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Moriya RM, de Oliveira CEC, Reiche EMV, Passini JLL, Nunes SOV. Association of adverse childhood experiences and overweight or obesity in adolescents: A systematic review and network analysis. Obes Rev 2024; 25:e13809. [PMID: 39075564 DOI: 10.1111/obr.13809] [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: 10/14/2022] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 07/31/2024]
Abstract
This systematic review with meta-analysis assessed the effects of adverse childhood experiences (ACEs) linked to overweight or obesity in adolescents. Twenty-eight studies (cross-sectional, case-control, or cohort) were included, which described individuals with a history of ACE or adverse family experiences, such as physical, emotional, or psychological abuses; neglect; exposure to domestic violence or peer violence; and sexual abuse. Body mass index (BMI) or BMI z score was used by the study to define adolescents with overweight or obesity. Adolescents who reported childhood experiences, mainly physical, sexual, and emotional abuses, were more associated with overweight/obesity, especially those who experienced four or more ACEs. Network meta-analysis indicated that physical, sexual, and neglect were the most common ACEs associated with obesity in adolescents. Due to significant differences and imprecision among the studies, network meta-analysis was inconclusive in determining the impact of other types of ACE on outcomes. However, evidence suggests that exposure to sexual and physical abuse, as well as neglect, is associated with adolescents who are obese or overweight, as well as with the number of ACE experienced. The study presented evidence suggesting that dealing with many ACEs may be a risk factor for overweight and obesity in adolescents.
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Affiliation(s)
- Renato Mikio Moriya
- Department of Clinical Medicine, Psychiatry Unit, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
- Health Sciences Post-Graduation Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | | | - Edna Maria Vissoci Reiche
- Health Sciences Post-Graduation Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
- Campus Londrina, School of Medicine, Pontifical Catholic University of Paraná, Londrina, Paraná, Brazil
| | - João Luís Lima Passini
- Department of Clinical Medicine, Psychiatry Unit, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Sandra Odebrecht Vargas Nunes
- Department of Clinical Medicine, Psychiatry Unit, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
- Health Sciences Post-Graduation Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
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2
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Barman N, Islam ABMMK, Haque MA. Association between adverse childhood experiences and type 2 diabetes mellitus in later life: A case-control study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002715. [PMID: 38917185 PMCID: PMC11198900 DOI: 10.1371/journal.pgph.0002715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 05/24/2024] [Indexed: 06/27/2024]
Abstract
Adverse childhood experiences (ACEs) are potentially traumatic events that occur before 18 years of age. Studies emphasize the importance of childhood adversity as a risk factor for developing non-communicable diseases, including type-2 diabetes mellitus (T2DM) in adulthood. This case-control study involved 137 patients with T2DM and 134 non-diabetic adults of both genders (mean age 46.9 and 45.7 years, respectively). In addition to collecting socio-demographic, behavioral, and anthropological data, a 10-item ACE scale was utilized to gather information regarding childhood adversities, while perceived stress was assessed using the perceived stress scale-4. Fasting and 2-hour post glucose load blood sugar levels, HbA1c, and fasting lipid profiles were measured. Both univariable and multivariable binary logistic regression analyses were performed to investigate whether ACE is a potential risk factor for T2DM, with a significance level of 0.05. Around two-thirds of T2DM patients reported having ACE scores of 4 or higher, with the mean ACE score significantly higher in the case group than in the control group (3.96 vs. 3.34; p<0.0001). The logistic regression analysis found that T2DM was linked to female gender, hypertension, dyslipidemia, family history of DM, higher perceived stress, and a higher ACE score of 4 and above. After adjusting for confounding factors, individuals with an ACE score of 4 or higher had a significantly greater risk of developing T2DM (OR: 2.24; 95% CI 1.238-4.061). The study revealed a significant association between higher ACE scores and an increased risk of developing T2DM. As a recommendation, further investigation into the epigenetic mechanisms underlying this relationship is warranted.
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Affiliation(s)
- Nilima Barman
- Department of Genetic Engineering and Biotechnology, University of Dhaka, Dhaka, Bangladesh
- Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine and Metabolic Disorder (BIRDEM) General Hospital, Dhaka, Bangladesh
| | - Abul B. M. M. K. Islam
- Department of Genetic Engineering and Biotechnology, University of Dhaka, Dhaka, Bangladesh
| | - M. Atiqul Haque
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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3
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Kim C, Harrall KK, Glueck DH, Hockett C, Dabelea D. Epigenetic age acceleration is associated with speed of pubertal growth but not age of pubertal onset. Sci Rep 2024; 14:2981. [PMID: 38316849 PMCID: PMC10844280 DOI: 10.1038/s41598-024-53508-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] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 02/01/2024] [Indexed: 02/07/2024] Open
Abstract
Using data from a longitudinal cohort of children, we examined whether epigenetic age acceleration (EAA) was associated with pubertal growth and whether these associations were mediated by adiposity. We examined associations between EAA at approximately 10 years of age with pubertal growth metrics, including age at peak height velocity (PHV), PHV, and sex steroid levels and whether these associations were mediated by measures of adiposity including body mass index (BMI) and MRI-assessed visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). Children (n = 135) with accelerated EAA had higher PHV (β 0.018, p = 0.0008) although the effect size was small. The association between EAA and age at PHV was not significant (β - 0.0022, p = 0.067). Although EAA was associated with higher BMI (β 0.16, p = 0.0041), VAT (β 0.50, p = 0.037), and SAT (β 3.47, p = 0.0076), BMI and VAT did not mediate associations between EAA and PHV, while SAT explained 8.4% of the association. Boys with higher EAA had lower total testosterone (β - 12.03, p = 0.0014), but associations between EAA and other sex steroids were not significant, and EAA was not associated with sex steroid levels in girls. We conclude that EAA did not have strong associations with either age at onset of puberty or pubertal growth speed, although associations with growth speed were statistically significant. Studies with larger sample sizes are needed to confirm this pattern of associations.
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Affiliation(s)
- Catherine Kim
- Departments of Medicine, Obstetrics & Gynecology, and Epidemiology, University of Michigan, 2800 Plymouth Road, Building 16, Room 405E, Ann Arbor, MI, 48109, USA.
| | - Kylie K Harrall
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver, Aurora, CO, USA
| | - Deborah H Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver, Aurora, CO, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Christine Hockett
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver, Aurora, CO, USA
- Avera Research Institute, Sioux Falls, SD, USA
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver, Aurora, CO, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
- Department of Epidemiology, University of Colorado, Aurora, CO, USA
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4
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Chen C, Naveed H, Chen K. Research progress on branched-chain amino acid aminotransferases. Front Genet 2023; 14:1233669. [PMID: 38028625 PMCID: PMC10658711 DOI: 10.3389/fgene.2023.1233669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Branched-chain amino acid aminotransferases, widely present in natural organisms, catalyze bidirectional amino transfer between branched-chain amino acids and branched-chain α-ketoacids in cells. Branched-chain amino acid aminotransferases play an important role in the metabolism of branched-chain amino acids. In this paper, the interspecific evolution and biological characteristics of branched-chain amino acid aminotransferases are introduced, the related research of branched-chain amino acid aminotransferases in animals, plants, microorganisms and humans is summarized and the molecular mechanism of branched-chain amino acid aminotransferase is analyzed. It has been found that branched-chain amino acid metabolism disorders are closely related to various diseases in humans and animals and plants, such as diabetes, cardiovascular diseases, brain diseases, neurological diseases and cancer. In particular, branched-chain amino acid aminotransferases play an important role in the development of various tumors. Branched-chain amino acid aminotransferases have been used as potential targets for various cancers. This article reviews the research on branched-chain amino acid aminotransferases, aiming to provide a reference for clinical research on targeted therapy for various diseases and different cancers.
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Affiliation(s)
- Can Chen
- School of Life Sciences, Jiangsu University, Zhenjiang, China
| | - Hassan Naveed
- School of Life Sciences, Jiangsu University, Zhenjiang, China
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang, China
| | - Keping Chen
- School of Life Sciences, Jiangsu University, Zhenjiang, China
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Vasile CM, Padovani P, Rujinski SD, Nicolosu D, Toma C, Turcu AA, Cioboata R. The Increase in Childhood Obesity and Its Association with Hypertension during Pandemics. J Clin Med 2023; 12:5909. [PMID: 37762850 PMCID: PMC10531996 DOI: 10.3390/jcm12185909] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/07/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
There has been a major ongoing health impact of the COVID-19 pandemic on children's lives, including lifestyle and overall health. Enforcement of prevention measures, such as school closures and social distancing, has significantly affected children's daily routines and activities. This perspective manuscript aims to explore the rise in childhood obesity and its association with hypertension during pandemics. The COVID-19 pandemic has led to significant disruptions in children's routines, including reduced physical activity, increased sedentary behavior, and changes in dietary patterns. These factors, coupled with the psychological impact of the pandemic, have contributed to an alarming increase in childhood obesity rates. This paper has highlighted the concerning increase in childhood obesity and hypertension during pandemics. The disruptions caused by the COVID-19 pandemic, including reduced physical activity, increased sedentary behaviors, and changes in dietary patterns, have contributed to the rise in these health conditions. It is crucial to recognize the long-term consequences of childhood obesity and hypertension and the urgent need for a comprehensive approach to address them.
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Affiliation(s)
- Corina Maria Vasile
- Department of Pediatric and Adult Congenital Cardiology, University Hospital of Bordeaux, F-33600 Bordeaux, France;
| | - Paul Padovani
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PreciCare, F-44000 Nantes, France;
- Nantes Université, CHU Nantes, INSERM, CIC FEA 1413, F-44000 Nantes, France
| | | | - Dragos Nicolosu
- Pneumology Department, Victor Babes University Hospital Craiova, 200515 Craiova, Romania; (D.N.); (R.C.)
| | - Claudia Toma
- Pneumology Department, University of Medicine Carol Davila, 020021 Bucharest, Romania;
| | - Adina Andreea Turcu
- Faculty of Dentistry, University of Pharmacy and Medicine Craiova, 200349 Craiova, Romania
| | - Ramona Cioboata
- Pneumology Department, Victor Babes University Hospital Craiova, 200515 Craiova, Romania; (D.N.); (R.C.)
- Pneumology Department, University of Medicine and Pharmacy, 200349 Craiova, Romania
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Hsu J, Cooper JJ, Ross DA. Not Just Counting Calories: A Neurodevelopmental Approach to Obesity. Biol Psychiatry 2023; 94:e15-e17. [PMID: 37558314 DOI: 10.1016/j.biopsych.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 06/18/2023] [Accepted: 06/20/2023] [Indexed: 08/11/2023]
Affiliation(s)
- Jennifer Hsu
- Department of Psychiatry, Oregon Health and Science Center, Portland, Oregon.
| | - Joseph J Cooper
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - David A Ross
- Department of Psychiatry, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
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Wu Y, Montrose L, Kochmanski JK, Dolinoy DC, Téllez-Rojo MM, Cantoral A, Mercado-García A, Peterson KE, Goodrich JM. Is adiposity related to repeat measures of blood leukocyte DNA methylation across childhood and adolescence? Clin Obes 2023; 13:e12566. [PMID: 36416295 PMCID: PMC9991944 DOI: 10.1111/cob.12566] [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: 12/19/2021] [Revised: 03/28/2022] [Accepted: 03/31/2022] [Indexed: 11/24/2022]
Abstract
Epigenetic modifications such as DNA methylation may influence gene expression and phenotypes, including obesity in childhood. The directionality of this relationship is nevertheless unclear, and some evidence suggests that adiposity modifies the epigenome, rather than the other way around. In this pilot study, we utilize data from the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) study to examine whether measures of adiposity in childhood and early adolescence are associated with repeated measures of blood leukocyte DNA methylation at LINE-1 repetitive elements and two genes implicated in growth and adiposity: H19 and HSD11B2. Longitudinal epigenetic data were generated from cord blood and blood from follow-up visits in early and late adolescence. We assessed interactions between age and measures of body mass index (BMI) at 5 years of age and weight, BMI and waist circumference in early adolescence to infer whether adiposity deflects age-related DNA methylation changes throughout childhood. Applying linear mixed-effects models, we found an inverse association between measures of childhood BMI (kg/m2 ) and early-teen weight (kg) with repeat measures of H19 DNA methylation. We did not observe any statistically significant associations (p-value <.05) between any anthropometric measures and DNA methylation at LINE-1 or HSD11B2. We did not demonstrate statistically significant evidence in support of deflection of age-related DNA methylation trajectories by adiposity-related measures (age by adiposity interaction term). Given the pilot nature of this study, the relationships between repeat measures of DNA methylation and adiposity-measures across childhood merit further exploration in larger study populations.
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Affiliation(s)
- Yue Wu
- Department of Bioinformatics and Biostatistics, Shanghai Jiao Tong University, Shanghai, CN
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Luke Montrose
- Department of Community and Environmental Health, Boise State University, Boise, ID, USA
| | - Joseph K. Kochmanski
- Department of Translational Neuroscience, Michigan State University, Grand Rapids, MI, USA
| | - Dana C. Dolinoy
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, MX
| | | | - Adriana Mercado-García
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, MX
| | - Karen E. Peterson
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Jaclyn M. Goodrich
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
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8
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Kappes C, Stein R, Körner A, Merkenschlager A, Kiess W. Stress, Stress Reduction and Obesity in Childhood and Adolescence. Horm Res Paediatr 2023; 96:88-96. [PMID: 34469895 DOI: 10.1159/000519284] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/11/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Obesity in childhood and adolescence remains a great global health challenge. Stress exposure during childhood and adolescence is associated with a higher risk for obesity, yet the linkage between stress and obesity is multidimensional, and its biological and behavioral mechanisms are still not fully understood. SUMMARY In this literature review, we identified different types of stress exposure in children and adolescents, including first studied effects of the COVID-19 pandemic as a prolonged stress exposure and their association with obesity risk. We investigated studies on the connection of altered stress biology and behavioral pathways as well as intervention programs on stress reduction in children and adolescents with obesity. KEY MESSAGES There is evidence that stress exposure in childhood and adolescence promotes biological and behavioral alterations that contribute to the multifactorial pathogenesis of obesity. COVID-19 related-stress presents the most current example of a negative influence on weight development in children and adolescents. However, longitudinal studies on the linkage between environmental, behavioral, and biological factors across development are few, and results are partly equivocal. Intervention programs to reduce stress in children through mindfulness might be a promising adjunctive tool in the prevention and treatment of childhood and adolescent obesity that could further offer proof of concept of theoretically elaborated cause-and-effect relationships.
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Affiliation(s)
- Claudia Kappes
- University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Robert Stein
- University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, Leipzig, Germany.,Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | - Antje Körner
- University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Andreas Merkenschlager
- University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Wieland Kiess
- University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, Leipzig, Germany
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Abstract
Nowadays, obesity is one of the largest public health problems worldwide. In the last few decades, there has been a marked increase in the obesity epidemic and its related comorbidities. Worldwide, more than 2.2 billion people (33%) are affected by overweight or obesity (712 million, 10%) and its associated metabolic complications. Although a high heritability of obesity has been estimated, the genetic variants conducted from genetic association studies only partially explain the variation of body mass index. This has led to a growing interest in understanding the potential role of epigenetics as a key regulator of gene-environment interactions on the development of obesity and its associated complications. Rapid advances in epigenetic research methods and reduced costs of epigenome-wide association studies have led to a great expansion of population-based studies. The field of epigenetics and metabolic diseases such as obesity has advanced rapidly in a short period of time. The main epigenetic mechanisms include DNA methylation, histone modifications, microRNA (miRNA)-mediated regulation and so on. DNA methylation is the most investigated epigenetic mechanism. Preliminary evidence from animal and human studies supports the effect of epigenetics on obesity. Studies of epigenome-wide association studies and genome-wide histone modifications from different biological specimens such as blood samples (newborn, children, adolescent, youth, woman, man, twin, race, and meta-analysis), adipose tissues, skeletal muscle cells, placenta, and saliva have reported the differential expression status of multiple genes before and after obesity interventions and have identified multiple candidate genes and biological markers. These findings may improve the understanding of the complex etiology of obesity and its related comorbidities, and help to predict an individual's risk of obesity at a young age and open possibilities for introducing targeted prevention and treatment strategies.
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Affiliation(s)
- Feng-Yao Wu
- Department of Comprehensive Internal Medicine, Affiliated Infectious Disease Hospital of Nanning (The Fourth People’s Hospital of Nanning), Guangxi Medical University, No. 1 Erli, Changgang Road, Nanning, 530023 Guangxi People’s Republic of China
| | - Rui-Xing Yin
- Department of Comprehensive Internal Medicine, Affiliated Infectious Disease Hospital of Nanning (The Fourth People’s Hospital of Nanning), Guangxi Medical University, No. 1 Erli, Changgang Road, Nanning, 530023 Guangxi People’s Republic of China
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021 Guangxi People’s Republic of China
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10
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Hanć T, Bryl E, Szcześniewska P, Dutkiewicz A, Borkowska AR, Paszyńska E, Słopień A, Dmitrzak-Węglarz M. Association of adverse childhood experiences (ACEs) with obesity and underweight in children. Eat Weight Disord 2022; 27:1751-1763. [PMID: 34661883 PMCID: PMC9123056 DOI: 10.1007/s40519-021-01314-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 09/29/2021] [Indexed: 12/03/2022] Open
Abstract
PURPOSE The aim of the study was to test the hypothesis that adverse childhood experiences (ACEs) are related to both obesity and underweight from childhood, and that the association of ACEs with weight abnormalities is modulated by type of ACEs, sex and socioeconomic status (SES) indices. METHODS The relations between ACEs (0 vs ≥ 1), ACE accumulation and ACE type with weight status and z scores BMI were assessed in 503 children aged 6-12 years from Poznan, Poland. The effects of interaction of ACEs with sex and SES on z scores BMI were included in the analyses. RESULTS ACEs were significantly related to both obesity and underweight, in unadjusted analysis, and when sex and SES indices, such as size of place of residence, people per room in household, and parental education were controlled. The relation of ACEs with z scores BMI was modulated by ACE type, parental subjective assessment of economic situation of a family and parental education. ACE accumulation was not related to an increase of obesity or underweight rate, or z scores BMI. CONCLUSION The study implicates the need for both obesity and underweight prevention in individuals with adverse experiences as early as in childhood. LEVEL OF EVIDENCE III: evidence obtained from well-designed cohort study.
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Affiliation(s)
- Tomasz Hanć
- Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, ul. Uniwersytetu Poznańskiego 6, 61-614, Poznań, Poland.
| | - Ewa Bryl
- Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, ul. Uniwersytetu Poznańskiego 6, 61-614, Poznań, Poland
| | - Paula Szcześniewska
- Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, ul. Uniwersytetu Poznańskiego 6, 61-614, Poznań, Poland
| | - Agata Dutkiewicz
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Ul. Szpitalna 27/33, 60-572, Poznań, Poland
| | - Aneta R Borkowska
- Faculty of Education and Psychology, Maria Curie-Sklodowska University, Ul. Prezydenta Gabriela Narutowicza 12, 20-400, Lublin, Poland
| | - Elżbieta Paszyńska
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Ul. Bukowska 70, 60-812, Poznań, Poland
| | - Agnieszka Słopień
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Ul. Szpitalna 27/33, 60-572, Poznań, Poland
| | - Monika Dmitrzak-Węglarz
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Ul. Rokietnicka 8, 60-806, Poznań, Poland
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11
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Adulthood asthma as a consequence of childhood adversity: a systematic review of epigenetically affected genes. J Dev Orig Health Dis 2022; 13:674-682. [PMID: 35256035 DOI: 10.1017/s2040174422000083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
There is an accumulating data that shows relation between childhood adversity and vulnerability to chronic diseases as well as epigenetic influences that in turn give rise to these diseases. Asthma is one of the chronic diseases that is influenced from genetic regulation of the inflammatory biomolecules and therefore the hypothesis in this research was childhood adversity might have caused epigenetic differentiation in the asthma-related genes in the population who had childhood trauma. To test this hypothesis, the literature was systematically reviewed to extract epigenetically modified gene data of the adults who had childhood adversity, and affected genes were further evaluated for their association with asthma. PRISMA guidelines were adopted and PubMed and Google Scholar were included in the searched databases, to evaluate epigenetic modifications in asthma-related genes of physically, emotionally or sexually abused children. After retrieving a total of 5245 articles, 36 of them were included in the study. Several genes and pathways that may contribute to pathogenesis of asthma development, increased inflammation, or response to asthma treatment were found epigenetically affected by childhood traumas. Childhood adversity, causing epigenetic changes in DNA, may lead to asthma development or influence the course of the disease and therefore should be taken into account for the prolonged health consequences.
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12
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Alfano R, Robinson O, Handakas E, Nawrot TS, Vineis P, Plusquin M. Perspectives and challenges of epigenetic determinants of childhood obesity: A systematic review. Obes Rev 2022; 23 Suppl 1:e13389. [PMID: 34816569 DOI: 10.1111/obr.13389] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 12/20/2022]
Abstract
The tremendous increase in childhood obesity prevalence over the last few decades cannot merely be explained by genetics and evolutionary changes in the genome, implying that gene-environment interactions, such as epigenetic modifications, likely play a major role. This systematic review aims to summarize the evidence of the association between epigenetics and childhood obesity. A literature search was performed via PubMed and Scopus engines using a combination of terms related to epigenetics and pediatric obesity. Articles studying the association between epigenetic mechanisms (including DNA methylation and hydroxymethylation, non-coding RNAs, and chromatin and histones modification) and obesity and/or overweight (or any related anthropometric parameters) in children (0-18 years) were included. The risk of bias was assessed with a modified Newcastle-Ottawa scale for non-randomized studies. One hundred twenty-one studies explored epigenetic changes related to childhood obesity. DNA methylation was the most widely investigated mechanism (N = 101 studies), followed by non-coding RNAs (N = 19 studies) with evidence suggestive of an association with childhood obesity for DNA methylation of specific genes and microRNAs (miRNAs). One study, focusing on histones modification, was identified. Heterogeneity of findings may have hindered more insights into the epigenetic changes related to childhood obesity. Gaps and challenges that future research should face are herein described.
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Affiliation(s)
- Rossella Alfano
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK.,Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK.,Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Oliver Robinson
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK.,Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK
| | - Evangelos Handakas
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK.,Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK.,Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK.,Unit of Molecular and Genetic Epidemiology, Human Genetic Foundation (HuGeF), Turin, Italy
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
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Stabouli S, Erdine S, Suurorg L, Jankauskienė A, Lurbe E. Obesity and Eating Disorders in Children and Adolescents: The Bidirectional Link. Nutrients 2021; 13:nu13124321. [PMID: 34959873 PMCID: PMC8705700 DOI: 10.3390/nu13124321] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 02/07/2023] Open
Abstract
Obesity, eating disorders and unhealthy dieting practices among children and adolescents are alarming health concerns due to their high prevalence and adverse effects on physical and psychosocial health. We present the evidence that eating disorders and obesity can be managed or prevented using the same interventions in the pediatric age. In the presence of obesity in the pediatric age, disordered eating behaviors are highly prevalent, increasing the risk of developing eating disorders. The most frequently observed in subjects with obesity are bulimia nervosa and binge-eating disorders, both of which are characterized by abnormal eating or weight-control behaviors. Various are the mechanisms overlying the interaction including environmental and individual ones, and different are the approaches to reduce the consequences. Evidence-based treatments for obesity and eating disorders in childhood include as first line approaches weight loss with nutritional management and lifestyle modification via behavioral psychotherapy, as well as treatment of psychiatric comorbidities if those are not a consequence of the eating disorder. Drugs and bariatric surgery need to be used in extreme cases. Future research is necessary for early detection of risk factors for prevention, more precise elucidation of the mechanisms that underpin these problems and, finally, in the cases requiring therapeutic intervention, to provide tailored and timely treatment. Collective efforts between the fields are crucial for reducing the factors of health disparity and improving public health.
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Affiliation(s)
- Stella Stabouli
- First Department of Pediatrics, Hipnmpokration Hospital, Aristotle University, 54124 Thessaloniki, Greece;
| | - Serap Erdine
- Hypertension and Arteriosclerosis Research and Implementation Center, School of Medicine, Marmara University, Istanbul 34722, Turkey;
| | - Lagle Suurorg
- Tallinn Children’s Hospital, 2813419 Estonia, Estonia;
| | - Augustina Jankauskienė
- Pediatric Center, Institute of Clinical Medicine, Vilnius University, 01513 Vilnius, Lithuania;
| | - Empar Lurbe
- Department of Pediatrics, University of Valencia, 1346010 Valencia, Spain
- CIBER Fisiopatologia Obesidad y Nutricion, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-96-3131800
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14
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Harada M, Guerrero A, Iyer S, Slusser W, Szilagyi M, Koolwijk I. The Relationship Between Adverse Childhood Experiences and Weight-Related Health Behaviors in a National Sample of Children. Acad Pediatr 2021; 21:1372-1379. [PMID: 34098173 DOI: 10.1016/j.acap.2021.05.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/28/2021] [Accepted: 05/29/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To examine how adverse childhood experiences (ACEs) relate to healthy weight behaviors in children. METHODS We examined data from the 2016 National Survey of Children's Health. ACE scores were calculated from 6 measures of household dysfunction. Outcome measures included 5 healthy weight behaviors. Logistic regression models assessed associations between ACEs and healthy weight behaviors controlling for sociodemographic variables. RESULTS Children 6 to 17 years of age (n = 32,528) with 0 ACEs had increased odds of: watching 2 hours or less of television daily (6-12 years: odds ratio [OR] 1.46; 95% confidence interval [CI], 1.20-1.80, 13-17 years: OR 1.64; 95% CI, 1.39-1.94), using electronics for 2 hours or less daily (6-12 years: OR 1.44; 95% CI, 1.15-1.80, 13-17 years: OR 1.86; 95% CI, 1.60-2.16), sharing 4 or more family meals per week (6-12 years: OR 1.39; 95% CI, 1.17-1.66, 13-17 years: OR 1.68; 95% CI, 1.44-1.95), and getting adequate age-specific sleep (6-12 years: OR 1.50; 95% CI, 1.26-1.79, 13-17 years: OR 1.31; 95% CI, 1.11-1.55) when compared to children with one or more ACEs. Children 13 to 17 years of age with 0 ACEs had increased odds of exercising for 60 minutes daily (OR 1.27; 95% CI, 1.02-1.58) when compared to children with one or more ACEs. There was an overall gradient dose pattern; the odds of engaging in a healthy weight behavior decreased as the number of ACEs increased, with mixed significance levels. CONCLUSIONS In children, ACE exposure is associated with decreased healthy weight behaviors and behavior counseling alone may be insufficient. Trauma-informed care to address intra-familial adversity may be necessary.
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Affiliation(s)
- Melissa Harada
- Developmental-Behavioral Pediatrics, Department of Pediatrics, University of California Los Angeles (M Harada, S Iyer, M Szilagyi, and I Koolwijk).
| | - Alma Guerrero
- Department of Pediatrics, University of California Los Angeles (A Guerrero, W Slusser)
| | - Sai Iyer
- Developmental-Behavioral Pediatrics, Department of Pediatrics, University of California Los Angeles (M Harada, S Iyer, M Szilagyi, and I Koolwijk)
| | - Wendelin Slusser
- Department of Pediatrics, University of California Los Angeles (A Guerrero, W Slusser); David Geffen School of Medicine, Fielding School of Public Health and the Semel Healthy Campus Initiative Center at UCLA (W Slusser)
| | - Moira Szilagyi
- Developmental-Behavioral Pediatrics, Department of Pediatrics, University of California Los Angeles (M Harada, S Iyer, M Szilagyi, and I Koolwijk)
| | - Irene Koolwijk
- Developmental-Behavioral Pediatrics, Department of Pediatrics, University of California Los Angeles (M Harada, S Iyer, M Szilagyi, and I Koolwijk)
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15
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Henry CJ, Higgins M, Carlson N, Song MK. Racial Disparities in Stillbirth Risk Factors among non-Hispanic Black Women and non-Hispanic White Women in the United States. MCN Am J Matern Child Nurs 2021; 46:352-359. [PMID: 34653033 PMCID: PMC9026592 DOI: 10.1097/nmc.0000000000000772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Historically, stillbirth risk factors are more prevalent among non-Hispanic Black women than non-Hispanic White women, including age < 20, lower formal educational attainment, prepregnancy obesity, smoking, hypertension, diabetes, short interpregnancy interval, small for gestational age newborn, late prenatal care, and previous cesarean birth. We examined whether these disparities have changed since 2011 and identified a group of risk factors that differed between Black women and White women when accounting for correlations among variables. METHODS In a random sample of 315 stillbirths from the National Center for Health Statistics' 2016 fetal death data, Black women and White women were compared for each risk factor using t-tests or chi-square tests. Variables with p ≤ .20 were analyzed using multivariate analysis of variance. RESULTS In this sample, Black women experiencing stillbirth were less likely to have a Bachelor's degree (12.94% vs. 28.49%, p = .04), and more likely to be obese (44.5% vs. 29.1%, p = .01) than White women. Multivariate analysis accounting for correlations among variables showed a group of risk factors that differed between Black women and White women: age < 20, lower education, prepregnancy obesity, hypertension (chronic and pregnancy-associated), nulliparity before stillbirth, and earlier gestation. CLINICAL IMPLICATIONS Less formal education, obesity, age <20, hypertension, chronic and pregnancy-associated, nulliparity, and earlier gestation are important to consider in multilevel stillbirth prevention interventions to decrease racial disparity in stillbirth. Respectfully listening to women and taking their concerns seriously is one way nurses and other health care providers can promote equity in health outcomes for childbearing women.
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16
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Derks IPM, Hannani S, Vehmeijer FOL, Tiemeier H, Jansen PW. The experience of life events and body composition in middle childhood: a population-based study. Int J Behav Nutr Phys Act 2021; 18:109. [PMID: 34433463 PMCID: PMC8386051 DOI: 10.1186/s12966-021-01188-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 08/11/2021] [Indexed: 11/29/2022] Open
Abstract
While studies suggest potential influences of childhood adversities on obesity development in adulthood, less is known about the short-term association in children. We examined the association between a wide range of life events experienced in the first ten years of life (including maltreatment and milder adversities) and body composition in 5333 ten-year old Dutch children. In structured interviews, mothers retrospectively reported on their children’s experience of 24 events. BMI was calculated, and fat mass index and fat free mass index were determined by dual-x-ray absorptiometry scanning. Linear regressions showed that, unadjusted, a higher number of life events was associated with higher BMI and body composition. However, associations attenuated to non-significance after adjustment for covariates. Similar findings were observed for maltreatment and milder life events. Thus, the number of experienced life events was not associated with body composition in middle childhood. Rather, other factors, like socioeconomic conditions, accounted for the relationship between life events and weight development in children.
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Affiliation(s)
- Ivonne P M Derks
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, the Netherlands.,Department of Child and Adolescent Psychiatry/ Psychology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands.,The Generation R Study Group, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
| | - Sara Hannani
- Department of Child and Adolescent Psychiatry/ Psychology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
| | - Florianne O L Vehmeijer
- The Generation R Study Group, Erasmus MC-University Medical Center, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/ Psychology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands.,Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Pauline W Jansen
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, the Netherlands. .,Department of Child and Adolescent Psychiatry/ Psychology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands.
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17
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Nelson S, Bento S, Enlow MB. Biomarkers of Allostatic Load as Correlates of Impairment in Youth with Chronic Pain: An Initial Investigation. CHILDREN (BASEL, SWITZERLAND) 2021; 8:709. [PMID: 34438600 PMCID: PMC8392178 DOI: 10.3390/children8080709] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/10/2021] [Accepted: 08/13/2021] [Indexed: 11/25/2022]
Abstract
Pediatric chronic pain is common and responsible for significant healthcare burden. However, the mechanisms underlying the development and/or maintenance of pediatric chronic pain remain poorly understood. Allostatic load (AL), or wear and tear on the nervous system following significant or prolonged stress, has been proposed to play a role in the maintenance of chronic pain, but minimal research has examined this possibility. This gap in research is particularly notable given the high exposure to adverse childhood experiences (ACEs; abuse/neglect, etc.) and psychological stress in this population. Accordingly, the current study aimed to preliminarily examine the measurement of AL in a treatment-seeking pediatric pain population. Biomarkers were collected during an already scheduled new patient pain evaluation and included salivary cortisol, dehydroepiandrosterone (DHEA), and C-reactive protein, in addition to waist-hip ratio, body-mass index, and blood pressure. A total of 61 children and adolescents with chronic pain (Mage = 14.47 years; 88.5% female and white/Caucasian) completed study procedures and were included in analyses. Preliminary results indicated that a multifactorial AL composite is feasible to assess for in a tertiary pain treatment setting and that over 50% of youth with chronic pain were classified as high risk for AL (two or more risk factors). Further, it was found that individual AL risk factors were significantly associated with functional disability and that AL may moderate the association between psychosocial and functional outcomes. Given the pilot nature of this study, results should be used to inform future investigations with larger and more diverse pediatric pain samples.
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Affiliation(s)
- Sarah Nelson
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, MA 02115, USA;
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA;
| | - Samantha Bento
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, MA 02115, USA;
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA;
| | - Michelle Bosquet Enlow
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA;
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA 02115, USA
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18
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Cianfarani S, Pampanini V. The Impact of Stress on Health in Childhood and Adolescence in the Era of the COVID-19 Pandemic. Horm Res Paediatr 2021; 96:83-87. [PMID: 34261075 PMCID: PMC8339036 DOI: 10.1159/000517460] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 05/27/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is posing many challenges to global health. Efforts from the whole scientific community have shed light on the pathogenetic mechanisms and the clinical features of SARS-CoV-2 infection as well as on potential therapeutic strategies. SUMMARY The consequences of stress related to social isolation and anxiety generated by the pandemic on mental and physical health are collateral effects that are yet poorly investigated.
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Affiliation(s)
- Stefano Cianfarani
- Dipartimento Pediatrico Universitario Ospedaliero, IRCCS “Bambino Gesù” Children's Hospital, Rome, Italy
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Valentina Pampanini
- Dipartimento Pediatrico Universitario Ospedaliero, IRCCS “Bambino Gesù” Children's Hospital, Rome, Italy
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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19
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Emerald B, Kaimala S, Ansari S. Risk factors which influence DNA methylation in childhood obesity. HAMDAN MEDICAL JOURNAL 2021. [DOI: 10.4103/hmj.hmj_15_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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20
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López-Taboada I, González-Pardo H, Conejo NM. Western Diet: Implications for Brain Function and Behavior. Front Psychol 2020; 11:564413. [PMID: 33329193 PMCID: PMC7719696 DOI: 10.3389/fpsyg.2020.564413] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/02/2020] [Indexed: 12/12/2022] Open
Abstract
The Western diet (WD) pattern characterized by high daily intake of saturated fats and refined carbohydrates often leads to obesity and overweight, and it has been linked to cognitive impairment and emotional disorders in both animal models and humans. This dietary pattern alters the composition of gut microbiota, influencing brain function by different mechanisms involving the gut-brain axis. In addition, long-term exposure to highly palatable foods typical of WD could induce addictive-like eating behaviors and hypothalamic-pituitary-adrenal (HPA) axis dysregulation associated with chronic stress, anxiety, and depression. In turn, chronic stress modulates eating behavior, and it could have detrimental effects on different brain regions such as the hippocampus, hypothalamus, amygdala, and several cortical regions. Moreover, obesity and overweight induce neuroinflammation, causing neuronal dysfunction. In this review, we summarize the current scientific evidence about the mechanisms and factors relating WD consumption with altered brain function and behavior. Possible therapeutic interventions and limitations are also discussed, aiming to tackle and prevent this current pandemic.
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Affiliation(s)
| | | | - Nélida María Conejo
- Laboratory of Neuroscience, Department of Psychology, Instituto de Neurociencias del Principado de Asturias (INEUROPA), University of Oviedo, Oviedo, Spain
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21
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Purswani P, Marsicek SM, Amankwah EK. Association between cumulative exposure to adverse childhood experiences and childhood obesity. PLoS One 2020; 15:e0239940. [PMID: 32991598 PMCID: PMC7523986 DOI: 10.1371/journal.pone.0239940] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 09/15/2020] [Indexed: 01/29/2023] Open
Abstract
Background Exposure to adverse childhood experiences (ACEs) is associated with many childhood diseases and poor health outcomes in adulthood. However, the association with childhood obesity is inconsistent. We investigated the association between reported cumulative ACE score and body mass index (BMI) in a large sample of patients at a single institution. Methods This cross-sectional study included children aged 2–20 years that were screened in a general pediatrics clinic for ACEs utilizing the Center for Youth Wellness ACEs questionnaire between July 2017 and July 2018. Overall ACE score was categorized as ‘no exposure’ (score = 0), ‘low exposure’ (score = 1), and ‘high exposure’ (score≥ 2). BMI was categorized as overweight/obese (BMI percentile ≥ 85) or non-obese (BMI percentile < 85). The association between ACEs score and obesity was determined using univariate and multivariable logistic regression. Results Of the 948 patients included in the study, 30% (n = 314) were overweight/obese and 53% (n = 504) had no ACE exposure, 19% (n = 179) had low ACE exposure, and 28% (n = 265) had high ACE exposure. High ACE exposure was associated with increased odds of obesity (OR = 1.47, 95%CI = 1.07–2.03, p = 0.026). However, after adjusting for age, race/ethnicity, insurance type, and birth weight, the association attenuated and was null (OR = 1.01, 95%CI = 0.70–1.46, p = 0.97). Conclusion The study findings may suggest an association between ACE and childhood obesity. However, the association attenuated after adjusting for age, race/ethnicity, insurance type, and birth weight. Larger prospective studies are warranted to better understand the association.
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Affiliation(s)
- Pooja Purswani
- Department of Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, United States of America
| | - Sarah M. Marsicek
- Department of Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, United States of America
| | - Ernest K. Amankwah
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Cancer and Blood Disorders Institute, Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, United States of America
- * E-mail:
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22
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Krause BJ, Artigas R, Sciolla AF, Hamilton J. Epigenetic mechanisms activated by childhood adversity. Epigenomics 2020; 12:1239-1255. [PMID: 32706263 DOI: 10.2217/epi-2020-0042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Adverse childhood experiences (ACE) impair health and life expectancy and may result in an epigenetic signature that drives increased morbidity primed during early stages of life. This literature review focuses on the current evidence for epigenetic-mediated programming of brain and immune function resulting from ACE. To address this aim, a total of 88 articles indexed in PubMed before August 2019 concerning ACE and epigenetics were surveyed. Current evidence partially supports epigenetic programming of the hypothalamic-pituitary-adrenal axis, but convincingly shows that ACE impairs immune function. Additionally, the needs and challenges that face this area are discussed in order to provide a framework that may help to clarify the role of epigenetics in the long-lasting effects of ACE.
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Affiliation(s)
- Bernardo J Krause
- Instituto de Ciencias de la Salud, Universidad de O''Higgins, Rancagua, Chile.,CUIDA - Centro de Investigación del Abuso y la Adversidad Temprana, Pontificia Universidad Católica de Chile, Avenida Libertador Bernardo O'Higgins 340, Santiago, Chile
| | - Rocio Artigas
- CUIDA - Centro de Investigación del Abuso y la Adversidad Temprana, Pontificia Universidad Católica de Chile, Avenida Libertador Bernardo O'Higgins 340, Santiago, Chile
| | - Andres F Sciolla
- Department of Psychiatry & Behavioral Sciences, University of California, Davis, CA 95834, USA
| | - James Hamilton
- CUIDA - Centro de Investigación del Abuso y la Adversidad Temprana, Pontificia Universidad Católica de Chile, Avenida Libertador Bernardo O'Higgins 340, Santiago, Chile.,Fundación Para la Confianza, Pérez Valenzuela 1264, Providencia, Santiago, Chile
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23
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Adverse Childhood Experiences and Health Indicators in a Young Adult, College Student Sample: Differences by Gender. Int J Behav Med 2020; 27:660-667. [DOI: 10.1007/s12529-020-09913-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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24
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The Association Between Adverse Childhood Experiences (ACEs) and Postoperative Bariatric Surgery Weight Loss Outcomes. Obes Surg 2020; 30:4258-4266. [PMID: 32562131 DOI: 10.1007/s11695-020-04779-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE Previous research demonstrates that exposure to adverse childhood experiences (ACEs) is associated with development of obesity. The same mechanisms mediating this relationship could theoretically affect attempts to lose weight in adulthood. However, it is unclear whether or not exposure to ACEs impacts the effectiveness of bariatric surgery. The present study aimed to examine the association of exposure to ACEs to postoperative weight loss outcomes. MATERIALS AND METHODS One hundred ninety-eight patients undergoing bariatric surgery were evaluated for their exposure to ACEs, determined by a presurgical questionnaire and recorded as an ACEs score. Percent total weight loss (%TWL) was calculated to evaluate postoperative weight loss at 1-, 3-, and 6-month intervals postoperatively. One hundred forty-two participants were available for follow-up at the 6-month postoperative interval. RESULTS The sample consisted of 167 women and 31 men with a mean age of 47.7. Twenty-five percent of participants experienced high exposure to ACEs, defined as experiencing ≥ 4 ACEs. The average %TWL at 6 months was 16.52%. Multilevel modeling found no significant relationship between ACEs score and %TWL at any of the postoperative time intervals, both before and after adjusting for age, sex, and race. CONCLUSION High exposure to ACEs was not associated with poorer weight loss outcomes, and participants with a large number of ACEs generally lost the anticipated amount of weight.
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25
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Bassiouni SS. Commentary on "First They Came for the Socialists . . . ". ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:739. [PMID: 32345883 DOI: 10.1097/01.acm.0000662220.06895.a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Sarah S Bassiouni
- S.S. Bassiouni is research associate, University of California, San Diego, La Jolla, California; ; ORCID: https://orcid.org/0000-0002-2810-7008
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26
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Grant B, O’Loughlin K, Holbrook H, Althoff R, Kearney C, Perepletchikova F, Grasso D, Hudziak J, Kaufman J. A multi-method and multi-informant approach to assessing post-traumatic stress disorder (PTSD) in children. Int Rev Psychiatry 2020; 32:212-220. [PMID: 31880487 PMCID: PMC7190440 DOI: 10.1080/09540261.2019.1697212] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Trauma exposure is highly prevalent among children globally, and is associated with elevated rates of PTSD. The goal of this study was to systematically evaluate the effects of multiple informants and multiple screening measures on the identification of specific PTSD symptoms and rates of PTSD diagnoses. Participants in this study included 350 maltreated children from two cohorts, one recruited from Connecticut (n = 130), and the other from Vermont (n = 220). Both cohorts completed the Screen for Child Anxiety-Related Emotional Disorders (SCARED) before a PTSD self-report measure. The KSADS psychiatric interview was also completed with the Connecticut cohort, with best-estimate ratings generated using parent and child interview, child self-report, and teacher questionnaire data. In addition to the SCARED and PTSD self-report scale, parents of the Vermont cohort completed the Child Behavioural Checklist. Significant differences emerged between parent and child report of sleep, nightmares, concentration, and irritability problems, suggesting the need for multiple informants in PTSD screening. Children also under-reported nightmares when asked in the context of a trauma-specific screening tool. As child trauma is associated with a broad range of psychiatric sequelae, comprehensive assessment using both general symptomatology and trauma-specific measures is recommended, since children often shut down when completing trauma measures.
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Affiliation(s)
- B.R. Grant
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, MD,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| | - K. O’Loughlin
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT
| | - H.M. Holbrook
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT
| | - R.R. Althoff
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT
| | - C. Kearney
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, MD
| | - F. Perepletchikova
- Weill Cornell Medicine and NewYork-Presbyterian Hospital, White Plains, NY
| | - D.J. Grasso
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT
| | - J.J. Hudziak
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT
| | - J. Kaufman
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, MD,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
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27
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de Araújo CM, Hudziak J, Crocetti D, Wymbs NF, Montalvo-Ortiz JL, Orr C, Albaugh MD, Althoff RR, O'Loughlin K, Holbrook H, Garavan H, Yang BZ, Mostofsky S, Jackowski A, Lee RS, Gelernter J, Kaufman J. Tubulin Polymerization Promoting Protein (TPPP) gene methylation and corpus callosum measures in maltreated children. Psychiatry Res Neuroimaging 2020; 298:111058. [PMID: 32120304 PMCID: PMC11079625 DOI: 10.1016/j.pscychresns.2020.111058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/16/2020] [Accepted: 02/19/2020] [Indexed: 12/21/2022]
Abstract
The goal of the current study was to evaluate the impact of Tubulin Polymerization Promoting Protein (TPPP) methylation on structural and fractional anisotropy (FA) corpus callosum (CC) measures. TPPP is involved in the development of white matter tracts in the brain and was implicated in stress-related psychiatric disorders in an unbiased whole epigenome methylation study. The cohort included 63 participants (11.73 y/o ±1.91) from a larger study investigating risk and resilience in maltreated children. Voxel-based morphometry (VBM) was used to process the structural data, fractional anisotropy (FA) was determined using an atlas-based approach, and DNA specimens were derived from saliva in two batches using the 450 K (N = 39) and 850 K (N = 24) Illumina arrays, with the data from each batch analyzed separately. After controlling for multiple comparisons and relevant covariates (e.g., demographics, brain volume, cell composition, 3 PCs), 850 K derived TPPP methylation values, in interaction with a dimensional measure of children's trauma experiences, predicted left and right CC body volumes and genu, body and splenium FA (p < .007, all comparisons). The findings in the splenium replicated in subjects with the 450 K data. The results extend prior investigations and suggest a role for TPPP in brain changes associated with stress-related psychiatric disorders.
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Affiliation(s)
- Célia Maria de Araújo
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, United States; Universidade Federal de São Paulo, São Paulo, Brazil
| | - James Hudziak
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Deana Crocetti
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, United States
| | - Nicholas F Wymbs
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, United States
| | | | - Catherine Orr
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Matthew D Albaugh
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Robert R Althoff
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Kerry O'Loughlin
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Hannah Holbrook
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Hugh Garavan
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Bao-Zhu Yang
- Department of Psychiatry, Yale University, New Haven, CT, United States
| | - Stewart Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, United States; Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, , United States; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | | | - Richard S Lee
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Joel Gelernter
- Department of Psychiatry, Yale University, New Haven, CT, United States; Veterans Administration, West Haven, CT, United States
| | - Joan Kaufman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States; Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, MD, United States.
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Wymbs NF, Orr C, Albaugh MD, Althoff RR, O'Loughlin K, Holbrook H, Garavan H, Montalvo-Ortiz JL, Mostofsky S, Hudziak J, Kaufman J. Social supports moderate the effects of child adversity on neural correlates of threat processing. CHILD ABUSE & NEGLECT 2020; 102:104413. [PMID: 32065988 PMCID: PMC8060780 DOI: 10.1016/j.chiabu.2020.104413] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/29/2020] [Accepted: 02/05/2020] [Indexed: 06/02/2023]
Abstract
BACKGROUND Child abuse and other forms of adversity are associated with alterations in threat processing and emotion regulation brain circuits. OBJECTIVE The goal of the current investigation is to determine if the availability of positive social support can ameliorate the negative impact of adversity on these brain systems. PARTICIPANTS AND SETTING Subjects included 55 children ages 7-16 (X = 11.8, SD = 2.0). Approximately one-third of the cohort had no significant history of adversity, one-third had a history of moderate adversity, and one-third had a history of severe adversity. Brain imaging was conducted at the University of Vermont using a 3.0 T Philips scanner. METHODS The Emotional Go-NoGo task with fearful and calm facial stimuli was used to assess the neural correlates of threat processing and emotion regulation in children during functional magnetic resonance imaging (fMRI). Dimensional measures of anxiety, social supports, and children's adverse experiences were also obtained. RESULTS A conjunction analysis was used to test if trauma-related brain activation in responding to fearful vs. calm targets was impacted by social support. This approach identified multiple activation foci, including a cluster extending from the left amygdala to several other key brain regions involved in emotion regulation, including the orbitofrontal cortex, anterior cingulate cortex (ACC), anterior insula, nucleus accumbens, and frontal pole (Family Wise Error (FWE) correction, p < 0.05). CONCLUSIONS Greater social support may reduce the effect that adversity has on neural processing of threat stimuli, consistent with the protective role of positive supports in promoting resilience and recovery demonstrated in the literature.
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Affiliation(s)
- Nicholas F Wymbs
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD 21205, USA
| | - Catherine Orr
- Swinburne University of Technology, John St, Hawthorn, 3122, Australia; Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Matthew D Albaugh
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Robert R Althoff
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Kerry O'Loughlin
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Hannah Holbrook
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Hugh Garavan
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | | | - Stewart Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD 21205, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA; Department of Neurology, Johns Hopkins School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA
| | - James Hudziak
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Joan Kaufman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA; Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, 1741 Ashland Avenue, Baltimore, MD 21205, USA.
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Payne CF, Mall S, Kobayashi L, Kahn K, Berkman L. Life-Course Trauma and Later Life Mental, Physical, and Cognitive Health in a Postapartheid South African Population: Findings From the HAALSI study. J Aging Health 2020; 32:1244-1257. [PMID: 32207348 DOI: 10.1177/0898264320913450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To investigate the relationships between exposure to life-course traumatic events (TEs) and later life mental, physical, and cognitive health outcomes in the older population of a rural South African community. Method: Data were from baseline interviews with 2,473 adults aged ≥40 years in the population-representative Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) study, conducted in 2015. We assessed exposure to 16 TEs, and used logistic regression models to estimate associations with depression, post-traumatic stress disorder (PTSD), activities of daily living disability, and cognitive impairment. Results: Participants reported an average of 5 (SD = 2.4) TEs over their lifetimes. Exposure was ubiquitous across sociodemographic and socioeconomic groups. Trauma exposure was associated with higher odds of depression, PTSD, and disability, but not with cognitive health. Discussion: Results suggest that TEs experienced in earlier life continue to reverberate today in terms of mental health and physical disability outcomes in an older population in rural South Africa.
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Affiliation(s)
| | - Sumaya Mall
- University of the Witwatersrand, Johannesburg, South Africa
| | | | - Kathy Kahn
- University of the Witwatersrand, Johannesburg, South Africa.,Umeå University, Sweden
| | - Lisa Berkman
- University of the Witwatersrand, Johannesburg, South Africa.,Harvard T.H. Chan School of Public Health, Cambridge, USA
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Cecil CAM, Zhang Y, Nolte T. Childhood maltreatment and DNA methylation: A systematic review. Neurosci Biobehav Rev 2020; 112:392-409. [PMID: 32081689 DOI: 10.1016/j.neubiorev.2020.02.019] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 02/14/2020] [Accepted: 02/15/2020] [Indexed: 12/20/2022]
Abstract
DNA methylation (DNAm) - an epigenetic process that regulates gene expression - may represent a mechanism for the biological embedding of early traumatic experiences, including childhood maltreatment. Here, we conducted the first systematic review of human studies linking childhood maltreatment to DNAm. In total, 72 studies were included in the review (2008-2018). The majority of extant studies (i) were based on retrospective data in adults, (ii) employed a candidate gene approach (iii) focused on global maltreatment, (iv) were based on easily accessible peripheral tissues, typically blood; and (v) were cross-sectional. Two-thirds of studies (n = 48) also examined maltreatment-related outcomes, such as stress reactivity and psychiatric symptoms. While findings generally support an association between childhood maltreatment and altered patterns of DNAm, factors such as the lack of longitudinal data, low comparability across studies as well as potential genetic and 'pre-exposure' environmental confounding currently limit the conclusions that can be drawn. Key challenges are discussed and concrete recommendations for future research are provided to move the field forward.
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Affiliation(s)
- Charlotte A M Cecil
- Department of Child and Adolescent Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Yuning Zhang
- Centre for Innovation in Mental Health, University of Southampton; State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Tobias Nolte
- The Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom; Anna Freud National Centre for Children and Families, London, United Kingdom
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31
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Kansra AR, Lakkunarajah S, Jay MS. Childhood and Adolescent Obesity: A Review. Front Pediatr 2020; 8:581461. [PMID: 33511092 PMCID: PMC7835259 DOI: 10.3389/fped.2020.581461] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/23/2020] [Indexed: 12/12/2022] Open
Abstract
Obesity is a complex condition that interweaves biological, developmental, environmental, behavioral, and genetic factors; it is a significant public health problem. The most common cause of obesity throughout childhood and adolescence is an inequity in energy balance; that is, excess caloric intake without appropriate caloric expenditure. Adiposity rebound (AR) in early childhood is a risk factor for obesity in adolescence and adulthood. The increasing prevalence of childhood and adolescent obesity is associated with a rise in comorbidities previously identified in the adult population, such as Type 2 Diabetes Mellitus, Hypertension, Non-alcoholic Fatty Liver disease (NAFLD), Obstructive Sleep Apnea (OSA), and Dyslipidemia. Due to the lack of a single treatment option to address obesity, clinicians have generally relied on counseling dietary changes and exercise. Due to psychosocial issues that may accompany adolescence regarding body habitus, this approach can have negative results. Teens can develop unhealthy eating habits that result in Bulimia Nervosa (BN), Binge- Eating Disorder (BED), or Night eating syndrome (NES). Others can develop Anorexia Nervosa (AN) as they attempt to restrict their diet and overshoot their goal of "being healthy." To date, lifestyle interventions have shown only modest effects on weight loss. Emerging findings from basic science as well as interventional drug trials utilizing GLP-1 agonists have demonstrated success in effective weight loss in obese adults, adolescents, and pediatric patients. However, there is limited data on the efficacy and safety of other weight-loss medications in children and adolescents. Nearly 6% of adolescents in the United States are severely obese and bariatric surgery as a treatment consideration will be discussed. In summary, this paper will overview the pathophysiology, clinical, and psychological implications, and treatment options available for obese pediatric and adolescent patients.
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Affiliation(s)
- Alvina R Kansra
- Division of Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Sinduja Lakkunarajah
- Division of Adolescent Medicine, Department of Pediatrics, Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI, United States
| | - M Susan Jay
- Division of Adolescent Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
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