Childhood obesity — who is to blame and what can be done?

Aim of the study: We aimed to examine the relationship between various diet quality scores and obesity and Metabolic Syndrome (MetS) in children and adolescents.

Results: Obesity and MetS, which increase the risk of type 2 diabetes and cardiovascular disease from childhood through adolescence, have been associated with adherence to various diet quality scores. A systematic search was performed in PubMed/Medline, Scopus, SciELO, Embase, and Cochrane, covering the period until March 2024. Two researchers evaluated 3,519 studies according to the inclusion criteria. Finally, 73 articles that analysed the relationship between diet quality scores and obesity and MetS were included, and 6 of them were included in a meta-analysis. Children younger than 12 years old showed statistically significant differences indicating a higher Mediterranean diet (MD) score adherence compared to those with a low score adherence for BMI (MD = 0.33 kg/m2, 95% CI: 0.01, 0.64) and WC values (MD = 1.21 cm, 95% CI: 0.50, 1.93).

Aim of the study: The prevalence of childhood obesity is increasing worldwide with long-term health consequences. Effective strategies to stem the rising childhood obesity rates are needed but systematic reviews of interventions have reported inconsistent effects.

Results: Thirteen (46%) interventions led to improvements in childhood obesity measures, including body mass index z-score and body fat percentage, 12 of which included both parental/family-based interventions in conjunction with modifying the child's diet and physical activity behaviours. Home-based interventions were identified as the most effective setting as four out of five studies reported significant changes in the child's weight outcomes. Interventions conducted in the home setting and those which included parents/families were effective in preventing childhood obesity. These findings should be considered when developing optimal strategies for the prevention of childhood obesity.

Aim of the study: A healthy diet is essential to prevent childhood obesity, however, adherence to a healthy diet is challenging. The aim of this study was to give a comprehensive overview of the literature investigaating associations between food and beverages and overweight/obesity in children and adolescents in order to identify dietary risk factors.

Results: Furthermore, higher intake of meat (OR 1.02, p < 0.05 (n:7)) and refined grains (OR 1.28, p < 0.05 (n:3)) was associated with an increased risk of overweight/obesity. In contrast, higher intake of whole grain (OR 0.86, p = 0.04 (n:5)) and more surprisingly sweet bakery (OR 0.59, p < 0.05 (n:3)) was associated with a decreased risk of overweight/obesity. In conclusion, a higher intake of sugar-sweetened beverages and a higher intake of fast food was identified as the primary dietary risk factors for overweight/obesity. Future research is needed to strengthen the generalizability of these results.

Aim of the study: This study assessed associations between ultraprocessed food consumption and dietary nutrient profile linked to obesity in children and adolescents in Argentina, Australia, Brazil, Chile, Colombia, Mexico, the United Kingdom, and the United States using nationally representative data collected between 2004 and 2014.

Results: Linear regression models were used to evaluate associations between dietary share of ultraprocessed foods (country and age group-specific quintiles and a 10% share increase) and the energy density of diets and their content of free sugars and fiber. Ultraprocessed foods, defined by the NOVA system, ranged from 18% of total energy intake among preschool children in Colombia to 68% among adolescents in the United Kingdom. In almost all countries and age groups, increases in the dietary share of ultraprocessed foods were associated with increases in energy density and free sugars and decreases in fiber, suggesting that ultraprocessed food consumption is a potential determinant of obesity in children and adolescents. Effective global policy action to address growing ultraprocessed food consumption and childhood obesity is urgently needed.

Aim of the study: Childhood obesity has emerged as an important public health problem in the United States and other countries in the world. Currently 1 in 3 children in the United States is afflicted with overweight or obesity.

Results: There is limited information on the efficacy and safety of medications for weight loss in children. Bariatric surgery has been found to be effective in decreasing excess weight and improving comorbidities in adolescents with severe obesity. However, there are limited data on the long-term efficacy and safety of bariatric surgery in adolescents. For this comprehensive review, the literature was scanned from 1994 to 2016 using PubMed using the following search terms: childhood obesity, pediatric obesity, childhood overweight, bariatric surgery, and adolescents.

Aim of the study: Currently, food marketing for unhealthy foods is omnipresent. Foods high in fat, salt, and sugar (HFSS) are advertised intensively on several media platforms, including digital platforms that are increasingly used by children, such as social media, and can be bought almost everywhere.

Results: As the majority of children and adolescents do not eat the recommended amount of fruits and vegetables (F&V), which leads to chronic diseases, we need to change the obesogenic environment to a healthogenic environment. Reducing the marketing of energy-dense snacks to children and increasing the promotion of healthier foods, such as fruits and vegetables, may be an effective and necessary instrument to improve the dietary intake of children and reduce the risk of their experiencing some chronic diseases later in life. With this focused narrative review, we provide an overview of how children and adolescents react to food promotions and how food promotional efforts might be a useful tool to increase the attractiveness of fruit and vegetables.

Aim of the study: Childhood obesity is a leading public health challenge with rising global prevalence and significant impacts on cardiometabolic health extending into adulthood. Lifestyle intervention, with nutrition as its central component, is the main point of paediatric obesity management, yet the evidence base remains fragmented across regions, instruments, and clinical models.

Results: Low KIDMED score additionally functions as a screening signal for paediatric Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD). Continental comparisons suggest that dietary-quality predictors of paediatric obesity are broadly consistent across regions. However, the feasibility of Mediterranean-style approaches varies substantially with local food availability, culinary traditions and economic access, so cross-cultural application of KIDMED-based screening requires careful local adaptation. The review concludes that routine integration of KIDMED and CEBQ within structured multidisciplinary pathways represents an evidence-informed, implementation-ready step for pediatric obesity care, particularly in under-studied Central and Eastern Europe.

Aim of the study: Background/Objectives: Maternal diet plays a crucial role in fetal development and may influence offspring weight development. Although fruits and vegetables provide nutritional and metabolic benefits during pregnancy, evidence regarding their specific role on childhood overweight/obesity remains limited.

Results: Results: Higher maternal consumption of fruits and vegetables was inversely associated with overweight/obesity in children (OR: 0.31 [0.13-0.74]). No associations were observed for total or natural fruit juice, whereas higher consumption of commercial fruit juice was associated with increased odds of overweight/obesity (OR: 2.48 [1.06-5.78]). Conclusions: Higher maternal combined consumption of fruits and vegetables during pregnancy was associated with lower odds of overweight or obesity in offspring at 4 years of age, whereas the opposite association was observed for commercial, but not natural, fruit juice. These associations may involve both prenatal biological and postnatal behavioral and family dietary pathways; however, the commercial fruit juice finding should be considered exploratory and requires confirmation in larger prospective studies.

Aim of the study: Healthy dietary patterns (DP) in early life constitute an internationally recommended platform for preventing childhood obesity. New Zealand (NZ) ranks high globally for the prevalence of child obesity.

Results: Compared with females in the lowest tertile of adherence to a DP characterised by high intake of refined foods and those high in sugar, salt and unhealthy fats, those in the middle (PR: 1·56; 95 % CI 1·07-2·28; p = 0·021) and third tertile (PR: 2·14; 95 % CI 1·48-3·10; p < 0·001) had a higher prevalence of overweight/obesity (BMI/A). Scores in this DP were not associated with BMI/A > +2z in males nor with WtHR > 90th percentile in either sex. There were no associations between the tertiles of a DP characterised by high intake of fruit, vegetables and protein foods, and the two adiposity indicators examined for both sexes. Overall, poorer diet quality was linked to obesity at 54 months, with sex-specific effects, supporting national early childhood obesity prevention strategies targeting foods high in sugar, salt and unhealthy fats.

Results: Socioeconomic vulnerability influences children's dietary habits and contributes to obesity risk over time. These findings underscore the need for public health interventions targeting vulnerable populations to improve diet quality and reduce health disparities.