Dietary polyphenols in pediatric obesity and cardiometabolic risk: mechanisms and clinical evidence.

Abstract

Pediatric obesity is a major global health concern and is associated with early cardiometabolic alterations, including insulin resistance, dyslipidemia, hypertension, endothelial dysfunction, and chronic low-grade inflammation. Dietary polyphenols, naturally present in fruits, vegetables, legumes, cocoa, and tea, have emerged as potential nutritional modulators of these pathways because of their antioxidant, anti-inflammatory, metabolic, and microbiota-related effects. This narrative overview summarizes current evidence on the role of dietary polyphenols in pediatric obesity and cardiometabolic risk. It examines the main biological mechanisms through which polyphenols may influence oxidative stress, inflammation, glucose and lipid metabolism, vascular function, and gut microbiota composition. It also reviews the available observational and clinical evidence in children and adolescents, with particular attention to polyphenol-rich dietary patterns. Available evidence suggests that polyphenols may influence key mechanisms involved in pediatric obesity, including oxidative stress, inflammation, glucose and lipid metabolism, endothelial function, and gut microbiota balance. Observational studies indicate that polyphenol-rich dietary patterns, especially Mediterranean-style diets, are associated with more favorable adiposity and cardiometabolic profiles in children and adolescents. However, pediatric clinical trials remain limited and heterogeneous, preventing firm conclusions on efficacy and long-term safety. Polyphenols are biologically plausible contributors to cardiometabolic health in pediatric obesity, but current evidence mainly supports food-based dietary patterns rather than isolated supplementation. Larger pediatric-specific trials are needed to clarify their clinical relevance and long-term benefits.