Childhood Obesity

Teachers could play a major role in combating childhood obesity

Recent scholarly insights have underlined a potentially transformative role that educators can play in combating the alarming rates of childhood obesity, particularly in the United States (US). As published in the reputable journal Nutrients, a meticulous study embarked on an exploratory journey to gauge the impact teachers could make in mitigating this health crisis among the younger generation.

The roots of childhood obesity have embedded themselves deep within the US, displaying a consistent upward trend, with a pronounced prevalence in disadvantaged regions. The escalating concern has drawn concerted interventions from health authorities at local, state, and federal levels, spotlighting schools as pivotal arenas for executing preventative measures.

At the heart of these initiatives lies an appreciable emphasis on the instrumental role of teachers. By being on the frontlines of programme delivery, they emerge as invaluable assets in recognising and diffusing obesity-curbing strategies among students. However, the pressing commitments inherent to the teaching profession pose a formidable challenge to prioritising their health – a dilemma exacerbated by the outbreak of the COVID-19 pandemic, which brought to light the imperative of maintaining teacher well-being.

In 2022, a seminal report from the RAND Corporation shed light on a concerning level of job-induced stress among teachers, pointing towards a positive correlation between employer-facilitated wellness programs and reduced stress levels. Multiple strands of research echo a similar sentiment: a robust student-teacher rapport is a cornerstone for fostering student engagement, regular attendance, enhanced emotional well-being, and an overall conducive academic atmosphere.

An investigative team from the American University, Washington, orchestrated an elaborate five-year intervention venture beginning in 2017. The primary objective was to immerse educators in a milieu of nutrition literacy, aimed at equipping them with the requisite skill set to impart obesity-preventive knowledge among elementary scholars in Washington, DC. The study encapsulated four schools, two of which were designated as control while the others were intervention cohorts. Teachers, pivotal to this initiative, furnished demographic details and partook in Teacher Health Surveys before and subsequent to the intervention period.

Survey feedback, encapsulated through a Likert scale, facilitated an overall health score, amalgamated from various metrics including chronic conditions, self-efficacy, health education ideologies, and general health standings. The project’s crux was to evaluate the influence of a professional development scheme on augmenting teachers’ capacity to infuse nutrition-centric discourse into their pedagogical regimen.

Each intervention session commenced with a wellness-centric activity, transitioning into a demonstration lesson from “Serving up MyPlate: A Yummy Curriculum.” Teachers at the intervention forefront were required to integrate a minimum of three nutrition-dedicated lessons throughout the academic year. To measure the pedagogical impact, a Student Nutrition Literacy Survey was administered at both the outset and the conclusion of the intervention.

The data depicted a collective participation of 92 educators from both the control and intervention factions. The demographic backdrop of these teachers showcased a reasonable level of uniformity across the schools. An age average of 36 years, a predominant female representation (84.8%), and a significant Black demographic (68.5%) constituted the participant profile.

A cadre of 55 teachers from the intervention spectrum attended the professional development suite, orchestrating 71 nutrition-oriented lessons. A meticulous Poisson regression analysis unearthed a predictive association among job stress, professional development attendance, and self-efficacy towards the incorporation of nutrition lessons. An incremental self-efficacy score and each additional session attendance manifested a 25% and 48% increased likelihood, respectively, of infusing nutrition lectures into the curriculum. Interestingly, a stark inverse relation was observed between stress levels and self-efficacy scores.

The investigative lens also focused on the ripple effect of health scores, lesson implementations, and aggregate health scores. A noticeable inverse relationship emerged between lesson execution and stress levels, indicating that session attendance contributed to lower stress levels among teachers. Moreover, a higher aggregate health score was recorded for teachers who integrated three or more nutrition lessons compared to their counterparts. The student demographic, comprising both intervention and control schools, showcased a balanced representation concerning age, gender, and grade level.

The baseline knowledge levels didn’t exhibit significant discrepancies between the students of intervention and control schools. However, a commendable uptick in scores was observed among students of the intervention cohort who were recipients of nutrition education from session-attending teachers. Notably, students exposed to three or more nutrition lessons reflected a 10% enhancement in their scores compared to those receiving two or fewer lessons.

The observations evinced the practicability and sustainability of a short-term professional development module aimed at fostering teacher health while concurrently advancing nutrition education. It’s imperative to highlight that although the rise in healthful eating awareness is promising, it doesn’t necessarily translate to a behavioural modification. A holistic approach to enhancing student health necessitates a foundational support structure for teacher health, underscoring the necessity of workplace professional development.

Empowering teachers with a robust knowledge repository, a wealth of resources, and adeptness in managing their health not only transforms them into educational conduits but also as potent change agents in the classroom. By co-opting teachers as collaborative partners in the quest to curb childhood obesity, a more structured pathway towards attaining health equity is envisioned. The study, in essence, reinforces the potential of a professional development framework as a viable stratagem in advancing teacher well-being and fortifying the bulwark against childhood obesity.

New research links early adolescent weight gain to higher depression risks in teen years

Recent studies indicate a strong correlation between elevated body mass index (BMI) in children and increased instances of depression during their teenage years. This correlation, as pinpointed in the comprehensive research conducted by King’s College London, has flagged early adolescence as a critical period wherein weight gain can significantly influence the onset of depressive symptoms later on in life.

The King’s College London team analysed data from over 10,000 twins born from 1994 to 1996, charting their height and weight at ages 12, 16, and 21 to determine their BMI. Additionally, the young participants filled out questionnaires that helped monitor depression symptoms such as feelings of loneliness, low moods, and exhaustion.

The insights derived from the research underscored a higher tendency among children with overweight to develop depression, a risk amplified the earlier in life they started to experience weight issues. Particularly, the span between 12 and 16 years was identified as a “sensitive point,” with weight gains during this period more strongly linked to later depression compared to gains between the ages of 16 and 21.

Senior co-author of the study, Thalia Eley, Professor of Developmental Behavioural Genetics, highlighted the significant role of early adolescence in the co-evolution of obesity and depressive tendencies. She further underscored the urgency of adopting a proactive approach to fostering positive body image and wellbeing, as opposed to merely focusing on weight, to thwart the onset of depression in later years.

Echoing these sentiments, the study’s principal author, Dr. Ellen Thompson emphasised the imperative need to unravel the intricacies of the mental health-weight nexus in adolescence to devise timely and effective support mechanisms. While the current study did not delve into the underlying causes of the observed relationship, earlier studies have pointed to factors like body dissatisfaction and external weight-related stigma as potent triggers.

In light of the increasing concerns around obesity and mental health disorders amongst the UK’s youth — a demographic where one-third have overweight or obesity by the time they finish primary school — the researchers propose that educational institutions integrate positive body image narratives in their curriculum.

These recommendations come against a backdrop of an alarming rise in child mental health crises, exacerbated by the COVID-19 pandemic, and sustained school closures which have put unprecedented demand on the NHS’s mental health services for young people. According to recent statistics, one in four older teenagers are grappling with “probable” mental health disorders, a spectrum that encompasses depression and anxiety symptoms.

Furthermore, the persistent pressures from social media and the bottleneck created by long waiting lists for accessing mental health services portray a grim landscape for the younger generation. The scholars behind the study press for urgent interventions to mitigate this rapidly spiralling crisis, urging for a renewed focus on promoting a healthy body image to stave off depression and foster mental wellbeing among youth.

Child sleep apnea severity linked to obesity, finds new study

Researchers at UT Southwestern Medical Center and Children’s Health have discovered that obesity and older age are substantial predictors of the severity of obstructive sleep apnea (OSA) in children. The study, recently published in Laryngoscope Investigative Otolaryngology, underscores the essential role of obesity in paediatric OSA. This new finding contributes to the increasing recognition of the association between childhood obesity and various negative outcomes including cognitive deficits, impaired academic performance, behavioural issues, excessive daytime sleepiness, and potential long-term effects on cardiovascular health.

Obstructive sleep apnea is a sleep disorder characterised by repeated obstruction of the upper airway during sleep, leading to interruptions in both ventilation and sleep patterns. Diagnosis of OSA usually requires full-night polysomnography, an extensive sleep study that monitors brain waves, blood oxygen levels, and heart and breathing rates while the patient sleeps.

Traditionally, paediatric patients suffering from OSA have been treated with adenotonsillectomy, a surgical procedure involving the removal of the adenoids and tonsils. However, this surgery does not always resolve the problem, and some children continue to experience what is known as residual OSA after the procedure.

The study was led by Romaine F. Johnson, M.D., M.P.H., Professor of Otolaryngology – Head and Neck Surgery at UT Southwestern, who emphasised that “OSA is typically considered a condition that affects adults.” But Dr. Johnson pointed out that the growing epidemic of childhood obesity has led to an increase in the number of paediatric patients diagnosed with OSA. He explained that “higher levels of obesity and advancing age are key contributors to this issue,” and suggested that targeting childhood obesity could substantially enhance sleep quality and mitigate the detrimental consequences of both OSA and residual OSA.

Dr. Johnson and his research team initially embarked on the study to investigate the relationship between socioeconomic status (SES) and paediatric OSA. They examined the medical records of 249 children aged 18 or younger who underwent both polysomnogram and adenotonsillectomy at Children’s Health over a one-year span. To evaluate the influence of SES on paediatric OSA, the researchers utilised the area deprivation index (ADI), a metric defining neighbourhood-level disadvantages through various social determinants such as education, employment, and poverty.

Contrary to expectations, the study revealed that neighbourhood-level deprivation, as indicated by the ADI ranking, did not predict OSA severity or residual OSA after surgery. Instead, the team found that severe OSA was significantly associated with obesity, and residual OSA was more commonly linked with older age, particularly among adolescents.

While the research did not establish a direct link between SES and OSA severity, Dr. Johnson emphasised the need for further investigation into the relationship. He highlighted the critical nature of understanding how socioeconomic status intersects with paediatric OSA, stating that “social disadvantages can further affect the consequences of poor sleep quality.” He also noted that children who experience both OSA and social disadvantages might be at increased risk and may require specialised interventions.

The significance of this study lies in its identification of childhood obesity as a key factor in the severity of sleep apnea, thereby opening the door to potential interventions targeting weight management. Supported by the Beth and Marvin C. “Cub” Culbertson Professorship in Pediatric Otolaryngology, the research also emphasises the complex interplay between obesity, age, and sleep disorders in children, and calls attention to the need for a multifaceted approach to address these interconnected health challenges.

Luton Council takes action against childhood obesity by banning unhealthy food ads on municipal property

Luton Council has made a significant decision to combat the growing concern of childhood obesity in the town by implementing a ban on advertising for unhealthy food items on most of its council-owned property. As part of this determined initiative, advertisements featuring food products high in fat, salt, and sugar will no longer be permitted to be displayed on billboards, lampposts, screens, or roundabouts within the town’s jurisdiction.

This move, according to the council, aims to “protect children and adults” from the influence of marketing that promotes unhealthy eating habits. The situation has become particularly alarming in Luton, where childhood obesity rates have exceeded national levels. The latest figures from the National Child Measurement Programme (NCMP) revealed that 11.4% of reception age children in Luton (ages four to five) were classified as having obesity, compared to the national rate of 10.1%. Similarly, obesity among children aged 10 to 11 (Year 6) in Luton stood at 29.2%, noticeably higher than the national rate of 23.4%.

Labour councillor Khtija Malik, who holds the portfolio for public health, declared the ban as a “start” in the town’s efforts to decrease its “high rates of obesity among young children.” Ms. Malik stressed the importance of fostering healthy eating habits early in life, acknowledging the considerable impact advertising has on shaping people’s food choices.

This ban, although extensive, will not encompass all advertising locations within the town. Unhealthy food adverts may continue to be seen on bus shelters until at least 2027, as the council’s current advertising contract for these spaces extends to that year. However, Ms. Malik reassured that the council, having “control of our assets,” would exercise control over “what is advertised” in areas under its jurisdiction.

The move by Luton Council has not only demonstrated a proactive approach to a pressing public health issue but has also been met with support from advocacy groups. Fran Bernhardt, the children’s food campaign coordinator at Sustain, a group dedicated to better food and farming, lauded the council’s efforts, stating, “Luton Council has stood up to the food and drinks industry on behalf of all their residents.” She further emphasised the importance of the decision, pointing out that those residing in the most deprived areas are the ones most affected by unhealthy food advertising and are consequently most at risk from diet-related diseases.

The decision by Luton Council signifies an important step in recognising and addressing the complex factors that contribute to childhood obesity. By limiting the exposure to advertising that encourages unhealthy food choices, the council is actively working to create an environment that supports healthier lifestyle decisions. This ban is a notable example of local governance taking decisive action to influence public behaviour and health, reflecting a growing awareness of the pivotal role advertising plays in shaping dietary habits and preferences. It serves as a landmark measure that could potentially inspire similar initiatives in other towns and cities, contributing to a broader societal shift towards prioritising public health.

Scientists call for government action on portion sizes to tackle childhood obesity

Leading scientists are urging the government to establish standard portion sizes for young children as part of efforts to combat the obesity epidemic. In a damning report, government scientific advisers have revealed that young children are consuming excessive amounts of salt and sugar while falling short on fruit, fibre, and vegetable intake.

Official data indicates that one in ten reception-age children in the UK now has obesity, with experts projecting that the obesity crisis will cost the NHS £10 billion annually by 2050. The report from the Scientific Advisory Committee on Nutrition (SACN) highlights the absence of formal guidance on appropriate portion sizes for young children and emphasises the need for policymakers to address this issue. Oversized servings are contributing to the rapid consumption of excessive calories.

According to the report’s authors, the current diet of young children in the UK fails to meet the recommended dietary guidelines for several nutrients. They note that larger portion sizes of snacks and meals provided in preschool settings are associated with higher food and energy intake in the short term. To address these concerns, the authors recommend that the government consider developing age-appropriate portion sizes for food and beverages, including vegetables, fruit, fruit juice, and milk, targeting children aged 1 to 5 years.

The SACN, known for its advocacy of the forthcoming ban on fast-food advertising before 9 pm from 2025 and the fortification of bread with folic acid, has identified excessive sugar consumption as a widespread issue, leading to dental problems that pose long-term health risks for individuals and place a persistent burden on the NHS.

The report reveals that nutritional imbalances are prevalent in the average diet, with children from disadvantaged backgrounds experiencing even worse dietary quality. Commissioned by the Department for Health and Social Care, the report provides the first update on recommended food and beverage consumption for children aged one to five in nearly two decades. Based on a comprehensive review of two decades of studies and data, the panel of nutrition experts and paediatricians who form the SACN made several recommendations, highlighting the urgency of addressing the “high prevalence” of overweight and obesity in children in the UK.

Official figures indicate that approximately 3% of reception-age children have severe obesity, and one in ten children at this age meet the threshold for obesity.

The report authors also suggest that repeated exposure to initially disliked vegetables can help children develop a preference for them. They recommend that parents persistently offer the vegetable to their child eight to ten times to increase acceptance.

Additional recommendations from the report include avoiding fizzy drinks for children under the age of five, consuming unsweetened yoghurt products, and making milk and water the primary beverage choices. Semi-skimmed cow’s milk is acceptable, but fully skimmed milk should be avoided until age 5.

Bridget Benelam, a Nutrition Scientist from the British Nutrition Foundation, highlighted the report’s findings, stating that the diets of 1-5-year-olds were inadequate, characterised by excessive sugar, salt, and unhealthy energy-dense foods, and insufficient fibre, fruit, and vegetables.

The report also emphasises the importance of early childhood nutrition, not only for growth and development but also for establishing healthy habits that will benefit children later in life.

The report suggests several strategies for the government to consider, including promoting continued breastfeeding into the second year of life, ensuring children receive daily vitamin D and A supplements, and providing adequate vitamins and minerals for vegan families who may lack these nutrients commonly found in animal products.

A government spokesperson acknowledged that the report’s recommendations are being noted and considered. They highlighted the Start for Life resources, which provide expert NHS advice, helpful videos, and simple recipe ideas to support families in providing healthy meals for babies and young children.

Family-focused approach in paediatric primary care proves effective for child weight loss

A groundbreaking family-based treatment for childhood obesity, developed by researchers at the University at Buffalo (UB), has demonstrated significant success in a multicenter study conducted in paediatric primary care settings. Previously available only in specialised clinics, this evidence-based treatment has now been implemented for the first time in four U.S. cities, targeting children aged 6-12 and their parents.

Published in the Journal of the American Medical Association, the study reveals that family-based treatment conducted in paediatricians’ offices leads to improved weight-loss outcomes not only for the treated child and parent but also for untreated siblings. The research, supported by the National Heart, Lung and Blood Institute, emphasises that the healthy behaviours promoted during the treatment extend beyond the immediate family members, potentially improving the overall health of the entire family.

In the study, three times as many children in the treatment group (27%) experienced a clinically meaningful reduction in median body mass index (BMI) compared to the usual care group (9%). These improvements in weight correlated with enhanced cardiometabolic outcomes, such as blood pressure, lipids, and glucose regulation. The success of this novel family-focused treatment, pioneered by senior author Leonard H. Epstein, has significant implications for the long-term health and well-being of the treated children.

The family-based treatment program involves the implementation of eating and activity plans, education in parenting and behavioural techniques, and the facilitation of support for positive behaviour changes within both the family and peer environments. In individualised sessions, parents and children are seen together, reviewing self-monitored eating and activity levels, treatment manuals, handouts, and setting goals for weight and behaviour.

The randomised clinical trial enrolled 452 children aged 6 to 12, with one parent, in primary care practices across Buffalo, Rochester, Columbus, and St. Louis. Half of the children received family-based treatment, while the other half received usual care. Notably, the treatment demonstrated positive outcomes across racial and ethnic backgrounds.

Children receiving family-based treatment showed a significant difference in percent over median BMI compared to those receiving usual care, with a reduction of 6.48%. Furthermore, parents experienced a reduction of 3.97% in BMI, and untreated siblings who were overweight had a reduction of 5.38%. These changes in BMI among family members were interrelated, suggesting that the treatment fosters the modelling of healthy behaviours and facilitates real change in the shared family environment.

The success of this behavioural intervention underscores the growing need for similar treatments in paediatric primary care. The study authors emphasise the necessity for “coaches” in primary care settings who can provide support for obesity treatment and address various behavioural issues, including anxiety, depression, and eating disorders.

The implementation of this family-focused approach not only ensures the immediate health of children but also equips them with lifelong healthy practices. The study’s positive outcomes highlight the potential for transforming paediatric primary care into a hub for comprehensive behavioural interventions, addressing a wide range of health-related concerns.

NHS England to open 10 more clinics for children with obesity

In response to the alarming rise in childhood obesity, NHS England has announced plans to launch 10 additional clinics specifically tailored to the needs of children with obesity. This expansion comes as part of a concerted effort to combat the escalating numbers of children and young people struggling with obesity and its associated health complications.

According to recent data released by NHS England, hospital admissions for children with obesity have soared in the past decade, with 9,431 admissions recorded in the year 2021/22, compared to just 3,370 in 2011/12.

Targeting children as young as two, the specialised clinics will offer intensive support to children with severe obesity and their families. It is estimated that around 3,000 children and teenagers, ranging from 2 to 18 years of age, will benefit from these services.

These clinics are designed to address not just the physical aspects of obesity, but also the underlying psychological and social factors. The support provided will encompass tailored care packages which are developed in collaboration with the child’s family. These packages may include diet and nutrition plans, mental health support, and personalised coaching, among other services.

This expansion, backed by an £18 million investment, will bring the total number of specialised obesity clinics for children in England to 30. The project is set to be rolled out over the next two years.

Amanda Pritchard, Chief Executive of NHS England, is slated to formally announce the opening of the new clinics at the NHS ConfedExpo conference in Manchester. In her address, she is expected to underscore the urgent need for such initiatives, stating, “Obesity can lead to a myriad of severe illnesses including cancer and diabetes, not only putting tremendous strain on the NHS but also exacting a devastating toll on individuals and their families. Inaction is not an option. These new clinics will offer a comprehensive, compassionate and tailored approach to support thousands of young individuals and their families.”

Professor Simon Kenny, NHS England’s National Clinical Director for Children and Young People, emphasised the holistic approach of these clinics. He noted that obesity can have far-reaching effects on every organ system, leading to long-term complications like premature mortality, type 2 diabetes, strokes, early joint replacements, and mental health issues. “By addressing obesity and its root causes in a manner that respects and accommodates the unique circumstances of each child and young person, these clinics will play a pivotal role in helping them lead healthier, more fulfilling lives. Our commitment to supporting the physical and mental health of as many children and young people as possible is unwavering,” he added.

Prenatal exposure to durable ‘forever chemicals’ may contribute to childhood obesity, study finds

A recent study backed by federal funding suggests that exposure to per- and polyfluoroalkyl substances (PFAS), also known as ‘forever chemicals,’ during pregnancy is associated with higher body mass indices (BMIs) and increased risks of obesity in children.

The study, spearheaded by Brown University researchers, adds to the growing body of evidence that the consequences of exposure to PFAS begin even before birth, potentially predisposing children to health challenges later in life.

PFAS are a group of chemicals used in a variety of products such as water-repellent textiles, personal care items, firefighting foams, food packaging, and medical products, due to their oil and water-resistant properties. Their extremely stable structure means they can persist in the environment for thousands of years, earning them the nickname ‘forever chemicals’.

The research was carried out under the Environmental Influences on Child Health Outcomes (ECHO) program at the National Institutes of Health, employing a more extensive dataset compared to previous studies. Lead author Yun “Jamie” Liu, a postdoctoral research associate in epidemiology at the Brown University School of Public Health, stated that the study analysed eight research cohorts with varying demographics across the United States, making the findings more representative of the general population.

Using data collected over two decades involving 1,391 children aged between 2 and 5 years and their mothers, who were part of ECHO research sites in California, Illinois, Massachusetts, Colorado, New Hampshire, Georgia, and New York, the study examined blood samples taken from mothers during pregnancy. The levels of seven different PFAS were analysed, and children’s body mass indices were calculated.

The study revealed a correlation between higher levels of PFAS in the mothers’ blood during pregnancy and slightly elevated BMIs in children. This increased risk of obesity was consistent among both male and female children. Notably, these associations were evident even at relatively low levels of PFAS exposure.

Joseph Braun, the study’s senior author and a professor of epidemiology at Brown’s School of Public Health, highlighted the significance of these findings in contemporary contexts. He noted that despite the reduction in PFAS usage as manufacturers have phased them out due to health concerns, exposure during pregnancy could still pose risks. “This implies that children may continue to face risks of PFAS-related health issues,” Braun added.

Braun has been engaged in several studies examining the effects of PFAS on children’s health for over a decade. He believes that this kind of research can inform environmental policies and safety guidelines.

The research team aims to continue their investigations by exploring the relationships between maternal PFAS exposure and obesity-linked health outcomes in older children, eventually expanding to adolescents and adults.

The study received support from the ECHO program, the National Institute of Environmental Health Sciences, and the National Institute of General Medicine Sciences.

Harnessing machine learning to predict obesity: A focus on the first 1000 days of life

The recent publication in the Scientific Reports Journal showcases a novel utilisation of machine learning (ML) to forecast obesity in adults by examining risk factors and monitoring body mass index (BMI) during the initial 1,000 days of life, spanning from two to four years old.

The rise in obesity rates in both children and adults worldwide is undeniable. Early onset obesity in children is indicative of potential adult obesity, cardiometabolic risks, and other childhood diseases.

Obesity, once entrenched, is challenging to manage and is often chronic. As a result, a preventative approach to obesity is becoming a research priority. Identifying individuals at an elevated risk of obesity in adulthood during their early years could significantly enhance these prevention efforts.

Known adjustable risk factors encompass a mother’s higher pre-pregnancy BMI, pregnancy weight gain, socioeconomic status, high neonatal weight, and local community variables such as crime rates and food availability. Despite this, the cumulative risk estimation of these factors remains underexplored.

Currently, there is a lack of initiatives aimed at estimating childhood obesity, particularly those considering prenatal and neonatal risk factors. This is despite studies highlighting that the period between two to four years of age provides a valuable window for intervention due to heightened developmental flexibility and the ability to influence health behaviours.

The study in question employs ML algorithms to pinpoint children with a higher risk of obesity, providing vital data for the creation of prevention policies and strategies. Additionally, the researchers introduced a dynamic BMI tracker for use throughout childhood to help identify obesity risks in adulthood.

The researchers utilised a machine learning technique known as least absolute shrinkage and selection operator (LASSO) regression. This allowed them to maintain features that most significantly and relevantly relate to paediatric obesity, outside of height, weight, and body mass index.

The study examined data from 149,625 visits by 19,724 individuals aged up to 48 months, with an analysis of 10,348 individuals specifically aged between 30.0 and 48.0 months. Following data correction, the supplementation of missing values, and variable normalisation, 50 variables were chosen for consideration. After application of LASSO regression and subsequent tests, a final 19 variables were scrutinised.

The proposed model comprised variables such as mean height, BMI, weight at various intervals within the first two years, time differences between visits, and percentile ranks for weight and height at two years.

The predictive ability of the model was tested with a validation dataset comprising 20% of the patients. It showed an impressive accuracy in estimating childhood BMI, with a mean error of 1.0 across all three age ranges (30.0 to 36.0 months, 36.0 to 42.0 months, and 42.0 to 48.0 months).

Most variables in the model showed a significant association with paediatric BMI across all estimated ranges. These findings suggest that this predictive model could bolster both clinical and population-wide obesity prevention efforts in the earliest days of life.

Risk factors associated with higher childhood BMI identified in the study included maternal risks during pregnancy, C-section delivery, higher infant birth weight, and sleep disturbances in infants requiring assistance to sleep.

Interestingly, living in a food desert and having Hispanic ethnicity were factors that appeared protective against high BMI.

In summary, this study highlights that machine learning can help track paediatric BMI trajectories and identify modifiable risk factors during early childhood. This supports efforts to intervene before the onset of unhealthy weight gain, aiming to alleviate the health burden of obesity.

Factors such as maternal health, a child’s sleep quality, and socioeconomic influences can shape the weight trajectories of children into later

Increased risk of obesity and high blood sugar in children linked to prenatal cannabis exposure

A newly conducted study suggests that the use of cannabis during pregnancy may heighten the likelihood of children developing obesity or experiencing elevated blood sugar levels by the age of five.

Products containing non-psychoactive cannabidiol (CBD) or the psychoactive compound tetrahydrocannabinol (THC) are often employed by pregnant women to mitigate symptoms such as morning sickness, anxiety, post-traumatic stress disorder (PTSD), insomnia, and pain.

However, the study establishes a correlation between the exposure to such compounds during pregnancy and breastfeeding, and “increased percentages of fat mass and fasting glucose levels” in children upon their entry into school.

Brianna Moore, an assistant professor of epidemiology at the University of Colorado, who focuses her research on how early-life exposure to tobacco and cannabis impacts children’s growth and brain development, is the author of the study. Moore advises women to “avoid all forms of cannabis while pregnant or breastfeeding in order to minimise potential adverse health outcomes in their children.”

The research team analysed urine samples from 103 pregnant women, revealing that 15% of the women had detectable cannabinoid compounds in their bodies.

The findings show that the five-year-old children of these mothers had greater fat mass and fasting glucose levels compared to children whose mothers did not use cannabis during pregnancy.

Cannabis is known to contain over 100 cannabinoids, with CBD and THC being the most widely recognized. According to Dr. Moore, further studies are required to explore the effects of the other compounds on babies exposed to them during gestation and through breastfeeding.

In a separate 2016 study conducted in Colorado, it was discovered that up to 22% of pregnant women exhibited detectable cannabinoid levels in their bodies.

Earlier studies have also indicated that women who use CBD and THC during pregnancy not only increase the risk of their children having low birth weights and behavioural issues but are also doubling the likelihood of premature birth. Additionally, cannabis use during pregnancy has been associated with a higher prevalence of “psychotic-like” behaviours in nine-year-old children, as per other studies conducted in 2019 and 2020.

The research, titled ‘Fetal Exposure to Cannabis and Childhood Metabolic Outcomes: The Healthy Start Study’, is available in the Journal of Clinical Endocrinology and Metabolism published by the Endocrine Society.

Weight loss injections could be prescribed to children with obesity

UK government officials are contemplating offering weight-loss injections to children with obesity as young as 12 in an effort to combat the escalating childhood obesity problem in the country.

Specialists are currently evaluating if semaglutide injections, a weight-loss medication recently sanctioned for adult use by the NHS, could be beneficial for children with obesity aged between 12 and 17. Health authorities are now encouraging the National Institute for Health and Care Excellence (NICE) to consider providing these injections to teenagers struggling with obesity.

The final decision, expected to be announced in early 2024, is being supported by experts who argue that the medication could prevent more children from needing invasive weight-loss procedures. However, this suggestion has sparked controversy, with some arguing it could lead to an over-medicalisation of children.

Those opposed to the idea of weight loss injections for children raise several concerns. They fear the potential interference of these drugs with the physical and mental growth and development of children. They also highlight the lack of evidence regarding the long-term effects of such treatments on children’s health.

Critics further argue that such injections might encourage an unhealthy emphasis on weight and physical appearance, potentially leading to body image issues and disordered eating. The potential for serious side effects from weight loss injections is another concern. Additionally, they worry about the psychological message these injections could send, implying that a child’s body is unacceptable as it is.

Professor Keith Godfrey, from the National Institute for Health and Care Research’s Southampton Biomedical Research Centre, warns that providing weight-loss injections to children might lead to the unnecessary medicalisation of an entire generation.

Charlotte Summers from Gro Health, a company offering health and wellbeing programs for adults, children, and young people, advocates for a more holistic approach: “By promoting healthy eating habits, regular physical activity, and a positive relationship with food, we can enable our children to attain and maintain a healthy weight throughout their lives. This comprehensive strategy not only contributes to physical wellbeing, but also lays a solid foundation for emotional and mental health. We must collaborate to support our children in adopting a balanced and wholesome lifestyle for a healthier, brighter future.”

Caesarean births linked to higher childhood obesity risk, Japanese study finds

A recent scientific study published in the journal Scientific Reports explores the potential impact of Caesarean section (CS) delivery on the incidence of obesity among three-year-old Japanese children.

Childhood obesity is a growing global health issue, as it can often persist into adulthood and raise the risk of various cardiometabolic disorders. Prior research has suggested that children born via CS may have a higher likelihood of obesity, potentially due to disturbances in their gut microbiomes. These children have been found to exhibit lower adiponectin levels and greater insulin resistance.

While ethnicity and race are also factors in the prevalence of paediatric obesity, with Asian children reportedly at a higher risk than their White and European counterparts, the correlation between CS birth and childhood obesity in the Japanese population remains relatively unexplored.

The objective of this study was to investigate this correlation, which could aid in the early identification of children at risk of adult obesity, thereby enabling early intervention through weight management programs.

For the study, the research team analysed data from 60,769 Japanese mother-child pairs participating in the national Japan Environment and Children’s Study (JECS). The mode of delivery was determined from health records, while anthropometric data was gathered through online questionnaires completed by the participants themselves.

The researchers identified obesity in children using the body mass index (BMI) cut-off values defined by the International Obesity Task Force guidelines, and only included children from singleton births in the analysis. The study excluded any multiple participations, multiple births, stillbirths or miscarriages, or any data with missing information related to height and/or weight, mode of delivery, and other covariates.

The researchers used logistic regression analysis and estimated adjusted risk ratios (aRR), taking into account various maternal and paediatric factors. They also conducted a sensitivity analysis using the obesity thresholds provided by the Japanese Association for Human Auxology guidelines.

The study found that 19% of the children were born via CS, with 8% classified as having obesity. The aRR for obesity in three-year-old Japanese children born through CS was 1.2 compared to those born via vaginal delivery. When the data was stratified by sex, the aRR values were 1.1 for boys and 1.2 for girls.

The sensitivity analysis corroborated these findings, with the risk of childhood obesity remaining statistically significant for Japanese girls. This aligns with previous studies that have reported an increased risk of certain cancers in females born through CS.

The data also revealed that children born via CS had lower birth weights and heights and were more likely to be born before 37 weeks of gestation. Mothers who had a CS were generally older, had higher pre-pregnancy BMIs, were less educated, and had a higher rate of pregnancy-related and obstetric complications. They were also more likely to smoke, suffer from physical illnesses, and use assisted reproductive technology.

In conclusion, the study suggests that CS births slightly heighten the risk of obesity at age three for both boys and girls in the Japanese population. This indicates that the mode of delivery may influence metabolic health, even among ethnic groups that are typically less prone to obesity. Factors such as maternal pre-pregnancy BMI, education level, and the child’s birth weight appeared to confound this relationship.

The study emphasises the need for further research to understand the mechanisms underlying the increased risk of paediatric obesity associated with CS delivery, including the possible association with gut microbiota. Moreover, the long-term cardiometabolic impacts of CS delivery should be further investigated.

Study finds boys with obesity at higher risk of becoming infertile men

Italian researchers have discovered a potential link between obesity in boys and reduced testicle size, which may increase the risk of infertility in these young men later in life.

The study included boys aged 2 to 18 who were recommended to the Pediatric Endocrinology Unit at the University of Catania in Sicily for weight management. The researchers observed that boys with normal insulin levels displayed up to double the testicular volume in comparison to boys with high insulin levels.

Boys who had overweight or obesity and displayed hyperinsulinemia, or insulin resistance, generally had smaller testicles than other boys, according to the researchers. This condition, referred to as “testicular hypotrophy,” is known to elevate the risk of infertility in males.

Dr. Alex Robles, a fertility specialist at the Columbia University Fertility Center in New York, explained to Medical News Today that testicular volume is directly linked to semen profiles and is generally a reliable indicator of hormonal function. He added that infertile men typically have a smaller testicular volume compared to fertile men. This is also seen in men who consume exogenous anabolic steroids, leading to a reduction in the production of endogenous testosterone, testicular size, and sperm production.

Co-author of the study, Rossella Cannarella, a research assistant at the University of Catania in Italy, noted that the impact of obesity and related metabolic disorders on testicular growth is not thoroughly understood, despite the global rise in childhood obesity. The study, published in the European Journal of Endocrinology, found that having overweight or obesity was associated with a decrease in testicular volume during peri-puberty. Additionally, obesity-related conditions like hyperinsulinemia and insulin resistance were found to affect testicular volume both before and after puberty.

Cannarella suggests that more careful management of body weight during childhood could be a preventive strategy for preserving testicular function in adulthood.

Male infertility is believed to contribute to approximately half of all cases of couple infertility, but the causes often remain unknown. Research has shown a decrease in sperm concentration and count over the past four decades, while childhood obesity rates have increased dramatically. It is estimated that by age 35, 60% of children aged 2 to 19 will have obesity.

Dr. Robles also highlighted the significant connection between obesity and fertility issues, particularly in women. Obesity can disrupt the hormonal balance needed for egg growth, development, and ovulation. Similarly, in men, obesity can interfere with the hormones that assist in testosterone production by the testicles. Low testosterone is linked to reduced sperm production and quality.

However, Dr. Jagdish Khubchandani, a professor of public health at New Mexico State University, warned that while the study showed promise in highlighting the connection between obesity, metabolism, and testicular volume, it had limitations. The study was cross-sectional with a small population, so it could not establish a cause-and-effect relationship between testicular size, obesity, and risk of infertility.

Dr. Khubchandani emphasised that although there is a correlation between the global rise in obesity and the decline in sperm count, it doesn’t necessarily mean the two are directly linked. Factors such as diet and environment could independently influence obesity, metabolism, and reproductive health.

Dr. Robles agreed that while the findings of the retrospective review are plausible given the known impacts of obesity on hormonal regulation and testosterone levels, more research is necessary to determine if weight loss is an effective treatment for improving testicular volume. Previous research suggests that weight loss can improve hormonal health in men with obesity by restoring natural testosterone levels, which can subsequently increase testicular volume and sperm production.

Dr. Khubchandani highlighted the importance of early childhood interventions to address many health issues linked to obesity, including those discussed in this study. He added that obesity is a global pandemic and a leading cause of numerous health problems worldwide.

Obesity in childhood and puberty linked to higher risk of blood clots in later life

According to a new study by the University of Gothenburg, being overweight during childhood and early adulthood increases the risk of developing blood clots in later years. The study analysed the health data of 37,000 men and their early body mass index (BMI) and any blood clots that developed as they got older. The researchers found that both overweight in childhood and overweight in young adulthood increased the risk of venous blood clots later in life, with overweight in young adulthood proving to be a more influential factor than childhood overweight. While most blood clots occur in the legs and are not dangerous, they can become life-threatening if they travel to the lungs and cause a pulmonary embolism.

The link between obesity and blood clots is already well known, but the impact of a higher BMI in childhood on the risk was unclear. The researchers examined the data of a large group of men in Sweden who were born between 1945 and 1961, looking at school records at age 8 and Armed Forces medical examinations at age 20 to establish BMI data. They then looked at blood clot data on the men up to an average age of 62.

The study found that BMI at both age 8 and age 20 can be linked to blood clots independently of each other. As adults, the researchers found that two groups were more at risk – those who had been overweight both as a child and in early adulthood, and those with a normal weight in childhood but who became overweight in early adulthood. In addition, the study found that carrying excess weight in both childhood and early adulthood increased a person’s risk of arterial thrombi, which are clots that result from constricted blood vessels with fatty deposits. However, the researchers noted that more research is needed in this area as they only found a small number of cases.
The study’s senior authors emphasised that obesity and overweight during puberty seem to have a marked impact on a person’s future risks of venous thrombi. The study has been published in the Journal of Internal Medicine.

France sees a surprising surge in obesity

An article in The Economist titled “France sees a surprising surge in obesity” highlights the recent increase in obesity rates in France. The article notes that despite being known for its healthy eating habits and cuisine, France is experiencing a rise in obesity levels, particularly among children, and attributes the increase to a shift towards more sedentary lifestyles, as well as the availability of unhealthy food options. The article also discusses the potential health consequences of the trend and the need for public health initiatives to address the issue. The article concludes by stating that the obesity epidemic is a growing concern in many countries, and addressing the issue will require a multi-faceted approach, including changes in government policies, increased access to healthy food, and increased physical activity.

Positive parenting can reduce the risk that children develop obesity

Children with positive, early interactions with their caregivers — characterised by warmth, responsiveness, and a stimulating home environment — were at reduced risk of childhood obesity according to new research from Pennsylvania State University in the United States. 

​​The study, “Family Psychosocial Assets, Child Behavioral Regulation, and Obesity,” appeared in the journal Pediatrics. In the article, Brandi Rollins, assistant research professor of biobehavioural health and Lori Francis, associate professor of biobehavioural health, analysed data from over 1,000 mother-child pairs and found that children’s early exposures to family psychosocial assets — including a quality home environment, emotional warmth from the mother, and a child’s ability to self-regulate — reduced the risk of developing childhood obesity.  

“A lot of the discussion around childhood obesity and other health risks focuses on identifying and studying the exposure to risk,” said Rollins, “We took a strength-based approach in our analysis. We found that a supportive family and environment early in a child’s life may outweigh some of the cumulative risk factors that children can face.” 

An especially encouraging aspect of the study found that these factors were protective even when children faced familial risks for obesity, including poverty, maternal depression, or residence in a single-parent home.   

“Research on parenting has shown that these types of family assets influence children’s behaviour, academic success, career, and — not surprisingly — health,” Rollins said. “It is significant that these factors also protect against childhood obesity because the family assets we studied are not food or diet-specific at all. It is heartening to know that, by providing a loving, safe environment, we can reduce the risk that children will develop obesity.” 

Children are deemed to have obesity when their body mass indices (BMIs) are greater than 95% of other children their age and gender. There is a great deal of variance, however, in the BMIs of children who exceed the obesity threshold. Children whose BMI is 20% higher than the obesity threshold are considered to have severe obesity.  

The researchers found that children who had early-onset severe obesity did not face greater levels of family risk than children who were not obese. Children with severe obesity, however, did have fewer family assets than children who were not obese or who displayed moderate levels of obesity. More research is needed to understand which factors contribute to the development of severe obesity and which factors reduce the risk.  

“Though the findings on severe obesity may seem discouraging, they offer some hope,” Rollins explained. “Some risk factors, like household poverty, can be very difficult to change. Assets, on the other hand, may be easier to build. People can learn to parent responsively. It is encouraging that parenting really matters, that family matters.”