{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T03:44:16Z","timestamp":1786506256732,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100006741","name":"Stiftelsen Frimurare Barnhuset i Stockholm","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006741","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012306","name":"Center for Innovative Medicine, Johns Hopkins University","doi-asserted-by":"publisher","award":["SLL20190383"],"award-info":[{"award-number":["SLL20190383"]}],"id":[{"id":"10.13039\/100012306","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>It is unclear how early childhood obesity treatment affects metabolic risk. This study assessed long\u2010term metabolic health in children with obesity aged 4\u20136\u2009years and examined associations with weight status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study pooled data from the Sweden\u2010based More and Less randomized controlled trial, which compared a parent support program with standard care in 2012\u20132016. Children met the International Obesity Task Force (IOTF) criteria for obesity. Anthropometrics and metabolic risk factors were collected at baseline, 12 and 48\u2009months. Associations between metabolic markers and weight status were examined using linear mixed models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data from 106\/177 (60%) children, mean age at baseline 5.3\u2009years, were analysed. At baseline, 33\/90 (36.6%) had elevated metabolic risk markers. At 48\u2009months, one unit of body mass index standard deviation score (BMI SDS) was associated with higher glycosylated haemoglobin (HbA1c IFCC) (0.99\u2009mmol\/mol), higher fasting insulin (2.72 mIU\/L) and lower high\u2010density lipoprotein (HDL) (\u22120.16\u2009mmol\/L or \u22126.2\u2009mg\/dL). A BMI SDS reduction \u2265\u20090.25 was associated with lower HbA1c and triglycerides at 12\u2009months, and a reduction \u2265\u20090.5 with lower total cholesterol at 48\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Improved weight status may reverse metabolic disturbances present in early childhood.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apa.70633","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T13:35:08Z","timestamp":1780666508000},"page":"1891-1898","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Metabolic Risk Factors Are Associated With Weight Status Change Over Four Years in Children Aged 4\u20136\u2009Years With Obesity"],"prefix":"10.1111","volume":"115","author":[{"given":"Markus","family":"Brissman","sequence":"first","affiliation":[{"name":"Karolinska Institutet, Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Pediatrics  Stockholm Sweden"},{"name":"Allied Health Professionals Function, Occupational Therapy &amp; Physiotherapy Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2179-8408","authenticated-orcid":false,"given":"Anna","family":"Ek","sequence":"additional","affiliation":[{"name":"Karolinska Institutet, Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Pediatrics  Stockholm Sweden"},{"name":"National Childhood Obesity Centre Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella","family":"Wennborg","sequence":"additional","affiliation":[{"name":"Karolinska Institutet, Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Pediatrics  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Nordin","sequence":"additional","affiliation":[{"name":"Karolinska Institutet, Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Pediatrics  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Eli","sequence":"additional","affiliation":[{"name":"Warwick Medical School University of Warwick  Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5106-5670","authenticated-orcid":false,"given":"Annika","family":"Janson","sequence":"additional","affiliation":[{"name":"National Childhood Obesity Centre Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulina","family":"Nowicka","sequence":"additional","affiliation":[{"name":"Karolinska Institutet, Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Pediatrics  Stockholm Sweden"},{"name":"Department of Food Studies, Nutrition and Dietetics Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1006\/pmed.1993.1014"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2016.09.017"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.13547"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.17176"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2024.5552"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.113.000101"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2005.111"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/84.3.490"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2009.03.041"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12519-011-0324-2"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5448.2007.00271.x"},{"issue":"7","key":"e_1_2_12_13_1","article-title":"Interventions for Preventing Obesity in Children","volume":"7","author":"Brown T.","year":"2019","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_12_14_1","article-title":"Interventions for Preventing Obesity in Children","volume":"12","author":"Waters E.","year":"2011","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41366-020-00713-1"},{"issue":"3","key":"e_1_2_12_16_1","article-title":"Diet, Physical Activity, and Behavioural Interventions for the Treatment of Overweight or Obesity in Preschool Children up to the Age of 6\u2009Years","volume":"3","author":"Colquitt J. 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