Where the children play: Gender gaps in recess physical activity by age and playground area.

Objective: Recess contributes meaningfully to physical activity (PA), but recess time has declined. The study's purpose was to report PA by age, gender, and playground feature to inform potential playground configurations more conducive to PA during recess. Methods: Using the System for Observing Play and Leisure Activity in the Youth, kindergarten through 5th grade recesses were observed on at least four days at four schools in Little Rock, Arkansas, United States during May 2023. Target playground features were ball courts, grass, pavement, play structures, and swings. To provide inferential analysis, a comparison of conditional means across playground features, age, and gender was conducted using linear regression with robust standard errors clustered by school. Results: 3,356 playground scans (intercoder correlation = 0.93) were collected and aggregated by school, day, gender, age (grade), and target feature for a sample size of 292 observations. The gender gap was widest among 4-5th graders, 79 % (95 % CI: 72, 86) for males and 64 % (95 % CI: 58, 70) for females. Among females, PA was highest on swings [82 % (95 % CI: 77, 86)] and lowest on paved areas [56 % (95 % CI: 43, 69)]. Among males, it was highest on both swings [81 % (95 % CI: 75, 86)] and ball courts [83 % (95 % CI: 77, 89)] and lowest on grassy areas [64 % (95 % CI: 60, 67)]. Conclusion: Swings, courts, and play structures were associated with a higher proportion of children being engaged in PA. Research is needed to identify whether physical improvements to facilitate access to these features increase PA.

Examination of community-level interventions addressing early childhood obesity in Los Angeles County.

Objective: To help inform decisions regarding the equitable implementation of obesity interventions, we examined whether interventions were equitably reaching the most vulnerable communities, identified communities that received fewer interventions than expected, and estimated the effect of 'dose' of interventions on obesity prevalence. Methods: We created a database to identify and characterize obesity-related interventions implemented in Los Angeles County from 2005 to 2015 linked to community-level sociodemographic and obesity prevalence data. We ran generalized linear models with a Gamma distribution and log link to determine if interventions were directed toward vulnerable communities and to identify communities that received fewer interventions than expected. We ran fixed-effects models to estimate the association between obesity prevalence and intervention strategy count among preschool-aged children enrolled in the Special Supplemental Nutrition Assistance Program for Women Infants and Children. Results: We found that interventions targeted vulnerable communities with high poverty rates and percentages of minority residents. The small cluster of communities that received fewer interventions than expected tended to have poor socioeconomic profiles. Communities which received more intervention strategies saw greater declines in obesity prevalence (ß = -0.023; 95 % CI: -0.031, -0.016). Conclusions: It is important to determine if interventions are equitably reaching vulnerable populations as resources to tackle childhood obesity become available. Evaluating the population impact of multiple interventions implemented simultaneously presents methodological challenges in measuring intervention dose and identifying cost-effective strategies. Addressing these challenges must be an important research priority as community-wide interventions involve multiple intervention strategies to reduce health disparities.

Low-Protein Infant Formula Enriched with Alpha-Lactalbumin during Early Infancy May Reduce Insulin Resistance at 12 Months: A Follow-Up of a Randomized Controlled Trial.

High protein intake during infancy results in accelerated early weight gain and potentially later obesity. The aim of this follow-up study at 12 months was to evaluate if modified low-protein formulas fed during early infancy have long-term effects on growth and metabolism. In a double-blinded RCT, the ALFoNS study, 245 healthy-term infants received low-protein formulas with either alpha-lactalbumin-enriched whey (α-lac-EW; 1.75 g protein/100 kcal), casein glycomacropeptide-reduced whey (CGMP-RW; 1.76 g protein/100 kcal), or standard infant formula (SF; 2.2 g protein/100 kcal) between 2 and 6 months of age. Breastfed (BF) infants served as a reference. At 12 months, anthropometrics and dietary intake were assessed, and serum was analyzed for insulin, C-peptide, and insulin-like growth factor 1 (IGF-1). Weight gain between 6 and 12 months and BMI at 12 months were higher in the SF than in the BF infants (p = 0.019; p < 0.001, respectively), but were not significantly different between the low-protein formula groups and the BF group. S-insulin and C-peptide were higher in the SF than in the BF group (p < 0.001; p = 0.003, respectively), but more alike in the low-protein formula groups and the BF group. Serum IGF-1 at 12 months was similar in all study groups. Conclusion: Feeding modified low-protein formula during early infancy seems to reduce insulin resistance, resulting in more similar growth, serum insulin, and C-peptide concentrations to BF infants at 6-months post intervention. Feeding modified low-protein formula during early infancy results in more similar growth, serum insulin, and C-peptide concentrations to BF infants 6-months post intervention, probably due to reduced insulin resistance in the low-protein groups.

Eating Habits and Lifestyle Factors Related to Childhood Obesity Among Children Aged 5-6 Years: Cluster Analysis of Panel Survey Data in Korea.

BACKGROUND: Childhood obesity has emerged as a major health issue due to the rapid growth in the prevalence of obesity among young children worldwide. Establishing healthy eating habits and lifestyles in early childhood may help children gain appropriate weight and further improve their health outcomes later in life. OBJECTIVE: This study aims to classify clusters of young children according to their eating habits and identify the features of each cluster as they relate to childhood obesity. METHODS: A total of 1280 children were selected from the Panel Study on Korean Children. Data on their eating habits (eating speed, mealtime regularity, consistency of food amount, and balanced eating), sleep hours per day, outdoor activity hours per day, and BMI were obtained. We performed a cluster analysis on the children's eating habits using k-means methods. We conducted ANOVA and chi-square analyses to identify differences in the children's BMI, sleep hours, physical activity, and the characteristics of their parents and family by cluster. RESULTS: At both ages (ages 5 and 6 years), we identified 4 clusters based on the children's eating habits. Cluster 1 was characterized by a fast eating speed (fast eaters); cluster 2 by a slow eating speed (slow eaters); cluster 3 by irregular eating habits (poor eaters); and cluster 4 by a balanced diet, regular mealtimes, and consistent food amounts (healthy eaters). Slow eaters tended to have the lowest BMI (P<.001), and a low proportion had overweight and obesity at the age of 5 years (P=.03) and 1 year later (P=.005). There was a significant difference in sleep time (P=.01) and mother's education level (P=.03) at the age of 5 years. Moreover, there was a significant difference in sleep time (P=.03) and the father's education level (P=.02) at the age of 6 years. CONCLUSIONS: Efforts to establish healthy eating habits in early childhood may contribute to the prevention of obesity in children. Specifically, providing dietary guidance on a child's eating speed can help prevent childhood obesity. This research suggests that lifestyle modification could be a viable target to decrease the risk of childhood obesity and promote the development of healthy children. Additionally, we propose that future studies examine long-term changes in obesity resulting from lifestyle modifications in children from families with low educational levels.

Family systems approaches in pediatric obesity management: a scoping review.

Family-based obesity management interventions targeting child, adolescent and parental lifestyle behaviour modifications have shown promising results. Further intervening on the family system may lead to greater improvements in obesity management outcomes due to the broader focus on family patterns and dynamics that shape behaviours and health. This review aimed to summarize the scope of pediatric obesity management interventions informed by family systems theory (FST). Medline, Embase, CINAHL and PsycInfo were searched for articles where FST was used to inform pediatric obesity management interventions published from January 1980 to October 2023. After removal of duplicates, 6053 records were screened to determine eligibility. Data were extracted from 50 articles which met inclusion criteria; these described 27 unique FST-informed interventions. Most interventions targeted adolescents (44%), were delivered in outpatient hospital settings (37%), and were delivered in person (81%) using group session modalities (44%). Professionals most often involved were dieticians and nutritionists (48%). We identified 11 FST-related concepts that guided intervention components, including parenting skills, family communication, and social/family support. Among included studies, 33 reported intervention effects on at least one outcome, including body mass index (BMI) (n = 24), lifestyle behaviours (physical activity, diet, and sedentary behaviours) (n = 18), mental health (n = 12), FST-related outcomes (n = 10), and other outcomes (e.g., adiposity, cardiometabolic health) (n = 18). BMI generally improved following interventions, however studies relied on a variety of comparison groups to evaluate intervention effects. This scoping review synthesises the characteristics and breadth of existing FST-informed pediatric obesity management interventions and provides considerations for future practice and research.

Association of Serum Folate and Vitamin B 12 Concentrations with Obesity in Chinese Children and Adolescents.

Objective: This study aimed to evaluate the associations of serum folate and/or vitamin B 12 concentrations with obesity among Chinese children and adolescents. Methods: A cross-sectional study was conducted including 3,079 Chinese children and adolescents, aged 6 to 17 years, from Jiangsu, China. Anthropometric indices, such as, children's body mass index (BMI), BMI z-scores, waist circumference, and waist-to-height ratio were utilized. Multivariable linear regression and generalized additive models were used to investigate the associations of serum folate and vitamin B 12 levels with anthropometric indices and odds of obesity. Results: We observed that serum vitamin B 12 concentrations were inversely associated with all anthropometric indices and the odds of general obesity [odds ratio ( OR) = 0.68; 95% confidence interval ( CI) = 0.59, 0.78] and abdominal obesity ( OR = 0.68; 95% CI = 0.60, 0.77). When compared to participants with both serum vitamin levels in the two middle quartiles, those with both serum folate and vitamin B 12 levels in the highest quartile were less prone to general ( OR = 0.31, 95% CI = 0.19, 0.50) or abdominal obesity ( OR = 0.46, 95% CI = 0.31, 0.67). Conversely, participants with vitamin B 12 levels in the lowest quartile alongside folate levels in the highest quartile had higher odds of abdominal obesity ( OR = 2.06, 95% CI = 1.09, 3.91). Conclusion: Higher serum vitamin B 12 concentrations, but not serum folate concentrations, were associated with lower odds of childhood obesity. Children and adolescents with high levels of vitamin B 12 and folate were less likely to be obese.

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.

Addressing the Challenge: A Review of Effective Prevention Strategies for Childhood Obesity in India.

Childhood obesity is a growing public health concern in India, with rising prevalence rates and associated health risks. This review examines effective prevention strategies for addressing this issue. Through a comprehensive analysis of research findings, policy initiatives, and community-based interventions, the review identifies critical components of successful prevention efforts. These include multi-sectoral collaborations, tailored interventions addressing socioeconomic and cultural factors, and the involvement of families and healthcare professionals. The importance of addressing childhood obesity in India is underscored, given its significant impact on health outcomes, healthcare costs, and quality of life. The review concludes with a call to action for stakeholders and policymakers to prioritise prevention efforts, allocate resources, and implement evidence-based interventions to combat childhood obesity effectively. By working together, India can mitigate the adverse effects of childhood obesity and promote a healthier future for its children.

Obesity and dyslipidemia in early life: Impact on cardiometabolic risk.

Childhood obesity with its growing prevalence worldwide presents one of the most important health challenges nowadays. Multiple mechanisms are involved in the development of this condition, as well as in its associations with various cardiometabolic complications, such as insulin resistance, diabetes, metabolic dysfunction-associated steatotic liver disease and cardiovascular diseases. Recent findings suggest that childhood obesity and associated dyslipidemia at least partly originate from epigenetic modifications that take place in the earliest periods of life, namely prenatal and perinatal periods. Hence, alterations of maternal metabolism could be fundamentally responsible for fetal and neonatal metabolic programming and consequently, for metabolic health of offspring in later life. In this paper, we will review recent findings on the associations among intrauterine and early postnatal exposure to undesirable modulators of metabolism, development of childhood obesity and later cardiometabolic complications. Special attention will be given to maternal dyslipidemia as a driven force for undesirable epigenetic modulations in offspring. In addition, newly proposed lipid biomarkers of increased cardiometabolic risk in obese children and adolescents will be analyzed, with respect to their predictive potential and clinical applicability.

Effectiveness of a Preschool Motor Skill Intervention on Body Mass Index and Movement Behavior: 6-, 18-, and 30-Month Findings From a Cluster Randomized Controlled Trial.

PURPOSE: To study the effectiveness of a preschool staff-delivered motor skills intervention on body composition and physical activity over a 2.5-year time frame. METHODS: In this pragmatic parallel cluster randomized controlled trial (16 preschools), outcome data were collected after 6 (body composition only), 18, and 30 months of intervention. The main physical activity outcomes were accelerometer behavior measures summarizing the total percentage of child daily movement (walk, run, cycle, and standing that included minor movements) and preschool movement during preschool attendance. To estimate between-group mean differences in outcomes, mixed-linear regression analyses including baseline value of the selected outcome and a treatment × time interaction term as a fixed effect were applied. In addition, the baseline preschool and child were included as a random effect. RESULTS: For body mass index, a total of 437 children (90%) had at least one valid baseline and one follow-up assessment. The corresponding numbers for preschool movement and daily movement were 163 (55%) and 146 (49%), respectively. No significant between-group mean difference was identified for body mass index, waist-to-height ratio, or any physical activity outcomes. CONCLUSION: Overall, this preschool motor skills intervention had no effect on either child anthropometry or physical activity, consistent with previous studies.

The evaluation of non-alcoholic fatty liver disease in children with obesity with vibration-controlled transient elastography.

INTRODUCTION: Parallel to the worldwide increase in obesity, the epidemic of chronic liver disease is increasing also in pediatric population. Our aim is to provide a different outlook on the current screening confusion in pediatric non-alcoholic fatty liver disease (NAFLD) with the non-invasive vibration-controlled transient elastography (VCTE) method. MATERIALS AND METHODS: This single-center, cross-sectional, comparative study was performed at the tertiary center, included 95 patients with obesity and 116 controls, both groups were 9-18 years of ages. VCTE examinations performed in all patients. The cut-off values for controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were established by comparing the study and control groups. RESULTS: The cut-off for CAP was determined as >236 dB/m when comparing the two groups. The AUC was 0.900 (95% CI, 0.851-0.937) and the diagnostic accuracy was 77.9% and 91.4% for sensitivity and specificity, respectively. The cut-off value for LSM >5 kPa was determined by comparison of the two groups. The AUC was 0.794 (95% CI, 0.733-0.846) and the diagnostic accuracies were 50.5% and 90.5% for sensitivity and specificity, respectively. CONCLUSIONS: There is no benchmark method for screening pediatric NAFLD. However, VCTE is a promising method for screening pediatric NAFLD. It is accessible, repeatable and practical.

Role of one-carbon nutrient intake and diabetes during pregnancy in children's growth and neurodevelopment: A 2-year follow-up study of a prospective cohort.

BACKGROUND & AIMS: Both maternal metabolic dysregulation, e.g., gestational diabetes mellitus (GDM), and maternal supply of nutrients that participate in one-carbon (1C) metabolism, e.g., folate, choline, betaine, and vitamin B12, have been demonstrated to influence epigenetic modification such as DNA methylation, thereby exerting long-lasting impacts on growth and development of offspring. This study aimed to determine how maternal 1C nutrient intake was associated with DNA methylation and further, development of children, as well as whether maternal GDM status modified the association in a prospective cohort. METHODS: In this study, women with (n = 18) and without (n = 20) GDM were recruited at 25-33 weeks gestation. Detailed dietary intake data was collected by 3-day 24-h dietary recall and nutrient levels in maternal blood were also assessed at enrollment. The maternal-child dyads were invited to participate in a 2-year follow-up during which anthropometric measurement and the Bayley Scales of Infant and Toddler Development™ Screening Test (Third Edition) were conducted on children. The association between maternal 1C nutrients and children's developmental outcomes was analyzed with a generalized linear model controlling for maternal GDM status. RESULTS: We found that children born to mothers with GDM had lower scores in the language domain of the Bayley test (p = 0.049). Higher maternal food folate and choline intakes were associated with better language scores in children (p = 0.01 and 0.025, respectively). Higher maternal food folate intakes were also associated with better cognitive scores in children (p = 0.002). Higher 1C nutrient intakes during pregnancy were associated with lower body weight of children at 2 years of age (p < 0.05). However, global DNA methylation of children's buccal cells was not associated with any maternal 1C nutrients. CONCLUSIONS: In conclusion, higher 1C nutrient intake during pregnancy was associated with lower body weight and better neurodevelopmental outcomes of children. This may help overcome the lower language scores seen in GDM-affected children in this cohort. Studies in larger cohorts and with a longer follow-up duration are needed to further delineate the relationship between prenatal 1C nutrient exposure, especially in GDM-affected pregnancies, and offspring health outcomes.

BMI Growth Profiles Among Black Children from Immigrant and US-Born Families.

A large body of research has documented racial/ethnic disparities in childhood obesity in the United States (US) but less work has sought to understand differences within racial groups. Longitudinal studies are needed to describe BMI trajectories across development, particularly for Black children from immigrant families who have been underrepresented in childhood obesity research. The current study utilizes BMI data collected longitudinally from ages 5 to 8 years and growth mixture modeling to (1) identify and visualize growth patterns among Black children from primarily Caribbean immigrant families, and (2) to compare these patterns to growth trajectories among Black children from US-born families. First, we identified four classes or trajectories of growth for Black children from immigrant families. The largest trajectory (70% of the sample) maintained non-overweight throughout the study period. A second trajectory developed overweight by age 8 (25%). Two small trajectory groups demonstrated high rates of moderate and severe obesity-i.e., specifically, a trajectory of accelerated weight gain ending in moderate/severe obesity (3%), and a trajectory of early severe obesity with BMI decreasing slightly with age (2%). We identified a very similar four class/trajectory model among Black children from US-born families, and compared the model to the one for children from immigrant families using multi-group growth mixture modeling. We found that the patterns of growth did not differ significantly between the populations, with two notable exceptions. Among Black children from immigrant families, ∼ 5% were classified into the two heavier BMI trajectories, compared to ∼ 11% of children from US-born families. Additionally, among children with an accelerated weight gain trajectory, children from immigrant families had lower BMIs on average at each time point than children from US-born families. These findings describe the multiple trajectories of weight gain among Black children from immigrant families and demonstrate that although these trajectories are largely similar to those of Black children from US-born families, the differences provide some evidence for lower obesity risk among Black children from immigrant families compared to Black children from US-born families. As this study is the first to describe BMI trajectories for Black children from immigrant families across early and middle childhood, future work is needed to replicate these results and to explore differences in heavier weight trajectories between children from immigrant and US-born families.

Methylation profiles at birth linked to early childhood obesity.

Childhood obesity represents a significant global health concern and identifying its risk factors is crucial for developing intervention programs. Many "omics" factors associated with the risk of developing obesity have been identified, including genomic, microbiomic, and epigenomic factors. Here, using a sample of 48 infants, we investigated how the methylation profiles in cord blood and placenta at birth were associated with weight outcomes (specifically, conditional weight gain, body mass index, and weight-for-length ratio) at age six months. We characterized genome-wide DNA methylation profiles using the Illumina Infinium MethylationEpic chip, and incorporated information on child and maternal health, and various environmental factors into the analysis. We used regression analysis to identify genes with methylation profiles most predictive of infant weight outcomes, finding a total of 23 relevant genes in cord blood and 10 in placenta. Notably, in cord blood, the methylation profiles of three genes (PLIN4, UBE2F, and PPP1R16B) were associated with all three weight outcomes, which are also associated with weight outcomes in an independent cohort suggesting a strong relationship with weight trajectories in the first six months after birth. Additionally, we developed a Methylation Risk Score (MRS) that could be used to identify children most at risk for developing childhood obesity. While many of the genes identified by our analysis have been associated with weight-related traits (e.g., glucose metabolism, BMI, or hip-to-waist ratio) in previous genome-wide association and variant studies, our analysis implicated several others, whose involvement in the obesity phenotype should be evaluated in future functional investigations.

Performance of home-based and ambulatory blood pressure monitoring in obese children and their correlation with end organ damage.

BACKGROUND: The increasing prevalence of childhood obesity has led to a corresponding increase in hypertension among children, necessitating early identification of subclinical target organ damage for accurate cardiovascular risk assessment. However, in the pediatric population, there is a paucity of literature comparing ambulatory and home blood pressure monitoring, and this knowledge gap is exacerbated by limited access to ambulatory blood pressure monitoring (ABPM) facilities, particularly in developing countries, where pediatricians often resort to home blood BP monitoring as the preferred option. METHOD: In this cross-sectional study with 60 obese children (aged 5-18 years) at a tertiary health care in central India, we aimed to comprehensively characterize blood pressure profiles, including office, ambulatory and home and investigated their correlations with indicators of end-organ damage. RESULT: Among 60 children, 26 (43.3%) participants were found to be hypertensive based on 24 Hr ABPM evaluation. Masked hypertension and white coat hypertension (WCH) were observed in 21.6% and 13.3% respectively. Surprisingly, 20% of participants were identified as hypertensive through 7-day home BP monitoring (HBPM). A notable discordance of 36.6% was between HBPM and ABPM results. Moreover, 26.7% of the children had end-organ damage, with higher odds associated with night-time systolic ambulatory hypertension in the adjusted regression model (OR = 1.06, 95% CI: 1.03-1.10, p < 0.001). CONCLUSION: The study highlights 24-hour ABPM's vital role in classifying hypertensive status, especially in high-risk children. The diagnostic performance of HBPM shows poor sensitivity in detecting MH and lower specificity in identifying WCH compared to ABPM. This limitation translates to missed opportunities for early preventive interventions.

Obesity and Preventive Intervention Among Children: A Narrative Review.

Childhood obesity has become a major public health concern around the world, with a rise in prevalence over the last few decades. This abstract provides an overview of pediatric obesity, including its causes, implications, and potential treatments. Childhood obesity is caused by a complex combination of environmental, genetic, and behavioral variables. A child's likelihood of developing obesity is influenced by factors, such as socioeconomic status, family dynamics, and cultural norms. Childhood obesity leads to extensive repercussions, elevating the risk of chronic conditions, such as diabetes, cardiovascular diseases, and mental health challenges. Furthermore, children dealing with obesity often face social stigmatization, diminished self-esteem, and academic struggles. Efforts to prevent and manage childhood obesity should employ a comprehensive and multi-tiered approach. This involves enacting policies geared toward enhancing nutrition in schools and communities, advocating for increased physical activity (PA), and curbing sedentary behaviors.

Obesity contagion among classmates: Children's relation with each other regarding weight status, physical activity, and dietary intake.

A series of influential articles suggests that obesity may spread between couples, siblings, and close friends via an obesity contagion phenomenon. Classmates, as important structural equivalents in one's social network, may experience obesity contagion. However, this has rarely been examined. Anthropometric measurements, questionnaire surveys, and geographic information were collected from 3670 children from 26 schools in Northeast China. We found that classmates were positively related in terms of body mass index (BMI), body fat, physical activity, and intake of vegetables, fruits, fast food, snacks, and sugar-sweetened beverages. One standard deviation (SD) increase in classmates' mean BMI and percentage body fat was associated with 0.19 SD higher individual BMI (95% confidence interval [CI]: 0.00, 0.39) and 0.31 SD higher percentage body fat (95% CI: 0.13, 0.48). Coefficients ranged from 0.48 to 0.76 in models for physical activity, and the dietary intake of vegetables, fruit, fast food, snacks, and sugar-sweetened beverages. Children's BMI and body fat were more strongly associated with the maximum and minimum body fat levels of their same-sex classmates than with those of their general classmates. Their dietary intake and physical activity were more strongly associated with the mean/median levels of their general classmates than with those of their same-sex classmates. This study suggests that children's BMI, body fat, physical activity, and dietary intake may be related to those of their classmates. Modeling healthy behaviors in the classroom may help children develop habits that support achieving and maintaining a healthy weight. Future interventions should consider the inclusion of classmates as a social network strategy for obesity prevention.

Effect of aerobic exercise on anthropometric parameters among Indian primary school children.

Childhood obesity is a global public health concern with significant implications for long-term health. This study addresses the rising rates of obesity among school-age children (10-12 years) and investigates the effectiveness of aerobic exercise interventions in improving anthropometric parameters, specifically focusing on BMI and mid-arm circumference (MAC). The study emphasizes the role of schools in shaping children's behaviors and aims to contribute empirical evidence to inform health promotion strategies for this demographic. The research employs a quasi-experimental design, involving 60 school-age children in Visnagar, Gujarat, India. The 12-week aerobic exercise intervention, conducted three times a week, comprises activities like running, jumping jacks, and dance routines. Data collection includes sociodemographic information, BMI, and MAC measurements. The study design, participant criteria, and intervention details are carefully outlined. Socio-demographic variables such as age and monthly family income significantly influence BMI, highlighting the importance of considering these factors in interventions. Pretest results show 80% of children classified as overweight, reducing to 58.3% post-intervention. The mean BMI significantly decreases from 24.41 to 22.84 (p < 0.05), indicating the positive impact of aerobic exercise. The study also explores the association between BMI, MAC, and socio-demographic variables through chi-square tests. Data shows the prevalence of overweight and obesity among school-age children and demonstrates the effectiveness of a 12-week aerobic exercise program in improving BMI. Findings align with existing literature on the positive impact of physical activity on weight management in children.

Differences in children's exposure to television advertising of unhealthy foods and beverages in Spain by socio-economic level.

BACKGROUND: The influence of food advertising on food preferences and consumption could also contribute to the socio-economic inequalities among Spanish children in terms of eating habits and childhood obesity. Although the main food advertising channel targeted at children in Spain is television, available studies estimate exposure indirectly by combining content data with audience data. The aim of this study was therefore to describe the frequency of exposure to television advertising of unhealthy foods and drinks, measured directly, among Spanish children and adolescents, and analyse its socio-economic inequalities. METHODS: Observational study of television advertising impacts in a sample of 1590 children aged 4 to 16 years drawn from a consumer panel representative of the Spanish population in this age group, over the course of a full week of broadcasting in February 2022. The sample was obtained through stratified random sampling by Autonomous Region, with quotas being set by reference to socio-demographic variables. Exposure was measured with an audiometer, and the nutrient content of the food and drink advertised was analysed using the nutrient profile of the WHO Regional Office for Europe. We used the Chi-squared test to analyse possible differences in advertising coverage by socio-economic level. RESULTS: The participants saw a weekly mean of 82.4 food and drink commercials, 67.4 of which were for unhealthy products (81.8%), mostly outside the child-protection time slot. On average, low-social class participants received 94.4% more impacts from unhealthy food and drink advertising than did high-class participants (99.9 vs. 51.4 respectively). The mean advertising coverage of unhealthy foods and drinks was 71.6% higher in low-class than in high-class participants (10.9% vs. 18.7%; p = 0.01). CONCLUSION: Spanish children and adolescents received an average of 10 impacts per day from television spots for unhealthy foods and drinks. The exposure of low-class children is double that of high-class children, a finding compatible with the high prevalence of childhood obesity in Spain and the related socio-economic inequalities. To protect Spanish minors from the harmful effects of food advertising and reduce the related social health inequalities would require the implementation of a 24:00 watershed for unhealthy food advertising on television.

Convenience stores: an obesogenic promoter in a metropolitan area of northern Mexico?

Introduction: The prevalence of obesity in the Mexican school-age (5-11 years old) population increased from 8.9 to 18.1% between 1999 and 2022. Although overweight and obesity (OW + Ob) is a complex and multifactorial phenomenon, alongside its increasing trend, changes in eating patterns as a result of obesogenic environments that promote higher energy intake have been documented. The objective of the present study was to detect possible associations between schools and their proximity to and density of convenience stores in Monterrey, Mexico from 2015 to 2018. Materials and methods: Anthropometric data were obtained from a subset of measurements of the National Registry of Weight and Height (RNPT) performed in the Monterrey Mexico metropolitan area in 2015 and 2018, and obesity prevalence was computed and classified into quintiles at the school level. Convenience store data were obtained from the National Directory of Economic Units (DNUE). The analyses consisted of densities within 400-800 m buffers, distance to the nearest stores, and cartographic visualization of the store's kernel density versus OW + Ob hotspots for both periods. Results: A total of 175,804 children in 2015 and 175,964 in 2018 belonging to 1,552 elementary schools were included in the study; during this period, OW + Ob prevalence increased from 38.7 to 39.3%, and a directly proportional relationship was found between the quintiles with the higher OW + Ob prevalence and the number of stores for both radii. Hotspots of OW + Ob ranged from 63 to 91 between 2015 and 2018, and it was visually confirmed that such spots were associated with areas with a higher density of convenience stores regardless of socioeconomic conditions. Conclusion: Although some relationships between the store's proximity/density and OW + Ob could be identified, more research is needed to gather evidence about this. However, due to the trends and the magnitude of the problem, guidelines aimed at limiting or reducing the availability of junk food and sweetened beverages on the school's periphery must be implemented to control the obesogenic environment.