Risk Factors, Clinical Consequences, Prevention, and Treatment of Childhood Obesity

Exploring the Link between Oxidative Stress, Selenium Levels, and Obesity in Youth

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.

Changes in Muscle Mass and Strength in Adolescents Following High-Intensity Functional Training with Bodyweight Resistance Exercises in Physical Education Lessons

(1) Background: The growing prevalence of obesity, diabetes, hypertension, and declining physical fitness among children and adolescents due to sedentary lifestyles has increased attention toward preventive intervention to tackle this issue. This study investigated the age-related effects of high-intensity functional training (HIFT), based on bodyweight resistance exercises conducted during physical education lessons, on muscle mass and strength improvement. (2) Methods: Adolescent males (n = 116) were allocated to four HIFT experimental groups (EGs) and four standard physical education program control groups (CGs) according to age (15, 16, 17, and 18 years [y]). The changes in muscle mass (absolute and relative to height [SMI]), hand-grip strength (HGS), sit-ups (SUs), and standing broad jump (SBJ) were analyzed using two-way analysis of variance (ANOVA) with Bonferroni tests. (3) Results: HIFT significantly increased muscle mass and scores in all strength tests (p < 0.01), while chronological age was significant for HGS (p < 0.01). Interactions between HIFT and chronological age categories were observed for HGS (p = 0.01) and SBJ (p < 0.03). Detailed post hoc tests revealed improvement in muscle mass across all chronological age categories for both approaches (p < 0.05). The 18y-EG group improved HGS over their control peers (p < 0.01), the EG groups significantly improved their SU results (p < 0.01), and SBJ improved in the 15y-EG and 18y-EG groups compared to their control (p < 0.01). (4) Conclusions: This research highlights the effectiveness of a school-based HIFT program in promoting muscle mass gains and enhancing muscle strength among adolescents. The findings offer valuable insights for implementing bodyweight exercises during physical education classes.

The relationship between attitude toward physical activity and weight gain in children and young adolescence

Introduction

The purpose of this study was to investigate the association between attitudes toward physical activity and weight gain among children and young adolescents with an additional focus on the impact of gender on these attitudes.

Methods

Employing a descriptive survey method, data were systematically gathered via purposive sampling from 11 specific cities in Türkiye, ensuring representation from all seven regions. A total of 3,138 students, aged between 9 and 14 years, participated in this study, with a distribution of 46% girls and 54% boys. To assess the attitudes of children and young adolescents toward physical activity, the Youth Physical Activity Attitude Scale was utilized. Height and body weight measurements were taken to determine the body mass index of participants. SPSS 26.0 software facilitated the statistical analyses, including Pearson correlation analysis to explore relationships between variables. Multivariate Analysis of Variance was employed to evaluate the impact of age, BMI, and gender on attitudes toward physical activity.

Results

Participants classified as normal weight exhibited a more positive attitude towards physical activity compared to their obese and overweight counterparts. Moreover, a significant gender difference emerged, with boys demonstrating significantly higher positive attitudes toward physical activity than girls. However, no significant difference was observed in negative attitudes based on gender. The study also revealed that an escalation in negative attitudes towards physical activity correlated with students being categorized as underweight, overweight, or obese, as opposed to having a normal weight status. Additionally, a statistically significant divergence in both positive and negative attitudes towards physical activity was found based on age. Specifically, the results indicated that students aged 9 and 14 exhibited lower levels of positive attitude when contrasted with their counterparts of different age groups. Conversely, in the domain of negative attitudes, students at the age of 9 scored higher than their peers in other age categories.

Discussion

Attitudes towards physical activity can serve as a convenient indicator and guide for assessing the effectiveness of various practices or interventions aimed at promoting physical activity, with recognition of the significant gender difference in positive attitudes among children and young adolescents.

The Impact of Excessive Fructose Intake on Adipose Tissue and the Development of Childhood Obesity

Worldwide, childhood obesity cases continue to rise, and its prevalence is known to increase the risk of non-communicable diseases typically found in adults, such as cardiovascular disease and type 2 diabetes mellitus. Thus, comprehending its multiple causes to build healthier approaches and revert this scenario is urgent. Obesity development is strongly associated with high fructose intake since the excessive consumption of this highly lipogenic sugar leads to white fat accumulation and causes white adipose tissue (WAT) inflammation, oxidative stress, and dysregulated adipokine release. Unfortunately, the global consumption of fructose has increased dramatically in recent years, which is associated with the fact that fructose is not always evident to consumers, as it is commonly added as a sweetener in food and sugar-sweetened beverages (SSB). Therefore, here, we discuss the impact of excessive fructose intake on adipose tissue biology, its contribution to childhood obesity, and current strategies for reducing high fructose and/or free sugar intake. To achieve such reductions, we conclude that it is important that the population has access to reliable information about food ingredients via food labels. Consumers also need scientific education to understand potential health risks to themselves and their children.

Constipation: A Pristine Universal Pediatric Health Delinquent

Constipation suffered by children is a global public health problem. Functional constipation (FC) brings about deteriorating effects in the children's lives who suffer from it. The risk factors for the development of constipation include the consumption of a diet low in fiber and high in calories (such as the consumption of fast food), a sedentary lifestyle with a lack of exercise, a family history of constipation, and emotional and psychological stress endured by children in their families. It is one of the most common causes of stomachaches in children. FC may lead to fecal incontinence (FI), anal fissures, recurrent urinary tract infections (RUTI), and enuresis in children. Severe constipation may result in stool becoming rock-hard and inflexible in the rectum, which is clinically identified as fecal impaction. It is imperative to perform clinical evaluation and treatment, including pharmacological (the use of stimulant and osmotic laxatives) and non-pharmacological (education, changes in diet, intervention to promote positive behavior and address any emotional issues, toilet training, and physiotherapy for the pelvic floor) interventions. In the case of refractory patients, neuromodulation, the irrigation of the anal canal, and surgical management may be needed. It is essential to lead a healthy, stress-free lifestyle with plenty of exercise and a balanced diet rich in fiber (such as fruits and vegetables) so children can have regular bowel habits and thrive.

Childhood Mediterranean Diet Adherence Is Associated with Lower Prevalence of Childhood Obesity, Specific Sociodemographic, and Lifestyle Factors: A Cross-Sectional Study in Pre-School Children

BACKGROUND

The Mediterranean diet (MD) has been related with a decreased probability of overweight/obesity as well as central obesity at all stages of the human life, decreasing the risk of diverse disease states and improving quality of life. Over the last few years, the prevalence of childhood overweight/obesity and especially abdominal obesity has highly increased worldwide, being associated with a higher likelihood of overweight/obesity as well as central obesity at the next stages of the life during adulthood. The purpose of the present study was to explore the relationship of MD compliance with sociodemographic, anthropometry and lifestyle features in pre-school children aged 2-5 years old.

METHODS

This is a cross-sectional study, which includes 5188 pre-school children from diverse regions of Greece. Relevant questionnaires were applied to evaluate the sociodemographic features of the enrolled children. Anthropometric parameters were measured by relevant techniques. Qualified questionnaires were utilized for assessing several lifestyle factors such as physical activity, quality of life, breastfeeding practices, MD adherence, as well as the prevalence of childhood asthma and diabetes mellitus type I.

RESULTS

Of the enrolled children, 41.7% showed low MD compliance and 36.4% of them indicated moderated compliance, while only 21.9% of them showed a high MD adherence. Overweight/obesity was noted in 24.2% of the assigned children, while abdominal obesity was noticed in 18.2% of them. Higher MD compliance was related with an elevated prevalence of sex (boys, p = 0.0005), Greek nationality (p = 0.0088), rural type of residence (p = 0.0099), childhood overweight/obesity (p < 0.0001) and abdominal obesity (p < 0.0001), lower childbirth weight (p < 0.0001), increased physical activity (p = 0.0041), improved quality of life (p = 0.0008), exclusive breastfeeding (p < 0.0001), childhood asthma (p = 0.0001) and diabetes mellitus type 1 (p = 0.0002).

CONCLUSIONS

A higher MD adherence is associated with specific sociodemographic, better anthropometric, and beneficial lifestyle factors in pre-school children. However, MD compliance remains low or moderate in the vast majority of children aged 2-5 years old. Thus, future public strategies and policies should be performed to inform parents of the potential beneficial effects of MD against obesity and related chronic diseases at the next stage of their children's lives.

Screen Time and Its Health Consequences in Children and Adolescents

Nowadays, children and adolescents are exposed to digital media (DM) from an early age. Therefore, specific guidelines have been published by the World Health Organization, whose aim is to limit daily screen time (ST) viewing. However, during the COVID-19 pandemic, a rise in DM use, and consequently ST viewing, was observed. More and more aspects of modern life are thought to be affected by excessive ST viewing. Accordingly, the aim of this review is to document the health effects of excessive ST viewing on children and adolescents. A narrative review was performed in searchable databases. In total, 43 original articles were considered. Excessive ST viewing was correlated with increased risk for obesity and other cardiometabolic risk factors, mental health, unhealthy dietary habits and eating disorders, and problems in development and child-parent relationships. Sleep, physical activity, eyesight, headaches, and the musculoskeletal system were negatively affected as well. However, the effect of ST was weighted by the type of media used and the way types of media were used. Other confounding factors were reported. There is evidence to suggest a negative correlation between excessive ST and youth health exists. Nevertheless, more research is needed if this correlation is to be established.

Serum Concentrations and Dietary Intake of Vitamin B12 in Children and Adolescents on Metformin: A Case-Control Study

The International Society of Pediatric and Adolescent Diabetes (ISPAD) recommends metformin (MET) use for metabolic disturbances and hyperglycemia, either in combination with insulin therapy or alone. A caveat of MET therapy has been suggested to be biochemical vitamin B₁₂ deficiency, as seen mainly in studies conducted in adults. In the present case-control study, children and adolescents of different weight status tiers on MET therapy for a median of 17 months formed the cases group (n = 23) and were compared with their peers not taking MET (n = 46). Anthropometry, dietary intake, and blood assays were recorded for both groups. MET group members were older, heavier, and taller compared with the controls, although BMI z-scores did not differ. In parallel, blood phosphorus and alkaline phosphatase (ALP) concentrations were lower in the MET group, whereas MCV, Δ₄-androstenedione, and DHEA-S were higher. No differences were observed in the HOMA-IR, SHBG, hemoglobin, HbA1c, vitamin B₁₂, or serum 25(OH)D₃ concentrations between groups. Among those on MET, 17.4% exhibited vitamin B₁₂ deficiency, whereas none of the controls had low vitamin B₁₂ concentrations. Participants on MET therapy consumed less energy concerning their requirements, less vitamin B₁₂, more carbohydrates (as a percentage of the energy intake), and fewer fats (including saturated and trans fats) compared with their peers not on MET. None of the children received oral nutrient supplements with vitamin B₁₂. The results suggest that, in children and adolescents on MET therapy, the dietary intake of vitamin B₁₂ is suboptimal, with the median coverage reaching 54% of the age- and sex-specific recommended daily allowance. This low dietary intake, paired with MET, may act synergistically in reducing the circulating vitamin B₁₂ concentrations. Thus, caution is required when prescribing MET in children and adolescents, and replacement is warranted.