Childhood obesity represents a significant challenge both clinically and socio-economically. This study aimed to assess specific biochemical parameters, particularly glucose, insulin and lipid profile, before and after a year-long intervention program in 8- and 9-year-old children with excessive body weight living in Szczecin, Poland from 2016 to 2018. The research comprised two phases: screening in elementary schools and intervention in the outpatient clinic of the clinical Pomeranian Medical University hospital. Out of 11,494 8- to 9-year-olds in Szczecin, 42.54% (4890) participated in the screening. In the intervention phase, 515 children were examined. Anthropometric measurements were recorded at each visit, and blood samples were collected during the first and fourth visits. In the statistical analysis, the Kolmogorov–Smirnov, t-Student and ANOVA tests were employed (with statistical significance when p ≤ 0.05). Results highlighted a significant proportion of children exhibiting disruptions in carbohydrate and lipid metabolism. A total of 8.6% of participants had elevated total cholesterol, 9.7% had reduced HDL, 13.4% had elevated LDL, and 21.2% had elevated triglycerides. Initially, abnormal fasting glucose was detected in 4.7% of children, and elevated insulin levels in 3.1%. Metabolic disorders persisted post-intervention despite BMI improvement. The results emphasize the necessity for prolonged programs with frequent follow-ups targeting weight normalization in children.

Background: The increasing prevalence of severe obesity among children and adolescents poses a significant challenge for pediatricians and general practitioners. This study aimed to investigate the relationships between biochemical results, anthropometry, blood pressure measurements, and bioimpedance analysis (BIA)-derived parameters to identify potential cardiometabolic complications associated with severe obesity. Methods: This study included 347 children (162 boys, 185 girls) aged 0–19 years, meeting the criteria for severe obesity based on BMI thresholds for different age groups. The patients were recruited in four pediatric endocrinology centers in Poland (Zabrze, Cracow, Rzeszow, Szczecin). Each participant underwent anthropometric measurements, pubertal stage assessment, blood pressure measurement, biochemical and hormonal tests, and BIA. Results: BMI showed significant associations with fat mass percentage (FM%) and waist-to-height ratio (WHtR) but not waist-to-hip ratio (WHR). The relationship between BMI and FM% was stronger in girls and prepubertal children. The metabolic syndrome (MetS) Z-score showed a strong positive correlation with BMI in the pubertal children. A negative correlation between HDL and triglycerides was observed only in the boys. The prepubertal children exhibited more significant correlations, despite a smaller sample size and shorter duration of obesity. Conclusions: Considering multiple parameters beyond BMI alone provides a better understanding of cardiometabolic risks associated with severe obesity in children. MetS Z-score was not a reliable indicator of increased cardiometabolic risk in younger children. Early-onset severe obesity was associated with a higher risk of metabolic complications. Early intervention is crucial to mitigate metabolic complications in this population.

Background: Childhood obesity is a significant public health issue. This study aimed to evaluate the prevalence of overweight and obesity among 8- and 9-year-old children in Szczecin, Poland, and unlike other studies to assess differences in nutritional status within a single urban agglomeration of nearly 500,000 residents, it was influenced by place of residence and socioeconomic status. Methods: The study included 4705 children (2327 boys and 2378 girls) aged 8 and 9 years, attending 50 primary schools in Szczecin (45 public, 5 private) across four districts: North, Right Bank, City Center, and West. Anthropometric measurements were used to calculate BMI. Overweight was diagnosed when BMI was ≥85th percentile but lower than the 95th percentile for age and sex, while obesity was when the BMI was ≥95th percentile. Data on parental BMI, education, and place of residence were also collected. Results: The prevalence of overweight was 16.6%, and obesity was 6.2%. Overweight was more common in girls, while obesity was more frequent in boys. Children attending special education schools and living in the Right-Bank district had the highest rates of overweight and obesity. Parental obesity and low parental education, particularly the father’s, were the strongest risk factors for excess body weight. Conclusions: Differences in childhood nutritional status exist even within the same city, influenced by residence and socioeconomic factors. Parental obesity, low education, living in the city’s rural districts, and attending special education schools are key risk factors. Enhanced prevention programs tailored to these factors are crucial to combat childhood obesity effectively.

Background: Childhood obesity is a growing global health concern, with an increasing prevalence of severe obesity among young children. This study aimed to determine the average age of severe obesity onset in Polish children and evaluate the time gap between diagnosis and referral for specialized care. Methods: This data analysis was conducted across four Polish pediatric endocrinology centers specializing in childhood obesity management (Szczecin, Cracow, Zabrze, Rzeszów) between July 2022 and November 2023. The study included 367 children and adolescents (186 boys, 181 girls) aged 0–18 years, diagnosed with severe obesity based on age-specific BMI criteria. Anthropometric measurements were performed during the patient’s inclusion into the study and based on past medical records. BMI and BMI Z-scores were calculated for all current and past measurements. Results: The median age of the study population at the moment of inclusion into the study was 13.7 ± 2.9 years (range: 2.2–18 years). The median BMI was 40.9 ± 5.1 kg/m² (range: 30.1–65.8 kg/m²), and the median BMI Z-score was 2.7 ± 0.4 (range: 2.3–6.2). Out of the 367 children included, 327 (89%) had entered puberty. An analysis of past measurements revealed that 83% of children had severe obesity at their earliest recorded BMI measurement, with n median onset age of 3.2 years. The median age of referral to specialized care was 10 ± 5.0 years, reflecting a delay of almost 7 years from diagnosis to targeted medical care. Conclusions: This study highlights a substantial delay between the onset of severe obesity and referral for specialized care, underscoring the need for earlier intervention strategies tailored to age, sex, and developmental stage.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is now one of the most common chronic liver diseases in children and closely parallels the rising prevalence of severe pediatric obesity. Methods: This review synthesizes current evidence (2019–2025) and landmark studies on the diagnosis and management of pediatric MASLD, integrating contemporary guidelines and future directions. Results: Based on current data, we propose practical algorithms for screening and management of pediatric MASLD. Screening with alanine aminotransferase (ALT) as the initial test should be initiated in all children aged 9–11 years with obesity, in those who are overweight with additional risk factors, and in children with severe obesity or a family history of MASLD. Non-invasive imaging techniques show important limitations in children with increased amount of subcutaneous tissue requiring cautious interpretation. Lifestyle modification remains the cornerstone of therapy, while pharmacological treatments are investigational. In adolescents with severe obesity and significant comorbidities, bariatric surgery represents an effective therapeutic option with durable metabolic effects. Conclusions: Early identification of high-risk children, especially those with severe obesity, and implementation of multidisciplinary management are essential to prevent MASLD progression. Refinement of screening strategies and development of validated non-invasive biomarkers remain key priorities for future pediatric care.

Background: The increasing prevalence of severe obesity among children and adolescents poses a significant challenge for pediatricians and general practitioners. This study aimed to investigate the relationships between biochemical results, anthropometry, blood pressure measurements and bioimpedance analysis (BIA)-derived parameters, to identify potential cardiometabolic complications associated with severe obesity. Methods: The study included 347 children (162 boys, 185 girls) aged 0-19 years, meeting criteria for severe obesity based on BMI thresholds for different age groups. Patients were recruited in four pediatric endocrinology centers in Poland (Zabrze, Cracow, Rzeszow, Szczecin). Each participant underwent anthropometric measurements, pubertal stage assessment, blood pressure measurement, biochemical and hormonal tests and BIA. Results: BMI showed significant associations with fat mass percentage (FM%) and waist-to-height ratio (WHtR), but not waist-to-hip ratio (WHR). The relationship between BMI and FM% was stronger in girls and prepubertal children. Metabolic syndrome (MetS) Z-score showed a strong positive correlation with BMI in pubertal children. Negative correlation between HDL and triglycerides was observed only in boys. Prepubertal children exhibited more significant correlations despite a smaller sample size and shorter duration of obesity. Conclusions: Considering multiple parameters beyond BMI alone provides a better understanding of cardiometabolic risks associated with severe obesity in children. MetS Z-score was not a reliable indicator of increased cardiometabolic risk in younger children. Early-onset severe obesity was associated with a higher risk of metabolic complications. Early intervention is crucial to mitigate metabolic complications in this population.