Study Protocol of a Multicenter Randomized Controlled Trial to Tackle Obesity through a Mediterranean Diet vs. a Traditional Low-Fat Diet in Adolescents: The MED4Youth Study

Youth obesity is a strong predictor of adult obesity, which has well-known negative health consequences. Thus, addressing adult obesity requires tackling youth obesity. MED4Youth’s main objective is to strengthen the link between the Mediterranean Diet (MD) and the health benefits against youth obesity and associated cardiovascular disease (CVD) risk factors, identifying positive effects exerted by an MD including sourdough bread and healthy products from the Mediterranean basis (chickpeas/hummus, nuts, and pomegranate juice). For this purpose, a multicenter randomized controlled trial in which an MD-based intervention will be compared to a traditional low-fat diet intervention will be carried out with 240 overweight and obese adolescents (13–17 years) from Spain, Portugal, and Italy. Both interventions will be combined with an educational web-application addressed to engage the adolescents through a learning-through-playing approach, using both educational materials and games. To assess the interventions, adherence to the MD, dietary records, physical activity, food frequency, sociodemographic, and quality of life questionnaires as well as classical anthropometric and biochemical parameters will be evaluated. Furthermore, an omics approach will be performed to elucidate whether the interventions can shape the gut microbiota and gut-derived metabolites to gain knowledge on the mechanisms through which the MD can exert its beneficial effects.

Children’s Changes in Perceptions and Body Composition Following a Family-Based Fitness Intervention

Physical fitness is associated with decreased weight in children, which helps improve youth obesity rates. Family programs can provide practical approaches to improving physical fitness for children. The purpose of this study was to assess the influence of a family-based fitness intervention on changes in body composition, fitness status, and perceptions of obese children. Families attended exercise and education sessions for 60–90 min once per week for 10 weeks. Participants consisted of 10 children who participated in semi-structured interviews, body composition, and fitness assessments at pre- and posttest. Following the intervention, results showed that children had a significant increase in sit-ups (p = .03, effect size = 0.79), lean mass (p < .001, Cohen’s d = 1.95), and bone mineral content (p < .001, Cohen’s d = 0.46). Using thematic analysis, four main themes emerged from the pre- and postintervention interviews: an increase in after-school and weekend intentional physical fitness, rules regarding sedentary behavior and screen time, more prevalent physical fitness reinforcements, and a shift in perception of exercise. Results from this study indicate a family-based intervention had an influence on children’s appreciation for and engagement in physical fitness, as well as healthy body composition and fitness outcomes.

Clinical and School-based Intervention strategies for Youth Obesity Prevention: A systematic Review

In the last decades, numerous interventions strategies (IS) have been set up in school/community or clinical sectors using physical activity (PA) in order to prevent youth obesity. Those two sectors have shown interesting elements in terms of efficient results and best practices mechanisms but they have been rarely compared to learn one from the other. The aims of the systematic review was to analyze and synthesize PA IS from school/community or clinical domains, for the period 2013-2017, in French or English, targeting youth 5-19 years old through primary, secondary and tertiary prevention. In total, 68 full articles were kept for data extraction and synthesis and 617 were excluded because didn’t meet eligibility criteria. Results identified a number of differences between the studies of the various IS sectors and identified a third type of IS: mixed sectors. They should be privileged because it can add at a time school/community-based and clinical-based strength. Mixed IS showed the most promising results. This review also showed differences between sectors and their IS on intervention team, prevention objective, duration, material and efficiency. Future studies should focus on establishing a prevention program in a given geographical area involving all stakeholders with their respective skills/knowledge, in decision making and in the development of the IS, that it be the most efficient and best adapted to its environment.

Analysis on the Relationship between Eating Behavior, Physical Activities and Youth Obesity: Based on the Korea Youth Risk Behavior Survey for High School Students in 2016~2018

In this study, a total of 94,511 surveys were used for the analysis, using raw data from the recent 3 years (2016–2018) of the Korea Youth Risk Behavior Survey (KYRBS) to compare differences in obesity rates based on eating behavior and physical activity among high school students. The cross-analysis and logistic regression were performed in the composite sample design using the SPSS 25.0 statistical package. The results are as follows. First, the more physical activity male students have, the lower the obesity rate. Female students, however, showed a minor difference. Second, the group that drinks the soda was 1158 times more likely to be obese than the group that does not drink the soda, and third, the group that eats the fast food was 1129 times more likely to be obese than the group that does not. Fourth, students belonging to male or female schools had a 1230 times higher obesity rate than coeducational students. Fifth, the obesity rate was 1150 times higher for second grade and 1263 times higher for third grade compared to the first grade. Finally, there was no significant difference related to the nutrition education. It is suggested that, to fight youth obesity in high school students, institutions need to raise public awareness of this problem through information campaigns aimed at improving and fostering potentially existing educational measures.