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Ntimana CB, Seakamela KP, Mashaba RG, Maimela E. Determinants of central obesity in children and adolescents and associated complications in South Africa: a systematic review. Front Public Health 2024; 12:1324855. [PMID: 38716247 PMCID: PMC11075369 DOI: 10.3389/fpubh.2024.1324855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 03/19/2024] [Indexed: 05/23/2024] Open
Abstract
Background Central obesity in children is a global health concern associated with cardiovascular risk factors. In 2019 the World Obesity Federation predicted that in 2025, 206 million children and adolescents aged 5 to 19 will be obese, and the number is estimated to reach 254 million by 2030. There is limited literature on the factors that are associated with the development of central obesity in children. We report a systematic review, aimed to describe the current literature on determinants of central obesity and its associated health outcomes in children and adolescents in the South African population. Methods We searched for peer-reviewed studies in Google Scholar, PubMed, and Science Direct search engines, and about seven studies were included. This systematic review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO) (Registration number: CRD42023457012). This systematic review was conducted and reported according to an updated version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The quality of the included studies was assessed by following guidelines from the Newcastle-Ottawa Scale (NOS). The method considered three main domains: selection, comparability, and outcome across different study designs. Results The prevalence of central obesity in children and adolescents by waist-to-height ratio (WHtR) ranged from 2.0 to 41.0%; waist-to-hip [WHR ranged from 10 to 25%; waist circumference (WC) ranged from 9 to 35%]. Central obesity was associated with age, physical inactivity, gender socio, and demographic profiles of the household. Central obesity in children was associated with cardiovascular diseases and mental health issues. Conclusion Central obesity in children and adolescents was determined by gender, pubertal development, and age of the parents, households with high socioeconomic status, dietary practices, and overweight/obesity. Given the high prevalence of central obesity in children which can ultimately result in cardiometabolic diseases, cardiovascular risk factors, and mental health issues. This highlights the need for systems, jointly initiated by healthcare providers, policymakers, and the general society aimed at reducing the burden of central obesity such as introducing children and adolescents to health-promoting lifestyles.
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Affiliation(s)
- Cairo Bruce Ntimana
- DIMAMO Population Health Research Centre, University of Limpopo, Sovenga, South Africa
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Mannino A, Sarapis K, Mourouti N, Karaglani E, Anastasiou CA, Manios Y, Moschonis G. The Association of Maternal Weight Status throughout the Life-Course with the Development of Childhood Obesity: A Secondary Analysis of the Healthy Growth Study Data. Nutrients 2023; 15:4602. [PMID: 37960255 PMCID: PMC10649313 DOI: 10.3390/nu15214602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
Maternal weight-status at various time-points may influence child obesity development, however the most critical time-point remains unidentified. We used data from the Healthy Growth Study, a cross-sectional study of 2666 Greek schoolchildren aged 9-13 years, exploring associations between childhood obesity and maternal weight-status at pre-pregnancy, during pregnancy/gestational weight gain, and at the child's pre-adolescence. Logistic regression analyses examined associations between maternal weight-status being "below" or "above" the recommended cut-off points (WHO BMI thresholds or IOM cut-off points), at the three time-points, individually or combined into weight-status trajectory groups to determine the strongest associations with child obesity in pre-adolescence. Adjusted models found significant associations and the highest odds ratios [95% Confidence Intervals] for mothers affected by obesity before pregnancy (4.16 [2.47, 7.02]), those with excessive gestational weight gain during pregnancy (1.50 [1.08, 2.08]), and those affected by obesity at their child's pre-adolescence (3.3 [2.29, 4.87]). When combining these weight-status groups, mothers who were above-above-below (3.24 [1.10, 9.55]), and above-above-above (3.07 [1.95, 4.85]) the healthy weight recommendation-based thresholds in each time-point, had a three-fold higher likelihood of child obesity, compared to the below-below-below trajectory group. Maternal obesity across all examined time-points was significantly associated with childhood obesity. Effective childhood obesity preventive initiatives should commence at pre-conception, targeting maternal weight throughout the life-course and childhood developmental stages.
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Affiliation(s)
- Adriana Mannino
- Department of Food, Nutrition and Dietetics, School Allied Health, Human Services & Sport, La Trobe University, Melbourne, VIC 3086, Australia; (A.M.); (K.S.)
| | - Katerina Sarapis
- Department of Food, Nutrition and Dietetics, School Allied Health, Human Services & Sport, La Trobe University, Melbourne, VIC 3086, Australia; (A.M.); (K.S.)
| | - Niki Mourouti
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece; (N.M.); (E.K.); (C.A.A.); (Y.M.)
- Department of Nutrition and Dietetics, Hellenic Mediterranean University, 72300 Sitia, Greece
| | - Eva Karaglani
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece; (N.M.); (E.K.); (C.A.A.); (Y.M.)
| | - Costas A. Anastasiou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece; (N.M.); (E.K.); (C.A.A.); (Y.M.)
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece; (N.M.); (E.K.); (C.A.A.); (Y.M.)
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, 71410 Heraklion, Greece
| | - George Moschonis
- Department of Food, Nutrition and Dietetics, School Allied Health, Human Services & Sport, La Trobe University, Melbourne, VIC 3086, Australia; (A.M.); (K.S.)
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Mannino A, Sarapis K, Moschonis G. The Effect of Maternal Overweight and Obesity Pre-Pregnancy and During Childhood in the Development of Obesity in Children and Adolescents: A Systematic Literature Review. Nutrients 2022; 14:nu14235125. [PMID: 36501155 PMCID: PMC9739272 DOI: 10.3390/nu14235125] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/21/2022] [Accepted: 11/26/2022] [Indexed: 12/03/2022] Open
Abstract
Maternal overweight/obesity has been associated with an increased risk of obesity in childhood. We investigated the effect of maternal overweight/obesity during pre-pregnancy and whether it is a stronger predictor of child obesity, compared to maternal overweight/obesity during childhood. Prospective or retrospective cohort studies published in English, reporting on obese children and adolescents (2-18 years), with overweight/obese mothers in either pre-pregnancy or during childhood were included. A search was conducted from 2012 to April 2022 in MEDLINE, Web of Science, CINAHL, and EMBASE, followed by screening, data extraction, quality assessment and narrative synthesis. Eleven eligible studies (9 prospective and 2 retrospective cohort studies; total sample, n = 27,505) were identified. Eight studies examined maternal overweight/obesity in pre-conception, presenting consistent positive associations with childhood obesity, three reported positive associations between childhood obesity and maternal overweight/obesity during childhood, and one presented positive associations between both maternal exposures. The narrative synthesis failed to identify which maternal exposure is the strongest predictor of childhood obesity, with studies reporting significant associations between maternal overweight/obesity and child obesity in both time points. Intervention programs aiming to reduce childhood obesity should focus on supporting women of childbearing age with weight management from preconception and throughout their life-course.
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Hu H, Feng P, Yu Q, Zhu W, Xu H, Wu D, Wu L, Yin J, Li H. The mediating role of gestational diabetes mellitus in the associations of maternal prepregnancy body mass index with neonatal birth weight. J Diabetes 2022; 14:26-33. [PMID: 34668330 PMCID: PMC9060130 DOI: 10.1111/1753-0407.13233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Both prepregnancy obesity and gestational diabetes mellitus (GDM) have been linked to adverse neonatal birth weight. However, the mediating role of GDM between prepregnancy obesity and neonatal birth weight is unclear. METHOD The cohort study included 17 260 singleton pregnant women and their newborns. Participants' demographic characteristics, disease history, family history of the disease, and the perinatal outcomes were recorded. The association between maternal prepregnancy body mass index (BMI) status and small for gestational age (SGA) or large for gestational age (LGA) neonates was analyzed using logistic regressions, before and after adjusting for covariates and GDM. The potential mediation of GDM on the association between prepregnancy BMI and adverse birth weight was examined. RESULT Multivariate logistic regression demonstrated that prepregnancy underweight women were more likely to deliver SGA neonates compared to those who had normal weights, whereas prepregnancy obese pregnant women were more likely to have LGA neonates. The RMediation analyses illustrated that the mediation effect of GDM on the maternal prepregnancy BMI (continuous variable) and the risk of SGA was not significant, whereas the association between prepregnancy BMI and LGA was statistically mediated by GDM (95%CI of a*b: 0.009-0.051). The Iacobacci (2012) method indicated that the impact of maternal prepregnancy overweight (Zmediation = 2.418, P = .015) and obesity (Zmediation = 2.165, P = .030) on LGA was partially mediated by GDM, with an indirect effect of 16.3% and 13.1%, respectively. CONCLUSION Prepregnancy BMI was observed to be associated with SGA and LGA. The association of prepregnancy overweight and obesity with LGA was found to be partially mediated by GDM.
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Affiliation(s)
- Hao Hu
- Department of EpidemiologySchool of Public Health, Medical College of Soochow UniversitySuzhouChina
| | - Pei Feng
- Department of Community Health CareMaternal and Child Health Bureau of KunshanKunshanChina
| | - Qian Yu
- Department of Community Health CareMaternal and Child Health Bureau of KunshanKunshanChina
| | - Wei Zhu
- Department of Community Health CareMaternal and Child Health Bureau of KunshanKunshanChina
| | - He Xu
- Department of EpidemiologySchool of Public Health, Medical College of Soochow UniversitySuzhouChina
| | - Di Wu
- Department of EpidemiologySchool of Public Health, Medical College of Soochow UniversitySuzhouChina
| | - Lei Wu
- Suzhou Industrial Park Center for Disease Control and PreventionSuzhouChina
| | - Jieyun Yin
- Department of EpidemiologySchool of Public Health, Medical College of Soochow UniversitySuzhouChina
| | - Hongmei Li
- Department of EpidemiologySchool of Public Health, Medical College of Soochow UniversitySuzhouChina
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Leerkes EM, Buehler C, Calkins SD, Shriver LH, Wideman L. Protocol for iGrow (Infant Growth and Development Study): biopsychosocial predictors of childhood obesity risk at 2 years. BMC Public Health 2020; 20:1912. [PMID: 33317498 PMCID: PMC7734916 DOI: 10.1186/s12889-020-10003-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/03/2020] [Indexed: 11/26/2022] Open
Abstract
Background Childhood obesity remains a significant public health problem. To date, most research on the causes and correlates of obesity has focused on a small number of direct predictors of obesity rather than testing complex models that address the multifactorial nature of the origins of obesity in early development. We describe the rationale and methods of iGrow (Infant Growth and Development Study) which will test multiple pathways by which (a) prenatal maternal psychobiological risk predicts infant weight gain over the first 6 months of life, and (b) this early weight gain confers risk for obesity at age 2. Infant hormonal and psychobiological risk are proposed mediators from prenatal risk to early weight gain, though these are moderated by early maternal sensitivity and obesogenic feeding practices. In addition, higher maternal sensitivity and lower obesogenic feeding practices are proposed predictors of adaptive child self-regulation in the second year of life, and all three are proposed to buffer/reduce the association between high early infant weight gain and obesity risk at age 2. Methods iGrow is a prospective, longitudinal community-based study of 300 diverse mothers and infants to be followed across 5 data waves from pregnancy until children are age 2. Key measures include (a) maternal reports of demographics, stress, well-being, feeding practices and child characteristics and health; (b) direct observation of maternal and infant behavior during feeding, play, and distress-eliciting tasks during which infant heart rate is recorded to derive measures of vagal withdrawal; (c) anthropometric measures of mothers and infants; and (d) assays of maternal prenatal blood and infant saliva and urine. A host of demographic and other potential confounds will be considered as potential covariates in structural equation models that include tests of mediation and moderation. Efforts to mitigate the deleterious effects of COVID-19 on study success are detailed. Discussion This study has the potential to inform (1) basic science about early life processes casually related to childhood obesity and (2) development of targeted intervention and prevention approaches that consider mother, infant, and family risks and resources.
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Affiliation(s)
- Esther M Leerkes
- UNC Greensboro, Department of Human Development and Family Studies, Greensboro, NC, 27402-6170, USA.
| | - Cheryl Buehler
- UNC Greensboro, Department of Human Development and Family Studies, Greensboro, NC, 27402-6170, USA
| | - Susan D Calkins
- UNC Greensboro, Office of Research and Engagement, Greensboro, NC, 27402-6170, USA
| | - Lenka H Shriver
- UNC Greensboro, Department of Nutrition, Greensboro, NC, 27402-6170, USA
| | - Laurie Wideman
- UNC Greensboro, Department of Kinesiology, Greensboro, NC, 27402-6170, USA
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6
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Daundasekara SS, O’Connor DP, Berger Cardoso J, Ledoux T, Hernandez DC. Risk of Excess and Inadequate Gestational Weight Gain among Hispanic Women: Effects of Immigration Generational Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186452. [PMID: 32899746 PMCID: PMC7560227 DOI: 10.3390/ijerph17186452] [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: 07/14/2020] [Revised: 08/24/2020] [Accepted: 09/02/2020] [Indexed: 11/16/2022]
Abstract
There is a dearth of information on the risk of inadequate and excess gestational weight gain (GWG) among different generations of Hispanic women in the United States. Therefore, the objective of this study was to understand the relationship of GWG and immigration across three generations of Hispanic women. The study was conducted using data from National Longitudinal Survey of Youth 1979 (NLSY79). The study sample included 580 (unweighted count) women (148 first-generation, 117 second-generation, and 315 third-/higher-generation). Sociodemographic and immigration data were extracted from the main NLSY79 survey, and pregnancy data were extracted from the child/young adult survey following the biological children born to women in NLSY79. Covariate adjusted weighted logistic regression models were conducted to assess the risk of inadequate and excess GWG among the groups. Average total GWG was 14.98 kg, 23% had inadequate GWG, and 50% had excess GWG. After controlling for the covariates, there was no difference in the risk of inadequate GWG between the three generations. First-generation women (OR = 0.47, p = 0.039) and third-/higher-generation women (OR = 0.39, p = 0.004) had significantly lower risk of excess GWG compared to second-generation women. It is important to recognize the generational status of Hispanic women as a risk factor for excess GWG.
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Affiliation(s)
- Sajeevika S. Daundasekara
- Department of Health & Human Performance, The University of Houston, Houston, TX 77204, USA; (S.S.D.); (D.P.O.); (T.L.)
| | - Daniel P. O’Connor
- Department of Health & Human Performance, The University of Houston, Houston, TX 77204, USA; (S.S.D.); (D.P.O.); (T.L.)
- HEALTH Research Institute, The University of Houston, Houston, TX 77204, USA
| | - Jodi Berger Cardoso
- Graduate College of Social Work, The University of Houston, Houston, TX 77204, USA;
| | - Tracey Ledoux
- Department of Health & Human Performance, The University of Houston, Houston, TX 77204, USA; (S.S.D.); (D.P.O.); (T.L.)
| | - Daphne C. Hernandez
- Department of Research, Cizik School of Nursing, University of Texas Health Science Center, Houston, TX 77030, USA
- Correspondence: ; Tel.: +713-500-2052
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dos Santos CS, Picoito J, Nunes C, Loureiro I. Early Individual and Family Predictors of Weight Trajectories From Early Childhood to Adolescence: Results From the Millennium Cohort Study. Front Pediatr 2020; 8:417. [PMID: 32850533 PMCID: PMC7431491 DOI: 10.3389/fped.2020.00417] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 06/17/2020] [Indexed: 01/22/2023] Open
Abstract
Background: Early infancy and childhood are critical periods in the establishment of lifelong weight trajectories. Parents and early family environment have a strong effect on children's health behaviors that track into adolescence, influencing lifelong risk of obesity. Objective: We aimed to identify developmental trajectories of body mass index (BMI) from early childhood to adolescence and to assess their early individual and family predictors. Methods: This was a secondary analysis of the Millennium Cohort Study and included 17,165 children. Weight trajectories were estimated using growth mixture modeling based on age- and gender-specific BMI Z-scores, followed by a bias-adjusted regression analysis. Results: We found four BMI trajectories: Weight Loss (69%), Early Weight Gain (24%), Early Obesity (3.7%), and Late Weight Gain (3.3%). Weight trajectories were mainly settled by early adolescence. Lack of sleep and eating routines, low emotional self-regulation, child-parent conflict, and low child-parent closeness in early childhood were significantly associated with unhealthy weight trajectories, alongside poverty, low maternal education, maternal obesity, and prematurity. Conclusions: Unhealthy BMI trajectories were defined in early and middle-childhood, and disproportionally affected children from disadvantaged families. This study further points out that household routines, self-regulation, and child-parent relationship are possible areas for family-based obesity prevention interventions.
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Affiliation(s)
- Constança Soares dos Santos
- Department of Pediatrics, Centro Hospitalar Universitário Cova da Beira, Covilha, Portugal
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - João Picoito
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
- Department of Child and Adolescent Psychiatry, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Carla Nunes
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Isabel Loureiro
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
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Naets T, Vervoort L, Tanghe A, De Guchtenaere A, Braet C. Maladaptive Eating in Children and Adolescents With Obesity: Scrutinizing Differences in Inhibition. Front Psychiatry 2020; 11:309. [PMID: 32425824 PMCID: PMC7212434 DOI: 10.3389/fpsyt.2020.00309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/27/2020] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION In order to grasp the complex etiology of childhood obesity, we aim to clarify the relationship between external eating and weight. Based on theory and empirical evidence, we claim that inhibition is an important moderator in this association. In our first research question we expected that high external eating would be related to a higher weight status, especially for those with high inhibition problems. Secondly, we explored the moderating role of inhibition in the association between external eating and weight change after a multidisciplinary obesity treatment. METHOD We investigated n=572 participants (51% boys, aged 7-19) with moderate to extreme obesity recruited in a Belgian inpatient treatment center. At intake, parents reported on inhibition (BRIEF), while the children and adolescents reported on their eating behavior (DEBQ). Weight and length were objectively measured pre and post treatment (ADJUSTED BMI). Two hierarchical linear regression models were built to scrutinize the influence of inhibition on the association between external eating and both baseline weight and weight change. RESULTS First, predicting baseline weight, we found no significant moderating effect of inhibition problems. Second, predicting weight loss, inhibition turned out to be a substantial moderator, specifically in adolescents. Some unexpected gender differences occurred in favor of adolescent boys, in a way that those with high external eating and low inhibition problems lost most weight. CONCLUSION Inhibition problems act as a moderator explaining weight loss, but this only holds for adolescents. This suggests that external eating and inhibition play a complex role in weight loss in certain age and gender categories, and stresses the importance of identifying subgroups for tailoring interventions. For those with high inhibition problems, interventions aimed at increasing inhibition skills might be needed to optimize treatment outcomes.
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Affiliation(s)
- Tiffany Naets
- Clinical Child and Adolescent Psychology (CCAP) Lab, Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Leentje Vervoort
- Clinical Child and Adolescent Psychology (CCAP) Lab, Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Ann Tanghe
- Obesity Department, Zeepreventorium vzw, De Haan, Belgium
| | | | - Caroline Braet
- Clinical Child and Adolescent Psychology (CCAP) Lab, Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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Häkkänen P, But A, Ketola E, Laatikainen T. Distinct age-related patterns of overweight development to guide school healthcare interventions. Acta Paediatr 2020; 109:807-816. [PMID: 31560787 DOI: 10.1111/apa.15036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 09/23/2019] [Accepted: 09/26/2019] [Indexed: 12/21/2022]
Abstract
AIM We aimed to identify groups of primary school children with similar overweight development, reveal age-related patterns of overweight development in the resulting groups and analyse overweight-related school healthcare interventions. METHODS This retrospective longitudinal register study utilised electronic health records from six primary school years. From a random sample of 2000 sixth graders, we derived a study cohort of 508 children meeting criteria for overweight at least once during primary school. We investigated how many different groups (latent classes) of children with similar weight development would emerge by applying flexible latent class mixed models on body mass index standard deviation score. We also explored the resulting groups with respect to offered overweight-related interventions. RESULTS Per child, the data consisted in median 7 growth measurements over 5.4 years. We identified five overweight development groups for girls and four for boys. The groups converged temporarily around age 10 after which only some continued into obesity. School nurses and physicians offered overweight-related interventions to children with obesity, less to children gaining weight or with overweight. CONCLUSION Obesity prevention might benefit from awareness of typical overweight development patterns when designing intervention studies or planning and timing multidisciplinary school health check programmes.
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Affiliation(s)
- Paula Häkkänen
- Social Services and Health Care Division School and Student Welfare Helsinki Finland
- Department of General Practice and Primary Health Care University of Helsinki Helsinki Finland
| | - Anna But
- Department of Public Health University of Helsinki Helsinki Finland
| | - Eeva Ketola
- Information Services National Institute for Health and Welfare Helsinki Finland
| | - Tiina Laatikainen
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
- Siun Sote – The Joint Municipal Authority for North Karelia Social and Health Services Joensuu Finland
- Department of Public Health Solutions National Institute for Health and Welfare Helsinki Finland
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Ester WA, Jansen PW, Hoek HW, Verhulst FC, Jaddoe VW, Marques AH, Tiemeier H, Susser ES, Roza SJ. Fetal size and eating behaviour in childhood: a prospective cohort study. Int J Epidemiol 2020; 48:124-133. [PMID: 30508111 DOI: 10.1093/ije/dyy256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although studies showed that an adverse intrauterine environment increases the obesity risk in adulthood, little is known about consequences of fetal growth and birth size for eating behaviour. We examined whether fetal and birth size are associated with childhood eating behaviour. METHODS Participants were 4350 mother-child dyads of the prospective cohort study Generation R. We assessed the relation between fetal and birth size measurements with child eating behaviour at age 4 years by maternal report on the Child Eating Behaviour Questionnaire. Child body mass index (BMI) was measured at age 2 years. RESULTS Per one standard deviation (SD) larger birthweight, children scored lower on Satiety Responsiveness [-0.29 points; 95% confidence interval (CI): -0.39; -0.18], higher on Food Responsiveness (0.28 points; 95% CI: 0.17; 0.39) and on Enjoyment of Food (0.21 points; 95% CI: 0.12; 0.31) at age 4 years. Similar associations were found in late pregnancy. Per one SD increase in fetal growth from late pregnancy to birth, children scored lower on Satiety Responsiveness (-0.15 points; 95% CI: -0.26; -0.04). Children within the 10% highest birthweight scored higher on food approach and lower on food avoidant scales, whereas associations in children within the 10% lowest birthweights were absent. Although child BMI partly mediated the association, direct effects of birthweight on appetitive traits remained. CONCLUSIONS This study indicates that fetal size, especially being large in utero, is associated with obesity-inducing eating behaviour. Our findings point to intrauterine influences on appetite and satiety, and contribute to understanding the complex aetiology of obesity.
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Affiliation(s)
- Wietske A Ester
- Parnassia Psychiatric Institute, The Hague, The Netherlands.,Department of Epidemiology, Columbia University, New York, NY, USA
| | - Pauline W Jansen
- Department of Child and Adolescent Psychiatry & Psychology, Erasmus MC, Rotterdam, The Netherlands.,Department of Psychology, Education and Child Studies, Erasmus University, Rotterdam, The Netherlands
| | - Hans W Hoek
- Parnassia Psychiatric Institute, The Hague, The Netherlands.,Department of Epidemiology, Columbia University, New York, NY, USA.,Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry & Psychology, Erasmus MC, Rotterdam, The Netherlands
| | - Vincent W Jaddoe
- Generation R Study Group, Erasmus MC-Sophia, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC-Sophia, Rotterdam, The Netherlands
| | - Andrea H Marques
- Department of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry & Psychology, Erasmus MC, Rotterdam, The Netherlands.,Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - Ezra S Susser
- Department of Epidemiology, Columbia University, New York, NY, USA.,New York State Psychiatric Institute, New York, NY, USA
| | - Sabine J Roza
- Department of Child and Adolescent Psychiatry & Psychology, Erasmus MC, Rotterdam, The Netherlands.,Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
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11
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Hannon BA, Teran-Garcia M, Nickols-Richardson SM, Musaad SMA, Villegas EM, Hammons A, Wiley A, Fiese BH. Implementation and Evaluation of the Abriendo Caminos Program: A Randomized Control Trial Intervention for Hispanic Children and Families. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:1211-1219. [PMID: 31706460 DOI: 10.1016/j.jneb.2019.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 08/22/2019] [Accepted: 08/26/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To describe the methodology of a family-focused, culturally tailored program, Abriendo Caminos, for the prevention of excess weight gain in children. DESIGN Randomized control trial with outcome assessment at pretest, posttest, and 6 months after intervention or abbreviated-attention control group. SETTING Community setting across 5 sites (Illinois, California, Iowa, Texas, and Puerto Rico). PARTICIPANTS Mexican American and Puerto Rican families (parent and 1 child aged 6-18 years). A sample size of 100 families (50 intervention and 50 control) per site (n = 500) will provide adequate power to detect intervention effects. INTERVENTION Families will participate in 6 weekly, 2-hour group workshops on nutrition education through combined presentations and activities, family wellness, and physical activity. MAIN OUTCOME MEASURES The primary outcome is prevention of excess weight gain in children; secondary outcomes include changes in child diet, specifically fruit, vegetable, and sugar-sweetened beverage consumption, and changes in parents' diets and improvement of family routines. Measures will be collected at baseline, postintervention, and 6 months after. ANALYSIS Modeling to assess changes within and between experimental groups will be checked using standard methods including assessment of model fit, influence diagnostics, adjusted R2, and multicollinearity. Significance of effects will be examined using Type III tests.
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Affiliation(s)
- Bridget A Hannon
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL
| | - Margarita Teran-Garcia
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL; Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL; University of Illinois Extension, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL; Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL.
| | - Sharon M Nickols-Richardson
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL; University of Illinois Extension, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL; Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL
| | - Salma M A Musaad
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL; Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL
| | - Elizabeth M Villegas
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL
| | - Amber Hammons
- Child and Family Science, California State University, Fresno, CA
| | - Angela Wiley
- Department of Human Development and Family Studies, Auburn University, Auburn, AL; Child and Family Science, California State University, Fresno, CA
| | - Barbara H Fiese
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL; Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL
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12
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Josey MJ, McCullough LE, Hoyo C, Williams-DeVane C. Overall gestational weight gain mediates the relationship between maternal and child obesity. BMC Public Health 2019; 19:1062. [PMID: 31391077 PMCID: PMC6686549 DOI: 10.1186/s12889-019-7349-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/22/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Approximately 17% of children in the U.S. are obese. Children that are overweight or obese are also more likely to be obese as adults and suffer from various chronic diseases and premature death. Maternal obesity can affect the weight status of her offspring through intrauterine mechanisms like excessive gestational weight gain (GWG). Current literature shows a positive association between maternal weight status and GWG on child obesity, yet the direct and indirect effects have not been decomposed or quantified. The purpose of this study was to estimate the effect of maternal obesity on child obesity, mediated by GWG, which is a modifiable risk factor. METHODS The study participants were a birth cohort of offspring from women who received prenatal care in the Duke/Durham Regional health care system in Durham, NC between 2005 and 2009. Anthropomorphic data was collected via electronic medical records (EMRs) during each voluntary visit to a health care facility. The exposure of interest was maternal obesity, measured by pre-pregnancy body mass index, the mediator was GWG, dichotomized into excessive and not excessive based on maternal prenatal BMI, and the outcome was child obesity at age 4, measured as BMI z-scores from the last recorded height and weight. A counterfactual theory-based product method analysis estimated the mediated effects of GWG, adjusted for maternal race, socioeconomic status, and smoking status. RESULTS Of the 766 children, 25% were overweight or obese, and among all mothers, 25 and 31% were overweight and obese, respectively. Maternal BMI was associated with an overall increase of 0.04 in offspring z-score. The proportion of the effect of maternal obesity on child age 4 obesity mediated by GWG was 8.1%. CONCLUSION GWG, in part, mediated the relationship between maternal BMI and childhood adiposity. Even when the mediator is fixed, children are at an increased risk of a higher BMI if the mother is obese. These findings highlight an important public health education opportunity to stress the impact of a pre-pregnancy weight and excessive GWG on the risk of child obesity for all mothers.
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Affiliation(s)
- Michele J. Josey
- Arnold School of Public Health, Department of Epidemiology & Biostatistics, University of South Carolina, 915 Greene Street, Columbia, SC USA
- Biomedical and Biological Sciences Department, Bioinformatics Genomics Computational Chemistry Core, Biomedical/Biotechnology Research Institute, North Carolina Central University, 1801 Fayetteville Street, Durham, NC USA
| | - Lauren E. McCullough
- Rollins School of Public Health, Department of Epidemiology, Emory University, 1518 Clifton Rd, NE, Atlanta, GA USA
| | - Cathrine Hoyo
- Department of Biological Sciences, Integrated Health Sciences Facility Core, Center for Human Health and The Environment, Epidemiology and Environment Epigenomics Laboratory, North Carolina State University, Raleigh, USA
| | - ClarLynda Williams-DeVane
- Biomedical and Biological Sciences Department, Bioinformatics Genomics Computational Chemistry Core, Biomedical/Biotechnology Research Institute, North Carolina Central University, 1801 Fayetteville Street, Durham, NC USA
- Department of Mathematics and Computer Science, Fisk University, 1000 17th Ave, Nashville, TN USA
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13
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Liu R, Shelton RC, Eldred-Skemp N, Goldsmith J, Suglia SF. Early Exposure to Cumulative Social Risk and Trajectories of Body Mass Index in Childhood. Child Obes 2019; 15:48-55. [PMID: 30362818 PMCID: PMC6338568 DOI: 10.1089/chi.2018.0116] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Childhood social risk has been associated with increased risk of childhood obesity. However, little is known about early exposure of cumulative social risk on BMI percentile (BMIp) trajectories in early childhood. METHODS Public data from the Fragile Families and Child Wellbeing Study were analyzed (N = 3809). Maternal reports of experiences of multiple social risk factors were obtained at age 1 and 3 assessments of children. Two cumulative social risk scores were calculated by summing social factors assessed at age 1 and at age 3. Child BMIp was assessed at ages 3, 5, and 9. Linear mixed models were used to examine the effect of cumulative social risk on sex-specific BMIp trajectories. RESULTS Compared with girls experiencing low social risk at either age 1 or 3, girls experiencing high social risk (≥ 2 factors) at age 1 or 3 only had higher initial BMIp at age 3 [β0 = 5.70 (95% confidence interval, CI: 0.15-1.26) and 1.37 (95% CI: -2.25 to 4.99), respectively] and had nonsignificantly greater BMIp growth rate [β1 = 0.39 (95% CI: -0.86 to 1.63) and 0.32 (95% CI: -0.86 to 1.63)]. Girls experiencing high social risk at both ages had nonsignificantly but consistently lower BMIp [β1 = -1.24 (95% CI: -2.93 to 0.46)]. In addition, girls experiencing a sum of ≥4 risk factors at both ages had lower BMIp growth rate [β1 = -1.77 (95% CI: -3.39 to -0.15)] compared to girls experiencing no risk factor. No associations were observed among boys. CONCLUSIONS Early exposure to cumulative social risk may have long-term impact on BMIp trajectories among girls, depending on timing of exposure. Understanding the effect of cumulative social risk in different contexts, including sex, chronicity, and timing of exposure, may have practical implications for informing effective intervention to combat childhood obesity.
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Affiliation(s)
- Rongzhe Liu
- Department of Epidemiology, Columbia University, New York, NY
| | - Rachel C. Shelton
- Department of Sociomedical Sciences, Columbia University, New York, NY
| | | | - Jeff Goldsmith
- Department of Biostatistics Mailman School of Public Health, Columbia University, New York, NY
| | - Shakira F. Suglia
- Department of Sociomedical Sciences, Columbia University, New York, NY.,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.,Address correspondence to: Shakira F. Suglia, ScD, Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Room 4005, Atlanta, GA 30318
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14
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Magalhães EIDS, Sousa BAD, Lima NP, Horta BL. Maternal smoking during pregnancy and offspring body mass index and overweight: a systematic review and meta-analysis. CAD SAUDE PUBLICA 2019; 35:e00176118. [DOI: 10.1590/0102-311x00176118] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 08/02/2019] [Indexed: 08/30/2023] Open
Abstract
Abstract: The present study aimed to conduct a systematic review and meta-analysis to evaluate the evidence on the association of maternal smoking during pregnancy with offspring body composition in childhood, adolescence and adulthood. MEDLINE, Web of Science and LILACS databases were searched. Reference lists were also screened. We included original studies, conducted in humans, that assessed the association of maternal smoking during pregnancy with offspring body mass index (BMI) and overweight in childhood, adolescence and adulthood, published through May 1st, 2018. A meta-analysis was used to estimate pooled effect sizes. The systematic review included 64 studies, of which 37 evaluated the association of maternal smoking during pregnancy with overweight, 13 with BMI, and 14 evaluated both outcomes. Of these 64 studies, 95 measures of effect were extracted and included in the meta-analysis. We verified that the quality of evidence across studies regarding maternal smoking in pregnancy and overweight and BMI of offspring to be moderate and low, respectively. Most studies (44 studies) were classified as moderate risk bias. Heterogeneity among studies included was high and, in the random-effects pooled analysis, maternal smoking during pregnancy increased the odds of offspring overweight (OR: 1.43, 95%CI: 1.35; 1.52) and mean difference of BMI (β: 0.31, 95%CI: 0.23; 0.39). In conclusion, offspring of mothers who smoked during pregnancy have higher odds of overweight and mean difference of BMI, and these associations persisted into adulthood.
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15
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Albers L, Sobotzki C, Kuß O, Ajslev T, Batista RF, Bettiol H, Brabin B, Buka SL, Cardoso VC, Clifton VL, Devereux G, Gilman SE, Grzeskowiak LE, Heinrich J, Hummel S, Jacobsen GW, Jones G, Koshy G, Morgen CS, Oken E, Paus T, Pausova Z, Rifas-Shiman SL, Sharma AJ, da Silva AA, Sørensen TI, Thiering E, Turner S, Vik T, von Kries R. Maternal smoking during pregnancy and offspring overweight: is there a dose-response relationship? An individual patient data meta-analysis. Int J Obes (Lond) 2018; 42:1249-1264. [PMID: 29717267 DOI: 10.1038/s41366-018-0050-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/13/2017] [Accepted: 12/27/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND/OBJECTIVES A number of meta-analyses suggest an association between any maternal smoking in pregnancy and offspring overweight obesity. Whether there is a dose-response relationship across number of cigarettes and whether this differs by sex remains unclear. SUBJECT/METHODS Studies reporting number of cigarettes smoked during pregnancy and offspring BMI published up to May 2015 were searched. An individual patient data meta-analysis of association between the number of cigarettes smoked during pregnancy and offspring overweight (defined according to the International Obesity Task Force reference) was computed using a generalized additive mixed model with non-linear effects and adjustment for confounders (maternal weight status, breastfeeding, and maternal education) and stratification for sex. RESULTS Of 26 identified studies, 16 authors provided data on a total of 238,340 mother-child-pairs. A linear positive association was observed between the number of cigarettes smoked and offspring overweight for up to 15 cigarettes per day with an OR increase per cigarette of 1.03, 95% CI = [1.02-1.03]. The OR flattened with higher cigarette use. Associations were similar in males and females. Sensitivity analyses supported these results. CONCLUSIONS A linear dose-response relationship of maternal smoking was observed in the range of 1-15 cigarettes per day equally in boys and girls with no further risk increase for doses above 15 cigarettes.
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Affiliation(s)
- Lucia Albers
- Division of Epidemiology, Institute of Social Paediatrics and Adolescents Medicine, Ludwig-Maximilians-University Munich, Munich, Germany.
| | - Christina Sobotzki
- Division of Epidemiology, Institute of Social Paediatrics and Adolescents Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Oliver Kuß
- German Diabetes Center, Institute of Biometrics and Epidemiology, Düsseldorf, 40225, Germany
| | - Teresa Ajslev
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Bispebjerg and Frederiksberg Hospitals, The Capital Region, Denmark
| | - Rosangela Fl Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - Heloisa Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Bernard Brabin
- Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK.,Department of Community Child Health,Royal Liverpool Children's Hospital, NHS Trust Alder Hey, Liverpool, UK.,Emma Kinderziekenhuis, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Stephen L Buka
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Viviane C Cardoso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Vicki L Clifton
- Adelaide Medical School, The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | | | - Stephen E Gilman
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.,Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Luke E Grzeskowiak
- Adelaide Medical School, The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Joachim Heinrich
- Institute of Occupational, Social, and Environmental Medicine, University Hospital, Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Occupational, Social, and Environmental Medicine, University Hospital, Neuherberg, Germany
| | - Sandra Hummel
- Forschergruppe Diabetes der Technischen Universität München, Munich, Germany.,Institut für Diabetesforschung der Forschergruppe Diabetes e.V. am Helmholtz Zentrum München, Munich, Germany
| | - Geir W Jacobsen
- Department of Public Health and General Practice, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Gibby Koshy
- Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Camilla Schmidt Morgen
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Bispebjerg and Frederiksberg Hospitals, The Capital Region, Denmark
| | - Emily Oken
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Tomas Paus
- Rotman Research Institute and Departments of Psychology and Psychiatry, University of Toronto, Toronto, Canada
| | - Zdenka Pausova
- Hospital for Sick Children and Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, Canada
| | - Sheryl L Rifas-Shiman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | | | - Antônio Am da Silva
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - Thorkild Ia Sørensen
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Bispebjerg and Frederiksberg Hospitals, The Capital Region, Denmark.,Novo Nordisk Foundation Centre for Basic Metabolic Research, and Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth Thiering
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany
| | | | - Torstein Vik
- Department of Laboratory Medicine, Children and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Rüdiger von Kries
- Division of Epidemiology, Institute of Social Paediatrics and Adolescents Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
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16
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Kerr JA, Long C, Clifford SA, Muller J, Gillespie AN, Donath S, Wake M. Early-life exposures predicting onset and resolution of childhood overweight or obesity. Arch Dis Child 2017; 102:915-922. [PMID: 28235833 DOI: 10.1136/archdischild-2016-311568] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 01/30/2017] [Accepted: 02/01/2017] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To determine which of multiple early-life exposures predict onset or resolution of overweight/obesity during a 9-year period. METHODS Design: longitudinal cohort from three harmonised community-based cohorts enriched for overweight and obesity. Early-life exposures: child-gestational age; delivery; birth weight; breast feeding; solids introduction; baseline body mass index (BMI); waist circumference; diet; activity; global, physical and psychosocial health. Mother-baseline BMI; education; age; neighbourhood disadvantage; concern for child's weight. Outcome: change in BMI category. Analyses: adjusted logistic regression. RESULTS On average, the 363 children (57% retention) were 6 and 15 years old at baseline and follow-up. Children were classified as 'never' overweight/obese (38%), 'resolving' overweight/obese (15%), 'becoming' overweight/obese (8%) or 'always' overweight/obese (39%). Compared with 'never overweight/obese' children, odds of 'becoming overweight/obese' were greater with higher child (OR 2.33, 95% CI 1.02 to 5.29) and maternal BMI (OR 1.18, CI 1.07 to 1.31), and lower with higher maternal education (OR 0.09, CI 0.02 to 0.34). Compared with 'always overweight/obese' children, odds of 'resolving overweight/obese' were lower with higher maternal BMI (OR 0.87, CI 0.78 to 0.97), and higher with better child physical health (OR 1.06, CI 1.02 to 1.10) and higher maternal age (OR 1.11, CI 1.01 to 1.22) and education (OR 4.07, CI 1.02 to 16.19). CONCLUSIONS Readily available baseline information (child/maternal BMI, maternal age, education and child health) were the strongest predictors of both onset and resolution of overweight/obesity between the primary school and adolescent years. Perinatal, breastfeeding and lifestyle exposures were not strongly predictive. Results could stimulate development of algorithms identifying children most in need of targeted prevention or treatment.
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Affiliation(s)
- Jessica A Kerr
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Catherine Long
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Susan A Clifford
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Joshua Muller
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Alanna N Gillespie
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Susan Donath
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Department of Paediatrics & Liggins Institute, University of Auckland, Grafton, Auckland, New Zealand
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17
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Musaad SMA, Speirs KE, Hayes JT, Mobley AR, Fitzgerald N, Jones BL, VanBrackle A, Sigman-Grant M. The impact of environmental, parental and child factors on health-related behaviors among low-income children. Appetite 2017; 112:260-271. [PMID: 28159663 DOI: 10.1016/j.appet.2017.01.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 01/26/2017] [Accepted: 01/27/2017] [Indexed: 12/19/2022]
Abstract
Multi-level factors act in concert to influence child weight-related behaviors. This study examined the simultaneous impact of variables obtained at the level of the home environment (e.g., mealtime ritualization), parent (e.g., modeling) and child (e.g., satiety responsiveness) with the outcomes of practicing healthy and limiting unhealthy child behaviors (PHCB and LUCB, respectively) in a low-income U.S. SAMPLE This was a cross sectional study of caregivers of preschool children (n = 432). Caregivers were interviewed using validated scales. Structural equation modeling was used to examine associations with the outcomes. Adjusting for study region, demographics and caregiver's body mass index, we found significant associations between PHCB and higher mealtime ritualizations (β: 0.21, 95% confidence interval [CI]: 0.11; 0.32, more parental modeling (β: 0.39, 95% CI: 0.27; 0.49) and less parental restrictive behavior (β: -0.19, 95% CI: -0.29; -0.10). More parental covert control (β: 0.44, 95% CI: 0.35; 0.54), more parental overt control (β: 0.14, 95% CI: 0.03; 0.25) and less parental permissive behavior (β: -0.25, 95% CI: -0.34; -0.09) were significantly associated with LUCB. Findings suggest the synergistic effects of mealtime ritualizations and covert control at the environmental-level and parental modeling, overt control, restrictive and permissive behavior at the parent-level on the outcomes. Most factors are modifiable and support multidisciplinary interventions that promote healthy child weight-related behaviors.
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Affiliation(s)
- Salma M A Musaad
- Family Resiliency Center, Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, 2031 Doris Kelley Christopher Hall, 904 W. Nevada, Urbana, IL 61801, USA.
| | - Katherine E Speirs
- Department of Family Studies and Human Development, Norton School of Family and Consumer Sciences, University of Arizona, 650 N Park Ave, 315-L McClelland Park, Tucson, AZ, 85721-0078, USA.
| | - Jenna T Hayes
- University of Nevada, Reno, Human Development and Family Studies, 1664 N. Virginia St./Mail Stop 0140, Reno, NV 89557, USA.
| | - Amy R Mobley
- Department of Nutritional Sciences, University of Connecticut, 3624 Horsebarn Road Extension Unit 4017, Storrs, CT 06269-4017, USA.
| | - Nurgul Fitzgerald
- Department of Nutritional Sciences, Rutgers, The State University of New Jersey, 26 Nichol Avenue, Room 229A, New Brunswick, NJ 08901, USA.
| | - Blake L Jones
- Department of Human Development and Family Studies, Purdue University, 1202 W. State St., West Lafayette, IN 47907-2055, USA.
| | - Angela VanBrackle
- University of Nevada, Reno Cooperative Extension, 8050 Paradise Rd., Suite 100, Las Vegas, NV 89123, USA.
| | - Madeleine Sigman-Grant
- University of Nevada, Reno Cooperative Extension, 8050 Paradise Rd., Suite 100, Las Vegas, NV 89123, USA.
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18
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Identifying developmental trajectories of body mass index in childhood using latent class growth (mixture) modelling: associations with dietary, sedentary and physical activity behaviors: a longitudinal study. BMC Public Health 2016; 16:1128. [PMID: 27793201 PMCID: PMC5086035 DOI: 10.1186/s12889-016-3757-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 10/08/2016] [Indexed: 12/28/2022] Open
Abstract
Background To date, many epidemiologic studies examining associations between obesity and dietary and sedentary/physical activity behaviors have focused on assessing Body Mass Index (BMI) at one point in time. Recent developments in statistical techniques make it possible to study the potential heterogeneity in the development of BMI during childhood by identifying distinct subpopulations characterized by distinct developmental trajectories. Using Latent Class Growth (Mixture) Modelling (LCGMM) techniques we aimed to identify BMI trajectories in childhood and to examine associations between these distinct trajectories and dietary, sedentary and physical activity behaviors. Methods This longitudinal study explored BMI standard deviation score (SDS) trajectories in a sample of 613 children from 4 to 12 years of age. In 2006, 2009 and 2012 information on children’s health related behaviors was obtained by parental questionnaires, and children’s height and weight were measured. Associations with behaviors were investigated with logistic regression models. Results We identified two BMI SDS trajectories; a decreasing BMI SDS trajectory (n = 416; 68 %) and an increasing BMI SDS trajectory (n = 197; 32 %). The increasing BMI SDS trajectory consisted of more participants of lower socio-economic status (SES) and of non-western ethnicity. Maternal overweight status was associated with being in the increasing BMI SDS trajectory at both baseline and follow-up six years later (2006: Odds Ratio (OR), 2.9; 95 % confidence interval (CI) 1.9 to 4.3; 2012 OR, 1.8; 95 % CI 1.2 to 2.6). The increasing BMI SDS trajectory was associated with the following behaviors; drinking sugared drinks > 3 glasses per day, participation in organized sports < 1 h per week, and TV viewing > 2 h per day, though participation in organized sports at follow-up was the only significant result. Conclusions Our results indicate the importance of healthy lifestyle behaviors at a young age, and indicate that maternal BMI is a very important risk factor for the development of childhood overweight. Comprehension of heterogeneity in the development of BMI and associations with modifiable health related behaviors is interesting for prevention by targeting high risk behaviors in early childhood, especially in low SES children, children of non-western ethnicity and children whose mother is overweight. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3757-7) contains supplementary material, which is available to authorized users.
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19
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van Ekris E, Altenburg TM, Singh AS, Proper KI, Heymans MW, Chinapaw MJM. An evidence-update on the prospective relationship between childhood sedentary behaviour and biomedical health indicators: a systematic review and meta-analysis. Obes Rev 2016; 17:833-49. [PMID: 27256486 DOI: 10.1111/obr.12426] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/06/2016] [Accepted: 04/18/2016] [Indexed: 12/01/2022]
Abstract
Evidence for adverse health effects of excessive sedentary behaviour in children is predominantly based on cross-sectional studies, measuring TV viewing as proxy for sedentary behaviour. This systematic review and meta-analysis summarizes the evidence on the prospective relationship between childhood sedentary behaviour and biomedical health indicators, overall and stratified by type of sedentary behaviour (TV viewing, computer use/games, screen time and objective sedentary time). PubMed, EMBASE, PsycINFO and Cochrane were systematically searched till January 2015. Methodological quality of all included studies was scored, and a best evidence synthesis was applied. We included 109 studies of which 19 were of high quality. We found moderate-to-strong evidence for a relationship of overall sedentary time with some anthropometrics (overweight/obesity, weight-for-height), one cardiometabolic biomarker (HDL-cholesterol) and some fitness indicators (fitness, being unfit). For other health indicators, we found no convincing evidence because of inconsistent or non-significant findings. The evidence varied by type of sedentary behaviour. The meta-analysis indicated that each additional baseline hour of TV viewing (β = 0.01, 95%CI = [-0.002; 0.02]) or computer use (β = 0.00, 95%CI = [-0.004; 0.01]) per day was not significantly related with BMI at follow-up. We conclude that the evidence for a prospective relationship between childhood sedentary behaviour and biomedical health is in general unconvincing.
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Affiliation(s)
- E van Ekris
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - T M Altenburg
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - A S Singh
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - K I Proper
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - M W Heymans
- Department of Epidemiology and Biostatistics, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - M J M Chinapaw
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
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20
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Blewitt C, Bergmeier H, Macdonald JA, Olsson CA, Skouteris H. Associations between parent-child relationship quality and obesogenic risk in adolescence: a systematic review of recent literature. Obes Rev 2016; 17:612-22. [PMID: 27125464 DOI: 10.1111/obr.12413] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 02/12/2016] [Accepted: 02/12/2016] [Indexed: 01/17/2023]
Abstract
Adolescence is a period of significant cognitive, social and physiological change, presenting unique risk factors for weight gain. Childhood obesity research has traditionally focused on the influence of parent-level factors on children's eating and weight status. Increasingly, emphasis is turning towards the reciprocal nature of the parent-child relationship and its influence on health behaviour. A systematic literature review was conducted to investigate the relationship between parent-child relationship quality (defined as the felt emotional bond between parent and child) and obesogenic risk (weight status, eating attitudes and behaviours, level of physical activity and sedentary behaviour) in adolescence; 26 papers were included in the review. The results neither support nor challenge an association between parent-child relationship quality and weight, with study design flaws and limited measurement of the parent-child relationship precluding robust conclusions. The review does however suggests that several aspects of the parent-child relationship are important in understanding eating attitudes and behaviours, including the felt emotional bond between the parent and child, the child's perception of how much the parent cares for them and the mother's sensitivity towards the child. The need for further longitudinal research into the association between parent-child relationship quality and obesity risk across this developmental period is discussed.
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Affiliation(s)
- Claire Blewitt
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia
| | - Heidi Bergmeier
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia
| | - Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia.,Murdoch Childrens Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Craig A Olsson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia.,Murdoch Childrens Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Helen Skouteris
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia
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