Associations of intrauterine and postnatal weight and length gains with adolescent body composition: prospective birth cohort study from Brazil

Comparison of anthropometric, metabolic, and body compositional abnormalities in Korean children and adolescents born small, appropriate, and large for gestational age: a population-based study from KNHANES V (2010-2011)

PURPOSE

The impacts of growth restriction and programming in the fetal stage on metabolic and bone health in children and adolescents are poorly understood. Moreover, there is insufficient evidence for the relationship between current growth status and metabolic components. Herein, we compared the growth status, metabolic and body compositions, and bone mineral density in Korean children and adolescents based on birth weight at gestational age.

METHODS

We studied 1,748 subjects (272 small for gestational age [SGA], 1,286 appropriate for gestational age [AGA], and 190 large for gestational age [LGA]; 931 men and 817 women) aged 10-18 years from the Korean National Health and Nutrition Examination Survey (KNHANES) V (2010-2011). Anthropometric measurements, fasting blood biochemistry, and body composition data were analyzed according to birth weight and gestational age.

RESULTS

The prevalence of low birth weight (14.7% vs. 1.2% in AGA and 3.2% in LGA, p<0.001) and current short stature (2.237 [1.296-3.861] compared to AGA, p=0.004) in SGA subjects was greater than that in other groups; however, the prevalence of overweight and obesity risks, metabolic syndrome (MetS), and MetS component abnormalities was not. Moreover, no significant differences were found in age- and sex-adjusted lean mass ratio, fat mass ratio, truncal fat ratio, bone mineral content, or bone density among the SGA, AGA, and LGA groups in Korean children and adolescents.

CONCLUSION

Our data demonstrate that birth weight alone may not be a determining factor for body composition and bone mass in Korean children and adolescents. Further prospective and longitudinal studies in adults are necessary to confirm the impact of SGA on metabolic components and bone health.

Anthropometrics and fat mass, but not fat-free mass, are compromised in infants requiring parenteral nutrition after neonatal intestinal surgery

BACKGROUND

Children with intestinal failure (IF) receiving long-term parenteral nutrition (PN) have altered body composition (BC), but data on BC changes from start of PN onwards are lacking.

OBJECTIVES

We aimed to assess growth and BC in infants after neonatal intestinal surgery necessitating PN and at risk of IF, and to explore associations with clinical parameters.

METHODS

A prospective cohort study in infants after intestinal surgery. IF was defined as PN dependency for >60 d. SD scores (SDS) for anthropometry were calculated until 6-mo corrected age. In a subgroup, fat mass (FM) and fat-free mass (FFM) were measured with air-displacement plethysmography at 2- and 6-mo corrected age. SDS for length-adjusted FM index and FFM index were calculated. Associations between cumulative amount of PN and BC parameters were analyzed with linear mixed-effect models.

RESULTS

Ninety-five neonates were included (54% male, 35% born <32 wk) and 39 infants (41%) had IF. Studied infants had compromised anthropometric parameters during follow-up. At 6-mo corrected age, they remained smaller (median weight-for-age SDS -0.9 [IQR -1.5, 0.1], P < 0.001) than the normal population. In 57 infants, 93 BC measurements were performed. FM index SDS was lower than in healthy infants at 2- and 6-mo corrected age (-0.9 [-1.6, -0.3], P < 0.001 and -0.7 [-1.3, 0.1], P = 0.001, respectively), but FFM index SDS did not differ. A higher cumulative amount of PN predicted a higher FM index in female infants but lower FM index in male infants.

CONCLUSIONS

In this cohort of infants receiving PN after intestinal surgery, compromised anthropometrics, decreased FM, and adequate FFM were observed during the first 6 mo. Male and female infants seemed to respond differently to PN when it comes to FM index. Continuing growth monitoring after the age of 6 mo is strongly recommended, and further research should explore the benefit of incorporating ongoing BC monitoring during follow-up.

Inter-individual variability in children's physical growth and body composition: Findings of longitudinal ELOS-Pré study

BACKGROUND

Children's physical growth (PG) and body composition (BC) can be influenced by birth weight and type of delivery.

AIM

To longitudinally analyze the dynamics of PG and BC of children from 5 to 9 years; to investigate the inter-individual differences according to age, sex, BW, and type of delivery across the following years of the study.

SUBJECTS AND METHODS

A total of 1236 children (597 boys) were evaluated at 5-years of age and followed annually until 9-years. PG and BC measurements were evaluated. Multilevel modeling was used.

RESULTS

Annual increments were observed (p < .001). Girls presented lower height and fat-free-mass but higher %BF (p < .001). Distinct trajectories between the sexes were observed for height (p < .001). Low-birth-weight children presented lower height, body mass, and fat-free-mass (p < .001), but the interaction between velocity of growth and BC was significant only in height (p < .05). Children born by had lower height, body mass, and %BF, and gained less body mass per year than those born by vaginal delivery (p < .05). Significant inter-individual differences were observed at 5-years of age and in their trajectories, except for fat-free-mass (p < .01).

CONCLUSION

There are differences in the dynamics of PG and BC, low-birth-weight and type of delivery influence the dynamics of PG during this interval of ages.

Undernutrition and associated factors among children 1-5 years of age in rural area of Haryana, India: A community based cross-sectional study

Background:

Children under five years of age are most vulnerable to the vicious cycles of malnutrition, disease/infection and resultant disability all of which influence the present condition of a child at the microlevel and the future human resource development of the nation at the macrolevel.

Aim:

The present study was conducted to estimate the prevalence of undernutrition among under-five children; and to determine the associated factors.

Methods:

All 112 Anganwadi Centres in block Lakhan Majra were enlisted and 30 Anganwadi Centres were selected by adopting systematic random sampling. From each selected Anganwadi Centre, 20 children of 15 years of age group were selected by simple random sampling, thus, a sample of 600 children was included in the study.

Results:

Overall prevalence of undernutrition in our study was found as follows: wasted 18.4%; underweight 38.3%; stunted 41.3%. Mothers who had four or more ANC visits and IFA intake for 100 or more days had lower prevalence of wasting, stunting, and underweight than the mothers with three or less ANC visits and inadequate IFA intake. Children with a history of pre-lacteal feeding had higher prevalence of stunting, underweight, and wasting than the children with no history of pre-lacteal feeding.

Conclusion:

Every endeavor should be made to combat the outcomes of undernutrition through multipronged approach such as growth monitoring, nutritional supplementation, etc., Also, present study findings reinforce the importance of proper infant and child feeding practices and appropriate maternal care in prevention of childhood undernutrition.

Addressing the Double Burden of Malnutrition in Developing Countries: Need for Strategies to Improve the Lean Body Mass

The double burden of childhood undernutrition and adult-onset adiposity-related chronic diseases is a key concern in many developing countries that are currently undergoing epidemiological and nutrition transition. Impaired linear growth with suboptimal lean body mass development seems to be the link between these 2 seemingly contrasting forms of malnutrition. Studies assessing the role of early nutrition in the later lean body mass development have shown consistent positive association. In addition, the nutrition during life course, especially the dietary intake of protein, zinc, calcium, and vitamin D status, impacts the lean body mass. Promoting increased intake of these important nutrients throughout life course would, therefore, be important for optimal development and maintenance of lean body mass. Diversified diets with increased consumption of nutrient-rich foods, especially milk and other animal source foods, are crucial for the development of optimal body composition and alleviation of the double burden of malnutrition.

Nutritional status and related factors of schoolchildren in Çorum, Turkey

OBJECTIVE

We aimed to determine nutritional status and related factors among schoolchildren in Çorum, Central Anatolia, Turkey.

DESIGN

Schoolchildren's height and weight were measured to calculate BMI and BMI Z-scores. Height, weight and BMI Z-scores were analysed and nutritional status classified according to the WHO.

SETTING

Central Anatolia, Turkey.ParticipantsSchoolchildren aged 5-17 years (n 1684) participated in study.

RESULTS

Of children, 4·2% were stunted, 6·9% thin, 13·8% overweight and 6·6% were obese. Proportions of stunting, thinness and overweight/obesity were significantly higher in children aged &gt;10 years (78·6, 75·0 and 64·9%, respectively) than in those aged ≤10 years (21·4, 25·0 and 35·1%, respectively; all P &lt;0·001). Median (range) birth weight and breast-feeding duration in children with stunting (2750 (1400-3600)g; 10 (0-36) months) were significantly lower and shorter, respectively, than those of normal height (3200 (750-5500)g; 15 (0-72) months) and tall children (3500 (2500-4900)g; 18 (0-36) months; P &lt;0·001, &lt;0·001, 0·011 and 0·016, respectively). The same relationship was observed in thin children (3000 (1000-4500)g; 12 (0-36) months) compared with normal-weight (3200 (750-5500)g; 15 (0-72) months) and overweight/obese children (3300 (1200-5500)g; 16 (0-48) months; P=0·026, &lt;0·001, 0·045 and 0·011, respectively).

CONCLUSIONS

Overweight and obesity are health problems that must be addressed in schoolchildren. Adolescents also have a risk of double malnutrition. Promoting normal birth weight and encouraging long duration of breast-feeding are important to support normal growth in children.

Birth weight, physical growth and body composition in children: A longitudinal study

ABSTRACT Objective To describe children’s physical growth (body mass and height) velocity and body composition (fat percentage and Fat Free Mass); to investigate the magnitude of interindividual differences according to age, gender and birth weight categories, as well as to examine the differences in the average trajectories of children with Low Birth Weight and Normal Weight according to international references. Methods The sample consisted of 534 children (279 boys and 255 girls, 7 to 10 years old) evaluated in the first year of study and followed for 3 years with overlap between the ages of 7 and 9 years. Physical growth and body composition measurements included: height, body mass, fat percentage (%Fat) and Fat Free Mass. Multilevel Modelling was used. Results Birth weight was not associated with physical growth and body composition markers at 7 years old or with the velocity of their changes (p>0.05). There were significant interindividual differences in the trajectories of physical growth (height and body mass; p<0.001) and body composition (%Fat and Fat Free Mass; p<0.001). In plotting on international percentile charts, the trajectories of growth and body composition were within expected values for age and gender, regardless of birth weight. Conclusion There are significant differences in the dynamics of stature growth, body mass and Fat Free Mass, and Low Birth Weight has no influence on this trajectory. In addition, values are within the expected range for age and sex.

Conditions of gestation, childbirth and childhood associated with C-peptide in young adults in the 1982 Birth Cohort in Pelotas-RS; Brazil

BACKGROUND

The connecting peptide in insulin has been associated with cardiovascular risk and overall mortality in the adult population. However, its early determinants are unknown. Assess the association of exposures during pregnancy, delivery, and childhood with C-peptide among 22-23 years old individuals prospectively followed since birth, in a southern Brazilian city.

METHODS

In 1982, all hospital births in the city were identified and those livebirths whose families lived in the urban area were evaluated (n = 5914). The 1982 Pelotas Birth Cohort has prospectively followed these subjects at different moments. In this study, we evaluated the association of C-peptide with exposures occurring during pregnancy, delivery and childhood. In the 22-23 years follow-up visit, we tried to follow the whole cohort and the subjects were interviewed, examined and donated a blood sample. C-peptide was measured using the chemiluminescence immunoassay technique (Immulite®-Siemens, Germany).

RESULTS

In the 22-23 years visit, 4297 subjects were interviewed and the C-peptide was measured in 3807. The geometric mean of C-peptide was 0.83 ng/mL and the mean was higher among women. In the adjusted analysis, C-peptide was positively associated with family income at birth, lower among children of non-white mothers (0.90; CI95% 0.84-0.96), higher among females (1.22; CI95% 1.16-1.28), and positively associated with rapid weight gain between two and four years of age (1.18; CI95% 1.05-1.32).

CONCLUSION

Family income at birth, non-white maternal skin color, and rapid weight gain between two and four years of age were associated with high levels of C-peptide.

Early rapid weight gain and subsequent overweight and obesity in middle childhood in Peru

Background

Rapid postnatal weight gain is associated with risk of overweight and obesity, but it’s unclear whether this holds in populations exposed to concurrent obesogenic risk factors and for children who have been extensively breastfed. This study investigates whether an increase in weight for age from birth to 1 year (infancy) and from 1 to 5 years (early childhood) predicts overweight and obesity, and waist circumference at 8 years, using data from a longitudinal cohort study in Peru.

Methods

Generalized estimating equations (GEE) models were constructed for overweight and obesity, obesity alone and waist circumference at 8 years versus rapid weight gain in infancy, and early childhood including adjusted models to account for confounders.

Results

Rapid weight gain in both periods was associated with double the risk of overweight and obesity, obesity alone at 8 years and increased waist circumference even after controlling for maternal BMI and education level, sex of child, height-for-age at 8 years, consumption of “fast food” and number of days of active exercise. The association was significant, with some differences, for children in both rural and urban environments.

Conclusions

Rapid weight gain in infancy and in early childhood in Peru is associated with overweight and obesity at age 8 years even when considering other determinants of childhood obesity.

Electronic supplementary material

The online version of this article (doi:10.1186/s40608-016-0135-z) contains supplementary material, which is available to authorized users.

Catch-up growth and catch-up fat in children born small for gestational age

Infants born small for gestational age (SGA) are at increased risk of perinatal morbidity, persistent short stature, and metabolic alterations in later life. Recent studies have focused on the association between birth weight (BW) and later body composition. Some reports suggest that fetal nutrition, as reflected by BW, may have an inverse programing effect on abdominal adiposity later in life. This inverse association between BW and abdominal adiposity in adults may contribute to insulin resistance. Rapid weight gain during infancy in SGA children seemed to be associated with increased fat mass rather than lean mass. Early catch-up growth after SGA birth rather than SGA itself has been noted as a cardiovascular risk factor in later life. Children who are born SGA also have a predisposition to accumulation of fat mass, particularly intra-abdominal fat. It is not yet clear whether this predisposition is due to low BW itself, rapid postnatal catch-up growth, or a combination of both. In this report, we review the published literature on central fat accumulation and metabolic consequences of being SGA, as well as the currently popular research area of SGA, including growth aspects.

The Double Burden of Undernutrition and Overnutrition in Developing Countries: an Update

Many developing countries have achieved a remarkable improvement in nutrition status in the past decades. However, the prevalence of undernutrition remains a serious problem. At the same time, the prevalence of obesity is increasing substantially, and in some countries, it has approached that of developed countries. This article provides an update on this double burden of malnutrition (DBMN) in developing nations. One hundred countries (lower, middle-lower, and upper-middle income countries) were selected and analysed, and to support the analysis, a systematic review of current published studies was performed. The results show that DBMN already exists in almost all developing countries and that the DBMN ratio (i.e., overweight/underweight) has increased as income per capita has increased. DBMN may manifest within the community, household, or individual. In addition to common factors, poor nutrition in early childhood is suggested as another important driving factor behind the rising obesity rate in most developing countries. A life-course approach has been proposed to prevent undernutrition and overnutrition and should be integrated into the development of health systems to control double burden in developing countries.

Nutritional influences over the life course on lean body mass of individuals in developing countries

The double burden of childhood undernutrition and adult-onset adiposity in transitioning societies poses a significant public health challenge. The development of suboptimal lean body mass (LBM) could partly explain the link between these two forms of malnutrition. This review examines the evidence on both the role of nutrition in “developmental programming” of LBM and the nutritional influences that affect LBM throughout the life course. Studies from developing countries assessing the relationship of early nutrition with later LBM provide important insights. Overall, the evidence is consistent in suggesting a positive association of early nutritional status (indicated by birth weight and growth during first 2 years) with LBM in later life. Evidence on the impact of maternal nutritional supplementation during pregnancy on later LBM is inconsistent. In addition, the role of nutrients (protein, zinc, calcium, vitamin D) that can affect LBM throughout the life course is described. Promoting optimal intakes of these important nutrients throughout the life course is important for reducing childhood undernutrition as well as for improving the LBM of adults.

Strong nutrition governance is a key to addressing nutrition transition in low and middle-income countries: review of countries' nutrition policies

Nutrition transition necessitates low and middle-income countries (LAMICs) to scale up their efforts in addressing the burdens of undernutrition and overweight/obesity. Magnitudes of undernutrition and overweight are high in LAMICs, but no study has reviewed the existence of nutrition policies to address it. No evidence is also available on the effect of nutrition policies and governance on the undernutrition and overweight/obesity patterns in such countries. We conducted a policy review to examine the presence and associations of nutrition policies and governance with the children's nutrition statuses in LAMICs.

METHODS

We reviewed nutrition policies, nutrition governance, and the trends of nutrition status from LAMICs. We retrieved data on the policies from the global database on the implementation of nutrition actions (GINA). We also retrieved data on the trends of nutrition status and nutrition governance from the nutrition landscape information system (NLiS), and on LAMICs from the World Bank database. We then analyzed the data both descriptively and by using a mixed effects model with random-intercept by country.

RESULTS

Of the 139 LAMICs reviewed, only 39.6% had policies to address both undernutrition and overweight/obesity. A higher proportion of low-income countries (LICs) had policies to address undernutrition compared to that of middle-income countries (MICs) (86.1% vs. 63.1%, p = 0.002), and a low proportion of both had policy to address overweight. Having a nutrition policy that addresses undernutrition was not associated with better nutrition status outcomes. Strong nutrition governance in LAMICS was associated with low magnitudes of stunting (beta = -4.958, p = 0.015); wasting (beta = -5.418, p = 0.003); and underweight (beta = -6.452, p = 0.001).

CONCLUSION

Despite high magnitudes of undernutrition and overweight/obesity in LAMICs, only about one third of them had nutrition policies to address such nutrition transition. Having strong nutrition governance may help to bring down the magnitudes of undernutrition in LAMICs.