1
|
Liefke J, Sepúlveda-Martinez A, Shakya S, Ehrenborg KS, Arheden H, Morsing E, Ley D, Heiberg E, Hedström E. Early-Onset Fetal Growth Restriction Increases Left Ventricular Sphericity in Adolescents Born Very Preterm. Pediatr Cardiol 2024; 45:1729-1740. [PMID: 37596421 PMCID: PMC11442571 DOI: 10.1007/s00246-023-03265-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/04/2023] [Indexed: 08/20/2023]
Abstract
Left ventricular shape alterations predict cardiovascular outcomes and have been observed in children born preterm and after fetal growth restriction (FGR). The aim was to investigate whether left ventricular shape is altered in adolescents born very preterm and if FGR has an additive effect. Adolescents born very preterm due to verified early-onset FGR and two control groups with birthweight appropriate for gestational age (AGA), born at similar gestational age and at term, respectively, underwent cardiac MRI. Principal component analysis was applied to find the modes of variation best explaining shape variability for end-diastole, end-systole, and for the combination of both, the latter indicative of function. Seventy adolescents were included (13-16 years; 49% males). Sphericity was increased for preterm FGR versus term AGA for end-diastole (36[0-60] vs - 42[- 82-8]; p = 0.01) and the combined analysis (27[- 23-94] vs - 51[- 119-11]; p = 0.01), as well as for preterm AGA versus term AGA for end-diastole (30[- 56-115] vs - 42[- 82-8]; p = 0.04), for end-systole (57[- 29-89] vs - 30[- 79-34]; p = 0.03), and the combined analysis (44[- 50-145] vs - 51[- 119-11]; p = 0.02). No group differences were observed for left ventricular mass or ejection fraction (all p ≥ 0.33). Sphericity was increased after very preterm birth and exacerbated by early-onset FGR, indicating an additive effect to that of very preterm birth on left ventricular remodeling. Increased sphericity may be a prognostic biomarker of future cardiovascular disease in this cohort that as of yet shows no signs of cardiac dysfunction using standard clinical measurements.
Collapse
Affiliation(s)
- Jonas Liefke
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Clinical Physiology, Skåne University Hospital, Lund, Sweden
| | - Alvaro Sepúlveda-Martinez
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hospital Clínico de La Universidad de Chile, Santiago de Chile, Chile
| | - Snehlata Shakya
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | | | - Håkan Arheden
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Eva Morsing
- Paediatrics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Pediatrics, Skåne University Hospital, Lund, Sweden
| | - David Ley
- Paediatrics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Pediatrics, Skåne University Hospital, Lund, Sweden
| | - Einar Heiberg
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Erik Hedström
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
- Department of Clinical Physiology, Skåne University Hospital, Lund, Sweden.
- Diagnostic Radiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
- Department of Radiology, Skåne University Hospital, Lund, Sweden.
| |
Collapse
|
2
|
Aakvik KAD, Benum SD, Tikanmäki M, Hovi P, Räikkönen K, Harris SL, Woodward LJ, Darlow BA, Indredavik MS, Lydersen S, Mork PJ, Kajantie E, Evensen KAI. Physical activity and cognitive function in adults born very preterm or with very low birth weight-an individual participant data meta-analysis. PLoS One 2024; 19:e0298311. [PMID: 38349926 PMCID: PMC10863878 DOI: 10.1371/journal.pone.0298311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 12/30/2023] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE Individuals born very preterm (<32 weeks of gestation) or with very low birthweight (<1500g) have lower cognitive function compared with term-born peers. Furthermore, some studies suggest that they are less physically active as young adults than controls, but the relationship between physical activity and cognitive function remains unclear. We performed an individual participant data meta-analysis to examine whether being born preterm/with very low birth weight is associated with physical activity in adulthood and examined if cognitive function mediates this association. STUDY DESIGN Cohorts with data on physical activity and cognitive function in adults born very preterm/very low birth weight and term-born controls were recruited from the Research on European Children and Adults Born Preterm, and the Adults Born Preterm International Collaboration Consortia. A systematic literature search was performed in PubMed and Embase. RESULTS Five cohorts with 1644 participants aged 22-28 years (595 very preterm/very low birth weight and 1049 controls) were included. Adults born very preterm/very low birth weight reported 1.11 (95% CI: 0.68 to 1.54) hours less moderate to vigorous physical activity per week than controls, adjusted for cohort, age and sex. The difference between individuals born very preterm/very low birth weight and controls was larger among women than among men. Neither intelligence quotient nor self-reported executive function mediated the association between very preterm/very low birth weight and moderate to vigorous physical activity. Results were essentially the same when we excluded individuals with neurosensory impairments. CONCLUSION Adults born very preterm/very low birth weight, especially women, reported less moderate to vigorous physical activity than their term-born peers. Cognitive function did not mediate this association. Considering the risk of adverse health outcomes among individuals born preterm, physical activity could be a target for intervention.
Collapse
Affiliation(s)
- Kristina Anna Djupvik Aakvik
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Silje Dahl Benum
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marjaana Tikanmäki
- Clinical Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Public Health Unit, Finnish Institute for Health and Welfare, Helsinki/Oulu, Finland
| | - Petteri Hovi
- Public Health Unit, Finnish Institute for Health and Welfare, Helsinki/Oulu, Finland
- Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Sarah L. Harris
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
| | - Lianne J. Woodward
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | - Brian A. Darlow
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
| | - Marit S. Indredavik
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Lydersen
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eero Kajantie
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Clinical Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Public Health Unit, Finnish Institute for Health and Welfare, Helsinki/Oulu, Finland
- Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kari Anne I. Evensen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- Unit for Physiotherapy Services, Trondheim Municipality, Trondheim, Norway
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| |
Collapse
|
3
|
Kulmala M, Jørgensen APM, Aakvik KAD, Jussinniemi L, Benum SD, Ingvaldsen SH, Austeng D, Kajantie E, Evensen KAI, Majander A, Morken TS. Visual function in adults born preterm with very low birth weight-A two-country birth cohort study. Acta Ophthalmol 2024; 102:49-57. [PMID: 37172142 DOI: 10.1111/aos.15683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/17/2023] [Accepted: 04/21/2023] [Indexed: 05/14/2023]
Abstract
PURPOSE The purpose of the study was to investigate visual function and vision-related general health in adults that were born preterm with very low birth weight (VLBW: birth weight < 1500 g) in their 30s-40s. METHODS We recruited 137 adults born preterm with VLBW and 158 term-born controls aged 31-43 years from two birth cohorts: the Helsinki Study of Very Low Birth Weight Adults (Finland) and the NTNU Low Birth Weight in a Lifetime Perspective study (Norway). We used neonatal data and measured refraction, best-corrected visual acuity (BCVA) using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart, contrast sensitivity, visual fields, intraocular pressure (IOP), self-reported vision-targeted health status with the National Eye Institute Visual Function Questionnaire-25. RESULTS VLBW adults had a lower BCVA ETDRS score than controls: mean (SD) better eye 86.7 (13.4) versus 90.2 (4.4), p = 0.02; mean (SD) worse eye 82.3 (14.9) versus 87.6 (4.6), p = 0.003. VLBW adults also had lower contrast sensitivity thresholds in several spatial frequencies and scored lower than controls in eight out of the 12 subscales of self-reported vision-targeted health status. Refraction, visual fields and IOP were similar between groups. Two VLBW participants were blind. None had been treated for retinopathy of prematurity. CONCLUSION We suggest that lower visual function and vision-related health represent life-long consequences of prematurity and VLBW in the studied 31- to 43-year-old cohort. The underlying mechanisms remain to be determined.
Collapse
Affiliation(s)
- Maarit Kulmala
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland
| | | | | | - Laura Jussinniemi
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Oulu, Finland
| | - Silje Dahl Benum
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
| | - Sigrid Hegna Ingvaldsen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Ophthalmology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Dordi Austeng
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Ophthalmology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Eero Kajantie
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Oulu, Finland
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kari Anne I Evensen
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Anna Majander
- Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Tora Sund Morken
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Ophthalmology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| |
Collapse
|
4
|
Hollund IMH, Aakvik KAD, Benum SD, Ingvaldsen SH, Lydersen S, Tikanmäki M, Hovi P, Räikkönen K, Kajantie E, Johnson S, Marlow N, Baumann N, Wolke D, Indredavik MS, Evensen KAI. Mental health, pain and tiredness in adults born very preterm or with very low birthweight. Acta Paediatr 2024; 113:72-80. [PMID: 37787099 DOI: 10.1111/apa.16982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/15/2023] [Accepted: 09/19/2023] [Indexed: 10/04/2023]
Abstract
AIM Adults born preterm have increased risk of mental health problems and other neurodevelopmental conditions. We aimed to investigate associations of mental health with pain and tiredness in adults born very preterm (VP; <32 weeks) or very low birthweight (VLBW; <1500 g) and at term, and whether these associations are influenced by physical activity. METHODS As part of an EU Horizon 2020 project, individual participant data from six prospective cohort studies were harmonised for 617 VP/VLBW and 1122 term-born participants. Mental health was assessed by the Achenbach System of Empirically Based Assessment Adult Self-Report. Pain and tiredness were harmonised based on specific items from self-reported questionnaires. Associations between mental health and pain or tiredness were explored by linear regression. RESULTS An increase in the mental health scales internalising, externalising and total problems was associated with increased pain and tiredness in the preterm and term group alike. Results were maintained when adjusting for physical activity. CONCLUSION The findings indicate that associations between mental health, pain and tiredness in adults are independent of gestation or birthweight. Future research should explore other potential mechanisms that may underlie the increased risk of mental health problems in the preterm population.
Collapse
Affiliation(s)
- Ingrid Marie Husby Hollund
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Kristina Anna Djupvik Aakvik
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Silje Dahl Benum
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Sigrid Hegna Ingvaldsen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Lydersen
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marjaana Tikanmäki
- Clinical Medicine Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland
- Public Health Unit, Finnish Institute for Health and Welfare, Helsinki/Oulu, Finland
| | - Petteri Hovi
- Public Health Unit, Finnish Institute for Health and Welfare, Helsinki/Oulu, Finland
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Clinical Medicine Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland
- Public Health Unit, Finnish Institute for Health and Welfare, Helsinki/Oulu, Finland
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Samantha Johnson
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Neil Marlow
- UCL Elizabeth Garrett Anderson Institute for Women's Health, London, UK
| | - Nicole Baumann
- Department of Population Health Sciences, University of Leicester, Leicester, UK
- Turner Institute for Brain & Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Department of Psychology, University of Warwick, Coventry, UK
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Marit S Indredavik
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kari Anne I Evensen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- Unit for Physiotherapy Services, Trondheim Municipality, Trondheim, Norway
- Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| |
Collapse
|
5
|
Tornquist D, Crochemore-Silva I, Tornquist L, Mielke GI, Ekelund U, Murray J, Domingues MR. Trajectories of Device-Measured Physical Activity During Early Childhood and Its Determinants: Findings From the 2015 Pelotas (Brazil) Birth Cohort Study. J Phys Act Health 2023; 20:840-849. [PMID: 37451685 DOI: 10.1123/jpah.2022-0608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The objective was to describe trajectories of physical activity (PA) measured by accelerometry during early childhood and to test associations with sociodemographic, gestational, maternal, and perinatal determinants. METHODS Data from 1798 children from the 2015 Pelotas (Brazil) Birth Cohort were analyzed. PA was measured with wrist accelerometers at 1, 2, and 4 years. PA trajectories were estimated using group-based trajectory modeling, and associations with determinants were tested using Poisson regression with robust variance. RESULTS Two trajectories were identified: Moderate and high PA, both showing a linear increase in PA in the first years but differing in volume. Girls (prevalence ratio [PR]: 0.91; 95% confidence interval [CI], 0.88-0.94), highly educated mothers (PR: 0.93; 95% CI, 0.88-0.97), and high birth weight children (PR: 0.91; 95% CI, 0.85-0.97) showed less probability of high PA trajectory. Birth order ≥3 (PR: 1.06; 95% CI, 1.01-1.11) was associated with higher likelihood of high PA trajectory. CONCLUSIONS Children showed an increase in PA during the first years, with 2 trajectories that differ in PA levels. Female sex, high maternal schooling, and high birth weight reduced the probability of having a high PA trajectory, while higher birth order increased this probability. These characteristics should be considered when planning PA interventions for children in early childhood.
Collapse
Affiliation(s)
- Debora Tornquist
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Inácio Crochemore-Silva
- Postgraduate Program in Physical Education and Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Luciana Tornquist
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Grégore I Mielke
- School of Public Health, University of Queensland, Brisbane, QLD,Australia
| | - Ulf Ekelund
- Norwegian School of Sport Sciences, Oslo,Norway
| | - Joseph Murray
- Human Development and Violence Research Centre (DOVE), Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Marlos R Domingues
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS,Brazil
| |
Collapse
|
6
|
Poole G, Harris C, Greenough A. Exercise Capacity in Very Low Birth Weight Adults: A Systematic Review and Meta-Analysis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1427. [PMID: 37628426 PMCID: PMC10453861 DOI: 10.3390/children10081427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/31/2023] [Accepted: 08/05/2023] [Indexed: 08/27/2023]
Abstract
There is an association between very low birth weight (VLBW) and cardiovascular morbidity and mortality in adulthood. Aerobic fitness, measured as the maximal oxygen consumption (VO2 max), is a good indicator of cardiopulmonary health and predictor of cardiovascular mortality. Our aim was to determine the effect of birth weight on aerobic exercise capacity and physical activity. We systematically identified studies reporting exercise capacity (VO2 max and VO2 peak) and physical activity levels in participants born at VLBW aged eighteen years or older compared to term-born controls from six databases (MEDLINE, OVID, EMBASE, CI NAHL, CENTRAL, and Google Scholar). Meta-analysis of eligible studies was conducted using a random effect model. We screened 6202 articles and identified 15 relevant studies, 10 of which were eligible for meta-analysis. VLBW participants had a lower VO2 max compared to their term counterparts (-3.35, 95% CI: -5.23 to -1.47, p = 0.0005), as did VLBW adults who had developed bronchopulmonary dysplasia (-6.08, 95% CI -11.26 to -0.90, p = 0.02). Five of nine studies reported significantly reduced self-reported physical activity levels. Our systematic review and meta-analysis demonstrated reduced maximal aerobic exercise capacity in adults born at VLBW compared to term-born controls.
Collapse
Affiliation(s)
- Grace Poole
- Neonatal Intensive Care Centre, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK; (G.P.); (C.H.)
| | - Christopher Harris
- Neonatal Intensive Care Centre, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK; (G.P.); (C.H.)
| | - Anne Greenough
- Department of Women and Children’s Health, Faculty of Life Sciences and Medicine, King’s College London, London SE5 9RS, UK
| |
Collapse
|
7
|
Kuitunen I, Sund R, Sankilampi U. Association of Preterm Birth and Low Birthweight with Bone Fractures during Childhood. J Bone Miner Res 2023; 38:1116-1124. [PMID: 37221134 DOI: 10.1002/jbmr.4833] [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: 04/02/2023] [Revised: 05/08/2023] [Accepted: 05/13/2023] [Indexed: 05/25/2023]
Abstract
Preterm birth and low birthweight have been associated with increased fracture risk in children. Our aim was to analyze bone fractures during childhood in preterm, and low-birthweight newborns compared to full-term and normal-birthweight newborns. We conducted a nationwide register-based cohort study in Finland from 1998 to 2017 and utilized the Medical Birth Register and Care Register for Health Care. All newborns alive 28 days after birth were included, and data on all fracture visits in specialized healthcare units were gathered. Incidences per 100,000 person-years with 95% confidence intervals (CI) were calculated, and comparisons were made by incidence rate ratios (IRRs). Kaplan-Meier analysis was used to analyze the timing of fractures during childhood (0-20 years). We included a total of 997,468 newborns and 95,869 fractures; the mean follow-up was 10.0 years, and the overall incidence of fractures was 963 per 100,000 person-years. Very preterm (<32 gestational weeks) newborns had 23% lower fracture incidence than term newborns (IRR 0.77; CI: 0.70-0.85). Preterm newborns (32 to 36 gestational weeks) had a fracture rate (IRR 0.98; CI: 0.95-1.01) similar to that of term newborns. Birthweight showed a linear increase in the fracture rates as newborns with birthweight less than 1000 g had the lowest fracture incidence of 773 per 100,000 person-years and the highest incidence (966 per 100,000 person-years) was among newborns with birthweight 2500 g or more. Children born very preterm or with extremely low birthweight have in general a lower fracture incidence during childhood compared to children born full term and with normal birthweight. These findings possibly reflect, in addition to improvements of neonatal intensive care and early nutrition, the fact that childhood fracture incidences are more dependent on issues other than early life events. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Collapse
Affiliation(s)
- Ilari Kuitunen
- Institute of Clinical Medicine and Department of Pediatrics, University of Eastern Finland, Kuopio, Finland
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
| | - Reijo Sund
- Institute of Clinical Medicine and Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland
| | - Ulla Sankilampi
- Institute of Clinical Medicine and Department of Pediatrics, University of Eastern Finland, Kuopio, Finland
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
| |
Collapse
|
8
|
Hochmayr C, Ndayisaba JP, Gande N, Staudt A, Bernar B, Stock K, Kiechl SJ, Geiger R, Griesmaier E, Knoflach M, Kiechl-Kohlendorfer U. Cardiovascular health profiles in adolescents being born term or preterm-results from the EVA-Tyrol study. BMC Cardiovasc Disord 2023; 23:371. [PMID: 37488472 PMCID: PMC10367422 DOI: 10.1186/s12872-023-03360-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/21/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND AND AIMS Preterm birth has been linked with an increased risk of cardiovascular (CV) disease from childhood into adolescence and early adulthood. In this study, we aimed to investigate differences in CV health profiles between former term- and preterm-born infants in a cohort of Tyrolean adolescents. METHODS The Early Vascular Aging (EVA)-Tyrol study is a population-based non-randomized controlled trial, which prospectively enrolled 14- to 19-year-old adolescents in North Tyrol, Austria and South Tyrol, Italy between 2015 and 2018. Metrics of CV health (body mass index (BMI), systolic (SBP) and diastolic blood pressure (DBP), smoking, physical activity, dietary patterns, total cholesterol and fasting blood glucose) were assessed and compared between former term- and preterm-born girls and boys. RESULTS In total, 1,491 study participants (59.5% female, mean age 16.5 years) were included in the present analysis. SBP and DBP were significantly higher in former preterm-born adolescents (mean gestational age 34.6 ± 2.4 weeks) compared to term-born controls (p < 0.01). In the multivariate regression analysis these findings remained significant after adjustment for potential confounders in all models. No differences were found in all other CV health metrics. The number of participants meeting criteria for all seven health metrics to be in an ideal range was generally very low with 1.5% in former term born vs. 0.9% in former preterm born adolescents (p = 0.583). CONCLUSIONS Preterm birth is associated with elevated SBP and DBP in adolescence, which was even confirmed for former late preterm-born adolescents in our cohort. Our findings underscore the importance of promoting healthy lifestyles in former term- as well as preterm-born adolescents. In addition, we advise early screening for hypertension and long-term follow-up in the group of preterm-born individuals.
Collapse
Affiliation(s)
- Christoph Hochmayr
- Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
- VASCage, Center on Clinical Stroke Research, Tyrol, Innsbruck, Austria
| | - Jean-Pierre Ndayisaba
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
| | - Nina Gande
- Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
- VASCage, Center on Clinical Stroke Research, Tyrol, Innsbruck, Austria
| | - Anna Staudt
- Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
- VASCage, Center on Clinical Stroke Research, Tyrol, Innsbruck, Austria
| | - Benoit Bernar
- VASCage, Center on Clinical Stroke Research, Tyrol, Innsbruck, Austria
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Katharina Stock
- VASCage, Center on Clinical Stroke Research, Tyrol, Innsbruck, Austria
- Department of Pediatrics III (Pediatric Cardiology, Allergology and Cystic Fibrosis), Medical University of Innsbruck, Innsbruck, Austria
| | - Sophia J Kiechl
- VASCage, Center on Clinical Stroke Research, Tyrol, Innsbruck, Austria
- Department of Neurology, Hochzirl Hospital, Zirl, Austria
| | - Ralf Geiger
- Department of Pediatrics III (Pediatric Cardiology, Allergology and Cystic Fibrosis), Medical University of Innsbruck, Innsbruck, Austria
| | - Elke Griesmaier
- Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
| | - Michael Knoflach
- VASCage, Center on Clinical Stroke Research, Tyrol, Innsbruck, Austria.
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria.
| | - Ursula Kiechl-Kohlendorfer
- Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria.
| |
Collapse
|
9
|
Carregã M, Sousa P, Rocha G, Ferreira-Magalhães M, Azevedo I. Respiratory and non-respiratory outcomes of bronchopulmonary dysplasia in adolescents: A systematic review. Early Hum Dev 2023; 180:105756. [PMID: 36965348 DOI: 10.1016/j.earlhumdev.2023.105756] [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: 02/02/2023] [Revised: 03/17/2023] [Accepted: 03/17/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND There is lack of evidence synthesis on the global consequences of bronchopulmonary dysplasia (BPD) in adolescence. AIM Assess the impact of bronchopulmonary dysplasia on respiratory and non-respiratory outcomes in adolescents. METHODS A systematic review of studies assessing the outcomes of adolescents aged 10 to 19 years-old with BPD was conducted. We independently screened studies published until 6th March 2023 in PubMed® and Scopus® databases. Data on methodologic design, sample descriptive and findings were extracted from each study. Risk of bias was assessed using quality assessment tools. RESULTS Thirty-one studies were included. Adolescents with a history of BPD present with more respiratory symptoms (wheezing, respiratory exacerbations, need for respiratory medication) and twenty-five studies showed a reduction in pulmonary function, with varying impact according to BPD severity and no differences before and after the surfactant era. Spirometry evaluation throughout the years is not consensual, but methacholine and salbutamol response in BPD groups is increased compared to non-BPD groups. Markers of eosinophilic airway inflammation are not increased as in asthma patients. Exercise potential is identical, but data regarding physical capacity and activity are inconsistent. More frequent radiologic abnormalities translate into higher high-resolution computed tomography scores, with linear (72.2 %) and triangular subpleural opacities (58.3 %) as the most common findings. There is a higher risk for special needs in education, but quality of life seems to be equal to non-BPD adolescents. CONCLUSIONS BPD negatively impacts both pulmonary and non-pulmonary outcomes in adolescents.
Collapse
Affiliation(s)
- Mariana Carregã
- Unidade Local de Saúde de Matosinhos, Portugal; Medicine Faculty, University of Porto, Portugal.
| | - Patrícia Sousa
- Department of Pediatrics, Centro Hospitalar Universitário do São João, Porto, Portugal
| | - Gustavo Rocha
- Department of Neonatology, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Manuel Ferreira-Magalhães
- Department of Pediatric Pulmonology, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Porto, Portugal; Department of Child and Adolescent Medicine, Abel Salazar Biomedical Sciences Institute, Porto, Portugal; Department of Medicine of Community, Information and Health Decision (MEDCIDS), Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Inês Azevedo
- Department of Pediatrics, Centro Hospitalar Universitário do São João, Portugal; Department of Gynecology-Obstetrics and Pediatrics, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.
| |
Collapse
|
10
|
Gostelow T, Stöhr EJ. The Effect of Preterm Birth on Maximal Aerobic Exercise Capacity and Lung Function in Healthy Adults: A Systematic Review and Meta-analysis. Sports Med 2022; 52:2627-2635. [PMID: 35759177 PMCID: PMC9584843 DOI: 10.1007/s40279-022-01710-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND A negative impact of premature birth on health in adulthood is well established. However, it is not clear whether healthy adults who were born prematurely but have similar physical activity levels compared to adults born at term have a reduced maximal aerobic exercise capacity (maximum oxygen consumption [VO2max]). OBJECTIVE We aimed to determine the effect of premature birth on aerobic exercise capacity and lung function in otherwise healthy, physically active individuals. METHODS A broad literature search was conducted in the PubMed database. Search terms included 'preterm/premature birth' and 'aerobic exercise capacity'. Maximal oxygen consumption (mL/kg/min) was the main variable required for inclusion, and amongst those investigations forced expiratory volume in 1 s (FEV1, % predicted) was evaluated as a secondary parameter. For the systematic review, 29 eligible articles were identified. Importantly, for the meta-analysis, only studies which reported similar activity levels between healthy controls and the preterm group/s were included, resulting in 11 articles for the VO2max analysis (total n = 688, n = 333 preterm and n = 355 controls) and six articles for the FEV1 analysis (total n = 296, n = 147 preterm and n = 149 controls). Data were analysed using Review Manager ( Review Manager. RevMan version 5.4 software. The Cochrane Collaboration; 2020.). RESULTS The systematic review highlighted the broad biological impact of premature birth. While the current literature tends to suggest that there may be a negative impact of premature birth on both VO2max and FEV1, several studies did not control for the potential influence of differing physical activity levels between study groups, thus justifying a focused meta-analysis of selected studies. Our meta-analysis strongly suggests that prematurely born humans who are otherwise healthy do have a reduced VO2max (mean difference: - 4.40 [95% confidence interval - 6.02, - 2.78] mL/kg/min, p < 0.00001, test for overall effect: Z = 5.32) and FEV1 (mean difference - 9.22 [95% confidence interval - 13.54, - 4.89] % predicted, p < 0.0001, test for overall effect: Z = 4.18) independent of physical activity levels. CONCLUSIONS Whilst the current literature contains mixed findings on the effects of premature birth on VO2max and FEV1, our focused meta-analysis suggests that even when physical activity levels are similar, there is a clear reduction in VO2max and FEV1 in adults born prematurely. Therefore, future studies should carefully investigate the underlying determinants of the reduced VO2max and FEV1 in humans born preterm, and develop strategies to improve their maximal aerobic capacity and lung function beyond physical activity interventions.
Collapse
Affiliation(s)
- Thomas Gostelow
- School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Eric J Stöhr
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
- COR-HELIX (CardiOvascular Regulation and Exercise Laboratory-Integration and Xploration), Institute of Sport Science, Leibniz University Hannover, Am Moritzwinkel 6, Building 1806, 30167, Hannover, Germany.
| |
Collapse
|
11
|
Andrade MLSDS, Oliveira JDS, de Souza NP, Costa EC, Tavares FCDLP, Cabral PC, de Aquino NB, Leal VS, Cabral de Lira PI. Birth-related and current factors associated with physical inactivity in the leisure time in Brazilian adolescents. PLoS One 2022; 17:e0273611. [PMID: 36083895 PMCID: PMC9462571 DOI: 10.1371/journal.pone.0273611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 08/13/2022] [Indexed: 11/18/2022] Open
Abstract
Background
To determine whether biological and sociodemographic factors at birth and current factors are associated with insufficient physical activity during leisure among Brazilian adolescents.
Methods
A school-based cross-sectional study with national coverage was conducted involving Brazilian adolescents 12 to 17 years of age in municipalities with more than 100 thousand residents. The sample consisted of 74,589 adolescents who participated in the Study of Cardiovascular Risk in Adolescents. Insufficient leisure-time physical activity was categorized based on total volume (<300 minutes/week = insufficiently active; >300 minutes/week = sufficiently active). Poisson regression models were used to assess associated factors.
Results
Most adolescents were classified as insufficiently active (54.8%; 95%CI: 53.7–55.9). The variables associated with insufficient physical activity during leisure were the female sex (70.4%; 95%CI: 68.8–71.9), age between 15 and 17 years (57.8%; 95%CI: 56.3–59.2), pertaining to the low or middle class (54.5%; 95%CI: 52.8–56.1), and not being overweight (55.9%; 95%CI: 54.6–57.1).
Conclusion
Contrary to our hypothesis, birth related factors (e.g., low birth weight, preterm birth and exclusive breastfeeding until 6 months of age) are not associated with physical inactivity. The prevalence of insufficient physical activity during leisure was high among the adolescents evaluated and was associated with sociodemographic characteristics as well as nutritional status. It is necessary to implement strategies focused on physical activity at schools.
Collapse
Affiliation(s)
| | - Juliana de Souza Oliveira
- Nutrition Center, Centro Acadêmico de Vitória, Universidade Federal de Pernambuco, Vitória de Santo Antão, Pernambuco, Brazil
| | - Nathália Paula de Souza
- Nutrition Center, Centro Acadêmico de Vitória, Universidade Federal de Pernambuco, Vitória de Santo Antão, Pernambuco, Brazil
| | - Emilia Chagas Costa
- Nutrition Center, Centro Acadêmico de Vitória, Universidade Federal de Pernambuco, Vitória de Santo Antão, Pernambuco, Brazil
| | | | - Poliana Coelho Cabral
- Department of Nutrition, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | | | - Vanessa Sá Leal
- Nutrition Center, Centro Acadêmico de Vitória, Universidade Federal de Pernambuco, Vitória de Santo Antão, Pernambuco, Brazil
| | | |
Collapse
|
12
|
Blodgett JM, Norris T, Stamatakis E, O'Donovan G, Pinto Pereira SM, Hamer M. Prenatal and postnatal correlates of moderate-to-vigorous physical activity in midlife: evidence from the 1970 British Cohort Study. J Epidemiol Community Health 2022. [PMCID: PMC9554029 DOI: 10.1136/jech-2022-219213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background It is hypothesised that lifelong physical activity behaviours are established in early life, however there is minimal, and contradictory, evidence examining prenatal and postnatal factors in relation to adulthood physical activity. We investigated associations between prospectively ascertained prenatal/postnatal factors and device-measured moderate-to-vigorous physical activity (MVPA) in midlife. Methods Analyses included 5011 participants from the 1970 British Cohort Study, a birth cohort study of individuals born within the same week. At birth, the following factors were ascertained: socioeconomic position (SEP), maternal age, number of previous pregnancies, maternal smoking, maternal diabetes, gestational age, birth weight, breastfeeding status and infant health concerns. MVPA was captured at age 46 with a thigh-worn accelerometer device following a 24-hour protocol over 7 days. Results In sex-adjusted models, lower SEP (−6.7 min/day (95% CI: −9.0 to –4.4) in those with a partly or unskilled paternal occupation), younger maternal age (0.4 min/day (0.2 to 0.5) per additional year of maternal age), maternal smoking during pregnancy (−2.5 min/day (−4.0 to –1.0)) and post-term gestational age (−7.4 min/day (−11.5 to –3.4); boys only) were associated with lower MVPA at age 46. In the mutually adjusted model, associations did not change but there was some evidence that birth weight may also be associated with MVPA levels. Conclusions SEP, maternal age, maternal smoking, post-term birth in boys and birth weight were associated with MVPA in midlife, indicating that midlife physical activity behaviours may be partially established at birth. Early interventions in disadvantaged environments may have a positive impact on physical activity throughout the life course.
Collapse
Affiliation(s)
- Joanna M Blodgett
- Institute of Sport Exercise & Health, Department of Targeted Intervention, Division of Surgery & Interventional Science, University College London, London, UK
| | - Thomas Norris
- Institute of Sport Exercise & Health, Department of Targeted Intervention, Division of Surgery & Interventional Science, University College London, London, UK
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Gary O'Donovan
- Facultad de Medicina, Universidad de Los Andes, Bogotá, Colombia
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Snehal M Pinto Pereira
- Institute of Sport Exercise & Health, Department of Targeted Intervention, Division of Surgery & Interventional Science, University College London, London, UK
| | - Mark Hamer
- Institute of Sport Exercise & Health, Department of Targeted Intervention, Division of Surgery & Interventional Science, University College London, London, UK
| |
Collapse
|
13
|
Evensen KAI, Ustad T, Tikanmäki M, Haaramo P, Kajantie E. Long-term motor outcomes of very preterm and/or very low birth weight individuals without cerebral palsy: A review of the current evidence. Semin Fetal Neonatal Med 2020; 25:101116. [PMID: 32461044 DOI: 10.1016/j.siny.2020.101116] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
We reviewed literature on long-term motor outcomes of individuals aged five years or older born very preterm (VP: ≤32 weeks of gestation) or with very low birth weight (VLBW: ≤1500g), without cerebral palsy (CP). PubMed produced 2827 articles, whereof 38 were eligible. Assessed by standardised and norm-based motor tests, the Movement Assessment Battery for Children being the most widely used, VP/VLBW individuals showed poorer motor skills compared with term-born controls with differences of approximately 1 SD in magnitude. Some studies assessed subdomains and differences were present in fine motor/manual dexterity, ball skills and gross motor/balance. Prevalence of motor problems varied largely from 8-37% in studies with cut-off at the 5th percentile or -1.5 SD to 12-71% in studies with cut-off at the 15th percentile or -1 SD. This review shows that the degree of motor impairments continues to be substantial among VP/VLBW individuals who do not develop CP.
Collapse
Affiliation(s)
- Kari Anne I Evensen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway; Unit for Physiotherapy Services, Trondheim Municipality, Trondheim, Norway; Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.
| | - Tordis Ustad
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Marjaana Tikanmäki
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Finnish Institute for Health and Welfare, Public Health Promotion Unit, Helsinki, Oulu, Finland
| | - Peija Haaramo
- Finnish Institute for Health and Welfare, Public Health Promotion Unit, Helsinki, Oulu, Finland
| | - Eero Kajantie
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Finnish Institute for Health and Welfare, Public Health Promotion Unit, Helsinki, Oulu, Finland; Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| |
Collapse
|
14
|
Björkqvist J, Kuula J, Kuula L, Nurhonen M, Hovi P, Räikkönen K, Pesonen A, Kajantie E. Chronotype in very low birth weight adults - a sibling study. Chronobiol Int 2020; 37:1023-1033. [PMID: 32354238 DOI: 10.1080/07420528.2020.1754847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Chronotype is the temporal preference for activity and sleep during the 24 h day and is linked to mental and physical health, quality of life, and mortality. Later chronotypes, so-called "night owls", consistently display poorer health outcomes than "larks". Previous studies have suggested that preterm birth (<37 weeks of gestation) is associated with an earlier chronotype in children, adolescents, and young adults, but studies beyond this age are absent. Our aim was to determine if adults born preterm at very low birth weight (VLBW, ≤1500 g) display different chronotypes than their siblings. We studied VLBW adults, aged 29.9 years (SD 2.8), matched with same-sex term-born siblings as controls. A total of 123 participants, consisting of 53 sibling pairs and 17 unmatched participants, provided actigraphy-derived data on the timing, duration, and quality of sleep from 1640 nights (mean 13.3 per participant, SD 2.7). Mixed effects models provided estimates and significance tests. Compared to their siblings, VLBW adults displayed 27 min earlier sleep midpoint during free days (95% CI: 3 to 51 min, p =.029). This was also reflected in the timing of falling asleep, waking up, and sleep-debt corrected sleep midpoint. The findings were emphasized in VLBW participants born small for gestational age. VLBW adults displayed an earlier chronotype than their siblings still at age 30, which suggests that the earlier chronotype is an enduring individual trait not explained by shared family factors. This preference could provide protection from risks associated with preterm birth. ABBREVIATIONS AGA: Appropriate for gestational age; ELBW: Extremely low birth weight, ≤ 1000 grams; FMBR: Finnish Medical Birth Registry; HeSVA: Helsinki Study of Very low birth weight Adults; MSFsc: Midsleep on free days, corrected for sleep debt; SGA: Small for gestational age, ≤ -2 SD; VLBW: Very low birth weight, ≤ 1500 grams; WASO: Wake after sleep onset.
Collapse
Affiliation(s)
- Johan Björkqvist
- Children's Hospital, and Pediatric Research Center, University of Helsinki and Helsinki University Hospital , Helsinki, Finland.,Department of Public Health Promotion, Finnish Institute for Health and Welfare , Helsinki, Finland
| | - Juho Kuula
- Department of Public Health Promotion, Finnish Institute for Health and Welfare , Helsinki, Finland.,Department of Radiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital , Helsinki, Finland
| | - Liisa Kuula
- SleepWell Research Program, Faculty of Medicine, University of Helsinki , Helsinki, Finland
| | - Markku Nurhonen
- Department of Public Health Promotion, Finnish Institute for Health and Welfare , Helsinki, Finland
| | - Petteri Hovi
- Children's Hospital, and Pediatric Research Center, University of Helsinki and Helsinki University Hospital , Helsinki, Finland.,Department of Public Health Promotion, Finnish Institute for Health and Welfare , Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki , Helsinki, Finland
| | - Anu Pesonen
- SleepWell Research Program, Faculty of Medicine, University of Helsinki , Helsinki, Finland
| | - Eero Kajantie
- Children's Hospital, and Pediatric Research Center, University of Helsinki and Helsinki University Hospital , Helsinki, Finland.,Department of Public Health Promotion, Finnish Institute for Health and Welfare , Helsinki, Finland.,PEDEGO Research Unit, University of Oulu , Oulu, Finland.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology , Trondheim, Norway
| |
Collapse
|
15
|
Abstract
PURPOSE OF REVIEW To summarize the current literature evaluating long-term pulmonary morbidity among surviving very preterm infants with bronchopulmonary dysplasia (BPD). RECENT FINDINGS BPD predisposes very preterm infants to adverse respiratory signs and symptoms, greater respiratory medication use, and more frequent need for rehospitalization throughout early childhood. Reassuringly, studies also indicate that older children and adolescents with BPD experience, on average, similar functional status and quality of life when compared to former very preterm infants without BPD. However, measured deficits in pulmonary function may persist in those with BPD and indicate an increased susceptibility to early-onset chronic obstructive pulmonary disease during adulthood. Moreover, subtle differences in exercise tolerance and activity may put survivors with BPD at further risk of future morbidity in later life. SUMMARY Despite advances in neonatal respiratory care, a diagnosis of BPD continues to be associated with significant pulmonary morbidity over the first two decades of life. Long-term longitudinal studies are needed to determine if recent survivors of BPD will also be at increased risk of debilitating pulmonary disease in adulthood.
Collapse
|
16
|
Ho KY, Goto R, Näsänen‐Gilmore P, Andersson S, Eriksson JG, Kajantie E, Hovi P. High-sensitivity C-reactive protein concentration in young adults in the Helsinki Study of Very Low Birth Weight Adults. Acta Paediatr 2020; 109:855-858. [PMID: 28960518 DOI: 10.1111/apa.14104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 08/27/2017] [Accepted: 09/25/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Kai Yin Ho
- Division of Biological Anthropology Department of Archaeology and Anthropology University of Cambridge Cambridge UK
| | - Rie Goto
- Division of Biological Anthropology Department of Archaeology and Anthropology University of Cambridge Cambridge UK
| | - Pieta Näsänen‐Gilmore
- Department of Health Chronic Diseases Prevention Unit National Institute for Health and Welfare of Finland Helsinki Finland
| | - Sture Andersson
- Children's Hospital University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Johan G. Eriksson
- Department of Health Chronic Diseases Prevention Unit National Institute for Health and Welfare of Finland Helsinki Finland
- Folkhälsan Research Centre Helsinki Finland
- Department of General Practice and Primary Health Care University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Eero Kajantie
- Department of Health Chronic Diseases Prevention Unit National Institute for Health and Welfare of Finland Helsinki Finland
- Children's Hospital University of Helsinki and Helsinki University Hospital Helsinki Finland
- Department of Obstetrics and Gynaecology Medical Research Centre Oulu Oulu University Hospital and University of Oulu Oulu Finland
| | - Petteri Hovi
- Department of Health Chronic Diseases Prevention Unit National Institute for Health and Welfare of Finland Helsinki Finland
- Children's Hospital University of Helsinki and Helsinki University Hospital Helsinki Finland
| |
Collapse
|
17
|
Nixon PA, Shaltout HA, South AM, Jensen ET, O'Shea TM, Brown CL, Washburn LK. Antenatal Steroid Exposure, Aerobic Fitness, and Physical Activity in Adolescents Born Preterm with Very Low Birth Weight. J Pediatr 2019; 215:98-106.e2. [PMID: 31604627 PMCID: PMC6920012 DOI: 10.1016/j.jpeds.2019.08.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/15/2019] [Accepted: 08/06/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To determine whether antenatal corticosteroid exposure is associated with aerobic fitness or physical activity participation in adolescents born preterm with very low birth weight (VLBW). STUDY DESIGN Observational cohort study of 14-year-old adolescents (n = 173) born with VLBW between 1992 and 1996 at a regional perinatal center with 91 exposed to antenatal corticosteroids. Aerobic fitness was determined from peak oxygen uptake (V˙O2peak) obtained via maximal exercise testing on a cycle ergometer. Physical activity levels for the past year and past 2 months were estimated from a questionnaire. Between-group comparisons for continuous variables were evaluated using independent t tests or Mann-Whitney U tests. Generalized linear models were used to compare differences in fitness and physical activity between those exposed to antenatal corticosteroids and not exposed to antenatal corticosteroids, with race and sex in models. RESULTS Regression analysis revealed an antenatal corticosteroids × sex × race interaction for V˙O2peak (P ≤ .001). Nonblack male adolescents exposed to antenatal corticosteroids had significantly greater V˙O2peak than nonblack male adolescents not exposed to antenatal corticosteroids expressed relative to body mass (mean difference [95% CI]; 8.5 [2.1-15.0] mL·kg-1·min-1) and lean body mass (9.0 [1.1-16.9] mL·kglean body mass-1·min-1). No antenatal corticosteroid group differences in V˙O2peak were evident in black male adolescents, or black and nonblack female adolescents. Male adolescents exposed to antenatal corticosteroids reported participating in significantly more total physical activity (medians: 14.6 vs 8.5) and vigorous physical activity (3.0 vs 0.95) per week for the past 2 months than male adolescents not exposed to antenatal corticosteroids. CONCLUSIONS Exposure to antenatal corticosteroids was associated with greater physical activity participation and aerobic fitness in adolescents with VLBW, particularly in nonblack male adolescents, which may confer health benefits in this at-risk population.
Collapse
Affiliation(s)
- Patricia A Nixon
- Department of Health and Exercise Science, Wake Forest University, Winston Salem, NC; Department of Pediatrics, Wake Forest University School of Medicine, Winston Salem, NC.
| | - Hossam A Shaltout
- Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston Salem, NC; Department of Pharmacology and Toxicology, School of Pharmacy, University of Alexandria, Alexandria, Egypt
| | - Andrew M South
- Department of Pediatrics, Wake Forest University School of Medicine, Winston Salem, NC; Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston Salem, NC
| | - Elizabeth T Jensen
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston Salem, NC
| | - T Michael O'Shea
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Callie L Brown
- Department of Pediatrics, Wake Forest University School of Medicine, Winston Salem, NC
| | - Lisa K Washburn
- Department of Pediatrics, Wake Forest University School of Medicine, Winston Salem, NC
| |
Collapse
|
18
|
Spiegler J, Mendonça M, Wolke D. Association of sport participation in preterm and full term born children and body and fat mass indices from age 3 to 14 years. J Sci Med Sport 2019; 23:493-497. [PMID: 31785988 DOI: 10.1016/j.jsams.2019.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 10/03/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To assess the association of gestational age groups (VP: <32 weeks, MP: 32-33 weeks, LP: 34-36 weeks and FT: ≥37 weeks of gestation) and club sport participation in childhood on body mass index (BMI), fat free mass index (FFMI) and fat mass index (FMI). DESIGN Longitudinal, cross sectional. METHODS BMI (age 3, 5, 7, 11 and 14 years; N=10581-14702) and FFMI/FMI (age 7, 11 and 14 years; N=10446-12996) and consistent club sport participation at age 5, 7 and 11 years (ranging from never participating to participating at all three ages) were assessed prospectively. These were compared by gestational age and their associations with BMI and FMI were investigated, while controlling for confounders (socio-economic, maternal obesity, child related, diet). RESULTS BMI and FFMI was lower in VP or MP until age 7, but no differences were found in BMI, FFMI or FMI after age 11 with regard to gestational age. Consistent club sport participation from age 5-11 was unrelated to BMI at ages 3-7. However, FT children with club sport participation had lower BMI and FMI at ages 11 and 14; but this association was not found in VP or MP. CONCLUSIONS During adolescence body composition of VP and MP become similar to FT born peers. Consistent sport participation reduces BMI and FMI in FT only. In VP or MP children modifying effects of sport on body composition might not be detected due to the catch-up growth in weight, height and fat mass at the same time.
Collapse
Affiliation(s)
- Juliane Spiegler
- Department of Psychology and Division of Mental Health & Wellbeing, University of Warwick, United Kingdom; Department of Paediatrics, University of Lübeck, Germany.
| | - Marina Mendonça
- Department of Psychology and Division of Mental Health & Wellbeing, University of Warwick, United Kingdom
| | - Dieter Wolke
- Department of Psychology and Division of Mental Health & Wellbeing, University of Warwick, United Kingdom
| |
Collapse
|
19
|
Ruf K, Thomas W, Brunner M, Speer CP, Hebestreit H. Diverging effects of premature birth and bronchopulmonary dysplasia on exercise capacity and physical activity - a case control study. Respir Res 2019; 20:260. [PMID: 31752871 PMCID: PMC6873747 DOI: 10.1186/s12931-019-1238-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/11/2019] [Indexed: 01/24/2023] Open
Abstract
Background Extreme prematurity has been associated with exercise intolerance and reduced physical activity. We hypothesized that children with bronchopulmonary dysplasia (BPD) would be especially affected based on long-term lung function impairments. Therefore, the objective of this study was to compare exercise capacity and habitual physical activity between children born very and extremely preterm with and without BPD and term-born children. Methods Twenty-two school-aged children (aged 8 to 12 years) born with a gestational age < 32 weeks and a birthweight < 1500 g (9 with moderate or severe BPD (=BPD), 13 without BPD (=No-BPD)) and 15 healthy term-born children (=CONTROL) were included in the study. Physical activity was measured by accelerometry, lung function by spirometry and exercise capacity by an incremental cardiopulmonary exercise test. Results Peak oxygen uptake was reduced in the BPD-group (83 ± 11%predicted) compared to the No-BPD group (91 ± 8%predicted) and the CONTROL group (94 ± 9%predicted). In a general linear model, variance of peak oxygen uptake was significantly explained by BPD status and height but not by prematurity (p < 0.001). Compared to CONTROL, all children born preterm spent significantly more time in sedentary behaviour (BPD 478 ± 50 min, No-BPD 450 ± 52 min, CONTROL 398 ± 56 min, p < 0.05) and less time in moderate-to-vigorous-physical activity (BPD 13 ± 8 min, No-BPD 16 ± 8 min, CONTROL 33 ± 16 min, p < 0.001). Prematurity but not BPD contributed significantly to explained variance in a general linear model of sedentary behaviour and likewise moderate-to-vigorous-physical activity (p < 0.05 and p < 0.001 respectively). Conclusion In our cohort, BPD but not prematurity was associated with a reduced exercise capacity at school-age. However, prematurity regardless of BPD was related to less engagement in physical activity and more time spent in sedentary behaviour. Thus, our findings suggest diverging effects of prematurity and BPD on exercise capacity and physical activity.
Collapse
Affiliation(s)
- Katharina Ruf
- University Children's Hospital Würzburg, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany.
| | - Wolfgang Thomas
- University Children's Hospital Würzburg, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany.,Abteilung für Kinder- und Jugendmedizin, Klinikum Mutterhaus der Borromäerinnen, Feldstr. 16, 54290, Trier, Germany
| | - Maximilian Brunner
- University Children's Hospital Würzburg, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany.,Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Erlangen, Krankenhausstraße 12, 91054, Erlangen, Germany
| | - Christian P Speer
- University Children's Hospital Würzburg, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany
| | - Helge Hebestreit
- University Children's Hospital Würzburg, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany
| |
Collapse
|
20
|
Abstract
PURPOSE OF REVIEW A growing body of epidemiological and experimental data indicate that nutritional or environmental stressors during early development can induce long-term adaptations that increase risk of obesity, diabetes, cardiovascular disease, and other chronic conditions-a phenomenon termed "developmental programming." A common phenotype in humans and animal models is altered body composition, with reduced muscle and bone mass, and increased fat mass. In this review, we summarize the recent literature linking prenatal factors to future body composition and explore contributing mechanisms. RECENT FINDINGS Many prenatal exposures, including intrauterine growth restriction, extremes of birth weight, maternal obesity, and maternal diabetes, are associated with increased fat mass, reduced muscle mass, and decreased bone density, with effects reported throughout infancy and childhood, and persisting into middle age. Mechanisms and mediators include maternal diet, breastmilk composition, metabolites, appetite regulation, genetic and epigenetic influences, stem cell commitment and function, and mitochondrial metabolism. Differences in body composition are a common phenotype following disruptions to the prenatal environment, and may contribute to developmental programming of obesity and diabetes risk.
Collapse
Affiliation(s)
- Elvira Isganaitis
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
- Research Division, Joslin Diabetes Center, 1 Joslin Place, Room 655A, Boston, 02215, MA, USA.
| |
Collapse
|
21
|
Spiegler J, Eves R, Mendonça M, Wolke D. Association of physical activity and cardiorespiratory function or BMI and body composition in preterm-born individuals: a systematic review. Acta Paediatr 2019; 108:1205-1214. [PMID: 30664798 DOI: 10.1111/apa.14726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 12/01/2022]
Abstract
AIM To evaluate the association of physical activity (PA) and forced expiratory volume in one second (FEV1), peak oxygen consumption (pVO2), body mass index (BMI) and body composition in preterm-born individuals. METHODS Cochrane Library, EMBASE, MEDLINE, AMED, ERIC, Web of Science and PsycInfo were searched with no restriction on language and date of publication from inception to January 2018. Data were extracted comparing preterm-born individuals with different frequencies of PA and the outcome of interest. RESULTS One randomized controlled, two longitudinal and thirteen cross-sectional studies comprising 1922 preterm-born individuals aged 5-25 were included. Assessment varied from a PA program to accelerometer data, interviews and self-report questionnaires. In preterm-born children, more PA was associated with better cardiorespiratory function in those groups with impaired lung function or with lower BMI in those groups with increased risk factors, but no association was found in unimpaired children. In preterm-born adults, more PA was associated with higher pVO2 and lower BMI. CONCLUSION Only tentative conclusions can be drawn, especially regarding differences of the association of PA between preterm- and term-born populations. Further studies are needed to analyse the association of PA in preterm-born individuals with reduced cardiorespiratory function.
Collapse
Affiliation(s)
- Juliane Spiegler
- Department of Psychology and Division of Mental Health & Wellbeing University of Warwick Coventry UK
- Department of Paediatrics University of Lübeck Lübeck Germany
| | - Robert Eves
- Department of Psychology and Division of Mental Health & Wellbeing University of Warwick Coventry UK
| | - Marina Mendonça
- Department of Psychology and Division of Mental Health & Wellbeing University of Warwick Coventry UK
| | - Dieter Wolke
- Department of Psychology and Division of Mental Health & Wellbeing University of Warwick Coventry UK
| |
Collapse
|
22
|
Portella AK, Paquet C, Bischoff AR, Molle RD, Faber A, Moore S, Arora N, Levitan R, Silveira PP, Dube L. Multi-behavioral obesogenic phenotypes among school-aged boys and girls along the birth weight continuum. PLoS One 2019; 14:e0212290. [PMID: 30789933 PMCID: PMC6383887 DOI: 10.1371/journal.pone.0212290] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/30/2019] [Indexed: 11/18/2022] Open
Abstract
Evidence shows that extremes of birth weight (BW) carry a common increased risk for the development of adiposity and related cardiovascular diseases, but little is known about the role of obesogenic behaviors in this process. Moreover, no one has empirically examined whether the relationship between BW, obesogenic behaviors and BMI along the full low-to-high birthweight continuum reflects the U-shape pattern expected from common risk at both BW extremes. Our objective was to characterize physical activity, screen time, and eating behavior and their relationship to BMI as a function of BW among school-aged boys and girls. In this cross-sectional study, 460 children aged 6 to 12 years (50% boys) from Montreal, Canada provided information on sleeping time, screen time, physical activity levels, eating behavior (emotional, external and restrained eating) and anthropometrics (height, weight, BW) through parent reported questionnaires. BMI was normalized using WHO Standards (zBMI), and BW expressed as ratio using Canadian population standards (BW for gestational age and sex). Analyses were conducted using generalized linear models with linear and quadratic terms for BW, stratified by sex and adjusted for age, ethnicity and household income. In boys, physical activity and screen time showed U-shaped associations with BW, while physical activity had an inverted U-shaped in girls. Emotional and restrained eating had positive linear relations with BW in boys and girls. Sleep time and external eating were not associated with BW. A U-shaped relationship between BW and zBMI was found in boys but no association was found in girls. Only sleep (in boys and girls), and emotional eating (girls only) were related to zBMI and mediation of the BW-zBMI relationship was only supported for emotional eating. In conclusion, BW relates to obesogenic behaviors and BMI in both non-linear and linear ways, and these associations differed by sex.
Collapse
Affiliation(s)
- Andre Krumel Portella
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
- PostGraduate Program in Pediatrics, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, RS, Brasil
- * E-mail:
| | - Catherine Paquet
- School of Health Sciences, Centre for Population Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Adrianne Rahde Bischoff
- Division of Neonatology, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Roberta Dalle Molle
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Aida Faber
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Spencer Moore
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | | | - Robert Levitan
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Patricia Pelufo Silveira
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Sackler Institute for Epigenetics & Psychobiology, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Centre, Montreal, QC, Canada
| | - Laurette Dube
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| |
Collapse
|
23
|
Is willingness to exercise programmed in utero? Reviewing sedentary behavior and the benefits of physical activity in intrauterine growth restricted individuals. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2018. [DOI: 10.1016/j.jpedp.2018.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
24
|
Bischoff AR, Cunha FDS, Dalle Molle R, Maróstica PJC, Silveira PP. Is willingness to exercise programmed in utero? Reviewing sedentary behavior and the benefits of physical activity in intrauterine growth restricted individuals. J Pediatr (Rio J) 2018; 94:582-595. [PMID: 29476706 DOI: 10.1016/j.jped.2017.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 12/06/2017] [Accepted: 12/15/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE The literature suggests that a fetus will adapt to surrounding adversities by optimizing its use of energy to improve survival, ultimately leading to the programming of the individual's energy intake and expenditure. While recent reviews focused on the fetal programming of energy intake and food preferences, there is also some evidence that fetal adversity is associated with diminished physical activity levels. Therefore, we aimed to review (a) the evidence for an association between being born with intrauterine growth restriction and sedentarism over the life-course and (b) the potential benefits of physical activity over cardiometabolic risk factors for this population. SOURCES PubMed, Scielo, Scopus and Embase. SUMMARY OF FINDINGS Most clinical studies that used objective measures found no association between intrauterine growth restriction and physical activity levels, while most studies that used self-reported questionnaires revealed such relationships, particularly leisure time physical activity. Experimental studies support the existence of fetal programming of physical activity, and show that exposure to exercise during IUGR individuals' life improves metabolic outcomes but less effect was seen on muscle architecture or function. CONCLUSIONS Alterations in muscle strength and metabolism, as well as altered aerobic performance, may predispose IUGR individuals to be spontaneously less physically active, suggesting that this population may be an important target for preventive interventions. Although very heterogeneous, the different studies allow us to infer that physical activity may have beneficial effects especially for individuals that are more vulnerable to metabolic modifications such as those with IUGR.
Collapse
Affiliation(s)
- Adrianne Rahde Bischoff
- University of Toronto, Department of Pediatrics, Division of Neonatology, Toronto, Canada; Hospital for Sick Children, Toronto, Canada.
| | - Fábio da Silva Cunha
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Pediatria, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil
| | - Roberta Dalle Molle
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Pediatria, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil
| | - Paulo José Cauduro Maróstica
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Pediatria, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil
| | - Patrícia Pelufo Silveira
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Pediatria, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil; McGill University, Douglas Mental Health University Institute, Ludmer Centre for Neuroinformatics and Mental Health, Montreal, Canada
| |
Collapse
|
25
|
Nordvall-Lassen M, Hegaard HK, Obel C, Lindhard MS, Hedegaard M, Henriksen TB. Leisure time physical activity in 9- to 11-year-old children born moderately preterm: a cohort study. BMC Pediatr 2018; 18:163. [PMID: 29753323 PMCID: PMC5948819 DOI: 10.1186/s12887-018-1141-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 05/03/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity is one of the best documented activities with impacts on health in children and adults. Children born preterm show reduced physical and psychosocial function compared to children born at term. This may influence their level of physical activity. Reports on moderately preterm children's physical activities during childhood are limited. Thus, the aim of this study was to compare the leisure time physical activity at age 9-11 years of moderately preterm children with that of children born at term. METHODS Data from 4941 mother-child pairs from the Aarhus Birth Cohort (1989-91) were used. The cohort gathered clinical information, including gestational age at delivery. Information about parental socio-demographic and lifestyle factors was obtained from questionnaires completed during the second trimester of pregnancy. Information about children's physical activities was reported in a 9- to 11-year follow-up questionnaire completed by parents detailing how many times per week their child participated in sports activities outside of school, hours spent per week playing outside, and hours per week engaged in sedentary activities. Data were analysed using multiple logistic regression with the lowest activity group as a reference group. RESULTS A total of 158 children (3.2%) were born moderately preterm, i.e., between 32 and 36 completed weeks. Children born moderately preterm participated in sports activities as often as their peers born at term; they also participated in frequent sports activities (≥ 4 times per week) as often as their peers. There were no differences in hours per week spent playing outside or in sedentary activities between the two groups. CONCLUSIONS Nine- to 11-year-old moderately preterm children participated in sports activities outside school to a similar extent as their peers and engaged in outdoor activities and sedentary activities for the same duration of time per week as their peers born at term.
Collapse
Affiliation(s)
- M Nordvall-Lassen
- The Research Unit of Women's and Children's Health, section 7821, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
| | - H K Hegaard
- The Research Unit of Women's and Children's Health, section 7821, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Obstetric Clinic, The Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Child, Family and Reproductive Health, Department of Health Science, Faculty of Medicine, Lund University, Lund, Sweden
| | - C Obel
- Institute of General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - M S Lindhard
- Perinatal Epidemiology Research Unit, Department of Paediatrics, Aarhus University Hospital, Skejby, Aarhus, Denmark
| | - M Hedegaard
- Obstetric Clinic, The Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - T B Henriksen
- Perinatal Epidemiology Research Unit, Department of Paediatrics, Aarhus University Hospital, Skejby, Aarhus, Denmark
| |
Collapse
|
26
|
Spearman AD, Loomba RS, Danduran M, Kovach J. Intrauterine growth restriction is not associated with decreased exercise capacity in adolescents with congenital heart disease. CONGENIT HEART DIS 2018; 13:369-376. [DOI: 10.1111/chd.12577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 11/20/2017] [Accepted: 12/26/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Andrew D. Spearman
- Division of Cardiology, Children's Hospital of Wisconsin, Medical College of Wisconsin; Milwaukee Wisconsin, USA
| | - Rohit S. Loomba
- Division of Cardiology, Cincinnati Children's Hospital Medical Center; Ohio, USA
| | - Michael Danduran
- Division of Cardiology, Children's Hospital of Wisconsin, Medical College of Wisconsin; Milwaukee Wisconsin, USA
| | - Joshua Kovach
- Division of Cardiology, Children's Hospital of Wisconsin, Medical College of Wisconsin; Milwaukee Wisconsin, USA
| |
Collapse
|
27
|
Tetri LH, Diffee GM, Barton GP, Braun RK, Yoder HE, Haraldsdottir K, Eldridge MW, Goss KN. Sex-Specific Skeletal Muscle Fatigability and Decreased Mitochondrial Oxidative Capacity in Adult Rats Exposed to Postnatal Hyperoxia. Front Physiol 2018; 9:326. [PMID: 29651255 PMCID: PMC5884929 DOI: 10.3389/fphys.2018.00326] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 03/15/2018] [Indexed: 01/17/2023] Open
Abstract
Premature birth affects more than 10% of live births, and is characterized by relative hyperoxia exposure in an immature host. Long-term consequences of preterm birth include decreased aerobic capacity, decreased muscular strength and endurance, and increased prevalence of metabolic diseases such as type 2 diabetes mellitus. Postnatal hyperoxia exposure in rodents is a well-established model of chronic lung disease of prematurity, and also recapitulates the pulmonary vascular, cardiovascular, and renal phenotype of premature birth. The objective of this study was to evaluate whether postnatal hyperoxia exposure in rats could recapitulate the skeletal and metabolic phenotype of premature birth, and to characterize the subcellular metabolic changes associated with postnatal hyperoxia exposure, with a secondary aim to evaluate sex differences in this model. Compared to control rats, male rats exposed to 14 days of postnatal hyperoxia then aged to 1 year demonstrated higher skeletal muscle fatigability, lower muscle mitochondrial oxidative capacity, more mitochondrial damage, and higher glycolytic enzyme expression. These differences were not present in female rats with the same postnatal hyperoxia exposure. This study demonstrates detrimental mitochondrial and muscular outcomes in the adult male rat exposed to postnatal hyperoxia. Given that young adults born premature also demonstrate skeletal muscle dysfunction, future studies are merited to determine whether this dysfunction as well as reduced aerobic capacity is due to reduced mitochondrial oxidative capacity and metabolic dysfunction.
Collapse
Affiliation(s)
- Laura H Tetri
- Department of Pediatrics, University of Wisconsin, Madison, WI, United States
| | - Gary M Diffee
- Department of Kinesiology, University of Wisconsin, Madison, WI, United States
| | - Gregory P Barton
- Department of Pediatrics, University of Wisconsin, Madison, WI, United States
| | - Rudolf K Braun
- Department of Pediatrics, University of Wisconsin, Madison, WI, United States
| | - Hannah E Yoder
- Department of Pediatrics, University of Wisconsin, Madison, WI, United States
| | - Kristin Haraldsdottir
- Department of Pediatrics, University of Wisconsin, Madison, WI, United States.,Department of Kinesiology, University of Wisconsin, Madison, WI, United States
| | - Marlowe W Eldridge
- Department of Pediatrics, University of Wisconsin, Madison, WI, United States.,Department of Kinesiology, University of Wisconsin, Madison, WI, United States
| | - Kara N Goss
- Department of Pediatrics, University of Wisconsin, Madison, WI, United States.,Department of Medicine, University of Wisconsin, Madison, WI, United States
| |
Collapse
|
28
|
Malleske DT, Chorna O, Maitre NL. Pulmonary sequelae and functional limitations in children and adults with bronchopulmonary dysplasia. Paediatr Respir Rev 2018; 26:55-59. [PMID: 29031795 DOI: 10.1016/j.prrv.2017.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/07/2017] [Accepted: 07/11/2017] [Indexed: 12/13/2022]
Abstract
Preterm infants with bronchopulmonary dysplasia (BPD) often suffer from life-long pulmonary impairments in pulmonary physical function. This review summarizes our current understanding of the chronic pulmonary impairments and physical functional limitations associated with BPD from preterm birth to adulthood. It also identifies opportunities for intervention in children and adults living with chronic lung disease (CLD) after preterm birth.
Collapse
Affiliation(s)
- Daniel T Malleske
- Division of Neonatology, Nationwide Children's Hospital/The Ohio State University College of Medicine, United States.
| | - Olena Chorna
- Center for Perinatal Research, Nationwide Children's Hospital, United States
| | - Nathalie L Maitre
- Division of Neonatology, Nationwide Children's Hospital/The Ohio State University College of Medicine, United States; Center for Perinatal Research, Nationwide Children's Hospital, United States
| |
Collapse
|
29
|
Björkqvist J, Pesonen AK, Kuula L, Matinolli HM, Lano A, Sipola-Leppänen M, Tikanmäki M, Wolke D, Järvelin MR, Eriksson JG, Andersson S, Vääräsmäki M, Heinonen K, Räikkönen K, Hovi P, Kajantie E. Premature birth and circadian preference in young adulthood: evidence from two birth cohorts. Chronobiol Int 2018; 35:555-564. [DOI: 10.1080/07420528.2017.1420078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Johan Björkqvist
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki and Oulu, Finland
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Finland
| | - Anu-Katriina Pesonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Liisa Kuula
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Hanna-Maria Matinolli
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki and Oulu, Finland
- Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Aulikki Lano
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Finland
| | - Marika Sipola-Leppänen
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki and Oulu, Finland
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marjaana Tikanmäki
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki and Oulu, Finland
- Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Warwick, United Kingdom
| | - Marjo-Riitta Järvelin
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- School of Public Health, Faculty of Medicine, Imperial College, London, United Kingdom
| | - Johan G Eriksson
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki and Oulu, Finland
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Vasa Central Hospital, Vasa, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Sture Andersson
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Finland
| | - Marja Vääräsmäki
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki and Oulu, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Petteri Hovi
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki and Oulu, Finland
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Finland
| | - Eero Kajantie
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki and Oulu, Finland
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| |
Collapse
|
30
|
Matinolli HM, Hovi P, Levälahti E, Kaseva N, Silveira PP, Hemiö K, Järvenpää AL, Eriksson JG, Andersson S, Lindström J, Männistö S, Kajantie E. Neonatal Nutrition Predicts Energy Balance in Young Adults Born Preterm at Very Low Birth Weight. Nutrients 2017; 9:nu9121282. [PMID: 29186804 PMCID: PMC5748733 DOI: 10.3390/nu9121282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 11/20/2017] [Accepted: 11/21/2017] [Indexed: 12/17/2022] Open
Abstract
Epidemiological studies and animal models suggest that early postnatal nutrition and growth can influence adult health. However, few human studies have objective recordings of early nutrient intake. We studied whether nutrient intake and growth during the first 9 weeks after preterm birth with very low birth weight (VLBW, <1500 g) predict total energy intake, resting energy expenditure (REE), physical activity and food preferences in young adulthood. We collected daily nutritional intakes and weights during the initial hospital stay from hospital records for 127 unimpaired VLBW participants. At an average age 22.5 years, they completed a three-day food record and a physical activity questionnaire and underwent measurements of body composition (dual X-ray absorptiometry; n = 115 with adequate data) and REE (n = 92 with adequate data). We used linear regression and path analysis to investigate associations between neonatal nutrient intake and adult outcomes. Higher energy, protein and fat intakes during the first three weeks of life predicted lower relative (=per unit lean body mass) energy intake and relative REE in adulthood, independent of other pre- and neonatal factors. In path analysis, total effects of early nutrition and growth on relative energy intake were mostly explained by direct effects of early life nutrition. A path mediated by early growth reached statistical significance only for protein intake. There were no associations of neonatal intakes with physical activity or food preferences in adulthood. As a conclusion, higher intake of energy and nutrients during first three weeks of life of VLBW infants predicts energy balance after 20 years. This association is partly mediated through postnatal growth.
Collapse
Affiliation(s)
- Hanna-Maria Matinolli
- Department of Public Health Solutions, National Institute for Health and Welfare, FI-00271 Helsinki, Finland; (P.H.); (E.L.); (N.K.); (K.H.); (J.L.); (S.M.); (E.K.)
- Institute for Health Sciences, University of Oulu, FI-90014 Oulu, Finland
- Correspondence: ; Tel.: +358-29-524-6000
| | - Petteri Hovi
- Department of Public Health Solutions, National Institute for Health and Welfare, FI-00271 Helsinki, Finland; (P.H.); (E.L.); (N.K.); (K.H.); (J.L.); (S.M.); (E.K.)
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, FI-00290 Helsinki, Finland; (A.-L.J.); (S.A.)
| | - Esko Levälahti
- Department of Public Health Solutions, National Institute for Health and Welfare, FI-00271 Helsinki, Finland; (P.H.); (E.L.); (N.K.); (K.H.); (J.L.); (S.M.); (E.K.)
| | - Nina Kaseva
- Department of Public Health Solutions, National Institute for Health and Welfare, FI-00271 Helsinki, Finland; (P.H.); (E.L.); (N.K.); (K.H.); (J.L.); (S.M.); (E.K.)
| | - Patricia P. Silveira
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC H3T 1E2, Canada;
| | - Katri Hemiö
- Department of Public Health Solutions, National Institute for Health and Welfare, FI-00271 Helsinki, Finland; (P.H.); (E.L.); (N.K.); (K.H.); (J.L.); (S.M.); (E.K.)
| | - Anna-Liisa Järvenpää
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, FI-00290 Helsinki, Finland; (A.-L.J.); (S.A.)
| | - Johan G. Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, FI-00014 Helsinki, Finland;
- Folkhälsan Research Center, FI-00280 Helsinki, Finland
| | - Sture Andersson
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, FI-00290 Helsinki, Finland; (A.-L.J.); (S.A.)
| | - Jaana Lindström
- Department of Public Health Solutions, National Institute for Health and Welfare, FI-00271 Helsinki, Finland; (P.H.); (E.L.); (N.K.); (K.H.); (J.L.); (S.M.); (E.K.)
| | - Satu Männistö
- Department of Public Health Solutions, National Institute for Health and Welfare, FI-00271 Helsinki, Finland; (P.H.); (E.L.); (N.K.); (K.H.); (J.L.); (S.M.); (E.K.)
| | - Eero Kajantie
- Department of Public Health Solutions, National Institute for Health and Welfare, FI-00271 Helsinki, Finland; (P.H.); (E.L.); (N.K.); (K.H.); (J.L.); (S.M.); (E.K.)
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, FI-00290 Helsinki, Finland; (A.-L.J.); (S.A.)
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, FI-90014 Oulu, Finland
| |
Collapse
|
31
|
Tikanmäki M, Kaseva N, Tammelin T, Sipola-Leppänen M, Matinolli HM, Eriksson JG, Järvelin MR, Vääräsmäki M, Kajantie E. Leisure Time Physical Activity in Young Adults Born Preterm. J Pediatr 2017; 189:135-142.e2. [PMID: 28751124 DOI: 10.1016/j.jpeds.2017.06.068] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 06/14/2017] [Accepted: 06/28/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the amount of self-reported physical activity in young adults born prematurely compared with those born at term. STUDY DESIGN Unimpaired participants of the Preterm Birth Study (Preterm Birth and Early Life Programming of Adult Health and Disease) birth cohort study were studied at age 23.3 ± 1.2 (SD) years: 118 born early preterm (<34 weeks), 210 late preterm (34-36 weeks), and 311 born at term (≥37 weeks, controls). The participants completed a validated 30-item, 12-month physical activity questionnaire. The annual frequency and total volume of conditioning and nonconditioning leisure time physical activity and commuting physical activity were calculated and the data analyzed by means of linear regression. RESULTS Adults born early preterm reported a 31.5% (95% CI, 17.4-43.2) lower volume of leisure time physical activity (in metabolic equivalents [MET] h/year) and had a 2.0-fold increased OR (1.2-3.3) of being in the least active quintile than controls. Lower amounts of conditioning, nonconditioning, and commuting physical activity all contributed to the difference. In addition, early preterm participants undertook less vigorous physical activity (≥6 MET). No differences in physical activity were found between the late preterm and control groups. Adjustments for potential early life confounders and current mediating health characteristics did not change the results. CONCLUSIONS Young adults born early preterm engage less in leisure time physical activities than peers born at term. This finding may in part underlie the increased risk factors of cardiometabolic and other noncommunicable diseases in adults born preterm. Low physical activity is a risk factor for several noncommunicable diseases and amenable to prevention.
Collapse
Affiliation(s)
- Marjaana Tikanmäki
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu, Helsinki, Finland; Institute of Health Sciences, University of Oulu, Oulu, Finland.
| | - Nina Kaseva
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu, Helsinki, Finland
| | - Tuija Tammelin
- LIKES Research Center for Physical Activity and Health, Jyväskylä, Finland
| | - Marika Sipola-Leppänen
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu, Helsinki, Finland; Institute of Health Sciences, University of Oulu, Oulu, Finland; PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Hanna-Maria Matinolli
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu, Helsinki, Finland; Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Johan G Eriksson
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Health Research Center, Helsinki, Finland
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, MRC-PHE Center for Environment & Health, School of Public Health, Imperial College London, United Kingdom; Center for Life Course Epidemiology, Faculty of Medicine, University of Oulu, Oulu, Finland; Biocenter Oulu, Oulu, Finland; Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Marja Vääräsmäki
- PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland; Children, Adolescents and Families Unit, Department of Welfare, National Institute for Health and Welfare, Oulu, Finland
| | - Eero Kajantie
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu, Helsinki, Finland; PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland; Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| |
Collapse
|
32
|
Robič Pikel T, Starc G, Strel J, Kovač M, Babnik J, Golja P. Impact of prematurity on exercise capacity and agility of children and youth aged 8 to 18. Early Hum Dev 2017; 110:39-45. [PMID: 28521272 DOI: 10.1016/j.earlhumdev.2017.04.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 04/21/2017] [Accepted: 04/25/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Preterm (PT) birth and low birth mass (LBW) can impair growth and development of children and may therefore affect their physical performance up to adulthood. AIMS Our aim was to evaluate long-term consequences of prematurity, especially (an)aerobic exercise capacity and agility up to adulthood, by comparing premature and full-term (FT) individuals. STUDY DESIGN, SUBJECTS From 474 subjects born in 1987, who were enrolled into a longitudinal study, 396 (178 PT and 218 FT (with 127 of them LBW)) were followed-up into their early adulthood. Their mass, respiratory status at birth, and results of SLOfit monitoring system (i.e. results of exercise capacity and agility) were monitored on a yearly basis from their age of 8 to 18years. Data were compared statistically with Student t-test or ANOVA. OUTCOME MEASURES, RESULTS PT (or LBW) individuals performed aerobic (time of 600-meter run of females) and the majority of anaerobic tests (sit-ups, standing broad jump, and time of 60-meter run, but not bent arm hang) worse (p<0.05) than FT individuals. Before puberty, however, the agility and fine motor tests (arm plate tapping, polygon backwards, and standing reach touch) were performed better (p<0.05) by PT (or LBW) females, as compared to their FT peers, with no similar results in males. CONCLUSIONS Our results clearly demonstrate that prematurity (especially extreme prematurity) diminishes exercise capacity and agility on the long-term scale, therefore, PT children should be encouraged towards more regular participation in physical activities from early childhood onwards.
Collapse
Affiliation(s)
- Tatjana Robič Pikel
- University of Ljubljana, Biotechnical Faculty, Department of Biology, Ljubljana, Slovenia
| | - Gregor Starc
- University of Ljubljana, Faculty of Sport, Department of Physical Education, Ljubljana, Slovenia
| | - Janko Strel
- Fitlab Institute for Holistic Health and Kinesiology Treatment, Logatec, Slovenia
| | - Marjeta Kovač
- University of Ljubljana, Faculty of Sport, Department of Physical Education, Ljubljana, Slovenia
| | - Janez Babnik
- Neonatal Intensive Care Unit, Division of Perinatology, Department of Obstetrics and Gynecology, University Medical Centre, Ljubljana, Slovenia
| | - Petra Golja
- University of Ljubljana, Biotechnical Faculty, Department of Biology, Ljubljana, Slovenia.
| |
Collapse
|
33
|
Balasuriya CND, Evensen KAI, Mosti MP, Brubakk AM, Jacobsen GW, Indredavik MS, Schei B, Stunes AK, Syversen U. Peak Bone Mass and Bone Microarchitecture in Adults Born With Low Birth Weight Preterm or at Term: A Cohort Study. J Clin Endocrinol Metab 2017; 102:2491-2500. [PMID: 28453635 DOI: 10.1210/jc.2016-3827] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 04/19/2017] [Indexed: 02/05/2023]
Abstract
CONTEXT AND OBJECTIVES Peak bone mass (PBM) is regarded as the most important determinant of osteoporosis. Growing evidence suggests a role of intrauterine programming in skeletal development. We examined PBM and trabecular bone score (TBS) in adults born preterm with very low birth weight (VLBW) or small for gestational age (SGA) at term compared with term-born controls. DESIGN, SETTING, PARTICIPANTS, AND OUTCOMES This follow-up cohort study included 186 men and women (25 to 28 years); 52 preterm VLBW (≤1500 g), 59 term-born SGA (<10th percentile), and 75 controls (>10th percentile). Main outcome was bone mineral density (BMD) by dual x-ray absorptiometry. Secondary outcomes were bone mineral content (BMC), TBS, and serum bone markers. RESULTS VLBW adults had lower BMC and BMD vs controls, also when adjusted for height, weight, and potential confounders, with the following BMD Z-score differences: femoral neck, 0.6 standard deviation (SD) (P = 0.003); total hip, 0.4 SD (P = 0.01); whole body, 0.5 SD (P = 0.007); and lumbar spine, 0.3 SD (P = 0.213). The SGA group displayed lower spine BMC and whole-body BMD Z-scores, but not after adjustment. Adjusted odds ratios for osteopenia/osteoporosis were 2.4 and 2.0 in VLBW and SGA adults, respectively. TBS did not differ between groups, but it was lower in men than in women. Serum Dickkopf-1 was higher in VLBW subjects vs controls; however, it was not significant after adjustment for multiple comparisons. CONCLUSIONS Both low-birth-weight groups displayed lower PBM and higher frequency of osteopenia/osteoporosis, implying increased future fracture risk. The most pronounced bone deficit was seen in VLBW adults.
Collapse
Affiliation(s)
- Chandima N D Balasuriya
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, 7489 Trondheim, Norway
- Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
| | - Kari Anne I Evensen
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, 7489 Trondheim, Norway
- Department of Public Health and General Practice, Norwegian University of Science and Technology, 7489 Trondheim, Norway
- Department of Physiotherapy, Trondheim Municipality, Trondheim, Norway
| | - Mats P Mosti
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, 7489 Trondheim, Norway
| | - Ann-Mari Brubakk
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, 7489 Trondheim, Norway
| | - Geir W Jacobsen
- Department of Public Health and General Practice, Norwegian University of Science and Technology, 7489 Trondheim, Norway
| | - Marit S Indredavik
- Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, 7489 Trondheim, Norway
- Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
| | - Berit Schei
- Department of Public Health and General Practice, Norwegian University of Science and Technology, 7489 Trondheim, Norway
- Department of Gynecology at the Women's Clinic, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
| | - Astrid Kamilla Stunes
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, 7489 Trondheim, Norway
| | - Unni Syversen
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, 7489 Trondheim, Norway
- Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
| |
Collapse
|
34
|
Tikanmäki M, Tammelin T, Vääräsmäki M, Sipola-Leppänen M, Miettola S, Pouta A, Järvelin MR, Kajantie E. Prenatal determinants of physical activity and cardiorespiratory fitness in adolescence - Northern Finland Birth Cohort 1986 study. BMC Public Health 2017; 17:346. [PMID: 28427374 PMCID: PMC5399469 DOI: 10.1186/s12889-017-4237-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 04/06/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Lower levels of physical activity and cardiorespiratory fitness are key risk factors of chronic adult diseases. Physical activity and cardiorespiratory fitness are predicted by birth weight, but the underlying parental and pregnancy-related factors remain largely unknown. We examined how prenatal determinants are associated with physical activity and cardiorespiratory fitness in adolescence. METHODS Of the 16-year-old members of the population-based Northern Finland Birth Cohort 1986 (NFBC 1986), 6682 singletons with no major physical disability reported their amount of physical activity outside school hours, and 4706 completed a submaximal cycle ergometer test assessing cardiorespiratory fitness. Physical activity was expressed as metabolic equivalent hours per week (METh/week) and cardiorespiratory fitness as peak oxygen uptake (ml·kg-1·min-1). Prenatal determinants included birth weight, length of gestation, mother's and father's body mass index (BMI), maternal gestational diabetes mellitus (GDM), and maternal hypertension and smoking during pregnancy. Data were analyzed by multiple linear regression. RESULTS A higher birth weight and longer length of gestation predicted lower levels of physical activity and cardiorespiratory fitness at 16 years, although the association between length of gestation and physical activity was inverse U-shaped. Mother's or father's overweight or obesity before pregnancy were associated with lower levels of their offspring's physical activity and fitness in adolescence. Adjusting for maternal pregnancy disorders and the adolescent's own BMI attenuated the associations with the mother's but not the father's overweight/obesity. Furthermore, maternal GDM predicted lower cardiorespiratory fitness. CONCLUSIONS A high birth weight and parental overweight/obesity are associated with lower levels of both physical activity and cardiorespiratory fitness in adolescence, while maternal GDM and longer length of gestation are associated with lower cardiorespiratory fitness. Both long and short lengths of gestation predict low physical activity.
Collapse
Affiliation(s)
- Marjaana Tikanmäki
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu and Helsinki, Finland
- Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Tuija Tammelin
- LIKES Research Center for Physical Activity and Health, Jyväskylä, Finland
| | - Marja Vääräsmäki
- Pediatrics and Adolescence and Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Children, Adolescents and Families Unit, Department of Welfare, National Institute for Health and Welfare, Oulu, Finland
| | - Marika Sipola-Leppänen
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu and Helsinki, Finland
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Pediatrics and Adolescence and Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Satu Miettola
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu and Helsinki, Finland
- Pediatrics and Adolescence and Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anneli Pouta
- Pediatrics and Adolescence and Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Government Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, MRC–PHE Centre for Environment & Health, School of Public Health, Imperial College London, London, UK
- Center for Life Course Epidemiology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Biocenter Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Eero Kajantie
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu and Helsinki, Finland
- Pediatrics and Adolescence and Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Children’s Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| |
Collapse
|
35
|
Tikanmäki M, Tammelin T, Kaseva N, Sipola-Leppänen M, Matinolli HM, Hakonen H, Ekelund U, Eriksson JG, Järvelin MR, Vääräsmäki M, Kajantie E. Objectively measured physical activity and sedentary time in young adults born preterm-The ESTER study. Pediatr Res 2017; 81:550-555. [PMID: 27935902 DOI: 10.1038/pr.2016.262] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 10/13/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Young adults born preterm have higher levels of cardio metabolic risk factors and they report less physical activity than their peers born at term. Physical activity provides important cardio metabolic health benefits. We hypothesized that objectively measured physical activity levels are lower and time spent sedentary is higher among preterm-born individuals compared with controls. METHODS We studied unimpaired participants of the ESTER birth cohort study at age 23.3 y (SD: 1.2): 60 born early preterm (<34 wk), 108 late preterm (34-36 wk), and 178 at term (controls). Physical activity and sedentary time were measured by hip-worn accelerometer (ActiGraph). RESULTS As compared with controls' (mean physical activity, 303 counts per minute (cpm; SD 129)), physical activity was similar among adults born early preterm (mean difference = 21 cpm, 95% CI -61, 19) or late preterm (5 cpm, -27, 38). Time spent sedentary was also similar. Adjustments for early life confounders or current mediating characteristics did not change the results. CONCLUSION In contrast to our hypothesis, we found no difference in objectively measured physical activity or time spent sedentary between adults born preterm and at term. The previously reported differences may be limited to physical activity captured by self-report.
Collapse
Affiliation(s)
- Marjaana Tikanmäki
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Oulu and Helsinki, Finland.,Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Tuija Tammelin
- LIKES Research Center for Physical Activity and Health, Jyväskylä, Finland
| | - Nina Kaseva
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Oulu and Helsinki, Finland
| | - Marika Sipola-Leppänen
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Oulu and Helsinki, Finland.,Institute of Health Sciences, University of Oulu, Oulu, Finland.,PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Hanna-Maria Matinolli
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Oulu and Helsinki, Finland.,Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Harto Hakonen
- LIKES Research Center for Physical Activity and Health, Jyväskylä, Finland
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Johan G Eriksson
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Oulu and Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment & Health, School of Public Health, Imperial College London, United Kingdom.,Faculty of Medicine, Center for Life Course Epidemiology, University of Oulu, Oulu, Finland.,Biocenter Oulu, Oulu, Finland.,Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Marja Vääräsmäki
- PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Welfare, Children, Adolescents and Families Unit, National Institute for Health and Welfare, Oulu, Finland
| | - Eero Kajantie
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Oulu and Helsinki, Finland.,PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland.,Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| |
Collapse
|
36
|
Abstract
Physical activity (PA) is an important mediator of health and disease. Many correlates may play an important role in explaining differences in PA between populations; however, the role of birth outcomes such as prematurity on levels of PA is relatively poorly represented in the literature. Children born preterm may be at risk for reduced levels of PA as they have increased respiratory symptoms as well as decrements in lung function and exercise capacity. Emerging evidence suggests that the effects are prevalent across the whole range of gestational age. This review summarises the current literature in regards to levels of PA in preterm-born children and also explores PA in cohorts of young adults in order to contextualise the possible impact on long term risks to respiratory health.
Collapse
|
37
|
van Deutekom AW, Chinapaw MJM, Jansma EP, Vrijkotte TGM, Gemke RJBJ. The Association of Birth Weight and Infant Growth with Energy Balance-Related Behavior - A Systematic Review and Best-Evidence Synthesis of Human Studies. PLoS One 2017; 12:e0168186. [PMID: 28081150 PMCID: PMC5232347 DOI: 10.1371/journal.pone.0168186] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/28/2016] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Suboptimal prenatal and early postnatal growths are associated with obesity in later life, but the underlying mechanisms are unknown. The aim of this study was to systematically review the literature that reports on the longitudinal association of (i) birth size or (ii) infant growth with later (i) energy intake, (ii) eating behaviors, (iii) physical activity or (iv) sedentary behavior in humans. METHODS A comprehensive search of MEDLINE, EMBASE, PsycINFO and The Cochrane Library was conducted to identify relevant publications. We appraised the methodological quality of the studies and synthesized the extracted data through a best-evidence synthesis. RESULTS Data from 41 publications were included. The quality of the studies was high in three papers, moderate in 11 and low in the large majority (n = 27) of papers appraised. Our best-evidence synthesis indicates that there is no evidence for an association of birth weight with later energy intake, eating behavior, physical activity or sedentary behavior. We found moderate evidence for an association of extreme birth weights (at both ends of the spectrum) with lower physical activity levels at a later age. Evidence for the association of infant growth with energy balance-related behavior was generally insufficient. CONCLUSIONS We conclude that current evidence does not support an association of early-life growth with energy balance-related behaviors in later life, except for an association of extreme birth weights with later physical activity.
Collapse
Affiliation(s)
- Arend W. van Deutekom
- Department of Pediatrics, EMGO Institute for Health & Care Research, Institute for Cardiovascular Research VU, VU University Medical Center, Amsterdam, the Netherlands
- * E-mail:
| | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, EMGO institute for Health & Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Elise P. Jansma
- Department of Epidemiology and Biostatistics, EMGO institute for Health & Care Research, VU University Medical Centre, Amsterdam, Netherlands
| | - Tanja G. M. Vrijkotte
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Reinoud J. B. J. Gemke
- Department of Pediatrics, EMGO Institute for Health & Care Research, Institute for Cardiovascular Research VU, VU University Medical Center, Amsterdam, the Netherlands
| |
Collapse
|
38
|
Bush A, Bolton CE. Longer Term Sequelae of Prematurity: The Adolescent and Young Adult. RESPIRATORY OUTCOMES IN PRETERM INFANTS 2017. [DOI: 10.1007/978-3-319-48835-6_7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
39
|
Affiliation(s)
- Nihal Thomas
- Department of Endocrinology, Diabetes and Metabolism, Unit-1, Christian Medical College, Vellore, Tamil Nadu, India
| | - I. B. Bygbjerg
- Department of International Health, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
40
|
Placental restriction in multi-fetal pregnancies increases spontaneous ambulatory activity during daylight hours in young adult female sheep. J Dev Orig Health Dis 2016; 7:525-537. [PMID: 27335227 DOI: 10.1017/s2040174416000283] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Intrauterine growth restriction (IUGR) has adverse effects on metabolic health and early life, whereas physical activity is protective against later development of metabolic disease. Relationships between birth weight and physical activity in humans, and effects of IUGR on voluntary activity in rodents, are mixed and few studies have measured physical activity in a free-ranging environment. We hypothesized that induced restriction of placental growth and function (PR) in sheep would decrease spontaneous ambulatory activity (SAA) in free-ranging adolescent and young adult progeny from multi-fetal pregnancies. To test this hypothesis, we used Global Positioning System watches to continuously record SAA between 1800 and 1200 h the following day, twice during a 16-day recording period, in progeny of control (CON, n=5 males, 9 females) and PR pregnancies (n=9 males, 10 females) as adolescents (30 weeks) and as young adults (43 weeks). PR reduced size at birth overall, but not in survivors included in SAA studies. In adolescents, SAA did not differ between treatments and females were more active than males overall and during the day (each P<0.001). In adults, daytime SAA was greater in PR than CON females (P=0.020), with a similar trend in males (P=0.053) and was greater in females than males (P=0.016). Adult SAA was negatively correlated with birth weight in females only. Contrary to our hypothesis, restricted placental function and small size at birth did not reduce progeny SAA. The mechanisms for increased daytime SAA in adult female PR and low birth weight sheep require further investigation.
Collapse
|
41
|
Hagmann-von Arx P, Manicolo O, Perkinson-Gloor N, Weber P, Grob A, Lemola S. Gait in Very Preterm School-Aged Children in Dual-Task Paradigms. PLoS One 2015; 10:e0144363. [PMID: 26641492 PMCID: PMC4671605 DOI: 10.1371/journal.pone.0144363] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 11/17/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The control of gait requires executive and attentional functions. As preterm children show executive and attentional deficits compared to full-term children, performing concurrent tasks that impose additional cognitive load may lead to poorer walking performance in preterm compared to full-term children. Knowledge regarding gait in preterm children after early childhood is scarce. We examined straight walking and if it is more affected in very preterm than in full-term children in dual-task paradigms. STUDY DESIGN Twenty preterm children with very low birth-weight (≤ 1500 g), 24 preterm children with birth-weight > 1500 g, and 44 full-term children, born between 2001 and 2006, were investigated. Gait was assessed using an electronic walkway system (GAITRite) while walking without a concurrent task (single-task) and while performing one concurrent (dual-task) or two concurrent (triple-task) tasks. Spatio-temporal gait parameters (gait velocity, cadence, stride length, single support time, double support time), normalized gait parameters (normalized velocity, normalized cadence, normalized stride length) and gait variability parameters (stride velocity variability, stride length variability) were analyzed. RESULTS In dual- and triple-task conditions children showed decreased gait velocity, cadence, stride length, as well as increased single support time, double support time and gait variability compared to single-task walking. Further, results showed systematic decreases in stride velocity variability from preterm children with very low birth weight (≤ 1500 g) to preterm children with birth weight > 1500 g to full-term children. There were no significant interactions between walking conditions and prematurity status. CONCLUSIONS Dual and triple tasking affects gait of preterm and full-term children, confirming previous results that walking requires executive and attentional functions. Birth-weight dependent systematic changes in stride velocity variability indicate poorer walking performance in preterm children who were less mature at birth.
Collapse
Affiliation(s)
| | - Olivia Manicolo
- Department of Psychology, University of Basel, Basel, Switzerland
| | | | - Peter Weber
- Division of Neuropediatrics and Developmental Medicine, University Children’s Hospital Basel, Basel, Switzerland
| | - Alexander Grob
- Department of Psychology, University of Basel, Basel, Switzerland
| | - Sakari Lemola
- Department of Psychology, University of Basel, Basel, Switzerland
| |
Collapse
|
42
|
Clemm HH, Vollsaeter M, Røksund OD, Markestad T, Halvorsen T. Adolescents who were born extremely preterm demonstrate modest decreases in exercise capacity. Acta Paediatr 2015; 104:1174-81. [PMID: 26096772 DOI: 10.1111/apa.13080] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 04/14/2015] [Accepted: 06/09/2015] [Indexed: 11/28/2022]
Abstract
AIM We aimed to investigate exercise capacity in adolescents who were born extremely preterm and to study changes through puberty and associations with neonatal data, exercise habits and lung function. METHODS This Norwegian population-based controlled cohort study focused on all infants (n = 35) born at a gestational age of ≤ 28 weeks or with a birthweight of ≤ 1000 grams in 1991-1992, together with matched term-born controls. Participants underwent spirometry and a maximal cardiopulmonary treadmill exercise test at 10 and 18 years. RESULTS At 18 years of age, mean (95% confidence interval) peak oxygen consumption (peak VO2 ) was 42.3 (39.2-45.4) vs 45.3 (41.3-49.3) mL/kg/min in the preterm- and term-born groups, while the completed treadmill distance was 915 (837-992) vs 1017 (912-1122) metres. Peak VO2 was unrelated to neonatal factors and current lung function. Changes between 10 and 18 were similar in the two groups, and positive associations between exercise habits and peak VO2 developed during the period. CONCLUSION Exercise capacity was modestly reduced in adolescents born extremely preterm, but the values were considered normal in most participants. Changes during puberty were similar to those observed for term controls, and the findings suggest similar trainability.
Collapse
Affiliation(s)
- Hege H. Clemm
- Department of Pediatrics; Haukeland University Hospital; Bergen Norway
- Department of Clinical Science; University of Bergen; Bergen Norway
| | - Maria Vollsaeter
- Department of Pediatrics; Haukeland University Hospital; Bergen Norway
- Department of Clinical Science; University of Bergen; Bergen Norway
| | - Ola D. Røksund
- Department of Pediatrics; Haukeland University Hospital; Bergen Norway
- Department of Occupational Therapy, Physiotherapy and Radiography; Bergen University College; Bergen Norway
| | - Trond Markestad
- Department of Pediatrics; Haukeland University Hospital; Bergen Norway
- Department of Clinical Science; University of Bergen; Bergen Norway
| | - Thomas Halvorsen
- Department of Pediatrics; Haukeland University Hospital; Bergen Norway
- Department of Clinical Science; University of Bergen; Bergen Norway
| |
Collapse
|
43
|
Mata Zubillaga D, Rodríguez Fernández C, Rodríguez Fernández L, de Paz Fernández J, Arboleda Franco S, Alonso Patiño F. Evaluation of isometric force in lower limbs and body composition in preterm infants. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2015. [DOI: 10.1016/j.anpede.2014.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
44
|
The fetal programming of food preferences: current clinical and experimental evidence. J Dev Orig Health Dis 2015; 7:222-230. [PMID: 26412563 DOI: 10.1017/s2040174415007187] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Increased energy consumption is one of the major factors implicated in the epidemic of obesity. There is compelling evidence, both clinical and experimental, that fetal paucity of nutrients may have programming effects on feeding preferences and behaviors that can contribute to the development of diseases. Clinical studies in different age groups show that individuals born small for their gestational age (SGA) have preferences towards highly caloric foods such as carbohydrates and fats. Some studies have also shown altered eating behaviors in SGA children. Despite an apparent discrepancy in different age groups, all studies seem to converge to an increased intake of palatable foods in SGA individuals. Small nutrient imbalances across lifespan increase the risk of noncommunicable diseases in adult life. Homeostatic factors such as altered responses to leptin and insulin and alterations in neuropeptides associated with appetite and satiety are likely involved. Imbalances between homeostatic and hedonic signaling are another proposed mechanism, with the mesocorticolimbic dopaminergic pathway having differential reward and pleasure responses when facing palatable foods. Early exposure to undernutrition also programs hypothalamic-pituitary-adrenal axis, with SGA having higher levels of cortisol in different ages, leading to chronic hyperactivity of this neuroendocrine axis. This review summarizes the clinical and experimental evidence related to fetal programming of feeding preferences by SGA.
Collapse
|
45
|
Matinolli HM, Hovi P, Männistö S, Sipola-Leppänen M, Eriksson JG, Mäkitie O, Järvenpää AL, Andersson S, Kajantie E. Early Protein Intake Is Associated with Body Composition and Resting Energy Expenditure in Young Adults Born with Very Low Birth Weight. J Nutr 2015; 145:2084-91. [PMID: 26180246 DOI: 10.3945/jn.115.212415] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 06/24/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Suboptimal nutrition during fetal life and early childhood may be important in early programming of health and disease. Preterm infants born with very low birth weight (VLBW; <1500 g) frequently receive inadequate neonatal nutrition; the long-term consequences are poorly known. OBJECTIVE We evaluated the association between early macronutrient intake and body composition in young adults born with VLBW. METHODS We collected comprehensive information on daily nutritional intake during the initial hospital stay for 127 participants of the Helsinki Study of Very Low Birth Weight Adults. We calculated mean daily intakes of energy, protein, fat, and carbohydrate during the first 9 wk of life. At the mean age of 22.5 y, the subjects underwent measurements of weight, height, body composition by dual-energy X-ray absorptiometry, and resting energy expenditure. The associations were examined by linear regression. RESULTS We found that energy, protein, and fat intakes during the first 3 wk of life, all below current recommendations, predicted adult body composition. When adjusted for sex, age, birth weight SD score, and gestational age, a 1 g · kg(-1) · d(-1) higher protein intake predicted 11.1% higher lean body mass (LBM) (95% CI: 3.7%, 18.9%) and 8.5% higher resting energy expenditure (REE) (95% CI: 0.2%, 17.0%). Among those born before 28 wk of gestation, the numbers were 22.5% (95% CI: 1.9%, 47.4%) for LBM and 22.1% (95% CI: 3.6%, 44.0%) for REE. Similar associations were seen with energy (P = 0.01, P = 0.05) and fat (P < 0.01, P = 0.03) but not with carbohydrate. Energy intake was also associated with BMI (P = 0.01) and fat intake with BMI (P < 0.01) and percentage body fat (P = 0.05). The results were little changed when adjusted for prenatal and postnatal characteristics. CONCLUSIONS At relatively low neonatal protein intake levels, additional protein intake is reflected in a healthier body composition, accompanied by a higher metabolic rate, in young adults born with VLBW 20 y earlier.
Collapse
Affiliation(s)
- Hanna-Maria Matinolli
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Institute of Health Sciences, University of Oulu, Oulu, Finland;
| | - Petteri Hovi
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Satu Männistö
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Marika Sipola-Leppänen
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Institute of Health Sciences, University of Oulu, Oulu, Finland; Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland
| | - Johan G Eriksson
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of General Practice and Primary Health Care, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland; Unit of General Practice, Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Centre, Helsinki, Finland; and
| | - Outi Mäkitie
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Centre, Helsinki, Finland; and
| | - Anna-Liisa Järvenpää
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sture Andersson
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Eero Kajantie
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Obstetrics and Gynaecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| |
Collapse
|
46
|
Abstract
PURPOSE OF REVIEW Eleven percent of infants are born preterm worldwide. Preterm infants continue their development and growth in a substantially different environment than in uterus. The prenatal and postnatal period have long-lasting effects on a child's health. Previous studies have shown that adults born preterm with very low birth weight show enhancement of cardiometabolic risk factors such as elevated blood pressure and impaired glucose regulation compared with their peers born at term. RECENT FINDINGS Recent studies have more often included individuals born less preterm, as over 70% of premature infants are born late preterm (in 34-36 gestational weeks). Adults born preterm have elevated levels of cardiometabolic-risk factors concerning several aspects such as body size and composition, energy metabolism, blood pressure, vascular structure, glucose and lipid metabolism, lifestyle, and some emerging cardiometabolic-risk factors. SUMMARY Most of the cardiometabolic-risk factors related to preterm birth are modifiable. Favorable early-life circumstances of premature infants, such as optimal nutrition and growth, might reduce the risk of later cardiometabolic disorders. In addition, adults born preterm might particularly benefit from screening of risk factors and promotion of a healthy lifestyle.
Collapse
Affiliation(s)
- Marika Sipola-Leppänen
- aChronic Disease Prevention Unit, National Institute for Health and Welfare, Oulu bChronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki cDepartment of Pediatrics and Adolescence, PEDEGO, Oulu University Hospital, Oulu dInstitute of Health Science, University of Oulu eChildren's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki fDepartment of Obstetrics and Gynecology, MRC Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | | |
Collapse
|
47
|
Cunha FDS, Dalle Molle R, Portella AK, Benetti CDS, Noschang C, Goldani MZ, Silveira PP. Both food restriction and high-fat diet during gestation induce low birth weight and altered physical activity in adult rat offspring: the "Similarities in the Inequalities" model. PLoS One 2015; 10:e0118586. [PMID: 25738800 PMCID: PMC4349804 DOI: 10.1371/journal.pone.0118586] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 01/20/2015] [Indexed: 11/18/2022] Open
Abstract
We have previously described a theoretical model in humans, called "Similarities in the Inequalities", in which extremely unequal social backgrounds coexist in a complex scenario promoting similar health outcomes in adulthood. Based on the potential applicability of and to further explore the "similarities in the inequalities" phenomenon, this study used a rat model to investigate the effect of different nutritional backgrounds during gestation on the willingness of offspring to engage in physical activity in adulthood. Sprague-Dawley rats were time mated and randomly allocated to one of three dietary groups: Control (Adlib), receiving standard laboratory chow ad libitum; 50% food restricted (FR), receiving 50% of the ad libitum-fed dam's habitual intake; or high-fat diet (HF), receiving a diet containing 23% fat. The diets were provided from day 10 of pregnancy until weaning. Within 24 hours of birth, pups were cross-fostered to other dams, forming the following groups: Adlib_Adlib, FR_Adlib, and HF_Adlib. Maternal chow consumption and weight gain, and offspring birth weight, growth, physical activity (one week of free exercise in running wheels), abdominal adiposity and biochemical data were evaluated. Western blot was performed to assess D2 receptors in the dorsal striatum. The "similarities in the inequalities" effect was observed on birth weight (both FR and HF groups were smaller than the Adlib group at birth) and physical activity (both FR_Adlib and HF_Adlib groups were different from the Adlib_Adlib group, with less active males and more active females). Our findings contribute to the view that health inequalities in fetal life may program the health outcomes manifested in offspring adult life (such as altered physical activity and metabolic parameters), probably through different biological mechanisms.
Collapse
Affiliation(s)
- Fábio da Silva Cunha
- Programa de Pós-Graduação da Saúde da Criança e do Adolescente, Departamento de Pediatria, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Roberta Dalle Molle
- Programa de Pós-Graduação da Saúde da Criança e do Adolescente, Departamento de Pediatria, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - André Krumel Portella
- Departamento de Pediatria, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Carla da Silva Benetti
- Programa de Pós-Graduação da Saúde da Criança e do Adolescente, Departamento de Pediatria, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Cristie Noschang
- Programa de Pós-Graduação da Saúde da Criança e do Adolescente, Departamento de Pediatria, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Marcelo Zubaran Goldani
- Programa de Pós-Graduação da Saúde da Criança e do Adolescente, Departamento de Pediatria, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Patrícia Pelufo Silveira
- Programa de Pós-Graduação da Saúde da Criança e do Adolescente, Departamento de Pediatria, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| |
Collapse
|
48
|
Kaseva N, Martikainen S, Tammelin T, Hovi P, Järvenpää AL, Andersson S, Eriksson JG, Räikkönen K, Pesonen AK, Wehkalampi K, Kajantie E. Objectively measured physical activity in young adults born preterm at very low birth weight. J Pediatr 2015; 166:474-6. [PMID: 25454929 DOI: 10.1016/j.jpeds.2014.10.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 08/15/2014] [Accepted: 10/03/2014] [Indexed: 10/24/2022]
Abstract
Unimpaired adults born preterm at very low birth weight (<1500 g) consistently have lower conditioning physical activity than those born at term. We used wrist-worn accelerometers to measure objectively physical activity in 57 very low birth weight and 47 control subjects aged 25 years. We found no difference in any physical activity measures.
Collapse
Affiliation(s)
- Nina Kaseva
- National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki, Finland; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
| | - Silja Martikainen
- Department of Behavioral Sciences, University of Helsinki, Helsinki, Finland
| | - Tuija Tammelin
- LIKES Research Center for Sport and Health Sciences, Jyväskylä, Finland
| | - Petteri Hovi
- National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki, Finland; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Anna-Liisa Järvenpää
- Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Sture Andersson
- Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Johan G Eriksson
- National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland; Vasa Central Hospital, Vasa, Finland; Folkhälsan Research Centre, Helsinki, Finland
| | - Katri Räikkönen
- Department of Behavioral Sciences, University of Helsinki, Helsinki, Finland
| | | | - Karoliina Wehkalampi
- National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki, Finland; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki, Finland; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| |
Collapse
|
49
|
Mata Zubillaga D, Rodríguez Fernández C, Rodríguez Fernández LM, de Paz Fernández JA, Arboleda Franco S, Alonso Patiño F. [Evaluation of isometric force in lower limbs and body composition in preterm infants]. An Pediatr (Barc) 2015; 83:229-35. [PMID: 25639163 DOI: 10.1016/j.anpedi.2014.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 11/20/2014] [Accepted: 12/16/2014] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Strength is a physical quality with a clear influence on quality of life. It is determined by the structure of the musculoskeletal system, and depends on the muscular structure. It has been described that prematurity conditions both qualities. The aims of this study are to determine whether prematurity is associated with strength or body composition and evaluate the relationship between prematurity, strength and muscle mass. MATERIAL AND METHODS Case-control study. Participants were premature 7-to-11 year-old children and full-term birth controls. Strength was measured by a strength gauge and body composition from DEXA (duel-energy X-ray absorptiometry) scans. A total of 89 subjects were included and divided into three groups: 30 prematures with birth-weight ≤ 1500g, 29 prematures with birth-weight 1500-2000g, and 30 controls. RESULTS Weight and BMI z-score was lower in the premature group. No differences were found in muscular mass or strength between groups. A ratio was established between strength and weight or muscular mass. It was observed that it was possible for them to move four times their weight, without finding any differences between groups or a relationship with birth-weight. CONCLUSIONS Between 7 and 11 years of age, children who were premature have lower weight and BMI than the rest of the children. However, there were no differences in body composition or strength between preterm children and controls.
Collapse
Affiliation(s)
- D Mata Zubillaga
- Unidad de Pediatría, Centro de Salud Ponferrada IV. Ponferrada, León.
| | - C Rodríguez Fernández
- Servicio de Pediatría y Neonatología, Complejo Asistencial Universitario de León, León
| | | | - J A de Paz Fernández
- Facultad de Ciencias de la Educación Física y del Deporte, Universidad de León, León
| | - S Arboleda Franco
- Facultad de Ciencias de la Educación Física y del Deporte, Universidad de León, León
| | - F Alonso Patiño
- Facultad de Ciencias de la Educación Física y del Deporte, Universidad de León, León
| |
Collapse
|
50
|
Effects of an outdoor bicycle-based intervention in healthy rural Indian men with normal and low birth weight. J Dev Orig Health Dis 2014; 6:27-37. [PMID: 25514893 DOI: 10.1017/s2040174414000609] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Physical inactivity and low birth weight (LBW) may lead to an increased risk for developing type 2 diabetes. The extent to which LBW individuals may benefit from physical exercise training when compared with those with normal birth weight (NBW) controls is uncertain. We assessed the impact of an outdoor exercise intervention on body composition, insulin secretion and action in young men born with LBW and NBW in rural India. A total of 61 LBW and 56 NBW healthy young men were recruited into the study. The individuals were instructed to perform outdoor bicycle exercise training for 45 min every day. Fasting blood samples, intravenous glucose tolerance tests and bioimpedance body composition assessment were carried out. Physical activity was measured using combined accelerometry and heart rate monitoring during the first and the last week of the intervention. Following the exercise intervention, the LBW group displayed an increase in physical fitness [55.0 ml (O2)/kg min (52.0-58.0)-57.5 ml (O2)/kg min (54.4-60.5)] level and total fat-free mass [10.9% (8.0-13.4)-11.4% (8.0-14.6)], as well as a corresponding decline in the ratio of total fat mass/fat-free mass. In contrast, an increase in total fat percentage as well as total fat mass was observed in the NBW group. After intervention, fasting plasma insulin levels, homoeostasis model assessments (HOMA) of insulin resistance (HOMA-IR) and insulin secretion (HOMA-IS), improved to the same extent in both the groups. In summary, young men born with LBW in rural India benefit metabolically from exercise training to an extent comparable with NBW controls.
Collapse
|