Developmental trends in auditory processing can provide early predictions of language acquisition in young infants

Auditory processing capabilities at the subcortical level have been hypothesized to impact an individual's development of both language and reading abilities. The present study examined whether auditory processing capabilities relate to language development in healthy 9-month-old infants. Participants were 71 infants (31 boys and 40 girls) with both Auditory Brainstem Response (ABR) and language assessments. At 6 weeks and/or 9 months of age, the infants underwent ABR testing using both a standard hearing screening protocol with 30 dB clicks and a second protocol using click pairs separated by 8, 16, and 64-ms intervals presented at 80 dB. We evaluated the effects of interval duration on ABR latency and amplitude elicited by the second click. At 9 months, language development was assessed via parent report on the Chinese Communicative Development Inventory - Putonghua version (CCDI-P). Wave V latency z-scores of the 64-ms condition at 6 weeks showed strong direct relationships with Wave V latency in the same condition at 9 months. More importantly, shorter Wave V latencies at 9 months showed strong relationships with the CCDI-P composite consisting of phrases understood, gestures, and words produced. Likewise, infants who had greater decreases in Wave V latencies from 6 weeks to 9 months had higher CCDI-P composite scores. Females had higher language development scores and shorter Wave V latencies at both ages than males. Interestingly, when the ABR Wave V latencies at both ages were taken into account, the direct effects of gender on language disappeared. In conclusion, these results support the importance of low-level auditory processing capabilities for early language acquisition in a population of typically developing young infants. Moreover, the auditory brainstem response in this paradigm shows promise as an electrophysiological marker to predict individual differences in language development in young children.

Enhancing self-regulation as a strategy for obesity prevention in Head Start preschoolers: the growing healthy study

BACKGROUND

Nearly one in five 4-year-old children in the United States are obese, with low-income children almost twice as likely to be obese as their middle/upper-income peers. Few obesity prevention programs for low-income preschoolers and their parents have been rigorously tested, and effects are modest. We are testing a novel obesity prevention program for low-income preschoolers built on the premise that children who are better able to self-regulate in the face of psychosocial stressors may be less likely to eat impulsively in response to stress. Enhancing behavioral self-regulation skills in low-income children may be a unique and important intervention approach to prevent childhood obesity.

METHODS/DESIGN

The Growing Healthy study is a randomized controlled trial evaluating two obesity prevention interventions in 600 low-income preschoolers attending Head Start, a federally-funded preschool program for low-income children. Interventions are delivered by community-based, nutrition-education staff partnering with Head Start. The first intervention (n = 200), Preschool Obesity Prevention Series (POPS), addresses evidence-based obesity prevention behaviors for preschool-aged children and their parents. The second intervention (n = 200) comprises POPS in combination with the Incredible Years Series (IYS), an evidence-based approach to improving self-regulation among preschool-aged children. The comparison condition (n = 200) is Usual Head Start Exposure. We hypothesize that POPS will yield positive effects compared to Usual Head Start, and that the combined intervention (POPS + IYS) addressing behaviors well-known to be associated with obesity risk, as well as self-regulatory capacity, will be most effective in preventing excessive increases in child adiposity indices (body mass index, skinfold thickness). We will evaluate additional child outcomes using parent and teacher reports and direct assessments of food-related self-regulation. We will also gather process data on intervention implementation, including fidelity, attendance, engagement, and satisfaction.

DISCUSSION

The Growing Healthy study will shed light on associations between self-regulation skills and obesity risk in low-income preschoolers. If the project is effective in preventing obesity, results can also provide critical insights into how best to deliver obesity prevention programming to parents and children in a community-based setting like Head Start in order to promote better health among at-risk children.

TRIAL REGISTRATION NUMBER

Clinicaltrials.gov Identifier: NCT01398358.

Maternal serum ferritin concentration is positively associated with newborn iron stores in women with low ferritin status in late pregnancy

Iron deficiency (ID) is common in pregnant women and infants, particularly in developing countries. The relation between maternal and neonatal iron status remains unclear. This study considered the issue in a large sample of mother-newborn pairs in rural southeastern China. Hemoglobin (Hb) and serum ferritin (SF) were measured in 3702 pregnant women at ≥37 wk gestation and in cord blood of their infants born at term (37-42 wk gestation). Maternal anemia (Hb <110 g/L) was present in 27.5% and associated with maternal SF <20 μg/L in 86.9%. Only 5.6% of neonates were anemic (Hb <130 g/L) and 9.5% had cord-blood SF <75 μg/L. There were low-order correlations between maternal and newborn iron measures (r = 0.07-0.10 for both Hb and SF; P ≤ 0.0001 due to the large number). We excluded 430 neonates with suggestion of inflammation [cord SF >370 μg/L, n = 208 and/or C-reactive protein (CRP) >5 mg/L, n = 233]. Piecewise linear regression analyses identified a threshold for maternal SF at which cord-blood SF was affected. For maternal SF below the threshold of 13.6 μg/L (β = 2.4; P = 0.001), cord SF was 0.17 SD lower than in neonates whose mothers had SF above the threshold (167 ± 75 vs. 179 ± 80 μg/L). The study confirmed that ID anemia remains common during pregnancy in rural southeastern China. Despite widespread maternal ID, however, iron nutrition seemed to meet fetal needs except when mothers were very iron deficient. The impact of somewhat lower cord SF on iron status later in infancy warrants further study.

Behavior and monoamine deficits in prenatal and perinatal iron deficiency are not corrected by early postnatal moderate-iron or high-iron diets in rats

Developmental iron deficiency anemia (IDA) causes brain and behavioral deficits in rodent models, which cannot be reversed when treated at periods equivalent to later infancy in humans. This study sought to determine whether earlier iron treatment can normalize deficits of IDA in rats and what iron dose is optimal. The offspring of dams with IDA during gestation were cross-fostered at postnatal d (P) 8 to dams receiving diets with 1 of 3 iron concentrations until weaning (P21): 0.003-0.01 g/kg [totally iron deficient (TID)]; 0.04 g/kg [formerly iron deficient (FID-40)]; or 0.4 g/kg (FID-400). Always iron-sufficient control dams (CN-40) received a 0.04-g/kg iron diet. At P21, TID pups received a 0.01 g iron/kg diet; all others received a 0.04 g iron/kg diet. Hematocrit and brain iron and monoamine concentrations were assessed at P21 and P100. Pup growth, development, activity, object recognition, hesitancy, and watermaze performance were evaluated. Regional brain iron was restored by iron treatment. Regional monoamine and metabolite concentrations were elevated in FID-40 rats and reduced in FID-400 and TID rats compared with CN-40 rats. FID-40 offspring had motor delays similar to TID during lactation and FID-400 rats had elevated thigmotaxis similar to TID rats at P25 and P100 in the spatial watermaze. In conclusion, iron treatment at P8 in rats did not normalize all monoamine or behavioral measures after early IDA. Moderate iron treatment improved adult behavior, but higher iron treatment caused brain and behavioral patterns similar to TID in the short and long term.

Reduced birth weight in relation to pesticide mixtures detected in cord blood of full-term infants

Previous research has shown that prenatal exposure to pesticides may be associated with decreased fetal growth. The specific pesticides investigated and results reported across studies have been inconsistent, and there is a mounting need for the consideration of mixtures rather than individual agents in studies of health outcomes in relation to environmental exposures. There are also many individual pesticides that have not been investigated in human health studies to date. We conducted a pilot study in rural Zhejiang province, China, measuring 20 non-persistent pesticides (10 insecticides, 6 herbicides, 3 fungicides, and 1 repellant) in umbilical cord blood of 112 full term (> 37 weeks) infants. The pesticides detected with the greatest frequency were diethyltoluamide (DEET) (73%), a repellant, and vinclozolin (49%), a fungicide. The samples had detectable concentrations for a mean of 4.6 pesticides (SD=1.9) with a maximum of 10. Adjusting for potential confounders, newborn birth weight was inversely associated with the number of pesticides detected in cord blood (p=0.04); birth weight decreased by a mean of 37.1g (95% CI, -72.5 to -1.8) for each detected pesticide. When assessing relationships by pesticide type, detection of fungicides was also associated with decreased birth weight (adjusted β=-116 g [95% CI, -212 to -19.2]). For individual pesticides analyzed as dichotomous (detect vs. non-detect) variables, only vinclozolin (adjusted β=-174 g [95% CI, -312 to -36.3]) and acetochlor (adjusted β=-165 g [95% CI, -325 to -5.7]) were significantly associated with reduced birth weight. No significant associations were seen between birth weight and individual pesticides assessed as continuous or 3-level ordinal variables. Our findings from this pilot investigation suggest that exposure to fungicides may adversely impact fetal growth. Exposure to mixtures of multiple pesticides is also of concern and should be explored in addition to individual pesticides. Additional research is needed to establish causality and to understand the function and impact of fungicides and pesticide mixtures on fetal development.

Blood pressure measurement device, number and timing of visits, and intra-individual visit-to-visit variability of blood pressure

Visit-to-visit variability (VVV) of blood pressure is associated with cardiovascular disease. The authors examined the effects of visit number and timing and automated or manual measurement device on VVV in the placebo arm of the Trial of Preventing Hypertension (TROPHY) (N=225) and simulations. VVV was assessed using intra-individual standard deviation (SD), range, maximum, coefficient of variation, successive variation, and average real variability of systolic blood pressure. VVV increased with number of visits used to calculate it in the TROPHY population (P for trend <.05 for all metrics) and simulations. Using consecutive visits in TROPHY, average SD was 5.6 mm Hg from 3 visits, 6.8 mm Hg from 7 visits, and 7.7 mm Hg from 18 visits. When 7 visits were spread out across 4 years, the average SD was higher (7.5 mm Hg) than when visits were consecutive over 18 months (P<.001). SD was higher using a single blood pressure measurement per visit (compared with the mean of 3 measurements per visit P<.001) and with automated vs manual devices (P<.001). In summary, number and timing of visits and device used to measure blood pressure influence VVV and need to be considered when designing, interpreting, and comparing studies.

TROPHY study: Outcomes based on the Seventh Report of the Joint National Committee on Hypertension definition of hypertension

Trial of Preventing Hypertension (TROPHY) investigated whether pharmacological treatment of prehypertension prevents or postpones stage 1 hypertension. Hypertension was originally defined when a participant had blood pressure (BP) >/=140 and/or >/=90 mm Hg at any three clinic visits over 4 years. Contemporary guidelines define hypertension if the BP is >/=140 and/or >/=90 at two consecutive visits. TROPHY results were recalculated based on the current definition. Participants with repeated BP of 130 - 139 and/or 85 - 89 mm Hg were randomly assigned to 2 years of candesartan or placebo, followed by 2 years of placebo for all. All participants received lifestyle counseling at every visit. When participants reached hypertension, antihypertensive treatment was initiated. The 4-year incidence of hypertension was significantly (P < .001) lower than previously reported in the placebo (-11.3%) and candesartan (-11.0%) groups. During the first 2 years, hypertension developed in 162 placebo and 53 candesartan participants (relative risk reduction [RRR], 68%; P < .001; original report 66%; P < .001). After 4 years, hypertension occurred in 197 placebo and 165 candesartan participants (RRR, 18%; P < .009; original report 16%; P < .007). The new definition resulted in a lower incidence of hypertension, but the outcomes were remarkably similar with both definitions and confirmed our original findings.

Long-term neuroendocrine effects of iron-deficiency anemia in infancy

INTRODUCTION

Iron-deficiency anemia (IDA) is recognized to have long-lasting effects on neurodevelopment, but there is little research on neuroendocrine systems.

METHODS

This study examined the effects of IDA in early or later infancy on plasma cortisol and prolactin stress-response patterns for 1 h after a venipuncture and catheter placement in 10-y-old healthy Chilean children. Children identified with IDA at 6 mo (IDA-6; n = 13) or 12 mo (IDA-12; n = 24) and who were iron sufficient (IS) at other infancy time points were compared to children who were IS at all time points during infancy (n = 23). All children received at least 6 mo of oral iron treatment in infancy.

RESULTS

At 10 y of age, IDA-6 and IDA-12 children demonstrated altered cortisol response patterns; both showed a more immediate decline and IDA-12 children showed a blunted curvature as compared to IS children. IDA-12 children showed significantly lower cortisol levels at 30 and 45 min after venipuncture and catheter placement than did IS children. There were no significant differences for stress-responsive plasma prolactin patterns between groups.

DISCUSSION

The results indicate that having IDA during infancy is associated with long-term neuroendocrine effects on stress-responsive cortisol patterns.

Observed assertive and intrusive maternal feeding behaviors increase child adiposity

BACKGROUND

Few studies have examined observed maternal feeding behaviors and their potential association with child adiposity. The association between maternal prompting to eat and child adiposity has been inconsistent.

OBJECTIVES

This study sought to identify factors associated with maternal feeding behaviors and to test the hypothesis that more maternal prompts to eat, more assertive prompts, and more intrusiveness are associated with greater child adiposity.

DESIGN

Children (n = 1218) and their mothers were videotaped eating a standardized snack at ages 15, 24, and 36 mo. Maternal prompts to eat, the percentage of prompts that were assertive, and intrusiveness were coded. Adjusted regression analyses evaluated predictors of prompts, the percentage of assertive prompts, and intrusiveness and the relation of each of these factors with child adiposity (weight-for-length z score at 15 mo and BMI z score at 24 and 36 mo) after control for the child's race-ethnicity and sex, family income-to-needs ratio, and maternal education, weight status, and depressive symptoms.

RESULTS

At 36 mo, mothers gave an average of 9.3 prompts; 61% of prompts were assertive, and 48% of mothers were intrusive. Lower maternal education and minority race-ethnicity were associated with a greater percentage of assertive prompts and intrusiveness. A greater percentage of assertive prompts and intrusiveness, but not total prompts, was associated with higher child adiposity.

CONCLUSIONS

Assertive prompting and an intrusive style had small but significant associations with greater child adiposity. Future work should focus on maternal motivations for assertive and intrusive feeding styles and mechanisms through which these feeding styles might increase child adiposity.

Regulation of corticoid and serotonin receptor brain system following early life exposure of glucocorticoids: long term implications for the neurobiology of mood

Potent glucocorticoids (GC) administered early in life have improved premature infant survival dramatically. However, these agents may increase the risk for physical, neurological and behavior alterations. Anxiety, depression and attention difficulties are commonly described in adolescent and young adult survivors of prematurity. In the present study we administered vehicle, dexamethasone, or hydrocortisone to Sprague-Dawley rat pups on postnatal days 5 and 6, mimicking a short term clinical protocol commonly used in human infants. Two systems that are implicated in the regulation of stress and behavior were assessed: the limbic-hypothalamic-pituitary-adrenal axis [LHPA; glucocorticoid and mineralocorticoid receptors within] and the Serotonin (5-HT) system. We found that as adults, male Sprague-Dawley pups treated with GC showed agent specific altered growth, anxiety-related behavior, changes in corticoid response to novelty and gene expression changes within LHPA and 5-HT-related circuitry. The data suggest that prolonged GC-receptor stimulation during the early neonatal period can contribute to the development of individual differences in stress response and anxiety-related behavior later in life.

Maternal styles of talking about child feeding across sociodemographic groups

This study sought to identify maternal styles of talking about child feeding from a semistructured interview and to evaluate associated maternal and child characteristics. Mothers of preschool-aged children (n=133) of diverse race/ethnicity and socioeconomic status (SES) (45 lower SES black, 29 lower SES white, 32 lower SES Hispanic, 15 middle to upper SES white, and 12 middle to upper SES Asian) participated in a semistructured interview about feeding. Interviews were audiotaped and transcribed. Themes were identified, and individual interviews were coded within these themes: authority (high/low), confidence (confident/conflicted/unopinionated), and investment (deep/mild/removed). Demographic characteristics were collected and a subset of children had measured weights and heights. Cluster analysis was used to identify narrative styles. Participant characteristics were compared across clusters using Fisher's exact test and analysis of variance. Six narrative styles were identified: Easy-Going, Practical No-Nonsense, Disengaged, Effortful No-Nonsense, Indulgent Worry, and Conflicted Control. Cluster membership differed significantly based on maternal demographic group (P<0.001) and child weight status (P<0.05). More than half (60%) of children of mothers in the Conflicted Control cluster were obese. Maternal styles of talking about feeding are associated with maternal and child characteristics.

Predictors of recovery from prenatal depressive symptoms from pregnancy through postpartum

BACKGROUND

Identifying predictors of the course of depressive symptoms from pregnancy through postpartum is important to inform clinical interventions.

METHODS

This longitudinal study investigated predictors of recovery from prenatal elevated depressive symptoms in the postpartum period. Forty-one pregnant women completed demographic, interpersonal, and psychosocial self-report assessment measures at 32 weeks of gestation and again 12 weeks postpartum.

RESULTS

Of those with elevated depressive symptoms, defined as a Beck Depression Inventory-II (BDI-II) score ≥10, at the prenatal baseline, 39% (n=16) recovered to nonelevated symptom levels postpartum, whereas 61% (n=25) experienced sustained elevated symptoms. Women who recovered evidenced significantly lower baseline depression severity and more frequent engagement in physical activity and cohabitated with a romantic partner. In multiparous women (n=25), history of past postpartum depression (PPD) differentiated between those with transient and those with persisting symptoms, although history of lifetime depression did not. None of the additional demographic, interpersonal, or psychosocial variables investigated differentiated between groups. Logistic regression analysis showed prenatal depression severity and exercise frequency as predictors of recovery postpartum.

CONCLUSIONS

Results suggest most women will not experience spontaneous recovery. Women with prenatal heightened symptom severity and previous experiences with PPD are acutely vulnerable to experience sustained symptoms. In contrast, having a cohabitating partner and engagement in prenatal exercise predicted symptom improvement. Physical exercise may be an important clinical recommendation, as it may improve mood. Given the small sample size, these results are preliminary. Implications and future research recommendations are discussed.

I'll have what she's having: the impact of model characteristics on children's food choices

This research investigates children's use of social categories in their food selection. Across three studies, we presented preschoolers with sets of photographs that contrasted food-eating models with different characteristics, including model gender, race (Black, White), age (child or adult), and/or expression (acceptance or rejection of the food). Children were asked to pick between the photographs to choose which food they would like for snack. Results demonstrated that preschoolers prefer foods being eaten by models with positive over negative expressions, foods being eaten by child over adult models, and foods being eaten by child models of the same gender as themselves over models of the other gender. This work connects with previous research on children's understanding of social categories and also has important practical implications for how characteristics of a food-eating model can affect children's willingness to try new foods.

Is acute high-dose secondhand smoke exposure always harmful to microvascular function in healthy adults?

Prev Cardiol. Long-term exposure to secondhand smoke (SHS) is associated with impaired vascular function. The authors investigated the vascular and blood pressure (BP) reactions to acute SHS exposure. Twenty-five healthy nonsmoking adults underwent a 1-hour exposure to SHS (mean fine particulate matter < 2.5 μm level = 315 ± 116 μg/m(3) ). Microvascular endothelial-dependent vasodilatation (EDV) (EndoPAT, Itamar Medical, Caesarea, Israel) and aortic hemodynamics/compliance (SphygmoCor, AtCor Medical, West Ryde, Australia) were measured before and after the SHS exposure with BP measured every 15 minutes during and for a 24-hour period before and after the exposure. SHS exposure did not change EDV, aortic hemodynamics, arterial compliance, or 24-hour BP. However, diastolic BP significantly increased during the SHS exposure period by 3.4 ± 5.6 mm Hg. Our brief SHS exposure did not impair microvascular endothelial function or arterial compliance in healthy nonsmoking adults, but brachial diastolic BP increased.

Benefits of additional courses of systemic azithromycin in periodontal therapy

The use of systemic antimicrobials such as doxycycline, metronidazole, and azithromycin in conjunction with debridement has achieved results superior to those produced by debridement alone. The purpose of the present study was to determine if previous results could be improved upon by administering repeated doses of azithromycin during the hygiene phase. One hundred patients with moderate to advanced periodontitis were treated with scaling and root planing plus three courses of azithromycin during the hygiene phase. All patients then were re-evaluated and periodontal surgery and/or extractions involving 96 teeth were performed in 32 patients. All patients then entered a maintenance program that lasted up to 192 weeks, with four-month recalls. Clinical parameters were recorded at baseline, at re-evaluation (week 6 after baseline), and at 96 and 192 weeks into maintenance. The results indicated that probing depths, bleeding upon probing, and suppuration were reduced significantly at re-evaluation. In addition, 14 teeth that displayed a Class III mobility at baseline improved to either Class I or Class II . There was no relapse during the maintenance phase. Multivariate analysis after 192 weeks indicated no change in the number of sites that bled upon probing, or had pockets that were 5.0-6.0 mm or ≥ 7 mm. Ninety-five percent of the sites that initially bled upon probing did not do so four years post-treatment. The results indicate that three courses of azithromicin in conjunction with root instrumentation during the hygiene phase led to long-lasting beneficial effects on all clinical parameters for at least 192 weeks.

Exercise self-regulation among older women participating in a heart disease-management intervention

Using behavioral self-regulation processes may facilitate exercise among older women with heart disease. Data from women in a heart disease-management program (n = 658, mean 73 years), was used to explore associations among exercise self-regulation components (i.e., choosing to improve exercise and observing, judging, and reacting to one's behavior) and exercise capacity. General linear models showed that choosing exercise predicted higher exercise self-regulation scores postprogram and 8 months later. In turn, these scores predicted greater improvements in exercise capacity concurrently and 8 months later. Interaction analyses revealed that the effect of self-regulation on exercise capacity was stronger among women who chose to work on exercise.

Progression of symptoms and functioning among female cardiac patients with and without diabetes

OBJECTIVE

To determine if older women with both heart disease and diabetes experience worse physical and psychosocial functioning and higher symptom burden over an 18-month period compared with those with heart disease alone.

METHODS

Data from older women with heart disease (≥60 years, n = 1008, 18% with diabetes) were used to assess the impact of diabetes on physical functioning (Sickness Impact Profile [SIP]-Physical and Six-Minute Walk test [6MWT]), psychosocial functioning (SIP-Psychosocial and depressive symptoms), and physical symptom burden (cardiac and general) at baseline and 4, 12, and 18 months later. Generalized estimating equation models compared trends in outcomes over time between groups with and without diabetes.

RESULTS

Across all four time points, women with heart disease and diabetes had greater functional impairment, as indicated by higher SIP scores, than those without diabetes (43%-71% higher SIP-Physical scores and 32%-65% higher SIP-Pyschosocial scores; all p ≤ 0.002). 6MWT distance was 17%-30% less in the diabetes group across time points (all p ≤ 0.002). Depressive symptoms were 27%-39% higher in the diabetes group (all p < 0.03) except at month 4. Women with diabetes scored 15%-29% higher on a physical symptom index across time points (all p < 0.05) than those without diabetes; no significant differences were observed in cardiac symptoms until month 18 (diabetes group 29% higher, p = 0.02). Subgroups with and without diabetes in this sample experienced significantly different trends over time in SIP-Physical scores (p = 0.02) and 6MWT distance (p = 0.05), such that the disadvantage of the diabetes group at baseline was greater 18 months later.

CONCLUSIONS

Women with comorbid diabetes and heart disease are vulnerable to poor health-related quality of life, particularly in terms of physical functioning and symptoms, and require special efforts from clinical care providers to ameliorate a potential downward trend in these outcomes over time.

Depressive symptoms during pregnancy: impact on neuroendocrine and neonatal outcomes

OBJECTIVE

To explore the interplay of maternal depressive symptoms on the infant limbic-hypothalamic-pituitary axis (LHPA) and neurological development.

DESIGN

Pregnant women were monitored for depressive symptoms using the Beck Depression Inventory (BDI) at 28, 32, and 37 weeks of gestation and at delivery. A mixture growth curve analysis divided the women into three risk groups: low/stable, intermediate, and high/increasing depression based on BDI scores. The infant neuroendocrine system was examined using cord blood for adrenocorticotrophic hormone (ACTH) and cortisol measurements. Two-week-old infants were examined using Neonatal Intensive Care Unit Neurobehavioral Scale (NNNS).

RESULTS

Infants born to women of the high/increasing depression group had significant ACTH elevation at birth. On NNNS examination, these infants were more hypotonic and habituated to auditory and visual stimuli.

CONCLUSION

When compared to non-depressed women, maternal depressive symptoms, even in the absence of major depressive disorder, appeared to facilitate a different developmental pathway for the infant LHPA and early neurological development.

Motor development in 9-month-old infants in relation to cultural differences and iron status

Motor development, which allows infants to explore their environment, promoting cognitive, social, and perceptual development, can be influenced by cultural practices and nutritional factors, such as iron deficiency. This study compared fine and gross motor development in 209 9-month-old infants from urban areas of China, Ghana, and USA (African-Americans) and considered effects of iron status. Iron deficiency anemia was most common in the Ghana sample (55%) followed by USA and China samples. Controlling for iron status, Ghanaian infants displayed precocity in gross motor development and most fine-motor reach-and-grasp tasks. US African-Americans performed the poorest in all tasks except bimanual coordination and the large ball. Controlling for cultural site, iron status showed linear trends for gross motor milestones and fine motor skills with small objects. Our findings add to the sparse literature on infant fine motor development across cultures. The results also indicate the need to consider nutritional factors when examining cultural differences in infant development.

Iron deficiency in infancy and neurocognitive functioning at 19 years: evidence of long-term deficits in executive function and recognition memory

Iron deficiency in infancy negatively impacts a variety of neurodevelopmental processes at the time of nutrient insufficiency, with persistent central nervous system alterations and deficits in behavioral functioning, despite iron therapy. In rodent models, early iron deficiency impairs the hippocampus and the dopamine system. We examined the possibility that young adults who had experienced chronic, severe, iron deficiency as infants would exhibit deficits on neurocognitive tests with documented frontostriatal (Trail Making Test, Intra-/Extra-dimensional Shift, Stockings of Cambridge, Spatial Working Memory, Rapid Visual Information Processing) and hippocampal specificity (Pattern Recognition Memory, Spatial Recognition Memory). Participants with chronic, severe iron deficiency in infancy performed less well on frontostriatal-mediated executive functions, including inhibitory control, set-shifting, and planning. Participants also exhibited impairment on a hippocampus-based recognition memory task. We suggest that these deficits may result from the long-term effects of early iron deficiency on the dopamine system, the hippocampus, and their interaction.

Maternal perception of neighborhood safety as a predictor of child weight status: The moderating effect of gender and assessment of potential mediators

OBJECTIVE

To determine if there is a relationship between maternal perception of neighborhood safety in 3(rd) grade and weight status in 5(th) grade children, to test if gender moderates this relationship, and to identify potential mediators.

METHOD

Data from 868 children and their mothers involved in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (NICHD-SECCYD) were used to examine the relationship between maternal perception of neighborhood safety in the 3(rd) grade and child body mass index (BMI) z-score in the 5(th) grade. Multiple regression models tested this relationship, the effect of gender, and potential mediating variables (time outdoors in neighborhood, television viewing, child behavior problems and puberty status).

RESULTS

Neighborhood safety ratings in the least safe tertile, compared with the safest tertile, were associated with an increased risk of obesity independent of gender, race and income-to-needs ratio (OR=1.59; 95% confidence interval [CI]: 1.03, 2.46), and higher child BMI z-scores among girls, but not boys, compared with the safest tertile (beta=0.33; 95% CI: 0.09, 0.57). Neither amount of time spent outdoors in the neighborhood, television viewing, child behavior problems (internalizing or externalizing), nor puberty status altered the relationship.

CONCLUSIONS

Maternal perception of the neighborhood as unsafe in 3(rd) grade independently predicted a higher risk of obesity, and a higher BMI z-score among girls, but not boys, in the 5(th) grade. The relationship was not explained by several potential mediators. Further investigation is needed to explore these gender differences and potential mediators.

Weight status as a predictor of being bullied in third through sixth grades

OBJECTIVES

Childhood obesity and bullying both are pervasive public health problems. The objective of this study was to determine the relationship between childhood obesity and being bullied in third, fifth, and sixth grades while testing for potential confounding and moderation.

METHODS

A total of 821 children who were participating in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (50% male, 81% white, 17% obese, 15% overweight in third grade) were studied. Generalized estimating equations were used to evaluate the relationship between child weight status and the odds of being bullied as reported by child, mother, and teacher, accounting for repeated measures and adjusting for grade level in school, child gender, child race, family income-to-needs ratio, school racial and socioeconomic composition, and mother- and teacher-reported child social skills and child academic achievement.

RESULTS

In sixth grade, 33.9%, 44.5%, and 24.9% of the children were reported to be bullied per teacher-, mother-, and self-report, respectively. There was a significant independent association between being obese and being bullied (odds ratio: 1.63 [95% confidence interval: 1.18-2.25]). The relationship between being obese and being bullied was attenuated but not eliminated by all covariates except gender. The relationship was not moderated by any of the covariates.

CONCLUSIONS

Children who are obese are more likely to be bullied, regardless of a number of potential sociodemographic, social, and academic confounders. No protective factors were identified. Effective interventions to reduce bullying of obese children need to be identified.