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Li N, Li J, Wang H, Qiao Y, Li W, Gao M, Liu E, Yu Z, Hu G, Fang Z, Leng J, Yang X. Serum Sulfur-Containing Amino Acids and Risk of Maternal Gestational Diabetes and Adverse Growth Patterns in Offspring. Nutrients 2023; 15:4089. [PMID: 37764871 PMCID: PMC10537007 DOI: 10.3390/nu15184089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND To estimate associations of sulfur-containing amino acids (SAAs) in the early trimester of pregnancy and gestational diabetes mellitus (GDM) and estimate associations of maternal SAAs with adverse growth patterns in offspring. METHODS We established a 1:1 matched case-control study (n = 486) from our cohort of pregnant women, and 401 children were followed up at ages 1 to 8 years. We conducted binary conditional logistic regression to estimate the risk associations of serum SAAs with GDM. Multinomial logistic regression was implemented to explore associations of maternal SAAs with adverse growth patterns in the offspring. RESULTS High serum methionine and cystine were independently associated with increased GDM risk (OR: 1.92, 95%CI: 1.18-3.13 and 2.69, 1.59-4.53). Conversely, a low level of serum taurine was independently associated with increased GDM risk (2.61, 1.64-4.16). Maternal high cystine and low taurine were also associated with an increased risk of persistent obesity growth pattern (POGP) in offspring (OR: 2.79, 95%CI: 1.09-7.17 and 3.92, 1.11-13.89) and the effect was largely independent of GDM. CONCLUSIONS High serum methionine, cystine and low serum taurine in the early trimester of pregnancy were associated with a greatly increased risk of GDM. Maternal high cystine and low taurine were associated with elevated risk of offspring POGP, largely independent of GDM.
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Affiliation(s)
- Ninghua Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China; (N.L.); (J.L.); (H.W.); (M.G.)
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China; (N.L.); (J.L.); (H.W.); (M.G.)
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China;
- Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Hui Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China; (N.L.); (J.L.); (H.W.); (M.G.)
| | - Yijuan Qiao
- Project Office, Tianjin Women and Children’s Health Center, Tianjin 300070, China; (Y.Q.); (W.L.); (E.L.)
| | - Weiqin Li
- Project Office, Tianjin Women and Children’s Health Center, Tianjin 300070, China; (Y.Q.); (W.L.); (E.L.)
| | - Ming Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China; (N.L.); (J.L.); (H.W.); (M.G.)
| | - Enqing Liu
- Project Office, Tianjin Women and Children’s Health Center, Tianjin 300070, China; (Y.Q.); (W.L.); (E.L.)
| | - Zhijie Yu
- Population Cancer Research Program and Department of Pediatrics, Dalhousie University, Halifax, NS 15000, Canada;
| | - Gang Hu
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA;
| | - Zhongze Fang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China;
- Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Junhong Leng
- Project Office, Tianjin Women and Children’s Health Center, Tianjin 300070, China; (Y.Q.); (W.L.); (E.L.)
| | - Xilin Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China; (N.L.); (J.L.); (H.W.); (M.G.)
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China;
- Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
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Xu P, Hu J, Chen H, Cai W. SMAX1 interacts with DELLA protein to inhibit seed germination under weak light conditions via gibberellin biosynthesis in Arabidopsis. Cell Rep 2023; 42:112740. [PMID: 37405917 DOI: 10.1016/j.celrep.2023.112740] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 01/11/2023] [Accepted: 06/19/2023] [Indexed: 07/07/2023] Open
Abstract
Karrikins (KARs) were first identified as a class of small-molecule chemicals derived from smoke that promote seed germination. However, the implied mechanism is still not well understood. Here, we find that KAR signaling mutants have a lower germination percentage than that of wild type under weak light conditions, and KARs promote seed germination through transcriptional activation of gibberellin (GA) biosynthesis via SMAX1. SMAX1 interacts with the DELLA proteins REPRESSOR of ga1-3-LIKE 1 (RGL1) and RGL3. The interaction enhances the transcriptional activity of SMAX1 and inhibits GIBBERELLIN 3-oxidase 2 (GA3ox2) gene expression. The KAR signaling mutant seed germination defect under weak light is partially rescued by exogenous application of GA3 or by GA3ox2 overexpression, and the rgl1 rgl3 smax1 triple mutant exhibits higher germination rates under weak light than the smax1 mutant. Thus, we show a crosstalk between KAR and GA signaling pathways via a SMAX1-DELLA module in regulating seed germination in Arabidopsis.
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Affiliation(s)
- Peipei Xu
- Laboratory of Photosynthesis and Environment, CAS Center for Excellence in Molecular Plant Sciences, Shanghai Institute of Plant Physiology and Ecology, Chinese Academy of Sciences, No. 300 Fenglin Road, Shanghai 200032, China; University of Chinese Academy of Sciences, Beijing 100039, China.
| | - Jinbo Hu
- Laboratory of Photosynthesis and Environment, CAS Center for Excellence in Molecular Plant Sciences, Shanghai Institute of Plant Physiology and Ecology, Chinese Academy of Sciences, No. 300 Fenglin Road, Shanghai 200032, China; University of Chinese Academy of Sciences, Beijing 100039, China
| | - Haiying Chen
- Laboratory of Photosynthesis and Environment, CAS Center for Excellence in Molecular Plant Sciences, Shanghai Institute of Plant Physiology and Ecology, Chinese Academy of Sciences, No. 300 Fenglin Road, Shanghai 200032, China
| | - Weiming Cai
- Laboratory of Photosynthesis and Environment, CAS Center for Excellence in Molecular Plant Sciences, Shanghai Institute of Plant Physiology and Ecology, Chinese Academy of Sciences, No. 300 Fenglin Road, Shanghai 200032, China.
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Gupta M, Phan TLT, Lê-Scherban F, Eckrich D, Bunnell HT, Beheshti R. Associations of longitudinal BMI percentile classification patterns in early childhood with neighborhood-level social determinants of health. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.06.08.23291145. [PMID: 37398451 PMCID: PMC10312866 DOI: 10.1101/2023.06.08.23291145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Background Understanding social determinants of health (SDOH) that may be risk factors for childhood obesity is important to developing targeted interventions to prevent obesity. Prior studies have examined these risk factors, mostly examining obesity as a static outcome variable. Objectives This study aimed to identify distinct subpopulations based on BMI percentile classification or changes in BMI percentile classifications over time and explore these longitudinal associations with neighborhood-level SDOH factors in children from 0 to 7 years of age. Methods Using Latent Class Growth (Mixture) Modelling (LCGMM) we identify distinct BMI% classification groups in children from 0 to 7 years of age. We used multinomial logistic regression to study associations between SDOH factors with each BMI% classification group. Results From the study cohort of 36,910 children, five distinct BMI% classification groups emerged: always having obesity (n=429; 1.16%), overweight most of the time (n=15,006; 40.65%), increasing BMI% (n=9,060; 24.54%), decreasing BMI% (n=5,058; 13.70%), and always normal weight (n=7,357; 19.89%). Compared to children in the decreasing BMI% and always normal weight groups, children in the other three groups were more likely to live in neighborhoods with higher rates of poverty, unemployment, crowded households, and single-parent households, and lower rates of preschool enrollment. Conclusions Neighborhood-level SDOH factors have significant associations with children's BMI% classification and changes in classification over time. This highlights the need to develop tailored obesity interventions for different groups to address the barriers faced by communities that can impact the weight and health of the children living within them.
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Affiliation(s)
- Mehak Gupta
- Computer & Info. Sciences, University of Delaware, Newark, DE 19716, USA
| | | | - Félice Lê-Scherban
- Epidemiology & Biostatistics, and Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA
| | | | | | - Rahmatollah Beheshti
- Computer & Info. Sciences, and Epidemiology, University of Delaware, Newark, DE 19716, USA
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4
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Budge M, Sharifi M, Maciejewski KR, Diehl D, Paige M, Nogelo P, Rosenthal MS, Fenick AM. A Mixed-Methods Analysis of a Special Supplemental Nutrition Program for Women, Infants, and Children and Primary Care Partnership to Promote Responsive Feeding for Infants in Group Well-Child Care. Acad Pediatr 2023; 23:304-313. [PMID: 36599376 DOI: 10.1016/j.acap.2022.12.017] [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: 08/23/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To evaluate the Healthy Eating through Group Well-Child Care (GWCC) intervention, a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and primary care partnership which seeks to promote responsive feeding practices among low-income caregivers, by examining its impact on infant growth and exploring the experiences of caregivers who participated in this intervention. METHODS Using a difference-in-differences approach, we examined change in weight-for-length among infants in GWCC before versus after implementation of the intervention compared with infants in individual well-child care (IWCC) over the same time-period. In parallel, we conducted semi-structured interviews in English and Spanish with caregivers who participated in the intervention to explore their perspectives and analyzed transcripts via the constant comparative method to identify salient themes. RESULTS Using electronic health record data from 279 GWCC and 6134 IWCC participants, we found no significant difference in first-year weight-for-length trajectory associated with participation in the intervention. We reached thematic saturation after 19 interviews with 22 caregivers and identified four major themes around feeding: 1) structural barriers limit access to healthy foods through WIC, 2) conflicting sources of nutrition advice challenge parental decision making, 3) exposure to novel foods facilitated further experimentation with healthier foods, and 4) discussion of responsive feeding facilitated awareness and adoption. CONCLUSIONS A primary care and WIC partnership to promote responsive feeding in the context of GWCC was well received by caregivers but was not associated with improved weight-for-length among infants. Structural barriers to implementing responsive feeding and healthy eating practices may have impacted lack of measurable results from the intervention.
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Affiliation(s)
| | - Mona Sharifi
- Department of Pediatrics, Yale School of Medicine (M Sharifi, MS Rosenthal, and AM Fenick), New Haven, Conn
| | - Kaitlin R Maciejewski
- Yale Center for Analytical Sciences, Yale School of Public Health (KR Maciejewski), New Haven, Conn
| | - Deborah Diehl
- WIC Program, Yale New Haven Health (D Diehl and M Paige), New Haven, Conn
| | - Mary Paige
- WIC Program, Yale New Haven Health (D Diehl and M Paige), New Haven, Conn
| | - Patricia Nogelo
- Social Work Department, Yale New Haven Hospital (P Nogelo), New Haven, Conn
| | - Marjorie S Rosenthal
- Department of Pediatrics, Yale School of Medicine (M Sharifi, MS Rosenthal, and AM Fenick), New Haven, Conn
| | - Ada M Fenick
- Department of Pediatrics, Yale School of Medicine (M Sharifi, MS Rosenthal, and AM Fenick), New Haven, Conn.
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5
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Jasper EA, Hellwege JN, Piekos JA, Jones SH, Hartmann KE, Mautz B, Aronoff DM, Edwards TL, Edwards DRV. Genetically-predicted placental gene expression is associated with birthweight and adult body mass index. Sci Rep 2023; 13:322. [PMID: 36609580 PMCID: PMC9822919 DOI: 10.1038/s41598-022-26572-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 12/16/2022] [Indexed: 01/09/2023] Open
Abstract
The placenta is critical to human growth and development and has been implicated in health outcomes. Understanding the mechanisms through which the placenta influences perinatal and later-life outcomes requires further investigation. We evaluated the relationships between birthweight and adult body mass index (BMI) and genetically-predicted gene expression in human placenta. Birthweight genome-wide association summary statistics were obtained from the Early Growth Genetics Consortium (N = 298,142). Adult BMI summary statistics were obtained from the GIANT consortium (N = 681,275). We used S-PrediXcan to evaluate associations between the outcomes and predicted gene expression in placental tissue and, to identify genes where placental expression was exclusively associated with the outcomes, compared to 48 other tissues (GTEx v7). We identified 24 genes where predicted placental expression was significantly associated with birthweight, 15 of which were not associated with birthweight in any other tissue. One of these genes has been previously linked to birthweight. Analyses identified 182 genes where placental expression was associated with adult BMI, 110 were not associated with BMI in any other tissue. Eleven genes that had placental gene expression levels exclusively associated with BMI have been previously associated with BMI. Expression of a single gene, PAX4, was associated with both outcomes exclusively in the placenta. Inter-individual variation of gene expression in placental tissue may contribute to observed variation in birthweight and adult BMI, supporting developmental origins hypothesis.
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Affiliation(s)
- Elizabeth A Jasper
- Vanderbilt Genetics Institute, Vanderbilt University, Nashville, TN, USA.
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA.
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Jacklyn N Hellwege
- Vanderbilt Genetics Institute, Vanderbilt University, Nashville, TN, USA
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Epidemiology Center, Vanderbilt University, Nashville, TN, USA
| | | | - Sarah H Jones
- Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Katherine E Hartmann
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Epidemiology Center, Vanderbilt University, Nashville, TN, USA
- Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brian Mautz
- Vanderbilt Genetics Institute, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Epidemiology Center, Vanderbilt University, Nashville, TN, USA
- Population Analytics, Analytics and Insights, Data Sciences, Janssen Research & Development, Spring House, PA, USA
| | - David M Aronoff
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Todd L Edwards
- Vanderbilt Genetics Institute, Vanderbilt University, Nashville, TN, USA
- Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Digna R Velez Edwards
- Vanderbilt Genetics Institute, Vanderbilt University, Nashville, TN, USA.
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA.
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.
- Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.
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Yoshinaga M, Takahashi H, Ito Y, Aoki M, Miyazaki A, Kubo T, Shinomiya M, Horigome H, Tokuda M, Lin L, Ogata H, Nagashima M. Developmental trajectories at a high risk for childhood overweight/obesity. Pediatr Int 2023; 65:e15425. [PMID: 36416571 DOI: 10.1111/ped.15425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 08/24/2022] [Accepted: 10/12/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The associations between developmental patterns (trajectories) in children and maternal factors have been widely investigated, but paternal effects on these trajectories are unclear. This study aimed to determine child and parental factors involved in developmental trajectories at high risk for causing adverse cardiovascular (CV) profiles in children. METHODS We analyzed longitudinal anthropometric data from birth to the present and CV profiles of 1,832 healthy volunteers (51% girls) aged 3-15 years who participated in a nationwide study between July 2012 and January 2014. Six trajectory latent class growth models were developed using body mass index z- scores. Predictors for being in developmental trajectories at high risk for causing adverse CV profiles were determined by multivariate regression analysis. RESULTS The mean±standard deviation number of anthropometric data points was 12±3 for both boys and girls. Among the six trajectories, the infantile onset and continual increase groups had significantly worse levels of many CV profiles than those in the remaining groups. Paternal overweight/obesity was an independent predictor for boys being in the infantile onset group and for girls being in the continual increase group. Additionally, maternal pre-pregnancy overweight/obesity in boys and maternal excessive gestational weight gain in girls were independent predictors for being in the infantile onset group. Having no sibling in boys and an older maternal age were independent predictors for being in the continual increase group. CONCLUSIONS Interventions to prevent childhood obesity should include strategies that focus on fathers and mothers as well as those that focus on children with certain types of familial background.
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Affiliation(s)
- Masao Yoshinaga
- Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan.,Orange Medical and Welfare Center for Severe Motor and Intellectual Disabilities, Kirishima, Japan
| | | | - Yoshiya Ito
- Clinical Medicine Area, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
| | - Machiko Aoki
- Department of Pediatrics, Aoki Internal Medicine and Cardiovascular and Pediatrics Clinic, Fukuoka, Japan
| | - Ayumi Miyazaki
- Department of Pediatrics, Japan Community Health Care Organization Takaoka Fushiki Hospital, Takaoka, Japan
| | - Toshihide Kubo
- Department of Pediatrics, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Masaki Shinomiya
- Department of Internal Medicine, Nishifuna Naika, Funabashi, Japan
| | - Hitoshi Horigome
- Department of Child Health, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | | | - Lisheng Lin
- Department of Child Health, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Hiromitsu Ogata
- Epidemiology and Biostatistics, Kagawa Nutrition University, Sakado, Japan
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Khalsa AS, Li R, Rausch J, Klebanoff MA, Ingol TT, Boone KM, Keim SA. Early childhood growth trajectories in a Medicaid population. Pediatr Obes 2022; 17:e12918. [PMID: 35307980 PMCID: PMC9357091 DOI: 10.1111/ijpo.12918] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 02/07/2022] [Accepted: 02/28/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Evidence on the role of early growth trajectories and later obesity risk is primarily based on privately insured or universally insured samples. OBJECTIVES We aimed to characterize and determine factors associated with early growth trajectories and estimate associations with overweight/obesity risk in a Medicaid-insured and uninsured cohort. METHODS Infants seen at a large pediatric academic centre in 2010-2016 were included. Weight and length/height measurements were converted to age and sex-specific BMI z-scores (BMIz) based on the World Health Organization (WHO) Growth Standards. Group-based trajectories were modelled using BMIz created groups. Logistic and log-binomial regression models estimated associations between membership in trajectories and maternal/child factors and overweight or obesity at 36, 48, and 60 months, separately. Analyses were performed between 2019 and 2021. RESULTS The best-fitting model identified five BMIz trajectories among 30 189 children and 310 113 clinical encounters; two trajectories showed rapid rise in BMIz. Lower maternal education, pre-pregnancy maternal overweight/obese status, and maternal smoking were positively associated with both rapid-rising BMIz trajectories. Children in either of the two rapid-rising trajectories were 3.00 (95% CI: 2.85, 3.25), 2.97 (95% CI: 2.77, 3.18) and 2.76 (95% CI: 2.53, 3.01) times more likely to have overweight or obesity at 36, 48, and 60 months, respectively compared to children in the stable trajectory groups. CONCLUSIONS Among Medicaid insured and uninsured children, several maternal and child characteristics were associated with early rapid-rise in BMIz. Clinical monitoring of early rapidly rising BMI may be important to address modifiable risk factors for obesity in families from low-income households.
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Affiliation(s)
- Amrik Singh Khalsa
- Division of Primary Care Pediatrics, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205
- Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital 700 Children’s Drive, Columbus, OH 43205
- Department of Pediatrics, College of Medicine, The Ohio State University 370 W. 9th Ave. Columbus, OH 43210
| | - Rui Li
- Department of Hematology, James Cancer Hospital & Solove Research Institute, The Ohio State University Wexner Medical Center 460 W 10th Ave, Columbus, OH 43210
| | - Joseph Rausch
- Department of Pediatrics, College of Medicine, The Ohio State University 370 W. 9th Ave. Columbus, OH 43210
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205
| | - Mark A. Klebanoff
- Department of Pediatrics, College of Medicine, The Ohio State University 370 W. 9th Ave. Columbus, OH 43210
- Center for Perinatal Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205
- Division of Epidemiology, College of Public Health, The Ohio State University 370 W. 9 Ave. Columbus, OH 43210
| | - Taniqua T. Ingol
- Division of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599
| | - Kelly M. Boone
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205
| | - Sarah A. Keim
- Department of Pediatrics, College of Medicine, The Ohio State University 370 W. 9th Ave. Columbus, OH 43210
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205
- Division of Epidemiology, College of Public Health, The Ohio State University 370 W. 9 Ave. Columbus, OH 43210
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Amberntsson A, Bärebring L, Winkvist A, Lissner L, Meltzer HM, Brantsæter AL, Papadopoulou E, Augustin H. Maternal vitamin D status in relation to infant BMI growth trajectories up to 2 years of age in two prospective pregnancy cohorts. Obes Sci Pract 2022; 8:670-681. [PMID: 36238227 PMCID: PMC9535664 DOI: 10.1002/osp4.602] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/10/2022] [Accepted: 03/24/2022] [Indexed: 11/20/2022] Open
Abstract
Background Early childhood growth can affect the child's health status later in life. Maternal vitamin D status has been suggested to affect early childhood growth. However, there is a lack of studies investigating the role of maternal vitamin D status on growth trajectories during infancy. By using growth mixture modeling (GMM), maternal vitamin D status during pregnancy can be investigated in relation to different classes of infant growth trajectories. Objectives To examine the association between maternal 25‐hydroxyvitamin D (25OHD) and classes of infant body mass index (BMI) growth trajectories. Methods Mother–child pairs were included from the Norwegian Mother, Father, and Child Cohort Study (MoBa, n = 2522) and the Swedish GraviD cohort (n = 862). Maternal 25OHD in pregnancy was analyzed by liquid chromatography tandem mass spectrometry. Children's weights and heights were registry‐based. GMM identified classes of infant BMI growth trajectories up to 2 years. The association between maternal 25OHD and infant BMI class by cohort was estimated using a log‐link generalized linear model. Mixed model analysis estimated the pooled association including both cohorts. Results Two infant BMI classes were identified, stable normal and stable high. In MoBa, maternal 25OHD <50 and 50–75 nmol/L were associated (RR 2.70, 95% CI 1.26–5.77 and RR 2.56, 95% CI 1.20–5.47) with a higher risk of the infant stable high BMI class, compared with 25OHD >75 nmol/L. In GraviD, no association was found. In pooled analysis, maternal 25OHD ≤75 nmol/L was non‐significantly associated with a higher risk of the stable high BMI growth class. Conclusions Maternal 25OHD ≤75 nmol/L may be associated with a higher class of BMI growth trajectory during infancy.
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Affiliation(s)
- Anna Amberntsson
- Department of Internal Medicine and Clinical Nutrition Institute of Medicine Sahlgrenska Academy University of Gothenburg Goteborg Sweden
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition Institute of Medicine Sahlgrenska Academy University of Gothenburg Goteborg Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition Institute of Medicine Sahlgrenska Academy University of Gothenburg Goteborg Sweden
| | - Lauren Lissner
- School of Public Health and Community Medicine Institute of Medicine, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
| | - Helle Margrete Meltzer
- Department of Food Safety Division of Climate and Environmental Health, Norwegian Institute of Public Health Oslo Norway
| | - Anne Lise Brantsæter
- Department of Food Safety Division of Climate and Environmental Health, Norwegian Institute of Public Health Oslo Norway
| | - Eleni Papadopoulou
- Global Health Cluster Division of Health Services, Norwegian Institute of Public Health Oslo Norway
| | - Hanna Augustin
- Department of Internal Medicine and Clinical Nutrition Institute of Medicine Sahlgrenska Academy University of Gothenburg Goteborg Sweden
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9
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Zheng M, Campbell KJ, Baur L, Rissel C, Wen LM. Infant feeding and growth trajectories in early childhood: the application and comparison of two longitudinal modelling approaches. Int J Obes (Lond) 2021; 45:2230-2237. [PMID: 34230577 DOI: 10.1038/s41366-021-00892-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 05/11/2021] [Accepted: 06/24/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVES The role of infant feeding practices in longitudinal growth trajectories in children remains equivocal. This study utilised two longitudinal approaches to examine the associations of infant feeding mode (breastfeeding, mixed feeding, formula feeding), breastfeeding duration, and the timing of solid foods introduction with body mass index (BMI) z-score in early childhood. SUBJECTS/METHODS Secondary analyses of data from the Healthy Beginnings Trial were conducted. Infant feeding practices were reported by mothers at 6, 12, and 24 months of child age. Child weight and length were measured at birth, 12, 24, 42, and 60 months. Two longitudinal approaches: linear spline multilevel model (LSMM) and group-based trajectory modelling (GBTM) were used to describe BMI z-score trajectories and assess its associations with infant feeding practices. RESULTS The LSMM approach demonstrated that the breastfeeding group showed lower BMI z-scores from ages 12 to 60 months than the mixed feeding and formula feeding groups. Children who were breastfed for ≥ 6 versus < 6 months exhibited a lower BMI z-score trajectory from ages 12 to 60 months. Results from the GBTM approach revealed that the mixed feeding (OR: 1.83, 95%CI 1.04, 3.21) and the formula feeding group (OR: 2.00, 95%CI 0.67, 5.92) showed a tendency for higher odds of following the "High BMIz" trajectory than the breastfeeding group. Breastfeeding duration ≥6 versus < 6 months was linked with lower odds of following the "High BMIz" trajectory (OR 0.65, 95%CI 0.43, 0.98). Both approaches revealed no evidence of an association between the timing of solid foods introduction and BMI z-score trajectory. CONCLUSIONS The two longitudinal approaches revealed similar findings that infant feeding mode and breastfeeding duration, but not the timing of solid foods introduction, were associated with BMI z-score trajectory in early childhood. The findings provide robust longitudinal evidence to encourage and support extended breastfeeding for childhood obesity prevention.
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Affiliation(s)
- Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Louise Baur
- School of Public Health and Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Chris Rissel
- School of Public Health and Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Li Ming Wen
- School of Public Health and Sydney Medical School, The University of Sydney, Sydney, Australia.,Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, NSW, Sydney, Australia
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10
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The Effect of Growth Rate during Infancy on the Risk of Developing Obesity in Childhood: A Systematic Literature Review. Nutrients 2021; 13:nu13103449. [PMID: 34684450 PMCID: PMC8537274 DOI: 10.3390/nu13103449] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 01/12/2023] Open
Abstract
The prevalence of childhood obesity has been trending upwards over the last few decades. Recent evidence suggests that infant growth rate has the potential to increase the risk of obesity development during childhood. This systematic literature review aimed to summarise the existing evidence on the relationship between infant growth rate and subsequent childhood obesity. Studies were sought for that assessed the effect of infant growth rate on outcomes of overweight, obesity, BMI, waist circumference or body composition measures among a population group of children aged 2 to 12 years old. Data sources included PubMed, CINAHL, Web of Science and MedLine. Twenty-four studies were identified as eligible and included in this review, out of 2302 publications. The ADA Quality Checklist was used to assess the quality of individual studies. Ten studies received a positive result and 14 studies a neutral result. A narrative synthesis was completed to present study characteristics and results. Several independent positive associations were determined between rapid growth at different stages during infancy and overweight, obesity, BMI, waist circumference and body composition in childhood. Further investigation is required to determine if a specific period of infancy carries greater associations of risk with childhood outcomes. Determining an ideal rate of infants' growth as a means to minimise the future risk of childhood obesity should be the focus of future research that will also inform early life obesity prevention strategies. Registration no.: CRD42021244029.
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11
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Norris T, Mansukoski L, Gilthorpe MS, Hamer M, Hardy R, Howe LD, Li L, Ong KK, Ploubidis GB, Viner RM, Johnson W. Early childhood weight gain: Latent patterns and body composition outcomes. Paediatr Perinat Epidemiol 2021; 35:557-568. [PMID: 33960515 DOI: 10.1111/ppe.12754] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/26/2020] [Accepted: 01/03/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Despite early childhood weight gain being a key indicator of obesity risk, we do not have a good understanding of the different patterns that exist. OBJECTIVES To identify and characterise distinct groups of children displaying similar early-life weight trajectories. METHODS A growth mixture model captured heterogeneity in weight trajectories between 0 and 60 months in 1390 children in the Avon Longitudinal Study of Parents and Children. Differences between the classes in characteristics and body size/composition at 9 years were investigated. RESULTS The best model had five classes. The "Normal" (45%) and "Normal after initial catch-down" (24%) classes were close to the 50th centile of a growth standard between 24 and 60 months. The "High-decreasing" (21%) and "Stable-high" (7%) classes peaked at the ~91st centile at 12-18 months, but while the former declined to the ~75th centile and comprised constitutionally big children, the latter did not. The "Rapidly increasing" (3%) class gained weight from below the 50th centile at 4 months to above the 91st centile at 60 months. By 9 years, their mean body mass index (BMI) placed them at the 98th centile. This class was characterised by the highest maternal BMI; highest parity; highest levels of gestational hypertension and diabetes; and the lowest socio-economic position. At 9 years, the "Rapidly increasing" class was estimated to have 68.2% (95% confidence interval [CI] 48.3, 88.1) more fat mass than the "Normal" class, but only 14.0% (95% CI 9.1, 18.9) more lean mass. CONCLUSIONS Criteria used in growth monitoring practice are unlikely to consistently distinguish between the different patterns of weight gain reported here.
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Affiliation(s)
- Tom Norris
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Liina Mansukoski
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Mark S Gilthorpe
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,Faculty of Medicine and Health, University of Leeds, Leeds, UK.,Alan Turing Institute, British Library, London, UK
| | - Mark Hamer
- Division of Surgery and Interventional Sciences, Faculty Medical Sciences, University College London, London, UK
| | - Rebecca Hardy
- CLOSER, Department of Social Science, University College London, London, UK
| | - Laura D Howe
- MRC Integrative Epidemiology Unit at the University of Bristol, Population Health Sciences, University of Bristol, Bristol, UK
| | - Leah Li
- Population, Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Ken K Ong
- MRC Epidemiology Unit and Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - George B Ploubidis
- Centre for Longitudinal Studies, Department of Social Science, University College London, London, UK
| | - Russell M Viner
- Population, Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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12
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Fan Z, Shi Y, Huang G, Hou D, Liu J. Long-term changes in body composition and their relationships with cardiometabolic risk factors: A population-based cohort study. PLoS One 2021; 16:e0251486. [PMID: 33984012 PMCID: PMC8118322 DOI: 10.1371/journal.pone.0251486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/28/2021] [Indexed: 12/18/2022] Open
Abstract
The aim of the present study was to classify the latent body fat trajectories of Chinese adults and their relationships with cardiometabolic risk factors. Data were obtained from the China Health Nutrition Survey for 3,013 participants, who underwent six follow-up visits between 1993 and 2009. Skinfold thickness and other anthropometric indicators were used to estimate body composition. The latent growth model was used to create fat mass to fat-free mass ratio (F2FFMR) trajectory groups. Blood pressure, fasting plasma glucose, total cholesterol, triglycerides, and high- and low-density lipoprotein-cholesterol were measured in venous blood after an overnight fast. Logistic regression was used to explore the relationships of F2FFMR trajectory with cardiometabolic risk factors. In men, four types of F2FFMR trajectory were identified. After adjustment for behavioral and lifestyle factors, age, and weight status, and compared with the Low stability group, the High stability group showed a significant association with diabetes. In women, three types of F2FFMR trajectory were identified. Compared to the Low stability group, the High stability group showed significant associations with diabetes and hypertension after adjustment for the same covariates as in men. Thus, in this long-term study we have identified three F2FFMR trajectory groups in women and four in men. In both sexes, the highly stable F2FFMR is associated with the highest risk of developing diabetes, independent of age and body mass. In addition, in women, it is associated with the highest risk of hypertension, independent of age and body mass.
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Affiliation(s)
- Zhaoyang Fan
- Department of Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | - Yunping Shi
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Guimin Huang
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Dongqing Hou
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Junting Liu
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
- * E-mail:
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13
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Huvinen E, Tuomaala AK, Bergman PH, Meinilä J, Tammelin T, Kulmala J, Engberg E, Koivusalo SB. Ascending Growth is Associated with Offspring Adiposity in Pregnancies Complicated with Obesity or Gestational Diabetes. J Clin Endocrinol Metab 2021; 106:e1993-e2004. [PMID: 33524144 DOI: 10.1210/clinem/dgaa979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Early growth is associated with childhood adiposity, but the influence of lifestyle remains unknown. OBJECTIVE This work aimed to investigate the association of growth profiles from high-risk pregnancies with adiposity at age 5 years, taking into account lifestyle and several antenatal/postnatal exposures. METHODS This prospective cohort study. INCLUDED 609 children born during the Finnish Gestational Diabetes Prevention Study (RADIEL), recruiting women with body mass index (BMI) greater than or equal to 30 and/or prior gestational diabetes mellitus (GDM) (2008-2013). Altogether 332 children attended the 5-year follow-up (2014-2017). Main outcome measures included growth profiles based on ponderal index (PI = weight/height3), investigated using latent class mixed models. Adiposity was assessed with anthropometrics and body composition (InBody720). RESULTS We identified 3 growth profiles: ascending (n = 82), intermediate (n = 351), and descending (n = 149). Children with ascending growth had a higher body fat percentage, ISO-BMI, and waist circumference (P < .05) at age 5 years. Ascending (β 4.09; CI, 1.60-6.58) and intermediate (β 2.27; CI, 0.50-4.03) profiles were associated with higher fat percentage, even after adjustment for age, sex, gestational age, diet, physical activity, education, and prepregnancy BMI. Similar associations existed with ISO-BMI. After adjusting for age and education, ascending growth was associated with prepregnancy BMI (odds ratio [OR] 1.06; CI, 1.01-1.12), primiparity (OR 3.07; CI, 1.68-5.62), cesarean delivery (OR 2.23; CI, 1.18-4.21), and lifestyle intervention (OR 2.56; CI, 1.44-4.57). However, meeting the intervention goals and exclusive breastfeeding for 3 months or more were associated with lower odds of ascending growth. CONCLUSION Accelerated early growth was associated with higher adiposity in 5-year-old children from high-risk pregnancies, even when adjusted for lifestyle. Reducing cesarean deliveries and promoting breastfeeding may be beneficial for postnatal growth.
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Affiliation(s)
- Emilia Huvinen
- Teratology Information Service, Emergency Medicine, Department of Prehospital Emergency Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anna-Kaisa Tuomaala
- Department of Pediatrics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Paula H Bergman
- Biostatistics Consulting, Department of Public Health, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jelena Meinilä
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Tuija Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Janne Kulmala
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Elina Engberg
- Folkhälsan Research Center, Helsinki, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Saila B Koivusalo
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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14
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Jasper EA, Cho H, Breheny PJ, Bao W, Dagle JM, Ryckman KK. Perinatal determinants of growth trajectories in children born preterm. PLoS One 2021; 16:e0245387. [PMID: 33507964 PMCID: PMC7842887 DOI: 10.1371/journal.pone.0245387] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/29/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A growing amount of evidence indicates in utero and early life growth has profound, long-term consequences for an individual's health throughout the life course; however, there is limited data in preterm infants, a vulnerable population at risk for growth abnormalities. OBJECTIVE To address the gap in knowledge concerning early growth and its determinants in preterm infants. METHODS A retrospective cohort study was performed using a population of preterm (< 37 weeks gestation) infants obtained from an electronic medical record database. Weight z-scores were acquired from discharge until roughly two years corrected age. Linear mixed effects modeling, with random slopes and intercepts, was employed to estimate growth trajectories. RESULTS Thirteen variables, including maternal race, hypertension during pregnancy, preeclampsia, first trimester body mass index, multiple status, gestational age, birth weight, birth length, head circumference, year of birth, length of birth hospitalization stay, total parenteral nutrition, and dextrose treatment, were significantly associated with growth rates of preterm infants in univariate analyses. A small percentage (1.32% - 2.07%) of the variation in the growth of preterm infants can be explained in a joint model of these perinatal factors. In extremely preterm infants, additional variation in growth trajectories can be explained by conditions whose risk differs by degree of prematurity. Specifically, infants with periventricular leukomalacia or retinopathy of prematurity experienced decelerated rates of growth compared to infants without such conditions. CONCLUSIONS Factors found to influence growth over time in children born at term also affect growth of preterm infants. The strength of association and the magnitude of the effect varied by gestational age, revealing that significant heterogeneity in growth and its determinants exists within the preterm population.
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Affiliation(s)
- Elizabeth A. Jasper
- Department of Epidemiology, University of Iowa, Iowa City, IA, United States of America
- * E-mail:
| | - Hyunkeun Cho
- Department of Biostatistics, University of Iowa, Iowa City, IA, United States of America
| | - Patrick J. Breheny
- Department of Biostatistics, University of Iowa, Iowa City, IA, United States of America
| | - Wei Bao
- Department of Epidemiology, University of Iowa, Iowa City, IA, United States of America
| | - John M. Dagle
- Department of Pediatrics, University of Iowa, Iowa City, IA, United States of America
| | - Kelli K. Ryckman
- Department of Epidemiology, University of Iowa, Iowa City, IA, United States of America
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15
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Li X, Keown-Stoneman CDG, Lebovic G, Maguire JL, Omand JA, Sievenpiper JL, Birken CS. Body Mass Index Mediates the Association between Growth Trajectories and Cardiometabolic Risk in Children. Child Obes 2021; 17:36-42. [PMID: 33252262 DOI: 10.1089/chi.2020.0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Few studies have published mediation analyses to quantify the role concurrent BMI plays in the relationship between growth and cardiometabolic risk (CMR) outcomes. Methods: We used data from a longitudinal cohort study conducted in children aged 0-60 months through The Applied Research Group for Kids (TARGet Kids!) in Canada. Four age and sex standardized BMI (zBMI) trajectories were identified using latent class mixed models. CMR were assessed using a CMR score. Concurrent zBMI was the zBMI measured on the same visit as CMR. Mediation analyses were performed comparing each trajectory with the reference trajectory. Results: One thousand one hundred sixty-five children were included. On average, compared with being in the stable low trajectory, being in the catch-up trajectory was associated with an increased CMR score of 0.42, 0.28 of which was mediated through concurrent zBMI [95% confidence interval (CI) 0.17 to 0.41, p = 0.001]; being in the stable high trajectory was associated with an increased CMR score of 0.23, 0.24 through concurrent zBMI (95% CI 0.18 to 0.31, p < 0.001). Similarly, being in the rapid accelerating trajectory was associated with an increased CMR score of 1.43, 1.18 of which was through concurrent zBMI (95% CI 0.89 to 1.50, p < 0.001). Conclusions: There was a strong evidence that the effect of BMI trajectories on CMR was indirect via concurrent BMI. It is important for researchers to choose the most appropriate analytic method based on the study hypothesis to understand the total or direct effect of growth patterns on cardiometabolic disease risk in children.
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Affiliation(s)
- Xuedi Li
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Charles D G Keown-Stoneman
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Biostatistics Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Gerald Lebovic
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jonathon L Maguire
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Jessica A Omand
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Catherine S Birken
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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16
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Li X, Keown-Stoneman CDG, Lebovic G, Omand JA, Adeli K, Hamilton JK, Hanley AJ, Mamdani M, McCrindle BW, Sievenpiper JL, Tremblay MS, Maguire JL, Parkin PC, Birken CS. The association between body mass index trajectories and cardiometabolic risk in young children. Pediatr Obes 2020; 15:e12633. [PMID: 32181602 DOI: 10.1111/ijpo.12633] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/04/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Rapid growth is associated with increased cardiometabolic risk (CMR) in adolescence and adulthood. Little is known about whether the association between rapid growth and increased CMR originates in early childhood. OBJECTIVES To identify age and sex standardized body mass index (zBMI) trajectories and to examine the association between zBMI trajectories and CMR outcomes in children 0 to 60 months. STUDY DESIGN A longitudinal cohort study was conducted through The Applied Research Group for Kids (TARGet Kids!) in Toronto, Canada. Participants had repeated measures of weight and length or height performed from birth to 60 months of age. Latent class mixed modelling was used to identify the zBMI trajectories. Linear regressions were performed to determine the association between zBMI trajectories and the primary outcome, a CMR score, quantified as the sum of age- and sex- standardized waist circumference, systolic blood pressure, glucose, log-triglycerides and negative high-density lipoprotein cholesterol (HDL-C), divided by √5. Secondary outcomes were the individual components of the CMR formula as well as diastolic blood pressure and non-HDL-C. RESULTS Four BMI trajectories were identified among the 1166 children. After adjusting for all covariates, children in the rapidly accelerating trajectory had increased total CMR score (β = 1.38, 95% CI 0.77; 1.99, P < .001) and increased waist circumference score (β = 2.39, 95% CI 1.92; 2.86, P < .001) compared to the stable low group. CONCLUSIONS Rapid growth during early childhood is associated with increased CMR in preschool children, largely driven by larger waist circumference.
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Affiliation(s)
- Xuedi Li
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Charles D G Keown-Stoneman
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Gerald Lebovic
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jessica A Omand
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Khosrow Adeli
- Clinical Biochemistry, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Biochemistry and Laboratory Medicine & Pathology, University of Toronto, Toronto, Ontario, Canada
| | - Jill K Hamilton
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Anthony J Hanley
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Muhammad Mamdani
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Li Ka Shing Centre for Healthcare Analytics Research and Training, St. Michael's Hospital, Toronto, Ontario, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Brian W McCrindle
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Preventative Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Mark S Tremblay
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Jonathon L Maguire
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Patricia C Parkin
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Catherine S Birken
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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17
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Zhu Z, Chang S, Cheng Y, Qi Q, Li S, Elhoumed M, Yan H, Dibley MJ, Fawzi WW, Zeng L, Sudfeld CR. Early life cognitive development trajectories and intelligence quotient in middle childhood and early adolescence in rural western China. Sci Rep 2019; 9:18315. [PMID: 31797987 PMCID: PMC6892923 DOI: 10.1038/s41598-019-54755-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 11/19/2019] [Indexed: 12/24/2022] Open
Abstract
The relationship of cognitive developmental trajectories during the dynamic first years with later life development outcomes remains unclear in low- and middle-income countries. 1388 Children born to women who participated in a randomized trial of antenatal micronutrient supplementation in rural China were prospectively followed. Cognitive development was assessed six times between 3 and 30 months of age using Bayley Scales of Infant Development, and then in mid-childhood (7–9 years) and early adolescence (10–12 years) using Wechsler Intelligence Scale for Children. We identified four distinct infant cognitive development trajectory subgroups using group-based trajectory modeling: (i) consistently above average, (ii) consistently average, (iii) started below average and then improved, and (iv) started below average and then declined. LBW infants (<2500 g) were 10.60 times (95% CI 3.57, 31.49) more likely to be in the trajectory group that started below average and then declined, while each grade increase in maternal education decreased the risk of being in this group by 73% (95% CI 54%, 84%). Infants who performed consistently above average had 8.02 (95% CI 1.46, 14.59) points higher IQ in adolescence versus the declining trajectory group. These findings suggest that interventions to improve early child development trajectories may produce long-term human capital benefits.
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Affiliation(s)
- Zhonghai Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, P.R. China.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Suying Chang
- United Nations Children's Fund, China Office, Beijing, 100600, P.R. China
| | - Yue Cheng
- Department of Nutrition and Food Safety Research, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, P.R. China
| | - Qi Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, P.R. China
| | - Shaoru Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, P.R. China
| | - Mohamed Elhoumed
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, P.R. China
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, P.R. China.,Nutrition and Food Safety Engineering Research Center of Shaanxi Province, Xi'an, 710061, Shaanxi, China.,Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, Xi'an, 710061, Shaanxi, China
| | - Michael J Dibley
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, P.R. China. .,Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, Xi'an, 710061, Shaanxi, China.
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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18
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Wibaek R, Vistisen D, Girma T, Admassu B, Abera M, Abdissa A, Mudie K, Kæstel P, Jørgensen ME, Wells JCK, Michaelsen KF, Friis H, Andersen GS. Body mass index trajectories in early childhood in relation to cardiometabolic risk profile and body composition at 5 years of age. Am J Clin Nutr 2019; 110:1175-1185. [PMID: 31504088 DOI: 10.1093/ajcn/nqz170] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 07/03/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Both impaired and accelerated postnatal growth have been associated with adult risks of obesity and cardiometabolic diseases, like type 2 diabetes and cardiovascular disease. However, the timing of the onset of cardiometabolic changes and the specific growth trajectories linking early growth with later disease risks are not well understood. OBJECTIVES The aim of this study was to identify distinct trajectories of BMI growth from 0 to 5 y and examine their associations with body composition and markers of cardiometabolic risk at age 5 y. METHODS In a prospective birth cohort study of 453 healthy and term Ethiopian children with BMIs assessed a median of 9 times during follow-up, we identified subgroups of distinct BMI trajectories in early childhood using latent class trajectory modeling. Associations of the identified growth trajectories with cardiometabolic markers and body composition at 5 y were analyzed using multiple linear regression analyses in 4 adjustment models for each outcome. RESULTS We identified 4 heterogeneous BMI growth trajectories: stable low BMI (19.2%), normal BMI (48.8%), rapid catch-up to high BMI (17.9%), and slow catch-up to high BMI (14.1%). Compared with the normal BMI trajectory, children in the rapid catch-up to high BMI trajectory had higher triglycerides (TGs) (range of β-coefficients in Models 1-4: 19-21%), C-peptides (23-25%), fat masses (0.48-0.60 kg), and fat-free masses (0.50-0.77 kg) across the 4 adjustment models. Children in the stable low BMI trajectory had lower LDL cholesterol concentrations (0.14-0.17 mmol/L), HDL cholesterol concentrations (0.05-0.09 mmol/L), fat masses (0.60-0.64 kg), and fat-free masses (0.35-0.49 kg), but higher TGs (11-13%). CONCLUSIONS The development of obesity and cardiometabolic risks may be established already in early childhood; thus, our data provide a further basis for timely interventions targeted at young children from low-income countries with unfavorable growth patterns. The birth cohort was registered at ISRCTN as ISRCTN46718296.
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Affiliation(s)
- Rasmus Wibaek
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Dorte Vistisen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Tsinuel Girma
- Department of Pediatrics and Child Health, Jimma University, Jimma, Ethiopia.,Jimma University Clinical and Nutrition Research Partnership, Jimma University, Jimma, Ethiopia
| | - Bitiya Admassu
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,Jimma University Clinical and Nutrition Research Partnership, Jimma University, Jimma, Ethiopia.,Department of Population and Family Health, Jimma University, Jimma, Ethiopia
| | - Mubarek Abera
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,Jimma University Clinical and Nutrition Research Partnership, Jimma University, Jimma, Ethiopia.,Department of Psychiatry, Jimma University, Jimma, Ethiopia
| | - Alemseged Abdissa
- Jimma University Clinical and Nutrition Research Partnership, Jimma University, Jimma, Ethiopia.,Department of Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Kissi Mudie
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Pernille Kæstel
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Marit E Jørgensen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark.,National Institute of Public Health, Southern Denmark University, Copenhagen, Denmark
| | - Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Gregers S Andersen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
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19
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Fresh versus frozen embryo transfer has no effect on childhood weight. Fertil Steril 2019; 112:684-690.e1. [PMID: 31371050 DOI: 10.1016/j.fertnstert.2019.05.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 04/27/2019] [Accepted: 05/17/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the effect of frozen, compared with fresh, embryo transfer on neonatal and pediatric weight and weight gain trajectory. DESIGN Retrospective cohort study. SETTING Academic medical center. PATIENT(S) Women who underwent fresh or frozen embryo transfer at the Mayo Clinic from 2010 to 2014. All included embryo transfers resulted in a singleton live birth. Children were followed from birth to at least 18 months. When possible, growth was evaluated to 5 years of age. INTERVENTIONS(S) Fresh versus frozen embryo transfer. MAIN OUTCOME MEASURE(S) Propensity score methodology was used to balance the two groups by maternal characteristics and gestational age before evaluating outcomes. Each infant and childhood growth measurement was compared between the two groups. RESULT(S) Of the 136 women, 87 underwent a fresh embryo transfer and 49 underwent a frozen embryo transfer. Birth length and head circumference were significantly different in infants delivered after fresh versus frozen embryo transfer. There was a statistically significant difference in birth weight between infants born after fresh versus frozen embryo transfer. However, this difference did not persist when adjusted for gestational age, sex, and maternal factors. Childhood growth measurements including age- and sex-specific weight, and body mass index percentiles were not significantly different between groups. CONCLUSION(S) This study confirmed an association of frozen embryo transfer and increased birth weight, but the association did not persist when controlling for confounding maternal factors. We found no effect of fresh versus frozen embryo transfer on neonatal weight and childhood weight gain trajectory.
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20
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Mattsson M, Maher GM, Boland F, Fitzgerald AP, Murray DM, Biesma R. Group-based trajectory modelling for BMI trajectories in childhood: A systematic review. Obes Rev 2019; 20:998-1015. [PMID: 30942535 DOI: 10.1111/obr.12842] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/19/2019] [Accepted: 01/20/2019] [Indexed: 12/24/2022]
Abstract
Childhood obesity is an important public health issue. We aimed to systematically review studies that used group-based trajectory modelling approaches to investigate body mass index (BMI) trajectories in early childhood, explore associated determinants, and the association with body composition outcomes. Five databases were searched systematically for studies using group-based trajectory modelling approaches to track BMI trajectories from birth. Fourteen studies using latent class growth analysis or growth mixture modelling to track BMI trajectories were identified. Three or four trajectories were identified in most studies. High maternal pre-pregnancy BMI was the most frequently identified risk factor for membership of a rapid gain trajectory. Significant associations between rapid weight gain and stable high trajectories and body measures at follow-up were identified by several studies. Relatively similar trajectories were identified across studies. Trajectories characterized by rapid weight gain were associated with several predictors, as well as body measures at follow-up, however not with great consistency. Similar associations with body measure outcomes were found for stable high and rapid gain trajectories, suggesting that long-term outcomes do not differ greatly between children with consistently high BMI and children with rapid increases in BMI. As the shape and timing of the trajectories differed between studies, it is difficult to draw conclusions.
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Affiliation(s)
- Molly Mattsson
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Gillian M Maher
- School of Public Health, University College Cork, Cork, Ireland
| | - Fiona Boland
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Deirdre M Murray
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Regien Biesma
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
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21
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Hu Z, Tylavsky FA, Han JC, Kocak M, Fowke JH, Davis RL, Lewinn K, Bush NR, Zhao Q. Maternal metabolic factors during pregnancy predict early childhood growth trajectories and obesity risk: the CANDLE Study. Int J Obes (Lond) 2019; 43:1914-1922. [PMID: 30705389 PMCID: PMC6669102 DOI: 10.1038/s41366-019-0326-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/08/2018] [Accepted: 01/13/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND We investigated the individual and additive effects of three modifiable maternal metabolic factors, including pre-pregnancy overweight/obesity, gestational weight gain (GWG), and gestational diabetes mellitus (GDM), on early childhood growth trajectories and obesity risk. METHODS A total of 1425 mother-offspring dyads (953 black and 472 white) from a longitudinal birth cohort were included in this study. Latent class growth modeling was performed to identify the trajectories of body mass index (BMI) from birth to 4 years in children. Poisson regression models were used to examine the associations between the maternal metabolic risk factors and child BMI trajectories and obesity risk at 4 years. RESULTS We identified three discrete BMI trajectory groups, characterized as rising-high-BMI (12.6%), moderate-BMI (61.0%), or low-BMI (26.4%) growth. Both maternal pre-pregnancy obesity (adjusted relative risk [adjRR] = 1.96; 95% confidence interval [CI]: 1.36-2.83) and excessive GWG (adjRR = 1.71, 95% CI: 1.13-2.58) were significantly associated with the rising-high-BMI trajectory, as manifested by rapid weight gain during infancy and a stable but high BMI until 4 years. All three maternal metabolic indices were significantly associated with childhood obesity at age 4 years (adjRR for pre-pregnancy obesity = 2.24, 95% CI: 1.62-3.10; adjRR for excessive GWG = 1.46, 95% CI: 1.01-2.09; and adjRR for GDM = 2.14, 95% = 1.47-3.12). In addition, risk of rising-high BMI trajectory or obesity at age 4 years was stronger among mothers with more than one metabolic risk factor. We did not observe any difference in these associations by race. CONCLUSION Maternal pre-pregnancy obesity, excessive GWG, and GDM individually and jointly predict rapid growth and obesity at age 4 years in offspring, regardless of race. Interventions targeting maternal obesity and metabolism may prevent or slow the rate of development of childhood obesity.
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Affiliation(s)
- Zunsong Hu
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Joan C Han
- Departments of Pediatrics and Physiology, University of Tennessee Health Science Center, Memphis, TN, 38103, USA.,Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, 38103, USA
| | - Mehmet Kocak
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Jay H Fowke
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Robert L Davis
- Department of Pediatrics, Center for Biomedical Informatics, University of Tennessee Health Science Center, Memphis, TN, 38103, USA
| | - Kaja Lewinn
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, 94118, USA
| | - Nicole R Bush
- Departments of Pediatrics and Psychiatry, University of California San Francisco, San Francisco, CA, 94118, USA
| | - Qi Zhao
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, 38163, USA.
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22
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Hayes A, Tan EJ, Lung T, Brown V, Moodie M, Baur L. A New Model for Evaluation of Interventions to Prevent Obesity in Early Childhood. Front Endocrinol (Lausanne) 2019; 10:132. [PMID: 30881347 PMCID: PMC6405882 DOI: 10.3389/fendo.2019.00132] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 02/12/2019] [Indexed: 01/22/2023] Open
Abstract
Background: Childhood obesity is a serious public health issue. In Australia, 1 in 4 children is already affected by overweight or obesity at the time of school entry. Governments around the world have recognized this problem through investment in the prevention of pediatric obesity, yet few interventions in early childhood have been subjected to economic evaluation. Information on cost-effectiveness is vital to decisions about program implementation. A challenge in evaluating preventive interventions in early childhood is to capture long-term costs and outcomes beyond the duration of an intervention, as the benefits of early obesity prevention will not be realized until some years into the future. However, decisions need to be made in the present, and modeling is one way to inform such decisions. Objective: To describe the conceptual structure of a new health economic model (the Early Prevention of Obesity in CHildhood (EPOCH) model) for evaluating childhood obesity interventions; and to validate the epidemiologic predictions. Methods and Results: We use an individual-level (micro-simulation) method to model BMI trajectories and the progression of obesity from early childhood to adolescence. The equations predicting individual BMI change underpinning our model were derived from data from the population-representative study, the Longitudinal Study of Australian Children (LSAC). Our approach is novel because it will account for costs and benefits accrued throughout childhood and adolescence. As a first step to validate the epidemiological predictions of the model, we used input data representing over 250,000 children aged 4/5 years, and simulated BMI and obesity trajectories until adolescence. Simulated mean BMI and obesity prevalence for boys and girls were verified by nationally-representative data on children at 14/15 years of age. Discussion: The EPOCH model is epidemiologically sound in its prediction of both BMI trajectories and prevalence of obesity for boys and girls. Future developments of the model will include socio-economic position and will incorporate the impacts of obesity on healthcare costs. The EPOCH model will help answer: when is it best to intervene in childhood; what are the most cost-effective approaches and which population groups will benefit most from interventions.
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Affiliation(s)
- Alison Hayes
- Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, NSW, Australia
| | - Eng J Tan
- Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, NSW, Australia
| | - Thomas Lung
- Health Economics and Process Evaluation, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Vicki Brown
- Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia
- Deakin Health Economics, Centre for Population Health Research, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
| | - Marj Moodie
- Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia
- Deakin Health Economics, Centre for Population Health Research, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
| | - Louise Baur
- Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia
- The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
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23
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Liu J, Liu J, Frongillo EA, Boghossian NS, Cai B, Zhou H, Hazlett LJ. Body mass index trajectories during the first year of life and their determining factors. Am J Hum Biol 2018; 31:e23188. [PMID: 30499610 DOI: 10.1002/ajhb.23188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 07/30/2018] [Accepted: 09/15/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The purpose of this study was to examine the trajectories of body mass index (BMI) in the first year of life and their determining factors. METHODS We used data from the Infant Feeding Practices Survey II restricted to children with 2 or more time points of BMI data during follow-up visits within the first year of life (n = 2320). Latent class growth analysis was used to identify distinct BMI trajectories. Using multinomial logistic regression, we examined the prenatal and early life determinants of the identified trajectories. RESULTS Three BMI trajectories were identified during the first year of life: "low-stable" (81.6%), "high-stable" (15.6%), and "rising" (2.8%) trajectories. Boys, preterm infants, infants born to overweight mothers, Hispanic mothers, non-Hispanic Black mothers, and mothers who smoked during pregnancy were significantly more likely to have high-stable versus low-stable trajectories. Infants born to non-Hispanic Black mothers were more likely to have a rising versus a low-stable trajectory. Household income ≥350% of the federal poverty level and full adherence to the guidelines of the American Academy of Pediatrics for both breastfeeding exclusivity and duration reduced the likelihood of infants being in the rising versus the low-stable trajectory. CONCLUSION Distinct BMI trajectories were evident as early as infancy. The predictors of these trajectories offer information about high-risk groups, and important and preventable prenatal and postnatal risk factors for future intervention programs.
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Affiliation(s)
- Junxiu Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.,Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Nansi S Boghossian
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Bo Cai
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Haiming Zhou
- Division of Statistics - Northern Illinois University, DeKalb, Illinois
| | - Linda J Hazlett
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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