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Determinants, Screening, Prevention and Management of Obesity in Youth

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Obesity".

Deadline for manuscript submissions: closed (20 December 2022) | Viewed by 35817

Special Issue Editors


E-Mail Website1 Website2
Guest Editor
Laboratory of Clinical Nutrition and Dietetics (CND-Lab), Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece
Interests: clinical nutrition; pediatric nutrition; obesity; obesity-related diseases
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
1. Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece
2. Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
Interests: childhood obesity; adolescent endocrinology; growth disorders; disorders of sex development; gender dysphoria; anorexia nervosa; stress-related disorders; molecular mechanisms of glucocorticoid action
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The prevalence of overweight and obesity has significantly increased over the past few decades and is linked to metabolic diseases across the lifespan. Its etiology has been attributed to a large number of sociodemographic, behavioral (e.g., unhealthy nutrition, low levels of physical activity), perinatal, and clinical risk factors, which are active already from childhood and adolescence. Still, its exact role, interplay, and mechanisms implicated in this process remain unclear. The trends of childhood obesity call for actions regarding the prevention and management of this disease early in life.

The Special Issue “Determinants, Screening, Prevention and Management of Obesity in Youth” aims to host original articles, (systematic) reviews or meta-analyses that will advance the current knowledge on the role of health behaviors, especially of nutrition, on the development of overweight or obesity in childhood and adolescence, provide valuable information about the nutritional habits of overweight/obese children and adolescents, and describe novel approaches via lifestyle modification for the prevention or management of obesity in youth.

Dr. Odysseas Androutsos
Prof. Dr. Evangelia Charmandari
Guest Editors

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Keywords

  • childhood obesity
  • nutrition
  • diet
  • determinants
  • risk factors
  • energy-balance-related behaviors
  • prevention
  • treatment
  • management

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Published Papers (25 papers)

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Editorial

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5 pages, 209 KiB  
Editorial
Determinants, Screening, Prevention and Management of Obesity in Youth: New Evidence and Horizons
by Odysseas Androutsos and Evangelia Charmandari
Nutrients 2022, 14(16), 3280; https://doi.org/10.3390/nu14163280 - 11 Aug 2022
Cited by 1 | Viewed by 1831
Abstract
The prevalence of obesity has significantly increased over the last four decades worldwide [...] Full article

Research

Jump to: Editorial, Review, Other

13 pages, 1234 KiB  
Article
Relative Enhancement in Gadoxetate Disodium-Enhanced Liver MRI as an Imaging Biomarker in the Diagnosis of Non-Alcoholic Fatty Liver Disease in Pediatric Obesity
by Azadeh Hojreh, Julia Lischka, Dietmar Tamandl, Dariga Ramazanova, Amra Mulabdic, Susanne Greber-Platzer and Ahmed Ba-Ssalamah
Nutrients 2023, 15(3), 558; https://doi.org/10.3390/nu15030558 - 20 Jan 2023
Cited by 1 | Viewed by 2202
Abstract
Relative enhancement (RE) in gadoxetate disodium (Gd-EOB-DTPA)-enhanced MRI is a reliable, non-invasive method for the evaluation and differentiation between simple steatosis and non-alcoholic steatohepatitis in adults. This study evaluated the diagnostic accuracy of RE in Gd-EOB-DTPA-enhanced liver MRI and hepatic fat fraction (HFF) [...] Read more.
Relative enhancement (RE) in gadoxetate disodium (Gd-EOB-DTPA)-enhanced MRI is a reliable, non-invasive method for the evaluation and differentiation between simple steatosis and non-alcoholic steatohepatitis in adults. This study evaluated the diagnostic accuracy of RE in Gd-EOB-DTPA-enhanced liver MRI and hepatic fat fraction (HFF) in unenhanced liver MRI and ultrasound (US) for non-alcoholic fatty liver disease (NAFLD) screening in pediatric obesity. Seventy-four liver US and MRIs from 68 pediatric patients (13.07 ± 2.95 years) with obesity (BMI > BMI-for-age + 2SD) were reviewed with regard to imaging biomarkers (liver size, volume, echogenicity, HFF, and RE in Gd-EOB-DTPA-enhanced MRIs, and spleen size), blood biomarkers, and BMI. The agreement between the steatosis grade, according to HFF in MRI and the echogenicity in US, was moderate. Alanine aminotransferase correlated better with the imaging biomarkers in MRI than with those in US. BMI correlated better with liver size and volume on MRI than in US. In patients with RE < 1, blood biomarkers correlated better with RE than those in the whole sample, with a significant association between gamma-glutamyltransferase and RE (p = 0.033). In conclusion, the relative enhancement and hepatic fat fraction can be considered as non-invasive tools for the screening and follow-up of NAFLD in pediatric obesity, superior to echogenicity on ultrasound. Full article
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12 pages, 1011 KiB  
Article
Longitudinal Association of Telomere Dynamics with Obesity and Metabolic Disorders in Young Children
by Simon Toupance, Sofia I. Karampatsou, Carlos Labat, Sofia-Maria Genitsaridi, Athanasia Tragomalou, Penio Kassari, George Soulis, Allyson Hollander, Evangelia Charmandari and Athanase Benetos
Nutrients 2022, 14(23), 5191; https://doi.org/10.3390/nu14235191 - 6 Dec 2022
Cited by 4 | Viewed by 2512
Abstract
In adults, short leukocyte telomere length (LTL) is associated with metabolic disorders, such as obesity and diabetes mellitus type 2. These associations could stem from early life interactions between LTL and metabolic disorders. To test this hypothesis, we explored the associations between LTL [...] Read more.
In adults, short leukocyte telomere length (LTL) is associated with metabolic disorders, such as obesity and diabetes mellitus type 2. These associations could stem from early life interactions between LTL and metabolic disorders. To test this hypothesis, we explored the associations between LTL and metabolic parameters as well as their evolution over time in children with or without obesity at baseline. Seventy-three (n = 73) children attending our Outpatient Clinic for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence, aged 2–10 years (mean ± SD: 7.6 ± 2.0 years), were followed for 2 to 4 years. Anthropometric, clinical, and biological (including LTL by Southern blot) measurements were performed annually. Baseline LTL correlated negatively with BMI (p = 0.02), fat percentage (p = 0.01), and blood glucose (p = 0.0007). These associations persisted after adjustments for age and sex. No associations were found between LTL attrition during the follow-up period and any of the metabolic parameters. In young children, obesity and metabolic disturbances were associated with shorter telomeres but were not associated with more pronounced LTL attrition. These results suggest that short telomeres contribute to the development of obesity and metabolic disorders very early in life, which can have a major impact on health. Full article
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21 pages, 592 KiB  
Article
The Effect of a Comprehensive Life-Style Intervention Program of Diet and Exercise on Four Bone-Derived Proteins, FGF-23, Osteopontin, NGAL and Sclerostin, in Overweight or Obese Children and Adolescents
by Sofia I. Karampatsou, George Paltoglou, Sofia M. Genitsaridi, Penio Kassari and Evangelia Charmandari
Nutrients 2022, 14(18), 3772; https://doi.org/10.3390/nu14183772 - 13 Sep 2022
Cited by 10 | Viewed by 2397
Abstract
The adipose and bone tissues demonstrate considerable interconnected endocrine function. In the present study, we determined the concentrations of fibroblast growth factor-23 (FGF-23), osteopontin, neutrophil gelatinase-associated lipocalin (NGAL) and sclerostin in 345 children and adolescents who were overweight or obese (mean age ± [...] Read more.
The adipose and bone tissues demonstrate considerable interconnected endocrine function. In the present study, we determined the concentrations of fibroblast growth factor-23 (FGF-23), osteopontin, neutrophil gelatinase-associated lipocalin (NGAL) and sclerostin in 345 children and adolescents who were overweight or obese (mean age ± SD mean: 10.36 ± 0.16 years; 172 males, 173 females; 181 prepubertal; and 164 pubertal) before and after their participation in a comprehensive life-style intervention program of diet and exercise for one year. Following the one-year life-style interventions, there was a significant decrease in BMI (p < 0.01), FGF-23 (p < 0.05), osteopontin (p < 0.01) and NGAL (p < 0.01), and an increase in sclerostin (p < 0.01) concentrations. BMI z-score (b = 0.242, p < 0.05) and fat mass (b = 0.431, p < 0.05) were the best positive predictors and waist-to-height ratio (WHtR) (b = −0.344, p < 0.05) was the best negative predictor of the change of osteopontin. NGAL concentrations correlated positively with HbA1C (b = 0.326, p < 0.05), WHtR (b = 0.439, p < 0.05) and HOMA-IR (b = 0.401, p < 0.05), while BMI (b = 0.264, p < 0.05), fat mass (b = 1.207, p < 0.05), HDL (b = 0.359, p < 0.05) and waist circumference (b = 0.263, p < 0.05) were the best positive predictors of NGAL. These results indicate that FGF-23, osteopontin, NGAL and sclerostin are associated with being overweight or obese and are altered in relation to alterations in BMI. They also indicate a crosstalk between adipose tissue and bone tissue and may play a role as potential biomarkers of glucose metabolism. Further studies are required to delineate the physiological mechanisms underlying this association in children and adolescents. Full article
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11 pages, 1187 KiB  
Article
The Effect of a Multidisciplinary Lifestyle Intervention on Health Parameters in Children versus Adolescents with Severe Obesity
by Kelly G. H. van de Pas, Judith W. Lubrecht, Marijn L. Hesselink, Bjorn Winkens, François M. H. van Dielen and Anita C. E. Vreugdenhil
Nutrients 2022, 14(9), 1795; https://doi.org/10.3390/nu14091795 - 25 Apr 2022
Cited by 6 | Viewed by 2235
Abstract
Lifestyle interventions are the common treatment for children and adolescents with severe obesity. The efficacy of these interventions across age groups remain unknown. Therefore, this study aimed to compare the effectiveness of a lifestyle intervention on health parameters between children and adolescents with [...] Read more.
Lifestyle interventions are the common treatment for children and adolescents with severe obesity. The efficacy of these interventions across age groups remain unknown. Therefore, this study aimed to compare the effectiveness of a lifestyle intervention on health parameters between children and adolescents with severe obesity. A longitudinal design was carried out at the Centre for Overweight Adolescent and Children’s Healthcare (COACH) between December 2010 and June 2020. Children (2–11 years old, n = 83) and adolescents (12–18 years old, n = 77) with severe obesity received a long-term, tailored, multidisciplinary lifestyle intervention. After 1 year, 24 children (28.9%) and 33 adolescents (42.9%) dropped out of the intervention. The primary outcome was the change in body mass index (BMI) z-score after one and two years of intervention. The decrease in BMI z-score over time was significantly higher in children compared to adolescents, the mean decrease was 0.15 (0.08–0.23) versus 0.03 (−0.05–0.11) after one year and 0.25 (0.15–0.35) versus 0.06 (−0.06–0.17) after two years of intervention; p values for the difference between children and adolescents were 0.035 and 0.012. After two years, multiple improvements in cardio metabolic health parameters were observed, especially in children. In conclusion, during our tailored lifestyle intervention, a positive and maintained effect on health parameters was observed in children with severe obesity. Compared to children, the effect on health parameters was less pronounced in adolescents. Full article
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9 pages, 826 KiB  
Article
Adverse Effects of Infant Formula Made with Corn-Syrup Solids on the Development of Eating Behaviors in Hispanic Children
by Hailey E. Hampson, Roshonda B. Jones, Paige K. Berger, Jasmine F. Plows, Kelsey A. Schmidt, Tanya L. Alderete and Michael I. Goran
Nutrients 2022, 14(5), 1115; https://doi.org/10.3390/nu14051115 - 7 Mar 2022
Cited by 5 | Viewed by 5772
Abstract
Few studies have investigated the influence of infant formulas made with added corn-syrup solids on the development of child eating behaviors. We examined associations of breastmilk (BM), traditional formula (TF), and formula containing corn-syrup solids (CSSF) with changes in eating behaviors over a [...] Read more.
Few studies have investigated the influence of infant formulas made with added corn-syrup solids on the development of child eating behaviors. We examined associations of breastmilk (BM), traditional formula (TF), and formula containing corn-syrup solids (CSSF) with changes in eating behaviors over a period of 2 years. Feeding type was assessed at 6 months in 115 mother–infant pairs. Eating behaviors were assessed at 12, 18 and 24 months. Repeated Measures ANCOVA was used to determine changes in eating behaviors over time as a function of feeding type. Food fussiness and enjoyment of food differed between the feeding groups (p < 0.05) and changed over time for CSSF and TF (p < 0.01). Food fussiness increased from 12 to 18 and 12 to 24 months for CSSF and from 12 to 24 months for TF (p < 0.01), while it remained stable for BM. Enjoyment of food decreased from 12 to 24 months for CSSF (p < 0.01), while it remained stable for TF and BM. There was an interaction between feeding type and time for food fussiness and enjoyment of food (p < 0.01). Our findings suggest that Hispanic infants consuming CSSF may develop greater food fussiness and reduced enjoyment of food in the first 2 years of life compared to BM-fed infants. Full article
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9 pages, 254 KiB  
Article
The Prevalence of Overweight Status among Early Adolescents from Private Schools in Indonesia: Sex-Specific Patterns Determined by School Urbanization Level
by Eveline Sarintohe, Junilla K. Larsen, William J. Burk and Jacqueline M. Vink
Nutrients 2022, 14(5), 1001; https://doi.org/10.3390/nu14051001 - 27 Feb 2022
Cited by 3 | Viewed by 2382
Abstract
(1) Background: Few studies have investigated (demographic) correlates of (prevalent) overweight rates among early adolescents, especially from higher socioeconomic positions (SEP) in developing countries, such as Indonesia. The current study aims to fill this gap. (2) Methods: Participants included 411 adolescents from five [...] Read more.
(1) Background: Few studies have investigated (demographic) correlates of (prevalent) overweight rates among early adolescents, especially from higher socioeconomic positions (SEP) in developing countries, such as Indonesia. The current study aims to fill this gap. (2) Methods: Participants included 411 adolescents from five private schools in Indonesia. Adolescents’ weight and height were measured, and adolescents completed questionnaires on demographic factors (i.e., sex, school area, ethnicity, pocket money) and previous year dieting. (3) Results: Results showed that more than one-third of the sample was overweight, with higher rates among adolescent males (47%) than females (24%). Moreover, adolescents attending schools in urban areas (compared with suburban areas), and those reporting past dieting (compared with those reporting no dieting) had higher overweight rates. Ethnicity and the amount of pocket money were not related to overweight status. Finally, a clear sex-specific interaction was found involving school area, showing that males in urban areas had a significantly higher risk to be overweight, whereas this did not apply to females. (4) Conclusions: males from urban area private schools in Indonesia may be an important target group for future preventive overweight interventions. Full article
11 pages, 976 KiB  
Article
Obesity Risk-Factor Variation Based on Island Clusters: A Secondary Analysis of Indonesian Basic Health Research 2018
by Sri Astuti Thamrin, Dian Sidik Arsyad, Hedi Kuswanto, Armin Lawi and Andi Imam Arundhana
Nutrients 2022, 14(5), 971; https://doi.org/10.3390/nu14050971 - 24 Feb 2022
Cited by 4 | Viewed by 3600
Abstract
Obesity has become a rising global health problem affecting quality of life for adults. The objective of this study is to describe the prevalence of obesity in Indonesian adults based on the cluster of islands. The study also aims to identify the risk [...] Read more.
Obesity has become a rising global health problem affecting quality of life for adults. The objective of this study is to describe the prevalence of obesity in Indonesian adults based on the cluster of islands. The study also aims to identify the risk factors of obesity in each island cluster. This study analyzes the secondary data of Indonesian Basic Health Research 2018. Data for this analysis comprised 618,910 adults (≥18 years) randomly selected, proportionate to the population size throughout Indonesia. We included 20 variables for the socio-demographic and obesity-related risk factors for analysis. The obesity status was defined using Body Mass Index (BMI) ≥ 25 kg/m2. Our current study defines 7 major island clusters as the unit analysis consisting of 34 provinces in Indonesia. Descriptive analysis was conducted to determine the characteristics of the population and to calculate the prevalence of obesity within the provinces in each of the island clusters. Multivariate logistic regression analyses to calculate the odds ratios (ORs) was performed using SPSS version 27. The study results show that all the island clusters have at least one province with an obesity prevalence above the national prevalence (35.4%). Six out of twenty variables, comprising four dietary factors (the consumption of sweet food, high-salt food, meat, and carbonated drinks) and one psychological factor (mental health disorders), varied across the island clusters. In conclusion, there was a variation of obesity prevalence of the provinces within and between island clusters. The variation of risk factors found in each island cluster suggests that a government rethink of the current intervention strategies to address obesity is recommended. Full article
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11 pages, 255 KiB  
Article
Associations of Caregiver Cooking Skills with Child Dietary Behaviors and Weight Status: Results from the A-CHILD Study
by Yukako Tani, Aya Isumi, Satomi Doi and Takeo Fujiwara
Nutrients 2021, 13(12), 4549; https://doi.org/10.3390/nu13124549 - 18 Dec 2021
Cited by 5 | Viewed by 3374
Abstract
We examined whether caregiver cooking skills were associated with frequency of home cooking, child dietary behaviors, and child body weight status in Japan. We used cross-sectional data from the 2018 Adachi Child Health Impact of Living Difficulty study, targeting primary and junior high [...] Read more.
We examined whether caregiver cooking skills were associated with frequency of home cooking, child dietary behaviors, and child body weight status in Japan. We used cross-sectional data from the 2018 Adachi Child Health Impact of Living Difficulty study, targeting primary and junior high school students aged 9–14 years in Adachi City, Tokyo, Japan (n = 5257). Caregiver cooking skills were assessed using a scale with good validity and reliability modified for use in Japan. Child heights and weights derived from school heath checkup data were used to calculate WHO standard body mass index z-scores. After adjusting for potential confounders, caregivers with low-level cooking skills were 4.31 (95% confidence interval (CI): 2.68–6.94) times more likely to have lower frequency of home cooking than those with high level of cooking skills. Children with low-level caregiver cooking skills were 2.81 (95% CI: 2.06–3.84) times more likely to have lower frequency of vegetable intake and 1.74 (95% CI: 1.08–2.82) times more likely to be obese. A low level of caregiver cooking skills was associated with infrequent home cooking, unhealthy child dietary behaviors, and child obesity. Full article
12 pages, 717 KiB  
Article
Healthy Schoolhouse 2.0 Health Promotion Intervention to Reduce Childhood Obesity in Washington, DC: A Feasibility Study
by Melissa Hawkins, Sarah Irvine Belson, Robin McClave, Lauren Kohls, Sarah Little and Anastasia Snelling
Nutrients 2021, 13(9), 2935; https://doi.org/10.3390/nu13092935 - 25 Aug 2021
Cited by 9 | Viewed by 4867
Abstract
Childhood obesity prevalence trends involve complex societal and environmental factors as well as individual behaviors. The Healthy Schoolhouse 2.0 program seeks to improve nutrition literacy among elementary school students through an equity-focused intervention that supports the health of students, teachers, and the community. [...] Read more.
Childhood obesity prevalence trends involve complex societal and environmental factors as well as individual behaviors. The Healthy Schoolhouse 2.0 program seeks to improve nutrition literacy among elementary school students through an equity-focused intervention that supports the health of students, teachers, and the community. This five-year quasi-experimental study follows a baseline–post-test design. Research activities examine the feasibility and effectiveness of a professional development series in the first program year to improve teachers’ self-efficacy and students’ nutrition literacy. Four elementary schools in Washington, DC (two intervention, two comparison) enrolled in the program (N = 1302 students). Demographic and baseline assessments were similar between schools. Teacher participation in professional development sessions was positively correlated with implementing nutrition lessons (r = 0.6, p < 0.001, n = 55). Post-test student nutrition knowledge scores (W = 39985, p < 0.010, n = 659) and knowledge score changes (W = 17064, p < 0.010, n = 448) were higher among students in the intervention schools. Students who received three nutrition lessons had higher post knowledge scores than students who received fewer lessons (H(2) =22.75, p < 0.001, n = 659). Engaging teachers to implement nutrition curricula may support sustainable obesity prevention efforts in the elementary school environment. Full article
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12 pages, 303 KiB  
Article
Breastfeeding and Overweight in European Preschoolers: The ToyBox Study
by Natalya Usheva, Mina Lateva, Sonya Galcheva, Berthold V. Koletzko, Greet Cardon, Marieke De Craemer, Odysseas Androutsos, Aneta Kotowska, Piotr Socha, Luis A. Moreno, Yannis Manios, Violeta Iotova and on behalf of the ToyBox-Study Group
Nutrients 2021, 13(8), 2880; https://doi.org/10.3390/nu13082880 - 21 Aug 2021
Cited by 11 | Viewed by 4114
Abstract
The benefits of breastfeeding (BF) include risk reduction of later overweight and obesity. We aimed to analyse the association between breastfeeding practices and overweight/obesity among preschool children participating in the ToyBox study. Data from children in the six countries, participating in the ToyBox-study [...] Read more.
The benefits of breastfeeding (BF) include risk reduction of later overweight and obesity. We aimed to analyse the association between breastfeeding practices and overweight/obesity among preschool children participating in the ToyBox study. Data from children in the six countries, participating in the ToyBox-study (Belgium, Bulgaria, Germany, Greece, Poland, and Spain) 7554 children/families and their age is 3.5–5.5 years, 51.9% were boys collected cross-sectionally in 2012. The questionnaires included parents’ self-reported data on their weight, height, socio-demographic status, and infant feeding practices. Measurements of preschool children’s weight and height were done by trained researchers using standard protocols and equipment. The ever breastfeeding rate in the total sample was 85.0% (n = 5777). Only 6.3% (n = 428) of the children from the general sample were exclusively breastfed (EBF) for the duration of the first six months. EBF for four to six months was significantly (p < 0.001) less likely among mothers with formal education < 12 years (adjusted Odds Ratio (OR) = 0.61; 95% Confidence interval (CI) 0.44–0.85), smoking throughout pregnancy (adjusted OR = 0.39; 95% CI 0.24–0.62), overweight before pregnancy (adjusted OR = 0.67; 95%CI 0.47–0.95) and ≤25 years old. The median duration of any breastfeeding was five months. The prevalence of exclusive formula feeding during the first five months in the general sample was about 12% (n = 830). The prevalence of overweight and obesity at preschool age was 8.0% (n = 542) and 2.8% (n = 190), respectively. The study did not identify any significant association between breastfeeding practices and obesity in childhood when adjusted for relevant confounding factors (p > 0.05). It is likely that sociodemographic and lifestyle factors associated with breastfeeding practices may have an impact on childhood obesity. The identified lower than desirable rates and duration of breastfeeding practices should prompt enhanced efforts for effective promotion, protection, and support of breastfeeding across Europe, and in particular in regions with low BF rates. Full article
10 pages, 495 KiB  
Article
Effects of School-Based Interventions on Reducing Sugar-Sweetened Beverage Consumption among Chinese Children and Adolescents
by Zhenni Zhu, Chunyan Luo, Shuangxiao Qu, Xiaohui Wei, Jingyuan Feng, Shuo Zhang, Yinyi Wang and Jin Su
Nutrients 2021, 13(6), 1862; https://doi.org/10.3390/nu13061862 - 30 May 2021
Cited by 7 | Viewed by 4116
Abstract
We set up a series of school-based interventions on the basis of an ecological model targeting sugar-sweetened beverage (SSB) reduction in Chinese elementary and middle schools and evaluated the effects. A total of 1046 students from Chinese elementary and middle schools were randomly [...] Read more.
We set up a series of school-based interventions on the basis of an ecological model targeting sugar-sweetened beverage (SSB) reduction in Chinese elementary and middle schools and evaluated the effects. A total of 1046 students from Chinese elementary and middle schools were randomly recruited in an intervention group, as were 1156 counterparts in a control group. The interventions were conducted in the intervention schools for one year. The participants were orally instructed to answer all the questionnaires by themselves at baseline and after intervention. The difference in difference statistical approach was used to identify the effects exclusively attributable to the interventions. There were differences in grade composition and no difference in sex distribution between the intervention and control groups. After adjusting for age, sex, and group differences at baseline, a significant reduction in SSB intake was found in the intervention group post intervention, with a decrease of 35.0 mL/day (p = 0.034). Additionally, the frequency of SSB consumption decreased by 0.2 times/day (p = 0.071). The students in the elementary schools with interventions significantly reduced their SSB intake by 61.6 mL/day (p = 0.002) and their frequency of SSB consumption by 0.3 times/day (p = 0.017) after the intervention. The boys in the intervention group had an intervention effect of a 50.2 mL/day reduction in their SSB intake (p = 0.036). School-based interventions were effective in reducing SSB consumption, especially among younger ones. The boys were more responsive to the interventions than the girls. (ChiCTR, ChiCTR1900020781.) Full article
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15 pages, 457 KiB  
Article
Associations between Children’s Genetic Susceptibility to Obesity, Infant’s Appetite and Parental Feeding Practices in Toddlerhood
by Claire Guivarch, Marie-Aline Charles, Anne Forhan, Ken K. Ong, Barbara Heude and Blandine de Lauzon-Guillain
Nutrients 2021, 13(5), 1468; https://doi.org/10.3390/nu13051468 - 26 Apr 2021
Cited by 8 | Viewed by 3484
Abstract
Previous findings suggest that parental feeding practices may adapt to children’s eating behavior and sex, but few studies assessed these associations in toddlerhood. We aimed to study the associations between infant’s appetite or children’s genetic susceptibility to obesity and parental feeding practices. We [...] Read more.
Previous findings suggest that parental feeding practices may adapt to children’s eating behavior and sex, but few studies assessed these associations in toddlerhood. We aimed to study the associations between infant’s appetite or children’s genetic susceptibility to obesity and parental feeding practices. We assessed infant’s appetite (three-category indicator: low, normal or high appetite, labelled 4-to-24-month appetite) and calculated a combined obesity risk-allele score (genetic risk score of body mass index (BMI-GRS)) in a longitudinal study of respectively 1358 and 932 children from the EDEN cohort. Parental feeding practices were assessed at 2-year-follow-up by the CFPQ. Three of the five tested scores were used as continuous variables; others were considered as binary variables, according to the median. Associations between infant’s appetite or child’s BMI-GRS and parental feeding practices were assessed by linear and logistic regression models, stratified on child’s sex if interactions were significant. 4-to-24-month appetite was positively associated with restrictive feeding practices among boys and girls. Among boys, high compared to normal 4-to-24-month appetite was associated with higher use of food to regulate child’s emotions (OR [95% CI] = 2.24 [1.36; 3.68]). Child’s BMI-GRS was not related to parental feeding practices. Parental feeding practices may adapt to parental perception of infant’s appetite and child’s sex. Full article
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12 pages, 272 KiB  
Article
Physical Activity, Sedentariness, Eating Behaviour and Well-Being during a COVID-19 Lockdown Period in Greek Adolescents
by Ioannis D. Morres, Evangelos Galanis, Antonis Hatzigeorgiadis, Odysseas Androutsos and Yannis Theodorakis
Nutrients 2021, 13(5), 1449; https://doi.org/10.3390/nu13051449 - 24 Apr 2021
Cited by 39 | Viewed by 7261
Abstract
Adolescents’ daily life has dramatically changed during the COVID-19 era due to the social restrictions that have been imposed, including closures of schools, leisure centers and sport facilities. The purpose of this study was to examine levels of well-being and mood and their [...] Read more.
Adolescents’ daily life has dramatically changed during the COVID-19 era due to the social restrictions that have been imposed, including closures of schools, leisure centers and sport facilities. The purpose of this study was to examine levels of well-being and mood and their relations with physical (in)activity and eating behaviors in adolescents during a lockdown period in Greece. A total of 950 adolescents (Mean Age = 14.41 years ± 1.63) participated in a web-based survey while education was conducted online and organized sport activities were interrupted. Participants showed poor well-being, insufficient physical activity levels and moderate scores of healthy eating behavior. Hierarchical regression analysis showed that, after controlling for the effect of gender and body mass index, increased physical activity and healthier eating behavior predicted better well-being (b = 0.24, p < 0.01 and b = 0.19, p < 0.01, respectively), whereas sedentariness predicted worse well-being (b = −0.16, p < 0.01). Furthermore, it was revealed that days of physical activity per week was a stronger predictor of well-being than minutes of physical activity per week, and that both in-house and out-of-house physical activity were beneficial. Considering that well-being in our study was below the threshold recommended by the World Health Organization as indicative of possible depressive symptoms, measures to increase physical activity, decrease sedentariness and improve eating behavior should become a priority for communities and policy makers. Full article
15 pages, 1785 KiB  
Article
Resting Energy Expenditure Is Not Altered in Children and Adolescents with Obesity. Effect of Age and Gender and Association with Serum Leptin Levels
by J. Karina Zapata, Victoria Catalán, Amaia Rodríguez, Beatriz Ramírez, Camilo Silva, Javier Escalada, Javier Salvador, Giuseppe Calamita, M. Cristina Azcona-Sanjulian, Gema Frühbeck and Javier Gómez-Ambrosi
Nutrients 2021, 13(4), 1216; https://doi.org/10.3390/nu13041216 - 7 Apr 2021
Cited by 13 | Viewed by 3091
Abstract
In children and adolescents, obesity does not seem to depend on a reduction of resting energy expenditure (REE). Moreover, in this young population, the interactions between either age and obesity or between age and gender, or the role of leptin on REE are [...] Read more.
In children and adolescents, obesity does not seem to depend on a reduction of resting energy expenditure (REE). Moreover, in this young population, the interactions between either age and obesity or between age and gender, or the role of leptin on REE are not clearly understood. To compare the levels of REE in children and adolescents we studied 181 Caucasian individuals (62% girls) classified on the basis of age- and sex-specific body mass index (BMI) percentile as healthy weight (n = 50), with overweight (n = 34), or with obesity (n = 97) and in different age groups: 8–10 (n = 38), 11–13 (n = 50), and 14–17 years (n = 93). REE was measured by indirect calorimetry and body composition by air displacement plethysmography. Statistically significant differences in REE/fat-free mass (FFM) regarding obesity or gender were not observed. Absolute REE increases with age (p < 0.001), but REE/FFM decreases (p < 0.001) and there is an interaction between gender and age (p < 0.001) on absolute REE showing that the age-related increase is more marked in boys than in girls, in line with a higher FFM. Interestingly, the effect of obesity on absolute REE is not observed in the 8–10 year-old group, in which serum leptin concentrations correlate with the REE/FFM (r = 0.48; p = 0.011). In conclusion, REE/FFM is not affected by obesity or gender, while the effect of age on absolute REE is gender-dependent and leptin may influence the REE/FFM in 8–10 year-olds. Full article
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12 pages, 295 KiB  
Article
Complementary Feeding and Overweight in European Preschoolers: The ToyBox-Study
by Natalya Usheva, Sonya Galcheva, Greet Cardon, Marieke De Craemer, Odysseas Androutsos, Aneta Kotowska, Piotr Socha, Berthold V. Koletzko, Luis A. Moreno, Violeta Iotova, Yannis Manios and on behalf of the ToyBox-study Group
Nutrients 2021, 13(4), 1199; https://doi.org/10.3390/nu13041199 - 5 Apr 2021
Cited by 9 | Viewed by 4057
Abstract
Complementary feeding (CF) should start between 4–6 months of age to ensure infants’ growth but is also linked to childhood obesity. This study aimed to investigate the association of the timing of CF, breastfeeding and overweight in preschool children. Infant-feeding practices were self-reported [...] Read more.
Complementary feeding (CF) should start between 4–6 months of age to ensure infants’ growth but is also linked to childhood obesity. This study aimed to investigate the association of the timing of CF, breastfeeding and overweight in preschool children. Infant-feeding practices were self-reported in 2012 via a validated questionnaire by >7500 parents from six European countries participating in the ToyBox-study. The proportion of children who received breast milk and CF at 4–6 months was 51.2%. There was a positive association between timing of solid food (SF) introduction and duration of breastfeeding, as well as socioeconomic status and a negative association with smoking throughout pregnancy (p < 0.005). No significant risk to become overweight was observed among preschoolers who were introduced to SF at 1–3 months of age compared to those introduced at 4–6 months regardless of the type of milk feeding. Similarly, no significant association was observed between the early introduction of SF and risk for overweight in preschoolers who were breastfed for ≥4 months or were formula-fed. The study did not identify any significant association between the timing of introducing SF and obesity in childhood. It is likely that other factors than timing of SF introduction may have impact on childhood obesity. Full article
10 pages, 481 KiB  
Article
Antenatal Determinants of Childhood Obesity in High-Risk Offspring: Protocol for the DiGest Follow-Up Study
by Danielle Jones, Emanuella De Lucia Rolfe, Kirsten L. Rennie, Linda M. Oude Griep, Laura C. Kusinski, Deborah J. Hughes, Soren Brage, Ken K. Ong, Kathryn Beardsall and Claire L. Meek
Nutrients 2021, 13(4), 1156; https://doi.org/10.3390/nu13041156 - 31 Mar 2021
Cited by 2 | Viewed by 3744
Abstract
Childhood obesity is an area of intense concern internationally and is influenced by events during antenatal and postnatal life. Although pregnancy complications, such as gestational diabetes and large-for-gestational-age birthweight have been associated with increased obesity risk in offspring, very few successful interventions in [...] Read more.
Childhood obesity is an area of intense concern internationally and is influenced by events during antenatal and postnatal life. Although pregnancy complications, such as gestational diabetes and large-for-gestational-age birthweight have been associated with increased obesity risk in offspring, very few successful interventions in pregnancy have been identified. We describe a study protocol to identify if a reduced calorie diet in pregnancy can reduce adiposity in children to 3 years of age. The dietary intervention in gestational diabetes (DiGest) study is a randomised, controlled trial of a reduced calorie diet provided by a whole-diet replacement in pregnant women with gestational diabetes. Women receive a weekly dietbox intervention from enrolment until delivery and are blinded to calorie allocation. This follow-up study will assess associations between a reduced calorie diet in pregnancy with offspring adiposity and maternal weight and glycaemia. Anthropometry will be performed in infants and mothers at 3 months, 1, 2 and 3 years post-birth. Glycaemia will be assessed using bloodspot C-peptide in infants and continuous glucose monitoring with HbA1c in mothers. Data regarding maternal glycaemia in pregnancy, maternal nutrition, infant birthweight, offspring feeding behaviour and milk composition will also be collected. The DiGest follow-up study is expected to take 5 years, with recruitment finishing in 2026. Full article
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11 pages, 253 KiB  
Article
Lifestyle Changes and Determinants of Children’s and Adolescents’ Body Weight Increase during the First COVID-19 Lockdown in Greece: The COV-EAT Study
by Odysseas Androutsos, Maria Perperidi, Christos Georgiou and Giorgos Chouliaras
Nutrients 2021, 13(3), 930; https://doi.org/10.3390/nu13030930 - 13 Mar 2021
Cited by 135 | Viewed by 12967
Abstract
Previous studies showed that the coronavirus disease 2019 (COVID-19) lockdown imposed changes in adults’ lifestyle behaviors; however, there is limited information regarding the effects on youth. The COV-EAT study aimed to report changes in children’s and adolescents’ lifestyle habits during the first COVID-19 [...] Read more.
Previous studies showed that the coronavirus disease 2019 (COVID-19) lockdown imposed changes in adults’ lifestyle behaviors; however, there is limited information regarding the effects on youth. The COV-EAT study aimed to report changes in children’s and adolescents’ lifestyle habits during the first COVID-19 lockdown and explore potential associations between changes of participants’ lifestyle behaviors and body weight. An online survey among 397 children/adolescents and their parents across 63 municipalities in Greece was conducted in April–May 2020. Parents self-reported changes of their children’s lifestyle habits and body weight, as well as sociodemographic data of their family. The present study shows that during the lockdown, children’s/adolescents’ sleep duration and screen time increased, while their physical activity decreased. Their consumption of fruits and fresh fruit juices, vegetables, dairy products, pasta, sweets, total snacks, and breakfast increased, while fast-food consumption decreased. Body weight increased in 35% of children/adolescents. A multiple regression analysis showed that the body weight increase was associated with increased consumption of breakfast, salty snacks, and total snacks and with decreased physical activity. The COV-EAT study revealed changes in children’s and adolescents’ lifestyle behaviors during the first COVID-19 lockdown in Greece. Effective strategies are needed to prevent excessive body weight gain in future COVID-19 lockdowns. Full article
17 pages, 1855 KiB  
Article
Characteristic-Grouped Adiposity Indicators for Identifying Metabolic Syndrome in Adolescents: Develop and Valid Risk Screening Tools Using Dual Population
by Yu-Ting Chin, Wei-Ting Lin, Pei-Wen Wu, Sharon Tsai, Chun-Ying Lee, David W. Seal, Ted Chen, Hsiao-Ling Huang and Chien-Hung Lee
Nutrients 2020, 12(10), 3165; https://doi.org/10.3390/nu12103165 - 16 Oct 2020
Cited by 9 | Viewed by 2631
Abstract
A simple, robust, and characterized adiposity indicator may be appropriate to be used as a risk screening tool for identifying metabolic syndrome (MetS) in adolescents. This study used dual adolescent populations to develop and validate efficient adiposity indicators from 12 characterized candidates for [...] Read more.
A simple, robust, and characterized adiposity indicator may be appropriate to be used as a risk screening tool for identifying metabolic syndrome (MetS) in adolescents. This study used dual adolescent populations to develop and validate efficient adiposity indicators from 12 characterized candidates for identifying MetS that may occur during the transition from adolescence to young adulthood. Data from the adolescent Nutrition and Health Survey in Taiwan (n = 1920, 12–18 years) and the multilevel Risk Profiles for adolescent MetS study (n = 2727, 12–16 years) were respectively used as training and validation datasets. The diagnostic criteria defined by the International Diabetes Federation for adolescents (IDF-adoMetS) and the Joint Interim Statement for adults (JIS-AdMetS) were employed to evaluate MetS. In the training dataset, principal component analysis converted 12 interrelated obesity indices into bodyfat-, lipid-, and body-shape-enhanced groups, with the first two characteristic-groups having a higher discriminatory capability in identifying IDF-adoMetS and JIS-AdMetS. In the validation dataset, abdominal volume index (AVI) among girls and waist circumference (WC) among boys were respectively validated to have a higher Youden’s index (0.740–0.816 and 0.798–0.884) in identifying the two MetS. Every 7.4 and 4.3 positive tests of AVI (cutoff = 13.96) had an accurate IDF-adoMetS and JIS-AdMetS, respectively, and every 32.4 total tests of WC (cutoff = 90.5 cm) had a correct identification for the two MetS. This study stresses the discriminatory capability of bodyfat- and lipid-enhanced adiposity indicators for identifying MetS. AVI and WC were, respectively, supported as a risk screening tool for identifying female and male MetS as adolescents transition to adulthood. Full article
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Review

Jump to: Editorial, Research, Other

24 pages, 1754 KiB  
Review
Effects of L-Citrulline Supplementation and Aerobic Training on Vascular Function in Individuals with Obesity across the Lifespan
by Anaisa Genoveva Flores-Ramírez, Verónica Ivette Tovar-Villegas, Arun Maharaj, Ma Eugenia Garay-Sevilla and Arturo Figueroa
Nutrients 2021, 13(9), 2991; https://doi.org/10.3390/nu13092991 - 27 Aug 2021
Cited by 6 | Viewed by 4879
Abstract
Children with obesity are at higher risk for developing cardiometabolic diseases that once were considered health conditions of adults. Obesity is commonly associated with cardiometabolic risk factors such as dyslipidemia, hyperglycemia, hyperinsulinemia and hypertension that contribute to the development of endothelial dysfunction. Endothelial [...] Read more.
Children with obesity are at higher risk for developing cardiometabolic diseases that once were considered health conditions of adults. Obesity is commonly associated with cardiometabolic risk factors such as dyslipidemia, hyperglycemia, hyperinsulinemia and hypertension that contribute to the development of endothelial dysfunction. Endothelial dysfunction, characterized by reduced nitric oxide (NO) production, precedes vascular abnormalities including atherosclerosis and arterial stiffness. Thus, early detection and treatment of cardiometabolic risk factors are necessary to prevent deleterious vascular consequences of obesity at an early age. Non-pharmacological interventions including L-Citrulline (L-Cit) supplementation and aerobic training stimulate endothelial NO mediated vasodilation, leading to improvements in organ perfusion, blood pressure, arterial stiffness, atherosclerosis and metabolic health (glucose control and lipid profile). Few studies suggest that the combination of L-Cit supplementation and exercise training can be an effective strategy to counteract the adverse effects of obesity on vascular function in older adults. Therefore, this review examined the efficacy of L-Cit supplementation and aerobic training interventions on vascular and metabolic parameters in obese individuals. Full article
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15 pages, 1255 KiB  
Review
Management of Childhood Obesity—Time to Shift from Generalized to Personalized Intervention Strategies
by Mohamad Motevalli, Clemens Drenowatz, Derrick R. Tanous, Naim Akhtar Khan and Katharina Wirnitzer
Nutrients 2021, 13(4), 1200; https://doi.org/10.3390/nu13041200 - 6 Apr 2021
Cited by 25 | Viewed by 12159
Abstract
As a major public health concern, childhood obesity is a multifaceted and multilevel metabolic disorder influenced by genetic and behavioral aspects. While genetic risk factors contribute to and interact with the onset and development of excess body weight, available evidence indicates that several [...] Read more.
As a major public health concern, childhood obesity is a multifaceted and multilevel metabolic disorder influenced by genetic and behavioral aspects. While genetic risk factors contribute to and interact with the onset and development of excess body weight, available evidence indicates that several modifiable obesogenic behaviors play a crucial role in the etiology of childhood obesity. Although a variety of systematic reviews and meta-analyses have reported the effectiveness of several interventions in community-based, school-based, and home-based programs regarding childhood obesity, the prevalence of children with excess body weight remains high. Additionally, researchers and pediatric clinicians are often encountering several challenges and the characteristics of an optimal weight management strategy remain controversial. Strategies involving a combination of physical activity, nutritional, and educational interventions are likely to yield better outcomes compared to single-component strategies but various prohibitory limitations have been reported in practice. This review seeks to (i) provide a brief overview of the current preventative and therapeutic approaches towards childhood obesity, (ii) discuss the complexity and limitations of research in the childhood obesity area, and (iii) suggest an Etiology-Based Personalized Intervention Strategy Targeting Childhood Obesity (EPISTCO). This purposeful approach includes prioritized nutritional, educational, behavioral, and physical activity intervention strategies directly based on the etiology of obesity and interpretation of individual characteristics. Full article
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13 pages, 904 KiB  
Review
The Influence of Parental Dietary Behaviors and Practices on Children’s Eating Habits
by Lubna Mahmood, Paloma Flores-Barrantes, Luis A. Moreno, Yannis Manios and Esther M. Gonzalez-Gil
Nutrients 2021, 13(4), 1138; https://doi.org/10.3390/nu13041138 - 30 Mar 2021
Cited by 138 | Viewed by 38506
Abstract
Poor dietary habits established during childhood might persist into adulthood, increasing the risk of developing obesity and obesity-related complications such as Type 2 Diabetes Mellitus. It has been found that early modifications in eating habits, especially during childhood, might promote health and decrease [...] Read more.
Poor dietary habits established during childhood might persist into adulthood, increasing the risk of developing obesity and obesity-related complications such as Type 2 Diabetes Mellitus. It has been found that early modifications in eating habits, especially during childhood, might promote health and decrease the risk of developing diseases during later life. Various studies found a great influence of parental dietary habits on dietary behaviors of their children regardless of demographic characteristics such as gender, age, socioeconomic status and country; however, the exact mechanism is still not clear. Therefore, in this review, we aimed to investigate both parents’ and children’s dietary behaviors, and to provide evidence for the potential influence of parents’ dietary behaviors and practices on certain children’s eating habits. Family meals were found to contribute the most in modeling children’s dietary habits as they represent an important moment of control and interaction between parents and their children. The parental practices that influenced their children most were role modeling and moderate restriction, suggesting that the increase of parental encouragement and decrease of excessive pressure could have a positive impact in their children’s dietary behaviors. This narrative review highlights that parental child-feeding behaviors should receive more attention in research studies as modifiable risk factors, which could help to design future dietary interventions and policies to prevent dietary-related diseases. Full article
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27 pages, 1042 KiB  
Review
Impact of Strategies for Preventing Obesity and Risk Factors for Eating Disorders among Adolescents: A Systematic Review
by Ana Carolina B. Leme, Jess Haines, Lisa Tang, Karin L. L. Dunker, Sonia T. Philippi, Mauro Fisberg, Gerson L. Ferrari and Regina M. Fisberg
Nutrients 2020, 12(10), 3134; https://doi.org/10.3390/nu12103134 - 14 Oct 2020
Cited by 31 | Viewed by 10760
Abstract
An effective behavior change program is the first line of prevention for youth obesity. However, effectiveness in prevention of adolescent obesity requires several approaches, with special attention paid to disordered eating behaviors and psychological support, among other environmental factors. The aim of this [...] Read more.
An effective behavior change program is the first line of prevention for youth obesity. However, effectiveness in prevention of adolescent obesity requires several approaches, with special attention paid to disordered eating behaviors and psychological support, among other environmental factors. The aim of this systematic review is to compare the impact of two types of obesity prevention programs, inclusive of behavior change components, on weight outcomes. “Energy-balance” studies are aimed at reducing calories from high-energy sources and increasing physical activity (PA) levels, while “shared risk factors for obesity and eating disorders” focus on reducing disordered eating behaviors to promote a positive food and eating relationship. A systematic search of ProQuest, PubMed, PsycInfo, SciELO, and Web of Science identified 8825 articles. Thirty-five studies were included in the review, of which 20 regarded “energy-balance” and 15 “shared risk factors for obesity and eating disorders”. “Energy-balance” studies were unable to support maintenance weight status, diet, and PA. “Shared risk factors for obesity and eating disorders” programs also did not result in significant differences in weight status over time. However, the majority of “shared risk factors for obesity and eating disorders” studies demonstrated reduced body dissatisfaction, dieting, and weight-control behaviors. Research is needed to examine how a shared risk factor approach can address both obesity and eating disorders. Full article
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21 pages, 952 KiB  
Review
Adipose Tissue Development and Expansion from the Womb to Adolescence: An Overview
by Camila E. Orsso, Eloisa Colin-Ramirez, Catherine J. Field, Karen L. Madsen, Carla M. Prado and Andrea M. Haqq
Nutrients 2020, 12(9), 2735; https://doi.org/10.3390/nu12092735 - 8 Sep 2020
Cited by 52 | Viewed by 8130
Abstract
Prevalence rates of pediatric obesity continue to rise worldwide. Adipose tissue (AT) development and expansion initiate in the fetus and extend throughout the lifespan. This paper presents an overview of the AT developmental trajectories from the intrauterine period to adolescence; factors determining adiposity [...] Read more.
Prevalence rates of pediatric obesity continue to rise worldwide. Adipose tissue (AT) development and expansion initiate in the fetus and extend throughout the lifespan. This paper presents an overview of the AT developmental trajectories from the intrauterine period to adolescence; factors determining adiposity expansion are also discussed. The greatest fetal increases in AT were observed in the third pregnancy trimester, with growing evidence suggesting that maternal health and nutrition, toxin exposure, and genetic defects impact AT development. From birth up to six months, healthy term newborns experience steep increases in AT; but a subsequent reduction in AT is observed during infancy. Important determinants of AT in infancy identified in this review included feeding practices and factors shaping the gut microbiome. Low AT accrual rates are maintained up to puberty onset, at which time, the pattern of adiposity expansion becomes sex dependent. As girls experience rapid increases and boys experience decreases in AT, sexual dimorphism in hormone secretion can be considered the main contributor for changes. Eating patterns/behaviors and interactions between dietary components, gut microbiome, and immune cells also influence AT expansion. Despite the plasticity of this tissue, substantial evidence supports that adiposity at birth and infancy highly influences its levels across subsequent life stages. Thus, a unique window of opportunity for the prevention and/or slowing down of the predisposition toward obesity, exists from pregnancy through childhood. Full article
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35 pages, 719 KiB  
Systematic Review
The Genetic Basis of Childhood Obesity: A Systematic Review
by Aikaterini Vourdoumpa, George Paltoglou and Evangelia Charmandari
Nutrients 2023, 15(6), 1416; https://doi.org/10.3390/nu15061416 - 15 Mar 2023
Cited by 24 | Viewed by 8048
Abstract
Overweight and obesity in childhood and adolescence represents one of the most challenging public health problems of our century owing to its epidemic proportions and the associated significant morbidity, mortality, and increase in public health costs. The pathogenesis of polygenic obesity is multifactorial [...] Read more.
Overweight and obesity in childhood and adolescence represents one of the most challenging public health problems of our century owing to its epidemic proportions and the associated significant morbidity, mortality, and increase in public health costs. The pathogenesis of polygenic obesity is multifactorial and is due to the interaction among genetic, epigenetic, and environmental factors. More than 1100 independent genetic loci associated with obesity traits have been currently identified, and there is great interest in the decoding of their biological functions and the gene–environment interaction. The present study aimed to systematically review the scientific evidence and to explore the relation of single-nucleotide polymorphisms (SNPs) and copy number variants (CNVs) with changes in body mass index (BMI) and other measures of body composition in children and adolescents with obesity, as well as their response to lifestyle interventions. Twenty-seven studies were included in the qualitative synthesis, which consisted of 7928 overweight/obese children and adolescents at different stages of pubertal development who underwent multidisciplinary management. The effect of polymorphisms in 92 different genes was assessed and revealed SNPs in 24 genetic loci significantly associated with BMI and/or body composition change, which contribute to the complex metabolic imbalance of obesity, including the regulation of appetite and energy balance, the homeostasis of glucose, lipid, and adipose tissue, as well as their interactions. The decoding of the genetic and molecular/cellular pathophysiology of obesity and the gene–environment interactions, alongside with the individual genotype, will enable us to design targeted and personalized preventive and management interventions for obesity early in life. Full article
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