Applying the principles of 5P medicine to the prevention and treatment of childhood obesity: from genetic prediction to precision therapy (review)
Abstract
The spread of obesity among children and adolescents has reached pandemic proportions and leads to the development of severe cardiometabolic disorders, which significantly reduces the duration and quality of life. Since standard clinical recommendations demonstrate insufficient long-term effectiveness, there is an urgent need to change the paradigm and implement a proactive health care model based on the concept of 5P-medicine. Objective — to substantiate and propose for implementation in pediatric practice a holistic methodological model of obesity management in children and adolescents, built on the five principles of 5P-medicine (predictability, prevention, personalization, participation and precision) to increase the effectiveness of treatment, improve compliance and reduce the risk of complications. Materials and methods. The work was performed in the format of a narrative literature review with elements of a systematic search according to the PRISMA 2020 methodology in the international databases PubMed/MEDLINE, Scopus, Web of Science and Google Scholar for the period from January 1, 2015 to June 30, 2026. Of more than 680 identified sources, after deduplication and screening, 21 publications were included in the final analysis. Methodological quality was assessed using validated tools AMSTAR-2, Cochrane RoB 2, NOS, SANRA and JBI.Results and discussion. The evidence base of the review was formed based on the analysis of 21 key studies of high (Level A, 8 works) and moderate (Level B, 13 works) levels of evidence with a wide geography and sample power. Data synthesis demonstrated the following patterns across the 5P domains: Predictive: focuses on polygenic risk scores, targeted sequencing to detect monogenic forms, and epigenetic markers. Preventive: focuses on modifying risk factors in the «first 1000 days of life» (nutrition, microbiome formation). Precision/Personalized: reflects phenotype-oriented therapy, the use of artificial intelligence, and targeted pharmacotherapy. Participatory/Digital: demonstrates the high effectiveness of family involvement through digital family platforms and cognitive behavioral therapy. Conclusions. The management of childhood obesity is finally transforming from template approaches to personalized precision medicine that takes into account the genetic profile, microbiome state, and patient phenotype.