ISMAEL PERDOMO PEDIATRA

One of the most important debates in current pediatric nutrition is no longer only how much children eat, but how much of their diet comes from ultraprocessed foods. These industrial formulations often concentrate free sugars, sodium, low-quality fats, additives, and high energy density while displacing fresh or minimally processed foods. In clinical practice, frequent intake is associated with poorer diet quality and greater difficulty sustaining protective eating patterns during childhood.   Childhood obesity must be understood as a chronic disease in which the food environment plays a decisive role. From a pathophysiologic perspective, ultraprocessed foods may promote higher glycemic load, lower satiety, hyper-palatability, and repeated exposure to dietary patterns that favor positive energy balance. Epidemiologically, this matters because exposure starts early and overlaps with rising obesity prevalence. WHO continues to describe pediatric overweight and obesity as a growi...

Modern well-child care should not be limited to tracking weight, length, and vaccines; it must also anticipate the everyday behaviors that shape future metabolic risk. In early infancy, practices such as persistent nighttime feeding without clear need, pressure to finish the bottle, screen use during feeding, and poor sleep routines can become early obesogenic factors. This study is important because it translates obesity prevention into real infant life and shows that pediatric primary care can intervene before overt excess weight appears.   From a pediatric standpoint, the issue is not only how many calories an infant receives, but how appetite self-regulation, sleep patterns, and caregiver-child interaction are established. Childhood obesity is a long-trajectory disease, and its pathophysiology includes disrupted satiety signaling, nonresponsive feeding, early sedentary behaviors, and sleep-related circadian disruption. Current epidemiology makes this stage impossible to ig...

Childhood obesity does not begin when a child starts school or when excess weight becomes visible. Its biological and behavioral trajectory often starts before birth and consolidates during the first 1000 days of life, from preconception to age two. This concept is highly relevant in preventive pediatrics because it shifts the focus from late correction to early, family-centered, population-level prevention. The EndObesity Consortium review places that idea at the center of current scientific discussion: if we want to alter the obesity epidemic, we must intervene before the phenotype is fully expressed.   Medically, childhood obesity is a chronic, multifactorial, relapsing disease. Its epidemiology no longer allows us to treat it as a minor issue: it affects hundreds of millions of children worldwide and is linked to hypertension, insulin resistance, dyslipidemia, obstructive sleep apnea, metabolic dysfunction-associated steatotic liver disease, and long-term cardiometabolic r...

Una actualización clínica que la salud pública no puede ignorar Cuando se habla de nutrición infantil, el debate público suele concentrarse en obesidad y olvida otra parte crítica del problema: los trastornos alimentarios pediátricos. La revisión publicada en Nutrients en mayo de 2025 recuerda que anorexia nerviosa, bulimia nerviosa, trastorno por atracón y ARFID representan desafíos diagnósticos y terapéuticos complejos por su inicio temprano, sus comorbilidades psiquiátricas y su capacidad de comprometer crecimiento, pubertad, salud ósea, función cardiovascular y bienestar psicológico. El artículo sintetiza literatura de 2018 a 2024 y destaca la necesidad de modelos integrados y multidisciplinarios.     Desde el punto de vista médico, anorexia nerviosa se caracteriza por restricción alimentaria, miedo intenso a ganar peso y bajo peso clínicamente significativo; bulimia nerviosa por episodios de atracón seguidos de conductas compensatorias; el trastorno por atracón ( binge-ea...

Uno de los argumentos más dañinos en obesidad pediátrica es la resignación terapéutica: “ya bajará cuando crezca” o “lo importante es esperar”. El estudio publicado en JAMA Pediatrics en 2025 responde con datos sólidos. Investigó a 6.713 niños y adolescentes con obesidad tratados en el registro sueco BORIS, comparados con controles de la población general, y evaluó desenlaces entre los 18 y 30 años. El hallazgo central fue contundente: una mejor respuesta al tratamiento en la infancia se asoció con menor riesgo posterior de diabetes tipo 2, dislipidemia, hipertensión e incluso menor mortalidad en la adultez joven.     El estudio fue una cohorte prospectiva dinámica con datos clínicos y vinculación a registros nacionales. Incluyó pacientes de 6 a 17 años con al menos un año de tratamiento; la respuesta se clasificó según el cambio en el puntaje de desviación estándar del IMC, desde mala respuesta hasta remisión de la obesidad. La mediana de edad al inicio fue 12,1 años, y la du...

What the Latest CDC Data Show   The latest NCHS/CDC data leave little room for complacency. In August 2021 through August 2023, an estimated 21.1% of U.S. children and adolescents aged 2–19 were living with obesity, including 7.0% with severe obesity; another 15.1% were overweight. Published as a Health E-Stat in 2026, the report shows a long-term upward trend dating back to the 1970s and confirms that pediatric obesity is not a temporary deviation but an entrenched national public health condition.     The report uses NHANES, a multistage probability sample of the U.S. civilian noninstitutionalized population, with household interviews and health examinations. That methodological detail matters because the estimates come from measured, not merely self-reported, height and weight. Medically, pediatric obesity is defined as BMI at or above the 95th percentile for age and sex; severe obesity is BMI at least 120% of that percentile. Clinical consequences include hypertension...