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Musa E, Salazar-Petres E, Vatish M, Levitt N, Sferruzzi-Perri AN, Matjila MJ. Kisspeptin signalling and its correlation with placental ultrastructure and clinical outcomes in pregnant South African women with obesity and gestational diabetes. Placenta 2024; 154:49-59. [PMID: 38878622 DOI: 10.1016/j.placenta.2024.05.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 05/13/2024] [Accepted: 05/30/2024] [Indexed: 09/03/2024]
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is a major pregnancy metabolic disorder and is strongly linked with obesity. Kisspeptin is a hormone that increases several thousand-fold in the maternal circulation during human pregnancy, with placenta as its main source. Studies have suggested that kisspeptin regulates trophoblast invasion and promotes pancreatic insulin secretion and peripheral insulin sensitivity. METHODS In a well-characterized cohort of pregnant South African women and molecular and histological techniques, this study explored the impact and interaction of maternal obesity and GDM on kisspeptin (KISS1) signalling in relation to placental morphology and maternal and neonatal parameters. RESULTS We found that GDM had no effect on placental KISS1 and KISS1R (KISS1 receptor) mRNA and/or protein expression. However, obesity reduced placental KISS1R mRNA expression even though overall KISS1 protein abundance or localization was not different from the non-obese group. Maternal and cord circulating KISS1 concentrations did not vary with obesity or GDM, but maternal circulating KISS1 was positively correlated with placenta weight in non-GDM obese women, and negatively correlated with placental intervillous space volume in non-GDM non-obese women. Cord serum KISS1 was positively correlated with infant weight in GDM obese women, but negatively correlated with maternal BMI in the non-obese GDM group. Placental syncytiotrophoblast extracellular vesicles exhibited detectable KISS1 and its abundance was ∼50 % lower in those from obese GDM compared to non-GDM women. DISCUSSION This study shows maternal obesity and GDM can modulate placental kisspeptin signalling and placental morphological development with potential pathophysiological implications for clinically-relevant pregnancy and perinatal outcomes.
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Affiliation(s)
- Ezekiel Musa
- Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa; Department of Internal Medicine, Kaduna State University, Kaduna, Nigeria
| | - Esteban Salazar-Petres
- Carrera de Obstetricia, Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Valdivia, Chile
| | - Manu Vatish
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Naomi Levitt
- Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Amanda N Sferruzzi-Perri
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK.
| | - Mushi J Matjila
- Department of Obstetrics and Gynaecology, University of Cape Town, Cape Town, South Africa.
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2
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Kranjac AW, Kranjac D, Aguilera RI. Pediatric obesity in the United States: Age-period-cohort analysis. Heliyon 2024; 10:e32603. [PMID: 39183830 PMCID: PMC11341345 DOI: 10.1016/j.heliyon.2024.e32603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 05/24/2024] [Accepted: 06/05/2024] [Indexed: 08/27/2024] Open
Abstract
The rates of obesity among American children aged 2-5 years has reached a historic high. It is crucial to identify the putative sources of population-level increases in obesity prevalence among preschool-aged children because early childhood is a critical window for obesity prevention and thus reduction of future incidence. We used the National Health and Nutrition Examination Survey data and hierarchical age-period-cohort analysis to examine lifecycle (i.e., age), historical (i.e., period), and generational (i.e., cohort) distribution of age- and sex-specific body mass index z-scores (zBMI) among 2-5-year-olds in the U.S. from 1999 to 2018. Our current findings indicate that period effects, rather than differences in groups born at a specific time (i.e., cohort effects), account for almost all of the observed changes in zBMI. We need a broad socioeconomic, cultural, and environmental strategy to counteract the current obesogenic environment that influences children of all ages and generations in order to reach large segments of preschoolers and achieve population-wide improvement.
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Affiliation(s)
- Ashley W. Kranjac
- Department of Sociology, Wilkinson College, Chapman University, Orange, CA, USA
- The Earl Babbie Research Center, Chapman University, Orange, CA, USA
| | - Dinko Kranjac
- Psychology Program, College of Health and Community Well-Being, University of La Verne, La Verne, CA, USA
- Institute of Mental Health and Psychological Well-Being, University of La Verne, La Verne, CA, USA
| | - Roxanne I. Aguilera
- Department of Sociology, Wilkinson College, Chapman University, Orange, CA, USA
- The Earl Babbie Research Center, Chapman University, Orange, CA, USA
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3
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Growth and body composition trajectories in infants meeting the WHO growth standards study requirements. Pediatr Res 2022; 92:1640-1647. [PMID: 35296784 DOI: 10.1038/s41390-022-02005-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/13/2022] [Accepted: 02/15/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND While the World Health Organization (WHO) developed postnatal growth standards for infants, corresponding body composition data remains scarce. This study explores growth and body composition trajectories in infants meeting the WHO Multicentre Growth Reference Study (MGRS) eligibility criteria. STUDY DESIGN Infants enrolled in this longitudinal cohort underwent anthropometric and body composition measurement by air displacement plethysmography (ADP) at 6 weeks, 12 weeks, and 5 months postnatally. Age and sex-specific growth and body composition percentiles were generated using GAMLSS, with extrapolated data at 5 months for those exceeding ADP weight limits. We evaluated which anthropometric measure (body mass index (BMI), weight for length or mid upper arm circumference) was most closely related to adiposity. RESULTS Of the 225 infants with body composition measures, 187 met the WHO MGRS criteria. Their length and weight curves were comparable with WHO growth curves. Trajectory curves for fat and fat-free mass were developed. Of the anthropometric measures, BMI z score was most closely related to fat mass index z score at all timepoints. CONCLUSION This study presents body composition trajectories for infants meeting the WHO growth standard criteria. BMI z score is the best anthropometric metric to estimate adiposity in infants. IMPACT While postnatal growth standards derived from the WHO Multicentre Growth Reference Study (MGRS) exist for the routine clinical assessment of infant growth, this study fills the previous gap in the availability of corresponding body composition data for term-born, healthy, breastfed infants meeting the MGRS criteria. Extrapolation was used to obtain body composition values for infants exceeding the weight limit of the ADP device, to avoid construction of biased body composition curves. Sex-specific growth curves for fat mass, fat-free mass, fat mass index, and fat-free mass index are presented for a population meeting the World Health Organization growth standard criteria.
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Gomula A, Nowak-Szczepanska N, Chakraborty R, Koziel S. Relative Body Fat Distribution in Preadolescent Indian Children Exposed to a Natural Disaster during Early Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116356. [PMID: 35681941 PMCID: PMC9179979 DOI: 10.3390/ijerph19116356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022]
Abstract
Fetal life and infancy are critical periods when adverse environmental conditions, such as natural disasters, may alter a developing organism, leading to life-lasting unfavorable health outcomes, such as central body fat distribution. Therefore, the aim of this study was to assess the effect of the exposure to cyclone Aila in utero or during infancy on the relative subcutaneous adiposity distribution in preadolescent Indian children. The study included children prenatally (N = 336) or postnatally (during infancy, N = 212) exposed to Aila and a non-affected group (N = 284). Anthropometric indices involved, i.e., subscapular, suprailiac, triceps, and biceps skinfolds. The relative adiposity distribution (PC1) and socioeconomic status (SES) were assessed using principal component analysis. An analysis of covariance and Tukey’s post hoc test for unequal samples were performed to assess the effect of exposure to a natural disaster on the PC1, controlling for age, sex, Z-BMI, and SES. Prenatally and postnatally Aila-exposed children revealed a significantly more central-oriented pattern of relative subcutaneous fat distribution compared to the controls (p < 0.05). Early-life exposure to a natural disaster was related to an adverse pattern of relative adipose tissue distribution in preadolescent children.
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Affiliation(s)
- Aleksandra Gomula
- Department of Anthropology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland; (N.N.-S.); (S.K.)
- Correspondence:
| | - Natalia Nowak-Szczepanska
- Department of Anthropology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland; (N.N.-S.); (S.K.)
| | - Raja Chakraborty
- Department of Anthropology and Tribal Studies, Sidho-Kanho-Birsha University, Purulia 723104, West Bengal, India;
- Department of Anthropology, Dinabandhu Mahavidyalaya, Bongaon 743235, West Bengal, India
| | - Slawomir Koziel
- Department of Anthropology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland; (N.N.-S.); (S.K.)
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Nagel EM, Jacobs D, Johnson KE, Foster L, Duncan K, Kharbanda EO, Gregg B, Harnack L, Fields DA, Demerath EW. Maternal Dietary Intake of Total Fat, Saturated Fat, and Added Sugar Is Associated with Infant Adiposity and Weight Status at 6 mo of Age. J Nutr 2021; 151:2353-2360. [PMID: 33982119 PMCID: PMC8435996 DOI: 10.1093/jn/nxab101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/25/2021] [Accepted: 03/16/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Whether current dietary guidelines are appropriate for pregnancy and lactation has not been well studied. Many women of reproductive age are not meeting recommendations for dietary components such as fat, added sugar, and fiber. OBJECTIVES To assess associations between maternal dietary components during pregnancy and lactation and infant growth and adiposity at 6 mo of age. METHODS Mother-infant dyads (n = 349) from the prospective, observational Mothers and Infants Linked for Healthy Growth study were included (100% fully breastfed for 1 mo; 75% to 6 mo). Daily intake of fat, fiber, and added sugar was obtained using the National Cancer Institute Diet History Questionnaire II during the third trimester of pregnancy and at 1 and 3 mo postpartum. Furthermore, intakes were categorized as meeting/exceeding 2015-2020 Dietary Guidelines for Americans. Multiple linear regression models adjusted for numerous potential confounders tested relations between dietary components and infant adiposity (via DXA) and growth parameters. Regression coefficients (β) for continuous variables were expressed per SD to allow for comparison of effect sizes. RESULTS Maternal intake of total fat and saturated fat was positively associated with infant percent body fat (%BF) (β: 0.84 per SD, P = 0.04; β: 0.96 per SD, P = 0.01, respectively). Added sugar intake was positively associated with infant weight-for-length z score (β: 0.16 per SD, P = 0.02), and excessive added sugar intake was positively associated with %BF at 6 mo (β: 0.75 per SD, P = 0.05). CONCLUSIONS In a predominantly fully breastfeeding cohort of women, maternal intake of fat and added sugar during pregnancy and lactation were associated with small increases in infant adiposity and relative weight at 6 mo. Additional research is needed to determine if these relations persist later in infancy and if such elevations in adiposity are important for long-term obesity risk.
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Affiliation(s)
- Emily M Nagel
- School of Public Health, University of Minnesota–Twin Cities, Minneapolis, MN, USA
| | - David Jacobs
- School of Public Health, University of Minnesota–Twin Cities, Minneapolis, MN, USA
| | - Kelsey E Johnson
- Department of Genetics, Cell Biology, and Development, University of Minnesota–Twin Cities, Minneapolis, MN, USA
| | - Laurie Foster
- School of Public Health, University of Minnesota–Twin Cities, Minneapolis, MN, USA
| | - Katy Duncan
- Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, OK, USA
| | | | - Brigid Gregg
- Division of Pediatric Endocrinology, University of Michigan, Ann Arbor, MI, USA
| | - Lisa Harnack
- School of Public Health, University of Minnesota–Twin Cities, Minneapolis, MN, USA
| | - David A Fields
- Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, OK, USA
| | - Ellen W Demerath
- School of Public Health, University of Minnesota–Twin Cities, Minneapolis, MN, USA
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6
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Whyte K, Johnson J, Kelly K, Horowitz M, Widen EM, Toro-Ramos T, Gidwani S, Paley C, Crane J, Lin S, Rosenn B, Thornton J, Pi-Sunyer FX, Gallagher D. No sustained effects of an intervention to prevent excessive GWG on offspring fat and lean mass at 54 weeks: Yet a greater head circumference persists. Pediatr Obes 2021; 16:e12767. [PMID: 33394566 PMCID: PMC8178185 DOI: 10.1111/ijpo.12767] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 12/07/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND LIFT (Lifestyle Intervention for Two) trial found that intervening in women with overweight and obesity through promoting healthy diet and physical activity to control gestational weight gain (GWG) resulted in neonates with greater weight, lean mass and head circumference and similar fat mass at birth. Whether these neonate outcomes are sustained at 1-year was the focus of this investigation. METHODS Measures included body composition by PEA POD air displacement plethysmography (ADP) and Echo Infant quantitative magnetic resonance (QMR) and head circumference at birth (n = 169), 14 (n = 136) and 54 weeks (n = 137). Differences in fat and lean mass between lifestyle intervention (LI) and Usual care (UC) groups were examined using ANCOVA adjusting for maternal age and BMI, GWG, offspring sex and age. RESULTS Compared to UC, LI infants had similar weight (112 ± 131 g; P = .40), fat mass (14 ± 80 g; P = .86), lean mass (100 ± 63 g; P = .12) at 14 weeks and similar weight (168 ± 183 g; P = .36), fat mass (148 ± 124 g; P = .24), lean mass (117 ± 92 g; P = .21) at 54 weeks. Head circumference was greater in LI at 54 weeks (0.46 ± 2.1 cm P = .03). CONCLUSIONS Greater lean mass observed at birth in LI offspring was not sustained at 14 and 54 weeks, whereas the greater head circumference in LI offspring persisted at 54 weeks.
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Affiliation(s)
- Kathryn Whyte
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Jill Johnson
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Kim Kelly
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Michelle Horowitz
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Elizabeth M. Widen
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center, New York, New York,Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, New York,Department of Nutritional Sciences, University of Texas at Austin, New York, New York
| | - Tatiana Toro-Ramos
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Sonia Gidwani
- Department Pediatrics, Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine, New York, New York
| | - Charles Paley
- Department Pediatrics, Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine, New York, New York
| | - Janet Crane
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Susan Lin
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center, New York, New York,Center for Family and Community Medicine, Columbia University Irving Medical Center, New York, New York
| | - Barak Rosenn
- Department of Obstetrics and Gynecology, Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine, New York, New York
| | | | - F. Xavier Pi-Sunyer
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center, New York, New York,Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Dympna Gallagher
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center, New York, New York,Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, New York
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Abstract
Maternal obesity is an established risk factor for poor infant neurodevelopmental outcomes; however, the link between maternal weight and fetal development in utero is unknown. We investigated whether maternal obesity negatively influences fetal autonomic nervous system (ANS) development. Fetal heart rate variability (HRV) is an index of the ANS that is associated with neurodevelopmental outcomes in the infant. Maternal-fetal magnetocardiograms were recorded using a fetal biomagnetometer at 36 weeks (n = 46). Fetal HRV was represented by the standard deviation of sinus beat-to-beat intervals (SDNN). Maternal weight was measured at enrollment (12-20 weeks) and 36 weeks. The relationships between fetal HRV and maternal weight at both time points were modeled using adjusted ordinary least squares regression models. Higher maternal weight at enrollment and 36 weeks were associated with lower fetal HRV, an indicator of poorer ANS development. Further study is needed to better understand how maternal obesity influences fetal autonomic development and long-term neurodevelopmental outcomes.
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8
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Human Milk Exosomal MicroRNA: Associations with Maternal Overweight/Obesity and Infant Body Composition at 1 Month of Life. Nutrients 2021; 13:nu13041091. [PMID: 33801634 PMCID: PMC8066780 DOI: 10.3390/nu13041091] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 12/11/2022] Open
Abstract
Among all the body fluids, breast milk is one of the richest sources of microRNAs (miRNAs). MiRNAs packaged within the milk exosomes are bioavailable to breastfeeding infants. The role of miRNAs in determining infant growth and the impact of maternal overweight/obesity on human milk (HM) miRNAs is poorly understood. The objectives of this study were to examine the impact of maternal overweight/obesity on select miRNAs (miR-148a, miR-30b, miR-29a, miR-29b, miR-let-7a and miR-32) involved in adipogenesis and glucose metabolism and to examine the relationship of these miRNAs with measures of infant body composition in the first 6 months of life. Milk samples were collected from a cohort of 60 mothers (30 normal-weight [NW] and 30 overweight [OW]/obese [OB]) at 1-month and a subset of 48 of these at 3 months of lactation. Relative abundance of miRNA was determined using real-time PCR. The associations between the miRNAs of interest and infant weight and body composition at one, three, and six months were examined after adjusting for infant gestational age, birth weight, and sex. The abundance of miR-148a and miR-30b was lower by 30% and 42%, respectively, in the OW/OB group than in the NW group at 1 month. miR-148a was negatively associated with infant weight, fat mass, and fat free mass, while miR-30b was positively associated with infant weight, percent body fat, and fat mass at 1 month. Maternal obesity is negatively associated with the content of select miRNAs in human milk. An association of specific miRNAs with infant body composition was observed during the first month of life, suggesting a potential role in the infant's adaptation to enteral nutrition.
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9
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Abstract
Worldwide obesity is increasing at an alarming rate in children and adolescents, with the consequent emergence of co-morbidities. Moreover, the maternal environment during pregnancy plays an important role in obesity, contributing to transgenerational transmission of the same and metabolic dysfunction. White adipose tissue represents a prime target of metabolic programming induced by maternal milieu. In this article, we review adipose tissue physiology and development, as well as maternal influences during the perinatal period that may lead to obesity in early postnatal life and adulthood. First, we describe the adipose tissue cell composition, distribution and hormonal action, together with the evidence of hormonal factors participating in fetal/postnatal programming. Subsequently, we describe the critical periods of adipose tissue development and the relationship of gestational and early postnatal life with healthy fetal adipose tissue expansion. Furthermore, we discuss the evidence showing that adipose tissue is an important target for nutritional, hormonal and epigenetic signals to modulate fetal growth. Finally, we describe nutritional, hormonal, epigenetic and microbiome changes observed in maternal obesity, and whether their disruption alters fetal growth and adiposity. The presented evidence supports the developmental origins of health and disease concept, which proposes that the homeostatic system is affected during gestational and postnatal development, impeding the ability to regulate body weight after birth, thereby resulting in adult obesity. Consequently, we anticipate that promoting a healthy early-life programming of adipose tissue and increasing the knowledge of the mechanisms by which maternal factors affect the health of future generations may offer novel strategies for explaining and addressing worldwide health problems such as obesity.
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10
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Sanchez-Escobedo S, Azcorra H, Bogin B, Hoogesteijn AL, Sámano R, Varela-Silva MI, Dickinson F. Birth weight, birth order, and age at first solid food introduction influence child growth and body composition in 6- to 8-year-old Maya children: The importance of the first 1000 days of life. Am J Hum Biol 2020; 32:e23385. [PMID: 31994809 DOI: 10.1002/ajhb.23385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To analyze the relationship of birth weight, birth order, breastfeeding duration, and age of introduction of solid foods with height, fat mass, and fat-free mass in a sample of Maya children when aged 6 to 8 years old. METHODS We collected data on anthropometry, body composition, children's birth weight, birth order, early feeding practices, and household socioeconomic characteristics in a sample of 260 Maya children aged 6 to 8 years living in Merida and Motul, two cities in Yucatan, Mexico. Multiple regression models were performed to identify variables associated with height-for-age (HAZ), fat mass index (FMI), and fat-free mass index (FFMI). The predictors included in the models were birth weight (kg), birth order, duration of breastfeeding (months), age at introduction of solid foods (months), maternal age (years), and height (cm). Models were adjusted for the influence of children's age and sex, maternal educational level, and household overcrowding. RESULTS HAZ was positively associated with child birthweight and maternal height and age, but inversely associated with birth order and age of introduction of solid foods. FMI was positively associated with birth weight, maternal age, and height, and negatively associated with birth order. FFMI was positively associated with maternal age and birth weight. CONCLUSIONS These results are evidence of the importance of the first 1000 days of life for the growth and body composition of Maya children and contributed to understand the development of nutritional dual burden in this population.
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Affiliation(s)
- Samantha Sanchez-Escobedo
- Departamento de Ecología Humana, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mérida, Yucatán, Mexico.,Universidad Vizcaya de las Américas, Mérida, Yuc, Mexico
| | - Hugo Azcorra
- Departamento de Ecología Humana, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mérida, Yucatán, Mexico.,Centro de Investigaciones Silvio Zavala, Universidad Modelo, Carretera a Cholul 200 mts periférico norte, Mérida, Yucatán, México
| | - Barry Bogin
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,UCSD/Salk Center for Academic Research and Training in Anthropogeny (CARTA), Palo Alto, California
| | - Almira L Hoogesteijn
- Departamento de Ecología Humana, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mérida, Yucatán, Mexico
| | - Reyna Sámano
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Miguel Hidalgo, Ciudad de México, Mexico
| | - Maria I Varela-Silva
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Federico Dickinson
- Departamento de Ecología Humana, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mérida, Yucatán, Mexico
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11
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Larqué E, Labayen I, Flodmark CE, Lissau I, Czernin S, Moreno LA, Pietrobelli A, Widhalm K. From conception to infancy - early risk factors for childhood obesity. Nat Rev Endocrinol 2019; 15:456-478. [PMID: 31270440 DOI: 10.1038/s41574-019-0219-1] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/10/2019] [Indexed: 12/25/2022]
Abstract
Maternal lifestyle during pregnancy, as well as early nutrition and the environment infants are raised in, are considered relevant factors for the prevention of childhood obesity. Several models are available for the prediction of childhood overweight and obesity, yet most have not been externally validated. Moreover, the factors considered in the models differ among studies as the outcomes manifest after birth and depend on maturation processes that vary between individuals. The current Review examines and interprets data on the early determinants of childhood obesity to provide relevant strategies for daily clinical work. We evaluate a selection of prenatal and postnatal factors associated with child adiposity. Actions to be considered for preventing childhood obesity include the promotion of healthy maternal nutrition and weight status at reproductive age and during pregnancy, as well as careful monitoring of infant growth to detect early excessive weight gain. Paediatricians and other health-care professionals should provide scientifically validated, individual nutritional advice to families to counteract excessive adiposity in children. Based on systematic reviews, original papers and scientific reports, we provide information to help with setting up public health strategies to prevent overweight and obesity in childhood.
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Affiliation(s)
- Elvira Larqué
- Department of Physiology, University of Murcia, Murcia, Spain
| | - Idoia Labayen
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD) and Department of Health Sciences, Public University of Navarra, Pamplona, Spain
| | - Carl-Erik Flodmark
- Childhood Obesity Unit, Department of Pediatrics, Skane University Hospital, Malmo, Sweden
- Department of Clinical Sciences, Faculty of Medicine, University of Lund, Lund, Sweden
| | - Inge Lissau
- Childhood Obesity Unit, Department of Pediatrics, Skane University Hospital, Malmo, Sweden
- Department of Clinical Sciences, Faculty of Medicine, University of Lund, Lund, Sweden
- Clinical Research Centre, University Hospital Copenhagen, Hvidovre, Denmark
| | - Sarah Czernin
- Deptartment of Pediatrics, Division of Nutrition and Metabolism and Austrian Academic institute for Clinical Nutrition, Vienna, Austria
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development Research Group, Universidad de Zaragoza, Zaragoza, Spain.
- Instituto Agroalimentario de Aragón (IA2) and Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
| | - Angelo Pietrobelli
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Kurt Widhalm
- Deptartment of Pediatrics, Division of Nutrition and Metabolism and Austrian Academic institute for Clinical Nutrition, Vienna, Austria
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12
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Isganaitis E, Venditti S, Matthews TJ, Lerin C, Demerath EW, Fields DA. Maternal obesity and the human milk metabolome: associations with infant body composition and postnatal weight gain. Am J Clin Nutr 2019; 110:111-120. [PMID: 30968129 PMCID: PMC6599743 DOI: 10.1093/ajcn/nqy334] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 09/28/2018] [Accepted: 10/24/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Maternal obesity is a risk factor for childhood obesity; this is a major public health concern given that ∼40% of pregnant women are either overweight or obese. Whether differences in milk composition in lean compared with obese women contribute to childhood obesity is unclear. OBJECTIVES We aimed to analyze relationships between maternal obesity and human milk metabolites, infant body composition, and postnatal weight gain. METHODS This was a prospective study in which mothers intending to breastfeed exclusively, and their newborn infants, were enrolled at delivery (n = 35 mother-infant pairs). We excluded mothers with diabetes, other medical conditions, or pregnancy complications. Participants were grouped by maternal prepregnancy BMI <25 (lean) or ≥25 kg/m2 (overweight/obese). We analyzed infant body composition by dual-energy X-ray absorptiometry and used untargeted liquid chromatography-gas chromatography-mass spectrometry to measure the milk content of 275 metabolites at 1 and 6 mo postpartum. RESULTS At 1 mo postpartum, 10 metabolites differed between overweight/obese and lean groups with nominal P < 0.05, but none was altered with a false discovery rate <0.25. Many differentially abundant metabolites belonged to the same chemical class; e.g., 4/10 metabolites were nucleotide derivatives, and 3/10 were human milk oligosaccharides. Milk adenine correlated positively with both continuously distributed maternal BMI and with infant adiposity and fat accrual. Analysis of milk composition at 6 mo postpartum revealed 20 differentially abundant metabolites (P < 0.05) in overweight/obese compared with lean women, including 6 metabolites with a false discovery rate of <0.25. At both 1 and 6 mo, human milk abundance of 1,5-anhydroglucitol, which has not previously been described in milk, was positively associated with maternal BMI. CONCLUSIONS Maternal obesity is associated with changes in the human milk metabolome. While only a subset of metabolites correlated with both maternal and infant weight, these point to potential milk-dependent mechanisms for mother-child transmission of obesity. This trial was registered at www.clinicaltrials.gov as NCT02535637.
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Affiliation(s)
- Elvira Isganaitis
- Research Division, Joslin Diabetes Center, Boston, MA
- Department of Pediatrics, Harvard Medical School, Boston, MA
| | | | | | - Carles Lerin
- Endocrinology Department, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Ellen W Demerath
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - David A Fields
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK
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Woo JG, Sucharew H, Su W, Khoury PR, Daniels SR, Kalkwarf HJ. Infant Weight and Length Growth Trajectories Modeled Using Superimposition by Translation and Rotation Are Differentially Associated with Body Composition Components at 3 and 7 Years of Age. J Pediatr 2018. [PMID: 29525070 DOI: 10.1016/j.jpeds.2017.12.077] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To evaluate how infant weigh and length growth trajectories associate with body composition at 3 and 7 years because previous studies have noted that rapid infant weight gain increases risk for high body mass index (BMI) in children. STUDY DESIGN There were 322 children enrolled at 3 years of age with dual x-ray absorptiometry body composition data and pediatrician growth data for 0-2 years of age who were included in analysis. Superimposition by translation and rotation modeling was used to characterize infant weight and length trajectories in terms of size, tempo and velocity measures. Associations of these measures with fat mass, lean mass, percent body fat, bone mineral content, BMI z-score, and overweight prevalence at 3 and 7 years of age were determined. RESULTS Infant growth trajectories differed by sex, race, and breastfeeding status. Higher overall weight size and weight velocity from 0 to 2 years of age were associated positively with all age 3 body composition and anthropometry outcomes. However, longer length size from 0 to 2 years of age was associated independently with higher bone mineral content and lean mass, but lower percent body fat, BMI z-score, and a lower odds of overweight at 3 years of age. By 7 years of age, later than average infant weight tempo was also associated with lower fat mass, lean mass, and BMI z-score. CONCLUSIONS Greater average weight size and greater weight velocity in infancy are markers for greater overall body size at 3 and 7 years of age. However, longer average lengths and later weight gain tempo between 0 and 2 years of age may help to establish a leaner body composition by 3 and 7 years of age.
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Affiliation(s)
- Jessica G Woo
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
| | - Heidi Sucharew
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Weiji Su
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Philip R Khoury
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | | | - Heidi J Kalkwarf
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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14
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Fiks AG, Gruver RS, Bishop-Gilyard CT, Shults J, Virudachalam S, Suh AW, Gerdes M, Kalra GK, DeRusso PA, Lieberman A, Weng D, Elovitz MA, Berkowitz RI, Power TJ. A Social Media Peer Group for Mothers To Prevent Obesity from Infancy: The Grow2Gether Randomized Trial. Child Obes 2017; 13:356-368. [PMID: 28557558 PMCID: PMC5647509 DOI: 10.1089/chi.2017.0042] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Few studies have addressed obesity prevention among low-income families whose infants are at increased obesity risk. We tested a Facebook peer-group intervention for low-income mothers to foster behaviors promoting healthy infant growth. METHODS In this randomized controlled trial, 87 pregnant women (Medicaid insured, BMI ≥25 kg/m2) were randomized to the Grow2Gether intervention or text message appointment reminders. Grow2Gether participants joined a private Facebook group of 9-13 women from 2 months before delivery until infant age 9 months. A psychologist facilitated groups featuring a curriculum of weekly videos addressing feeding, sleep, parenting, and maternal well-being. Feasibility was assessed using the frequency and content of participation, and acceptability using surveys. Maternal beliefs and behaviors and infant growth were assessed at birth, 2, 4, 6, and 9 months. Differences in infant growth between study arms were explored. We conducted intention-to-treat analyses using quasi-least-squares regression. RESULTS Eighty-eight percent (75/85) of intervention participants (42% (36/85) food insecure, 88% (75/85) black) reported the group was helpful. Participants posted 30 times/group/week on average. At 9 months, the intervention group had significant improvement in feeding behaviors (Infant Feeding Style Questionnaire) compared to the control group (p = 0.01, effect size = 0.45). Intervention group mothers were significantly less likely to pressure infants to finish food and, at age 6 months, give cereal in the bottle. Differences were not observed for other outcomes, including maternal feeding beliefs or infant weight-for-length. CONCLUSIONS A social media peer-group intervention was engaging and significantly impacted certain feeding behaviors in families with infants at high risk of obesity.
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Affiliation(s)
- Alexander G. Fiks
- Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Rachel S. Gruver
- Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Chanelle T. Bishop-Gilyard
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, PA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Justine Shults
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Senbagam Virudachalam
- Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Andrew W. Suh
- Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Marsha Gerdes
- Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Gurpreet K. Kalra
- Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Patricia A. DeRusso
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Alexandra Lieberman
- Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Daniel Weng
- Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Michal A. Elovitz
- Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA
| | - Robert I. Berkowitz
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, PA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Thomas J. Power
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Division of Developmental and Behavioral Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
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Shenassa ED. Maternal Smoking during Pregnancy and Offspring Weight Gain: a Consideration of Competing Explanations. Paediatr Perinat Epidemiol 2017; 31:409-411. [PMID: 28869795 DOI: 10.1111/ppe.12405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Edmond D Shenassa
- Maternal & Child Health Program, School of Public Health, University of Maryland, College Park, MD.,Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD.,Department of Epidemiology & Biostatistics, School of Public Health, Brown University, Providence, RI.,Department of Epidemiology & Biostatistics, School of Medicine, University of Maryland, Baltimore, MD
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16
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Fields DA, George B, Williams M, Whitaker K, Allison DB, Teague A, Demerath EW. Associations between human breast milk hormones and adipocytokines and infant growth and body composition in the first 6 months of life. Pediatr Obes 2017; 12 Suppl 1:78-85. [PMID: 28160457 PMCID: PMC5540830 DOI: 10.1111/ijpo.12182] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 08/22/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Much is to be learnt about human breast milk (HBM). OBJECTIVES The purpose of this study is to extend our knowledge of HBM by investigating the role of maternal body mass index (BMI), sex and stage of lactation (month 1 vs. 6) on HBM insulin, glucose, leptin, IL-6 and TNF-α and their associations with infant body composition. METHODS Thirty-seven exclusively breastfeeding infants (n = 37; 16♀, 21♂), and their mothers (19-47 kg m-2 ) were studied at 1 and 6 months of lactation. Infants had body composition measured (using dual-energy X-ray absorptiometry) and HBM collected. RESULTS A significant interaction between maternal BMI and infant sex on insulin levels (p = 0.0322) was observed such that insulin was 229% higher in obese mothers nursing female infants than in normal weight mothers nursing female infants and 179% higher than obese mothers nursing male infants. For leptin, a significant association with BMI category was observed (p < 0.0001) such that overweight and obese mothers had 96.5% and 315.1% higher leptin levels than normal weight mothers, respectively. Leptin was also found to have a significant (p = 0.0004) 33.7% decrease from months 1 to 6, controlling for BMI category and sex. A significant inverse relationship between month 1 leptin levels and infant length (p = 0.0257), percent fat (p = 0.0223), total fat mass (p = 0.0226) and trunk fat mass (p = 0.0111) at month 6 was also found. No associations or interactions were observed for glucose, TNF-α or IL-6. CONCLUSIONS These data demonstrate that maternal BMI, infant sex and stage of lactation affect the compositional make-up of insulin and leptin.
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Affiliation(s)
- David A. Fields
- Department of Pediatrics, University of Oklahoma Health Sciences Center and CMRI Metabolic Research Program, Oklahoma City, OK
| | - Brandon George
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, Nutrition Obesity Research Center, Birmingham, AL
| | - Marvin Williams
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Kara Whitaker
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN
| | - David B. Allison
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, Nutrition Obesity Research Center, Birmingham, AL
| | - April Teague
- Department of Pediatrics, University of Oklahoma Health Sciences Center and CMRI Metabolic Research Program, Oklahoma City, OK
| | - Ellen W. Demerath
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN
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Woo JG. Fast, Slow, High, and Low: Infant and Childhood Growth as Predictors of Cardiometabolic Outcomes. J Pediatr 2017; 186:14-16. [PMID: 28396023 DOI: 10.1016/j.jpeds.2017.03.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 03/17/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Jessica G Woo
- Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center; Department of Pediatrics University of Cincinnati College of Medicine Cincinnati, Ohio.
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18
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Neonatal fatty acid profiles are correlated with infant growth measures at 6 months. J Dev Orig Health Dis 2017; 8:474-482. [PMID: 28300011 DOI: 10.1017/s2040174417000150] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Rapid weight gain in infancy and low levels of n-3 long chain polyunsaturated fatty acids (LCPUFA) at birth are associated with increased adiposity later in life. The association between placental LCPUFA delivery and weight gain in infancy is poorly understood. We sought to determine the relationships between maternal phenotype, placental fatty acid transporter expression and offspring growth patterns over the first 6 months. Placental tissue and cord blood were collected at term delivery from women with uncomplicated pregnancies. Offspring body composition measurements were recorded 1 day and 6 months after birth. Body mass index (BMI) z-scores were determined using World Health Organization 2006 reference data. Body phenotype patterns were compared among offspring who had an increase in BMI z-score and those who had a decrease. High skinfold thickness at birth and positive change in BMI z-scores during infancy were associated with low neonatal n-3 LCPUFA plasma levels (r=-0.46, P=0.046) and high saturated fatty acids levels (r=0.49, P=0.034). Growth of skinfolds over 6 months of age was associated with placental fatty acid transporter gene expression. Change in BMI z-score in the first 6 months of life correlated with arm muscle area growth, a measure of lean mass (r=0.62, P=0.003), but not with growth in skinfold thickness. Early infancy weight gain was associated with poor plasma LCPUFA status at birth, and fat deposition in infancy was related to changes in placental lipid handling. Thus, neonatal fatty acid profiles may influence the trajectory of infant growth and fat and lean mass deposition.
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MATERNAL HEIGHT AND PRE-PREGNANCY WEIGHT STATUS ARE ASSOCIATED WITH FETAL GROWTH PATTERNS AND NEWBORN SIZE. J Biosoc Sci 2016; 49:392-407. [DOI: 10.1017/s0021932016000493] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SummaryThe impact of maternal height, pre-pregnancy weight status and gestational weight gain on fetal growth patterns and newborn size was analysed using a dataset of 4261 singleton term births taking place at the Viennese Danube Hospital between 2005 and 2013. Fetal growth patterns were reconstructed from three ultrasound examinations carried out at the 11th/12th, 20th/21th and 32th/33th weeks of gestation. Crown–rump length, biparietal diameter, fronto-occipital diameter, head circumference, abdominal transverse diameter, abdominal anterior–posterior diameter, abdominal circumference and femur length were determined. Birth weight, birth length and head circumference were measured immediately after birth. The vast majority of newborns were of normal weight, i.e. between 2500 and 4000 g. Maternal height showed a just-significant but weak positive association (r=0.03: p=0.039) with crown–rump length at the first trimester and with the majority of fetal parameters at the second trimester (r>0.06; p<0.001) and third trimester (r>0.09; p<0.001). Pre-pregnancy weight status was significantly positively associated with nearly all fetal dimensions at the third trimester (r>0.08; p<0.001). Maternal height (r>0.17; p<0.001) and pre-pregnancy weight status (r>0.13; p<0.001), but also gestational weight gain (r>0.13; p<0.001), were significantly positively associated with newborn size. Some of these associations were quite weak and the statistical significance was mainly due to the large sample size. The association patterns between maternal height and pre-pregnancy weight status with fetal growth patterns (p<0.001), as well as newborn size (p<0.001), were independent of maternal age, nicotine consumption and fetal sex. In general, taller and heavier women gave birth to larger infants. This association between maternal size and fetal growth patterns was detectable from the first trimester onwards.
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20
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Gruver RS, Bishop-Gilyard CT, Lieberman A, Gerdes M, Virudachalam S, Suh AW, Kalra GK, Magge SN, Shults J, Schreiner MS, Power TJ, Berkowitz RI, Fiks AG. A Social Media Peer Group Intervention for Mothers to Prevent Obesity and Promote Healthy Growth from Infancy: Development and Pilot Trial. JMIR Res Protoc 2016; 5:e159. [PMID: 27485934 PMCID: PMC4987492 DOI: 10.2196/resprot.5276] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 02/22/2016] [Accepted: 03/18/2016] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Evidence increasingly indicates that childhood obesity prevention efforts should begin as early as infancy. However, few interventions meet the needs of families whose infants are at increased obesity risk due to factors including income and maternal body mass index (BMI). Social media peer groups may offer a promising new way to provide these families with the knowledge, strategies, and support they need to adopt obesity prevention behaviors. OBJECTIVE The aim of this study is to develop and pilot test a Facebook-based peer group intervention for mothers, designed to prevent pediatric obesity and promote health beginning in infancy. METHODS We conducted in-depth semi-structured interviews with 29 mothers of infants and focus groups with 30 pediatric clinicians, to inform the development of a theory-based intervention. We then conducted a single-group pilot trial with 8 mothers to assess its feasibility and acceptability. All participants were recruited offline at pediatric primary care practices. Participants in the pilot trial joined a private Facebook group, moderated by a psychologist, with a weekly video-based curriculum, and also had the option to meet at a face-to-face event. Within the Facebook group, mothers were encouraged to chat, ask questions, and share photos and videos of themselves and babies practicing healthy behaviors. Consistent with the literature on obesity prevention, the curriculum addressed infant feeding, sleep, activity, and maternal well-being. Feasibility was assessed using the frequency and content of group participation by mothers, and acceptability was measured using online surveys and phone interviews. RESULTS Based on preferences of mothers interviewed (mean BMI 35 kg/m(2), all Medicaid-insured, mean age 27, all Black), we designed the intervention to include frequent posts with new information, videos showing parents of infants demonstrating healthy behaviors, and an optional face-to-face meeting. We developed a privacy and safety plan that met the needs of participants as well as the requirements of the local institutional review board (IRB), which included use of a "secret" group and frequent screening of participant posts. Clinicians, 97% (29/30) women and 87% (26/30) pediatricians, preferred no direct involvement in the intervention, but were supportive of their patients' participation. In our 8-week, single group pilot trial, all participants (mean BMI 35 kg/m(2), all Medicaid-insured, mean age 28, all Black) viewed every weekly video post, and interacted frequently, with a weekly average of 4.4 posts/comments from each participant. All participant posts were related to parenting topics. Participants initiated conversations about behaviors related to healthy infant growth including solid food introduction, feeding volume, and managing stress. All 8 pilot group participants reported that they found the group helpful and would recommend it to others. CONCLUSIONS Our methodology was feasible and acceptable to low-income mothers of infants at high risk of obesity, and could be adapted to implement peer groups through social media for underserved populations in varied settings. CLINICALTRIAL ClinicalTrials.gov NCT01977105; https://clinicaltrials.gov/ct2/show/NCT01977105 (Archived by WebCite at http://www.webcitation.org/6iMFfOBat).
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Affiliation(s)
- Rachel S Gruver
- Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
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21
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Barbour LA, Hernandez TL, Reynolds RM, Reece MS, Chartier-Logan C, Anderson MK, Kelly T, Friedman JE, Van Pelt RE. Striking differences in estimates of infant adiposity by new and old DXA software, PEAPOD and skin-folds at 2 weeks and 1 year of life. Pediatr Obes 2016. [PMID: 26198967 PMCID: PMC4762753 DOI: 10.1111/ijpo.12055] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Infant adiposity better predicts childhood obesity/metabolic risk than weight, but technical challenges fuel controversy over the accuracy of adiposity estimates. OBJECTIVE We prospectively measured adiposity (%fat) in term newborns (NB) at 2 weeks (n = 41) and 1 year (n = 30). METHODS %fat was measured by dual X-ray absorptiometry (DXA), PEAPOD and skin-folds (SF). DXAs were analyzed using Hologic Apex software 3.2(DXAv1) and a new version 5.5.2(DXAv2). RESULTS NB %fat by DXAv2 was 55% higher than DXAv1 (14.2% vs. 9.1%), 45% higher than SF (9.8%), and 36% higher than PEAPOD (10.4%). Among NB, Pearson correlations were 0.73-0.89, but agreement (intra-class correlations) poor between DXAv2 and DXAv1 (0.527), SF (0.354) and PEAPOD (0.618). At 1 year, %fat by DXAv2 was 51% higher than DXAv1 (33.6% vs. 22.4%), and twice as high compared with SF (14.6%). Agreement was poor between DXAv2 and DXAv1 (0.204), and SF (0.038). The absolute increase in %fat from 2 weeks to 1 year was 19.7% (DXAv2), 13.6% (DXAv1) and only 4.8% by SF. CONCLUSION Analysis of the same DXA scans using new software yielded considerably higher adiposity estimates at birth and 1 year compared with the previous version. Using different modalities to assess body composition longitudinally is problematic. Standardization is gravely needed to determine how early life exposures affect childhood obesity/metabolic risk.
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Affiliation(s)
- Linda A Barbour
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Teri L Hernandez
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado,College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Regina M Reynolds
- Department of Pediatrics, Section of Neonatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Melanie S Reece
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Catherine Chartier-Logan
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Molly K Anderson
- Department Medicine, Division of Geriatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - Jacob E Friedman
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Department of Pediatrics, Section of Neonatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Rachael E Van Pelt
- Department Medicine, Division of Geriatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Abstract
The aims of this study were to develop and validate a prediction equation of fat-free mass (FFM) based on bioelectrical impedance analysis (BIA) and anthropometry using air-displacement plethysmography (ADP) as a reference in Asian neonates and to test the applicability of the prediction equations in an independent Western cohort. A total of 173 neonates at birth and 140 at two weeks of age were included. Multiple linear regression analysis was performed to develop the prediction equations in a two-third randomly selected subset and validated on the remaining one-third subset at each time point and in an independent Queensland cohort. FFM measured by ADP was the dependent variable, and anthropometric measures, sex and impedance quotient (L2/R50) were independent variables in the model. Accuracy of prediction equations was assessed using intra-class correlation and Bland-Altman analyses. L2/R50 was the significant predictor of FFM at week two but not at birth. Compared with the model using weight, sex and length, including L2/R50 slightly improved the prediction with a bias of 0·01 kg with 2 sd limits of agreement (LOA) (0·18, -0·20). Prediction explained 88·9 % of variation but not beyond that of anthropometry. Applying these equations to the Queensland cohort provided similar performance at the appropriate age. However, when the Queensland equations were applied to our cohort, the bias increased slightly but with similar LOA. BIA appears to have limited use in predicting FFM in the first few weeks of life compared with simple anthropometry in Asian populations. There is a need for population- and age-appropriate FFM prediction equations.
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Alderete TL, Autran C, Brekke BE, Knight R, Bode L, Goran MI, Fields DA. Associations between human milk oligosaccharides and infant body composition in the first 6 mo of life. Am J Clin Nutr 2015; 102:1381-8. [PMID: 26511224 PMCID: PMC6546222 DOI: 10.3945/ajcn.115.115451] [Citation(s) in RCA: 140] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 09/24/2015] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Evidence linking breastfeeding to reduced risk of developing childhood obesity is inconclusive, yet previous studies have not considered variation in specific components of breast milk that may affect early development. OBJECTIVE We examined whether differences in the composition of human milk oligosaccharides (HMOs) correlate with infant growth and body composition at 1 and 6 mo of age. DESIGN Twenty-five mother-infant dyads were recruited from the University Hospital at the University of Oklahoma Health Sciences Center. Infants were breastfed for 6 mo. Breast-milk and infant measures were obtained at 1 and 6 mo of infant age. HMO composition was analyzed by high-pressure liquid chromatography, and infant growth (length and weight) and body composition (percentage fat, total fat, lean mass) were measured by dual-energy X-ray absorptiometry. Relations between HMOs and infant growth and body composition were examined by using multiple linear regression. A priori covariates included maternal prepregnancy body mass index, pregnancy weight gain, and infant age and sex. RESULTS Higher HMO diversity and evenness at 1 mo were associated with lower total and percentage fat mass at 1 mo. At 1 mo, each 1-μg/mL increase in lacto-N-fucopentaose (LNFP) I was associated with a 0.40-kg lower infant weight (P = 0.03). At 6 mo, each 1-μg/mL increase in LNFPI was associated with a 1.11-kg lower weight (P = 0.03) and a 0.85-g lower lean mass (P = 0.01). At 6 mo, each 1-μg/mL increase in LNFPI was associated with a 0.79-g lower fat mass (P = 0.02), whereas disialyl-lacto-N-tetraose and LNFPII were associated with a 1.92-g (P = 0.02) and 0.42-g (P = 0.02) greater fat mass, respectively. At 6 mo, each 1-μg/mL increase in fucosyl-disialyl-lacto-N-hexaose and lacto-N-neotetraose was associated with 0.04% higher (P = 0.03) and 0.03% lower (P < 0.01) body fat, respectively. CONCLUSION These findings support the hypothesis that differences in HMO composition in mother's milk are associated with infant growth and body composition. This trial was registered at clinicaltrials.gov as NCT02535637.
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Affiliation(s)
- Tanya L Alderete
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | | | - Benjamin E Brekke
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Rob Knight
- Departments of Pediatrics and Computer Science and Engineering, University of California, San Diego, CA; and
| | | | - Michael I Goran
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA;
| | - David A Fields
- Department of Pediatrics, University of Oklahoma Health Sciences Center and Children's Medical Research Institute Metabolic Research Program, Oklahoma City, OK
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24
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Trotman G, Chhatre G, Darolia R, Tefera E, Damle L, Gomez-Lobo V. The Effect of Centering Pregnancy versus Traditional Prenatal Care Models on Improved Adolescent Health Behaviors in the Perinatal Period. J Pediatr Adolesc Gynecol 2015; 28:395-401. [PMID: 26233287 DOI: 10.1016/j.jpag.2014.12.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 11/25/2014] [Accepted: 12/10/2014] [Indexed: 12/21/2022]
Abstract
STUDY OBJECTIVE To determine if the CenteringPregnancy model of prenatal care improves maternal health behaviors in adolescent pregnancy. DESIGN We conducted a retrospective chart review comparing 150 pregnant adolescents who received prenatal care between 2008 to 2012 with CenteringPregnancy to those receiving care in traditional prenatal care models with either multiprovider or single-provider visits. Outcome measures included weight gain during pregnancy, compliance to prenatal care appointments, infant feeding method, postpartum follow up and contraceptive use postpartum. A χ(2) analysis was used to compare outcomes between the 3 groups at a 2-tailed α of .05. RESULTS Fifty individuals were evaluated in each group. Adolescents in the CenteringPregnancy group were more likely to comply with prenatal and postpartum visits and to meet the 2009 Institute of Medicine gestational weight guidelines for weight gain in pregnancy than were adolescents in either multiprovider (62.0% vs 38.0%, P = .02) or single-provider (62.0% vs 38.0%, P = .02) groups. The CenteringPregnancy group was also more likely to solely breastfeed compared with adolescents in the multiprovider group (40.0% vs 20.0%, P = .03) and include breastfeeding in addition to bottle-feeding compared with both multiprovider (32.0% vs 14.0%, P = .03) and single-provider (32.0% vs 12.0%, P = .03) patient groups. Additionally, the CenteringPregnancy group had increased uptake of long-acting reversible contraception and were less likely to suffer from postpartum depression. CONCLUSIONS CenteringPregnancy Prenatal Care program aids in compliance to prenatal visits, appropriate weight gain, increased uptake of highly effective contraception, and breastfeeding among adolescent mothers.
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Affiliation(s)
- Gylynthia Trotman
- MedStar Washington Hospital Center, Department of Women and Infants' Services, Washington, DC.
| | - Gayatri Chhatre
- MedStar Washington Hospital Center, Department of Women and Infants' Services, Washington, DC
| | - Renuka Darolia
- MedStar Washington Hospital Center, Department of Women and Infants' Services, Washington, DC
| | | | - Lauren Damle
- MedStar Washington Hospital Center, Department of Women and Infants' Services, Washington, DC
| | - Veronica Gomez-Lobo
- MedStar Washington Hospital Center, Department of Women and Infants' Services, Washington, DC
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25
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Shepard DN, Chandler-Laney PC. Prospective associations of eating behaviors with weight gain in infants. Obesity (Silver Spring) 2015; 23:1881-5. [PMID: 26242892 PMCID: PMC4551607 DOI: 10.1002/oby.21168] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 05/07/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To examine whether maternal reports of infant eating behaviors are stable over time and whether eating behaviors are prospectively associated with weight gain. METHODS In an ongoing study of infant growth, weight and length were measured at 2 weeks, 3 months, and 5 months of age. Food responsiveness (FR), satiety responsiveness (SR), enjoyment of feeding (EF), and slow eating (SE) were assessed with the Baby Eating Behavior Questionnaire. Repeated measures ANOVA was used to examine changes in eating behaviors from 2 weeks to 5 months. Simple Pearson correlations examined associations among eating behaviors across time and associations of eating behaviors with subsequent change in weight-for-length z-scores. RESULTS Among 31 infants studied from 2 weeks to 3 months, FR and SR remained consistent (P < 0.05), and among 21 infants studied from 3 to 5 months, FR, EF, and SE were consistent (P < 0.01). Infants ate more quickly (P < 0.01) and tended to have greater SR with age (P = 0.09). Only SE at 3 months was associated with subsequent gain in weight-for-length (P < 0.05). CONCLUSIONS Consistent with previous research, SE was predictive of weight gain during infancy. Given that eating behaviors were largely consistent after 3 months of age, it may be important to encourage the development of healthy eating behaviors during early infancy.
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Affiliation(s)
- Desti N Shepard
- Department of Psychology, University of Alabama at Birmingham, Alabama, USA
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26
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Hull HR, Thornton J, Paley C, Navder K, Gallagher D. Maternal obesity influences the relationship between location of neonate fat mass and total fat mass. Pediatr Obes 2015; 10:245-51. [PMID: 25088238 PMCID: PMC4317390 DOI: 10.1111/ijpo.257] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 06/04/2014] [Accepted: 06/11/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND It is suggested that maternal obesity perpetuates offspring obesity to future generations. OBJECTIVE To determine whether location of neonate fat mass (FM: central vs. peripheral) is related to total neonate FM and whether maternal obesity influences this relationship. METHODS Neonate body composition and skin-fold thicknesses were assessed in healthy neonates (n = 371; 1-3 days old). Linear regression models examined the relationship between total FM and location of FM (central vs. peripheral). Location of FM was calculated by skin-folds: peripheral was the sum of (biceps and triceps)/2 and central was represented by the subscapular skin-fold. RESULTS A significant interaction was found for location of FM and maternal obesity. Holding all predictors constant, in offspring born to non-obese mothers, a 0.5 mm increase in central FM predicted a 15 g greater total FM, whereas a 0.5 mm increase in peripheral FM predicted a 66 g greater total FM. However, in offspring born to obese mothers, a 0.5 mm increase in central FM predicted a 56 g total FM, whereas a 0.5 mm increase in peripheral FM predicted a 14 g greater total FM. CONCLUSIONS The relationship between total FM and location of FM is influenced by maternal obesity.
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Affiliation(s)
- Holly R. Hull
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS,New York Obesity Nutrition Research Center at Columbia University, St. Luke's-Roosevelt Hosp., NY, NY
| | - John Thornton
- New York Obesity Nutrition Research Center at Columbia University, St. Luke's-Roosevelt Hosp., NY, NY
| | - Charles Paley
- Department of Pediatrics, St. Luke's-Roosevelt Hospital, NY, NY
| | | | - Dympna Gallagher
- New York Obesity Nutrition Research Center at Columbia University, St. Luke's-Roosevelt Hosp., NY, NY
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27
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Andres A, Hull HR, Shankar K, Casey PH, Cleves MA, Badger TM. Longitudinal body composition of children born to mothers with normal weight, overweight, and obesity. Obesity (Silver Spring) 2015; 23:1252-8. [PMID: 25960251 DOI: 10.1002/oby.21078] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 02/11/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The longitudinal trajectories of body composition of children born to mothers with normal weight, overweight, and obesity have not been evaluated using precise body composition methods. This study investigated the relationship between maternal prepregnancy BMI and offspring body composition trajectories during the first 6 years of life. METHODS Healthy infants (N = 325) were assessed longitudinally (at ages 0.25, 0.5, 0.75, 1, 2, 3, 4, 5, and 6 years) using dual-energy X-ray absorptiometry. Mixed-effects regression for repeated measures was used to model each continuous outcome as a function of maternal BMI and covariates (race, gestational age, birth weight, and mode of infant feeding). RESULTS Maternal obesity differentially impacted body fat, but not bone mineral content or density, of girls and boys. Boys born to mothers with obesity have higher body fat from ages 2-6 years compared to boys born to normal-weight and overweight mothers (P < 0.05), whereas body composition of girls born to mothers with obesity was not different across groups during the first 6 years of life (P > 0.05). CONCLUSIONS This clinical observational study demonstrates a sexual dimorphism in offspring body composition until age 6 years based on maternal BMI, with a greater effect of maternal adiposity seen in boys than in girls.
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Affiliation(s)
- Aline Andres
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Holly R Hull
- School of Health Professions, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kartik Shankar
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Patrick H Casey
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Mario A Cleves
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Thomas M Badger
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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28
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Casazza K, Hanks LJ, Fields DA. The relationship between bioactive components in breast milk and bone mass in infants. BONEKEY REPORTS 2014; 3:577. [PMID: 25328673 DOI: 10.1038/bonekey.2014.72] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 07/26/2014] [Indexed: 12/29/2022]
Abstract
Human breast milk (HBM) contains numerous bioactive components, recently shown to be associated with growth and body composition in breastfed offspring. Reciprocity in adipogenic and osteogenic pathways suggests bone mass may also be influenced by these components. The association between bioactive components found in HBM and bone mineral content (BMC), to our knowledge, is unknown. The purpose of this proof-of-principle study was to evaluate the association between specific bioactive components in HBM in exclusively breastfed infants and skeletal health in the first 6 months of life and examine potential gender differences in these associations. Thirty-five mother-infant dyads were followed from 1 to 6 months. The contents of a single breast expression were used for analyses of bioactive components (insulin, glucose, leptin, interleukin-6 and tumor necrosis factor-α (TNFα), whereas BMC was evaluated by dual-energy X-ray absorptiometry. In the total sample, there was a positive association between TNFα and BMC at 1 (P=0.004) and 6 months (P=0.007). When stratified by sex, females exhibited a positive association between BMC and glucose and an inverse relationship between BMC and TNF-α at 1 month with TNF-α strengthening (P=0.006) at 6 months. In males, at 6 months a positive relationship between BMC and HBM glucose and an inverse relationship with HBM leptin were observed with no associations observed at 1 month. Although preliminary, the associations between bioactive components in HBM highlight the importance HBM has on bone accretion. It is critically important to identify factors in HBM that contribute to optimal bone health.
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Affiliation(s)
- Krista Casazza
- Department of Nutrition Sciences, University of Alabama at Birmingham , Birmingham, AL, USA
| | - Lynae J Hanks
- Division of Nephrology, School of Medicine, University of Alabama at Birmingham , Birmingham, AL, USA
| | - David A Fields
- Section of Endocrinology and Diabetes, Department of Pediatrics and Children's Hospital Foundation Metabolic Research Program, University of Oklahoma Health Sciences Center , Oklahoma City, OK, USA
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29
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Hazell TJ, Gallo S, Berzina L, Vanstone CA, Rodd C, Weiler HA. Plasma 25-hydroxyvitamin D, more so than its epimer, has a linear relationship to leaner body composition across infancy in healthy term infants. Appl Physiol Nutr Metab 2014; 39:1137-43. [DOI: 10.1139/apnm-2013-0586] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Vitamin D status positively associates with skeletal muscle mass and function in adolescents. The C-3 alpha epimer of 25-hydroxyvitamin D3 (3-epi-25(OH)D3) is high in infants, yet the potential impacts of 25-hydroxyvitamin D3 (25(OH)D3) and 3-epi-25(OH)D3 on skeletal muscle development are largely unexplored. The objective of this study was (i) to explore how the concentrations of 25(OH)D3 and 3-epi-25(OH)D3 track with body composition (lean mass (LM) and fat mass (FM)) and (ii) to determine the association between 25(OH)D3 and 3-epi-25(OH)D3 in infancy. Healthy breastfed infants (n = 132) were followed from 1 to 12 months of age as part of a vitamin D dose–response study (NCT00381914). Anthropometry and diet were assessed. Body composition was measured with dual-energy X-ray absorptiometry. Plasma 25(OH)D3 and 3-epi-25(OH)D3 concentrations were evaluated using liquid chromatography tandem mass spectrometry. Plasma 25(OH)D3 and 3-epi-25(OH)D3 increased from 1 to 3 months of age and decreased thereafter (p < 0.05). Infants with 25(OH)D3 concentrations above 75 nmol/L did not have a higher LM (g or %; p > 0.273) than those below this cutoff. LM was not associated with 25(OH)D3, whereas LM% was positively associated with 25(OH)D3 (β = 0.03; CI: 0.01 to 0.06; p = 0.006), while accounting for sex, weight-for-age Z-score, protein and fat intake, and age. For FM, the variables accounting for a significant amount of the variation were plasma 25(OH)D3 concentration (β = −2.38; CI: −4.35, −0.41; p = 0.019), weight-for-age Z-score, protein and fat intake, and time. In healthy infants, higher vitamin D status associates with leaner body composition, though the effect is smaller in magnitude relative to growth.
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Affiliation(s)
- Tom J. Hazell
- Department of Kinesiology and Physical Education, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada
| | - Sina Gallo
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA
| | - llze Berzina
- Mary Emily Clinical Nutrition Research Unit, School of Dietetics and Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 2E3, Canada
| | - Catherine A. Vanstone
- Mary Emily Clinical Nutrition Research Unit, School of Dietetics and Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 2E3, Canada
| | - Celia Rodd
- Department of Pediatrics, McGill University, Montréal, QC H3A 1Y1, Canada
- Montreal Children’s Hospital, Montréal, QC H3H 1P3, Canada
| | - Hope A. Weiler
- Mary Emily Clinical Nutrition Research Unit, School of Dietetics and Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 2E3, Canada
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30
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Hanieh S, Ha TT, Simpson JA, Thuy TT, Khuong NC, Thoang DD, Tran TD, Tuan T, Fisher J, Biggs BA. Postnatal growth outcomes and influence of maternal gestational weight gain: a prospective cohort study in rural Vietnam. BMC Pregnancy Childbirth 2014; 14:339. [PMID: 25271061 PMCID: PMC4190350 DOI: 10.1186/1471-2393-14-339] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 09/25/2014] [Indexed: 01/17/2023] Open
Abstract
Background Suboptimal weight gain during pregnancy may result in adverse outcomes for both the mother and child, including increased risk of pre-eclampsia and gestational diabetes, delivery of low birth weight and small-for-gestational age (SGA) infants, and preterm delivery. The objectives of this study were to identify maternal predictors of rate of weight gain in pregnancy, and to evaluate the association of gestational weight gain with infant postnatal growth outcomes. Methods We conducted a prospective cohort study of infants born to women who had previously participated in a double-blind cluster randomized controlled trial of antenatal micronutrient supplementation, in Ha Nam province, Vietnam. Pregnant women (n = 1258) were seen at enrolment and 32 weeks gestation, and infants (n = 965) were followed until 6 months of age. Primary outcome was infant anthropometric indicators at 6 months of age (weight for age, length for age, weight for height z scores), and infant weight gain velocity during the first 6 months of life. Results Low body mass index (<18.5 kg/m2) was present in 26% of women, and rate of gestational weight gain was 0.4 kg per week [SD 0.12]. Rate of weight gain during pregnancy was significantly associated with infant weight-for-age (MD 1.13, 95% CI 0.58 to 1.68), length-for-age (MD 1.11, 95% CI 0.66 to 1.55), weight-for-length z scores (MD 0.63, 95% CI 0.07 to 1.19), and infant weight gain velocity during the first 6 months of life (MD 93.6 g per month, 95% CI 8.2 to 179.0). Conclusions Rate of gestational weight gain is predictive of postnatal growth at six months of age in this setting. Public health programs should be targeted towards improving body mass index and weight gain in pregnant women in rural Vietnam.
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Affiliation(s)
- Sarah Hanieh
- Department of Medicine, University of Melbourne, L 4 Clinical Science Building, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia.
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