{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:47:37Z","timestamp":1793119657760,"version":"4.5.0"},"reference-count":146,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","clinicalnutritionespen.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Clinical Nutrition ESPEN"],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.1016\/j.clnesp.2026.103260","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T15:31:03Z","timestamp":1774971063000},"page":"103260","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"special_numbering":"C","title":["Childhood obesity and cardiac risk in youth: Emerging challenges toward 2050"],"prefix":"10.1016","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0405-2700","authenticated-orcid":false,"given":"Nikunja Kishor","family":"Mishra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.clnesp.2026.103260_bib1","series-title":"Report of the Commission on Ending Childhood Obesity: implementation plan: executive summary","year":"2017"},{"issue":"3","key":"10.1016\/j.clnesp.2026.103260_bib2","doi-asserted-by":"crossref","first-page":"294","DOI":"10.4103\/1735-1995.156179","article-title":"Systematic review on the association of abdominal obesity in children and adolescents with cardio-metabolic risk factors","volume":"20","author":"Kelishadi","year":"2015","journal-title":"J Res Med Sci"},{"issue":"1","key":"10.1016\/j.clnesp.2026.103260_bib3","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1136\/adc.73.1.25","article-title":"Body mass index reference curves for the UK, 1990","volume":"73","author":"Cole","year":"1995","journal-title":"Arch. Dis. Child"},{"issue":"1","key":"10.1016\/j.clnesp.2026.103260_bib4","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1038\/ijo.2009.61","article-title":"Childhood obesity and adult cardiovascular disease risk: a systematic review","volume":"34","author":"Owen","year":"2010","journal-title":"Int J Obes (Lond)"},{"issue":"20","key":"10.1016\/j.clnesp.2026.103260_bib5","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.1056\/NEJMoa2109191","article-title":"Childhood cardiovascular risk factors and adult cardiovascular events","volume":"386","author":"Jacobs","year":"2022","journal-title":"N Engl J Med"},{"issue":"2","key":"10.1016\/j.clnesp.2026.103260_bib6","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2019-0137","article-title":"Cardiometabolic risk and body composition in youth with Down syndrome","volume":"144","author":"Magge","year":"2019","journal-title":"Pediatrics"},{"issue":"3","key":"10.1016\/j.clnesp.2026.103260_bib7","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1038\/s41390-019-0438-0","article-title":"Lipoprotein particles in patients with pediatric Cushing disease and possible cardiovascular risks","volume":"86","author":"Makri","year":"2019","journal-title":"Pediatr Res"},{"issue":"11","key":"10.1016\/j.clnesp.2026.103260_bib8","doi-asserted-by":"crossref","first-page":"1882","DOI":"10.1002\/oby.23261","article-title":"Associations of midchildhood to early adolescence central adiposity gain with cardiometabolic health in early adolescence","volume":"29","author":"Wu","year":"2021","journal-title":"Obesity (Silver Spring)"},{"key":"10.1016\/j.clnesp.2026.103260_bib9","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2022.892206","article-title":"Visceral adipose tissue and cardiometabolic risk factors in young Hispanic and non-Hispanic girls","volume":"10","author":"Bland","year":"2022","journal-title":"Front Pediatr"},{"issue":"10","key":"10.1016\/j.clnesp.2026.103260_bib10","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s11892-018-1062-9","article-title":"The impact of childhood and adolescent obesity on cardiovascular risk in adulthood: a systematic review","volume":"18","author":"Sommer","year":"2018","journal-title":"Curr Diab Rep"},{"issue":"1","key":"10.1016\/j.clnesp.2026.103260_bib11","doi-asserted-by":"crossref","first-page":"13","DOI":"10.4103\/2230-8210.91176","article-title":"Obesity and cardiovascular risk in children and adolescents","volume":"16","author":"Raj","year":"2012","journal-title":"Indian J Endocrinol Metab"},{"issue":"4","key":"10.1016\/j.clnesp.2026.103260_bib12","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.pbj.2017.02.004","article-title":"Paediatric obesity and cardiovascular risk factors \u2013 a life course approach","volume":"2","author":"Ara\u00fajo","year":"2017","journal-title":"Porto Biomed J"},{"issue":"8","key":"10.1016\/j.clnesp.2026.103260_bib13","first-page":"1","article-title":"Childhood and adolescent obesity: A review","volume":"12","author":"Kansra","year":"2021","journal-title":"Frontiers in Pediatrics"},{"issue":"7244","key":"10.1016\/j.clnesp.2026.103260_bib14","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1136\/bmj.320.7244.1240","article-title":"Establishing a standard definition for child overweight and obesity worldwide: international survey","volume":"320","author":"Cole","year":"2000","journal-title":"BMJ"},{"issue":"5","key":"10.1016\/j.clnesp.2026.103260_bib17","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1017\/S0007114524001582","article-title":"Epidemiology of overweight in under-five children in India: insights from National Family Health Survey","volume":"132","author":"Manapurath","year":"2024","journal-title":"Br J Nutr"},{"issue":"10481","key":"10.1016\/j.clnesp.2026.103260_bib18","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/S0140-6736(25)00355-1","article-title":"Global, regional, and national prevalence of adult overweight and obesity, 1990\u20132021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021","volume":"405","author":"Ng","year":"2025","journal-title":"Lancet"},{"key":"10.1016\/j.clnesp.2026.103260_bib19","series-title":"China National Survey on Students\u2019 Constitution and Health (CNSSCH) 2019","year":"2019"},{"key":"10.1016\/j.clnesp.2026.103260_bib20","series-title":"Global report on obesity","year":"2022"},{"key":"10.1016\/j.clnesp.2026.103260_bib21","series-title":"Report of the Commission on Ending Childhood Obesity","year":"2016"},{"key":"10.1016\/j.clnesp.2026.103260_bib22","volume":"2019\u201321","year":"2021"},{"key":"10.1016\/j.clnesp.2026.103260_bib23","series-title":"National Health and Nutrition Examination Survey (NHANES), 2017\u20132020","year":"2020"},{"key":"10.1016\/j.clnesp.2026.103260_bib24","series-title":"National Child Measurement Programme, England, 2022\u201323","year":"2023"},{"issue":"8","key":"10.1016\/j.clnesp.2026.103260_bib25","doi-asserted-by":"crossref","first-page":"551","DOI":"10.3390\/metabo11080551","article-title":"Cardiovascular risk factors in children with obesity, preventive diagnostics and possible interventions","volume":"11","author":"Mo\u010dnik","year":"2021","journal-title":"Metabolites"},{"key":"10.1016\/j.clnesp.2026.103260_bib26","doi-asserted-by":"crossref","unstructured":"Tilg H, Moschen AR. Adipocytokines: mediators linking adipose tissue, inflammation and immunity. Nat Rev Immunol 2006;6(10):772\u2013783.","DOI":"10.1038\/nri1937"},{"issue":"23","key":"10.1016\/j.clnesp.2026.103260_bib27","doi-asserted-by":"crossref","first-page":"2362","DOI":"10.1056\/NEJMoa031049","article-title":"Obesity and the metabolic syndrome in children and adolescents","volume":"350","author":"Weiss","year":"2004","journal-title":"N Engl J Med"},{"issue":"9727","key":"10.1016\/j.clnesp.2026.103260_bib28","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1016\/S0140-6736(10)60171-7","article-title":"Childhood obesity","volume":"375","author":"Han","year":"2010","journal-title":"Lancet"},{"issue":"2","key":"10.1016\/j.clnesp.2026.103260_bib29","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1038\/s41576-021-00414-z","article-title":"The genetics of obesity: from discovery to biology","volume":"23","author":"Loos","year":"2022","journal-title":"Nature Reviews Genetics"},{"issue":"3","key":"10.1016\/j.clnesp.2026.103260_bib30","doi-asserted-by":"crossref","first-page":"577","DOI":"10.4103\/2230-8210.105575","article-title":"Leptin in pediatrics: a hormone from adipocyte that wheels several functions in children","volume":"16","author":"Soliman","year":"2012","journal-title":"Indian Journal of Endocrinology and Metabolism"},{"key":"10.1016\/j.clnesp.2026.103260_bib31","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.ecl.2009.06.007","article-title":"Pediatric obesity: etiology and treatment","volume":"38","author":"Crocker","year":"2009","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"11","key":"10.1016\/j.clnesp.2026.103260_bib32","first-page":"4521","article-title":"Mutations in the melanocortin 4 receptor gene and early-onset obesity: prevalence, functional characterization, and implications for treatment","volume":"101","author":"K\u00fchnen","year":"2016","journal-title":"J Clin Endocrinol Metabol"},{"issue":"6","key":"10.1016\/j.clnesp.2026.103260_bib33","doi-asserted-by":"crossref","first-page":"2351","DOI":"10.1016\/j.gendis.2022.04.014","article-title":"Studies on the fat mass and obesity-associated (FTO) gene and its impact on obesity-associated diseases","volume":"10","author":"Huang","year":"2023","journal-title":"Genes Dis"},{"issue":"5826","key":"10.1016\/j.clnesp.2026.103260_bib34","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1126\/science.1141634","article-title":"A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity","volume":"316","author":"Frayling","year":"2007","journal-title":"Science"},{"issue":"7538","key":"10.1016\/j.clnesp.2026.103260_bib35","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1038\/nature14177","article-title":"Genetic studies of body mass index yield new insights for obesity biology","volume":"518","author":"Locke","year":"2015","journal-title":"Nature"},{"issue":"11","key":"10.1016\/j.clnesp.2026.103260_bib36","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1038\/ng.686","article-title":"Association analyses of 249,796 individuals reveal 18 new loci associated with body mass index","volume":"42","author":"Speliotes","year":"2010","journal-title":"Na Genet"},{"issue":"7281","key":"10.1016\/j.clnesp.2026.103260_bib37","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1038\/nature08689","article-title":"Large, rare chromosomal deletions associated with severe early-onset obesity","volume":"463","author":"Bochukova","year":"2010","journal-title":"Nature"},{"issue":"9","key":"10.1016\/j.clnesp.2026.103260_bib38","first-page":"2337","article-title":"Enhanced hypothalamic leptin signaling in SH2B1 knockout mice protects against diet-induced obesity","volume":"21","author":"Ren","year":"2007","journal-title":"Mol Endocrinol"},{"key":"10.1016\/j.clnesp.2026.103260_bib39","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1038\/150563a0","article-title":"Canalization of development and the inheritance of acquired characters","volume":"150","author":"Waddington","year":"1942","journal-title":"Nature"},{"key":"10.1016\/j.clnesp.2026.103260_bib40","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1038\/s41580-019-0159-6","article-title":"The diverse roles of DNA methylation in mammalian development and disease","volume":"20","author":"Greenberg","year":"2019","journal-title":"Nat Rev Mol Cell Biol"},{"key":"10.1016\/j.clnesp.2026.103260_bib41","first-page":"2376","article-title":"Quantitative proteomic analysis of histone modifications Chem","volume":"115","author":"Huang","year":"2015","journal-title":"Rev"},{"key":"10.1016\/j.clnesp.2026.103260_bib42","doi-asserted-by":"crossref","DOI":"10.1016\/j.bcp.2020.113973","article-title":"The role of epigenetics in the development of obesity","volume":"177","author":"Obri","year":"2020","journal-title":"Biochem Pharmacol"},{"issue":"2","key":"10.1016\/j.clnesp.2026.103260_bib43","doi-asserted-by":"crossref","first-page":"187","DOI":"10.4103\/2249-4863.154628","article-title":"Childhood obesity: causes and consequences","volume":"4","author":"Sahoo","year":"2015","journal-title":"J Fam Med Prim Care"},{"issue":"9986","key":"10.1016\/j.clnesp.2026.103260_bib44","doi-asserted-by":"crossref","first-page":"2510","DOI":"10.1016\/S0140-6736(14)61746-3","article-title":"Child and adolescent obesity: part of a bigger picture","volume":"385","author":"Lobstein","year":"2015","journal-title":"Lancet"},{"key":"10.1016\/j.clnesp.2026.103260_bib45","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.appet.2012.04.017","article-title":"Systematic reviews of the evidence on the nature, extent, and effects of food marketing to children: a retrospective summary","volume":"62","author":"Cairns","year":"2013","journal-title":"Appetite"},{"issue":"6","key":"10.1016\/j.clnesp.2026.103260_bib46","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1139\/apnm-2015-0627","article-title":"Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth","volume":"41","author":"Chaput","year":"2016","journal-title":"Appl Physiol Nutr Metabol"},{"issue":"7","key":"10.1016\/j.clnesp.2026.103260_bib47","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1038\/ijo.2010.222","article-title":"Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review","volume":"35","author":"Reilly","year":"2011","journal-title":"Int J Obes"},{"key":"10.1016\/j.clnesp.2026.103260_bib48","doi-asserted-by":"crossref","first-page":"S74","DOI":"10.1038\/ijo.2009.22","article-title":"Preventing childhood obesity: what works?","volume":"33","author":"Birch","year":"2009","journal-title":"Int J Obes"},{"key":"10.1016\/j.clnesp.2026.103260_bib49","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1186\/1479-5868-8-98","article-title":"Systematic review of sedentary behaviour and health indicators in school-aged children and youth","volume":"8","author":"Tremblay","year":"2011","journal-title":"Int J Behav Nutr Phys Act"},{"issue":"Suppl 2","key":"10.1016\/j.clnesp.2026.103260_bib50","doi-asserted-by":"crossref","first-page":"S97","DOI":"10.1542\/peds.2016-1758K","article-title":"Screen media exposure and obesity in children and adolescents","volume":"140","author":"Robinson","year":"2017","journal-title":"Pediatrics"},{"issue":"7","key":"10.1016\/j.clnesp.2026.103260_bib51","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1002\/oby.22155","article-title":"Pathways of association from stress to obesity in early childhood. Obesity","volume":"26","author":"Miller","year":"2018","journal-title":"Silver Spring"},{"issue":"1-2","key":"10.1016\/j.clnesp.2026.103260_bib52","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1038\/pr.2015.208","article-title":"Biological, environmental, and social influences on childhood obesity","volume":"79","author":"Campbell","year":"2016","journal-title":"Pediatr Res"},{"issue":"11","key":"10.1016\/j.clnesp.2026.103260_bib53","article-title":"Natural environment and childhood obesity: a systematic review","volume":"21","author":"Jia","year":"2020","journal-title":"Obes Rev"},{"issue":"7","key":"10.1016\/j.clnesp.2026.103260_bib54","first-page":"97","article-title":"Environmental determinants of childhood obesity: A meta-analysis","volume":"11","author":"Jia","year":"2023","journal-title":"Lancet Glob Health"},{"key":"10.1016\/j.clnesp.2026.103260_bib55","article-title":"Psychosocial and environmental risk factors of obesity and hypertension in children and adolescents","volume":"10","author":"Fijacko","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"10.1016\/j.clnesp.2026.103260_bib56","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s12887-015-0366-z","article-title":"Waist circumference, waist-to-hip ratio and waist-to-height ratio reference percentiles for abdominal obesity among Greek adolescents","volume":"15","author":"Bacopoulou","year":"2015","journal-title":"BMC Pediatrics"},{"issue":"10","key":"10.1016\/j.clnesp.2026.103260_bib57","doi-asserted-by":"crossref","first-page":"2563","DOI":"10.1002\/stem.190","article-title":"Depot-specific differences in adipogenic progenitor abundance and proliferative response to high-fat diet","volume":"27","author":"Joe","year":"2009","journal-title":"Stem Cells"},{"issue":"3","key":"10.1016\/j.clnesp.2026.103260_bib58","doi-asserted-by":"crossref","first-page":"294","DOI":"10.4103\/1735-1995.156179","article-title":"Systematic review on the association of abdominal obesity in children and adolescents with cardio-metabolic risk factors","volume":"20","author":"Kelishadi","year":"2015","journal-title":"J Res Med Sci"},{"issue":"1","key":"10.1016\/j.clnesp.2026.103260_bib59","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/j.2047-6310.2012.00136.x","article-title":"Screening for impaired glucose tolerance in obese children and adolescents: A validation and implementation study","volume":"9","author":"Morandi","year":"2014","journal-title":"Pediatr Obes"},{"issue":"3","key":"10.1016\/j.clnesp.2026.103260_bib60","first-page":"235","article-title":"Type 2 diabetes mellitus in children and adolescents: a relatively new clinical problem within pediatric practice","volume":"9","author":"Temneanu","year":"2016","journal-title":"J Med Life"},{"issue":"8","key":"10.1016\/j.clnesp.2026.103260_bib61","doi-asserted-by":"crossref","first-page":"711","DOI":"10.7150\/ijms.20126","article-title":"Arterial stiffness, thickness and association to suitable novel markers of risk at the origin of cardiovascular disease in obese children","volume":"14","author":"Manco","year":"2017","journal-title":"Int J Med Sci"},{"key":"10.1016\/j.clnesp.2026.103260_bib62","doi-asserted-by":"crossref","first-page":"2665","DOI":"10.1038\/s41598-022-06578-w","article-title":"Body composition, physical fitness and cardiovascular risk factors in 9-year-old children","volume":"12","author":"Henriksson","year":"2022","journal-title":"Scientific Rep"},{"issue":"9","key":"10.1016\/j.clnesp.2026.103260_bib63","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004098","article-title":"Childhood body mass index trajectories and associations with adult-onset chronic kidney disease in Denmark: a population-based cohort study","volume":"19","author":"Aarestrup","year":"2022","journal-title":"PLoS Med"},{"issue":"3","key":"10.1016\/j.clnesp.2026.103260_bib64","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1097\/MNH.0000000000000212","article-title":"The dual roles of obesity in chronic kidney disease: A review of the current literature","volume":"25","author":"Rhee","year":"2016","journal-title":"Curr Opin Nephrol Hypertens"},{"issue":"5","key":"10.1016\/j.clnesp.2026.103260_bib65","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1038\/ng.2606","article-title":"Genome-wide meta-analysis identifies 11 new loci for anthropometric traits and provides insights into genetic architecture","volume":"45","author":"Berndt","year":"2013","journal-title":"Nat Genet"},{"issue":"5","key":"10.1016\/j.clnesp.2026.103260_bib66","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1038\/ng.2247","article-title":"A genome-wide association meta-analysis identifies new childhood obesity loci","volume":"44","author":"Bradfield","year":"2012","journal-title":"Nat Genet"},{"issue":"3","key":"10.1016\/j.clnesp.2026.103260_bib67","doi-asserted-by":"crossref","first-page":"221-e226","DOI":"10.1542\/peds.111.3.e221","article-title":"Maternal gestational diabetes, birth weight, and adolescent obesity","volume":"111","author":"Gillman","year":"2003","journal-title":"Pediatrics"},{"issue":"1","key":"10.1016\/j.clnesp.2026.103260_bib68","first-page":"50","article-title":"Obesity and insulin resistance in children and adolescents","volume":"20","author":"Reinehr","year":"2013","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"10.1016\/j.clnesp.2026.103260_bib69","first-page":"21","article-title":"Childhood obesity: causes, consequences, and prevention","volume":"72","author":"Ali","year":"2023","journal-title":"Cesslov Farm"},{"issue":"6","key":"10.1016\/j.clnesp.2026.103260_bib70","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1002\/oby.22813","article-title":"COVID-19-related school closings and risk of weight gain among children","volume":"28","author":"Rundle","year":"2020","journal-title":"Obesity"},{"issue":"8","key":"10.1016\/j.clnesp.2026.103260_bib71","doi-asserted-by":"crossref","first-page":"2352","DOI":"10.3390\/nu12082352","article-title":"The impact of COVID-19 on health behavior, stress, financial and food security among middle to high income Canadian families with young children","volume":"12","author":"Carroll","year":"2020","journal-title":"Nutrients"},{"issue":"6","key":"10.1016\/j.clnesp.2026.103260_bib72","first-page":"1232","article-title":"Effect of lockdown for COVID-19 on self-reported body weight gain in a sample of obese patients","volume":"37","author":"De Luis Roman","year":"2020","journal-title":"NutricionHospitalaria"},{"issue":"6","key":"10.1016\/j.clnesp.2026.103260_bib73","doi-asserted-by":"crossref","DOI":"10.1111\/cob.12406","article-title":"I am terrified of something happening to me: The lived experience of people with obesity during the COVID-19 pandemic","volume":"10","author":"Grannell","year":"2020","journal-title":"Clin Obes"},{"issue":"13","key":"10.1016\/j.clnesp.2026.103260_bib74","doi-asserted-by":"crossref","first-page":"7603","DOI":"10.3390\/ijerph19137603","article-title":"Obesity and COVID-19 in children and adolescents: reciprocal detrimental influence \u2013 systematic literature review and meta-analysis","volume":"19","author":"La","year":"2022","journal-title":"Int Res J Publ Environ Health"},{"key":"10.1016\/j.clnesp.2026.103260_bib75","first-page":"21","article-title":"Childhood obesity: Causes, consequences, and prevention","volume":"72","author":"Ali","year":"2023","journal-title":"Ceska a slovenskafarmacie"},{"issue":"3","key":"10.1016\/j.clnesp.2026.103260_bib76","doi-asserted-by":"crossref","first-page":"176","DOI":"10.3109\/09540261.2012.688195","article-title":"The global childhood obesity epidemic and the association between socio-economic status and childhood obesity","volume":"24","author":"Wang","year":"2012","journal-title":"Int Rev Psychiatr"},{"issue":"1","key":"10.1016\/j.clnesp.2026.103260_bib77","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.annepidem.2009.09.008","article-title":"Rising social inequalities in US childhood obesity","volume":"20","author":"Singh","year":"2003","journal-title":"Ann Epidemiol"},{"issue":"1","key":"10.1016\/j.clnesp.2026.103260_bib78","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1093\/ajcn\/70.1.145s","article-title":"Tracking of body mass index in children in relation to overweight in adulthood","volume":"70","author":"Guo","year":"1999","journal-title":"Am J Clin Nutr"},{"issue":"3","key":"10.1016\/j.clnesp.2026.103260_bib79","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1542\/peds.111.3.e221","article-title":"Maternal gestational diabetes, birth weight, and adolescent obesity","volume":"111","author":"Gillman","year":"2003","journal-title":"Pediatrics"},{"issue":"4","key":"10.1016\/j.clnesp.2026.103260_bib80","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0061627","article-title":"Pre-pregnancy body mass index in relation to infant birth weight and offspring overweight\/obesity: a systematic review and meta-analysis","volume":"8","author":"Yu","year":"2013","journal-title":"PLOS ONE"},{"issue":"2","key":"10.1016\/j.clnesp.2026.103260_bib81","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002744","article-title":"Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: An individual participant data meta-analysis","volume":"16","author":"Voerman","year":"2019","journal-title":"PLOS Med"},{"issue":"2","key":"10.1016\/j.clnesp.2026.103260_bib82","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1111\/obr.12334","article-title":"Predicting adult obesity from childhood obesity: A systematic review and meta-analysis","volume":"17","author":"Simmonds","year":"2016","journal-title":"Obes Rev"},{"issue":"20","key":"10.1016\/j.clnesp.2026.103260_bib83","doi-asserted-by":"crossref","first-page":"1876","DOI":"10.1056\/NEJMoa1010112","article-title":"Childhood adiposity, adult adiposity, and cardiovascular risk factors","volume":"365","author":"Juonala","year":"2011","journal-title":"N Engl J Med"},{"key":"10.1016\/j.clnesp.2026.103260_bib84","doi-asserted-by":"crossref","first-page":"4759","DOI":"10.1136\/bmj.e4759","article-title":"Cardiovascular disease risk in healthy children and its association with body mass index: systematic review and meta-analysis","volume":"345","author":"Friedemann","year":"2012","journal-title":"BMJ"},{"issue":"8","key":"10.1016\/j.clnesp.2026.103260_bib85","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1161\/CIRCULATIONAHA.109.191856","article-title":"Implementing American Heart Association pediatric and adult nutrition guidelines: A scientific statement from the American Heart Association Nutrition Committee of the Council on Nutrition, Physical Activity and Metabolism","volume":"119","author":"Gidding","year":"2009","journal-title":"Circulation"},{"issue":"3","key":"10.1016\/j.clnesp.2026.103260_bib86","first-page":"379","article-title":"Obesity and heart failure with preserved ejection fraction: epidemiology, pathophysiology, and therapeutic considerations","volume":"14","author":"Haykowsky","year":"2018","journal-title":"Heart Fail Clins"},{"issue":"6","key":"10.1016\/j.clnesp.2026.103260_bib87","first-page":"911","article-title":"The relationship of body mass index and blood pressure in primary care pediatric patients","volume":"157","author":"Falkner","year":"2010","journal-title":"J Pediatr"},{"issue":"4","key":"10.1016\/j.clnesp.2026.103260_bib88","first-page":"385","article-title":"Childhood adiposity, insulin resistance, and metabolic syndrome in relation to adult cardiovascular disease","volume":"13","author":"Srinivasan","year":"2002","journal-title":"Curr Opin Lipidol"},{"issue":"21","key":"10.1016\/j.clnesp.2026.103260_bib89","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1161\/CIR.0000000000000973","article-title":"American Heart Association Obesity Committee. Obesity and cardiovascular disease: a scientific statement from the American Heart Association","volume":"143","author":"Powell-Wiley","year":"2021","journal-title":"Circulation"},{"issue":"12","key":"10.1016\/j.clnesp.2026.103260_bib90","doi-asserted-by":"crossref","first-page":"3051","DOI":"10.1210\/clinem\/dgad361","article-title":"Childhood obesity, diabetes, and cardiovascular disease risk","volume":"108","author":"Salama","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"10.1016\/j.clnesp.2026.103260_bib91","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1007\/s13679-016-0235-6","article-title":"Effects of obesity on cardiovascular hemodynamics, cardiac morphology, and ventricular function","volume":"5","author":"Alpert","year":"2016","journal-title":"Curr Obes Rep"},{"issue":"5","key":"10.1016\/j.clnesp.2026.103260_bib92","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.3945\/ajcn.2010.28701B","article-title":"Childhood obesity and adult morbidities","volume":"91","author":"Biro","year":"2010","journal-title":"Am J Clin Nutr"},{"issue":"6","key":"10.1016\/j.clnesp.2026.103260_bib93","first-page":"353","article-title":"Obesity and autonomic function: the role of leptin and inflammatory cytokines","volume":"19","author":"Fung","year":"2009","journal-title":"Clin Auton Res"},{"issue":"7","key":"10.1016\/j.clnesp.2026.103260_bib94","first-page":"768","article-title":"Cardiac arrhythmias and obesity in children and adolescents: a systematic review","volume":"18","author":"Patel","year":"2017","journal-title":"Obes Rev"},{"issue":"20","key":"10.1016\/j.clnesp.2026.103260_bib95","first-page":"2466","article-title":"Obesity and subclinical cardiac damage: A population-based imaging study","volume":"76","author":"Petersen","year":"2020","journal-title":"J Am Coll Cardiol"},{"issue":"5","key":"10.1016\/j.clnesp.2026.103260_bib96","first-page":"435","article-title":"Association of obstructive sleep apnea with arrhythmias and increased QT interval in the general population","volume":"55","author":"Romero-Corral","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.clnesp.2026.103260_bib97","series-title":"Global estimates and trends in pediatric hypertension and obesity: An epidemiological update (WHO Childhood Obesity and BP Trends Report, 2025)","year":"2025"},{"key":"10.1016\/j.clnesp.2026.103260_bib98","article-title":"Prevalence and risk of sustained hypertension in obese adolescents: a multicenter cohort study","year":"2025","journal-title":"JAMA Pediatrics"},{"key":"10.1016\/j.clnesp.2026.103260_bib99","series-title":"Elk Grove Village (IL)","article-title":"Clinical practice guidelines for the diagnosis and management of high blood pressure in children and adolescents","year":"2025"},{"issue":"4","key":"10.1016\/j.clnesp.2026.103260_bib100","article-title":"The prevalence of elevated blood pressure and its association with obesity in children aged 6\u201313 years in rural India: a cross-sectional study","volume":"15","author":"James","year":"2023","journal-title":"Cureus"},{"issue":"10","key":"10.1016\/j.clnesp.2026.103260_bib101","first-page":"1031","article-title":"Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality","volume":"55","author":"Romero-Corral","year":"2010","journal-title":"J Am Coll Cardiol"},{"issue":"15","key":"10.1016\/j.clnesp.2026.103260_bib102","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1161\/CIR.0b013e3182a5cfb3","article-title":"Severe obesity in children and adolescents: Identification, associated health risks, and treatment approaches: A scientific statement from the American Heart Association","volume":"128","author":"Kelly","year":"2013","journal-title":"Circulation"},{"issue":"4","key":"10.1016\/j.clnesp.2026.103260_bib103","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1111\/j.1464-5491.2009.02686.x","article-title":"Metabolic syndrome and short-term heart rate variability in young adults: the Cardiovascular Risk in Young Finns Study","volume":"26","author":"Koskinen","year":"2009","journal-title":"Diabet Med"},{"issue":"1","key":"10.1016\/j.clnesp.2026.103260_bib104","first-page":"58","article-title":"Sweat testing to evaluate autonomic function","volume":"19","author":"Fung","year":"2009","journal-title":"Clin Auton Res"},{"key":"10.1016\/j.clnesp.2026.103260_bib105","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1146\/annurev-publhealth-031816-044604","article-title":"Obesity in low- and middle-income countries: burden, drivers, and emerging challenges","volume":"38","author":"Ford","year":"2017","journal-title":"Annu Rev Public Health"},{"key":"10.1016\/j.clnesp.2026.103260_bib106","first-page":"113","article-title":"High blood pressure in children aged 3 to 12 years with overweight or obesity","volume":"266","author":"Kharbanda","year":"2024","journal-title":"J Pediatr"},{"issue":"3","key":"10.1016\/j.clnesp.2026.103260_bib107","first-page":"130","article-title":"Blood pressure pattern and the relationship with body mass index in children and adolescents","volume":"12","author":"Bugaje","year":"2018","journal-title":"S Afric J Child Heal"},{"issue":"1","key":"10.1016\/j.clnesp.2026.103260_bib108","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1212\/WNL.59.1.34","article-title":"Risk of stroke in children: Ethnic and gender disparities","volume":"68","author":"Fullerton","year":"2007","journal-title":"Neurology"},{"issue":"23","key":"10.1016\/j.clnesp.2026.103260_bib109","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1056\/NEJM199806043382302","article-title":"Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults: The Bogalusa Heart Study","volume":"338","author":"Berenson","year":"1998","journal-title":"N Engl J Med"},{"issue":"10","key":"10.1016\/j.clnesp.2026.103260_bib110","first-page":"1097","article-title":"Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: A systematic review of cohort studies","volume":"55","author":"Romero-Corral","year":"2010","journal-title":"J Am Coll Cardiol"},{"issue":"4","key":"10.1016\/j.clnesp.2026.103260_bib111","first-page":"309","article-title":"Stroke in children: Recognition, treatment, and future directions","volume":"7","author":"DeVeber","year":"2000","journal-title":"Semin PediatrNeurol"},{"key":"10.1016\/j.clnesp.2026.103260_bib112","doi-asserted-by":"crossref","DOI":"10.3389\/fgene.2021.727475","article-title":"Childhood obesity and risk of stroke: A Mendelian randomisation analysis","volume":"12","author":"Zou","year":"2021","journal-title":"Front Genet"},{"issue":"11","key":"10.1016\/j.clnesp.2026.103260_bib113","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1001\/jamaneurol.2017.1627","article-title":"Association of childhood body mass index and change in body mass index with first adult ischemic stroke","volume":"74","author":"Gjaerde","year":"2017","journal-title":"JAMA Neurol"},{"key":"10.1016\/j.clnesp.2026.103260_bib114","series-title":"Obesity and overweight","year":"2024"},{"key":"10.1016\/j.clnesp.2026.103260_bib115","series-title":"Childhood obesity: Causes & consequences","year":"2025"},{"issue":"1","key":"10.1016\/j.clnesp.2026.103260_bib116","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.jpeds.2006.08.042","article-title":"Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study","volume":"150","author":"Freedman","year":"2007","journal-title":"J Pediatr"},{"issue":"9727","key":"10.1016\/j.clnesp.2026.103260_bib117","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1016\/S0140-6736(10)60171-7","article-title":"Childhood obesity","volume":"375","author":"Han","year":"2010","journal-title":"Lancet"},{"issue":"2","key":"10.1016\/j.clnesp.2026.103260_bib118","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.mayocp.2016.09.017","article-title":"Review of childhood obesity: From epidemiology, etiology, and comorbidities to clinical assessment and treatment","volume":"92","author":"Kumar","year":"2017","journal-title":"Mayo Clin Proc"},{"issue":"1","key":"10.1016\/j.clnesp.2026.103260_bib119","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1111\/j.1467-789X.2006.00242.x","article-title":"Reducing obesity and related chronic disease risk in children and youth: a synthesis of evidence with \u2018best practice\u2019 recommendations","volume":"7","author":"Flynn","year":"2006","journal-title":"Obes Rev"},{"key":"10.1016\/j.clnesp.2026.103260_bib120","doi-asserted-by":"crossref","first-page":"4759","DOI":"10.1136\/bmj.e4759","article-title":"Cardiovascular disease risk in healthy children and its association with body mass index: systematic review and meta-analysis","volume":"345","author":"Friedemann","year":"2012","journal-title":"BMJ"},{"key":"10.1016\/j.clnesp.2026.103260_bib121","series-title":"Childhood obesity: Causes & consequences Atlanta","year":"2023"},{"key":"10.1016\/j.clnesp.2026.103260_bib122","series-title":"Taking action on childhood obesity: Report of the Commission on Ending Childhood Obesity","year":"2016"},{"issue":"10173","key":"10.1016\/j.clnesp.2026.103260_bib124","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/S0140-6736(18)32822-8","article-title":"The global syndemic of obesity, undernutrition, and climate change: The Lancet Commission report","volume":"393","author":"Swinburn","year":"2019","journal-title":"Lancet"},{"issue":"12","key":"10.1016\/j.clnesp.2026.103260_bib126","first-page":"CD001871","article-title":"Interventions for preventing obesity in children","author":"Waters","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"10.1016\/j.clnesp.2026.103260_bib127","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1377\/hlthaff.2011.0410","article-title":"A penny-per-ounce tax on sugar-sweetened beverages would cut health and cost burdens of diabetes","volume":"31","author":"Wang","year":"2012","journal-title":"Health Aff (Millwood)"},{"issue":"1","key":"10.1016\/j.clnesp.2026.103260_bib128","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1353\/foc.2006.0006","article-title":"The role of parents in preventing childhood obesity","volume":"16","author":"Lindsay","year":"2006","journal-title":"Future Child"},{"issue":"3","key":"10.1016\/j.clnesp.2026.103260_bib129","first-page":"462","article-title":"Public health strategies for preventing and controlling overweight and obesity in school-aged children","volume":"27","author":"Katz","year":"2008","journal-title":"Health Aff (Millwood)"},{"issue":"1","key":"10.1016\/j.clnesp.2026.103260_bib130","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.amepre.2015.03.032","article-title":"Cost effectiveness of childhood obesity interventions: evidence and methods for CHOICES","volume":"49","author":"Gortmaker","year":"2015","journal-title":"Am J Prev Med"},{"key":"10.1016\/j.clnesp.2026.103260_bib132","first-page":"134","article-title":"Systematic review of school-based interventions to prevent obesity","volume":"20","author":"Brown","year":"2019","journal-title":"Obes Rev"},{"issue":"1","key":"10.1016\/j.clnesp.2026.103260_bib133","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/S1368980015003663","article-title":"WHO report on ending childhood obesity echoes earlier recommendations","volume":"19","author":"Swinburn","year":"2016","journal-title":"Public Health Nutr"},{"key":"10.1016\/j.clnesp.2026.103260_bib134","first-page":"1","article-title":"Global strategy on diet, physical activity and health","volume":"916","year":"2004","journal-title":"World Health Organ Tech Rep Ser"},{"key":"10.1016\/j.clnesp.2026.103260_bib135","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1186\/s12889-015-1360-y","article-title":"The World Health Organization\u2019s Health Promoting Schools framework: a Cochrane systematic review and meta-analysis","volume":"15","author":"Langford","year":"2015","journal-title":"BMC Public Health"},{"key":"10.1016\/j.clnesp.2026.103260_bib136","series-title":"Global Action Plan on Physical Activity 2018\u20132030: More active people for a healthier world","year":"2018"},{"key":"10.1016\/j.clnesp.2026.103260_bib137","first-page":"1","article-title":"World Obesity Day \u2013 4 March 2025","volume":"49","author":"Stensel","year":"2025","journal-title":"Int J Obes"},{"issue":"9","key":"10.1016\/j.clnesp.2026.103260_bib138","doi-asserted-by":"crossref","first-page":"3686","DOI":"10.1007\/s11695-025-08080-4","article-title":"Trends and outcomes of metabolic surgery in adolescents with BMI \u2265 50 vs < 50 kg\/m2: a retrospective study using the MBSAQIP database","volume":"35","author":"Kachornvitaya","year":"2025","journal-title":"Obes Surg"},{"issue":"2","key":"10.1016\/j.clnesp.2026.103260_bib139","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0314787","article-title":"Pharmacological interventions for addressing pediatric and adolescent obesity: a systematic review and network meta-analysis","volume":"20","author":"Yang","year":"2025","journal-title":"PLoS One"},{"key":"10.1016\/j.clnesp.2026.103260_bib140","article-title":"Novo\u2019s older obesity drug is safe and effective for children, study finds","author":"Fick","year":"2024","journal-title":"Reuters"},{"issue":"11","key":"10.1016\/j.clnesp.2026.103260_bib141","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.3390\/children12111427","article-title":"Beyond weight loss: optimizing GLP-1 receptor agonist use in children","volume":"12","author":"Zaitoon","year":"2025","journal-title":"Childr"},{"key":"10.1016\/j.clnesp.2026.103260_bib142","article-title":"Eli Lilly\u2019s tirzepatide shows superior weight loss to Novo\u2019s semaglutide","author":"Singh","year":"2025","journal-title":"Business Standard"},{"key":"10.1016\/j.clnesp.2026.103260_bib143","series-title":"Tirzepatide weight loss study shows faster results than semaglutide in India","author":"Clarance","year":"2025"},{"issue":"1","key":"10.1016\/j.clnesp.2026.103260_bib144","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1056\/NEJMoa2416394","article-title":"Tirzepatide as compared with semaglutide for the treatment of obesity","volume":"393","author":"Aronne","year":"2025","journal-title":"N Engl J Med"},{"key":"10.1016\/j.clnesp.2026.103260_bib145","series-title":"Retatrutide outperforms Ozempic in weight loss, new study finds","author":"Clarance","year":"2025"},{"key":"10.1016\/j.clnesp.2026.103260_bib146","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMoa2502081","article-title":"Coadministeredcagrilintide and semaglutide in adults with overweight or obesity","author":"Garvey","year":"2025","journal-title":"N Engl J Med"},{"issue":"5","key":"10.1016\/j.clnesp.2026.103260_bib147","doi-asserted-by":"crossref","first-page":"445","DOI":"10.4103\/ijem.ijem_442_23","article-title":"Approved and emerging hormone-based anti-obesity medications: a review article","volume":"28","author":"Sidrak","year":"2024","journal-title":"Indian J Endocrinol Metab"},{"issue":"3","key":"10.1016\/j.clnesp.2026.103260_bib148","first-page":"205","article-title":"Once-weekly semaglutide in adults with overweight or obesity","volume":"387","author":"Wilding","year":"2022","journal-title":"N Engl J Med"},{"key":"10.1016\/j.clnesp.2026.103260_bib149","doi-asserted-by":"crossref","DOI":"10.1016\/j.omtm.2017.09.005","article-title":"Molecular therapy of melanocortin-4-receptor obesity by an autoregulatory BDNF vector","volume":"7","author":"Siu","year":"2017","journal-title":"Mol Ther Methods Clin Dev"},{"issue":"2","key":"10.1016\/j.clnesp.2026.103260_bib150","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.jgg.2021.01.008","article-title":"Leptin gene-targeted editing in ob\/ob mouse adipose tissue based on the CRISPR\/Cas9 system","volume":"48","author":"Zhu","year":"2021","journal-title":"J Genet Genomics"},{"issue":"11","key":"10.1016\/j.clnesp.2026.103260_bib151","first-page":"596","article-title":"ACC\/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"140","author":"Arnett","year":"2019","journal-title":"Circulation"}],"container-title":["Clinical Nutrition ESPEN"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2405457726003566?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2405457726003566?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T01:39:20Z","timestamp":1779413960000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2405457726003566"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":146,"alternative-id":["S2405457726003566"],"URL":"https:\/\/doi.org\/10.1016\/j.clnesp.2026.103260","relation":{},"ISSN":["2405-4577"],"issn-type":[{"value":"2405-4577","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Childhood obesity and cardiac risk in youth: Emerging challenges toward 2050","name":"articletitle","label":"Article Title"},{"value":"Clinical Nutrition ESPEN","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.clnesp.2026.103260","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"103260"}}