Obesity, eating disorders and unhealthy dieting practices among children and adolescents are alarming health concerns due to their high prevalence and adverse effects on physical and psychosocial health. We present the evidence that eating disorders and obesity can be managed or prevented using the same interventions in the pediatric age. In the presence of obesity in the pediatric age, disordered eating behaviors are highly prevalent, increasing the risk of developing eating disorders. The most frequently observed in subjects with obesity are bulimia nervosa and binge-eating disorders, both of which are characterized by abnormal eating or weight-control behaviors. Various are the mechanisms overlying the interaction including environmental and individual ones, and different are the approaches to reduce the consequences. Evidence-based treatments for obesity and eating disorders in childhood include as first line approaches weight loss with nutritional management and lifestyle modification via behavioral psychotherapy, as well as treatment of psychiatric comorbidities if those are not a consequence of the eating disorder. Drugs and bariatric surgery need to be used in extreme cases. Future research is necessary for early detection of risk factors for prevention, more precise elucidation of the mechanisms that underpin these problems and, finally, in the cases requiring therapeutic intervention, to provide tailored and timely treatment. Collective efforts between the fields are crucial for reducing the factors of health disparity and improving public health.

Background: The aim of this study was to explore the impact of ambulatory blood pressure (ABP) parameters on arterial stiffness measured by carotid–femoral pulse wave velocity (cf-PWV) in children and adolescents. Method: The study population consisted of 138 consecutive young patients (age range 4–20 years) referred to our hypertension center. Office blood pressure (BP), 24-h ABP monitoring and cf-PWV measurements were performed in all patients. Family history and smoking habits were also recorded. Results: Among the study population, 10.6% had cf-PWV values equal to or higher than the 95th percentile of the study population. cf-PWV was higher in the hypertensive compared to the normotensive patients, classified by ABP levels even after adjustment for age and sex. Significant correlations were found between cf-PWV and age, weight, height, estimated central pulse pressure (PP), office SBP and DBP, and ABP parameters including 24-h SBP and DBP, weighted 24-h SBP variability, 24-h SBP and DBP load, 24-h mean arterial pressure (MAP), daytime and night-time SBP, daytime and night-time SBP variability, but not with office and 24-h heart rate, 24-h heart rate variability, 24-h daytime and night-time PP, DBP variability, ambulatory arterial stiffeness index and BMI z-score. In analysis of covariance, only weighted 24-h SBP variability (β = 0.28, P < 0.05) and daytime SBP variability (β = 0.15, P < 0.05) were the independent determinants of cf-PWV in children and adolescents. Conclusion: These data may suggest that increased SBP variability is closely associated with arterial stiffness in children and adolescents.

Background: Vascular phenotype by assessing carotid–femoral pulse wave velocity (cf-PWV) and central SBP (cSP) in the young could be used as an intermediate cardiovascular outcome measure. Tonometry is considered the gold-standard technique, but its use is challenging in clinical practice, especially when used in children. The purpose of this study was to validate cf-PWV and cSP assessment with novel oscillometric device (SphygmoCor XCEL) in children and adolescents. Methods: cf-PWV and cSP were measured in 72 children and adolescents aged 6–20 years. Measurements were performed by applanation tonometry and by the SphygmoCor XCEL device at the same visit under standardized conditions. Regression analysis and Bland–Altman plots were used for comparison of the tonometer-based with oscillometric-based method. Results: Mean cf-PWV measured by applanation tonometry was 4.85 ± 0.81 m/s and measured by SpygmoCor XCEL was 4.75 ± 0.81 m/s. The mean difference between the two devices was 0.09 ± 0.47 m/s (P = NS). cSP measured by SpygmoCor XCEL was strongly correlated with cSP measured by applanation tonometry (R² = 0.87, P < 0.001). Mean cSP measured by applanation tonometry was 103.23 ± 9.43 mmHg and measured by SpygmoCor XCEL was 103.54 ± 8.87 mmHg. The mean cSP difference between the two devices was −0.30 ± 3.34 mmHg (P = NS), and fulfilled the AAMI criterion 1. The estimated intersubject variability was 2.17 mmHg. Conclusion: The new oscillometric SphygmoCor XCEL device provides equivalent results for cf-PWV and cSP values to those obtained by tonometry in children and adolescents. Thus, the SphygmoCor XCEL device could be appropriate for assessing cf-PWV and cSP in the pediatric population.

Obesity and metabolic syndrome (O&MS) due to the worldwide obesity epidemic affects children at all stages of chronic kidney disease (CKD) including dialysis and after kidney transplantation. The presence of O&MS in the pediatric CKD population may augment the already increased cardiovascular risk and contribute to the loss of kidney function. The Pediatric Renal Nutrition Taskforce (PRNT) is an international team of pediatric renal dietitians and pediatric nephrologists who develop clinical practice recommendations (CPRs) for the nutritional management of children with kidney diseases. We present CPRs for the assessment and management of O&MS in children with CKD stages 2–5, on dialysis and after kidney transplantation. We address the risk factors and diagnostic criteria for O&MS and discuss their management focusing on non-pharmacological treatment management, including diet, physical activity, and behavior modification in the context of age and CKD stage. The statements have been graded using the American Academy of Pediatrics grading matrix. Statements with a low grade or those that are opinion-based must be carefully considered and adapted to individual patient needs based on the clinical judgment of the treating physician and dietitian. Research recommendations are provided. The CPRs will be periodically audited and updated by the PRNT.

Background and objective Type 1 diabetes is an important risk factor for the development of cardiovascular disease. Pulse wave velocity (PWV) and carotid intima‐media thickness (cIMT) measurements are well recognized as independent predictors for future cardiovascular disease. The aim of the current study was to systematically review the literature and conduct a meta‐analysis assessing measures of subclinical arterial damage in children and adolescents with type 1 diabetes in comparison to healthy controls. Methods PubMed and Cochrane Library were searched to identify studies comparing cIMT and carotid‐femoral PWV levels between children with type 1 diabetes and healthy controls. Meta‐analysis was performed to compare the difference of overall mean cIMT and carotid‐femoral PWV levels between the two groups. New Castle Ottawa quality assessment scale for case‐control studies was used to assess study quality. Results Twenty‐three studies were finally included in the meta‐analysis (20 studies for cIMT and 4 studies for carotid‐femoral PWV). Youth with type 1 diabetes had significantly higher cIMT levels than controls (mean difference [d]= 0.03, 95% confidence interval [CI] = 0.02–0.04), as well as higher carotid‐femoral PWV levels (d= 0.26, 95% CI = 0.18–0.34). Heterogeneity was present only in the cIMT analysis (I² > 90%). Conclusions Youth with type 1 diabetes showed signs of subclinical arterial damage, as suggested by higher levels of cIMT and carotid‐femoral PWV compared to healthy controls at childhood and adolescence. Preventive and therapeutic interventions early in course of disease may be further studied to decrease morbidity in this high‐risk young patient group.