Advances in the Management of Children and Adolescents with Obesity

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

Deadline for manuscript submissions: closed (30 December 2024) | Viewed by 11141

Special Issue Editor


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Guest Editor
Faculty of Sciences, Analytical Chemistry, Nutrition and Bromatology, University of Alicante, 03690 Alicante, Spain
Interests: pediatric obesity; primary care; obesigenic environment; eating behavior and disorder; obesogenic environment

Special Issue Information

Dear Colleagues,

It is a great honor to serve as the Guest Editors for this Special Issue of Children, ”Advances in the management of children and adolescents with obesity”.

Obesity is a frequent, severe, complex, recurrent and chronic disease characterized by an excessive accumulation of fat that can have negative effects on health and decrease life expectancy.

Obesity is widely recognized as a major public health problem. According to the fifth edition of the World Atlas of Obesity, in 2035, obesity is expected to affect almost 2 billion adults, children and adolescents. Prior to the COVID-19 pandemic, the prevalence of this disease was increasing in low- and middle-income countries, and it is possible that it has since increased in high-income countries as well, especially in families whose income or standard of living is lower than that of the rest of their community.

Obesity occurs when a combination of genetic and epigenetic factors, risky behavioral patterns, and broader environmental and sociocultural influences affect body composition regulation systems.

Suggested treatments include behavioral interactions based on changes that the family should address in several areas: diet or dietary supplementation, physical activity, sedentary behavior, sleep quality and drug treatment.

Although advances have been made in the treatment of obesity, the expected changes in overweight children and adolescents from low- and middle-income countries have not been observed.

The aim of this Special Issue is to present new strategies such as lifestyle changes that lead to significant changes in body composition, biochemical markers, and other health parameters.

Endocrinologists, dietitians–nutritionists, physical activity and sport sciences professionals and any researcher working in the line of pediatric obesity are invited to submit to this Special Issue. Original articles (prospective/retrospective studies), experimental studies, systemic reviews and meta-analyses, or new diagnostic or surgical techniques are welcome. Single case reports and narrative reviews will not be considered.

Dr. Manuel Reig Garcia-Galbis
Guest Editor

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Keywords

  • obesity
  • developing countries
  • child
  • adolescent
  • family
  • precision nutrition
  • exercise
  • health risk behaviors

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Published Papers (7 papers)

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Editorial

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3 pages, 132 KiB  
Editorial
Advances in the Management of Children and Adolescents with Obesity
by Manuel Reig García-Galbis and Rosa María Martínez-Espinosa
Children 2025, 12(4), 452; https://doi.org/10.3390/children12040452 - 31 Mar 2025
Viewed by 181
Abstract
Obesity is a frequent, severe, complex, recurrent, and chronic disease characterized by an excessive accumulation of fat, which can have negative effects on health and decrease life expectancy [...] Full article
(This article belongs to the Special Issue Advances in the Management of Children and Adolescents with Obesity)

Research

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13 pages, 1181 KiB  
Article
Effectiveness of Smartphone App for the Treatment of Pediatric Obesity: A Randomized Controlled Trial
by Giuseppina Rosaria Umano, Mariapia Masino, Grazia Cirillo, Giulia Rondinelli, Francesca Massa, Giuseppe Salvatore R. C. Mangoni di Santo Stefano, Anna Di Sessa, Pierluigi Marzuillo, Emanuele Miraglia del Giudice and Pietro Buono
Children 2024, 11(10), 1178; https://doi.org/10.3390/children11101178 - 27 Sep 2024
Viewed by 1736
Abstract
Background: Pediatric obesity treatment is based on high-intensity lifestyle counseling. However, high dropout rates and low effectiveness have been reported, even in specialized centers. Mobile health technologies have been used to overcome these limits with contrasting results. This study aims at evaluating the [...] Read more.
Background: Pediatric obesity treatment is based on high-intensity lifestyle counseling. However, high dropout rates and low effectiveness have been reported, even in specialized centers. Mobile health technologies have been used to overcome these limits with contrasting results. This study aims at evaluating the effectiveness of a six-month intervention with a mobile app for the treatment of pediatric obesity at 6 and 12 months of follow-up. Methods: Seventy-five patients were randomly assigned to standard care or standard care plus mobile app (2:1) using an online randomizer system. The mobile app delivered high-intensity lifestyle counseling for diet and physical activity. Results: At six months of follow-up, the M-App group showed significantly lower dropout rates compared to standard care (p = 0.01). The risk of dropout was significantly higher in controls compared to the intervention group (OR 3.86, 95% C.I. 1.39–10.42, p = 0.01). After one year, we observed lower albeit non-statistically significant dropout rates in the M-App compared to the standard care group (p = 0.24). No differences were observed in z-score BMI and percentage of BMI reduction between the two groups. Conclusions: Our findings suggest that the mobile app might help in the clinical management of children and adolescents with obesity in terms of dropout reduction. Full article
(This article belongs to the Special Issue Advances in the Management of Children and Adolescents with Obesity)
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14 pages, 273 KiB  
Article
Weight Status Determines the Impact of a School-Based Nutrition Education Intervention on Lifestyle Behaviors in Children
by María L. Miguel-Berges, Alicia Larruy-García, Pilar De Miguel-Etayo, Andrea Jimeno-Martinez, Antonio Torres and Luis A. Moreno
Children 2024, 11(9), 1093; https://doi.org/10.3390/children11091093 - 6 Sep 2024
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Abstract
Background/Objectives: This study investigated the impact of the FLUYE school-based intervention on children’s lifestyle behaviors, Mediterranean diet adherence, and emotional well-being in Spain. The objective was to promote healthy habits through nutrition education, physical activity, and emotional support within the school environment, with [...] Read more.
Background/Objectives: This study investigated the impact of the FLUYE school-based intervention on children’s lifestyle behaviors, Mediterranean diet adherence, and emotional well-being in Spain. The objective was to promote healthy habits through nutrition education, physical activity, and emotional support within the school environment, with a focus on addressing the needs of both normal-weight and overweight/obese children. Methods: A total of 552 children aged 3 to 12 years participated in the study, with data collected at baseline (T0) and follow-up (T1). The intervention was designed to integrate health education into the school curriculum, emphasizing the development of personal competencies in diet, physical activity, and emotional well-being. The analysis included changes in dietary habits, screen time, physical activity, and psychosocial outcomes, with comparisons made between the normal-weight and overweight/obese groups. Results: Significant improvements were observed in water consumption and reductions in sugar-sweetened beverage intake across both weight groups. However, an increase in screen time, particularly among normal-weight children, highlighted ongoing challenges in reducing sedentary behavior. Adherence to the Mediterranean diet improved more significantly in the overweight/obese group, suggesting the program’s effectiveness in promoting healthier eating patterns among at-risk children. Emotional well-being and self-esteem also saw significant enhancements, with children reporting increased feelings of pride and positivity post-intervention. Conclusions: The FLUYE program effectively improved various aspects of children’s lifestyle behaviors, particularly in dietary habits and emotional well-being. These findings underscore the importance of comprehensive, school-based interventions that address both physical and psychosocial aspects of health, especially for children at higher risk for obesity. Full article
(This article belongs to the Special Issue Advances in the Management of Children and Adolescents with Obesity)
14 pages, 386 KiB  
Article
The Association between Social Isolation and Physical Activity among Korean Adolescents
by Sarang Jang and Na-Young Park
Children 2024, 11(8), 1003; https://doi.org/10.3390/children11081003 - 16 Aug 2024
Viewed by 1529
Abstract
Objectives: This study investigated the impact of structural isolation within peer relationships on physical activity levels among Korean adolescents, exploring how different types of social isolation within classroom networks influence physical activity. Methods: This study utilized cross-sectional survey data. Specifically, using data from [...] Read more.
Objectives: This study investigated the impact of structural isolation within peer relationships on physical activity levels among Korean adolescents, exploring how different types of social isolation within classroom networks influence physical activity. Methods: This study utilized cross-sectional survey data. Specifically, using data from the 8th Korean Children and Youth Happiness Index survey (2016), which included 3356 middle and high school students in Korea, the study employed binary logistic regression and social network analysis to assess the relationship between social isolation and physical activity. Based on types of isolation, adolescents were categorized into social avoidant, actively isolated and socially indifferent groups. Results: The analysis demonstrated significant differences in physical activity based on social isolation status (χ2 = 13.0, p < 0.001) and types of social isolation (χ2 = 18.3, p < 0.001). Key variables such as gender, household subjective economic status, and self-rated health significantly influenced physical activity. The number of physically active friends had a considerable impact on both non-isolated groups (OR = 1.31, p < 0.001) and the actively isolated group (OR = 1.42, p < 0.05). The actively isolated group exhibited the highest explanatory power in the logistic regression models (Nagelkerke R² = 0.230). Conclusions: This study has highlighted that not only social isolation but also the type of isolation significantly influences physical activity among adolescents. Understanding these distinctions and tailoring interventions accordingly are crucial for promoting physical activity among socially isolated adolescents. Full article
(This article belongs to the Special Issue Advances in the Management of Children and Adolescents with Obesity)
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13 pages, 258 KiB  
Article
Investigating the Sociodemographic and Health Characteristics of Non-Sugar Sweeteners Consumption in Greek School-Aged Children: A Cross-Sectional Study
by Kyriaki Apergi, Olga Malisova, Antonis Vlassopoulos, Philippa Fidanoglou, Aikaterini Kandyliari and Maria Kapsokefalou
Children 2024, 11(7), 813; https://doi.org/10.3390/children11070813 - 2 Jul 2024
Cited by 1 | Viewed by 1141
Abstract
Background/Objectives: The childhood consumption of non-sugar-sweetened (NSS) soft drinks is a growing concern due to its potential health implications. This study investigated demographic, anthropometric, and lifestyle factors influencing NSS soft drink consumption among children. Methods: A sample of 1304 children and their parents [...] Read more.
Background/Objectives: The childhood consumption of non-sugar-sweetened (NSS) soft drinks is a growing concern due to its potential health implications. This study investigated demographic, anthropometric, and lifestyle factors influencing NSS soft drink consumption among children. Methods: A sample of 1304 children and their parents were surveyed. Results: Analysis revealed that nearly 60% reported consuming NSS soft drinks at least once a week. Also, positive associations were found between NSS soft drink consumption and lower socioeconomic status, increased total beverage consumption, higher maternal BMI, and parental soft drink habits. However, upon employing multivariable models, only the association between total and NSS soft drinks consumption remained statistically significant (OR = 18.925, p < 0.05 for children; OR = 3.801, p < 0.05 for parents), highlighting the pivotal role of parental behavior in shaping children’s consumption patterns. Conclusions: These findings emphasize the importance of tracking parental habits, revealing a strong correlation between parental behavior and children’s soft drink consumption patterns. Understanding these factors is crucial for developing effective public health strategies for children, which should prioritize not only individual behaviors but also parental modeling and household dynamics. Full article
(This article belongs to the Special Issue Advances in the Management of Children and Adolescents with Obesity)
16 pages, 326 KiB  
Article
Prevalence of the Double Burden of Malnutrition among Adolescents: Associations with Lifestyle Behaviors and Clusters of Social Determinants
by Raytta Silva Viana, Marcus Vinicius Nascimento-Ferreira, Beatriz D. Schaan, Katia Vergetti Bloch, Kênia Mara Baiocchi de Carvalho, Felipe Vogt Cureau and Augusto César Ferreira De Moraes
Children 2024, 11(6), 620; https://doi.org/10.3390/children11060620 - 22 May 2024
Cited by 1 | Viewed by 2075
Abstract
The double burden of malnutrition (DBM) is a condition in which malnutrition coexists with overweight, reflecting a new layer of malnutrition. Our objectives were to assess prevalence; test associations between DBM and 24-hour movement behaviors; and investigate whether DBM is associated with clusters [...] Read more.
The double burden of malnutrition (DBM) is a condition in which malnutrition coexists with overweight, reflecting a new layer of malnutrition. Our objectives were to assess prevalence; test associations between DBM and 24-hour movement behaviors; and investigate whether DBM is associated with clusters of social determinants. Methods: This multicenter cross-sectional study included 1152 adolescents (12 to 17 years old) from four Brazilian cities. Body mass index (BMI, kg/m2) was used to estimate overweight, and the adopted cutoff points took into account the curves established for age and sex: Z-score > 1 and ≤2 (overweight) and Z-score > 2 (obesity). The serum concentration of 25-hydroxyvitamin D [25(OH)D] was stratified into three levels: vitamin D deficiency ≤ 20 ng/mL; vitamin D insufficiency = 21–29 ng/mL; optimal vitamin D ≥ 30 ng/mL. We used multilevel Poisson regression models to estimate prevalence ratios (PRs) and their respective 95% confidence intervals (95%CI) and to analyze the association between DBM and covariates. A significance level of p < 0.05 was considered. Cluster analyses were performed by applying a combination of hierarchical and non-hierarchical methods. Results: A population prevalence of DBM of 7.3% (95% CI: 5.9–8.9) was revealed. A percentage of 19.2% (95% CI: 17.0–21.6) of adolescents were overweight, and 8.3% (95% CI: 6.8–10.1) were obese. A total of 41.5% (95% CI: 38.7–44.4) had vitamin D deficiency, and 25.8% (95% CI: 23.4–28.4) had vitamin D insufficiency. However, 24-hour movement behaviors were not associated with DBM. Adolescents living in the southern region of the country, from public schools whose mothers have higher education, have a 1.94 [PR = 2.94 (95% CI: 1.20–7.23)] times greater chance of developing DBM. These results highlight the importance of specific factors to improve the nutritional health of adolescents, considering the specific social determinants identified in this study. Full article
(This article belongs to the Special Issue Advances in the Management of Children and Adolescents with Obesity)
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Other

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16 pages, 1328 KiB  
Systematic Review
Evaluation of Family-Based Interventions as a Therapeutic Tool in the Modulation of Childhood Obesity: A Systematic Review
by Diego Fernández-Lázaro, Ana M. Celorrio San Miguel, Evelina Garrosa, Ana M. Fernández-Araque, Juan Mielgo-Ayuso, Enrique Roche and Soledad Arribalzaga
Children 2024, 11(8), 930; https://doi.org/10.3390/children11080930 - 31 Jul 2024
Viewed by 2246
Abstract
Childhood obesity is a major public health burden. The prevalence of weight excess for children and the adolescent population (8 to 16 years) is 34.9%. During childhood, lifestyles are acquired, which are developed in adulthood. In this context, the role of parents is [...] Read more.
Childhood obesity is a major public health burden. The prevalence of weight excess for children and the adolescent population (8 to 16 years) is 34.9%. During childhood, lifestyles are acquired, which are developed in adulthood. In this context, the role of parents is crucial, since they are the model to imitate. We aimed to evaluate the current evidence on the effects of family-based interventions as a tool in the treatment of childhood obesity. We reviewed studies indexed in several databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Original articles published from 1 January 2014 to 30 May 2024 with a controlled trial design were considered, in which family-based interventions were carried out compared to a control group or to data before the intervention. Although 148 records were identified in the search, 6 studies met inclusion criteria. Overall, studies reported beneficial effects of family-based interventions on improving anthropometric parameters: BMI z-score, BMI, waist circumference, and body fat percentage. Regarding nutritional and physical activity guidelines, general recommendations must consider increased consumption of fruits and vegetables, reducing sugary drinks, controlled screen time, and 30–60 min of physical activity/day. Thus, family-based interventions could be an effective non-pharmacological strategy for modulating childhood obesity, allowing families to modify their lifestyles. Full article
(This article belongs to the Special Issue Advances in the Management of Children and Adolescents with Obesity)
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