The obesity epidemic in children: Latino children are disproportionately affected at younger ages

Es Niño o Niña?: Gender Differences in Feeding Practices and Obesity Risk among Latino Infants

Background

Obesity prevalence is significantly higher among Latino boys than girls. Weight status at 12 mo, a significant predictor of childhood obesity, is associated with feeding practices during infancy.

Objectives

The objectives were to examine breastfeeding and formula-feeding practices overall and by infant gender and to examine relations among infant gender, milk-feeding practices, and obesity risk among Latino infants over the first year of life.

Methods

Latino mother-infant dyads (n = 90) were recruited from a pediatric clinic. Mothers were interviewed at regular intervals (infants aged 2, 4, 6, and 9 mo), and 24-h feeding recalls were conducted when infants were aged 6 and 9 mo. Infants' lengths and weights were retrieved from clinic records to calculate weight-for-length percentiles. A bivariate analysis was conducted to compare feeding practices by gender and mediation analysis to test whether feeding practices mediated the relation between gender and obesity risk.

Results

The majority (80%) of mothers were born outside the United States. In early infancy, mixed feeding of formula and breastfeeding was common. At 6 and 9 mo of age, milk-feeding practices differed, with formula feeding more common for boys than girls. At 12 mo, 38% of infants experienced obesity risk (≥85th weight-for-length percentile). Infants' obesity risk increased by 18% per 1 oz increase in powdered formula intake. Formula intake among boys was on average 1.42 oz (in dry weight) higher than that among girls, which, in turn, mediated their increased obesity risk (IERR = 1.27, 95% confidence interval: 1.02, 1.90).

Conclusions

The increased obesity risk among Latino boys compared with girls at 12 mo was explained by higher rates of formula feeding at 6 and 9 mo of age. Future investigations of cultural values and beliefs in gender-related feeding practices are warranted to understand the differences in obesity risk between Latino boys and girls.

The genetic risk of acute lymphoblastic leukemia and its implications for children of Latin American origin

Acute lymphoblastic leukemia (ALL) is the most common cancer in children, and disproportionately affects children of Hispanic/Latino ethnicity in the United States, who have the highest incidence of disease compared with other racial/ethnic groups. Incidence of childhood ALL is similarly high in several Latin American countries, notably in Mexico, and of concern is the rising incidence of childhood ALL in some Hispanic/Latino populations that may further widen this disparity. Prior studies have implicated common germline genetic variants in the increased risk of ALL among Hispanic/Latino children. In this review, we describe the known disparities in ALL incidence as well as patient outcomes that disproportionately affect Hispanic/Latino children across the Americas, and we focus on the role of genetic variation as well as Indigenous American ancestry in the etiology of these disparities. Finally, we discuss future avenues of research to further our understanding of the causes of the disparities in ALL incidence and outcomes in children of Latin American origin, which will be required for future precision prevention efforts.

Randomized-controlled trial of a whole-family obesity prevention and treatment intervention designed for low-income Hispanic families: HeLP the healthy living program

BACKGROUND

Low-income Hispanic families face marked disparities in obesity, but interventions for obesity prevention and treatment have rarely been designed with this population as a focus. Hispanic culture is characterized by Familism, a value that prioritizes familial respect, cooperation, and togetherness. We describe the rationale and design of a trial of the Healthy Living Program (HeLP), a bilingual whole-family behavioral obesity prevention and treatment intervention designed around the value Familism and addressing food insecurity.

METHODS/DESIGN

This two-group randomized comparative effectiveness trial will compare the effects of HeLP versus a primary care counseling intervention (Recommended Treatment of Obesity in Primary Care, or RTOP) on decreasing body mass index (BMI; kg/m2) in Hispanic children 2-16 years of age with obesity and preventing BMI increase among siblings without obesity. 164 families per arm will be recruited from primary care practices. Families randomized to HeLP will participate in 12 two-hour sessions, followed by booster sessions. HeLP sessions include family meals and instruction in parenting skills, nutrition, culinary skills, fitness, and mindfulness delivered at community recreation centers by bilingual health educators and athletic trainers. Families randomized to RTOP will be offered individual visits in primary care every 3 months throughout the 18-month follow-up period. Secondary outcomes include changes to objectively measured child fitness, the home environment related to nutrition, physical activity, and media usage, food insecurity, child eating behaviors, quality of life, parent BMI and waist circumference, and implementation outcomes.

DISCUSSION

This protocol paper describes the rationale and planned methods for the comparative effectiveness trial.

TRIAL REGISTRATION

Clinicaltrials.gov Identifier NCT05041855 (6/13/2023).

Excess pregnancy weight gain in latinas: Impact on infant's adiposity and growth hormones at birth

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Immigrant Latinas with overweight and obesity have excessive gestational gain.

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Excessive gestational weight gain is associated with high birthweight percentiles.

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Higher IGF-1 and lower PYY in cord blood in context of excessive gestational gain.

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Gestational weight counseling in pregnancy may help prevent childhood obesity.

Excess maternal weight gain during pregnancy has been associated with childhood overweight and obesity both in mothers with and without obesity. Latinx children are at higher risk for earlier obesity compared with other population groups. A cohort of 82 self-identified pregnant Latina women were recruited at the prenatal clinics of Zuckerberg San Francisco General Hospital (ZSFG) prior to delivery during the second and third trimesters of pregnancy in 2011 and 2012. Maternal pre-pregnancy weight and weight prior to delivery were collected by self-report to calculate maternal pre-pregnancy body mass index (BMI) and weight gain in pregnancy. At delivery, anthropometric measurements of infants were obtained and cord blood and maternal finger stick blood samples were collected for hormonal assays. Fifty-three point seven percent of women had excessive weight gain in pregnancy. A high percentage of the cohort was overweight and obese prior to pregnancy (67.1%) with mean pre-pregnancy BMI 27.4 ± 4.5 kg/m² and greater pre-pregnancy weight was independently associated with weight gain during pregnancy (OR 1.05, 95%CI 1.002–1.09). Mean infant birthweight was 3377.2 ± 481.5 g and excessive weight gain in pregnancy was independently associated with birthweight percentile (OR 13.46, 95%CI 2.43–34.50). Excessive gestational gain was positively associated with cord blood insulin-like growth factor-1 (IGF-1) and negatively with Peptide YY (PYY) levels. Latina women with pre-pregnancy overweight and obesity have a high rate of excessive gestational gain in pregnancy and could benefit from early counseling about appropriate gain in pregnancy. Excessive gestational weight impacts the intrauterine environment in high-risk infants impacting fetal growth and development.

Mendelian Inconsistent Signatures from 1314 Ancestrally Diverse Family Trios Distinguish Biological Variation from Sequencing Error

Next-generation sequencing enables advances in the clinical application of genomics by providing high-throughput detection of genomic variation. However, next-generation sequencing technologies, especially whole-genome sequencing (WGS), are often associated with a high false-positive rate. Trio-based WGS can contribute significantly towards improved quality control methods. Mendelian-inconsistent calls (MIC) in parent–child trios are commonly attributed to erroneous sequencing calls, as the true de novo mutation rate is extremely low compared with MIC incidence. Here, we analyzed WGS data from 1314 mother, father, and child trios across ethnically diverse populations with the goal of characterizing MIC. Genotype calls in a trio can be used to assign different signatures to MIC. MIC occur more frequently within repeats but show varying distribution and error mechanisms across repeat types. MIC are enriched within poly-A/T runs in short interspersed nuclear elements. Alignability scores, allele balance, and relative parental read depth vary among MIC signatures and these differences should be considered when designing filters for MIC reduction. MIC cluster in germline deletions and these MIC also segregate with population. Our results provide a basis for making decisions on how each MIC type should be evaluated before discarding them as errors or including them in alternative applications. With the reduction of sequencing cost, family trio whole genome and exome analysis are being performed more routinely in clinical practice. We provide a reference that can be used for annotating MIC with their frequencies in a larger population to aid in the filtering of candidate de novo mutations.