Management of Childhood Obesity—Time to Shift from Generalized to Personalized Intervention Strategies

Abstract

As a major public health concern, childhood obesity is a multifaceted and multilevel metabolic disorder influenced by genetic and behavioral aspects. While genetic risk factors contribute to and interact with the onset and development of excess body weight, available evidence indicates that several modifiable obesogenic behaviors play a crucial role in the etiology of childhood obesity. Although a variety of systematic reviews and meta-analyses have reported the effectiveness of several interventions in community-based, school-based, and home-based programs regarding childhood obesity, the prevalence of children with excess body weight remains high. Additionally, researchers and pediatric clinicians are often encountering several challenges and the characteristics of an optimal weight management strategy remain controversial. Strategies involving a combination of physical activity, nutritional, and educational interventions are likely to yield better outcomes compared to single-component strategies but various prohibitory limitations have been reported in practice. This review seeks to (i) provide a brief overview of the current preventative and therapeutic approaches towards childhood obesity, (ii) discuss the complexity and limitations of research in the childhood obesity area, and (iii) suggest an Etiology-Based Personalized Intervention Strategy Targeting Childhood Obesity (EPISTCO). This purposeful approach includes prioritized nutritional, educational, behavioral, and physical activity intervention strategies directly based on the etiology of obesity and interpretation of individual characteristics.

Frequent Medical Supervision Increases the Effectiveness of a Longitudinal Multidisciplinary Body Weight Reduction Program: A Real-World Experience in a Population of Children and Adolescents with Obesity

“…Although patients' participation is fundamental for achieving therapeutic success, we believe that the constant tailoring of any intervention to the specific clinical characteristics of the obese patients (e.g., the presence of comorbidities or psychological status) plays a pivotal role [24][25][26]. In particular, the medical and paramedical staff of our institution, through repeated sessions of medical supervision, can make therapeutic adjustments that, meeting a patient's different needs, ensure the achievement of even ambitious targets in terms of weight loss and cardiometabolic outcomes [27].…”

Precision Food Parenting: A Proposed Conceptual Model and Research Agenda

“…To keep pace with consumer expectations and the available science and technology, behavioral nutrition must move toward precision dietary behavior change [11,12], i.e., transitioning away from generic, one-size-fits-all dietary change procedures used to influence everyone (groups of people) to procedures tailored to most likely to be effective with a specific individual and the situations or environments they encounter. How to achieve this goal, however, is unclear.…”

Epigenetic Alterations in Pediatric Sleep Apnea

“…With almost 170 million children currently considered obese, and at least half of those children maintaining obesity into adulthood [6], the number of children with undiagnosed sleep apnea is likely very high. The risk of pediatric OSA also increases in vulnerable populations, such as children from low socioeconomic backgrounds, especially preterm infants [7].…”