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Masukume G, Khashan AS, Morton SMB, Baker PN, Kenny LC, McCarthy FP. Caesarean section delivery and childhood obesity in a British longitudinal cohort study. PLoS One 2019; 14:e0223856. [PMID: 31665164 PMCID: PMC6821069 DOI: 10.1371/journal.pone.0223856] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/29/2019] [Indexed: 01/08/2023] Open
Abstract
Background Several studies reported an association between Caesarean section (CS) birth and childhood obesity. However, there are several limitations in the current literature. These include an inability to distinguish between planned and emergency CS, small study sample sizes and not adjusting for pre-pregnancy body-mass-index (BMI). We examined the association between CS delivery and childhood obesity using the United Kingdom Millennium Cohort Study (MCS). Methods Mother-infant pairs were recruited into the MCS. Use of sampling weights ensured the sample was representative of the population. The exposure was categorised as normal vaginal delivery (VD) [reference], assisted VD, planned CS and emergency CS. Childhood obesity prevalence, at age three, five, seven, eleven and fourteen years was calculated using the International Obesity Taskforce criteria. Mixed-effects linear regression models were fitted with associations adjusted for several potential confounders like maternal age, pre-pregnancy BMI, education and infant macrosomia. Linear regression models were fitted evaluating body fat percentage (BF%), at age seven and fourteen years. Results Of the 18,116 infants, 3872 (21.4%) were delivered by CS; 9.2% by planned CS. Obesity prevalence was 5.4%, 5.7%, 6.5%, 7.1% and 7.6% at age three, five, seven, eleven and fourteen years respectively. The mixed-effects linear regression model showed no association between planned (adjusted mean difference = 0.00; [95% confidence interval (CI) -0.10; 0.10], p-value = 0.97) or emergency CS (adjusted mean difference = 0.08; [95% CI -0.01; 0.17], p-value = 0.09) and child BMI. At age seven years, there was no association between planned CS and BF% (adjusted mean difference = 0.13; [95% CI -0.23; 0.49]); there was no association at age fourteen years. Conclusions Infants born by planned CS did not have a significantly higher BMI or BF% compared to those born by normal VD. This may suggest that the association, described in the literature, could be due to the indications/reasons for CS birth or residual confounding.
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Affiliation(s)
- Gwinyai Masukume
- INFANT Research Centre, Cork, Ireland
- Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
| | - Ali S. Khashan
- INFANT Research Centre, Cork, Ireland
- School of Public Health, Western Gateway Building, University College Cork, Cork, Ireland
| | - Susan M. B. Morton
- Centre for Longitudinal Research–He Ara ki Mua, University of Auckland, Auckland, New Zealand
| | - Philip N. Baker
- College of Life Sciences, University of Leicester, Leicester, England, United Kingdom
| | - Louise C. Kenny
- Department of Women’s and Children’s Health, Institute of Translational Medicine, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, England, United Kingdom
| | - Fergus P. McCarthy
- INFANT Research Centre, Cork, Ireland
- Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, London, England, United Kingdom
- * E-mail:
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Duraccio KM, Krietsch KN, Chardon ML, Van Dyk TR, Beebe DW. Poor sleep and adolescent obesity risk: a narrative review of potential mechanisms. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2019; 10:117-130. [PMID: 31572040 PMCID: PMC6749827 DOI: 10.2147/ahmt.s219594] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 08/17/2019] [Indexed: 12/12/2022]
Abstract
Poor sleep is related to increased obesity risk in adolescents, though the mechanisms of this relationship are unclear. This paper presents a conceptual framework of the various pathways that have been proposed to drive this relationship. In this framework, increased food reward, emotional reactivity, decreased inhibitory control, metabolic disturbances, poorer dietary quality, and disrupted meal timings may increase the likelihood of increasing overall energy intake. This paper further notes how poor sleep increases sedentary behavior and screen time, which likely limits overall energy expenditure. The model posits that these mechanisms result in an imbalance of energy intake and expenditure following poor sleep, intensifying the overall risk for obesity. Increases in food reward processes, decreases in insulin sensitivity, disrupted meal timing, and increases in sedentary behavior seem to be the most compelling mechanisms linking poor sleep with increased obesity risk in adolescents. Future directions and clinical implications of this framework are discussed.
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Affiliation(s)
- Kara M Duraccio
- Cincinnati Children's Hospital Center, Behavioral Medicine and Clinical Psychology Department, Cincinnati, OH, USA
| | - Kendra N Krietsch
- Cincinnati Children's Hospital Center, Behavioral Medicine and Clinical Psychology Department, Cincinnati, OH, USA
| | - Marie L Chardon
- Cincinnati Children's Hospital Center, Behavioral Medicine and Clinical Psychology Department, Cincinnati, OH, USA
| | - Tori R Van Dyk
- Loma Linda University, Department of Psychology, Loma Linda, CA, USA
| | - Dean W Beebe
- Cincinnati Children's Hospital Center, Behavioral Medicine and Clinical Psychology Department, Cincinnati, OH, USA.,University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH, USA
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MC4R and ENPP1 gene polymorphisms and their implication in maternal and neonatal risk for obesity. Sci Rep 2019; 9:10858. [PMID: 31350533 PMCID: PMC6659701 DOI: 10.1038/s41598-019-47402-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/10/2019] [Indexed: 12/25/2022] Open
Abstract
The aims of this study were to establish the role of MC4Rrs17782313 and ENPP1rs1044498 gene polymorphisms on pre-pregnancy BMI and the newborn’s status. We performed a cross-sectional study on 185 mothers and their offspring. The groups were divided into: control group- underweight or normal mothers with BMIinitial < 25 kg/m2 (n1 = 134) and study group-overweight/obese mothers with BMIinitial ≥ 25 kg/m2 (n2 = 51). All subjects underwent demographic, anthropometric, paraclinical, bioimpedance and genetic parameters. We found association between initial BMI and gestational weight gain (GWG), and a higher frequency of excessive GWG in overweight/obese women (p = 0.037). Higher values of anthropometric and bioimpedance parameters were observed in overweight/obese versus underweight/normal women. The MC4R rs17782313 and ENPP1 rs1044498 variant genotypes had an increased risk of pre-pregnancy overweight (OR = 1.41; 95% CI:[0.72; 2.78]; OR = 1.34; 95% CI:[0.65; 2.75]). The newborns from mothers with excessive GWG had a higher birth weight (BW) (p = 0.001). Higher MUAC values were noticed in newborns with MC4R rs17782313 wild-type genotype. Also, BW was correlated with GWG status smoking in pregnancy, gestational age and neonatal ENPP1rs1044498 variant genotype (p = 0.026). Our study pointed out the role of MC4R rs17782313 and ENPP1 rs1044498 genotypes in obesity determinisms in mothers and their newborns in correlation with BMI, MUAC, TST and bioimpedance parameters.
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54
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Jazwiec PA, Sloboda DM. Nutritional adversity, sex and reproduction: 30 years of DOHaD and what have we learned? J Endocrinol 2019; 242:T51-T68. [PMID: 31013473 DOI: 10.1530/joe-19-0048] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 03/25/2019] [Indexed: 12/12/2022]
Abstract
It is well established that early life environmental signals, including nutrition, set the stage for long-term health and disease risk - effects that span multiple generations. This relationship begins early, in the periconceptional period and extends into embryonic, fetal and early infant phases of life. Now known as the Developmental Origins of Health and Disease (DOHaD), this concept describes the adaptations that a developing organism makes in response to early life cues, resulting in adjustments in homeostatic systems that may prove maladaptive in postnatal life, leading to an increased risk of chronic disease and/or the inheritance of risk factors across generations. Reproductive maturation and function is similarly influenced by early life events. This should not be surprising, since primordial germ cells are established early in life and thus vulnerable to early life adversity. A multitude of 'modifying' cues inducing developmental adaptations have been identified that result in changes in reproductive development and impairments in reproductive function. Many types of nutritional challenges including caloric restriction, macronutrient excess and micronutrient insufficiencies have been shown to induce early life adaptations that produce long-term reproductive dysfunction. Many pathways have been suggested to underpin these associations, including epigenetic reprogramming of germ cells. While the mechanisms still remain to be fully investigated, it is clear that a lifecourse approach to understanding lifetime reproductive function is necessary. Furthermore, investigations of the impacts of early life adversity must be extended to include the paternal environment, especially in epidemiological and clinical studies of offspring reproductive function.
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Affiliation(s)
- Patrycja A Jazwiec
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Canada
- The Farncombe Family Digestive Diseases Research Institute, McMaster University, Hamilton, Canada
| | - Deborah M Sloboda
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Canada
- The Farncombe Family Digestive Diseases Research Institute, McMaster University, Hamilton, Canada
- Department of Pediatrics and Obstetrics and Gynecology, McMaster University, Hamilton, Canada
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Cauich-Viñas P, Azcorra H, Rodríguez L, Banik SD, Varela-Silva MI, Dickinson F. Body Mass Index in Mother and Child Dyads and its Association With Household Size and Parents' Education in 2 Urban Settings of Yucatan, Mexico. Food Nutr Bull 2019; 40:383-392. [PMID: 31195833 DOI: 10.1177/0379572119842990] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Overweight/obesity (OW/OB) coexists in mother-child dyads. However, a dearth of evidence on the factors associated with this phenomenon calls for research. OBJECTIVE To analyze the association of sociodemographic factors with OW/OB in a sample of 260 Maya mother-child dyads from Yucatan, Mexico. METHODS During 2011 to 2014, we measured height and weight in children and their mothers and calculated their body mass index (BMI). The OW/OB cutoff points were defined, for mothers, as having a BMI >25 kg/m2 and, for children, as having a BMI-for-age >2 standard deviation of the World Health Organization references. Mother-child dyads were grouped according to their BMI status: (1) normal weight mother and child, (2) normal weight mother and OW/OB child, (3) OW/OB mother and normal weight child, and (4) OW/OB mother and child. A multinomial logistic regression model was used to analyze the interrelationships among BMI status in mother-child dyads, household size, and parental education. RESULTS Overweight/obesity coexisted in 40% of dyads. Compared to normal weight dyads (1), each unit increase in household size and in years of maternal education decreased the risks of the coexistence of OW/OB in mother-child dyads (odds ratio [OR] = 0.72, 95% confidence interval [CI] 0.55-0.94, P = .015; OR = 0.70, 95% CI 0.52-0.94, P = .019, respectively). Conversely, each year increase in paternal education increased the risk for OW/OB in dyads (OR = 1.47, 95% CI 1.08-1.99, P = .015). CONCLUSIONS Results suggest that household size and parental education contribute to shape BMI-based nutritional status in this sample of mother-child dyads.
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Affiliation(s)
| | - Hugo Azcorra
- Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mérida, Yucatán, México
| | - Luis Rodríguez
- Universidad Autónoma de Yucatán, Mérida, Yucatán, México
| | - Sudip Datta Banik
- Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mérida, Yucatán, México
| | | | - Federico Dickinson
- Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mérida, Yucatán, México
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Heslehurst N, Vieira R, Akhter Z, Bailey H, Slack E, Ngongalah L, Pemu A, Rankin J. The association between maternal body mass index and child obesity: A systematic review and meta-analysis. PLoS Med 2019; 16:e1002817. [PMID: 31185012 PMCID: PMC6559702 DOI: 10.1371/journal.pmed.1002817] [Citation(s) in RCA: 210] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/01/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND There is a global obesity crisis, particularly among women and disadvantaged populations. Early-life intervention to prevent childhood obesity is a priority for public health, global health, and clinical practice. Understanding the association between childhood obesity and maternal pre-pregnancy weight status would inform policy and practice by allowing one to estimate the potential for offspring health gain through channelling resources into intervention. This systematic review and meta-analysis aimed to examine the dose-response association between maternal body mass index (BMI) and childhood obesity in the offspring. METHODS AND FINDINGS Searches in MEDLINE, Child Development & Adolescent Studies, CINAHL, Embase, and PsycInfo were carried out in August 2017 and updated in March 2019. Supplementary searches included hand-searching reference lists, performing citation searching, and contacting authors. Two researchers carried out independent screening, data extraction, and quality assessment. Observational studies published in English and reporting associations between continuous and/or categorical maternal and child BMI or z-score were included. Categorical outcomes were child obesity (≥95th percentile, primary outcome), overweight/obesity (≥85th percentile), and overweight (85th to 95th percentile). Linear and nonlinear dose-response meta-analyses were conducted using random effects models. Studies that could not be included in meta-analyses were summarised narratively. Seventy-nine of 41,301 studies identified met the inclusion criteria (n = 59 cohorts). Meta-analyses of child obesity included 20 studies (n = 88,872); child overweight/obesity, 22 studies (n = 181,800); and overweight, 10 studies (n = 53,238). Associations were nonlinear and there were significantly increased odds of child obesity with maternal obesity (odds ratio [OR] 3.64, 95% CI 2.68-4.95) and maternal overweight (OR 1.89, 95% CI 1.62-2.19). Significantly increased odds were observed for child overweight/obesity (OR 2.69, 95% CI 2.10-3.46) and for child overweight (OR 1.80, 95% CI 1.25, 2.59) with maternal obesity. A limitation of this research is that the included studies did not always report the data in a format that enabled inclusion in this complex meta-analysis. CONCLUSIONS This research has identified a 264% increase in the odds of child obesity when mothers have obesity before conception. This study provides substantial evidence for the need to develop interventions that commence prior to conception, to support women of childbearing age with weight management in order to halt intergenerational obesity.
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Affiliation(s)
- Nicola Heslehurst
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
- * E-mail:
| | - Rute Vieira
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen,
United Kingdom
| | - Zainab Akhter
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Hayley Bailey
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Emma Slack
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Lem Ngongalah
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Augustina Pemu
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Judith Rankin
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
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Kjaer TW, Faurholt-Jepsen D, Medrano R, Elwan D, Mehta K, Christensen VB, Wojcicki JM. Higher Birthweight and Maternal Pre-pregnancy BMI Persist with Obesity Association at Age 9 in High Risk Latino Children. J Immigr Minor Health 2019; 21:89-97. [PMID: 29397484 DOI: 10.1007/s10903-018-0702-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Childhood obesity is increasing especially in Latinos and early intervention is essential to prevent later obesity complications. Latino children (n = 201) recruited at two San Francisco hospitals were assessed at birth including infant anthropometrics and feeding practices and followed to age 9 with annual anthropometric assessments. We evaluated the relationship between perinatal risk factors and obesity at age 9 and chronic obesity (obesity at both 5 and 9 years). Higher birthweight [odds ratio (OR) 2.48, 95% confidence interval (CI) 1.06-5.81] and maternal pre-pregnancy body mass index (BMI) (OR 1.09, 95% CI 1.00-1.18) were associated with increased risk for obesity at 9 years. Higher maternal pre-pregnancy BMI (OR 1.10, 95% CI 1.01-1.20) was associated with chronic obesity. Additionally, prenatal depression symptoms were protective (OR 0.33, 95% CI 0.11-0.94) against chronic obesity. We found no association between maternal age and education, exclusive breastfeeding at 4-6 weeks, rapid infant weight gain, and obesity or chronic obesity. Perinatal risk factors for obesity including higher birthweight and maternal pre-pregnancy BMI persisted until age 9, whereas, other variables significant at age 5 in our cohort and other populations including exclusive breastfeeding and rapid infant weight gain were no longer associated with increased risk.
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Affiliation(s)
- Thora Wesenberg Kjaer
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.,School of Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Daniel Faurholt-Jepsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark
| | - Rosalinda Medrano
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Deena Elwan
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Kala Mehta
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Vibeke Brix Christensen
- Department of Pediatrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Janet M Wojcicki
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.
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Ntenda PAM, Mhone TG, Nkoka O. High Maternal Body Mass Index Is Associated with an Early-Onset of Overweight/Obesity in Pre-School-Aged Children in Malawi. A Multilevel Analysis of the 2015-16 Malawi Demographic and Health Survey. J Trop Pediatr 2019; 65:147-159. [PMID: 29800293 DOI: 10.1093/tropej/fmy028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Overweight/obesity in young children is one of the most serious public health issues globally. We examined whether individual- and community-level maternal nutritional status is associated with an early onset of overweight/obesity in pre-school-aged children in Malawi. DESIGN Data were obtained from the 2015-16 Malawi Demographic and Health Survey (MDHS). The maternal nutritional status as body mass index and childhood overweight/obesity status was assessed by using the World Health Organization (WHO) recommendations. To examine whether the maternal nutritional status is associated with overweight/obesity in pre-school-aged children, two-level multilevel logistic regression models were constructed on 4023 children of age less than five years dwelling in 850 different communities. RESULTS The multilevel regression analysis showed that children born to overweight/obese mothers had increased odds of being overweight/obese [adjusted odds ratio (aOR) = 3.11; 95% confidence interval (CI): 1.13-8.54]. At the community level, children born to mothers from the middle (aOR: 1.68; 95% CI: 1.02-2.78) and high (aOR: 1.69; 95% CI: 1.00-2.90) percentage of overweight/obese women had increased odds of being overweight/obese. In addition, there were significant variations in the odds of childhood overweight/obesity in the communities. CONCLUSIONS Strategies aimed at reducing childhood overweight/obesity in Malawi should address not only women and their children but also their communities. Appropriate choices of nutrition, diet and physical activity patterns should be emphasized upon in overweight/obese women of childbearing age throughout pregnancy and beyond.
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Affiliation(s)
- Peter Austin Morton Ntenda
- School of Public Health, College of Public Health, Taipei Medical University, No. 250, Wu-Hsing St, Taipei City, Taiwan
| | - Thomas Gabriel Mhone
- Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, No. 100, Shiquan 1st Road, Sanmin District, Kaohsiung City, Taiwan
| | - Owen Nkoka
- School of Public Health, College of Public Health, Taipei Medical University, No. 250, Wu-Hsing St, Taipei City, Taiwan
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Abstract
BACKGROUND Caesarean section birth may be associated with overweight in childhood; however, findings to date have been inconsistent. This study explored the association of caesarean section vs. vaginal birth with childhood overweight in Vietnam. METHODS This longitudinal cohort study explored the association of delivery mode with overweight, obesity, and overweight/or obesity at 8 years of age in children (n = 1937) across 20 sites in Vietnam, using Young Lives longitudinal cohort study data. Categories were defined using BMI z-scores in relationship to the World Health Organization (WHO) reference median: overweight >1 and <2 standard deviations (SD) above WHO reference median, obese >2 SD, and overweight/or obese >1 SD. Individual questionnaire data collected sociodemographic information and pregnancy/birth information through face-to-face interviews with mothers/caregivers. Anthropometric measurements for mother and child were collected at baseline and at 8 years for children. RESULTS Adjusted multivariable logistic models revealed a twofold increase in odds at age 8 years of overweight [odds ratio (OR) = 1.8, 95% confidence interval (95% CI) 1.03-3.2, p = 0.039], obese (OR = 2.2, 95% CI 1.2-4.0, p = 0.014), or overweight/or obese (OR = 2.1, 95% CI 1.3-3.3, p = 0.002) for children born through caesarean section compared with vaginal birth. Children born through planned caesarean section (adjusted OR = 2.3, 95% CI 1.2-4.1, p < 0.001) and unplanned caesarean section (adjusted OR = 1.9, 95% CI 1.1-3.5, p = 0.03) had similar increased odds of overweight/or obesity compared with children born through vaginal birth. CONCLUSIONS These findings suggest that there may be an association between caesarean section and childhood overweight even after adjustment for confounders. Further research is needed to explore the underlying mechanisms of this finding.
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Affiliation(s)
- Tina Lavin
- Centre for Health Services Research, School of Population and Global Health, The University of Western Australia , Crawley, Australia
| | - David B Preen
- Centre for Health Services Research, School of Population and Global Health, The University of Western Australia , Crawley, Australia
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Veile A, Valeggia C, Kramer KL. Cesarean birth and the growth of Yucatec Maya and Toba/Qom children. Am J Hum Biol 2019; 31:e23228. [PMID: 30815932 DOI: 10.1002/ajhb.23228] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 01/30/2019] [Accepted: 02/03/2019] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Cesarean delivery is often epidemiologically associated with childhood obesity. However, little attention is paid to post-birth modulatory environments, and most studies are conducted in settings where obesity arises for a number of reasons in addition to birth mode. We therefore assess population differences in the relationship between birth mode and childhood growth using data from rural and peri-urban Latin American indigenous populations, and test predictions developed using life history theory. METHODS Child height and weight were measured monthly in 80 Yucatec Maya and 58 Toba/Qom children aged 1-48 months (2007-2014, 3812 observations). Random-effects linear mixed models were used to compare children's growth by population, sex, and birth mode, accounting for potential confounders. RESULTS Cesarean delivery rates were 47% (Toba/Qom) and 20% (Yucatec Maya). Childhood obesity and overweight rates were low in both populations. Cesarean-delivered children had significantly greater weight gain (but similar height grain) compared to vaginally-delivered children. By age 4, cesarean delivered Yucatec Maya girls and boys, and Toba/Qom boys (not girls), had significantly higher weight-for-age compared to vaginally-delivered children from their own sex and population. CONCLUSIONS This provides one of the first attempts to document differences in children's growth patterns according to mode of birth in modernizing indigenous populations. Cesarean delivery is associated with young children's growth patterns, even in the absence of many obesity-inducing factors. There are also population, age, and sex differences in the relationship between birth mode and childhood weight trajectories that warrant future investigation.
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Affiliation(s)
- Amanda Veile
- Department of Anthropology, Purdue University, West Lafayette, Indiana
| | - Claudia Valeggia
- Department of Anthropology, Yale University, New Haven, Connecticut
| | - Karen L Kramer
- Department of Anthropology, University of Utah, Salt Lake City, Utah
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Walker R, Mazza D, Blumfield M, Bennett C, Truby H. Maternal gestational weight gain during pregnancy: prioritising the conversation. Aust J Prim Health 2019; 24:4-8. [PMID: 29262983 DOI: 10.1071/py17111] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 10/12/2017] [Indexed: 12/15/2022]
Abstract
Pregnancy is a critical stage of life requiring urgent attention when taking a lifespan approach to obesity prevention. Excessive gestational weight gain (GWG) is highly predictive of overweight and obesity later in life for women and their offspring. This discussion describes the challenges faced by health professionals (general practitioners, midwives, allied health) in primary care in Australia when addressing GWG, presents evidence that supports re-prioritising GWG and highlights strategies that can be used to address GWG. The revised National Health and Medical Research Council antenatal care guidelines (to be formally released in early 2018) indicate it will be the responsibility of health professionals in antenatal care to initiate conversations about GWG with women. Women are open to discussing this sensitive topic and health professionals in primary care have an opportunity to be proactive in addressing barriers that have hindered conversations about GWG in the past so that women are supported to manage their weight during pregnancy.
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Affiliation(s)
- Ruth Walker
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia
| | - Danielle Mazza
- Department of General Practice, School of Primary Health Care, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia
| | - Michelle Blumfield
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia
| | - Christie Bennett
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia
| | - Helen Truby
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia
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Liu J, Boghossian NS, Frongillo EA, Cai B, Hazlett LJ, Liu J. Associations of maternal gestational weight gain with the risk of offspring obesity and body mass index Z scores beyond the mean. Ann Epidemiol 2019; 32:64-71.e2. [PMID: 30799201 DOI: 10.1016/j.annepidem.2019.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 12/09/2018] [Accepted: 01/22/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE We examined the association of meeting the 2009 Institute of Medicine gestational weight gain (GWG) guidelines with offspring obesity and body mass index Z score (BMIZ) at age six overall and by maternal weight status. METHODS Data were from the Infant Feeding Practices Survey II Study (2005-2007) and their Year Six Follow-Up Study (2012). Logistic regression and quantile regression models were used. RESULTS Eleven percent of children were obese. Children born to mothers who gained excessive weight during pregnancy had an increased risk of obesity as compared with those born to mothers who gained adequate weight (adjusted odds ratio: 1.67). The association was stronger among normal-weight mothers (adjusted odds ratio: 3.50). Inadequate GWG was not associated with offspring obesity overall or in subsamples by maternal prepregnancy BMI. Children born to mothers who gained excessive weight had higher BMIZ. This distributional association was more pronounced among normal-weight mothers. Children born to obese mothers who gained inadequate weight had lower BMIZ at some percentiles of the BMIZ distribution. CONCLUSIONS Excessive GWG was associated with increased risk of offspring obesity and higher BMIZ at age six, whereas inadequate GWG was protective of high BMIZ among children born to obese mothers.
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Affiliation(s)
- Junxiu Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Nansi S Boghossian
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia
| | - Bo Cai
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Linda J Hazlett
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia.
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Rito AI, Buoncristiano M, Spinelli A, Salanave B, Kunešová M, Hejgaard T, García Solano M, Fijałkowska A, Sturua L, Hyska J, Kelleher C, Duleva V, Musić Milanović S, Farrugia Sant'Angelo V, Abdrakhmanova S, Kujundzic E, Peterkova V, Gualtieri A, Pudule I, Petrauskienė A, Tanrygulyyeva M, Sherali R, Huidumac-Petrescu C, Williams J, Ahrens W, Breda J. Association between Characteristics at Birth, Breastfeeding and Obesity in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative - COSI 2015/2017. Obes Facts 2019; 12:226-243. [PMID: 31030194 PMCID: PMC6547266 DOI: 10.1159/000500425] [Citation(s) in RCA: 153] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 04/16/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In Europe, although the prevalence of childhood obesity seems to be plateauing in some countries, progress on tackling this important public health issue remains slow and inconsistent. Breastfeeding has been described as a protective factor, and the more exclusively and the longer children are breastfed, the greater their protection from obesity. Birth weight has been shown to have a positive association with later risk for obesity. OBJECTIVES It was the aim of this paper to investigate the association of early-life factors, namely breastfeeding, exclusive breastfeeding and birth weight, with obesity among children. METHOD Data from 22 participating countries in the WHO European COSI study (round 4: 2015/2017) were collected using cross-sectional, nationally representative samples of 6- to 9-year-olds (n = 100,583). The children's standardized weight and height measurements followed a common WHO protocol. Information on the children's birth weight and breastfeeding practice and duration was collected through a family record form. A multivariate multilevel logistic regression analysis regarding breastfeeding practice (both general and exclusive) and characteristics at birth was performed. RESULTS The highest prevalence rates of obesity were observed in Spain (17.7%), Malta (17.2%) and Italy (16.8%). A wide between-country disparity in breastfeeding prevalence was found. Tajikistan had the highest percentage of children that were breastfed for ≥6 months (94.4%) and exclusively breastfed for ≥6 months (73.3%). In France, Ireland and Malta, only around 1 in 4 children was breastfed for ≥6 months. Italy and Malta showed the highest prevalence of obesity among children who have never been breastfed (21.2%), followed by Spain (21.0%). The pooled analysis showed that, compared to children who were breastfed for at least 6 months, the odds of being obese were higher among children never breastfed or breastfed for a shorter period, both in case of general (adjusted odds ratio [adjOR] [95% CI] 1.22 [1.16-1.28] and 1.12 [1.07-1.16], respectively) and exclusive breastfeeding (adjOR [95% CI] 1.25 [1.17-1.36] and 1.05 [0.99-1.12], respectively). Higher birth weight was associated with a higher risk of being overweight, which was reported in 11 out of the 22 countries. Bulgaria, Croatia, France, Italy, Poland and Romania showed that children who were preterm at birth had higher odds of being obese, compared to children who were full-term babies. CONCLUSION The present work confirms the beneficial effect of breastfeeding against obesity, which was highly increased if children had never been breastfed or had been breastfed for a shorter period. Nevertheless, adoption of exclusive breastfeeding is below global recommendations and far from the target endorsed by the WHO Member States at the World Health Assembly Global Targets for Nutrition of increasing the prevalence of exclusive breastfeeding in the first 6 months up to at least 50% by 2025.
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Affiliation(s)
- Ana Isabel Rito
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal,
| | - Marta Buoncristiano
- NCD Office, WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | | | - Marie Kunešová
- Institute of Endocrinology, Obesity Management Centre, Prague, Czechia
| | | | | | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Lela Sturua
- NCD Department, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Cecily Kelleher
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Vesselka Duleva
- Department of Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | | | | | | | - Enisa Kujundzic
- Institute of Public Health of Montenegro, Podgorica, Montenegro
| | | | | | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease Prevention and Control, Riga, Latvia
| | - Aušra Petrauskienė
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | - Rakhmatulloev Sherali
- Department for Organization and Provision of the Medical Care to Mother, Child and Family Planning, Ministry of Health and Social Protection of Population, Dushanbe, Tajikistan
| | - Constanta Huidumac-Petrescu
- National Health Assessment and Promotion Center, National Institute of Public Health Bucharest, Bucharest, Romania
| | - Julianne Williams
- NCD Office, WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
| | - João Breda
- NCD Office, WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
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Gibby CLK, Palacios C, Campos M, Lim E, Banna J. Associations between gestational weight gain and rate of infancy weight gain in Hawai'i and Puerto Rico WIC participants. BMC OBESITY 2018; 5:41. [PMID: 30524746 PMCID: PMC6276143 DOI: 10.1186/s40608-018-0219-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 11/19/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Excessive gestational weight gain and rapid infancy weight gain (RIWG) are associated with increased susceptibility to childhood obesity. Since low-income and minority children are particularly at risk, investigation of the associations between gestational weight gain and rate of infancy weight gain may inform childhood obesity prevention. This study investigated the associations between gestational weight gain and rate of infancy weight gain during the first four to six months postpartum in participants from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Hawai'i and Puerto Rico. METHODS This was a cross-sectional secondary data analysis from a text message-based intervention in WIC participants in Hawai'i and Puerto Rico. The analysis included 80 mother/infant pairs from the control group who completed the follow-up visit when infants were four to six months old. Maternal weight, height, and gestational weight gain were self-reported. Infant weight was measured at baseline and follow-up. A proportional odds model was used to investigate the association between gestational weight gain and infancy weight gain rate (rapid or extremely rapid, on-track, or slow), adjusting for maternal age, pregravid body mass index (BMI) status, parity, and being up-to-date with infant vaccinations. RESULTS In comparison to recommended gestational weight gain, excessive and inadequate (under the recommended amount) gestational weight gain was associated with 77% decreased (adjusted odds ratio [AOR] = 0.23; 95% confidence interval [CI] = 0.08, 0.70; p = 0.01) and 71% decreased (AOR = 0.29; 95% CI = 0.09, 0.94; p = 0.04) odds of RIWG versus on-track or slow infant weight gain, respectively. In comparison to women with one child, women with two children (AOR = 0.31; 95% CI = 0.11, 0.87; p = 0.03) or three or four children (AOR = 0.24; 95% CI = 0.07, 0.88; p = 0.03) had significantly lower odds of RIWG versus on-track or slow infancy weight gain. CONCLUSIONS Women with excessive or inadequate gestational weight gain had lower proportional odds of RIWG and were more likely to have slower infant weight gain than women who gained the recommended amount of weight. TRIAL REGISTRATION ClinicalTrials.gov Identifier; NCT02903186; September 16, 2016.
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Affiliation(s)
- Cheryl L. K. Gibby
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa. Agricultural Sciences 216, 1955 East-West Rd, Honolulu, HI 96822 USA
| | - Cristina Palacios
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th Street, AHC 5–313, Miami, FL 33199 USA
| | - Maribel Campos
- Dental and Craniofacial Genomics Unit, Endowed Health Services Research Center, Medical Sciences Campus, University of Puerto Rico, PO Box 365067, San Juan, PR 00936-5067 USA
| | - Eunjung Lim
- Department of Complementary and Integrative Medicine, Biostatistics Core Facility, John A. Burns School of Medicine, University of Hawai‘i at Mānoa. Medical Education Building 411, 651 Ilalo Street, Honolulu, HI 96813 USA
| | - Jinan Banna
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa. Agricultural Sciences 216, 1955 East-West Rd, Honolulu, HI 96822 USA
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Liang J, Guo Y, Dai M, Xiao Q, Cai W, Wei Y, Amakye WK, Jing J, Zhang Z. Differences in relationships of maternal and paternal age at childbirth with body fat distribution in offspring. Am J Hum Biol 2018; 30:e23143. [DOI: 10.1002/ajhb.23143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 04/16/2018] [Accepted: 05/16/2018] [Indexed: 01/09/2023] Open
Affiliation(s)
- Jingjing Liang
- Department of Maternal and Child Health, School of Public Health; Sun Yat-Sen University; Guangzhou Guangdong 510080 China
| | - Yangfeng Guo
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality; Guangzhou Guangdong 510180 China
| | - Meixia Dai
- Department of Maternal and Child Health, School of Public Health; Sun Yat-Sen University; Guangzhou Guangdong 510080 China
| | - Qipeng Xiao
- Department of Maternal and Child Health, School of Public Health; Sun Yat-Sen University; Guangzhou Guangdong 510080 China
| | - Weili Cai
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality; Guangzhou Guangdong 510180 China
| | - Yuanhuan Wei
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health; Southern Medical University; Guangzhou Guangdong 510515 China
| | - William Kwame Amakye
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health; Southern Medical University; Guangzhou Guangdong 510515 China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health; Sun Yat-Sen University; Guangzhou Guangdong 510080 China
| | - Zheqing Zhang
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health; Southern Medical University; Guangzhou Guangdong 510515 China
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Dodd JM, Louise J, Deussen AR, McPhee AJ, Owens JA, Robinson JS. Prenatal Diet and Child Growth at 18 Months. Pediatrics 2018; 142:peds.2018-0035. [PMID: 30089655 DOI: 10.1542/peds.2018-0035] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Our objective was to evaluate the effect of an antenatal dietary and lifestyle intervention in pregnant women who are overweight or obese on child outcomes at age 18 months. METHODS We conducted a follow-up study of children at 18 months of age who were born to women who participated in the Limiting Weight Gain in Overweight and Obese Women during Pregnancy to Improve Health Outcomes randomized trial. The primary follow-up study outcome was prevalence of child BMI z scores >85th percentile. Secondary study outcomes included a range of anthropometric measures, neurodevelopment, general health, and child feeding. Intention to treat principles were used in analyses, according to the treatment group allocated at randomization. RESULTS A total of 1602 children were assessed at age 18 months (lifestyle advice, n = 816; standard care, n = 786), representing 75.0% of the eligible sample (n = 2136). There were no statistically significant differences in the prevalence of child BMI z scores >85th percentile for children born to women in the lifestyle advice group, compared with the standard care group (lifestyle advice, 505 [47.11%] versus standard care, 483 [45.36%]; adjusted relative risk: 1.04; 95% confidence interval: 0.94 to 1.16; P = .45). There was no evidence of effects on child growth, adiposity, neurodevelopment, or dietary and physical activity patterns. CONCLUSIONS There is no evidence that providing pregnant women who were overweight or obese with an antenatal dietary and lifestyle intervention altered 18-month child growth and adiposity.
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Affiliation(s)
- Jodie M Dodd
- Discipline of Obstetrics and Gynaecology, Robinson Research Institute and .,Women's and Babies Division, Perinatal Medicine and
| | - Jennie Louise
- Discipline of Obstetrics and Gynaecology, Robinson Research Institute and.,Adelaide Health Technology Assessment, School of Public Health, University of Adelaide, Adelaide, Australia; and Departments of
| | - Andrea R Deussen
- Discipline of Obstetrics and Gynaecology, Robinson Research Institute and
| | - Andrew J McPhee
- Neonatal Medicine, Women's and Children's Hospital, Adelaide, Australia
| | - Julie A Owens
- Discipline of Obstetrics and Gynaecology, Robinson Research Institute and
| | - Jeffrey S Robinson
- Discipline of Obstetrics and Gynaecology, Robinson Research Institute and
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Dong L, Zhang Y, Yang L, Liu G, Ye J, Wang H. Effects of a High-Fat Diet on Adipose Tissue CD8+ T Cells in Young vs. Adult Mice. Inflammation 2018; 40:1944-1958. [PMID: 28866802 DOI: 10.1007/s10753-017-0635-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
T cells are involved in chronic inflammation of adipose tissue in obese conditions. However, the impact of age on the adipose T cells remains unknown. In this study, we investigated T cells in the white adipose tissue of young and adult mice. Obesity was induced in the mice using a high-fat diet (HFD) for 14 weeks. The young mice were fed an HFD at 3 weeks old, and adult mice were fed the HFD at 12 weeks old. Relative to adult mice, the young mice gained less fat and exhibited better glucose tolerance. Their adipose tissue contained more CD8+ T cells and higher levels of pro-inflammatory cytokines. Young mice showed a larger increase in CD4+ T cells. The young and adult mice showed similar insulin tolerance. HFD reduced the colon muscle layer, which was more obvious in the young mice. These data suggested that young and adult mice exhibit different responses to an HFD in terms of adipose tissue, glucose tolerance, and the colon muscle layer. The increase in CD8+ T cells and CD4+ T cells, together with higher levels of pro-inflammatory cytokines, suggested elevated inflammation in the presence of less fat gain in the young mice, which was unexpected. The significance of this inflammation remains unknown. We propose that inflammation might inhibit energy storage in the adipose tissue to provide more energy to the lean body mass in favor of growth in the young mice. The present study provides another example of the beneficial effect of inflammation in physiological conditions.
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Affiliation(s)
- Lijun Dong
- Research Center for Immunology, School of Laboratory Medicine, Xinxiang Medical University, Xinxiang, Henan Province, 453003, China
| | - Yao Zhang
- Collaborative Innovation Center of Molecular Diagnosis and Laboratory Medicine in Henan Province, Xinxiang Medical University, Xinxiang, Henan Province, 453003, China
| | - Li Yang
- Department of Laboratory Medicine, Qindao Women and Children's Hospital, Qindao, Shandong Province, 266034, China
| | - Guoyan Liu
- Research Center for Immunology, School of Laboratory Medicine, Xinxiang Medical University, Xinxiang, Henan Province, 453003, China
| | - Jianping Ye
- Antioxidant and Gene Regulation Laboratory, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, 70808, USA
| | - Hui Wang
- Research Center for Immunology, School of Laboratory Medicine, Xinxiang Medical University, Xinxiang, Henan Province, 453003, China. .,Collaborative Innovation Center of Molecular Diagnosis and Laboratory Medicine in Henan Province, Xinxiang Medical University, Xinxiang, Henan Province, 453003, China.
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Gonzalez-Nahm S, Mendez MA, Benjamin-Neelon SE, Murphy SK, Hogan VK, Rowley DL, Hoyo C. DNA methylation of imprinted genes at birth is associated with child weight status at birth, 1 year, and 3 years. Clin Epigenetics 2018; 10:90. [PMID: 29988473 PMCID: PMC6025828 DOI: 10.1186/s13148-018-0521-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 06/19/2018] [Indexed: 12/19/2022] Open
Abstract
Background This study assessed the associations between nine differentially methylated regions (DMRs) of imprinted genes in DNA derived from umbilical cord blood leukocytes in males and females and (1) birth weight for gestational age z score, (2) weight-for-length (WFL) z score at 1 year, and (3) body mass index (BMI) z score at 3 years. Methods We conducted multiple linear regression in n = 567 infants at birth, n = 288 children at 1 year, and n = 294 children at 3 years from the Newborn Epigenetics Study (NEST). We stratified by sex and adjusted for race/ethnicity, maternal education, maternal pre-pregnancy BMI, prenatal smoking, maternal age, gestational age, and paternal race. We also conducted analysis restricting to infants not born small for gestational age. Results We found an association between higher methylation of the sequences regulating paternally expressed gene 10 (PEG10) and anthropometric z scores at 1 year (β = 0.84; 95% CI = 0.34, 1.33; p = 0.001) and 3 years (β = 1.03; 95% CI = 0.37, 1.69; p value = 0.003) in males only. Higher methylation of the DMR regulating mesoderm-specific transcript (MEST) was associated with lower anthropometric z scores in females at 1 year (β = - 1.03; 95% CI - 1.60, - 0.45; p value = 0.001) and 3 years (β = - 1.11; 95% CI - 1.98, - 0.24; p value = 0.01). These associations persisted when we restricted to infants not born small for gestational age. Conclusion Our data support a sex-specific association between altered methylation and weight status in early life. These methylation marks can contribute to the compendium of epigenetically regulated regions detectable at birth, influencing obesity in childhood. Larger studies are required to confirm these findings.
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Affiliation(s)
- Sarah Gonzalez-Nahm
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205 USA
| | - Michelle A. Mendez
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Sara E. Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205 USA
| | - Susan K. Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC USA
| | | | - Diane L. Rowley
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC USA
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Iversen DS, Kesmodel US, Ovesen PG. Associations between parity and maternal BMI in a population-based cohort study. Acta Obstet Gynecol Scand 2018; 97:694-700. [PMID: 29415327 DOI: 10.1111/aogs.13321] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 01/29/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION We aimed to investigate the change in prevalence of overweight and obesity in pregnant Danish women from 2004 to 2012, and investigate whether increasing parity was associated with a change in body mass index (BMI) prevalence. MATERIAL AND METHODS We obtained a population-based cohort from the Danish Medical Birth Registry consisting of all Danish women giving birth in 2004-2012 (n = 572 321). This registry contains information on 99.8% of all births in Denmark. We calculated the overall change in prepregnancy BMI status among pregnant women in Denmark, and a multiple linear regression model with adjustment for several potential confounders was used to examine the change in prepregnancy BMI with increasing parity. RESULTS In 2004, the prevalence of prepregnancy overweight and obesity (BMI ≥ 25) and obesity alone (BMI ≥ 30) was 31.9 and 11%, respectively. In 2012, the prevalence had reached 34.2 and 12.8%. The mean BMI increased for every additional parity from 23.80 (95% CI 23.77-23.82) in parity group 1 to 26.70 (26.52-26.90) in parity group 5+. A multiple linear regression adjusted for potential confounders showed that women on average gained 0.62 (0.58-0.65) BMI units after every additional birth. CONCLUSIONS This study showed a 7.2% increase in overweight and obesity (BMI ≥ 25) and a 16.4% increase in obesity alone (BMI ≥ 30) for pregnant women in Denmark from 2004 to 2012. In addition, an increase in interpregnancy BMI was seen at every additional delivery, suggesting that obesity is an increasing challenge in obstetrics.
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Affiliation(s)
- Ditte S Iversen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Ulrik S Kesmodel
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.,Department of Obstetrics and Gynecology, Herlev University Hospital, Herlev, Denmark
| | - Per G Ovesen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
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Dodd JM, Deussen AR, Louise J. Optimising gestational weight gain and improving maternal and infant health outcomes through antenatal dietary, lifestyle and physical activity advice: the OPTIMISE randomised controlled trial protocol. BMJ Open 2018; 8:e019583. [PMID: 29463591 PMCID: PMC5855335 DOI: 10.1136/bmjopen-2017-019583] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Obesity represents a significant health burden, and WHO recognises the importance of preventing weight gain and subsequent development of obesity among adults who are within the healthy weight range. Women of reproductive age have demonstrated high rates of weight gain during pregnancy placing them at risk of becoming overweight or obese. We will evaluate the effects of dietary and physical activity advice on maternal, fetal and infant health outcomes, among pregnant women of normal body mass index (BMI). METHODS AND ANALYSIS We will conduct a randomised controlled trial, consenting and randomising women with a live singleton pregnancy between 10+0 and 20+0 weeks and BMI 18.5-24.9 kg/m2 at first antenatal visit, from a tertiary maternity hospital. Women randomised to the Lifestyle Advice Group will receive three face-to-face sessions (two with a research dietitian and one with a trained research assistant) and three telephone calls over pregnancy, in which they will be provided with dietary and lifestyle advice and encouraged to make change using a SMART goals approach. Women randomised to the Standard Care Group will receive routine antenatal care. The primary outcome is infant birth weight >4 kg. Secondary outcomes will include adverse infant and maternal outcomes, maternal weight change, maternal diet and physical activity changes, maternal quality of life and emotional well-being, fetal growth and costs of healthcare. We will recruit 624 women to detect a reduction from 8.72% to 3.87% (alpha 0.05 (two-tailed); power 70%) in infants with birth weight >4 kg. Analyses will be intention to treat with estimates reported as relative risks and 95% CIs. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Women's and Children's Hospital ethics committee. Findings will be disseminated widely via journal publication and conference presentation(s), and participants informed of results. TRIAL REGISTRATION NUMBER ACTRN12614000583640.
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Affiliation(s)
- Jodie M Dodd
- Discipline of Obstetrics and Gynaecology, Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
- Department of Perinatal Medicine, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Andrea R Deussen
- Discipline of Obstetrics and Gynaecology, Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Jennie Louise
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
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Kambondo G, Sartorius B. Risk Factors for Obesity and Overfat among Primary School Children in Mashonaland West Province, Zimbabwe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E249. [PMID: 29393863 PMCID: PMC5858318 DOI: 10.3390/ijerph15020249] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 01/26/2018] [Accepted: 01/29/2018] [Indexed: 12/16/2022]
Abstract
Associated childhood obesity risk factors are not well established in developing countries such as Zimbabwe and this information is essential for tailored intervention development. This study aimed to identify prominent risk factors for overweight/obese and overfat/obese among primary school children of Mashonaland West Province in Zimbabwe. A school-based cross-sectional study was conducted using multi-stage random cluster sampling approach (30 × 30). Bivariate and multivariable logistic regression was employed and identified the risk factors for overweight/obese and overfat/obese. A total of 974 participants were enrolled in the study. Prominent significant risk factors of overweight/obese after multivariable adjustment were higher socio-economic households; parental diabetes status; and living in Makonde, Zvimba, Sanyati or Mhondoro-Ngezi district as opposed to Hurungwe district. Risk factors for overfat/obese that remained statically significant were children in urban areas (aOR = 3.19, 95% CI: 2.18-4.66, p = 0.000), being one child in a household, and parents who have diabetes mellitus. Living in Makonde, Sanyati, and Zvimba district remained associated with overfat/obese compared to Hurungwe district. This study has identified prominent proximal determinants of overweight/obese and overfat/obese among primary school children in Zimbabwe, to better assist policy guidance. Aggressive education on good nutrition activities should be tailored and targeted to most affected urban areas within high-risk districts.
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Affiliation(s)
- George Kambondo
- Discipline of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4001, South Africa.
| | - Benn Sartorius
- Discipline of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4001, South Africa.
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Effects of an antenatal dietary intervention in overweight and obese women on 6 month infant outcomes: follow-up from the LIMIT randomised trial. Int J Obes (Lond) 2018; 42:1326-1335. [PMID: 29568100 PMCID: PMC6054603 DOI: 10.1038/s41366-018-0019-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 11/12/2017] [Accepted: 01/03/2018] [Indexed: 01/20/2023]
Abstract
Background The immediate impact of providing an antenatal dietary intervention during pregnancy has been extensively studied, but little is known of the effects beyond the neonatal period. Our objective was to evaluate the effect of an antenatal dietary intervention in overweight or obese women on infant outcomes 6 months after birth. Methods We conducted a follow up study of infants born to women who participated in the LIMIT trial during pregnancy. Live-born infants at 6-months of age, and whose mother provided consent to ongoing follow-up were eligible. The primary follow-up study endpoint was the incidence of infant BMI z-score ≥90th centile for infant sex and age. Secondary study outcomes included a range of infant anthropometric measures, neurodevelopment, general health, and infant feeding. Analyses used intention to treat principles according to the treatment group allocated in pregnancy. Missing data were imputed and analyses adjusted for maternal early pregnancy BMI, parity, study centre, socioeconomic status, age, and smoking status. Outcome assessors were blinded to the allocated treatment group. Results A total of 1754 infants were assessed at age 6 months (Lifestyle Advice n = 869; Standard Care n = 885), representing 82.1% of the eligible sample (n = 2136). There were no statistically significant differences in the incidence of infant BMI z-score ≥90th centile for infants born to women in the Lifestyle Advice group, compared with the Standard Care group (Lifestyle Advice 233 (21.71%) vs. Standard Care 233 (21.90%); adjusted relative risk (aRR) 0.99; 95% confidence interval 0.82 to 1.18; p = 0.88). There were no other effects on infant growth, adiposity, or neurodevelopment. Conclusion Providing pregnant women who were overweight or obese with an antenatal dietary and lifestyle intervention did not alter 6-month infant growth and adiposity. Trial Registration: Australian and New Zealand Clinical Trials Registry (ACTRN12607000161426).
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73
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Wang KW, de Souza RJ, Fleming A, Johnston DL, Zelcer SM, Rassekh SR, Burrow S, Thabane L, Samaan MC. Birth weight and body mass index z-score in childhood brain tumors: A cross-sectional study. Sci Rep 2018; 8:1642. [PMID: 29374278 PMCID: PMC5786044 DOI: 10.1038/s41598-018-19924-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 01/11/2018] [Indexed: 01/31/2023] Open
Abstract
Children with brain tumors (CBT) are at higher risk of cardiovascular disease and type 2 diabetes compared to the general population, in which birth weight is a risk factor for these diseases. However, this is not known in CBT. The primary aim of this study was to explore the association between birth weight and body mass measures in CBT, compared to non-cancer controls. This is a secondary data analysis using cross-sectional data from the CanDECIDE study (n = 78 CBT and n = 133 non-cancer controls). Age, sex, and birth weight (grams) were self-reported, and confirmed through examination of the medical records. Body mass index (BMI) was calculated from height and weight measures and reported as kg/m2. BMI z-scores were obtained for subjects under the age of 20 years. Multivariable linear regression was used to evaluate the relationship between birth weight and BMI and BMI z-score, adjusted for age, sex, puberty, and fat mass percentage. Higher birth weight was associated with higher BMI and BMI z-score among CBT and controls. In conclusion, birth weight is a risk factor for higher body mass during childhood in CBT, and this may help the identification of children at risk of future obesity and cardiometabolic risk.
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Affiliation(s)
- Kuan-Wen Wang
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
- Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Russell J de Souza
- Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Adam Fleming
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Donna L Johnston
- Division of Pediatric Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Shayna M Zelcer
- Pediatric Hematology Oncology, Children's Hospital, London Health Sciences Center, London, Ontario, Canada
| | - Shahrad Rod Rassekh
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, British Columbia's Children's Hospital, Vancouver, BC, Canada
| | - Sarah Burrow
- Division of Orthopedic Surgery, Department of Surgery, McMaster University Medical Centre, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines, St. Joseph's Health Care, Hamilton, Ontario, Canada
- Biostatistics Unit, St Joseph's Healthcare-Hamilton, Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada.
- Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario, Canada.
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
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Association between Cesarean Section and Weight Status in Chinese Children and Adolescents: A National Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121609. [PMID: 29261122 PMCID: PMC5751025 DOI: 10.3390/ijerph14121609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 12/09/2017] [Accepted: 12/16/2017] [Indexed: 12/31/2022]
Abstract
Previous research on the association between cesarean section (CS) and childhood obesity has yielded inconsistent findings. This study assessed the secular trend of CS and explored the relationship between CS and the risks of overweight and obesity in Chinese children and adolescents. Data came from a national multicenter school-based study conducted in seven provinces of China in 2013. Covariate data including weight, height and delivery mode were extracted. Poisson regression was applied to determine the risk ratios (RRs) and 95% confidence intervals (CIs) for the risks of overweight and obesity associated with the delivery mode. A total of 18,780 (41.2%) subjects were born by CS between 1997 and 2006. The rate of CS increased from 27.2% in 1997 to 54.1% in 2006. After adjusting for major confounders, the RRs (95% CI) of overweight and obesity among subjects born by CS were 1.21 (1.15 to 1.27) and 1.51 (1.42 to 1.61), respectively. Similar results were observed in different subgroups stratified by sex, age, and region. In summary, the CS rate increased sharply in China between 1997 and 2006. CS was associated with increased risks of overweight and obesity in offspring after accounting for major confounding factors.
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75
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Murang ZR, Tuah N, Naing L. Knowledge, attitude and practice towards eating and physical activity among primary school children in Brunei: a cross-sectional study. Int J Adolesc Med Health 2017; 32:/j/ijamh.ahead-of-print/ijamh-2017-0118/ijamh-2017-0118.xml. [PMID: 29190212 DOI: 10.1515/ijamh-2017-0118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 09/17/2017] [Indexed: 11/15/2022]
Abstract
Background Childhood obesity has become a global public health crisis. Many studies have been conducted to explore the knowledge, attitude and practices towards eating and physical activity amongst parents and healthcare workers. However, very little is known amongst children. It is imperative to understand these factors as they have been associated with obesity among children. Objective This study aimed to assess the knowledge, attitude and practices of Bruneian children towards eating and physical activity, in order to identify the factors that influence the development of obesity. Methods The study involved 353 children from four primary schools in Brunei. The data collection tool used was modified validated questionnaires with sections on demographic characteristic, knowledge about obesity, eating habits and physical activity. Results The majority of children (>60%) had good knowledge of obesity and intake of healthy food, but, 84.2% lacked knowledge on the required daily servings of fruits and vegetables. 68.8% purchased food and beverages from their school canteen. 93.8% were aware about the health benefits of physical activity and 70.2% spent only 1-2 h of screen time per day, however, 46.9% did not meet the recommended amount of physical activity although they reported to have performed enough. This suggested that a comprehensive education on food intake requirements and physical activity are necessary in order to better educate children. Conclusion Health educators and public health professionals may find our findings useful in order to plan and develop tailored interventions for children, as well as better promotion of a healthy lifestyle to children and their families.
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Affiliation(s)
- Zaidah Rizidah Murang
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, Negara Brunei Darussalam
| | - Naa Tuah
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, Negara Brunei Darussalam.,Department of Primary Care and Public Health, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Lin Naing
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, Negara Brunei Darussalam
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76
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Leonard SA, Rasmussen KM, King JC, Abrams B. Trajectories of maternal weight from before pregnancy through postpartum and associations with childhood obesity. Am J Clin Nutr 2017; 106:1295-1301. [PMID: 28877895 PMCID: PMC5657288 DOI: 10.3945/ajcn.117.158683] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 08/08/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Prepregnancy body mass index [BMI (in kg/m2)], gestational weight gain, and postpartum weight retention may have distinct effects on the development of child obesity, but their combined effect is currently unknown.Objective: We described longitudinal trajectories of maternal weight from before pregnancy through the postpartum period and assessed the relations between maternal weight trajectories and offspring obesity in childhood.Design: We analyzed data from 4436 pairs of mothers and their children in the National Longitudinal Survey of Youth 1979 (1981-2014). We used latent-class growth modeling in addition to national recommendations for prepregnancy BMI, gestational weight gain, and postpartum weight retention to create maternal weight trajectory groups. We used modified Poisson regression models to assess the associations between maternal weight trajectory group and offspring obesity at 3 age periods (2-5, 6-11, and 12-19 y).Results: Our analysis using maternal weight trajectories based on either latent-class results or recommendations showed that the risk of child obesity was lowest in the lowest maternal weight trajectory group. The differences in obesity risk were largest after 5 y of age and persisted into adolescence. In the latent-class analysis, the highest-order maternal weight trajectory group consisted almost entirely of women who were obese before pregnancy and was associated with a >2-fold increase in the risk of offspring obesity at ages 6-11 y (adjusted RR: 2.39; 95% CI: 1.97, 2.89) and 12-19 y (adjusted RR: 2.74; 95% CI: 2.13, 3.52). In the analysis with maternal weight trajectory groups based on recommendations, the risk of child obesity was consistently highest for women who were overweight or obese at the beginning of pregnancy.Conclusion: These findings suggest that high maternal weight across the childbearing period increases the risk of obesity in offspring during childhood, but high prepregnancy BMI has a stronger influence than either gestational weight gain or postpartum weight retention.
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Affiliation(s)
| | | | - Janet C King
- Nutrition and Metabolism Center, Children’s Hospital Oakland Research Institute, Oakland, CA
| | - Barbara Abrams
- Division of Epidemiology, University of California, Berkeley, CA
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Groth SW, Holland ML, Smith JA, Meng Y, Kitzman H. Effect of Gestational Weight Gain and Prepregnancy Body Mass Index in Adolescent Mothers on Weight and Body Mass Index of Adolescent Offspring. J Adolesc Health 2017; 61:626-633. [PMID: 28711316 PMCID: PMC5654683 DOI: 10.1016/j.jadohealth.2017.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 04/26/2017] [Accepted: 05/08/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of the study was to examine the association of the gestational weight gain and prepregnancy body mass index (BMI) of low-income adolescent mothers with the risk of their children being overweight and/or obese in late adolescence. METHODS Study subjects were low-income, primiparous adolescents (n = 360) who self-identified as black and participated in the New Mothers Study in Memphis, Tennessee, and their children. Gestational weight gain was examined as a continuous variable and also categorized into overgain, recommended gain, and undergain following the 2009 Institute of Medicine guidelines. The effects of maternal prepregnancy BMI percentiles and calculated BMI were also considered. Multivariable logistic and linear regression models were used. The main outcome measures were offspring overweight, obesity, and BMI. RESULTS Thirty-nine percent of offspring were overweight or obese. Higher maternal gestational weight gain increased the risk for offspring overweight and obesity. There was an interaction between gestational weight gain and prepregnancy BMI: offspring of mothers with a BMI percentile ≤76 were at greater risk of obesity with higher maternal weight gain. If mothers with a BMI percentile between the 29th and 83rd percentiles overgained, offspring were at greater risk for overweight. Using calculated BMIs, if a mother's BMI was ≤26 kg/m2, offspring risk for obesity was greater with higher gestational weight gain. CONCLUSIONS High gestational weight gain had a larger effect on offspring overweight and obesity if maternal prepregnancy BMI percentile was ≤76. The gestational weight gain of primiparous adolescents who self-identified as black had an effect on offspring weight.
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Affiliation(s)
- Susan W Groth
- School of Nursing, University of Rochester, Rochester, New York.
| | - Margaret L Holland
- School of Nursing, Yale University, P. O. Box 27399, West Haven, CT 06516-7399, USA
| | - Joyce A Smith
- University of Rochester, School of Nursing 601 Elmwood Ave., Box SON, Rochester, NY 14642, USA
| | - Ying Meng
- University of Rochester, School of Nursing 601 Elmwood Ave., Box SON, Rochester, NY 14642, USA
| | - Harriet Kitzman
- University of Rochester, School of Nursing 601 Elmwood Ave., Box SON, Rochester, NY 14642, USA
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78
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Body mass index trajectories during infancy and pediatric obesity at 6 years. Ann Epidemiol 2017; 27:708-715.e1. [DOI: 10.1016/j.annepidem.2017.10.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/25/2017] [Accepted: 10/04/2017] [Indexed: 11/21/2022]
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Vehapoglu A, Goknar N, Turel O, Torun E, Ozgurhan G. Risk factors for childhood obesity: Do the birth weight, type of delivery, and mother's overweight have an implication on current weight status? World J Pediatr 2017; 13:457-464. [PMID: 28434072 DOI: 10.1007/s12519-017-0030-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 07/29/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of this study was to identify risk factors, including the type of delivery, breastfeeding and its duration, birth weight, the timing of solid food introduction, the mother's education level at birth, and smoking status during pregnancy, that are associated with obesity in children living in Istanbul. METHODS This study involving 4990 healthy children aged 2-14 years, at an outpatient clinic in a tertiary care hospital from June 2012 to July 2014. RESULTS The overall rates of overweight and obesity in children were 13.1% and 7.8%, respectively. Results demonstrated that 44.5% of children were delivered by caesarean section. In all age groups, 7.8% of children delivered by caesarean section were obese compared with 7.9% of children born vaginally. No significant association between caesarean section delivery and obesity in childhood was found in our study [odds ratio (OR)=0.98, 95% confidence interval (CI)=0.64-2.87, P=0.454]. There was also no association between duration of breastfeeding and the introduction of solid foods before 4 months or after 6 months of age and childhood obesity (OR=0.95, 95% CI=0.69-1.3, P=0.771; OR=0.99, 95% CI=0.64-1.53, P=0.261). Regression analyses revealed that children with birth weights greater than 3801 g or those with maternal body mass index (BMI) equal to or greater than 30 had an increased risk of being obese or overweight (OR=1.78, 95% CI=1.19-2.65; OR=3.95, 95% CI=1.94-5.81). CONCLUSIONS This study demonstrated that increased birth weight and maternal BMI are significant risk factors for obesity in children living in Istanbul, Turkey. No relation between caesarean section delivery and childhood obesity was found in this study.
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Affiliation(s)
- Aysel Vehapoglu
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Vatan Street, Fatih, Istanbul, 34093, Turkey.
| | - Nilufer Goknar
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Vatan Street, Fatih, Istanbul, 34093, Turkey
| | - Ozden Turel
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Vatan Street, Fatih, Istanbul, 34093, Turkey
| | - Emel Torun
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Vatan Street, Fatih, Istanbul, 34093, Turkey
| | - Gamze Ozgurhan
- Department of Pediatrics, Suleymaniye Obstetrics and Gynecology Hospital, Istanbul, Turkey
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80
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Christiansen H, Brandt S, Walter V, Wabitsch M, Rothenbacher D, Brenner H, Schimmelmann BG, Hirsch O. Prediction of BMI at age 11 in a longitudinal sample of the Ulm Birth Cohort Study. PLoS One 2017; 12:e0182338. [PMID: 28832593 PMCID: PMC5568210 DOI: 10.1371/journal.pone.0182338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 07/17/2017] [Indexed: 11/18/2022] Open
Abstract
Obesity is one of the greatest public health challenges in the world with childhood prevalence rates between 20-26% and numerous associated health risks. The aim of the current study was to analyze the 11-year follow-up data of the Ulm Birth Cohort Study (UBCS), to identify whether abnormal eating behavior patterns, especially restrained eating, predict body mass index (BMI) at 11 years of age and to explore other factors known to be longitudinally associated with it. Of the original UBCS, n = 422 children (~ 40% of the original sample) and their parents participated in the 11-year follow-up. BMI at age 8 and 11 as well as information on restrained eating, psychological problems, depressive symptoms, lifestyle, and IQ at age 8 were assessed. Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to predict children's BMI scores at age 11. PLS-SEM explained 68% of the variance of BMI at age 11, with BMI at age 8 being the most important predictor. Restrained eating, via BMI at age 8 as well as parental BMI, had further weak associations with BMI at age 11; no other predictor was statistically significant. Since established overweight at age 8 already predicts BMI scores at age 11 longitudinally, obesity interventions should be implemented in early childhood.
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Affiliation(s)
- Hanna Christiansen
- Department of Clinical Child and Adolescent Psychology and Psychotherapy, Philipps University, Marburg, Germany
| | - Stephanie Brandt
- University Medical Center Ulm, Department of Pediatrics and Adolescent Medicine, Division of Pediatric Endocrinology and Diabetes, Ulm, Germany
| | - Viola Walter
- German Cancer Research Center (DKFZ), Division of Clinical Epidemiology and Aging Research, Heidelberg, Germany
| | - Martin Wabitsch
- University Medical Center Ulm, Department of Pediatrics and Adolescent Medicine, Division of Pediatric Endocrinology and Diabetes, Ulm, Germany
| | | | - Hermann Brenner
- German Cancer Research Center (DKFZ), Division of Clinical Epidemiology and Aging Research, Heidelberg, Germany
| | - Benno G. Schimmelmann
- University Hospital of Child and Adolescent Psychiatry, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Oliver Hirsch
- FOM University of Applied Sciences, Siegen, Germany
- * E-mail:
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81
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Zalbahar N, Najman J, McIntyre HD, Mamun A. Parental pre-pregnancy obesity and the risk of offspring weight and body mass index change from childhood to adulthood. Clin Obes 2017; 7:206-215. [PMID: 28557382 DOI: 10.1111/cob.12200] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 02/24/2017] [Accepted: 04/11/2017] [Indexed: 01/23/2023]
Abstract
The purpose of this study was to examine the association of parental pre-pregnancy weight and body mass index (BMI) on offspring weight and BMI change from childhood to adulthood. We analysed BMI data from a subsample of parents (n = 1494) from the Mater-University of Queensland Study of Pregnancy cohort that started in the early 1980s in Brisbane, Australia: data were collected at pre-pregnancy and then also for offspring at 5, 14 and 21-year follow-ups. Multiple regression for continuous outcomes and multinomial regression for categorical outcomes were performed. A total of 14.7% of offspring experienced BMI change from normal at 5 years to overweight or obese (OW/OB) at 14 years, 15.3% of normal at 14 years to OW/OB at 21 years and 22.8% from normal at 5 years to OW/OB at 21 years. Overall, the strength of the association of parental BMI with offspring BMI was stronger as offspring become older. Pre-pregnancy parental BMI differentially impacts offspring OW/OB across the life course. For every unit increase in paternal and maternal BMI z-score, offspring BMI z-score increased, on average, by between 0.15% (kg m-2 ) and 0.24% (kg m-2 ) throughout all three stages of life when both parents were OW/OB; these associations were stronger than with one parent. Parental pre-pregnancy BMI and OW/OB is a strong predictor of offspring weight and BMI change from early life to adulthood.
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Affiliation(s)
- N Zalbahar
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Department of Nutrition and Dietetics, Universiti Putra Malaysia, Serdang, Malaysia
| | - J Najman
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Social Science, The University of Queensland, Brisbane, Queensland, Australia
| | - H D McIntyre
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - A Mamun
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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Leonard SA, Petito LC, Rehkopf DH, Ritchie LD, Abrams B. Weight gain in pregnancy and child weight status from birth to adulthood in the United States. Pediatr Obes 2017; 12 Suppl 1:18-25. [PMID: 27350375 PMCID: PMC5404997 DOI: 10.1111/ijpo.12163] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 05/09/2016] [Accepted: 05/20/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND High weight gain in pregnancy has been associated with child adiposity, but few studies have assessed the relationship across childhood or in racially/ethnically diverse populations. OBJECTIVES The objectives of the study are to test if weight gain in pregnancy is associated with high birthweight and overweight/obesity in early, middle and late childhood and whether these associations differ by maternal race/ethnicity. METHODS Mother-child dyads (n = 7539) were included from the National Longitudinal Survey of Youth 1979, a nationally representative cohort study in the USA (1979-2012). Log-binomial regression models were used to analyse associations between weight gain and the outcomes: high birthweight (>4000 g) and overweight/obesity at ages 2-5, 6-11 and 12-19 years. RESULTS Excessive weight gain was positively associated, and inadequate weight gain was negatively associated with high birthweight after confounder adjustment (P < 0.05). Only excessive weight gain was associated with overweight in early, middle and late childhood. These associations were not significant in Hispanics or Blacks although racial/ethnic interaction was only significant ages 12-19 years (P = 0.03). CONCLUSIONS Helping pregnant women gain weight within national recommendations may aid in preventing overweight and obesity across childhood, particularly for non-Hispanic White mothers.
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Affiliation(s)
- Stephanie A. Leonard
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA
| | - Lucia C. Petito
- Division of Biostatistics, School of Public Health, University of California, Berkeley, CA
| | - David H. Rehkopf
- Division of General Medical Disciplines, Stanford University School of Medicine, Stanford, CA
| | - Lorrene D. Ritchie
- Nutrition Policy Institute, University of California, Division of Agriculture and Natural Resources, Oakland, CA
| | - Barbara Abrams
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA
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Dodd JM, Briley AL. Managing obesity in pregnancy – An obstetric and midwifery perspective. Midwifery 2017; 49:7-12. [DOI: 10.1016/j.midw.2017.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 03/03/2017] [Indexed: 11/15/2022]
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Dall GV, Britt KL. Estrogen Effects on the Mammary Gland in Early and Late Life and Breast Cancer Risk. Front Oncol 2017; 7:110. [PMID: 28603694 PMCID: PMC5445118 DOI: 10.3389/fonc.2017.00110] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 05/10/2017] [Indexed: 12/16/2022] Open
Abstract
A woman has an increased risk of breast cancer if her lifelong estrogen exposure is increased due to an early menarche, a late menopause, and/or an absence of childbearing. For decades, it was presumed that the number of years of exposure drove the increased risk, however, recent epidemiological data have shown that early life exposure (young menarche) has a more significant effect on cancer risk than late menopause. Thus, rather than the overall exposure it seems that the timing of hormone exposure plays a major role in defining breast cancer risk. In support of this, it is also known that aberrant hormonal exposure prior to puberty can also increase breast cancer risk, yet the elevated estrogen levels during pregnancy decrease breast cancer risk. This suggests that the effects of estrogen on the mammary gland/breast are age-dependent. In this review article, we will discuss the existing epidemiological data linking hormone exposure and estrogen receptor-positive breast cancer risk including menarche, menopause, parity, and aberrant environmental hormone exposure. We will discuss the predominantly rodent generated experimental data that confirm the association with hormone exposure and breast cancer risk, confirming its use as a model system. We will review the work that has been done attempting to define the direct effects of estrogen on the breast, which are beginning to reveal the mechanism of increased cancer risk. We will then conclude with our views on the most pertinent questions to be addressed experimentally in order to explore the relationship between age, estrogen exposure, and breast cancer risk.
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Affiliation(s)
| | - Kara Louise Britt
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
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85
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Gregory EF, Goldshore MA, Showell NN, Genies MC, Harding ME, Henderson JL. Parent and Clinician Perspectives on Sustained Behavior Change after a Prenatal Obesity Program: A Qualitative Study. Child Obes 2017; 13:85-92. [PMID: 27854496 PMCID: PMC6435345 DOI: 10.1089/chi.2016.0149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Infants of obese women are at a high risk for development of obesity. Prenatal interventions targeting gestational weight gain among obese women have not demonstrated consistent benefits for infant growth trajectories. METHODS To better understand why such programs may not influence infant growth, qualitative semi-structured interviews were conducted with 19 mothers who participated in a prenatal nutrition intervention for women with BMI 30 kg/m2 or greater, and with 19 clinicians (13 pediatric, 6 obstetrical). Interviews were transcribed and coded with themes emerging inductively from the data, using a grounded theory approach. RESULTS Mothers were interviewed a mean of 18 months postpartum and reported successful postnatal maintenance of behaviors that were relevant to the family food environment (Theme 1). Ambivalence around the importance of postnatal behavior maintenance (Theme 2) and enhanced postnatal healthcare (Theme 3) emerged as explanations for the failure of prenatal interventions to influence child growth. Mothers acknowledged their importance as role models for their children's behavior, but they often believed that body habitus was beyond their control. Though mothers attributed prenatal behavior change, in part, to additional support during pregnancy, clinicians had hesitations about providing children of obese parents with additional services postnatally. Both mothers and clinicians perceived a lack of interest or concern about infant growth during pediatric visits (Theme 4). CONCLUSIONS Prenatal interventions may better influence childhood growth if paired with improved communication regarding long-term modifiable risks for children. The healthcare community should clarify a package of enhanced preventive services for children with increased risk of developing obesity.
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Affiliation(s)
- Emily F. Gregory
- General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | | | - Nakiya N. Showell
- General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | - Marquita C. Genies
- General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, MD
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86
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Dodd JM, Grivell RM, Louise J, Deussen AR, Giles L, Mol BW, Vinter C, Tanvig M, Jensen DM, Bogaerts A, Devlieger R, Luoto R, McAuliffe F, Renault K, Carlsen E, Geiker N, Poston L, Briley A, Thangaratinam S, Rogozinska E, Owens JA. The effects of dietary and lifestyle interventions among pregnant women who are overweight or obese on longer-term maternal and early childhood outcomes: protocol for an individual participant data (IPD) meta-analysis. Syst Rev 2017; 6:51. [PMID: 28274270 PMCID: PMC5343397 DOI: 10.1186/s13643-017-0442-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 02/22/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The aim of this individual participant data meta-analysis (IPDMA) is to evaluate the effects of dietary and lifestyle interventions among pregnant women who are overweight or obese on later maternal and early childhood outcomes at ages 3-5 years. METHODS/DESIGN We will build on the established International Weight Management in Pregnancy (i-WIP) IPD Collaborative Network, having identified researchers who have conducted randomised dietary and lifestyle interventions among pregnant women who are overweight or obese, and where ongoing childhood follow-up of participants has been or is being undertaken. The primary maternal outcome is a diagnosis of maternal metabolic syndrome. The primary childhood outcome is BMI above 90%. We have identified 7 relevant trials, involving 5425 women who were overweight or obese during pregnancy, with approximately 3544 women and children with follow-up assessments available for inclusion in the meta-analysis. DISCUSSION The proposed IPDMA provides an opportunity to evaluate the effect of dietary and lifestyle interventions among pregnant women who are overweight or obese on later maternal and early childhood health outcomes, including risk of obesity. This knowledge is essential to effectively translate research findings into clinical practice and public health policy. SYSTEMATIC REVIEW REGISTRATION This IPD has been prospectively registered (PROSPERO), ID number CRD42016047165 .
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Affiliation(s)
- Jodie M Dodd
- The University of Adelaide, Discipline of Obstetrics & Gynaecology, and Robinson Research Institute, Adelaide, South Australia, Australia. .,Department of Perinatal Medicine, Women's and Children's Hospital, 72 King William Road, North Adelaide, South Australia, 5006, Australia.
| | - Rosalie M Grivell
- The University of Adelaide, Discipline of Obstetrics & Gynaecology, and Robinson Research Institute, Adelaide, South Australia, Australia.,Department of Perinatal Medicine, Women's and Children's Hospital, 72 King William Road, North Adelaide, South Australia, 5006, Australia
| | - Jennie Louise
- The University of Adelaide, Discipline of Obstetrics & Gynaecology, and Robinson Research Institute, Adelaide, South Australia, Australia
| | - Andrea R Deussen
- The University of Adelaide, Discipline of Obstetrics & Gynaecology, and Robinson Research Institute, Adelaide, South Australia, Australia
| | - Lynne Giles
- The University of Adelaide, School of Public Health, Adelaide, South Australia, Australia
| | - Ben W Mol
- The University of Adelaide, Discipline of Obstetrics & Gynaecology, and Robinson Research Institute, Adelaide, South Australia, Australia
| | - Christina Vinter
- Institute of Clinical Research, University of Southern Denmark, 5230, Odense M, Denmark.,Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Mette Tanvig
- Institute of Clinical Research, University of Southern Denmark, 5230, Odense M, Denmark.,Department of Endocrinology, Odense University Hospital, 5000, Odense C, Denmark
| | - Dorte Moller Jensen
- Department of Endocrinology, Odense University Hospital, 5000, Odense C, Denmark
| | - Annick Bogaerts
- Department of Healthcare Research, PHL University College, Limburg Catholic University College, Hasselt, Belgium
| | - Roland Devlieger
- Division of Mother and Child, Department of Obstetrics and Gynaecology, University Hospitals KU Leuven, Leuven, Belgium
| | - Riitta Luoto
- UKK Institute for Health Promotion, Tampere, Finland
| | - Fionnuala McAuliffe
- School of Medicine and Medical Science, UCD Institute of Food and Health, Dublin, Ireland
| | - Kristina Renault
- Department of Obstetrics and Gynaecology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Emma Carlsen
- Department of Obstetrics and Gynaecology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Nina Geiker
- Herlev and Gentofte Hospital Clinical Nutrition Research Unit, Copenhagen University Herlev, Herlev, Denmark
| | - Lucilla Poston
- Division of Women's Health, Women's Health Academic Centre, King's College London, St. Thomas' Hospital, London, UK
| | - Annette Briley
- Division of Women's Health, Women's Health Academic Centre, King's College London, St. Thomas' Hospital, London, UK
| | - Shakila Thangaratinam
- Multidisciplinary Evidence Synthesis Hub (mEsh), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Ewelina Rogozinska
- Multidisciplinary Evidence Synthesis Hub (mEsh), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Julie A Owens
- The University of Adelaide, Discipline of Obstetrics & Gynaecology, and Robinson Research Institute, Adelaide, South Australia, Australia
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87
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Fleary SA. Combined Patterns of Risk for Problem and Obesogenic Behaviors in Adolescents: A Latent Class Analysis Approach. THE JOURNAL OF SCHOOL HEALTH 2017; 87:182-193. [PMID: 28147457 DOI: 10.1111/josh.12481] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 05/11/2016] [Accepted: 09/21/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Several studies have used latent class analyses to explore obesogenic behaviors and substance use in adolescents independently. We explored a variety of health risks jointly to identify distinct patterns of risk behaviors among adolescents. METHODS Latent class models were estimated using Youth Risk Behavior Surveillance System (YRBSS) 2011 data. Behaviors in the models included substance use, physical fights, physical activity (PA), sedentary activity, sleep, fruit and vegetables (F&V) consumption, and weight-related variables. Models were estimated separately by sex. Constrained and unconstrained models were computed for race. Age and perceived and calculated weight status were compared among emergent latent classes using latent multinomial logistic regressions. RESULTS Four and 5 latent class solutions emerged for boys and girls, respectively. Healthy, sedentary, and physically active (PA) groups were common in both boys and girls. The sample of boys also included a health risk behavior (HRB)/PA group and the sample of girls included HRB and HRB/F&V groups. CONCLUSIONS The results confirm that obesogenic and HRBs should be conceptualized as combined patterns of risk. Health education programming in schools should adopt a multiple health behavior approach to target the continuum of risks adolescents engage in simultaneously.
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Affiliation(s)
- Sasha A Fleary
- Eliot-Pearson Department of Child Study and Human Development, Tufts University, 574 Boston Ave, Room 211C, Medford, MA 02155
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88
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Ester WA, Houghton LC, Lumey LH, Michels KB, Hoek HW, Wei Y, Susser ES, Cohn BA, Terry MB. Maternal and Early Childhood Determinants of Women's Body Size in Midlife: Overall Cohort and Sibling Analyses. Am J Epidemiol 2017; 185:385-394. [PMID: 28200097 DOI: 10.1093/aje/kww222] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 05/18/2016] [Indexed: 12/12/2022] Open
Abstract
Observational evidence suggests that adult body size has its roots earlier in life, yet few life-course studies have data on siblings with which to control for family-level confounding. Using prospective data from the Early Determinants of Mammographic Density Study (n = 1,108; 1959-2008), we examined the association of maternal prepregnancy body mass index (BMI; weight (kg)/height (m)2), gestational weight gain (GWG), birth size, and childhood growth factors with adult BMI in daughters at midlife using quantile, linear, and logistic regression models. We compared overall cohort findings (n = 1,108) with sibling differences (n = 246 sibling sets). Results derived by all 3 regression methods supported positive and independent associations of prepregnancy BMI, GWG, and percentile change in early childhood growth with BMI in daughters at midlife. Sibling analyses demonstrated that higher GWG was independently related to a higher adult BMI in daughters, particularly for the highest 90th quantile of adult BMI (β = 0.64 (standard error, 0.26) BMI units). Greater increases in weight percentiles between 1 and 4 years of age within siblings were also associated with higher adult BMI in the 75th quantile (β = 0.06 (standard error, 0.03) kg). Thus, even after consideration of the role of family-level fixed effects, maternal GWG and childhood weight gain are associated with adult body size in midlife.
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89
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Tchamo ME, Moura-Dos-Santos MA, Dos Santos FK, Prista A, Leandro CG. Deficits in anthropometric indices of nutritional status and motor performance among low birth weight children from Maputo City, Mozambique. Am J Hum Biol 2017; 29. [PMID: 28176405 DOI: 10.1002/ajhb.22949] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 10/26/2016] [Accepted: 11/22/2016] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To evaluate associations between low birth weight (LBW) and anthropometry, body composition, physical fitness, and gross motor coordination among schoolchildren from Maputo, Mozambique. METHODS A total of 353 children aged 7 to 10 years old from both genders born in Maputo (Mozambique) were sampled. The sample was divided into two groups: LBW (n = 155) and normal birth weight (NBW, n = 198). Body composition measurements and indices weight-for-age, height-for-age, and weight-for-height were assessed. Physical fitness was assessed by handgrip strength, flexibility, agility, long jump, and running speed. Gross motor coordination was evaluated by using the Korper Koordination Test fur Kinder (KTK) battery. RESULTS LBW children were lighter and smaller than NBW children with reduced indices for weight-for-age and height-for-age. They also showed a reduced performance in handgrip strength and sideways movement tests. These differences remained significant even after adjustment for age, gender, body size, and fatness skinfold thickness. CONCLUSION LBW seems to be the major factor that influences anthropometry, and is a predictor of low muscle strength and low performance on sideways movement tests. This result suggests that growth faltering in LBW children is associated with adverse health consequences, even after controlling for gender, age, fatness, and body size.
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Affiliation(s)
- Mario Eugénio Tchamo
- Faculty of Physical Education and Sports, Pedagogic University of Mozambique.,Department of Nutrition, Federal University of Pernambuco, Brazil
| | | | | | - António Prista
- Research Group for Physical Activity and Health - CIDAF -FEFD, Pedagogic University of Mozambique
| | - Carol Góis Leandro
- Department of Nutrition, Federal University of Pernambuco, Brazil.,Department of Physical Education and Sports Science, CAV, Federal University of Pernambuco, Brazil
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90
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Godfrey KM, Reynolds RM, Prescott SL, Nyirenda M, Jaddoe VWV, Eriksson JG, Broekman BFP. Influence of maternal obesity on the long-term health of offspring. Lancet Diabetes Endocrinol 2017; 5:53-64. [PMID: 27743978 PMCID: PMC5245733 DOI: 10.1016/s2213-8587(16)30107-3] [Citation(s) in RCA: 574] [Impact Index Per Article: 82.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 05/07/2016] [Accepted: 05/25/2016] [Indexed: 01/01/2023]
Abstract
In addition to immediate implications for pregnancy complications, increasing evidence implicates maternal obesity as a major determinant of offspring health during childhood and later adult life. Observational studies provide evidence for effects of maternal obesity on her offspring's risks of obesity, coronary heart disease, stroke, type 2 diabetes, and asthma. Maternal obesity could also lead to poorer cognitive performance and increased risk of neurodevelopmental disorders, including cerebral palsy. Preliminary evidence suggests potential implications for immune and infectious-disease-related outcomes. Insights from experimental studies support causal effects of maternal obesity on offspring outcomes, which are mediated at least partly through changes in epigenetic processes, such as alterations in DNA methylation, and perhaps through alterations in the gut microbiome. Although the offspring of obese women who lose weight before pregnancy have a reduced risk of obesity, few controlled intervention studies have been done in which maternal obesity is reversed and the consequences for offspring have been examined. Because the long-term effects of maternal obesity could have profound public health implications, there is an urgent need for studies on causality, underlying mechanisms, and effective interventions to reverse the epidemic of obesity in women of childbearing age and to mitigate consequences for offspring.
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Affiliation(s)
- Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Rebecca M Reynolds
- Endocrinology Unit, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Queen's Medical Research Institute, Edinburgh, Scotland, UK
| | - Susan L Prescott
- School of Paediatrics and Child Health, and Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Moffat Nyirenda
- London School of Hygiene & Tropical Medicine, London, UK; College of Medicine, University of Malawi, Blantyre, Malawi
| | - Vincent W V Jaddoe
- Departments of Epidemiology and Pediatrics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; National University Health System, Singapore, Singaporre
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91
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Pluymen LPM, Smit HA, Wijga AH, Gehring U, De Jongste JC, Van Rossem L. Cesarean Delivery, Overweight throughout Childhood, and Blood Pressure in Adolescence. J Pediatr 2016; 179:111-117.e3. [PMID: 27686586 DOI: 10.1016/j.jpeds.2016.08.059] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 07/20/2016] [Accepted: 08/17/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To investigate whether children delivered by cesarean had a higher risk of being overweight from early until late childhood and whether they had a higher blood pressure in adolescence compared with children delivered vaginally. STUDY DESIGN We used data from a Dutch birth cohort study with prenatal inclusion in 1996 and 1997. Mode of delivery (cesarean or vaginal delivery) was ascertained at 3 months after birth by questionnaire. During clinical examinations, height and weight (at age 4, 8, 12, and 16 years) and blood pressure (at age 12 and 16 years) were measured. We used mixed model analysis to estimate associations of cesarean delivery with overweight and blood pressure z scores in 2641 children who participated in at least 1 of the 4 examinations. RESULTS Children born by cesarean delivery (n = 236, 8.9%) had a 1.52 (95% CI 1.18, 1.96) higher odds of being overweight throughout childhood than children delivered vaginally. Children born by cesarean delivery had no higher systolic blood pressure z-score (0.11 SD, 95% CI -0.04, 0.26), nor a different diastolic blood pressure z-score (-0.00 SD, 95% CI -0.10, 0.09) in adolescence than children delivered vaginally. CONCLUSIONS Compared with children delivered vaginally, children delivered by cesarean had a 52% higher risk of being overweight throughout childhood, but this was not accompanied by a higher blood pressure in adolescence.
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Affiliation(s)
- Linda P M Pluymen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Henriëtte A Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Alet H Wijga
- Center for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Ulrike Gehring
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences,Utrecht University, Utrecht, The Netherlands
| | - Johan C De Jongste
- Department of Pediatrics, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Lenie Van Rossem
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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92
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Fernández-Barrés S, Romaguera D, Valvi D, Martínez D, Vioque J, Navarrete-Muñoz EM, Amiano P, Gonzalez-Palacios S, Guxens M, Pereda E, Riaño I, Tardón A, Iñiguez C, Arija V, Sunyer J, Vrijheid M. Mediterranean dietary pattern in pregnant women and offspring risk of overweight and abdominal obesity in early childhood: the INMA birth cohort study. Pediatr Obes 2016; 11:491-499. [PMID: 26763767 DOI: 10.1111/ijpo.12092] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/19/2015] [Accepted: 11/10/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND Animal models have suggested that maternal diet quality may reduce offspring obesity risk regardless of maternal body weight; however, evidence from human studies is scarce. OBJECTIVE The aim of this study was to evaluate associations between adherence to the Mediterranean diet (MD) during pregnancy and childhood overweight and abdominal obesity risk at 4 years of age. METHODS We analysed 1827 mother-child pairs from the Spanish 'Infancia y Medio Ambiente' cohort study, recruited between 2003 and 2008. Diet was assessed during pregnancy using a food frequency questionnaire and MD adherence by the relative Mediterranean diet score (rMED). Overweight (including obesity) was defined as an age-specific and sex-specific body mass index ≥85th percentile (World Health Organization referent), and abdominal obesity as a waist circumference (WC) >90th percentile. Multivariate adjusted linear and logistic regression models were used to evaluate associations between pregnancy rMED and offspring overweight and abdominal obesity. RESULT There was no association between rMED and body mass index z-score, whereas there was a significant association between higher adherence to MD and lower WC (β of high vs. low rMED: -0.62 cm; 95% confidence interval: -1.10, -0.14 cm, P for trend = 0.009). CONCLUSION Pregnancy adherence to the MD was not associated with childhood overweight risk, but it was associated with lower WC, a marker of abdominal obesity.
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Affiliation(s)
- S Fernández-Barrés
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Nutrition and Mental Health Group, Universitat Rovira I Virgili (URV), Reus, Spain
| | - D Romaguera
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Universitari Son Espases, Palma de Mallorca, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - D Valvi
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - D Martínez
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - J Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universidad Miguel Hernandez, Alicante, Spain
| | - E M Navarrete-Muñoz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universidad Miguel Hernandez, Alicante, Spain
| | - P Amiano
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastián, Spain
| | - S Gonzalez-Palacios
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universidad Miguel Hernandez, Alicante, Spain
| | - M Guxens
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - E Pereda
- Facultad de Psicología, Universidad del País Vasco-Euskal Herriko Unibertsitatea (UPV-EHU), Bizkaia, Spain
| | - I Riaño
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Hospital San Agustín, SESPA, Asturias, Spain
| | - A Tardón
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universidad de Oviedo, Asturias, Spain
| | - C Iñiguez
- FISABIO - Universitat Jaume I - Universitat de València Epidemiology and Environmental Health Joint Research Unit, Valencia, Spain
| | - V Arija
- Nutrition and Mental Health Group, Universitat Rovira I Virgili (URV), Reus, Spain
| | - J Sunyer
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Institut Hospital del Mar d'Investigacions Mèdiques-Parc de Salut Mar, Barcelona, Spain
| | - M Vrijheid
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Institut Hospital del Mar d'Investigacions Mèdiques-Parc de Salut Mar, Barcelona, Spain
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93
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Subica AM, Grills CT, Villanueva S, Douglas JA. Community Organizing for Healthier Communities: Environmental and Policy Outcomes of a National Initiative. Am J Prev Med 2016; 51:916-925. [PMID: 27712948 DOI: 10.1016/j.amepre.2016.06.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/17/2016] [Accepted: 07/05/2016] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Childhood obesity is disproportionately prevalent in communities of color, partially because of structural inequities in the social and built environment (e.g., poverty, food insecurity, pollution) that restrict healthy eating and active living. Community organizing is an underexamined, grassroots health promotion approach that empowers and mobilizes community residents to advocate for, and achieve, environmental and policy changes to rectify these structural inequities. This paper presents outcomes of the Robert Wood Johnson Foundation's Communities Creating Healthy Environments initiative: the first national program to apply community organizing to combat childhood obesity-causing structural inequities in communities of color. METHODS Twenty-one community-based organizations and tribal nations (grantees) conducted 3-year community organizing-based interventions primarily designed to increase children's healthy food and safe recreational access. Grantees' policy wins (environmental and policy changes resulting from grantee interventions) were measured from 2009 to 2014 using semi-structured interviews conducted quarterly and 6 months post-grant, and independently coded and reviewed in 2015 by researchers and expert community organizers. RESULTS The 21 grantees achieved 72 policy wins (mean=3.43, SD=1.78) across six domains: two directly addressed childhood obesity by enhancing children's healthy food (37.50%) and recreational access (33.33%), whereas four indirectly addressed obesity by promoting access to quality health care (8.33%); clean environments (9.73%); affordable housing (8.33%); and discrimination- and crime-free neighborhoods (2.78%). CONCLUSIONS These findings provide compelling evidence that community organizing-based interventions designed and led by community stakeholders can achieve diverse environmental and policy solutions to the structural inequities that foment childhood obesity in communities of color.
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Affiliation(s)
- Andrew M Subica
- Center for Healthy Communities, University of California Riverside School of Medicine, Riverside, California
| | - Cheryl T Grills
- Psychology Applied Research Center, Loyola Marymount University, Los Angeles, California.
| | - Sandra Villanueva
- Psychology Applied Research Center, Loyola Marymount University, Los Angeles, California
| | - Jason A Douglas
- Environmental Studies, San Jose State University, San Jose, California
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94
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Yuan C, Gaskins AJ, Blaine AI, Zhang C, Gillman MW, Missmer SA, Field AE, Chavarro JE. Association Between Cesarean Birth and Risk of Obesity in Offspring in Childhood, Adolescence, and Early Adulthood. JAMA Pediatr 2016; 170:e162385. [PMID: 27599167 PMCID: PMC5854473 DOI: 10.1001/jamapediatrics.2016.2385] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IMPORTANCE Cesarean birth has been associated with higher risk of obesity in offspring, but previous studies have focused primarily on childhood obesity and have been hampered by limited control for confounders. OBJECTIVE To investigate the association between cesarean birth and risk of obesity in offspring. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study was conducted from September 1, 1996, to December 31, 2012, among participants of the Growing Up Today Study, including 22 068 offspring born to 15 271 women, followed up via questionnaire from ages 9 to 14 through ages 20 to 28 years. Data analysis was conducted from October 10, 2015, to June 14, 2016. EXPOSURE Birth by cesarean delivery. MAIN OUTCOMES AND MEASURES Risk of obesity based on International Obesity Task Force or World Health Organization body mass index cutoffs, depending on age. Secondary outcomes included risks of obesity associated with changes in mode of delivery and differences in risk between siblings whose modes of birth were discordant. RESULTS Of the 22 068 offspring (20 950 white; 9359 male and 12 709 female), 4921 individuals (22.3%) were born by cesarean delivery. The cumulative risk of obesity through the end of follow-up was 13% among all participants. The adjusted risk ratio for obesity among offspring delivered via cesarean birth vs those delivered via vaginal birth was 1.15 (95% CI, 1.06-1.26; P = .002). This association was stronger among women without known indications for cesarean delivery (adjusted risk ratio, 1.30; 95% CI, 1.09-1.54; P = .004). Offspring delivered via vaginal birth among women who had undergone a previous cesarean delivery had a 31% (95% CI, 17%-47%) lower risk of obesity compared with those born to women with repeated cesarean deliveries. In within-family analysis, individuals born by cesarean delivery had 64% (8%-148%) higher odds of obesity than did their siblings born via vaginal delivery. CONCLUSIONS AND RELEVANCE Cesarean birth was associated with offspring obesity after accounting for major confounding factors. Although additional research is needed to clarify the mechanisms underlying this association, clinicians and patients should weigh this risk when considering cesarean delivery in the absence of a clear indication.
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Affiliation(s)
- Changzheng Yuan
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Audrey J. Gaskins
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Arianna I. Blaine
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH
| | - Cuilin Zhang
- Epidemiology Branch. Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Matthew W. Gillman
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA,Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA
| | - Stacey A. Missmer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA,Department of Obstetrics, Gynecology, and Reproductive Biology; Brigham and Women’s Hospital and Harvard Medical School, Boston, MA,Division of Adolescent/Young Adult Medicine, Department of Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA
| | - Alison E. Field
- Department of Epidemiology, Brown University School of Public Health, Providence, RI
| | - Jorge E. Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
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95
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Rutayisire E, Wu X, Huang K, Tao S, Chen Y, Tao F. Cesarean section may increase the risk of both overweight and obesity in preschool children. BMC Pregnancy Childbirth 2016; 16:338. [PMID: 27809806 PMCID: PMC5094065 DOI: 10.1186/s12884-016-1131-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 10/25/2016] [Indexed: 12/16/2022] Open
Abstract
Background The increase rates of cesarean section (CS) occurred at the same period as the dramatic increase of childhood overweight/obesity. In China, cesarean section rates have exponentially increased in the last 20 years and they now exceed World Health Organization (WHO) recommendation. Such high rates demand an understanding to the long-term consequences on child health. We aim to examine the association between CS and risk of overweight and obesity among preschool children. Method We recruited 9103 children from 35 kindergartens in 4 cities located in East China. Children anthropometric measurements were taken in person by trained personnel. The mode of delivery was classified as vaginal or CS, in sub-analyses we divided cesarean delivery into elective or non-elective. The mode of delivery and other parental information were self-reported by parents. Multivariate logistic regression analysis was used to examine the associations. Results In our cross-sectional study of 8900 preschool children aged 3–6 years, 67.3 % were born via CS, of whom 15.7 % were obese. Cesarean delivery was significantly associated with the risk of overweight [OR 1.24; (95 % CI 1.07–1.44); p = 0.003], and the risk of obesity [OR 1.29; (95 % CI 1.13–1.49); p < 0.001] in preschool children. After adjusted for child characteristics, parental factors and family income, the odd of overweight was 1.35 and of obesity was 1.25 in children delivered by elective CS. Conclusion The associations between CS and overweight/obesity in preschool children are influenced by potential confounders. Both children delivered by elective or non-elective CS are at increased risk of overweight/obesity. Potential consequences of CS on the health of the children should be discussed among both health care professionals and childbearing women.
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Affiliation(s)
- Erigene Rutayisire
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Xiaoyan Wu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, 230032, China
| | - Kun Huang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, 230032, China
| | - Shuman Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Yunxiao Chen
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China. .,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, 230032, China.
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96
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Veile A, Kramer KL. Childhood body mass is positively associated with cesarean birth in Yucatec Maya subsistence farmers. Am J Hum Biol 2016; 29. [PMID: 27699897 DOI: 10.1002/ajhb.22920] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 08/07/2016] [Accepted: 08/20/2016] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The epidemiologic link between cesarean birth and childhood obesity is unresolved, partly because most studies come from industrialized settings where many post-birth factors affect the risk for obesity. We take advantage of an unusual ethnographic situation where hospital and cesarean birth modes have recently been introduced among Yucatec Maya subsistence farmers, but young children have had minimal exposure to the nutritional transition. While we expect to find very low rates of childhood obesity, we predict that cesarean-born children will be larger and heavier than vaginally born children. METHODS Weight and height were collected monthly on 108 children aged 0-5 (3576 observations total). Birth mode and birthweight were collected by maternal interview. Data were analyzed using linear mixed models that compare child growth [Maya population-specific Z-scores for weight-for-age and body mass index-for-age (WAZ and BMIZ)] in cesarean and vaginally born children aged 0-5 years. RESULTS The cesarean rate was 20%, no children were obese, and 5% were overweight. Cesarean birth was a significant predictor of child WAZ and BMIZ after accounting for maternal effects, child birthweight, and sex. Children who were born by cesarean to mothers with high BMI had the highest WAZ of all children by 5 years of age, and the highest BMIZ of all children at all ages. CONCLUSION Cesarean-born Maya children had higher BMI than vaginally born children, even in the absence of many known confounding factors that contribute to childhood obesity. Child growth was most sensitive to birth mode when mothers had high BMI.
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Affiliation(s)
- Amanda Veile
- Department of Anthropology, Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, 47907-2050
| | - Karen L Kramer
- Department of Anthropology, University of Utah, Salt Lake City, Utah, 84112
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97
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Child and family health in the era of prevention: new opportunities and challenges. J Behav Med 2016; 40:159-174. [DOI: 10.1007/s10865-016-9791-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 08/29/2016] [Indexed: 02/04/2023]
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98
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Association of parental body mass index before pregnancy on infant growth and body composition: Evidence from a pregnancy cohort study in Malaysia. Obes Res Clin Pract 2016; 10 Suppl 1:S35-S47. [DOI: 10.1016/j.orcp.2015.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 07/01/2015] [Accepted: 08/07/2015] [Indexed: 11/19/2022]
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99
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Mourtakos SP, Tambalis KD, Panagiotakos DB, Antonogeorgos G, Alexi CD, Georgoulis M, Saade G, Sidossis LS. Association between gestational weight gain and risk of obesity in preadolescence: a longitudinal study (1997-2007) of 5125 children in Greece. J Hum Nutr Diet 2016; 30:51-58. [PMID: 27412890 DOI: 10.1111/jhn.12398] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND The present study aimed to investigate the association between gestational weight gain (GWG) and birth weight, as well as the body mass index (BMI) status, of children at the ages of 2 and 8 years. METHODS Population-based data were obtained from a database of all 7-9-year-old Greek children who attended primary school during 1997-2007. The study sample consisted of 5125 children matched with their mothers, randomly selected according to region and place of residence, and equally distributed (approximately 500 per year) throughout the study period (1997-2007). A standardised questionnaire was applied; telephone interviews were carried out to collect maternal age, BMI status at the beginning and the end of pregnancy and GWG, birth weight of offspring and BMI status at the ages of 2 and 8 years, as well as several other pregnancy characteristics (e.g. pregnancy duration, gestational medical problems, maternal smoking and alcohol consumption habits, and lactation of offspring after pregnancy). RESULTS Gestational weight gain was positively associated with the weight status of offspring at all three life stages studied: newborn (birth weight), infant (BMI) and child (BMI) [b = 0.008 (0.001), b = 0.053 (0.009) and b = 0.034 (0.007), respectively, all P < 0.001], after adjusting for maternal age at pregnancy (significant inverse predictor only at age 2 years). The same applied to excessive GWG, as defined by the Institute of Medicine guidelines. CONCLUSIONS Excessive GWG was associated with a higher risk of greater infant size at birth and a higher BMI status at the ages of 2 and 8 years. Healthcare providers should encourage women to limit their GWG to the range indicated by the current guidelines.
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Affiliation(s)
- S P Mourtakos
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - K D Tambalis
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.,Department of Physical Education and Sport Science, University of Athens, Athens, Greece
| | - D B Panagiotakos
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - G Antonogeorgos
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - C D Alexi
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - M Georgoulis
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - G Saade
- Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - L S Sidossis
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.,Department of Internal Medicine, Sealy Center on Aging, Institute for Translational Sciences and Shriners Hospital for Children, University of Texas Medical Branch at Galveston, Galveston, TX, USA
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100
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Mărginean C, Mărginean CO, Bănescu C, Meliţ L, Tripon F, Iancu M. Impact of demographic, genetic, and bioimpedance factors on gestational weight gain and birth weight in a Romanian population: A cross-sectional study in mothers and their newborns: the Monebo study (STROBE-compliant article). Medicine (Baltimore) 2016; 95:e4098. [PMID: 27399105 PMCID: PMC5058834 DOI: 10.1097/md.0000000000004098] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The present study had 2 objectives, first, to investigate possible relationships between increased gestational weight gain and demographic, clinical, paraclinical, genetic, and bioimpedance (BIA) characteristics of Romanian mothers, and second, to identify the influence of predictors (maternal and newborns characteristics) on our outcome birth weight (BW).We performed a cross-sectional study on 309 mothers and 309 newborns from Romania, divided into 2 groups: Group I-141 mothers with high gestational weight gain (GWG) and Group II-168 mothers with normal GWG, that is, control group.The groups were evaluated regarding demographic, anthropometric (body mass index [BMI], middle upper arm circumference, tricipital skinfold thickness, weight, height [H]), clinical, paraclinical, genetic (interleukin 6 [IL-6]: IL-6 -174G>C and IL-6 -572C>G gene polymorphisms), and BIA parameters.We noticed that fat mass (FM), muscle mass (MM), bone mass (BM), total body water (TBW), basal metabolism rate (BMR) and metabolic age (P < 0.001), anthropometric parameters (middle upper arm circumference, tricipital skinfold thickness; P < 0.001/P = 0.001) and hypertension (odds ratio = 4.65, 95% confidence interval: 1.27-17.03) were higher in mothers with high GWG. BW was positively correlated with mothers' FM (P < 0.001), TBW (P = 0.001), BMR (P = 0.02), while smoking was negatively correlated with BW (P = 0.04). Variant genotype (GG+GC) of the IL-6 -572C>G polymorphism was higher in the control group (P = 0.042).We observed that high GWG may be an important predictor factor for the afterward BW, being positively correlated with FM, TBW, BMR, metabolic age of the mothers, and negatively with the mother's smoking status. Variant genotype (GG+GC) of the IL-6 -572C>G gene polymorphism is a protector factor against obesity in mothers. All the variables considered explained 14.50% of the outcome variance.
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Affiliation(s)
| | | | - Claudia Bănescu
- Department of Genetics, University of Medicine and Pharmacy, Tîrgu Mureţ
- Correspondence: Claudia Bănescu, Department of Medical Genetics, University of Medicine and Pharmacy Tirgu Mures, 38 Gh Marinescu St, 540139, Tirgu Mures, Romania (e-mail: )
| | | | - Florin Tripon
- Department of Genetics, University of Medicine and Pharmacy, Tîrgu Mureţ
| | - Mihaela Iancu
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy, Cluj Napoca, Romania
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