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 Table of Contents 
FAMILY PRACTICE
Year : 2015  |  Volume : 4  |  Issue : 2  |  Page : 187-192  

Childhood obesity: causes and consequences


1 Phd Scholar, Department of Human Development and Family Studies, Maharana Pratap University of Agriculture and Technology, Udaipur, Rajasthan, India
2 Senior Resident, Department of Pediatrics, Vardhmann Medical College and Safdarjung Hospital, New Delhi, India
3 Assistant Professor, Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
4 Research Scientist, Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
5 CMO In Charge Emergency, Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India
6 Epidemiologist and Public Health Specialist, Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India

Date of Web Publication8-Apr-2015

Correspondence Address:
Ajeet Singh Bhadoria
Epidemiologist and Public Health Specialist, Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4863.154628

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  Abstract 

Childhood obesity has reached epidemic levels in developed as well as in developing countries. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. Overweight and obese children are likely to stay obese into adulthood and more likely to develop non-communicable diseases like diabetes and cardiovascular diseases at a younger age. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising prevalence of obesity worldwide. In general, overweight and obesity are assumed to be the results of an increase in caloric and fat intake. On the other hand, there are supporting evidence that excessive sugar intake by soft drink, increased portion size, and steady decline in physical activity have been playing major roles in the rising rates of obesity all around the world. Childhood obesity can profoundly affect children's physical health, social, and emotional well-being, and self esteem. It is also associated with poor academic performance and a lower quality of life experienced by the child. Many co-morbid conditions like metabolic, cardiovascular, orthopedic, neurological, hepatic, pulmonary, and renal disorders are also seen in association with childhood obesity.

Keywords: Childhood obesity, consequences, epidemiology, lifestyle, non-communicable disease, overweight


How to cite this article:
Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS. Childhood obesity: causes and consequences. J Family Med Prim Care 2015;4:187-92

How to cite this URL:
Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS. Childhood obesity: causes and consequences. J Family Med Prim Care [serial online] 2015 [cited 2020 Aug 14];4:187-92. Available from: http://www.jfmpc.com/text.asp?2015/4/2/187/154628


  Introduction Top


The world is undergoing a rapid epidemiological and nutritional transition characterized by persistent nutritional deficiencies, as evidenced by the prevalence of stunting, anemia, and iron and zinc deficiencies. Concomitantly, there is a progressive rise in the prevalence of obesity, diabetes and other nutrition related chronic diseases (NRCDs) like obesity, diabetes, cardiovascular disease, and some forms of cancer. Obesity has reached epidemic levels in developed countries. The highest prevalence rates of childhood obesity have been observed in developed countries; however, its prevalence is increasing in developing countries as well. [1] Females are more likely to be obese as compared to males, owing to inherent hormonal differences. [2]

It is emerging convincingly that the genesis of Type 2 Diabetes and Coronary Heart Disease begins in childhood, with childhood obesity serving as an important factor. [3] There has been a phenomenal rise in proportions of children having obesity in the last 4 decades, especially in the developed world. Studies emerging from different parts of India within last decade are also indicative of similar trend. [4],[5],[6],[7],[8],[9] This view has been challenged over recent years and we presently consider these as different forms of the global malnutrition problem. This new conceptualization leads us to simultaneously address the root causes of nutritional deficiencies which in turn will contribute to the control of under nutrition and the prevention of obesity, diabetes, and other NRCDs. This summary provides a public health overview of selected key issues related to the prevention of obesity and chronic diseases with a life-course perspective of nutrition and child growth.

Childhood obesity is one of the most serious public health challenges of the 21 st century. The problem is global and is steadily affecting many low and middle income countries, particularly in urban settings. The prevalence has increased at an alarming rate. Globally in 2010, the number of overweight children under the age of five is estimated to be over 42 million. Close to 35 million of these are living in developing countries.


  Definition of Childhood Obesity Top


Although definition of obesity and overweight has changed over time, it can be defined as an excess of body fat (BF). There is no consensus on a cut-off point for excess fatness of overweight or obesity in children and adolescents. A study by conducted by Williams et al. (1992), on 3,320 children in the age-group of 5-18 years classified children as fat if their percentage of body fat was at least 25% for males and 30% for females, respectively. [10] The Center for Disease Control and Prevention defined overweight as at or above the 95 th percentile of body mass index (BMI) for age and "at risk for overweight" as between 85 th to 95 th percentile of BMI for age. [11],[12] European researchers classified overweight as at or above 85 th percentile and obesity as at or above 95 th percentile of BMI. [13]

An Indian research study has defined overweight and obesity as overweight (between ≥85 th and <95 th percentile) and obesity (≥95 th percentile). [14] Another study has followed World Health Organization 2007 growth reference for defining overweight and obesity. [15]

There are also several methods to measure the percentage of body fat. In research, techniques include underwater weighing (densitometry), multi-frequency bioelectrical impedance analysis (BIA), and magnetic resonance imaging (MRI). In the clinical environment, techniques such as BMI, waist circumference, and skin-fold thickness have been used extensively. Although, these methods are less accurate than research methods, they are satisfactory to identify risk. While BMI seems appropriate for differentiating adults, it may not be as useful in children because of their changing body shape as they progress through normal growth. In addition, BMI fails to distinguish between fat and fat-free mass (muscle and bone) and may exaggerate obesity in large muscular children. Furthermore, maturation pattern differs between genders and different ethnic groups. Studies that used BMI to identify overweight and obese children based on percentage of body fat have found high specificity (95-100%), but low sensitivity (36-66%) for this system of classification. [16] While health consequences of obesity are related to excess fatness, the ideal method of classification should be based on direct measurement of fatness. Although methods such as densitometry can be used in research practice, they are not feasible for clinical settings. For large population-based studies and clinical situations, bioelectrical impedance analysis (BIA) is widely used. Waist circumference seems to be more accurate for children because it targets central obesity, which is a risk factor for type II diabetes and coronary heart disease.


  Causes of Childhood Obesity Top


It is widely accepted that increase in obesity results from an imbalance between energy intake and expenditure, with an increase in positive energy balance being closely associated with the lifestyle adopted and the dietary intake preferences. However, there is increasing evidence indicating that an individual's genetic background is important in determining obesity risk. Research has made important contributions to our understanding of the factors associated with obesity. The ecological model, as described by Davison et al., suggests that child risk factors for obesity include dietary intake, physical activity, and sedentary behavior. [17] The impact of such risk factors is moderated by factors such as age, gender. Family characteristics parenting style, parents' lifestyles also play a role. Environmental factors such as school policies, demographics, and parents' work-related demands further influence eating and activity behaviors.

Genetics are one of the biggest factors examined as a cause of obesity. Some studies have found that BMI is 25-40% heritable. [18] However, genetic susceptibility often needs to be coupled with contributing environmental and behavioral factors in order to affect weight. [19] The genetic factor accounts for less than 5% of cases of childhood obesity. [18] Therefore, while genetics can play a role in the development of obesity, it is not the cause of the dramatic increase in childhood obesity.

Basal metabolic rate has also been studied as a possible cause of obesity. Basal metabolic rate, or metabolism, is the body's expenditure of energy for normal resting functions. Basal metabolic rate is accountable for 60% of total energy expenditure in sedentary adults. It has been hypothesized that obese individuals have lower basal metabolic rates. However, differences in basal metabolic rates are not likely to be responsible for the rising rates of obesity. [18]

Review of the literature investigates factors behind poor diet and offers numerous insights into how parental factors may impact on obesity in children. [20] They note that children learn by modeling parents' and peers' preferences, intake and willingness to try new foods. Availability of, and repeated exposure to, healthy foods is key to developing preferences and can overcome dislike of foods. Mealtime structure is important with evidence suggesting that families who eat together consume more healthy foods. Furthermore, eating out or watching TV while eating is associated with a higher intake of fat. Parental feeding style is also significant. The author's found that authoritative feeding (determining which foods are offered, allowing the child to choose, and providing rationale for healthy options) is associated with positive cognitions about healthy foods and healthier intake. Interestingly authoritarian restriction of "junk-food" is associated with increased desire for unhealthy food and higher weight. [21]

Government and social policies could also potentially promote healthy behavior. Research indicates taste, followed by hunger and price, is the most important factor in adolescents snack choices. [22] Other studies demonstrate that adolescents associate junk food with pleasure, independence, and convenience, whereas liking healthy food is considered odd. [23] This suggests investment is required in changing meanings of food, and social perceptions of eating behavior. As proposed by the National Taskforce on Obesity (2005), fiscal policies such as taxing unhealthy options, providing incentives for the distribution of inexpensive healthy food, and investing in convenient recreational facilities or the esthetic quality of neighborhoods can enhance healthy eating and physical activity. [24]

Dietary factors have been studied extensively for its possible contributions to the rising rates of obesity. The dietary factors that have been examined include fast food consumption, sugary beverages, snack foods, and portion sizes.

Fast food Consumption: Increased fast food consumption has been linked with obesity in the recent years. Many families, especially those with two parents working outside the home, opt for these places as they are often favored by their children and are both convenient and inexpensive. [25] Foods served at fast food restaurants tend to contain a high number of calories with low nutritional values. A study conducted examined the eating habits of lean and overweight adolescents at fast food restaurants. [26] Researchers found that both groups consumed more calories eating fast food than they would typically in a home setting but the lean group compensated for the higher caloric intake by adjusting their caloric intake before or after the fast food meal in anticipation or compensation for the excess calories consumed during the fast food meal. Though many studies have shown weight gain with regular consumption of fast food, it is difficult to establish a causal relationship between fast food and obesity.

Sugary beverages

A study examining children aged 9-14 from 1996-1998, found that consumption of sugary beverages increased BMI by small amounts over the years. [18] Sugary drinks are another factor that has been examined as a potential contributing factor to obesity. Sugary drinks are often thought of as being limited to soda, but juice and other sweetened beverages fall into this category. Many studies have examined the link between sugary drink consumption and weight and it has been continually found to be a contributing factor to being overweight. [18] Sugary drinks are less filling than food and can be consumed quicker, which results in a higher caloric intake. [19]

Snack foods

Another factor that has been studied as a possible contributing factor of childhood obesity is the consumption of snack foods. Snack foods include foods such as chips, baked goods, and candy. Many studies have been conducted to examine whether these foods have contributed to the increase in childhood obesity. While snacking has been shown to increase overall caloric intake, no studies have been able to find a link between snacking and overweight. [18]

Portion size

Portion sizes have increased drastically in the past decade. Consuming large portions, in addition to frequent snacking on highly caloric foods, contribute to an excessive caloric intake. This energy imbalance can cause weight gain, and consequently obesity. [18]

Activity level

One of the factors that is most significantly linked to obesity is a sedentary lifestyle. Each additional hour of television per day increased the prevalence of obesity by 2%. [18] Television viewing among young children and adolescents has increased dramatically in recent years. [18],[27] The increased amount of time spent in sedentary behaviors has decreased the amount of time spent in physical activity. Research which indicates the number of hours children spend watching TV correlates with their consumption of the most advertised goods, including sweetened cereals, sweets, sweetened beverages, and salty snacks. [22] Despite difficulties in empirically assessing the media impact, other research discussed emphasizes that advertising effects should not be underestimated. Media effects have been found for adolescent aggression and smoking and formation of unrealistic body ideals. Regulation of marketing for unhealthy foods is recommended, as is media advocacy to promote healthy eating.

Environmental factors

While extensive television viewing and the use of other electronic media has contributed to the sedentary lifestyles, other environmental factors have reduced the opportunities for physical activity. Opportunities to be physically active and safe environments to be active in have decreased in the recent years. The majority of children in the past walked or rode their bike to school. A study conducted in 2002 found that 53% of parents drove their children to school. [18] Of these parents, 66% said they drove their children to school since their homes were too far away from the school. Other reasons parents gave for driving their children to school included no safe walking route, fear of child predators, and out of convenience for the child. [18] Children who live in unsafe areas or who do not have access to safe, well-lit walking routes have fewer opportunities to be physically active. [18]

Socio-cultural factors

Socio-cultural factors have also been found to influence the development of obesity. Our society tends to use food as a reward, as a means to control others, and as part of socializing. [28] These uses of food can encourage the development of unhealthy relationships with food, thereby increasing the risk of developing obesity.

Family factors

Family factors have also been associated with the increase of cases of obesity. The types of food available in the house and the food preferences of family members can influence the foods that children eat. In addition, family mealtimes can influence the type of food consumed and the amount thereof. Lastly, family habits, whether they are sedentary or physically active, influence the child. [28] Studies have shown that having an overweight mother and living in a single parent household are associated with overweight and childhood obesity. [29]

Psychological factors

Depression and anxiety

A recent review concluded that the majority of studies find a prospective relationship between eating disturbances and depression. [30] However, this relationship is not unidirectional; depression may be both a cause and a consequence of obesity. [31] Additionally, in a clinical sample of obese adolescents, a higher life-time prevalence of anxiety disorders was reported compared to non-obese controls. [32] Although some studies demonstrate no significant relationship between increased BMI and increased anxiety symptoms. [33] Thus, the relationship between obesity and anxiety may not be unidirectional and is certainly not conclusive.

Self-esteem

Research findings comparing overweight/obese children with normal-weight children in regards to self-esteem have been mixed. [34] Some studies have found that obese children have lower self-esteem while others do not. [35],[36],[37] There is some consensus in the literature that the global approach to self-esteem measurement with children who are overweight/obese is misleading as the physical and social domains of self-esteem seem to be where these children are most vulnerable. [38]

Body dissatisfaction

Research has consistently found that body satisfaction is higher in males than females at all ages. [39] Gender differences may reflect the westernized cultural ideals of beauty in that thinness is the only culturally defined ideal for females, while males are encouraged to be both lean and muscular. Thus, there is a linear relationship between body dissatisfaction and increasing BMI for girls; while for boys a U-shaped relationship suggests that boys with BMIs at the low and high extremes experience high levels of body dissatisfaction. [40],[41]

Eating disorder symptoms

Traits associated with eating disorders appear to be common in adolescent obese populations, particularly for girls. [42] A number of studies have shown higher prevalence of eating-related pathology (i.e. Anorexia, Bulimia Nervosa, and impulse regulation) in obese children/youth. [43],[44]

Emotional problems

In one of the few studies to investigate the psychological impact of being overweight/obese in children, a review of 10 published studies over a 10-year period (1995-2005) with sample sizes greater than 50 revealed that all participants reported some level of psychosocial impact as a result of their weight status. [45] Being younger, female, and with an increased perceived lack of control over eating seemed to heighten the psychosocial consequences.

Consequences of childhood obesity

Childhood obesity can profoundly affect children's physical health, social, and emotional well-being, and self esteem. It is also associated with poor academic performance and a lower quality of life experienced by the child. These potential consequences are further examined in the following sections.

Medical consequences

Childhood obesity has been linked to numerous medical conditions. These conditions include, but are not limited to, fatty liver disease, sleep apnea, Type 2 diabetes, asthma, hepatic steatosis (fatty liver disease), cardiovascular disease, high cholesterol, cholelithiasis (gallstones), glucose intolerance and insulin resistance, skin conditions, menstrual abnormalities, impaired balance, and orthopedic problems. [25],[46] Until recently, many of the above health conditions had only been found in adults; now they are extremely prevalent in obese children. Although most of the physical health conditions associated with childhood obesity are preventable and can disappear when a child or adolescent reaches a healthy weight, some continue to have negative consequences throughout adulthood. [46] In the worst cases, some of these health conditions can even result in death. Below, three of the more common health problems associated with childhood obesity are discussed, diabetes, sleep apnea, and cardiovascular disease.

Socio-emotional consequences

In addition to being implicated in numerous medical concerns, childhood obesity affects children's and adolescent's social and emotional health. Obesity has been described as being "one of the most stigmatizing and least socially acceptable conditions in childhood." [38] Overweight and obese children are often teased and/or bullied for their weight. They also face numerous other hardships including negative stereotypes, discrimination, and social marginalization. [46] Discrimination against obese individuals has been found in children as young as 2 years old. [28] Obese children are often excluded from activities, particularly competitive activities that require physical activity. It is often difficult for overweight children to participate in physical activities as they tend to be slower than their peers and contend with shortness of breath. [25] These negative social problems contribute to low self esteem, low self confidence, and a negative body image in children and can also affect academic performance. [46] All of the above-mentioned negative effects of overweight and obesity can be devastating to children and adolescents.

The social consequences of obesity may contribute to continuing difficulty in weight management. Overweight children tend to protect themselves from negative comments and attitudes by retreating to safe places, such as their homes, where they may seek food as a comfort. In addition, children who are overweight tend to have fewer friends than normal weight children, which results in less social interaction and play, and more time spent in sedentary activities. [25] As aforementioned, physical activity is often more difficult for overweight and obese children as they tend to get shortness of breath and often have a hard time keeping up with their peers. This in turn inevitably results in weight gain, as the amount of calories consumed exceeds the amount of energy burned. [25]

Academic consequences

Childhood obesity has also been found to negatively affect school performance. A research study concluded that overweight and obese children were four times more likely to report having problems at school than their normal weight peers. [38] They are also more likely to miss school more frequently, especially those with chronic health conditions such as diabetes and asthma, which can also affect academic performance.


  Conclusion Top


The growing issue of childhood obesity can be slowed, if society focuses on the causes. There are many components that play into childhood obesity, some being more crucial than others. A combined diet and physical activity intervention conducted in the community with a school component is more effective at preventing obesity or overweight. Moreover, if parents enforce a healthier lifestyle at home, many obesity problems could be avoided. What children learn at home about eating healthy, exercising and making the right nutritional choices will eventually spill over into other aspects of their life. This will have the biggest influence on the choices kids make when selecting foods to consume at school and fast-food restaurants and choosing to be active. Focusing on these causes may, over time, decrease childhood obesity and lead to a healthier society as a whole.

 
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4 Impact of a Ketogenic Diet on Metabolic Parameters in Patients with Obesity or Overweight and with or without Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials
Yeo Jin Choi,Sang-Min Jeon,Sooyoung Shin
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93 Short Sleep Duration and Later Overweight in Infants
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94 Physical fitness and activity, metabolic profile, adipokines and endothelial function in children
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95 Pediatric Obesity and Eating Disorders Symptoms: The Role of the Multidisciplinary Treatment. A Systematic Review
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96 Predicting childhood obesity using electronic health records and publicly available data
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97 “It's Good, It's Delicious, It's Great”
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98 The Association of the Executive Functions with Overweight and Obesity Indicators in Children and Adolescents: A Literature Review
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99 Dietary Guidelines Are Not Met by In-Home Child Care Providers in Low-Income Areas
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100 Different types of parental stress and childhood obesity: A systematic review of observational studies
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101 Australian parentsæ experiences when discussing their childæs overweight and obesity with the Maternal and Child Health nurse: A qualitative study
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102 DIABRISK-SL trial: further consideration of age and impact of imputations
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103 HEALTH AND DISEASE PROFILE OF CHILDREN IN REMOTE RURAL POCKETS OF HIMACHAL PRADESH, WITH A LOOK-OUT FOR UNCOMMON AND RARE DISEASES- A COLLAGE OF HEALTH CAMP BASED CROSS SECTIONAL STUDY
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104 Association between obesity in 4- to 7-year-old children and eight types of crime: a hierarchical linear modelling approach
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105 Behavioral, contextual and biological factors associated with obesity during adolescence: A systematic review
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107 Concordance between whole-body scan and half-body scan to evaluate body composition in dual-energy X-ray absorptiometry in children and adolescents with different nutritional and pubertal conditions
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108 Impact of lifestyle behaviors in early childhood on obesity and cardiometabolic risk in children: Results from the Spanish INMA birth cohort study
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109 Obesity Predicts Liver Function Testing and Abnormal Liver Results
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110 The Effect of Nurse-Led Diet and Physical Activity Program for Health on Diet and Physical Activity Behavior of Children
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111 Protective effect of Curcuma amada acetone extract against high-fat and high-sugar diet-induced obesity and memory impairment
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113 Psychometric properties of the Turkish version of the weight efficacy lifestyle questionnaire short-form for adolescents
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114 A Cluster Randomised Controlled Trial of an Intervention to Increase Physical Activity of Preschool-Aged Children Attending Early Childhood Education and Care: Study Protocol for the ‘Everybody Energise’ Trial
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115 The Association between Early Childhood and Later Childhood Sugar-Containing Beverage Intake: A Prospective Cohort Study
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116 Prevalence and Predictors of Obesity among 7- to 17-Year-Old Schoolchildren in Urban Arusha, Tanzania
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119 Design Guidelines for a Technology-Enabled Nutrition Education Program to Support Overweight and Obese Adolescents: Qualitative User-Centered Design Study
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121 Tri-Ponderal Mass Index: A Screening Tool for Risk of Central Fat Accumulation in Brazilian Preschool Children
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122 Salivary Alpha-Amylase Mediates the Increase in Hunger Levels in Adolescents with Excess Weight after Viewing Food Images
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124 Estimating the Double Burden of Malnutrition among 595,975 Children in 65 Low- and Middle-Income Countries: A Meta-Analysis of Demographic and Health Surveys
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125 The Dynamic Relationship Between Asthma and Obesity in Schoolchildren
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126 Associations of extracurricular physical activity patterns and body composition components in a multi-ethnic population of UK children (the Size and Lung Function in Children study): a multilevel modelling analysis
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128 Youth physical health and years in American homeschools: are they related?
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129 Increased acute postoperative wound problems following spinal fusion in overweight patients with adolescent idiopathic scoliosis
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130 Effectiveness of cognitive-behavioral therapy on nutrition improvement and weight of overweight and obese adolescents: A randomized controlled trial
Seyedeh Fatemeh Miri,Maryam Javadi,Chung-Ying Lin,Mark D. Griffiths,Maria Björk,Amir H. Pakpour
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131 The health challenges of families experiencing homelessness
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132 Cross-sectional associations of objectively assessed sleep duration with physical activity, BMI and television viewing in German primary school children
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134 One- and Two-Year Effects of the Healthy Primary School of the Future on Children’s Dietary and Physical Activity Behaviours: A Quasi-Experimental Study
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136 Impact of obese levels on the hepatic expression of nuclear receptors and drug-metabolizing enzymes in adult and offspring mice
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137 Investigating the Relationship Between Weight-Related Self-Stigma and Mental Health for Overweight/Obese Children in Hong Kong
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138 The Impact of Front-of-Package Traffic Light (Foptl) in the Senior High School Students’ Nutrition Labels Comprehension
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139 Change in obesity-related metabolic abnormalities associated with body mass index improvement through life-style intervention: A meta-regression
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141 Association between grandparent co-residence, socioeconomic status and dental caries among early school-aged children in Japan: A population-based prospective study
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144 The Impact of Following Solid Food Feeding Guides on BMI Among Infants: A Simulation Study
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146 Effect of the Resistance Exercise on Elementary School Students’ Physical Fitness
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147 Structural connectivity and weight loss in children with obesity: a study of the “connectobese”
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149 Characterizing Micro-scale Disparities in Childhood Obesity: Examining the Influence of Multilevel Factors on 4-Year Changes in BMI, Healthy Eating, and Physical Activity, Among a Cohort of Children Residing in Disadvantaged Urban Enclaves
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150 Monogenic leptin deficiency in early childhood obesity
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151 The association between children’s food habits, anthropometric parameters and health-related quality of life in Chilean schoolchildren
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152 Validity and Reliability of a Korean Version of Yale Food Addiction Scale for Children (YFAS-C)
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153 Parent and School-Age Childrenæs Food Preparation Cognitions and Behaviors Guide Recommendations for Future Interventions
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154 Predictors of victimization among youth who are overweight in a national sample
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155 Comorbidity, Codevelopment, and Temporal Associations Between Body Mass Index and Internalizing Symptoms From Early Childhood to Adolescence
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156 Extra-familial social factors and obesity in the Hispanic Community Children’s Health Study/Study of Latino Youth
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158 MOVI-daFIT! Intervention
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159 Factors Associated With Leisure Time Physical Activity Among Schoolchildren in a Predominantly Latino Community
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160 Health behavior knowledge among Hispanic California islanders: Evaluation of a parental educational intervention
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162 Cardiorespiratory Fitness Cut-Points are Related to Body Adiposity Parameters in Latin American Adolescents
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163 Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-Food Consumption: A Meta-Analysis of Global School-Based Student Health Surveys
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164 Call for action
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165 Mother and Father Controlling Feeding Behaviors and Associations With Observed Mealtime Family Functioning
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166 Unravelling the Effects of the Healthy Primary School of the Future: For Whom and Where Is It Effective?
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167 Associations between combined overweight and obesity, lifestyle behavioural risk and quality of life among Australian regional school children: baseline findings of the Goulburn Valley health behaviours monitoring study
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169 Prevalence of overweight and obesity among US youth with autism spectrum disorder
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170 Psychological well-being and weight-related teasing in childhood obesity: a case–control study
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171 A Report of Health Related Anthropometric Indices in 2–5 Years Old Children of Golestan Province of Iran in 2015
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172 Associations between Physical Activity and Food Intake among Children and Adolescents: Results of KiGGS Wave 2
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173 Prevalence of overweight among youth with chronic conditions in the United States: An update from the 2016 National Survey of Childrenæs Health
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174 Disturbed eating behaviours do not impact treatment response in a paediatric obesity chronic care treatment programme
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175 Effect of Curcumin and a-Lipoic Acid in Attenuating Weight Gain and Adiposity
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176 Psychomotor Limitations of Overweight and Obese Five-Year-Old Children: Influence of Body Mass Indices on Motor, Perceptual, and Social-Emotional Skills
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177 Health risk behaviors, violence exposure, and current asthma among adolescents in the United States
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178 Helping With Meal Preparation and Children’s Dietary Intake: A Literature Review
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179 Socio-Demographic Factors and Body Image Perception Are Associated with BMI-For-Age among Children Living in Welfare Homes in Selangor, Malaysia
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180 Physical Activity and Sedentary Time Are Positively Associated With Academic Performance: A 3-Year Longitudinal Study
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181 Are Movement Behaviors and Fundamental Motor Skills Associated With Fitness and Fatness in Early Childhood? Findings From the 2012 NHANES National Youth Fitness Survey
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182 Obesity and muscle-macrophage crosstalk in humans and mice: A systematic review
Srikesh Rudrapatna,Meha Bhatt,Kuan-Wen Wang,Rachel Bierbrier,Pei-Wen Wang,Laura Banfield,Wagdi Elsheikh,E. Danielle Sims,Devin Peterson,Lehana Thabane,Mark A. Tarnopolsky,Gregory R. Steinberg,M. Constantine Samaan
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183 Personalizing the Dietary Guidelines: use of a feedback report to help adolescent students plan health behaviors using a SMART goal approach
Sarah Martin,Moonseong Heo,Camille C Jimenez,Jean Lim,David W. Lounsbury,Lynn Fredericks,Michelle Bouchard,Tara Herrera,April Sosa,Judith Wylie-Rosett
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184 Association of Elective and Emergency Cesarean Delivery With Early Childhood Overweight at 12 Months of Age
Meijin Cai,See Ling Loy,Kok Hian Tan,Keith M. Godfrey,Peter D. Gluckman,Yap-Seng Chong,Lynette Pei-Chi Shek,Yin Bun Cheung,Ngee Lek,Yung Seng Lee,Shiao-Yng Chan,Jerry Kok Yen Chan,Fabian Yap,Seng Bin Ang
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185 Genetic Susceptibility for Childhood BMI has no Impact on Weight Loss Following Lifestyle Intervention in Danish Children
Mette Hollensted,Mette Fogh,Theresia M. Schnurr,Julie T. Kloppenborg,Christian T. Have,Tenna Ruest Haarmark Nielsen,Johanne Rask,Morten Asp Vonsild Lund,Christine Frithioff-Bøjsøe,Mia Østergaard Johansen,Emil Vincent Rosenbaum Appel,Yuvaraj Mahendran,Niels Grarup,Haja N. Kadarmideen,Oluf Pedersen,Jens-Christian Holm,Torben Hansen
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186 The iCook 4-H Study: Report on Physical Activity and Sedentary Time in Youth Participating in a Multicomponent Program Promoting Family Cooking, Eating, and Playing Together
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187 Viewing obesogenic advertising in childrenæs neighbourhoods using Google Street View
Victoria Egli,Caryn Zinn,Lisa Mackay,Niamh Donnellan,Karen Villanueva,Suzanne Mavoa,Daniel J. Exeter,Stefanie Vandevijvere,Melody Smith
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188 Differences in Step Counts, Motor Competence, and Enjoyment Between an Exergaming Group and a Non-Exergaming Group
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189 How Accurate Is Using Parent-Reported Height and Weight for Screening Children and Adolescents for Overweight and Obesity? Meta-Analyses at Both Population and Individual Levels
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190 Using the Intervention Mapping Protocol to develop an online video intervention for parents to prevent childhood obesity: Movie Models
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Global Health Promotion. 2018; 25(2): 56
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191 Health-related quality of life in adolescents with excess weight
Helen F. D’avila,Fabiana A. Poll,Cézane P. Reuter,Miria S. Burgos,Elza D. Mello
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192 Thirsty? Choose Water! Behavioural interventions and water stations in secondary schools a two-by-two factorial randomised controlled trial
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BMC Public Health. 2018; 18(1)
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193 The Associations Between Screen Time, Sleep Duration, and Body Mass Index (BMI) in Under Five-Year-Old Children
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Archives of Neuroscience. 2018; In Press(In Press)
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194 Does motivational interviewing improve the weight management process in adolescents? Protocol for a systematic review and meta-analysis
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195 Anorexia nervosa in adolescents: evolution of weight history and impact of excess premorbid weight
Klara Meierer,Alexandre Hudon,Marc Sznajder,Marie-France Leduc,Danielle Taddeo,Olivier Jamoulle,Jean-Yves Frappier,Chantal Stheneur
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196 Using Formative Research to Develop the Healthy Me, Healthy We Campaign
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197 EFETIVIDADE DE PROGRAMAS DE INTERVENÇÃO PARA OBESIDADE COM BASE EM ORIENTAÇÕES PARA ESCOLARES ADOLESCENTES: REVISÃO SISTEMÁTICA
Vaneza Lira Waldow Wolf,Juan Eduardo Samur-San-Martin,Suzy Ferreira de Sousa,Hemerson Dinis Oliveira Santos,Augusto Gerhart Folmann,Roberto Régis Ribeiro,Gil Guerra-Júnior
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198 Using Anthropometric Indicator to Identify Hypertension in Adolescents: A Study in Sarawak, Malaysia
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International Journal of Hypertension. 2018; 2018: 1
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199 Gut microbiota alterations and dietary modulation in childhood malnutrition – The role of short chain fatty acids
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Clinical Nutrition. 2018;
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200 The Impact of Brain Breaks Classroom-Based Physical Activities on Attitudes toward Physical Activity in Polish School Children in Third to Fifth Grade
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International Journal of Environmental Research and Public Health. 2018; 15(2): 368
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201 Grey matter alterations in obesity: A meta-analysis of whole-brain studies
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202 Self-reported weight and predictors of missing response in youth
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203 Maternal restrictive feeding practices for child weight control and associated characteristics
Fabrícia R. Freitas,Denise E.B. Moraes,Sarah Warkentin,Laís A. Mais,Júlia F. Ivers,José Augusto A.C. Taddei
Jornal de Pediatria. 2018;
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204 Qualitative perspectives on a family group intervention program for improving physical wellness
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205 Food claims and nutrition facts of commercial infant foods
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206 Relationship between Sedentary Time, Physical Activity and Multiple Lifestyle Factors in Children
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207 Validation of a child version of the Three-Factor Eating Questionnaire in a Canadian sample: a psychometric tool for the evaluation of eating behaviour
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208 A comparative analysis of socioeconomic inequities in stunting: a case of three middle-income African countries
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209 Association of maternal pre-pregnancy body mass index and gestational weight gain with Chinese infant growth
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210 Criterion Validity and Sensitivity to Change of a Pediatric Bioelectrical Impedance Analysis Scale in Adolescents
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211 Dietary behaviors throughout childhood are associated with adiposity and estimated insulin resistance in early adolescence: a longitudinal study
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International Journal of Behavioral Nutrition and Physical Activity. 2018; 15(1)
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212 Content Analysis of Media Coverage of Childhood Obesity Topics in UAE Newspapers and Popular Social Media Platforms, 2014-2017
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International Journal of Health Policy and Management. 2018; 8(2): 81
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213 Mindfulness and psychological adjustment in paediatric obesity: The mediating role of body image
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214 Changes in Self-Efficacy and Outcome Expectations From Child Participation in Bicycle Trains for Commuting to and From School
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215 Rural parents’ beliefs about healthy eating
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216 Prevalence of metabolically healthy obese phenotype and associated factors in South American overweight adolescents: a cross-sectional study
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217 The INSIGHT responsive parenting intervention reduced infant weight gain and overweight status
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218 Polymorphism of PPARG (P12A), APOA1 (G75A), and APOE (C112A and A158C) Genes in Children with Obesity and Arterial Hypertension: A Case-Control Study
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219 Childhood Obesity Research: A Synthetic Scoping Review
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220 Piloting the FIT Game to Increase Physical Activity in One Sixth Grade Classroom (Preprint)
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221 Effect of an Education Program on Nutrition Knowledge, Attitudes toward Nutrition, Diet Quality, Lifestyle, and Body Composition in Polish Teenagers. The ABC of Healthy Eating Project: Design, Protocol, and Methodology
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222 Type 1 and 2 diabetes mellitus: A review on current treatment approach and gene therapy as potential intervention
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Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2018;
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223 Understanding High Incidence of Severe Obesity and Very Low Food Security in Food Pantry Clients: Implications For Social Work
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Social Work in Public Health. 2018; : 1
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224 Obesity linking to hepatocellular carcinoma: A global view
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225 The association of air pollution with body mass index: evidence from Hong Kong’s “Children of 1997” birth cohort
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226 The prevalence and characteristics of overweight and obesity among students in Qatar
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227 ACE, APOA5, and MTP Gene Polymorphisms Analysis in Relation to Triglyceride and Insulin Levels in Pediatric Patients
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228 Impact of Diets Rich in Whole Grains and Fruits and Vegetables on Cardiovascular Risk Factors in Overweight and Obese Women: A Randomized Clinical Feeding Trial
Somaye Fatahi,Elnaz Daneshzad,Hamed Kord-Varkaneh,Nick Bellissimo,Neil R. Brett,Leila Azadbakht
Journal of the American College of Nutrition. 2018; : 1
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229 Association between dental hygiene, gingivitis and overweight or the risk of overweight in primary teeth of 4- and 5-year-old preschoolers in México
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230 Health-related quality-of-life model in adolescents with different body composition
Karina Franco-Paredes,Felipe J. Díaz-Reséndiz,Carlos Alejandro Hidalgo-Rasmussen,Lilián Elizabeth Bosques-Brugada
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity. 2018;
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231 Social vulnerabilities as determinants of overweight in 2-, 4- and 6-year-old Spanish children
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European Journal of Public Health. 2018; 28(2): 289
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232 Smoking habit from the paternal line and grand-child’s overweight or obesity status in early childhood: prospective findings from the lifeways cross-generation cohort study
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International Journal of Obesity. 2018;
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233 Body image dissatisfaction and dietary patterns according to nutritional status in adolescents
Rita de Cássia Ribeiro-Silva,Rosemeire Leovigildo Fiaccone,Maria Ester Pereira da Conceição-Machado,Ana Santos Ruiz,Maurício Lima Barreto,Mônica Leila Portela Santana
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234 Peripheral Blood Cells, a Transcriptomic Tool in Nutrigenomic and Obesity Studies: Current State of the Art
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Comprehensive Reviews in Food Science and Food Safety. 2018;
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235 Mother’s obesity and high child’s waist circumference are predictive factors of severe child’s obesity: an observational study in French Guiana
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236 Appendicular fracture epidemiology of children and adolescents: a 10-year case review in Western Australia (2005 to 2015)
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Archives of Osteoporosis. 2018; 13(1)
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237 Prevalence and factors associated with overweight and obesity among children from primary schools in urban areas of Lomé, Togo
Herbert Sagbo,Didier Koumavi Ekouevi,Dorland Tafitarilova Ranjandriarison,Serge Niangoran,Tchaa Abalo Bakai,Agbelenko Afanvi,Sewu Dieudonné,Yao Kassankogno,Philippe Vanhems,Nagham Khanafer
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238 Development and initial validation evidence for a mindful eating questionnaire for children
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239 Teens Implementing a Childhood Obesity Prevention Program in the Community: Feasibility and Perceptions of a Partnership with HSTA and iCook 4-H
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240 Health Disparities Score Composite of Youth and Parent Dyads from an Obesity Prevention Intervention: iCook 4-H
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241 PREVALENCE OF OBESITY IN STUDENTS WITH SPECIFIC LEARNING DISORDER IN A METROPOLITAN CITY OF INDIA
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242 Physical fitness and activity, metabolic profile, adipokines and endothelial function in children
Jociene Terra da Penha,Fernanda Mussi Gazolla,Cecília Noronha de Miranda Carvalho,Isabel Rey Madeira,Flávio Rodrigues-Júnior,Elisabeth de Amorim Machado,Fernando Lencastre Sicuro,Paulo Farinatti,Eliete Bouskela,Paulo Ferrez Collett-Solberg
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243 High Maternal Body Mass Index Is Associated with an Early-Onset of Overweight/Obesity in Pre-School-Aged Children in Malawi. A Multilevel Analysis of the 2015-16 Malawi Demographic and Health Survey
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244 EFFECTIVENESS OF AN INTENSIVE LIFESTYLE MODIFICATION PROGRAM IN REDUCING THE WEIGHT OF OBESE CHILDREN AGED 12-18 YEARS
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245 Differential prevalence and associations of overweight and obesity by gender and population group among school learners in South Africa: a cross-sectional study
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246 Obesity and Related Factors Among Children and Adolescents in Qatar
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247 Effect of yoga practices on micronutrient absorption in urban residential school children
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248 A Systematic Review of Mediators of Physical Activity, Nutrition, and Screen Time in Adolescents: Implications for Future Research and Clinical Practice
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249 Association of a history of childhood-onset obesity and dieting with eating disorders
Hellas Cena,Fatima Cody Stanford,Luana Ochner,Maria Luisa Fonte,Ginevra Biino,Rachele De Giuseppe,Elsie Taveras,Madhusmita Misra
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250 A 3-Arm randomised controlled trial of Communicating Healthy Beginnings Advice by Telephone (CHAT) to mothers with infants to prevent childhood obesity
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251 Body mass index trajectories in childhood is predictive of cardiovascular risk: results from the 23-year longitudinal Georgia Stress and Heart study
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252 High blood pressure and its relationship to adiposity in a school-aged population: body mass index vs waist circumference
William Rodrigues Tebar,Raphael Mendes Ritti-Dias,Breno Quintella Farah,Edner Fernando Zanuto,Luiz Carlos Marques Vanderlei,Diego Giulliano Destro Christofaro
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253 Parental Feeding Behaviors and Weight-Related Concerns in Children With Special Needs
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254 Clustering of energy balance-related behaviours and parental education in European preschool children: the ToyBox study
María L. Miguel-Berges,Konstantina Zachari,Alba M. Santaliestra-Pasias,Theodora Mouratidou,Odysseas Androutsos,Violeta Iotova,Sonya Galcheva,Marieke De Craemer,Greet Cardon,Berthold Koletzko,Zbigniew Kulaga,Yannis Manios,Luis A. Moreno
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255 Trimethylamine N-oxide Supplementation Abolishes the Cardioprotective Effects of Voluntary Exercise in Mice Fed a Western Diet
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256 Attachment and eating: A meta-analytic review of the relevance of attachment for unhealthy and healthy eating behaviors in the general population
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257 Observation and assessment of the nutritional quality of ‘out of school’ foods popular with secondary school pupils at lunchtime
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258 Theoretical frameworks informing family-based child and adolescent obesity interventions: A qualitative meta-synthesis
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259 Selected nutritional habits of teenagers associated with overweight and obesity
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260 Determining Barriers to Use of Edible School Gardens in Illinois
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261 Family influence on the consumption of sugary drinks by children under two years old
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262 Determinants of Advanced Bone Age in Childhood Obesity?
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263 Executive Functions and Dietary Behaviors in School-Aged Children
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264 Do mothers affect daughter’s behaviors? Diet, physical activity, and sedentary behaviors in Kuwaiti mother–daughter dyads
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265 Prevalence of overweight and obesity among children and adolescents in Saudi Arabia
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266 Gut Microbiota-Dependent Metabolite Trimethylamine N-Oxide Contributes to Cardiac Dysfunction in Western Diet-Induced Obese Mice
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R. A. Lima,K. A. Pfeiffer,A. Bugge,N. C. Møller,L. B. Andersen,D. F. Stodden
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268 Precocious obesity predisposes the development of more severe cisplatin-induced acute kidney injury in young adult mice
Rosemara S. Ribeiro,Clevia S. Passos,Antônio S. Novaes,Edgar Maquigussa,Maria A. Glória,Iria Visoná,Olinda Ykuta,Lila M. Oyama,Mirian A. Boim,Partha Mukhopadhyay
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269 Maternal perception of childrenæs nutritional status in the Federal District, Brazil
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