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Nutrients
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Obesity in Childhood and Adolescence: Etiology, Prevention and Treatment
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Obesity in Childhood and Adolescence: Etiology, Prevention and Treatment

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

Deadline for manuscript submissions: 5 March 2025 | Viewed by 10240

Special Issue Editors

Dr. Odysseas Androutsos

E-Mail Website
Guest Editor
Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece
Interests: human nutrition; dietetics; childhood obesity; non communicable diseases
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Evangelia Charmandari

E-Mail Website
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 from childhood and adolescence. Still, their exact role, interplay, and mechanisms implicated in this process remain unclear. The trends in childhood obesity call for actions regarding the prevention and management of this disease early in life.

The Special Issue, “Obesity in Childhood and Adolescence: Etiology, Prevention and Treatment”, aims to host original articles, (systematic) reviews, and 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 and/or management of obesity in youth.

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

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

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

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Published Papers (5 papers)

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Research

Jump to: Review

19 pages, 735 KiB  
Article
The Role of Secreted Frizzled-Related Protein 5 (Sfrp5) in Overweight and Obesity in Childhood and Adolescence
by Diamanto Koutaki, George Paltoglou, Maria Manou, Aikaterini Vourdoumpa, Eleni Ramouzi, Anastasia-Maria Tzounakou, Athanasios Michos, Flora Bacopoulou, Emilia Mantzou, Emmanouil Zoumakis, Marina Papadopoulou, Penio Kassari and Evangelia Charmandari
Nutrients 2024, 16(18), 3133; https://doi.org/10.3390/nu16183133 - 17 Sep 2024
Viewed by 1393
Abstract
Background/Objective: Secreted frizzled-related protein 5 (Sfrp5) is an anti-inflammatory adipokine that has been implicated in the pathophysiology of obesity and its metabolic complications. Despite the fact that numerous studies have been carried out in adults, limited data on Sfrp5 exist for youth, especially [...] Read more.
Background/Objective: Secreted frizzled-related protein 5 (Sfrp5) is an anti-inflammatory adipokine that has been implicated in the pathophysiology of obesity and its metabolic complications. Despite the fact that numerous studies have been carried out in adults, limited data on Sfrp5 exist for youth, especially in relation to overweight and obesity. Methods: In our study, we assessed the concentrations of Sfrp5, total oxidative (TOS) and antioxidative (TAS) status, high-sensitivity C-reactive protein (hs-CRP), and several cytokines (IL-1α, IL-1β, IL-2, IL-6, IL-8, IL-12, TNF-α) in 120 children and adolescents (mean age ± SE: 11.48 ± 0.25 years; 48 prepubertal, 72 pubertal; 74 males and 46 females) before and 1 year after the implementation of a personalized, structured, lifestyle intervention program of healthy diet, sleep, and physical exercise. Results: Based on the body mass index (BMI), participants were categorized as having morbid obesity (n = 63, 52.5%), obesity (n = 21, 17.5%), overweight (n = 22, 18.33%), or normal BMIs (n = 14, 11.67%), based on the International Obesity Task Force (IOTF) cut-off points. Following the 1-year lifestyle intervention program, a significant improvement in anthropometric measurements (BMI, BMI-z score, diastolic blood pressure, WHR, and WHtR), body-composition parameters, hepatic enzymes, lipid profile, inflammation markers, and the insulin-sensitivity profile (HbA1C, HOMA index) was observed in all subjects. Sfrp5 decreased in subjects with obesity (p < 0.01); however, it increased significantly (p < 0.05) in patients with morbid obesity. Linear regression analysis indicates that TNF-α and systolic blood pressure were the best positive predictors and hs-CRP was the best negative predictor for Sfpr5 concentration at initial assessment and glucose concentration for ΔSfrp5, while TNF-α and TAS were the best positive predictors for Sfpr5 concentration at annual assessment. Conclusions: These results indicate that Sfrp5 is associated with severe obesity and is increased following weight loss in children and adolescents with morbid obesity. It is also related to metabolic homeostasis, as well as inflammation and oxidative status. Full article
(This article belongs to the Special Issue Obesity in Childhood and Adolescence: Etiology, Prevention and Treatment)
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Figure 1

Figure 1
<p>Concentrations of Sfrp5 at initial and annual assessment. The asterisk (*) indicates statistically significant difference.</p> Full article ">Figure 2
<p>BMI <span class="html-italic">z</span>-score at initial and annual assessment based on BMI category. *: indicates significant difference from initial assessment. †: indicates significant difference from subjects with morbid obesity. ‡: indicates significant difference from subjects with obesity. #: Indicates significant difference from subjects with overweight.</p> Full article ">
12 pages, 1325 KiB  
Article
Exploring the Role of Serum Osteonectin and Hsp27 in Pediatric MAFLD Diagnosis and Cardiometabolic Health
by Anca Bălănescu, Paul-Cristian Bălănescu, Ioana Florentina Codreanu, Iustina-Violeta Stan, Valentina-Daniela Comanici, Alina Maria Robu and Tatiana Ciomârtan
Nutrients 2024, 16(6), 866; https://doi.org/10.3390/nu16060866 - 16 Mar 2024
Viewed by 1430
Abstract
Background: Childhood obesity is one of the major challenges of public health policies. The problem of fatty liver in childhood, known as MAFLD (metabolic dysfunction-associated fatty liver disease), is of particular interest as the gold standard diagnosis technique is invasive (liver biopsy). Hence, [...] Read more.
Background: Childhood obesity is one of the major challenges of public health policies. The problem of fatty liver in childhood, known as MAFLD (metabolic dysfunction-associated fatty liver disease), is of particular interest as the gold standard diagnosis technique is invasive (liver biopsy). Hence, efforts are made to discover more specific biomarkers for the MAFLD signature. Therefore, the aim of the study was to evaluate Osteonectin and Hsp27 as biomarkers for MAFLD diagnosis and to assess their links with auxological and biochemical profiles of overweight and obese pediatric subjects. Methods: A cross-sectional study in which we (re)analyzed data from the MR PONy cohort comprising 71 pediatric subjects. Auxological data, liver ultrasonography and biochemical serum profile were recorded. Lipid-derived indices and body composition indices were calculated. Nevertheless, serum Osteonectin and Hsp27 levels were assessed using an ELISA approach. Results: MAFLD prevalence was 40.8%. Higher Osteonectin levels were noted in MAFLD subjects versus non-MAFLD subjects and in dyslipidemic children regardless of their liver function status. Lipid-derived indices had good diagnostic capacity for MAFLD. Conclusions: We confirm Osteonectin as a MAFLD diagnosis biomarker in children. Also, lipid-derived indices are useful as metabolic-associated organ impairment markers in children even before the onset of obesity. Full article
(This article belongs to the Special Issue Obesity in Childhood and Adolescence: Etiology, Prevention and Treatment)
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Figure 1

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<p>Serum Osteonectin (SPARC) levels in non-MAFLD compared to MAFLD overweight and obese children. Differences are statistically significant, with <span class="html-italic">p</span> = 0.003 (Mann–Whitney U test). *—outliers.</p> Full article ">Figure 2
<p>Serum Hsp27 levels in non-MAFLD compared to MAFLD overweight and obese children Differences are not statistically significant, with <span class="html-italic">p</span> = 0.52 (Mann–Whitney U test). *—outliers.</p> Full article ">Figure 3
<p>ROC curves of TMI and BMI for MAFLD diagnosis.</p> Full article ">Figure 4
<p>ROC curves of serum SPARC, TG/HDL ratio, AIP and VAI for MAFLD diagnosis in overweight and obese children. AUROC for serum SPARC being 0.72 with a 95% CI (0.59–0.84), AUROC for the TG/HDL ratio being 0.77 with a 95% CI (0.65–0.89), AUROC for VAI being 0.77 with a 95% CI (0.65–0.89), AUROC for AIP being 0.77 with a 95% CI (0.65–0.89).</p> Full article ">
14 pages, 1606 KiB  
Article
Relative Body Mass Index Improves the BMI Percentile Performance for Detection and Monitoring of Excess Adiposity in Adolescents
by Pedro A. Velasquez-Mieyer, Ramfis Nieto-Martinez, Claudia P. Neira, Diana De Oliveira-Gomes, Andres E. Velasquez Rodriguez, Eunice Ugel and Patricia A. Cowan
Nutrients 2024, 16(5), 703; https://doi.org/10.3390/nu16050703 - 29 Feb 2024
Cited by 1 | Viewed by 1469
Abstract
Obesity is defined as excess adipose tissue; however, commonly used methods may under-detect adiposity in adolescents. This study compared the performance of body mass index percentile (BMI%) and relative body mass index (RBMI) in identifying excess body fat percentage (BF%) and estimated RBMI [...] Read more.
Obesity is defined as excess adipose tissue; however, commonly used methods may under-detect adiposity in adolescents. This study compared the performance of body mass index percentile (BMI%) and relative body mass index (RBMI) in identifying excess body fat percentage (BF%) and estimated RBMI cut points to better stratify severity of adiposity. In 567 adolescents ages 11–19 year, BF% measured by DXA was used to compare BMI% and RBMI performance at different degrees of adiposity. RBMI cut points for adiposity detection were derived via ROC curve analysis. BF% was strongly correlated with BMI% (r = 0.889, p < 0.001) and RBMI (r = 0.901, p < 0.001). However, RBMI exhibited less dispersion and better discriminated the relationship with BF% independent of age, race, and gender. Both BMI% and RBMI performed similarly for detecting high BF% (≥25 BF% in males; ≥30 BF% in females). Nonetheless, the relationship of BMI% with BF% was diminished among leaner adolescents. RBMI detected overweight in 21.3% more females and 14.2% more males. RBMI improved the detection of excess adiposity in individuals otherwise classified as having normal weight or overweight by BMI%. RBMI is a valuable and accessible tool for earlier detection, intervention, and effective follow-up of excess adiposity in youth at higher risk for complications. Full article
(This article belongs to the Special Issue Obesity in Childhood and Adolescence: Etiology, Prevention and Treatment)
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Figure 1

Figure 1
<p>(<b>a</b>) Correlation between body fat percentage (BF%) and BMI% and RBMI in both sexes; Spearman correlation analysis was performed; (<b>b</b>) Correlation between body fat percentage (BF%) and BMI% and RBMI in both races; Spearman correlation analysis was performed. Abbreviations: BMI—Body mass index, RBMI—Relative body mass index, r<sub>s</sub>—Spearman’s rank correlation coefficient.</p> Full article ">Figure 1 Cont.
<p>(<b>a</b>) Correlation between body fat percentage (BF%) and BMI% and RBMI in both sexes; Spearman correlation analysis was performed; (<b>b</b>) Correlation between body fat percentage (BF%) and BMI% and RBMI in both races; Spearman correlation analysis was performed. Abbreviations: BMI—Body mass index, RBMI—Relative body mass index, r<sub>s</sub>—Spearman’s rank correlation coefficient.</p> Full article ">Figure 2
<p>Receiver operating characteristic (ROC) curves for identifying high DXA total body fat percentage (BF%) by sex using BMI% and RBMI. Superscript a notates the Standard Error as being under the non-parametric assumption. Superscript b describes the asymptotic significance under a null hypothesis assuming a true area of 0.5.</p> Full article ">
16 pages, 701 KiB  
Article
Prenatal Vitamin D Levels Influence Growth and Body Composition until 11 Years in Boys
by Julia Sanguesa, Sandra Marquez, Mariona Bustamante, Jordi Sunyer, Carmen Iniguez, Jesus Vioque, Loreto Santa-Marina Rodriguez, Alba Jimeno-Romero, Matias Torrent, Maribel Casas and Martine Vrijheid
Nutrients 2023, 15(9), 2033; https://doi.org/10.3390/nu15092033 - 23 Apr 2023
Cited by 1 | Viewed by 3218
Abstract
Background: Gestational vitamin D levels may influence offspring growth and modulate adipogenesis. Findings from prospective studies are inconsistent, and few have evaluated the persistence of these associations into late childhood. Objective: To examine the association between prenatal vitamin D levels and growth and [...] Read more.
Background: Gestational vitamin D levels may influence offspring growth and modulate adipogenesis. Findings from prospective studies are inconsistent, and few have evaluated the persistence of these associations into late childhood. Objective: To examine the association between prenatal vitamin D levels and growth and adiposity in late childhood. Methods: We included 2027 mother–child pairs from the INMA birth cohort. 25-hydroxyvitamin D3 (vitamin D3) levels were measured in serum at 13 weeks of pregnancy. Sex- and age-specific body mass index z-scores were calculated at 7 and 11 years, overweight was defined as z-score ≥ 85th percentile, and body fat mass was measured at 11 years. Z-score body mass index (zBMI) trajectories from birth to 11 years were identified using latent class growth analysis. Results: The prevalence of vitamin D3 deficiency (<20 ng/mL) was 17.5%, and around 40% of the children had overweight at both ages. Associations between vitamin D levels and outcomes differed by sex. In boys, maternal vitamin D3 deficient status was associated with higher zBMI, higher fat mass percentage, higher odds of being overweight, and with an increased risk of belonging to lower birth size followed by accelerated BMI gain trajectory. In girls no associations were observed. Conclusion: Our results support a sex-specific programming effect of early pregnancy vitamin D3 levels on offspring body composition into late childhood observed in boys. Full article
(This article belongs to the Special Issue Obesity in Childhood and Adolescence: Etiology, Prevention and Treatment)
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Figure 1

Figure 1
<p>Plot of the associations between maternal vitamin D<sub>3</sub> levels (deficient vs. adequate) and zBMI at 7 and 11 years (<b>a</b>) and overweight at 7 and 11 years (<b>b</b>) divided by sex and categorized by the polygenic risk score categories (low, medium and high). The dotted line at the value of 1 on the <span class="html-italic">y</span>-axis typically represents the reference line. The value of 1 is the neutral point for an odds ratio. The reference line at 1 on the <span class="html-italic">y</span>-axis helps visually compare the effects of different categories or groups relative to the reference group in terms of odds ratio.</p> Full article ">

Review

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13 pages, 686 KiB  
Review
Childhood Obesity, Hypothalamic Inflammation, and the Onset of Puberty: A Narrative Review
by Anastasia-Maria Tzounakou, Galateia Stathori, George Paltoglou, Georgios Valsamakis, George Mastorakos, Nikolaos F. Vlahos and Evangelia Charmandari
Nutrients 2024, 16(11), 1720; https://doi.org/10.3390/nu16111720 - 31 May 2024
Cited by 2 | Viewed by 1777
Abstract
The onset of puberty, which is under the control of the hypothalamic–pituitary–gonadal (HPG) axis, is influenced by various factors, including obesity, which has been associated with the earlier onset of puberty. Obesity-induced hypothalamic inflammation may cause premature activation of gonadotropin-releasing hormone (GnRH) neurons, [...] Read more.
The onset of puberty, which is under the control of the hypothalamic–pituitary–gonadal (HPG) axis, is influenced by various factors, including obesity, which has been associated with the earlier onset of puberty. Obesity-induced hypothalamic inflammation may cause premature activation of gonadotropin-releasing hormone (GnRH) neurons, resulting in the development of precocious or early puberty. Mechanisms involving phoenixin action and hypothalamic microglial cells are implicated. Furthermore, obesity induces structural and cellular brain alterations, disrupting metabolic regulation. Imaging studies reveal neuroinflammatory changes in obese individuals, impacting pubertal timing. Magnetic resonance spectroscopy enables the assessment of the brain’s neurochemical composition by measuring key metabolites, highlighting potential pathways involved in neurological changes associated with obesity. In this article, we present evidence indicating a potential association among obesity, hypothalamic inflammation, and precocious puberty. Full article
(This article belongs to the Special Issue Obesity in Childhood and Adolescence: Etiology, Prevention and Treatment)
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<p>Diet-induced hypothalamic inflammation leading to precocious puberty.</p> Full article ">Figure 2
<p>Obesity and brain function.</p> Full article ">
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