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Dhanasekara CS, Ancona D, Cortes L, Hu A, Rimu AH, Robohm-Leavitt C, Payne D, Wakefield SM, Mastergeorge AM, Kahathuduwa CN. Association Between Autism Spectrum Disorders and Cardiometabolic Diseases: A Systematic Review and Meta-analysis. JAMA Pediatr 2023; 177:248-257. [PMID: 36716018 PMCID: PMC9887535 DOI: 10.1001/jamapediatrics.2022.5629] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/11/2022] [Indexed: 01/31/2023]
Abstract
Importance Although the increased risk of obesity among individuals with autism has been well established, evidence on the association between autism, cardiometabolic disorders, and obesity remains inconclusive. Objective To examine the association between autism spectrum disorders and cardiometabolic diseases in a systematic review and meta-analysis. Data Sources PubMed, Scopus, Web of Science, ProQuest, Embase, and Ovid databases were searched from inception through July 31, 2022, without restrictions on date of publication or language. Study Selection Observational or baseline data of interventional studies reporting the prevalence of cardiometabolic risk factors (ie, diabetes, hypertension, dyslipidemia, atherosclerotic macrovascular disease) among children and/or adults with autism and matched with participants without autism were included. Data Extraction and Synthesis Screening, data extraction, and quality assessment were performed independently by at least 2 researchers. DerSimonian-Laird random-effects meta-analyses were performed using the meta package in R. Main Outcomes and Measures Relative risks (RRs) of diabetes, hypertension, dyslipidemia, and atherosclerotic macrovascular disease among individuals with autism were the primary outcomes. Secondary outcomes included the RR of type 1 and type 2 diabetes, heart disease, stroke, and peripheral vascular disease. Results A total of 34 studies were evaluated and included 276 173 participants with autism and 7 733 306 participants without autism (mean [range] age, 31.2 [3.8-72.8] years; pooled proportion [range] of female individuals, 47% [0-66%]). Autism was associated with greater risks of developing diabetes overall (RR, 1.57; 95% CI, 1.23-2.01; 20 studies), type 1 diabetes (RR, 1.64; 95% CI, 1.06-2.54; 6 studies), and type 2 diabetes (RR, 2.47; 95% CI, 1.30-4.70; 3 studies). Autism was also associated with increased risks of dyslipidemia (RR, 1.69; 95% CI, 1.20-2.40; 7 studies) and heart disease (RR, 1.46; 95% CI, 1.42-1.50; 3 studies). Yet, there was no significantly associated increased risk of hypertension and stroke with autism (RR, 1.22; 95% CI, 0.98-1.52; 12 studies; and RR, 1.19; 95% CI, 0.63-2.24; 4 studies, respectively). Meta-regression analyses revealed that children with autism were at a greater associated risk of developing diabetes and hypertension compared with adults. High between-study heterogeneity was a concern for several meta-analyses. Conclusions and Relevance Results suggest that the associated increased risk of cardiometabolic diseases should prompt clinicians to vigilantly monitor individuals with autism for potential contributors, signs of cardiometabolic disease, and their complications.
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Affiliation(s)
- Chathurika S. Dhanasekara
- Department of Laboratory Science and Primary Care, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock
- Department of Surgery, School of Medicine, Texas Tech University Health Sciences Center, Lubbock
| | - Dominic Ancona
- Department of Laboratory Science and Primary Care, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock
| | - Leticia Cortes
- Department of Laboratory Science and Primary Care, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock
| | - Amy Hu
- Department of Laboratory Science and Primary Care, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock
| | - Afrina H. Rimu
- Department of Internal Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock
| | - Christina Robohm-Leavitt
- Department of Laboratory Science and Primary Care, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock
| | - Drew Payne
- Department of Internal Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock
| | - Sarah M. Wakefield
- Department of Psychiatry, School of Medicine, Texas Tech University Health Sciences Center, Lubbock
| | - Ann M. Mastergeorge
- Department of Human Development and Family Sciences, College of Human Sciences, Texas Tech University, Lubbock
| | - Chanaka N. Kahathuduwa
- Department of Laboratory Science and Primary Care, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock
- Department of Psychiatry, School of Medicine, Texas Tech University Health Sciences Center, Lubbock
- Department of Neurology, School of Medicine, Texas Tech University Health Sciences Center, Lubbock
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Hampl SE, Hassink SG, Skinner AC, Armstrong SC, Barlow SE, Bolling CF, Avila Edwards KC, Eneli I, Hamre R, Joseph MM, Lunsford D, Mendonca E, Michalsky MP, Mirza N, Ochoa ER, Sharifi M, Staiano AE, Weedn AE, Flinn SK, Lindros J, Okechukwu K. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics 2023; 151:e2022060640. [PMID: 36622115 DOI: 10.1542/peds.2022-060640] [Citation(s) in RCA: 229] [Impact Index Per Article: 229.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/10/2023] Open
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Wei X, Hu J, Liu Y, Ma Y, Wen D. Association between Marginally Low Birth Weight and Obesity-Related Outcomes and Indirect Effects via Attention-Deficit Hyperactivity Disorder and Abnormal Eating. Obes Facts 2022; 15:197-208. [PMID: 34915511 PMCID: PMC9021619 DOI: 10.1159/000520902] [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: 07/01/2020] [Accepted: 09/07/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Evidence of the association between children born with marginally low birth weight (MLBW) and obesity-related outcomes was controversial, and our study aimed to examine the role of attention-deficit hyperactivity disorder (ADHD) and/or abnormal eating in these associations. METHODS A retrospective cohort study consisting of 677 Chinese children was conducted. Obesity-related outcomes (body mass index [BMI], waist circumference [WC], skinfold thickness [SF], body fat, blood pressure, lipids, and blood glucose), behaviour problems (ADHD and eating behaviour) and birth weight were collected. Mediation analyses were used to explore whether ADHD and/or abnormal eating was an intermediary factor in the MLBW-OB relationship. RESULTS Children with MLBW tended to have higher SF, triglycerides, fasting blood glucose, waistline, body fat, and abdominal obesity risks. Birth weight was negatively related to obesity-related outcomes, and the associations were mediated, partially, by the increased risk of ADHD or abnormal eating behaviour after adjustment for the BMI Z score. Furthermore, lower birth weight predicted higher WC indirectly through emotional overeating caused by ADHD (β: -0.10; 95% confidence interval: -0.19, -0.01). CONCLUSION Our study suggests the hypothetical role of ADHD and abnormal eating as underlying mechanisms in the association between MLBW and obesity-related outcomes, providing novel scientific evidence for childhood development interventions.
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Affiliation(s)
- Xiaotong Wei
- Institute of Health Sciences, China Medical University, Shenyang, China,
| | - Jiajin Hu
- Institute of Health Sciences, China Medical University, Shenyang, China
| | - Yang Liu
- Institute of Health Sciences, China Medical University, Shenyang, China
| | - Yanan Ma
- Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, China
| | - Deliang Wen
- Institute of Health Sciences, China Medical University, Shenyang, China
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Fujita Y, Kouda K, Ohara K, Nakamura H, Nakama C, Nishiyama T, Iki M. Infant weight gain and DXA-measured adolescent adiposity: data from the Japan Kids Body-composition Study. J Physiol Anthropol 2021; 40:10. [PMID: 34452643 PMCID: PMC8399705 DOI: 10.1186/s40101-021-00261-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/19/2021] [Indexed: 12/25/2022] Open
Abstract
Background Rapid weight gain in early life is associated with adiposity later in life. However, there is limited information on the association between weight gain and body fat mass measured using precise methods. This study aimed to investigate whether weight gain is associated with body fat mass measured by dual-energy X-ray absorptiometry (DXA) in adolescents. Methods Participants of this retrospective cohort study were 423 adolescents born at full-term who were enrolled in the Japan Kids Body-composition Study. Anthropometric measurements related to pregnancy, delivery, and child health were obtained from the Japanese Maternal and Child Health Handbook. Fat mass in adolescents was measured with a DXA scanner. Weight gain was defined as the change in body weight from birth to age 1.5 years. Associations between birthweight and fat mass, and between weight gain and fat mass, were evaluated using multiple regression analysis. Results There was a significant positive association between weight gain from birth to age 1.5 years and fat mass in adolescents (boys: standardized regression coefficient (β) = 0.253, p < 0.01; girls: β = 0.246, p < 0.01), but not between birthweight standardized for gestational age and fat mass. Conclusion Children with a greater change in weight from birth to age 1.5 years tended to have increased fat mass in adolescence. Weight gain in early life has a greater impact on fat mass in adolescents than birthweight.
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Affiliation(s)
- Yuki Fujita
- Department of Public Health, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, 589-8511, Japan.
| | - Katsuyasu Kouda
- Department of Hygiene and Public Health, Kansai Medical University, Hirakata, Osaka, 573-1010, Japan
| | - Kumiko Ohara
- Department of Public Health, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Harunobu Nakamura
- Department of Human Development, Graduate School of Human Development and Environment, Kobe University, Kobe, 657-8501, Japan
| | - Chikako Nakama
- Department of Hygiene and Public Health, Kansai Medical University, Hirakata, Osaka, 573-1010, Japan
| | - Toshimasa Nishiyama
- Department of Hygiene and Public Health, Kansai Medical University, Hirakata, Osaka, 573-1010, Japan
| | - Masayuki Iki
- Department of Public Health, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, 589-8511, Japan
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Rallis D, Balomenou F, Tzoufi M, Giapros V. A systematic review indicates an association between birth weight and body fat in childhood. Acta Paediatr 2021; 110:2023-2039. [PMID: 33682216 DOI: 10.1111/apa.15834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 12/14/2022]
Abstract
AIM To summarise the existing evidence regarding the body fat of small or large for gestation subjects, evaluated from birth up to 18 years of age. METHODS The PRISMA guidelines were adopted for the current systematic review, including studies having evaluated body fat with bioelectrical impedance analysis, air displacement plethysmography, dual-energy X-ray absorptiometry or magnetic resonance imaging. RESULTS A total of 31 studies was included. The balance of evidence suggests that small for gestation infants have decreased fat mass at birth; postnatally they experience increased adiposity. In the long term, however, the evidence is inconclusive, since some studies suggest that foetal-restricted children with increased catch-up growth are at increased risk of fat accumulation, whereas other studies suggest a neutral or even negative association. Large for gestation infants have increased fat mass at birth, but in the long term, they have a lower body fat ratio, especially when they develop a catch-down growth. CONCLUSION Some studies suggested that foetal-restricted children with increased catch-up growth are at increased risk of later adiposity, while other studies suggested a neutral or negative association. Given that the evidence is inconclusive, further studies are warranted. Large for gestation subjects have lower body fat when they develop catch-down growth.
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Affiliation(s)
- Dimitrios Rallis
- Neonatal Intensive Care Unit University of Ioannina, School of Medicine Ioannina Greece
| | - Foteini Balomenou
- Neonatal Intensive Care Unit University of Ioannina, School of Medicine Ioannina Greece
| | - Meropi Tzoufi
- Department of Paediatrics University of Ioannina, School of Medicine Ioannina Greece
| | - Vasileios Giapros
- Neonatal Intensive Care Unit University of Ioannina, School of Medicine Ioannina Greece
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Lyons-Reid J, Albert BB, Kenealy T, Cutfield WS. Birth Size and Rapid Infant Weight Gain-Where Does the Obesity Risk Lie? J Pediatr 2021; 230:238-243. [PMID: 33157072 DOI: 10.1016/j.jpeds.2020.10.078] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/28/2020] [Accepted: 10/30/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Jaz Lyons-Reid
- Liggins Institute, The University of Aucklan, Auckland, New Zealand
| | | | - Timothy Kenealy
- Liggins Institute, The University of Aucklan, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, The University of Aucklan, Auckland, New Zealand; A Better Start - National Science Challenge, Auckland, New Zealand.
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Kahathuduwa CN, West BD, Blume J, Dharavath N, Moustaid-Moussa N, Mastergeorge A. The risk of overweight and obesity in children with autism spectrum disorders: A systematic review and meta-analysis. Obes Rev 2019; 20:1667-1679. [PMID: 31595678 DOI: 10.1111/obr.12933] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/25/2019] [Accepted: 07/25/2019] [Indexed: 02/06/2023]
Abstract
Multiple studies have suggested that autism spectrum disorders seem to increase the risk of overweight and obesity. We examined the pooled prevalence and relative risk of developing overweight or obesity among children with autism spectrum disorders in a systematic review and meta-analysis. We searched PubMed, Scopus, ProQuest, and Web of Science databases and subsequently screened the records to identify studies that reported prevalence of overweight and/or obesity in children with ASD and matched groups of neurotypical children. DerSimonian-Laird random-effects meta-analyses were performed to examine pooled prevalence and relative risk of obesity in children with autism spectrum disorders using the "meta" package in R software. Among children with autism spectrum disorders, the prevalence of obesity was 22.2%. Children with ASD had a 41.1% greater risk (P = .018) of development of obesity. Non-Caucasian race, increasing age, female sex, and living in the United States emerged as positive moderators of the association between autism spectrum disorders and prevalence of overweight or obesity. Autism spectrum disorders seem to increase the risk of childhood obesity. Increased awareness of this association may allow the implementation of early interventions to reduce obesity and prevent potential deterioration of quality-of-life in this population.
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Affiliation(s)
- Chanaka N Kahathuduwa
- Department of Human Development and Family Studies, Texas Tech University, Lubbock, Texas, USA.,Department of Laboratory Sciences and Primary Care, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.,Department of Psychiatry, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.,Obesity Research Institute, Texas Tech University, Lubbock, Texas, USA
| | - Blake D West
- Department of Human Development and Family Studies, Texas Tech University, Lubbock, Texas, USA.,The Burkhart Center for Autism Education and Research, Texas Tech University, Lubbock, Texas, USA
| | - Jessica Blume
- Department of Human Development and Family Studies, Texas Tech University, Lubbock, Texas, USA.,The Burkhart Center for Autism Education and Research, Texas Tech University, Lubbock, Texas, USA
| | - Nagaraju Dharavath
- Department of Human Development and Family Studies, Texas Tech University, Lubbock, Texas, USA
| | - Naima Moustaid-Moussa
- Obesity Research Institute, Texas Tech University, Lubbock, Texas, USA.,Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA.,Department of Plant and Soil Science, Texas Tech University, Lubbock, Texas, USA
| | - Ann Mastergeorge
- Department of Human Development and Family Studies, Texas Tech University, Lubbock, Texas, USA.,The Burkhart Center for Autism Education and Research, Texas Tech University, Lubbock, Texas, USA
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Kahathuduwa CN, West B, Mastergeorge A. Effects of Overweight or Obesity on Brain Resting State Functional Connectivity of Children with Autism Spectrum Disorder. J Autism Dev Disord 2019; 49:4751-4760. [DOI: 10.1007/s10803-019-04187-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Baran J, Weres A, Czenczek-Lewandowska E, Leszczak J, Kalandyk-Osinko K, Mazur A. Relationship between Children's Birth Weight and Birth Length and a Risk of Overweight and Obesity in 4-15-Year-Old Children. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E487. [PMID: 31443282 PMCID: PMC6722569 DOI: 10.3390/medicina55080487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/07/2019] [Accepted: 08/12/2019] [Indexed: 12/31/2022]
Abstract
Background and Objectives. The purpose of the study was to investigate the relationship between children's birth weight/length and a risk of overweight and obesity. Materials and Methods. The study involved 747 children from kindergartens, as well as primary and middle schools from southeastern Poland. All the subjects were examined on fasting status. Each child was examined for body mass and height, in order to calculate their body mass index (BMI), and BMI centile. The parents completed a questionnaire related to basic information about the child and the family. Results. In the study group, the male infants presented greater birth body weight and birth body length. A comparison of the distribution of birth weights and lengths between the children with normal BMI and with high BMI showed statistically significant differences only in the case of birth length of 12-15-year-old children and in the group of boys aged 12-15 years. In the case of the female children and the group of 7-11-year-olds a statistically significant difference was found in the BMI centile at a later age-a higher centile was found in the girls and in the children aged 7-11 years classified as adequate for gestational age (AGA). Conclusions. Birth body weight is positively related to BMI centile; however, no significant differences were found in birth weight between children with overweight/obesity and children with normal body weight. Birth length is associated with a lower BMI centile only in boys aged 12-15 years, and lower birth length is found in boys with overweight and obesity.
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Affiliation(s)
- Joanna Baran
- Institute of Physiotherapy, Medical Faculty, University of Rzeszów, 35-959 Rzeszów, Poland.
| | - Aneta Weres
- Institute of Physiotherapy, Medical Faculty, University of Rzeszów, 35-959 Rzeszów, Poland
| | | | - Justyna Leszczak
- Institute of Physiotherapy, Medical Faculty, University of Rzeszów, 35-959 Rzeszów, Poland
| | - Katarzyna Kalandyk-Osinko
- Institute of Midwifery and Medical Emergency, Medical Faculty, University of Rzeszów, 35-959 Rzeszów, Poland
| | - Artur Mazur
- Institute of Nursing and Health Sciences, Medical Faculty, University of Rzeszów, 35-959 Rzeszów, Poland
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Feeding the Late and Moderately Preterm Infant: A Position Paper of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr 2019; 69:259-270. [PMID: 31095091 DOI: 10.1097/mpg.0000000000002397] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Nutritional guidelines and requirements for late or moderately preterm (LMPT) infants are notably absent, although they represent the largest population of preterm infants. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition (CoN) performed a review of the literature with the aim to provide guidance on how to feed infants born LMPT, and identify gaps in the literature and research priorities.Only limited data from controlled trials are available. Late preterm infants have unique, often unrecognized, vulnerabilities that predispose them to high rates of nutritionally related morbidity and hospital readmissions. They frequently have feeding difficulties that delay hospital discharge, and poorer rates of breastfeeding initiation and duration compared with term infants. This review also identified that moderately preterm infants frequently exhibit postnatal growth restriction.The ESPGHAN CoN strongly endorses breast milk as the preferred method of feeding LMPT infants and also emphasizes that mothers of LMPT infants should receive qualified, extended lactation support, and frequent follow-up. Individualized feeding plans should be promoted. Hospital discharge should be delayed until LMPT infants have a safe discharge plan that takes into account local situation and resources.In the LMPT population, the need for active nutritional support increases with lower gestational ages. There may be a role for enhanced nutritional support including the use of human milk fortifier, enriched formula, parenteral nutrition, and/or additional supplements, depending on factors, such as gestational age, birth weight, and significant comorbidities. Further research is needed to assess the benefits (improved nutrient intakes) versus risks (interruption of breast-feeding) of providing nutrient-enrichment to the LMPT infant.
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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.
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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.
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Chen C, Jin Z, Yang Y, Jiang F, Huang H, Liu S, Jin X. Association of low birth weight with thinness and severe obesity in children aged 3-12 years: a large-scale population-based cross-sectional study in Shanghai, China. BMJ Open 2019; 9:e028738. [PMID: 31152041 PMCID: PMC6549709 DOI: 10.1136/bmjopen-2018-028738] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Low birth weight (BW) is a general symbol of inadequate intrauterine conditions that elicit abnormal fetal growth and development. The aim of current study is to investigate the relationship between low BW and thinness or severe obesity during maturation. DESIGN A large-scale cross-sectional population-based survey. SETTING 134 kindergartens and 70 elementary schools. PARTICIPANTS 70 284 Chinese children aged 3-12 years. OUTCOME MEASURES International Obesity Task Force body mass index (BMI) cut-offs were used to define grade 1, grade 2 and grade 3 thinness, overweight, obesity and severe obesity. Multinomial logistic regression was used to estimate the association between BW and BMI category. RESULTS A total of 70 284 children participated in the survey. The percentage of grade 1 thinness and severe obesity in children with low BW is significantly higher than that in children with normal BW (p<0.05). Low BW was associated with an increased risk of grade 1 thinness (OR 1.56, 95% CI 1.38 to 1.75), grade 2 thinness (OR 1.34, 95% CI 1.10 to 1.64), grade 3 thinness (OR 1.99, 95% CI 1.63 to 2.42) and severe obesity (OR 1.27, 95% CI 1.03 to 1.55) but was not associated with obesity (OR 0.85, 95% CI 0.67 to 1.06). CONCLUSION There is a positive association between low BW and thinness or severe obesity risk.
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Affiliation(s)
- Chang Chen
- Pediatric Translational Medicine Institute, Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
- Key Laboratory of Children’s Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhijuan Jin
- Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - You Yang
- Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Jiang
- Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong Huang
- Key Laboratory of Children’s Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shijian Liu
- Pediatric Translational Medicine Institute, Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
- Key Laboratory of Children’s Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xingming Jin
- Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Developmental and Behavioral Pediatrics, Shanghai Pubin Children Hospital, Shanghai, China
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Starnberg J, Norman M, Westrup B, Domellöf M, Berglund SK. Cardiometabolic risk factors in children born with marginally low birth weight: A longitudinal cohort study up to 7 years-of-age. PLoS One 2019; 14:e0215866. [PMID: 31002705 PMCID: PMC6474616 DOI: 10.1371/journal.pone.0215866] [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: 12/27/2018] [Accepted: 04/09/2019] [Indexed: 11/28/2022] Open
Abstract
Introduction Low birth weight (LBW, <2500 g) may predict an increased risk of an adverse cardiometabolic profile later in life, but long-term effects in different populations and birth weight strata are still unclear. We explored laboratory markers of cardiometabolic risk in children born with marginally LBW (2000–2500 g). Methods This was a prospective longitudinal cohort study including 285 Swedish marginally LBW children and 95 normal birth weight (NBW, 2501–4500 g) controls. At 3.5 and 7 years of age, blood samples for glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), cholesterol, triglycerides, high- and low density lipoprotein (HDL and LDL), apolipoprotein B (ApoB) and apolipoprotein A1 (ApoA1) were assessed and compared between the groups. Results No significant differences in levels of insulin, HOMA-IR, hs-CRP or blood lipids were observed between marginally LBW and NBW children. At 7 years there was a higher proportion of marginally LBW children with elevated levels of insulin, defined as above the 90th percentile of the control group (21% vs 8.6%, p = 0.038). This association was, however, confounded by maternal ethnicity. In marginally LBW children born small for gestational age (SGA), mean fasting glucose was significantly higher compared to controls (4.7 vs 4.5 mmol/L, p = 0.020). Conclusions There were no significant differences in insulin, insulin resistance, hs-CRP or blood lipids between the marginally LBW children and controls. The subgroup of marginally LBW children born SGA may present early signs of glucose imbalance already at school age.
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Affiliation(s)
- Josefine Starnberg
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
- * E-mail:
| | - Mikael Norman
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Björn Westrup
- Division of Neonatology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Domellöf
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Staffan K. Berglund
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine (WCMM), Umeå University, Umeå, Sweden
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Eny KM, Chen S, Anderson LN, Chen Y, Lebovic G, Pullenayegum E, Parkin PC, Maguire JL, Birken CS. Breastfeeding duration, maternal body mass index, and birth weight are associated with differences in body mass index growth trajectories in early childhood. Am J Clin Nutr 2018; 107:584-592. [PMID: 29635496 DOI: 10.1093/ajcn/nqx081] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 12/21/2017] [Indexed: 12/11/2022] Open
Abstract
Background Accelerated postnatal growth is an important predictor for obesity risk. It is unknown whether early-life obesity-related risk factors affect body mass index (BMI) growth rates during distinct growth periods from early infancy through preschool years. Objective We examined whether breastfeeding duration, maternal BMI, and birth weight are associated with growth trajectories of age- and sex-standardized WHO BMI z scores (zBMIs) in young children. Design Children (n = 5905) in The Applied Research Group for Kids (TARGet Kids!) prospective cohort study underwent repeated measures of weight and length or height from birth to 10 y of age. Piecewise linear mixed models were used to determine whether zBMI growth rates differ for each risk factor during periods of growth between birth and 1, 3, 18, 36, and 72 mo of age. Results Children who were breastfed <6 mo compared with ≥6 mo showed a higher growth rate between 1-3 and 3-18 mo, resulting in higher standardized BMIs (zBMIs) of +0.24, +0.12, and +0.19 at 18, 36, and 72 mo, respectively. Maternal BMI (in kg/m2) ≥30 compared with <30 resulted in higher growth rates between 1-3 and 36-72 mo and higher zBMIs of +0.22, +0.14, +0.18, and +0.41 at 3, 18, 36, and 72 mo, respectively. Infants weighing <2.5 kg at birth (compared with 2.5-4 kg) experienced higher growth rates between 1-3 and 3-18 mo but had lower zBMIs at all time points (zBMI: -1.45 to -0.21). Infants weighing ≥4 kg at birth (compared with 2.5-4 kg) had significantly lower growth rates in the first 3 mo but higher zBMIs at all time points (zBMI: +1.16 to +0.27). Conclusion Differences in zBMI growth rates by breastfeeding duration, maternal BMI, and birth weight are seen in early infancy and contribute to differences in zBMI, which persist into midchildhood. This trial was registered at www.clinicaltrials.gov as NCT01869530.
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Affiliation(s)
- Karen M Eny
- Child Health Evaluative Sciences and Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Shiyi Chen
- Child Health Evaluative Sciences and Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Laura N Anderson
- Child Health Evaluative Sciences and Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Yang Chen
- The Applied Health Research Center of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada
| | - Gerald Lebovic
- The Applied Health Research Center of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, and Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Eleanor Pullenayegum
- Child Health Evaluative Sciences and Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Patricia C Parkin
- Child Health Evaluative Sciences and Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada.,Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, and Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jonathon L Maguire
- The Applied Health Research Center of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, and Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Catherine S Birken
- Child Health Evaluative Sciences and Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada.,Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, and Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Placental, Matrilineal, and Epigenetic Mechanisms Promoting Environmentally Adaptive Development of the Mammalian Brain. Neural Plast 2016; 2016:6827135. [PMID: 27069693 PMCID: PMC4812471 DOI: 10.1155/2016/6827135] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 03/03/2016] [Indexed: 11/17/2022] Open
Abstract
The evolution of intrauterine development, vivipary, and placentation in eutherian mammals has introduced new possibilities and constraints in the regulation of neural plasticity and development which promote neural function that is adaptive to the environment that a developing brain is likely to encounter in the future. A range of evolutionary adaptations associated with placentation transfers disproportionate control of this process to the matriline, a period unique in mammalian development in that there are three matrilineal genomes interacting in the same organism at the same time (maternal, foetal, and postmeiotic oocytes). The interactions between the maternal and developing foetal hypothalamus and placenta can provide a template by which a mother can transmit potentially adaptive information concerning potential future environmental conditions to the developing brain. In conjunction with genomic imprinting, it also provides a template to integrate epigenetic information from both maternal and paternal lineages. Placentation also hands ultimate control of genomic imprinting and intergenerational epigenetic information transfer to the matriline as epigenetic markers undergo erasure and reprogramming in the developing oocyte. These developments, in conjunction with an expanded neocortex, provide a unique evolutionary template by which matrilineal transfer of maternal care, resources, and culture can be used to promote brain development and infant survival.
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