Multi-etiological Perspective on Child Obesity Prevention

  • Tom BaranowskiEmail author
  • Kathleen J. Motil
  • Jennette P. Moreno
Maternal and Childhood Nutrition (AC Wood, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Maternal and Childhood Nutrition


Purpose of Review

The simple energy balance model of obesity is inconsistent with the available findings on obesity etiology, prevention, and treatment. Yet, the most commonly stated causes of pediatric obesity are predicated on this model. A more comprehensive biological model is needed upon which to base behavioral interventions aimed at obesity prevention. In this light, alternative etiologies are little investigated and thereby poorly understood.

Recent Findings

Three candidate alternate etiologies are briefly presented: infectobesity, the gut microbiome, and circadian rhythms.


Behavioral child obesity preventive investigators need to collaborate with biological colleagues to more intensively analyze the behavioral aspects of these etiologies and to generate innovative procedures for preventing a multi-etiological problem, e.g., group risk analysis, triaging for likely causes of obesity.


Adenovirus-36 Microbiome Circadian rhythm Children Obesity Prevention 



The authors express their appreciation to the Section Editor, Alexis C. Wood, PhD, for her many important contributions in revising this manuscript.


Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under award number K99HD091396. This work is also a publication of the United States Department of Agriculture (USDA/ARS) Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, and had been funded in part with federal funds from the USDA/ARS under Cooperative Agreement No. 58-3092-5-001.

Compliance with Ethical Standards

Conflict of Interest

Tom Baranowski, Kathleen J. Motil, and Jennette P. Moreno declare they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


The contents of this publication do not necessarily reflect the views or policies of the USDA or the National Institutes of Health, nor does mention of trade names, commercial products, or organizations imply endorsement from the US government.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    World Health Organization. Childhood Obesity Surveillance Initiative (COSI) Factsheet. Highlights 2015–17. Accessed 27 Aug 2018.
  2. 2.
    Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS Data Brief. 2015;219:1–8.Google Scholar
  3. 3.
    Dombrowski SU, Knittle K, Avenell A, Araujo-Soares V, Sniehotta FF. Long term maintenance of weight loss with non-surgical interventions in obese adults: systematic review and meta-analyses of randomised controlled trials. BMJ. 2014;348:g2646.PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Cheung PC, Cunningham SA, Narayan KM, Kramer MR. Childhood obesity incidence in the United States: a systematic review. Child Obes. 2016;12(1):1–11.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Fryar CD, Carroll MD, Ogden CL. Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960–1962 through 2015–2016. In: Health E-Stats. Centers for Disease Control and Prevention, Atlanta, GA. 2018. Accessed 24 Sept 2018.
  6. 6.
    Waters E, de Silva-Sanigorski A, Hall BJ, Brown T, Campbell KJ, Gao Y, et al. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2011;12:CD001871.Google Scholar
  7. 7.
    • Baranowski T, Lytle L. Should the IDEFICS outcomes have been expected? Obes Rev. 2015;16(Suppl 2):162–72 Provides a comprehensive critique of childhood obesity prevention interventions. PubMedCrossRefGoogle Scholar
  8. 8.
    Heerman WJ, JaKa MM, Berge JM, Trapl ES, Sommer EC, Samuels LR, et al. The dose of behavioral interventions to prevent and treat childhood obesity: a systematic review and meta-regression. Int J Behav Nutr Phys Act. 2017;14(1):157.PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    Ells LJ, Rees K, Brown T, Mead E, Al-Khudairy L, Azevedo L, et al. Interventions for treating children and adolescents with overweight and obesity: an overview of Cochrane reviews. Int J Obes. 2018;42(11):1823–33.CrossRefGoogle Scholar
  10. 10.
    Bourke M, Whittaker PJ, Verma A. Are dietary interventions effective at increasing fruit and vegetable consumption among overweight children? A systematic review. J Epidemiol Community Health. 2014;68(5):485–90.PubMedCrossRefGoogle Scholar
  11. 11.
    Metcalf B, Henley W, Wilkin T. Effectiveness of intervention on physical activity of children: systematic review and meta-analysis of controlled trials with objectively measured outcomes (EarlyBird 54). BMJ. 2012;345:e5888.PubMedCrossRefGoogle Scholar
  12. 12.
    Lee BY, Bartsch SM, Mui Y, Haidari LA, Spiker ML, Gittelsohn J. A systems approach to obesity. Nutr Rev. 2017;75(suppl 1):94–106.PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Xue H, Slivka L, Igusa T, Huang TT, Wang Y. Applications of systems modelling in obesity research. Obes Rev. 2018;19(9):1293–308.PubMedCrossRefGoogle Scholar
  14. 14.
    •• Ludwig DS, Ebbeling CB. The carbohydrate-insulin model of obesity: beyond “calories in, calories out”. JAMA Intern Med. 2018;178(8):1098–103 Clear graphical elucidation of simple energy balance model of obesity. PubMedCrossRefGoogle Scholar
  15. 15.
    •• Hall KD, Guyenet SJ, Leibel RL. The carbohydrate-insulin model of obesity is difficult to reconcile with current evidence. JAMA Intern Med. 2018;178(8):1103–5 Clear statement of a multi-etiological perspective on obesity. PubMedCrossRefGoogle Scholar
  16. 16.
    Kumar S, Kelly AS. Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clin Proc. 2017;92(2):251–65.PubMedCrossRefGoogle Scholar
  17. 17.
    Anderson GH, Hunschede S, Akilen R, Kubant R. Physiology of food intake control in children. Adv Nutr. 2016;7(1):232s–40s.PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Tremblay A. Obesity management: what should we do if fat gain is necessary to maintain body homeostasis in a modern world? Front Endocrinol (Lausanne). 2018;9:285.CrossRefGoogle Scholar
  19. 19.
    McAllister EJ, Dhurandhar NV, Keith SW, Aronne LJ, Barger J, Baskin M, et al. Ten putative contributors to the obesity epidemic. Crit Rev Food Sci Nutr. 2009;49(10):868–913.PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Karatsoreos IN, Thaler JP, Borgland SL, Champagne FA, Hurd YL, Hill MN. Food for thought: hormonal, experiential, and neural influences on feeding and obesity. J Neurosci. 2013;33(45):17610–6.PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Stenvinkel P. Obesity—a disease with many aetiologies disguised in the same oversized phenotype: has the overeating theory failed? Nephrol Dial Transplant. 2015;30(10):1656–64.PubMedCrossRefGoogle Scholar
  22. 22.
    Silventoinen K, Jelenkovic A, Sund R, Hur YM, Yokoyama Y, Honda C, et al. Genetic and environmental effects on body mass index from infancy to the onset of adulthood: an individual-based pooled analysis of 45 twin cohorts participating in the COllaborative project of Development of Anthropometrical measures in Twins (CODATwins) study. Am J Clin Nutr. 2016;104(2):371–9.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Locke AE, Kahali B, Berndt SI, Justice AE, Pers TH, Day FR, et al. Genetic studies of body mass index yield new insights for obesity biology. Nature. 2015;518(7538):197–206.PubMedPubMedCentralCrossRefGoogle Scholar
  24. 24.
    Willer CJ, Speliotes EK, Loos RJ, Li S, Lindgren CM, Heid IM, et al. Six new loci associated with body mass index highlight a neuronal influence on body weight regulation. Nat Genet. 2009;41(1):25–34.PubMedCrossRefGoogle Scholar
  25. 25.
    Jacob R, Drapeau V, Tremblay A, Provencher V, Bouchard C, Perusse L. The role of eating behavior traits in mediating genetic susceptibility to obesity. Am J Clin Nutr. 2018;108(3):445–52.PubMedCrossRefGoogle Scholar
  26. 26.
    Wood AC, Momin S, Senn M, Hughes SO. Pediatric eating behaviors as the intersection of biology and parenting: lessons from the birds and the bees. Curr Nutr Rep. 2018;7(1):1–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Timpson NJ, Emmett PM, Frayling TM, Rogers I, Hattersley AT, McCarthy MI, et al. The fat mass- and obesity-associated locus and dietary intake in children. Am J Clin Nutr. 2008;88(4):971–8.PubMedPubMedCentralCrossRefGoogle Scholar
  28. 28.
    Cecil JE, Tavendale R, Watt P, Hetherington MM, Palmer CN. An obesity-associated FTO gene variant and increased energy intake in children. N Engl J Med. 2008;359(24):2558–66.PubMedCrossRefGoogle Scholar
  29. 29.
    Wardle J, Llewellyn C, Sanderson S, Plomin R. The FTO gene and measured food intake in children. Int J Obes. 2009;33(1):42–5.CrossRefGoogle Scholar
  30. 30.
    Tanofsky-Kraff M, Han JC, Anandalingam K, Shomaker LB, Columbo KM, Wolkoff LE, et al. The FTO gene rs9939609 obesity-risk allele and loss of control over eating. Am J Clin Nutr. 2009;90(6):1483–8.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Wardle J, Guthrie CA, Sanderson S, Rapoport L. Development of the Children’s Eating Behaviour Questionnaire. J Child Psychol Psychiatry. 2001;42(7):963–70.PubMedCrossRefPubMedCentralGoogle Scholar
  32. 32.
    Velders FP, De Wit JE, Jansen PW, Jaddoe VW, Hofman A, Verhulst FC, et al. FTO at rs9939609, food responsiveness, emotional control and symptoms of ADHD in preschool children. PLoS One. 2012;7(11):e49131.PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    Wardle J, Carnell S, Haworth CM, Farooqi IS, O’Rahilly S, Plomin R. Obesity associated genetic variation in FTO is associated with diminished satiety. J Clin Endocrinol Metab. 2008;93(9):3640–3.PubMedCrossRefGoogle Scholar
  34. 34.
    Wood AC. Appetitive traits: genetic contributions to pediatric eating behaviors. In: Lumeng JC, Fisher JO, editors. Pediatric food preferences and eating behaviors. San Diego: Academic Press; 2018. p. 127–46.CrossRefGoogle Scholar
  35. 35.
    Speakman JR, Loos RJF, O’Rahilly S, Hirschhorn JN, Allison DB. GWAS for BMI: a treasure trove of fundamental insights into the genetic basis of obesity. Int J Obes. 2018;42(8):1524–31.CrossRefGoogle Scholar
  36. 36.
    National Academies of Sciences Engineering and Medicine. Nutrigenomics and the future of nutrition: proceedings of a workshop—In Brief. Washington, DC: National Academies Press; 2018.Google Scholar
  37. 37.
    Marginean CO, Marginean C, Melit LE. New insights regarding genetic aspects of childhood obesity: a minireview. Front Pediatr. 2018;6:271.PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    •• Voss JD, Dhurandhar NV. Viral infections and obesity. Curr Obes Rep. 2017;6(1):28–37 Review of the infectobesity literature. PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Huttunen R, Syrjanen J. Obesity and the risk and outcome of infection. Int J Obes. 2013;37(3):333–40.CrossRefGoogle Scholar
  40. 40.
    Xu MY, Cao B, Wang DF, Guo JH, Chen KL, Shi M, et al. Human adenovirus 36 infection increased the risk of obesity: a meta-analysis update. Medicine (Baltimore). 2015;94(51):e2357.CrossRefGoogle Scholar
  41. 41.
    Vangipuram SD, Yu M, Tian J, Stanhope KL, Pasarica M, Havel PJ, et al. Adipogenic human adenovirus-36 reduces leptin expression and secretion and increases glucose uptake by fat cells. Int J Obes. 2007;31(1):87–96.CrossRefGoogle Scholar
  42. 42.
    Wang ZQ, Yu Y, Zhang XH, Floyd EZ, Cefalu WT. Human adenovirus 36 decreases fatty acid oxidation and increases de novo lipogenesis in primary cultured human skeletal muscle cells by promoting Cidec/FSP27 expression. Int J Obes. 2010;34(9):1355–64.CrossRefGoogle Scholar
  43. 43.
    Karachaliou M, de Sanjose S, Waterboer T, Roumeliotaki T, Vassilaki M, Sarri K, et al. Is early life exposure to polyomaviruses and herpesviruses associated with obesity indices and metabolic traits in childhood? Int J Obes. 2018;42(9):1590–601.CrossRefGoogle Scholar
  44. 44.
    Shang Q, Wang H, Song Y, Wei L, Lavebratt C, Zhang F, et al. Serological data analyses show that adenovirus 36 infection is associated with obesity: a meta-analysis involving 5739 subjects. Obesity (Silver Spring). 2014;22(3):895–900.CrossRefGoogle Scholar
  45. 45.
    Centers for Disease Control and Prevention. About adenoviruses - prevention & treatment. Accessed 8 Aug 2018.
  46. 46.
    Simpson RJ, Kunz H, Agha N, Graff R. Exercise and the regulation of immune functions. Prog Mol Biol Transl Sci. 2015;135:355–80.PubMedCrossRefGoogle Scholar
  47. 47.
    Sender R, Fuchs S, Milo R. Revised estimates for the number of human and bacteria cells in the body. PLoS Biol. 2016;14(8):e1002533.PubMedPubMedCentralCrossRefGoogle Scholar
  48. 48.
    Indiani CMDSP, Rizzardi KF, Castelo PM, Ferraz LFC, Darrieux M, Parisotto TM. Childhood obesity and Firmicutes/Bacteroidetes ratio in the gut microbiota: a systematic review. Child Obes. 2018;14(8):501–9.PubMedCrossRefGoogle Scholar
  49. 49.
    Turnbaugh PJ, Ley RE, Mahowald MA, Magrini V, Mardis ER, Gordon JI. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature. 2006;444(7122):1027–31.PubMedCrossRefGoogle Scholar
  50. 50.
    Muniz Pedrogo DA, Jensen MD, Van Dyke CT, Murray JA, Woods JA, Chen J, et al. Gut microbial carbohydrate metabolism hinders weight loss in overweight adults undergoing lifestyle intervention with a volumetric diet. Mayo Clin Proc. 2018;93(8):1104–10.PubMedCrossRefGoogle Scholar
  51. 51.
    •• Miller SA, Wu RKS, Oremus M. The association between antibiotic use in infancy and childhood overweight or obesity: a systematic review and meta-analysis. Obes Rev. 2018;19(11):1463–75 Review of the microbiome and obesity literature. PubMedCrossRefGoogle Scholar
  52. 52.
    Stark CM, Susi A, Emerick J, Nylund CM. Antibiotic and acid-suppression medications during early childhood are associated with obesity. Gut. 2018.
  53. 53.
    •• Komaroff AL. The microbiome and risk for obesity and diabetes. JAMA. 2017;317(4):355–6 Clear statement of support of the microbiome-obesity hypothesis. PubMedCrossRefGoogle Scholar
  54. 54.
    Tun MH, Tun HM, Mahoney JJ, Konya TB, Guttman DS, Becker AB, et al. Postnatal exposure to household disinfectants, infant gut microbiota and subsequent risk of overweight in children. CMAJ. 2018;190(37):E1097–107.PubMedPubMedCentralCrossRefGoogle Scholar
  55. 55.
    Stanislawski MA, Dabelea D, Wagner BD, Iszatt N, Dahl C, Sontag MK, et al. Gut microbiota in the first 2 years of life and the association with body mass index at age 12 in a Norwegian birth cohort. MBio. 2018;9(5):e01751–18.PubMedPubMedCentralCrossRefGoogle Scholar
  56. 56.
    Sun L, Ma L, Ma Y, Zhang F, Zhao C, Nie Y. Insights into the role of gut microbiota in obesity: pathogenesis, mechanisms, and therapeutic perspectives. Protein Cell. 2018.
  57. 57.
    Rastelli M, Knauf C, Cani PD. Gut microbes and health: a focus on the mechanisms linking microbes, obesity, and related disorders. Obesity (Silver Spring). 2018;26(5):792–800.CrossRefGoogle Scholar
  58. 58.
    Sanmiguel C, Gupta A, Mayer EA. Gut microbiome and obesity: a plausible explanation for obesity. Curr Obes Rep. 2015;4(2):250–61.PubMedPubMedCentralCrossRefGoogle Scholar
  59. 59.
    • Zeilstra D, Younes JA, Brummer RJ, Kleerebezem M. Perspective: fundamental limitations of the randomized controlled trial method in nutritional research: the example of probiotics. Adv Nutr. 2018;9(5):561–71 Clear delineation of threats to internal and external validity from randomized clinical trials for nutrition research. PubMedPubMedCentralCrossRefGoogle Scholar
  60. 60.
    Zmora N, Suez J, Elinav E. You are what you eat: diet, health and the gut microbiota. Nat Rev Gastroenterol Hepatol. 2018.
  61. 61.
    Forbes JD, Azad MB, Vehling L, Tun HM, Konya TB, Guttman DS, et al. Association of exposure to formula in the hospital and subsequent infant feeding practices with gut microbiota and risk of overweight in the first year of life. JAMA Pediatr. 2018;172(7):e181161.PubMedCrossRefGoogle Scholar
  62. 62.
    So D, Whelan K, Rossi M, Morrison M, Holtmann G, Kelly JT, et al. Dietary fiber intervention on gut microbiota composition in healthy adults: a systematic review and meta-analysis. Am J Clin Nutr. 2018;107(6):965–83.PubMedCrossRefGoogle Scholar
  63. 63.
    Borgeraas H, Johnson LK, Skattebu J, Hertel JK, Hjelmesaeth J. Effects of probiotics on body weight, body mass index, fat mass and fat percentage in subjects with overweight or obesity: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2018;19(2):219–32.PubMedCrossRefGoogle Scholar
  64. 64.
    Anhe FF, Nachbar RT, Varin TV, Trottier J, Dudonne S, Le Barz M, et al. Treatment with camu camu (Myrciaria dubia) prevents obesity by altering the gut microbiota and increasing energy expenditure in diet-induced obese mice. Gut. 2018.
  65. 65.
    Griffin NW, Ahern PP, Cheng J, Heath AC, Ilkayeva O, Newgard CB, et al. Prior dietary practices and connections to a human gut microbial metacommunity alter responses to diet interventions. Cell Host Microbe. 2017;21(1):84–96.PubMedCrossRefGoogle Scholar
  66. 66.
    O’Sullivan O, Cronin O, Clarke SF, Murphy EF, Molloy MG, Shanahan F, et al. Exercise and the microbiota. Gut Microbes. 2015;6(2):131–6.PubMedPubMedCentralCrossRefGoogle Scholar
  67. 67.
    Lipstein EA, Block JP, Dodds C, Forrest CB, Heerman WJ, Law JK, et al. Early antibiotics and childhood obesity: do future risks matter to parents and physicians? Clin Pediatr (Phila). 2018.
  68. 68.
    Baranowski T, O’Connor T, Johnston C, Hughes S, Moreno J, Chen TA, et al. School year versus summer differences in child weight gain: a narrative review. Child Obes. 2014;10(1):18–24.PubMedPubMedCentralCrossRefGoogle Scholar
  69. 69.
    • Chen TA, Baranowski T, Moreno JP, O’Connor TM, Hughes SO, Baranowski J, et al. Obesity status trajectory groups among elementary school children. BMC Public Health. 2016;16:526 Identifies age-related subgroups in the time trajectory of childhood obesity. PubMedPubMedCentralCrossRefGoogle Scholar
  70. 70.
    •• Laermans J, Depoortere I. Chronobesity: role of the circadian system in the obesity epidemic. Obes Rev. 2016;17(2):108–25 A review of circadian biological causes of obesity. PubMedCrossRefGoogle Scholar
  71. 71.
    Bray MS, Young ME. Circadian rhythms in the development of obesity: potential role for the circadian clock within the adipocyte. Obes Rev. 2007;8(2):169–81.PubMedCrossRefGoogle Scholar
  72. 72.
    •• Garaulet M, Gomez-Abellan P. Timing of food intake and obesity: a novel association. Physiol Behav. 2014;134:44–50 A review of the literature regarding the timing of food intake and obesity. PubMedCrossRefGoogle Scholar
  73. 73.
    Johnston JD, Ordovas JM, Scheer FA, Turek FW. Circadian rhythms, metabolism, and chrononutrition in rodents and humans. Adv Nutr. 2016;7(2):399–406.PubMedPubMedCentralCrossRefGoogle Scholar
  74. 74.
    Stothard ER, McHill AW, Depner CM, Birks BR, Moehlman TM, Ritchie HK, et al. Circadian entrainment to the natural light-dark cycle across seasons and the weekend. Curr Biol. 2017;27(4):508–13.PubMedPubMedCentralCrossRefGoogle Scholar
  75. 75.
    Wu Y, Zhai L, Zhang D. Sleep duration and obesity among adults: a meta-analysis of prospective studies. Sleep Med. 2014;15(12):1456–62.PubMedCrossRefGoogle Scholar
  76. 76.
    Itani O, Jike M, Watanabe N, Kaneita Y. Short sleep duration and health outcomes: a systematic review, meta-analysis, and meta-regression. Sleep Med. 2017;32:246–56.PubMedCrossRefGoogle Scholar
  77. 77.
    Cappuccio FP, Taggart FM, Kandala NB, Currie A, Peile E, Stranges S, et al. Meta-analysis of short sleep duration and obesity in children and adults. Sleep. 2008;31(5):619–26.PubMedPubMedCentralCrossRefGoogle Scholar
  78. 78.
    Fatima Y, Doi SA, Mamun AA. Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias-adjusted meta-analysis. Obes Rev. 2015;16(2):137–49.PubMedCrossRefGoogle Scholar
  79. 79.
    Wu Y, Gong Q, Zou Z, Li H, Zhang X. Short sleep duration and obesity among children: a systematic review and meta-analysis of prospective studies. Obes Res Clin Pract. 2017;11(2):140–50.PubMedCrossRefGoogle Scholar
  80. 80.
    Ruan H, Xun P, Cai W, He K, Tang Q. Habitual sleep duration and risk of childhood obesity: systematic review and dose-response meta-analysis of prospective cohort studies. Sci Rep. 2015;5:16160.PubMedPubMedCentralCrossRefGoogle Scholar
  81. 81.
    Patel SR, Hu FB. Short sleep duration and weight gain: a systematic review. Obesity (Silver Spring). 2008;16(3):643–53.CrossRefGoogle Scholar
  82. 82.
    Sha J, Zheng J, Meng C, Zhu D, Li L, Cui N. Survey on the clinical characteristics of paediatric allergic rhinitis. Allergy. 2017;72(Suppl 103):411–2.Google Scholar
  83. 83.
    Capers PL, Fobian AD, Kaiser KA, Borah R, Allison DB. A systematic review and meta-analysis of randomized controlled trials of the impact of sleep duration on adiposity and components of energy balance. Obes Rev. 2015;16(9):771–82.PubMedPubMedCentralCrossRefGoogle Scholar
  84. 84.
    •• Bray MS, Young ME. Chronobiological effects on obesity. Curr Obes Rep. 2012;1(1):9–15 A review of chronobiological causes of obesity with particular attention to the role of adipose tissue. PubMedPubMedCentralCrossRefGoogle Scholar
  85. 85.
    • Arble DM, Bass J, Laposky AD, Vitaterna MH, Turek FW. Circadian timing of food intake contributes to weight gain. Obesity (Silver Spring). 2009;17(11):2100–2 Study identified eating during the biological night led to accelerated weight gain. This was not accounted for by changes in diet or physical activity. CrossRefGoogle Scholar
  86. 86.
    McHill AW, Phillips AJ, Czeisler CA, Keating L, Yee K, Barger LK, et al. Later circadian timing of food intake is associated with increased body fat. Am J Clin Nutr. 2017;106(5):1213–9.PubMedPubMedCentralGoogle Scholar
  87. 87.
    Pendergast JS, Branecky KL, Yang W, Ellacott KL, Niswender KD, Yamazaki S. High-fat diet acutely affects circadian organisation and eating behavior. Eur J Neurosci. 2013;37(8):1350–6.PubMedPubMedCentralCrossRefGoogle Scholar
  88. 88.
    Kohsaka A, Laposky AD, Ramsey KM, Estrada C, Joshu C, Kobayashi Y, et al. High-fat diet disrupts behavioral and molecular circadian rhythms in mice. Cell Metab. 2007;6(5):414–21.PubMedCrossRefGoogle Scholar
  89. 89.
    Yasumoto Y, Hashimoto C, Nakao R, Yamazaki H, Hiroyama H, Nemoto T, et al. Short-term feeding at the wrong time is sufficient to desynchronize peripheral clocks and induce obesity with hyperphagia, physical inactivity and metabolic disorders in mice. Metabolism. 2016;65(5):714–27.CrossRefGoogle Scholar
  90. 90.
    •• Szewczyk-Golec K, Wozniak A, Reiter RJ. Inter-relationships of the chronobiotic, melatonin, with leptin and adiponectin: implications for obesity. J Pineal Res. 2015;59(3):277–91 Review of the literature on the role of melatonin in weight gain. PubMedCrossRefGoogle Scholar
  91. 91.
    Crowley SJ, Cain SW, Burns AC, Acebo C, Carskadon MA. Increased sensitivity of the circadian system to light in early/mid-puberty. J Clin Endocrinol Metab. 2015;100(11):4067–73.PubMedPubMedCentralCrossRefGoogle Scholar
  92. 92.
    Higuchi S, Nagafuchi Y, Lee SI, Harada T. Influence of light at night on melatonin suppression in children. J Clin Endocrinol Metab. 2014;99(9):3298–303.PubMedCrossRefGoogle Scholar
  93. 93.
    Cipolla-Neto J, Amaral FG, Afeche SC, Tan DX, Reiter RJ. Melatonin, energy metabolism, and obesity: a review. J Pineal Res. 2014;56(4):371–81.PubMedCrossRefGoogle Scholar
  94. 94.
    Alonso-Vale MI, Andreotti S, Mukai PY, Borges-Silva C, Peres SB, Cipolla-Neto J, et al. Melatonin and the circadian entrainment of metabolic and hormonal activities in primary isolated adipocytes. J Pineal Res. 2008;45(4):422–9.PubMedCrossRefGoogle Scholar
  95. 95.
    Song CK, Bartness TJ. CNS sympathetic outflow neurons to white fat that express MEL receptors may mediate seasonal adiposity. Am J Physiol Regul Integr Comp Physiol. 2001;281(2):R666–72.PubMedCrossRefGoogle Scholar
  96. 96.
    Jimenez-Aranda A, Fernandez-Vazquez G, Campos D, Tassi M, Velasco-Perez L, Tan DX, et al. Melatonin induces browning of inguinal white adipose tissue in Zucker diabetic fatty rats. J Pineal Res. 2013;55(4):416–23.PubMedGoogle Scholar
  97. 97.
    Fernandez Vazquez G, Reiter RJ, Agil A. Melatonin increases brown adipose tissue mass and function in Zucker diabetic fatty rats: implications for obesity control. J Pineal Res. 2018;64(4):e12472.PubMedCrossRefGoogle Scholar
  98. 98.
    •• Tan DX, Manchester LC, Fuentes-Broto L, Paredes SD, Reiter RJ. Significance and application of melatonin in the regulation of brown adipose tissue metabolism: relation to human obesity. Obes Rev. 2011;12(3):167–88 A review of the literature regarding the role of melatonin in obesity. PubMedCrossRefGoogle Scholar
  99. 99.
    Nixon GM, Thompson JM, Han DY, Becroft DM, Clark PM, Robinson E, et al. Short sleep duration in middle childhood: risk factors and consequences. Sleep. 2008;31(1):71–8.PubMedPubMedCentralCrossRefGoogle Scholar
  100. 100.
    Touchette E, Mongrain V, Petit D, Tremblay RE, Montplaisir JY. Development of sleep-wake schedules during childhood and relationship with sleep duration. Arch Pediatr Adolesc Med. 2008;162(4):343–9.PubMedCrossRefGoogle Scholar
  101. 101.
    • Szewczyk-Golec K, Rajewski P, Gackowski M, Mila-Kierzenkowska C, Wesolowski R, Sutkowy P, et al. Melatonin supplementation lowers oxidative stress and regulates adipokines in obese patients on a calorie-restricted diet. Oxid Med Cell Longev. 2017;2017:8494107 Melatonin may be used as a therapeutic agent for obesity prevention. PubMedPubMedCentralCrossRefGoogle Scholar
  102. 102.
    Coomans CP, Lucassen EA, Kooijman S, Fifel K, Deboer T, Rensen PC, et al. Plasticity of circadian clocks and consequences for metabolism. Diabetes Obes Metab. 2015;17(Suppl 1):65–75.PubMedCrossRefGoogle Scholar
  103. 103.
    Ptitsyn AA, Zvonic S, Conrad SA, Scott LK, Mynatt RL, Gimble JM. Circadian clocks are resounding in peripheral tissues. PLoS Comput Biol. 2006;2(3):e16.PubMedPubMedCentralCrossRefGoogle Scholar
  104. 104.
    Leung GKW, Huggins CE, Bonham MP. Effect of meal timing on postprandial glucose responses to a low glycemic index meal: a crossover trial in healthy volunteers. Clin Nutr. 2017.Google Scholar
  105. 105.
    Tsuchida Y, Hata S, Sone Y. Effects of a late supper on digestion and the absorption of dietary carbohydrates in the following morning. J Physiol Anthropol. 2013;32(1):9.PubMedPubMedCentralCrossRefGoogle Scholar
  106. 106.
    Eckel RH, Depner CM, Perreault L, Markwald RR, Smith MR, McHill AW, et al. Morning circadian misalignment during short sleep duration impacts insulin sensitivity. Curr Biol. 2015;25(22):3004–10.PubMedCrossRefGoogle Scholar
  107. 107.
    Plano SA, Casiraghi LP, Garcia Moro P, Paladino N, Golombek DA, Chiesa JJ. Circadian and metabolic effects of light: implications in weight homeostasis and health. Front Neurol. 2017;8:558.PubMedPubMedCentralCrossRefGoogle Scholar
  108. 108.
    • Thaiss CA, Zeevi D, Levy M, Zilberman-Schapira G, Suez J, Tengeler AC, et al. Transkingdom control of microbiota diurnal oscillations promotes metabolic homeostasis. Cell. 2014;159(3):514–29 Identified circadian rhythmicity of the microbiome and the possible role of disrupted circadian rhythmicity in weight gain. CrossRefGoogle Scholar
  109. 109.
    David LA, Maurice CF, Carmody RN, Gootenberg DB, Button JE, Wolfe BE, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature. 2014;505(7484):559–63.PubMedCrossRefGoogle Scholar
  110. 110.
    Leone V, Gibbons SM, Martinez K, Hutchison AL, Huang EY, Cham CM, et al. Effects of diurnal variation of gut microbes and high-fat feeding on host circadian clock function and metabolism. Cell Host Microbe. 2015;17(5):681–9.PubMedPubMedCentralCrossRefGoogle Scholar
  111. 111.
    Zarrinpar A, Chaix A, Yooseph S, Panda S. Diet and feeding pattern affect the diurnal dynamics of the gut microbiome. Cell Metab. 2014;20(6):1006–17.PubMedPubMedCentralCrossRefGoogle Scholar
  112. 112.
    Asher G, Sassone-Corsi P. Time for food: the intimate interplay between nutrition, metabolism, and the circadian clock. Cell. 2015;161(1):84–92.PubMedCrossRefGoogle Scholar
  113. 113.
    Mukherji A, Kobiita A, Ye T, Chambon P. Homeostasis in intestinal epithelium is orchestrated by the circadian clock and microbiota cues transduced by TLRs. Cell. 2013;153(4):812–27.CrossRefGoogle Scholar
  114. 114.
    Skeldon AC, Phillips AJ, Dijk DJ. The effects of self-selected light-dark cycles and social constraints on human sleep and circadian timing: a modeling approach. Sci Rep. 2017;7:45158.PubMedPubMedCentralCrossRefGoogle Scholar
  115. 115.
    Crowley SJ, Eastman CI. Phase advancing human circadian rhythms with morning bright light, afternoon melatonin, and gradually shifted sleep: can we reduce morning bright-light duration? Sleep Med. 2015;16(2):288–97.PubMedCrossRefGoogle Scholar
  116. 116.
    Buxton OM, Lee CW, L’Hermite-Baleriaux M, Turek FW, Van Cauter E. Exercise elicits phase shifts and acute alterations of melatonin that vary with circadian phase. Am J Physiol Regul Integr Comp Physiol. 2003;284(3):R714–24.PubMedCrossRefGoogle Scholar
  117. 117.
    Antle MC, Mistlberger RE. Circadian clock resetting by sleep deprivation without exercise in the Syrian hamster. J Neurosci. 2000;20(24):9326–32.PubMedCrossRefGoogle Scholar
  118. 118.
    Dworak M, Wiater A, Alfer D, Stephan E, Hollmann W, Struder HK. Increased slow wave sleep and reduced stage 2 sleep in children depending on exercise intensity. Sleep Med. 2008;9(3):266–72.PubMedCrossRefGoogle Scholar
  119. 119.
    Dworak M, Diel P, Voss S, Hollmann W, Struder HK. Intense exercise increases adenosine concentrations in rat brain: implications for a homeostatic sleep drive. Neuroscience. 2007;150(4):789–95.PubMedCrossRefGoogle Scholar
  120. 120.
    Watson EJ, Banks S, Coates AM, Kohler MJ. The relationship between caffeine, sleep, and behavior in children. J Clin Sleep Med. 2017;13(4):533–43.PubMedPubMedCentralCrossRefGoogle Scholar
  121. 121.
    St-Onge MP, Ard J, Baskin ML, Chiuve SE, Johnson HM, Kris-Etherton P, et al. Meal timing and frequency: implications for cardiovascular disease prevention: a scientific statement from the American Heart Association. Circulation. 2017;135(9):e96–e121.CrossRefGoogle Scholar
  122. 122.
    • Burgermaster M, Contento I, Koch P, Mamykina L. Behavior change is not one size fits all: psychosocial phenotypes of childhood obesity prevention intervention participants. Transl Behav Med. 2018;8(5):799–807 Delineates subgroups in responsiveness to an obesity prevention trial. PubMedCrossRefGoogle Scholar
  123. 123.
    Schrempft S, van Jaarsveld CHM, Fisher A, Herle M, Smith AD, Fildes A, et al. Variation in the heritability of child body mass index by obesogenic home environment. JAMA Pediatr. 2018.
  124. 124.
    He Y, Wu W, Zheng HM, Li P, McDonald D, Sheng HF, et al. Regional variation limits applications of healthy gut microbiome reference ranges and disease models. Nat Med. 2018;24(10):1532–5.PubMedCrossRefGoogle Scholar
  125. 125.
    Tomiyama AJ, Mann T. If shaming reduced obesity, there would be no fat people. Hast Cent Rep. 2013;43(3):4–5 discussion 9-10.CrossRefGoogle Scholar
  126. 126.
    Puhl RM, King KM. Weight discrimination and bullying. Best Pract Res Clin Endocrinol Metab. 2013;27(2):117–27.PubMedCrossRefGoogle Scholar
  127. 127.
    Pearl RL, Puhl RM. Weight bias internalization and health: a systematic review. Obes Rev. 2018;19(8):1141–63.PubMedCrossRefGoogle Scholar

Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2019

Authors and Affiliations

  • Tom Baranowski
    • 1
    Email author
  • Kathleen J. Motil
    • 1
  • Jennette P. Moreno
    • 1
  1. 1.USDA/ARS Children’s Nutrition Research Center, Department of PediatricsBaylor College of MedicineHoustonUSA

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