FROM AUTHOR]

This article aims to verify the relationship between the composition and diversity of oral microbiota with overweight and obese children and adolescents. This systematic review was registered in PROSPERO, followed PRISMA 2020, and included an electronic search until March 2022, in PubMed/MEDLINE, Web of Science, Scopus, and The Cochrane Library databases. Studies were eligible if they compared the oral microbiota according to nutrition status among children and adolescents. Independent peers using JBI Critical Appraisal Checklists assessed the quality of studies. Eleven studies were eligible to be included in this review, with a total of 1,695 children and adolescents, 224 were obese, 190 were overweight, 1,154 were eutrophics and 127 were underweight. The most frequent phyla in overweight and obese children and adolescents, in comparison to their counterparts were Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria and Fusobacteria. It was identified that nine of the eleven articles selected showed an association between oral microbiota and overweight and obesity in children and adolescents. We observed that there is an important association between oral bacterial composition diversity and overweight and obesity. This finding indicates the relevance of the evaluation and surveillance in oral health to control cases of overweight and obesity in children and adolescents. [ABSTRACT FROM AUTHOR]

Background: Children with obesity have low 25 hydroxy-vitamin D (25-OH-D3) levels compared to lean children. Recommendations on when to start vitamin D supplementation differ largely between countries. Longitudinal data on 25-OH-D3 levels to guide treatment decisions are scarce since they are largely influenced by solar radiation and are difficult to compare. Methods: We carried out a retrospective analysis of multiple 25-OH-D3 and parathyroid hormone (PTH) measurements in a cohort of 543 patients without vitamin D supplementation. All measurements were taken at the local paediatric obesity clinic as documented in the German-Austrian-Swiss APV (Prospective Documentation of Overweight Children and Adolescents) registry from 2009 to 2019. Serial 25-OH-D3 and PTH levels were adjusted for sunshine duration over the last 30 days to account for seasonal variation, as well as for sex and body mass index (BMI). We further performed an exploratory analysis of the association of sunshine duration, sex, BMI SDS (standard deviation score), abnormal lipid levels or dysglycemia with the 25-OH-D3 trend. Results: 229 obese patients (mean BMI SDS: 2,58 (± 0,56), 53% females, mean age: 12 (± 3) years, range: 2–21 years) with two, 115 with three and 96 with four repeated 25-OH-D3 measurements were identified. Mean adjusted 25-OH-D3 (48.2 nmol/l) and PTH (34.9 ng/l) levels remained stable over 120 weeks. 5% of the patients had an elevated PTH > 65 ng/l. High total cholesterol ≥ 200 mg/dl and high triglycerides ≥ 130 mg/dl were associated with higher 25-OH-D3 levels. Conclusion: We propose a simple method to include sunshine duration in the analysis of 25-OH-D3 levels to minimise the bias of seasonal variation. Based on our data we established the pragmatic strategy of limiting vitamin D supplementation to patients with biochemical signs of mineralisation disorders such as elevated PTH and alkaline phosphatase (AP). In children with normal PTH and AP we recommend adjustment of calcium intake and increase of outdoor activity instead. [ABSTRACT FROM AUTHOR]

The escalation of global obesity is driving research to understand environmental influences on this process, particularly during vulnerable developmental stages such as childhood and adolescence. Efforts include the development of various structured data collection tools. We aimed to adapt a series of previously validated questionnaires from the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE), the Child Feeding Questionnaire, and elements from the World Health Organization Childhood Obesity Surveillance Initiative (COSI) in order to assess local lifestyle patterns among Romanian high school students and their families that may predispose them to obesity. To this goal, an expert committee was formed as part of a research partnership to oversee the questionnaire's translation and adaptation. It consisted of education and school management specialists, clinical research professionals, language experts, and public health experts. The adapted questionnaires were then applied to 114 students enrolled in the 9th and 10th grades attending a high school situated in Sibiu, and their parents. The variables measured were investigated for correlations with overweight and obesity and, as a secondary objective, academic performance. The study revealed several critical findings, including suboptimal sleep durations and physical activity levels among students, a significant amount of screen time, and correlations between weight status and physical activity, sedentary time, and maternal weight status and education levels. The adapted questionnaires proved to be effective tools in capturing the multifaceted factors implicated in adolescent obesity, providing a foundation for targeted interventions and broader public health strategies to address this issue. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic has sparked concerns about weight management because of the changes in population lifestyle. As previous studies suggest, these changes can affect adolescents to a greater degree, especially as schools shut down. Designing a method for weight management that accounts for the specific conditions of the pandemic can help students attend to their physical conditions during the pandemic. Method: An online gamified peer pressure group on WhatsApp was employed to help 10th-grade boys in a high school in Tehran, Iran. The available sample consisted of 15 main group students and 13 control students. A paired t-test examined the difference between each group's initial and final state as well as the group's final state. Additionally, an ANCOVA test was done to ensure that the observed effect was because of the intervention. Results: The initial BMI for the intervention group (µ = 30.68, δ = 3.23) and the control group (µ = 29.73, δ = 3.23) were the same (p = 0.468). Two dropouts in the intervention group were found after forty days. A significant difference between the intervention group's steady and final states (p = 0.027) was detected; however, this difference was not significant in the control group (p = 0.634). Conclusion: Online gamified social groups can play a key role in adolescents' weight management during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

To verify if there is a moderator role of agility and speed in the relationship between genetic risk score (GRS) and waist circumference (WC) in adolescents. This is a cross-sectional study developed with 782 adolescents aged between 12 and 17 years from schools in a city in southern Brazil. To determine WC, an inelastic tape was used. Agility and speed were evaluated following the procedures of Projeto Esporte Brasil. The GRS was based on previously associated obesity single-nucleotide polymorphism rs9939609 (FTO), rs6548238 (TMEM18), and rs16835198 (FNDC5). Moderation analysis was applied through linear regression models. Significative interactions were observed for agility (β = −2592; CI = −4426; −0.757; P = 0.006) and speed (β = −2783; CI = −4838; −0.729; P = 0.008) × 3–4 risk alleles with WC. Additionally, it is observed that in the lowest tercile of agility and speed (better results in the testes), a lower WC is verified, including in the category ≥ 5 risk alleles. Agility and speed acted as moderators in the relationship between genetic risk score and WC in adolescents. These findings highlight the relevance of developing interventions targeting to improve higher levels of these physical fitness components. [ABSTRACT FROM AUTHOR]

Objective: Obesity and iron deficiency, which are public health problems that maintain their prevalence and for which the adolescent population is particularly at risk, may have important clinical consequences. This study aimed to assess the iron parameters and blood vitamin B12 levels in obese adolescents and identify the contributing variables to the development of anemia. Material and Methods: The present study involved a retrospective evaluation of 260 children (130 obese-130 control) who were admitted to the Ankara Children's Haematology Oncology Training and Research Hospital, Pediatric Outpatient Clinics, between March 2013 and May 2015. Children aged 12 to 18 years without acute or chronic illnesses and body mass index (BMI) above the 95th percentile for age and gender were required for inclusion in the study group. Data from patient files were used to collect information on physical examination findings, sociodemographic characteristics, daily dietary status, and level of physical activity. All patients had evaluations for CRP, iron parameters, vitamin B12, and complete blood count. Results: The study revealed that the obese group had significantly higher serum ferritin levels (p=0.002) and lower serum iron and vitamin B12 levels (p=0.036 and 0.047, respectively) as compared to the control group. In the obese population, elevated BMI has been demonstrated to be correlated with elevated CRP and ferritin levels. Conclusion: Obesity's chronic inflammation state may lead inflammatory pathophysiological pathways to activate resulting in iron deficiency and other nutritional deficiencies. Obesity should be followed up as a chronic disease and monitored in terms of nutritional deficiencies, especially in adolescents who have not completed their growth. [ABSTRACT FROM AUTHOR]

Summary: Obstructive sleep apnea (OSA) is a prevalent complication that affects up to 60% of children and adolescents with obesity. It is associated with poorer cardiometabolic outcomes and neurocognitive deficits. Appropriate screening and intervention for OSA are crucial in the management of children with obesity. We performed a scoping review of international and national pediatric obesity (n = 30) and pediatric OSA (n = 10) management guidelines to evaluate the recommendations on OSA screening in pediatric obesity. Sixteen (53%) of the pediatric obesity guidelines had incorporated OSA screening to varying extents, with no consistent recommendations on when and how to screen for OSA, and subsequent management of OSA in children with obesity. We provide our recommendations that are based on the strength and certainty of evidence presented. These include a clinical‐based screening for OSA in all children with body mass index (BMI) ≥ 85th percentile or those with rapid BMI gain (upward crossing of 2 BMI percentiles) and the use of overnight polysomnography to confirm the diagnosis of OSA in those with high clinical suspicion. We discuss further management of OSA unique to children with obesity. An appropriate screening strategy for OSA would facilitate timely intervention that has been shown to improve cardiometabolic and neurocognitive outcomes. [ABSTRACT FROM AUTHOR]

L'obésité de l'enfant et de l'adolescent est une pathologie dont la compréhension a profondément évolué depuis quelques années grâce à l'identification des formes génétiques et à un accroissement exponentiel des connaissances en biologie. Le tissu adipeux est un organe endocrine en dialogue permanent avec les autres organes dont les centres de régulation de l'appétit cérébraux et la signalisation neuroendocrine du tube digestif. Face à un enfant ou un adolescent développant une obésité, une analyse rigoureuse de la dynamique de sa pathologie, des éventuelles anomalies et complications cliniques associées est requise. La coopération avec les centres de référence pédiatriques et de recherche en nutrigénomique permettant d'identifier les mutations associées permet de poser dans des cas encore rares mais probablement sous diagnostiqués l'indication de traitement spécifiques efficaces. Récemment un essai randomisé a montré qu'un analogue du Glucagon like peptide 1 (GLP1-R), molécule clé de régulation de l'appétit d'origine intestinale, avait un effet bénéfique majeur dans des obésités polygéniques. Des études sont encore nécessaires pour s'assurer des résultats à long terme et de l'absence de toxicité mais les résultats acquis font d'ores et déjà rediscuter la place de la chirurgie bariatrique. Si la prévention doit rester une priorité, de nombreuses autres molécules et d'autres voies thérapeutiques sont en cours d'investigation dans la plus fréquente des maladies métaboliques et chroniques de l'enfance. Child and adolescent obesity is definitely a pathology the understanding of which has faced dramatic changes in recent years thanks to the identification of the genetic background of some cases and an amazing increase in the knowledge of its biological background. The adipose tissue is an endocrine organ in permanent communication with other ones, including the appetite regulation centres of the brain and the neuroendocrine system of the digestive tract. A precise analysis of the trajectory of weight gain and its associated manifestations such as abnormal physical or developmental features and complications is mandatory while facing a child or adolescent with obesity. A close cooperation with reference centres for childhood obesity and nutrigenomics research units leading to the diagnosis of genetic forms, likely to be underdiagnosed, may allow the use of targeted and efficient drug treatment. A recent double-blind study has shown that a Glucagon like peptide 1 (GLP1) analogue, a key contributor of appetite regulation from intestinal origin, has a major beneficial impact on adolescents with obesity of polygenic origin. Further studies are still required to ensure the long-term effect and the lack of side effects of such a treatment. However, such results already challenge the indication of bariatric surgery. While prevention still must be a priority, many other molecules and therapeutic approaches are underway for the most frequent metabolic and chronic childhood disorder. [ABSTRACT FROM AUTHOR]

Introduction: Childhood obesity has increased significantly, thus showing a concern regarding the treatment of obesity in childhood and adolescence. Objective: To correlate anthropometric variables, body composition and maximum oxygen consumption (VO2max) in overweight or obese adolescents. Materials and Methods: Cross-sectional, correlational and comparative study with 40 adolescents, separated by sex: (boys n=17 and girls n=23), aged=15.6 ±1.1 years. Body Mass Index (BMI) measurements were collected; Waist Circumference (WC); Hip Circumference (HC); Waist-Hip Ratio (WHR); Fat Mass (MG); Lean Mass (MM); Skeletal Muscle Mass (MME); Body Fat Percentage (%F) and VO2max. To estimate body composition, the InBody520® electrical bio-impedance was used. VO2 max was estimated using the Leger and Lambert test (1988). Normality was tested using the Shapiro-Wilk test. Results: Boys had higher values for WC; WHR; MM; MME and VO2 max (p<0.01), while girls had higher values for %BF (p<0.01). Boys and girls, there were negative correlations (p<0.05) between VO2 max and FM (r=-0.37), VO2 max and %BF (r=-0.63) and positive correlations (p<0.01) between VO2max and LM (r=0.51), VO2 max and MME (r=0.52). In boys, negative correlations (p<0.01) were identified between VO2 max and BMI (r=-0.68), VO2 max and WC (r=-0.64; p<0.01), VO2 max and HC (r=- 0.62), VO2 max and FM (r=-0.69) and VO2 max and %BF (r=-0.77). Conclusion: There were differences in body composition and VO2 max values between genders. Different anthropometric, body composition and VO2 max variables are correlated and may increase cardiometabolic risks in overweight or obese male adolescents. [ABSTRACT FROM AUTHOR]

Several references based on body mass index (BMI) have been used in Algeria to define adolescent obesity. No studies have been published to assess the diagnostic accuracy of these references. This study aimed to evaluate the sensitivity and specificity of the International Obesity Task Force (IOTF) and Algerian national data based on BMI to detect excess fat in adolescents. A cross sectional study of 257 adolescents aged 16-19 was conducted in Constantine, Algeria. The BMI was calculated from weight and height measurements. The body fat percentage (BF%) was estimated by impedancemetry (BIA). The IOTF and Algerian national data were evaluated for their sensitivity and specificity to detect excess body fat. The BF% thresholds used to define true positives were 25% for boys and 30% for girls. Body mass index was significantly associated with BF% in the whole population (r=0.759). Obesity is more common in girls (p<0.01), regardless of the reference used. The percentage of obesity among adolescents according to the IOTF, Algerian data and BF% was 5.84%, 5.45% and 20.62%, respectively. The obesity rate estimated by BF% was significantly higher (p<0.00001). Sensitivity of the evaluated criteria, IOTF and Algerian data, was high for males (83.3% and 100%, respectively) and low for females (19.2% for both IOTF and Algerian data). Specificity of the two criteria was high for both sexes (100%). Specificity was higher than sensitivity; therefore, the ability of BMI to detect non-obese adolescents was higher than its ability to identify obese adolescents. As BMI is an index of body weight rather than body fat, it can be a source of error. Local data and international references gave the same percentages of obesity. Body mass index is a very specific but less sensitive method to assess increased body adiposity in adolescents. It fails to identify excessive adiposity in a significant percentage of female teenagers. It seems necessary to measure body fat in addition to BMI in adolescent girls. Therefore, it is important to consider body fat mass when determining obesity in order to predict the consequences of obesity, which are mainly due to an increase in fat mass in the body. [ABSTRACT FROM AUTHOR]

This study aims to assess the key barriers to physical activity among overweight and obese adolescents, discovering that the most significant obstacles are a lack of time, different priorities, and a poor perception of one's body. A mixed method sequential explanatory design was used in the study which involves 50 respondents and 8 outliers in one of the public senior high schools in Cluster 1, Division of Pampanga. These findings are consistent with broader research, which shows that time constraints, low motivation, and self-consciousness pose typical challenges for those dealing with weight concerns. Interestingly, the study finds that social support from friends is the preferred coping strategy, implying a preference for emotional comfort over creative solutions. Despite exhibiting good internal problem-solving skills in planning and goal setting, there is a lack of confidence in execution. Furthermore, preferred avoidance coping mechanisms, such as daydreaming and fantasizing, indicate a preference for emotional distance and self-soothing over direct confrontation. The study underlines the value of building self-acceptance and engaging in the present moment as potential alternatives to daydreaming. It also identifies possible issues such as low self-esteem and a desire to escape reality. Notably, overweight and obese learners face different physical and psychological difficulties. The study points out the importance of peer support in coping techniques, as students rely greatly on peers for emotional support, which inspires emotions such as belonging and appreciation. Lastly, learners indicate a stronger willingness to get involved with organized activities such as sports, recognizing the potential benefits of improving physical fitness. It is recommended to further investigate the roles of peer support and sport program and how they affect obese and overweight students. Additionally, it is also recommended to explore the metal health aspects. [ABSTRACT FROM AUTHOR]

In recent years, the countries of the Middle East and North Africa (MENA) region have experienced alarming increases in the prevalence of childhood overweight and obesity. This updated systematic review sought to measure the prevalence and determinants of obesity and overweight among children and adolescents in MENA countries. A literature search for relevant observational studies published in English was conducted using PubMed, Web of Science, Google Scholar, and Saudi Digital Library. The risk of bias was evaluated using the Newcastle-Ottawa Scale. Twenty-one published articles during the past five years were included in the systematic review. Varied approaches were used to diagnose childhood overweight and obesity, including the International Obesity Taskforce (IOTF), Centre for Disease Control (CDC), World Health Organization (WHO), and Saudi Growth Pattern Curves. We found that the combined prevalence of childhood overweight and obesity in the Middle East is up to 49.4%, depending on the methods applied in their studies. Risk factors identified were age, male gender, lack of sufficient physical activity, consumption of fried food, perceived stress level, number of family members, family size, mother's occupation, education level, family history of obesity, high energy consumption from carbohydrates, ≥ 2 hours spent on watching television on weekend days with overweight, and always eating breakfast while watching television with obesity. The results of this review indicate that the issue of childhood and adolescent overweight and obesity in the Middle East is substantial and concerning. Most of the risk factors identified are modifiable and, if given appropriate attention, could significantly reduce the burden of associated chronic complications. [ABSTRACT FROM AUTHOR]