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Improving Childhood and Adolescent Health: Intervention Strategies for Reducing Early Obesity and Associated Risk for Diabetes, Cardiovascular Disease, Inflammation, and Oxidative Stress

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Adolescents".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 23996

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Special Issue Editors

Dr. Robert M. Badeau

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Chief Guest Editor

Department of Health Science, Indiana Institute of Technology, Fort Wayne, IN 46805, USA
Interests: cardiometabolic disease pathology; nutrition; resistance training and exercise

Dr. Prince Dadson

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Assistant Guest Editor

1. Turku PET Centre, University of Turku, Turku, Finland
2. Department of Clinical Medicine, University of Turku, Turku, Finland
Interests: obesity; metabolism; biomarkers; tissue metabolism; bariatric surgery studies; type 2 diabetes mellitus; eating disorders (anorexia nervosa); metabolic imaging
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Dr. Robert Femminella

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Assistant Guest Editor

Health Sciences Program, University of Bridgeport, Bridgeport, CT 06604, USA
Interests: cardiovascular disease pathology, immunology, nutrition, mind-body medicine

Special Issue Information

Dear Colleagues,

Worldwide, childhood and adolescent obesity is a major public health challenge. Between 1980 and 2013, the global prevalence of childhood and adolescent obesity increased by over 47%[1] .Early obesity predisposes these future adults to having increased risks for metabolic diseases such as Type 2 diabetes and cardiovascular diseases at a much earlier age compared to non-obese controls. Additionally, this early obesity leads to significantly lower mental health outcomes compared to controls. Early intervention is critical. Educational interventions covering endpoints such as healthy nutritional choices, managing energy balance, and proper physical activity regimens can markedly reduce childhood and adolescent obesity. However, the impact of these nutritional- and physical-activity-oriented interventions—both cross-sectional and longitudinal—on reducing obesity in children and adolescents, with the associated improvement in clinical outcomes being blood pressure and plasma lipid, insulin, and glucose concentrations, prove inconsistent. Additionally, the effects of these obesity-lowering interventions on circulating markers for inflammation and oxidative stress remain uncertain. Technology-driven interventions such as virtual consultations and mobile applications hold promise to sustain weight loss and improve clinical parameters in children and adolescents. Research articles in the form of original articles or reviews from different disciplines addressing these topics are invited for this Special Issue.

1 Prevalence of overweight and obesity in children and adults. Available Online: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)62367-9/fulltext (accessed on 11 January 2021)

Dr. Robert M. Badeau
Dr. Prince Dadson
Dr. Robert Femminella
Guest Editors

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Keywords

childhood obesity
adolescent obesity
nutrition
physical activity
inflammation
oxidative stress
cardiovascular disease
type 2 diabetes
energy balance
health and wellbeing

Published Papers (9 papers)

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Research

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15 pages, 1109 KiB

Open AccessArticle

Targeted Lipidomics and Inflammation Response to Six Weeks of Sprint Interval Training in Male Adolescents

by Aozhe Wang, Haifeng Zhang, Jianming Liu, Zhiyi Yan, Yaqi Sun, Wantang Su, Ji-Guo Yu, Jing Mi and Li Zhao

Int. J. Environ. Res. Public Health 2023, 20(4), 3329; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20043329 - 14 Feb 2023

Cited by 1 | Viewed by 1533

Abstract

Lipids play an important role in coordinating and regulating metabolic and inflammatory processes. Sprint interval training (SIT) is widely used to improve sports performance and health outcomes, but the current understanding of SIT-induced lipid metabolism and the corresponding systemic inflammatory status modification remains controversial and limited, especially in male adolescents. To answer these questions, twelve untrained male adolescents were recruited and underwent 6 weeks of SIT. The pre- and post-training testing included analyses of peak oxygen consumption (VO₂peak), biometric data (weight and body composition), serum biochemical parameters (fasting blood glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triacylglycerol, testosterone, and cortisol), inflammatory markers, and targeted lipidomics. After the 6-week SIT, the serum C-reactive protein (CRP), interleukin (IL)-1β, IL-2, IL-4, IL-10, tumor necrosis factor (TNF)-α, and transforming growth factor (TGF)-β significantly decreased (p < 0.05), whereas IL-6 and IL-10/TNF-α significantly increased (p < 0.05). In addition, the targeted lipidomics revealed changes in 296 lipids, of which 33 changed significantly (p < 0.05, fold change > 1.2 or <1/1.2). The correlation analysis revealed that the changes in the inflammatory markers were closely correlated with the changes in some of the lipids, such as LPC, HexCer, and FFA. In conclusion, the 6-week SIT induced significant changes in the inflammatory markers and circulating lipid composition, offering health benefits to the population. Full article

(This article belongs to the Special Issue Improving Childhood and Adolescent Health: Intervention Strategies for Reducing Early Obesity and Associated Risk for Diabetes, Cardiovascular Disease, Inflammation, and Oxidative Stress)

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14 pages, 1275 KiB

Open AccessArticle

The Effect of the KDL Active School Plan on Children and Adolescents’ Physical Fitness in China

by Tiantian Tong, Xiaozan Wang, Feng Zhai and Xingying Li

Int. J. Environ. Res. Public Health 2022, 19(20), 13286; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192013286 - 14 Oct 2022

Cited by 2 | Viewed by 1779

Abstract

The development of physical fitness among Chinese children and adolescents is not fundamentally improving, and an exploration of effective ways to promote it is an urgent need. Research into physical fitness promotion in schools is increasingly deepening worldwide. However, the implementation and verification of intervention programs with local characteristics in accordance with China’s national conditions are relatively weak. This study conducted a randomized controlled trial to examine the effects of the KDL (Know it, Do it, Love it) Active School Plan (KDL-ASP) on children and adolescents’ physical fitness. A total of 596 students from level two (2nd-grade students) to five (11th-grade students) in China were assessed in terms of their physical fitness. Of these, 308 students were randomly selected to participate in the KDL-ASP, which uses a combination of indoor and outdoor sports activities in which teachers, parents, and students participate together. The remaining 288 students performed conventional physical activities. After one school year of intervention with the KDL-ASP, the physical fitness of the children and adolescents improved. The improvements in the speed of level two girls, the strength of level four boys, and the lung capacity of level five boys were the most obvious. These results demonstrate the viability of indigenized intervention in schools to improve physical fitness and suggest that KDL-ASP needs to be considered throughout the whole progress of physical education learning for children and adolescents. Full article

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10 pages, 328 KiB

Open AccessArticle

Trends in Obesity and Obesity-Related Risk Factors among Adolescents in Korea from 2009 to 2019

by Eunok Park and Young Ko

Int. J. Environ. Res. Public Health 2022, 19(9), 5672; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19095672 - 06 May 2022

Cited by 3 | Viewed by 1711

Abstract

This study was conducted to identify the trends in obesity prevalence among adolescents and changes in the risk factors related to obesity. The study analyzed secondary data obtained from Korean Youth Risk Behavior Web-based Surveys conducted from 2009 to 2019. The Korean Youth Risk Behavior Web-based Survey is an annual survey of a nationwide representative sample of enrolled students aged 13–18 years in middle and high schools in Korea. Linear and trend analyses showed that the prevalence of obesity increased by 0.47% on average annually; this increase was statistically significant. Healthy food intake decreased significantly, but the prevalence of unhealthy food intake and the prevalence of skipping breakfast increased significantly. Vigorous-intensity physical activity, physical activity for over 60 min a day, and muscle-strengthening exercise for more than 3 days a week increased significantly, but so did the adolescents’ sedentary time. Therefore, health care providers and public policymakers need to actively manage adolescent obesity, which has been continuously increasing since 2009. In addition, long-term trends in obesity-related risk factors such as physical activity and dietary behaviors need to be considered in the development of obesity management strategies. Full article

13 pages, 1120 KiB

Open AccessArticle

Failure to Launch: Predictors of Unfavourable Physical Activity and Sedentary Behaviour Trajectories from Childhood to Adolescence: The Gateshead Millennium Study

by Abdulaziz Farooq, Laura Basterfield, Ashley J. Adamson, Mark S. Pearce, Adrienne R. Hughes, Xanne Janssen, Mathew G. Wilson and John J. Reilly

Int. J. Environ. Res. Public Health 2021, 18(24), 13283; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182413283 - 16 Dec 2021

Cited by 4 | Viewed by 2473

Abstract

In a previous study based on this cohort, only 15% of the participants belonged to a favourable physical activity/sedentary behaviour trajectory group (characterised by relatively high moderate–vigorous intensity physical activity and relatively low sedentary behaviour across childhood and adolescence). Since this favourable trajectory is protective against obesity, we aimed to identify factors associated with membership of this group. In this longitudinal study, 671 participants were assessed at ages 7, 9, 12 and 15 years. Participants’ demographics, socio-economic status (SES) and physical activity environment such as, sports club participation and commuting school were assessed at ages 7, 9 and 12 and analysed with favourable trajectory membership as an outcome using multinomial logistic regression. Sex (male) and SES (higher) were the non-modifiable factors associated with favourable trajectory group. Of the modifiable factors, commuting to school at age 7, a safe environment to play at age 7 and sports club participation at age 12 were all associated with more than 2.0 times increased probability of being in the most favourable trajectory. Future interventions to promote a favourable trajectory could focus on girls and participants with low SES. Promoting active commuting, safe local spaces to play and sports participation should also help lead to a favourable trajectory for physical activity and sedentary behaviour across childhood and adolescence. Full article

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22 pages, 557 KiB

Open AccessArticle

Australian School Stakeholders’ Perceived Strategies for Preventing Adolescent Obesity

by Kakale Buru, Theophilus I. Emeto, Aduli E. O. Malau-Aduli and Bunmi S. Malau-Aduli

Int. J. Environ. Res. Public Health 2021, 18(17), 9387; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179387 - 06 Sep 2021

Cited by 2 | Viewed by 4333

Abstract

Adolescent obesity is a complex multifactorial disease with a combination of environmental, behavioral, psychosocial, biological, cultural and genetic determinants. It remains a global public health issue that presents a major challenge to chronic disease prevention and health into adulthood. Schools have a rich opportunity to improve youth health and tackle obesity, yet they face barriers in fulfilling this function. This study investigated school stakeholders’ beliefs and perceptions of the barriers and enablers currently experienced by schools, as well as their recommendations towards preventing adolescent obesity. A sequential explanatory mixed-methods study design was utilised with surveys administered for the quantitative phase and individual interviews for the qualitative phase. Descriptive statistics and inductive thematic analyses were utilised for the survey and interview data, respectively. Triangulation of findings from the quantitative and qualitative phases aided in the better understanding and integration of the overall results. In total, 60 school stakeholders (52 subject teachers, 3 senior teachers and 5 heads of department) from both independent and public high schools in Queensland, Australia responded to the survey, while 14 respondents participated in the interviews. The main perceived causes of obesity were poor eating habits and sedentary lifestyle. Highlighted barriers were busy timetables, shortage of trained staff and funding, lack of robustness in the introduction and implementation of school interventions and insufficient motivation of learners to participate in obesity prevention programs. Enabling factors included parental support, easy access to fitness equipment during recess, supportive government policies, provision of healthier school tuck shop menu options and elimination of sugary drinks from vending machines. A model for the prevention of adolescent obesity was developed based on participants’ perceptions. Tripartite collaboration between the school, government and parents was perceived as fundamental to preventing adolescent obesity. Strategies targeting nutrition, physical activity and overall health, including parental education on health, formal health talks in schools by health professionals and better-targeted advertisement encouraging healthy lifestyle choices, were identified as essential for improved adolescent health outcomes. Full article

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12 pages, 7280 KiB

Open AccessArticle

Moderate-To-Vigorous Intensity Physical Activity and Sedentary Behaviour across Childhood and Adolescence, and Their Combined Relationship with Obesity Risk: A Multi-Trajectory Analysis

by Abdulaziz Farooq, Laura Basterfield, Ashley J. Adamson, Mark S. Pearce, Adrienne R. Hughes, Xanne Janssen, Mathew G. Wilson and John J. Reilly

Int. J. Environ. Res. Public Health 2021, 18(14), 7421; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18147421 - 12 Jul 2021

Cited by 4 | Viewed by 2996

Abstract

The combined role of objectively assessed moderate-vigorous intensity physical activity (MVPA) and sedentary behaviour (SB) is unclear in obesity prevention. This study aimed to identify latent groups for MVPA and SB trajectories from childhood to adolescence and examine their relationship with obesity risk at adolescence. From the Gateshead Millennium Study, accelerometer-based trajectories of time spent in MVPA and SB at ages 7, 9, 12, and 15 were derived as assigned as the predictor variable. Fat mass index (FMI), using bioelectrical impedance at age 15, was the outcome variable. From 672 children recruited, we identified three distinct multiple trajectory groups for time spent in MVPA and SB. The group with majority membership (54% of the cohort) had high MVPA and low SB at childhood, but MVPA declined and SB increased by age 15. One third of the cohort (31%) belonged to the trajectory with low MVPA and high time spent sedentary throughout. The third trajectory group (15% of the cohort) that had relatively high MVPA and relatively low SB throughout had lower FMI (−1.7, 95% CI (−3.4 to −1.0) kg/m², p = 0.034) at age 15 compared to the inactive throughout group. High MVPA and low SB trajectories when combined are protective against obesity. Full article

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13 pages, 620 KiB

Open AccessArticle

The Effect of Dietary Intake and Nutritional Status on Anthropometric Development and Systemic Inflammation: An Observational Study

by Roxana Maria Martin-Hadmaș, Ștefan Adrian Martin, Adela Romonți and Cristina Oana Mărginean

Int. J. Environ. Res. Public Health 2021, 18(11), 5635; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115635 - 25 May 2021

Cited by 2 | Viewed by 2265

Abstract

(1) Background: Daily caloric intake should aim to reduce the risk of obesity or poor anthropometric development. Our study objective was to analyze the association between food consumption, inflammatory status and anthropometric development; (2) Methods: We performed a prospective observational analytical research during September 2020 and April 2021 on a group of 160 healthy subjects, aged between 6 and 12 years old, by analyzing food ingestion, the basal metabolic rate, anthropometric development and the inflammatory status; (3) Results: IL-6 was significantly correlated to the sum of skinfolds, along with both serum proteins and triglycerides. The skin folds were significantly correlated with the caloric intake and with total fat intake, next to saturated and trans fats. Unlike the skin folds, the body weight was significantly correlated with the caloric intake along with some vitamins, such as Vitamin A and Vitamin B12. Inactive mass increased with excessive folic acid, Vitamin E, Vitamin K and saturated fat intake; (4) Conclusions: The inflammatory status was influenced by the ingestion of micronutrients, total serum lipids and proteins. The anthropometric development was associated with the ingestion of carbohydrates, energy balance and energy intake. We can conclude that daily menu and nutrition imbalances can influence both the risk of obesity and the inflammatory status. Full article

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Review

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19 pages, 7294 KiB

Open AccessReview

The Effects of Dietary Education Interventions on Individuals with Type 2 Diabetes: A Systematic Review and Meta-Analysis

by Juri Kim and Myung-Haeng Hur

Int. J. Environ. Res. Public Health 2021, 18(16), 8439; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168439 - 10 Aug 2021

Cited by 12 | Viewed by 3692

Abstract

As the incidence and prevalence of diabetes increases, intervention through dietary education is becoming more important for diabetes control. This systematic review examines the evidence for the efficacy of dietary education interventions on diabetes control. The study subjects were patients with type 2 diabetes, and the main outcome variable was glycosylated hemoglobin level (HbA1c). The target studies were randomized controlled trials. Thirty-six studies were included in the analysis, of which 33 were included in the meta-analysis. The effect size between dietary education and general interventions was −0.42 (n = 5639, MD = −0.42; 95% CI −0.53 to −0.31) and was significantly different (Z = 7.73, p < 0.001). When subgroup analyses were performed following the application periods, intervention methods, and intervention contents, the mean differences in 4–6-month application, individual education, and diet-exercise-psychosocial intervention were −0.51, (n = 2742, 95% CI −0.71 to −0.32), −0.63 (n = 627, 95% CI −1.00 to −0.26), and −0.51 (n = 3244, 95% CI −0.71 to −0.32), respectively. Dietary education interventions provided for at least 3 months were highly effective in controlling HbA1c levels. Regarding the education method, individualized education was more effective, and contact or non-contact education may be applied for this. Combining diet, exercise, and psychosocial intervention is more effective than diet education alone. Full article

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Other

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8 pages, 319 KiB

Open AccessBrief Report

Comparison of Leisure Time Physical Activities by Metabolic Syndrome Status among Adolescents

by Robert Booker, Harish Chander, Keith C. Norris, Roland J. Thorpe, Jr., Brad Vickers and Megan E. Holmes

Int. J. Environ. Res. Public Health 2022, 19(3), 1415; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19031415 - 27 Jan 2022

Cited by 1 | Viewed by 1989

Abstract

Background: Metabolic syndrome (MetS) increases the risk of premature morbidity and mortality. Physical activity (PA) beneficially affects MetS; however, it is unclear if PA types differ among adolescents 12–15 years old, according to their MetS status. This study compared self-reported PA types by MetS status. Methods: Using the 2015–2016 National Health and Nutritional Examination Survey (NHANES) data, 664 adolescents self-reported PA in the past seven days. MetS status was assessed using Ford’s pediatric adaptation of the ATP-III adult criteria. Pearson chi-square and t-tests were conducted to determine self-reported PA differences. Results: The adolescents’ mean age was 13.47 years (95% CIs; 13.04, 14.38) and 52.69% were male (352). Twenty-seven (4.07%) adolescents were MetS positive. The prevalence of PA engagement in the past seven days was similar for MetS-positive and -negative adolescents (77.67% and 70.51%, respectively; p > 0.05). No significant differences were observed for PA type by MetS status. MetS-positive adolescents reported higher sedentary time (565.77 [438.99, 692.56] vs. 490.59 [377.86, 603.33] minutes per day, respectively; p = 0239). Conclusions: Engagement in specific PA types does not appear to differ by MetS status, but MetS-positive adolescents have significantly higher sedentary time. PA promotion should target a variety of activities to maximize the effectiveness of public health programs and interventions should target reducing sedentary time. Full article

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Improving Childhood and Adolescent Health: Intervention Strategies for Reducing Early Obesity and Associated Risk for Diabetes, Cardiovascular Disease, Inflammation, and Oxidative Stress

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