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Lawton RI, Stanford FC. The Role of Racism in Childhood Obesity. Curr Obes Rep 2024; 13:98-106. [PMID: 38172479 PMCID: PMC10939728 DOI: 10.1007/s13679-023-00538-9] [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] [Accepted: 11/01/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE OF REVIEW Obesity rates continue to rise among children and have shown persistent racial disparities. Racism plays a potentially essential and actionable role in these disparities. This report reviews some mechanisms through which racism may shape childhood obesity. RECENT FINDINGS From the youngest ages, disparities in childhood obesity prevalence are already present. Racism may shape intergenerational and prenatal factors that affect obesity and various stressors and environments where children grow up. The relationships between clinicians and patients may also be shaped by everyday racism and legacies of past racism, which may affect obesity prevalence and treatment efficacy. Comprehensive data on the extent to which racism shapes childhood obesity is limited. However, compelling evidence suggests many ways through which racism ultimately does affect childhood obesity. Interventions to address racism at multiple points where it shapes childhood obesity, including intergenerational and prenatal mechanisms, may help to close disparities.
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Affiliation(s)
| | - Fatima Cody Stanford
- Harvard Medical School, Boston, MA, USA.
- MGH Weight Center, Department of Medicine-Division of Endocrinology-Neuroendocrine, Massachusetts General Hospital, Weight Center, 50 Staniford Street, 4th Floor, Boston, MA, 02114, USA.
- Department of Pediatrics-Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Weight Center, 50 Staniford Street, 4th Floor, Boston, MA, USA.
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2
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Kallak TK, Serapio S, Visser N, Lager S, Skalkidou A, Ahlsson F. Differential gene expression in two consecutive pregnancies between same sex siblings and implications on maternal constraint. Sci Rep 2024; 14:4210. [PMID: 38378837 PMCID: PMC10879170 DOI: 10.1038/s41598-024-54724-3] [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: 10/13/2023] [Accepted: 02/15/2024] [Indexed: 02/22/2024] Open
Abstract
The objective of this study was to investigate how placental gene expression differs in two consecutive pregnancies in same sex siblings, and its possible association with the "maternal constraint" hypothesis. Material was gathered from the BASIC study (Biological, Affect, Stress, Imaging, and Cognition in Pregnancy and the Puerperium), a population based prospective study that was started in 2009 in Uppsala. Over 900 specimens of placenta biopsies were collected and out of these 10 women gave birth twice, to the same sex child, and were included in this study. The total RNA was isolated and prepared from frozen villous tissue from the placenta and further analyzed by use of Ion AmpliSeq Human Transcriptome Gene Expression kit. A total of 234 genes differed significantly between the first and second pregnancy placentas, when adjusting for delivery mode, maternal BMI and gestational age. Of special interest was the down-regulated group of genes in the second pregnancy. Exemplified by Pentraxin 3, SRY-Box Transcription Factor 9, and Serum Amyloid A1, which all were associated with biological processes involved in the immune system and inflammation. Further, protein-protein interaction analysis visualized them as hub genes interacting with several of the other differentially expressed genes. How these altered gene expressions affect maternal constraint during pregnancy needs further validation in lager study cohorts and also future validation in functional assays.
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Affiliation(s)
| | - Solveig Serapio
- Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden
| | - Nadja Visser
- Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden
| | - Susanne Lager
- Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden
| | - Fredrik Ahlsson
- Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden
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Fortin-Miller S, Plonka B, Gibbs H, Christifano D, Hull H. Prenatal interventions and the development of childhood obesity. Pediatr Obes 2023; 18:e12981. [PMID: 36104864 DOI: 10.1111/ijpo.12981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 08/08/2022] [Accepted: 08/15/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Excess maternal adiposity during pregnancy has lasting effects on child outcomes including increased risk of overweight/obesity, which drives disease development. Prenatal interventions are a potential avenue to curb childhood obesity rates, but little is known on their long-term influence on offspring adiposity. OBJECTIVE Review the evidence for lasting effects of prenatal interventions on child adiposity. METHODS Three databases were searched for follow-up studies of completed prenatal RCTs that involved a diet, exercise, or combined (diet and exercise) intervention, and assessed offspring adiposity-related outcomes beyond birth. RESULTS A total of 18 follow-up studies describing 4277 offspring were included. Anthropometrics were collected in all studies while body composition was measured in 15 of the studies. Diet or exercise interventions did not have a consistent significant effect on child adiposity. Three combined interventions resulted in lower levels of child adiposity at 3, 6, and 12 months. CONCLUSIONS No strong association was found between prenatal diet, exercise, or combined interventions and child adiposity. Data are limited due to 63.6% overall retention rate for the follow-up studies and heterogeneity of intervention approach and child adiposity measures. Findings suggest combined interventions initiated early in pregnancy may decrease offspring adiposity in the first year of life.
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Affiliation(s)
- Sara Fortin-Miller
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Brendel Plonka
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Heather Gibbs
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Danielle Christifano
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Holly Hull
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
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Deruelle P, Anahory T, Ranisavljevic N, Duraes M, Fuchs F. [Are gestational weight gain guidelines for obese women still appropriate?]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2023; 51:73-75. [PMID: 36302474 DOI: 10.1016/j.gofs.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/13/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
Guidelines for adequate gestational weight gain were proposed in 2009 by the Institute of Medicine. In case of a BMI>30kg/m2, the recommended gestational weight gain should be between 5 and 9kg. However, these recommendations do not distinguish between different grades of obesity. Recent data suggest that the IOM recommendations are not restrictive enough for obese pregnant women and should be adapted to the grade of obesity.
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Affiliation(s)
- P Deruelle
- Faculté de médecine, maïeutique et sciences de la santé, Strasbourg, France; Pôle Gynécologie, obstétrique Fertilité, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
| | - T Anahory
- Service de gynécologie obstétrique, CHU de Montpellier, Montpellier, France; Faculté de médecine, Montpellier-Nîmes, France
| | - N Ranisavljevic
- Service de gynécologie obstétrique, CHU de Montpellier, Montpellier, France; Faculté de médecine, Montpellier-Nîmes, France
| | - M Duraes
- Service de gynécologie obstétrique, CHU de Montpellier, Montpellier, France; Faculté de médecine, Montpellier-Nîmes, France
| | - F Fuchs
- Service de gynécologie obstétrique, CHU de Montpellier, Montpellier, France; Faculté de médecine, Montpellier-Nîmes, France
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5
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Vladutiu CJ, Butera NM, Sotres-Alvarez D, Stuebe AM, Aviles-Santa L, Daviglus ML, Gellman MD, Isasi CR, Cordero C, Talavera GA, Van Horn L, Siega-Riz AM. Preconception Cardiometabolic Markers and Birth Outcomes Among Women in the Hispanic Community Health Study/Study of Latinos. J Womens Health (Larchmt) 2022; 31:1727-1735. [PMID: 35796721 PMCID: PMC9805846 DOI: 10.1089/jwh.2021.0474] [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] [Indexed: 01/14/2023] Open
Abstract
Background: Associations between preconception cardiometabolic markers and birth outcomes have been noted, but data are scarce for Hispanics/Latinos. We examined the association between preconception cardiometabolic markers, birthweight and preterm birth among U.S. Hispanic/Latina women. Materials and Methods: The Hispanic Community Health Study/Study of Latinos is a cohort study of U.S. adults 18-74 years of age, including 3,798 women of reproductive age (18-44 years) from four field centers representing Hispanic/Latino backgrounds of Cuban, Dominican, Mexican, Puerto Rican, Central American, and South American. A baseline clinic examination (2008-2011) and a second clinic examination (2014-2017), including ascertainment of birth outcomes, allowed for identification of 517 singleton live births between the exams. Preconception cardiometabolic markers included abdominal obesity (waist circumference ≥88 cm), body mass index >30 kg/m2, high blood pressure (systolic ≥120 mmHg and diastolic ≥80 mmHg), elevated triglycerides (≥150 mg/dL), low high-density lipoprotein cholesterol (<50 mg/dL), elevated fasting glucose (≥100 mg/dL), and insulin. Complex survey linear regression modeled the association between cardiometabolic markers and birthweight-for-gestational age z-score; complex survey logistic regression modeled the association with preterm birth. Analyses adjusted for Hispanic/Latina background, field center, years between baseline and birth, age, and nulliparity. Results: In adjusted linear regression models, elevated fasting glucose was associated with higher birthweight z-scores (β = 0.56, 95% confidence interval [95% CI] 0.14 to 0.99), even after further adjustment for maternal percent body fat (β = 0.53, 95% CI 0.10 to 0.95). In adjusted logistic regression models, high blood pressure (odds ratio [OR] = 2.57, 95% CI 1.13 to 5.88) and increased insulin (OR = 1.50, 95% CI 1.06 to 2.14, for a 10 mU/L increase) were associated with higher odds for preterm birth. Conclusions: Infant birthweight and preterm birth may be influenced by selected cardiometabolic risk factors before pregnancy among Hispanic/Latina women.
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Affiliation(s)
- Catherine J. Vladutiu
- Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services, Rockville, Maryland, USA
- Department of Obstetrics & Gynecology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Nicole M. Butera
- Biostatistics Center and Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, Maryland, USA
- Department of Biostatistics and the Collaborative Studies Coordinating Center, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Daniela Sotres-Alvarez
- Department of Biostatistics and the Collaborative Studies Coordinating Center, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Alison M. Stuebe
- Department of Obstetrics & Gynecology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Larissa Aviles-Santa
- National Institute on Minority Health and Health Disparities, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, USA
| | - Martha L. Daviglus
- Institute for Minority Health Research, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Marc D. Gellman
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Christina Cordero
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Gregory A. Talavera
- Department of Psychology, South Bay Latino Research Center, San Diego State University, San Diego, California, USA
| | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Anna Maria Siega-Riz
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
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Examining socio-cognitive factors and beliefs about mindful eating in healthy adults with differing practice experience: a cross-sectional study. BMC Psychol 2022; 10:268. [PMCID: PMC9664610 DOI: 10.1186/s40359-022-00977-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background Mindful eating (ME), defined as a “non-judgmental awareness of bodily and emotional sensations regarding food consumption”, may be a promising strategy to promote healthy eating behaviors. However, little is known about the psychosocial factors and underlying beliefs that explain ME adoption.
Methods Participants (N = 282; Mage = 43.2) responded to an online questionnaire based on the I-Change Model. Groups with different frequencies of prior engagement in ME, i.e., low (n = 82; LME), medium (n = 96), and high (n = 104), were compared via (M)ANOVAs on factors and individual beliefs regarding predisposing (i.e., habits, experience with mindfulness, emotional eating, facets of ME), pre-motivational (i.e., knowledge, behavioral cognizance, risk perception, cues to action), and motivational factors (i.e., attitudes, self-efficacy, social influence) as well as their intentions and action planning. Bivariate correlations and a forward-stepwise regression with ICM constructs were conducted to examine model fit. Results LME had a greater habit of mindless eating and significantly lower internal awareness, cognizance, cues, and less favorable attitudes, self-efficacy, engagement and support by their social environment, intention, and action plans about engaging in ME than the other two groups. Less habitual mindless eating, and greater experience, internal awareness, cognizance, susceptibility, support, and intention explained 54% of the variance in ME. Discussion and conclusion Results indicate that individuals need to be treated differently when promoting ME with respect to their psychosocial characteristics, rather than as a single group with homogenous baseline beliefs, abilities, support, and motivation. Future longitudinal research should examine which determinants are predictors of ME to better tailor program contents. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00977-4.
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Seneviratne SN, Rajindrajith S. Fetal programming of obesity and type 2 diabetes. World J Diabetes 2022; 13:482-497. [PMID: 36051425 PMCID: PMC9329845 DOI: 10.4239/wjd.v13.i7.482] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/18/2021] [Accepted: 06/03/2022] [Indexed: 02/06/2023] Open
Abstract
The prevalence of obesity and type 2 diabetes mellitus has increased rapidly over the past few decades, and prevention efforts have not been successful. Fetal programming involves the earliest stage of obesity development, and provides a novel concept to complement other strategies for lifelong prevention of obesity and type 2 diabetes mellitus. The World Health Organization now advocates a life-course approach to prevent/control obesity, starting with pre-conceptional and antenatal maternal health. Maternal overnutrition, gestational diabetes mellitus and excessive gestational weight gain lead to fetal overgrowth, and “programs” the offspring with an increased risk of obesity and type 2 diabetes mellitus in childhood and adulthood. This review summarizes current data on fetal programming of obesity and type 2 diabetes mellitus including potential causative factors, mechanisms and interventions to reduce its impact.
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Affiliation(s)
| | - Shaman Rajindrajith
- Department of Paediatrics, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka
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8
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Effects of Low Protein-High Carbohydrate Diet during Early and Late Pregnancy on Respiratory Quotient and Visceral Adiposity. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:3878581. [PMID: 35432727 PMCID: PMC9010209 DOI: 10.1155/2022/3878581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/03/2022] [Accepted: 02/09/2022] [Indexed: 12/05/2022]
Abstract
Background Low Protein-High Carbohydrate (LPHC) diet during pregnancy is considered a nutritional and health problem related to the development of maternal metabolic alterations, such as fatty liver and obesity in the perinatal and postnatal period. It is known that increase in visceral adiposity tissue (VAT) modulates maternal metabolic rate, with the respiratory quotient (RQ) being a parameter related to that variable; however, it is unknown whether LPHC intake during pregnancy affects the VAT and the RQ. In this study, we examine if consumption of LPHC during pregnancy modifies the VAT and RQ in early and late periods of pregnancy. Methods This is a longitudinal and cross-sectional study with Wistar rats during gestation (G) (3, 8, 15, and 20) and nonpregnant rats. Rats were fed with a control diet with 63/18% carbohydrate/protein and an experimental diet with 79/6% carbohydrate/protein. We studied water and food consumption and metabolic parameters such as RQ and energy expenditure (EE), calculated by indirect calorimetry. In the cross-sectional study, we determined visceral fat, as well as the concentration of free fatty acids, insulin, glucose, and lipid profile in serum. Results Nonpregnant rats with LPHC intake decreased significantly in VAT (86%) and the RQ (18%); in pregnant rats in early (8G) and late pregnancy (15G) in LPHC diet, both parameters (VAT and RQ) (25%-92%) increased during light time. When comparing time points during pregnancy in the control and LPHC groups, the RQ increased in 15G during daytime compared to 8G during the night period (17 and 5%, respectively). In late pregnancy, LPHC intake and triacylglyceride levels increased and cholesterol and glucose decreased (45 and 26%, respectively), in comparison to nonpregnant rats. Conclusions LPHC intake in nonpregnant rats decreases the RQ and VAT. Interestingly, the opposite occurs in early pregnancy: the RQ and VAT increased, and this correlates with free fatty acid (FFA) levels. The increase in RQ and VAT during light time in early pregnancy increased mobilization of carbohydrate and protein metabolism. These results suggest that LPHC intake during pregnancy increases the glucose metabolism as a compensatory mechanism for energy needs in the fetus and the mother in early pregnancy.
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Maternal exercise and high-fat diet affect hypothalamic neural projections in rat offspring in a sex-specific manner. J Nutr Biochem 2022; 103:108958. [DOI: 10.1016/j.jnutbio.2022.108958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/20/2021] [Accepted: 01/05/2022] [Indexed: 11/23/2022]
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10
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Ögge LE, Murray F, Modzelewska D, Lundqvist R, Nilsson S, Carré H, Kippler M, Wold AE, Sandberg AS, Sandin A, Jacobsson B, Barman M. Maternal characteristics and pregnancy outcomes in the NICE birth cohort: an assessment of self-selection bias. J Matern Fetal Neonatal Med 2022; 35:9014-9022. [PMID: 34979877 DOI: 10.1080/14767058.2021.2011854] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Prospective birth cohorts are essential for identifying associations between exposures and outcomes. However, voluntary participation introduces a potential bias due to self selection since the persons that chose to participate may differ in background characteristics and behaviors. OBJECTIVES To investigate potential bias due to self-selection in the Nutritional impact on Immunological maturation during Childhood in relation to the Environment (NICE) birth cohort in northern Sweden. METHODS Women in the NICE birth cohort (N = 621) were compared to nonparticipating pregnant women in Norrbotten County in northern Sweden who were eligible for participation (N = 4976) regarding maternal characteristics and lifestyle. Maternal characteristics and pregnancy outcomes were compared between the groups and associations between exposures (smoking, folic acid, BMI, parity, education) and pregnancy outcomes (birth weight and gestational age) were analyzed by linear regression analyses, examining any interaction with the group. RESULTS NICE participants were more highly educated, older and more likely to cohabit than the non-participants. They more often took folic acid and multivitamin supplements and less often smoked during early pregnancy. Pregnancy outcomes (mode of delivery, gestational age at delivery, birth weight and APGAR score) did, however, not differ significantly between participants and non-participants. Smoking, BMI, education and parity affected gestational age and birth weight, but the associations were of similar magnitude in participants and non-participants, with no significant effect on the group. CONCLUSION Self-selection to the NICE study was evident in some factors related to lifestyle and socioeconomic characteristics but did not appear to skew pregnancy outcomes or alter well-known effects of certain lifestyle parameters on pregnancy outcomes.
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Affiliation(s)
- Linda Englund Ögge
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Obstetrics and Gynaecology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Fiona Murray
- Department of Odontology, Norrbotten County Council, Sunderby Research Unit, Umeå University, Umeå, Sweden
| | - Dominika Modzelewska
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Robert Lundqvist
- Department of Public Health and Clinical Medicine, Norrbotten County Council, Sunderby Research Unit, Umeå University, Umeå, Sweden
| | - Staffan Nilsson
- Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden.,Department of Laboratory Medicine, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helena Carré
- Department of Clinical Sciences, Obstetrics and Gynecology, Sunderby Research Unit, Umeå University, Sweden
| | - Maria Kippler
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Agnes E Wold
- Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Ann-Sofie Sandberg
- Department of Biology and Biological Engineering, Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
| | - Anna Sandin
- Department of Clinical Science, Pediatrics, Sunderby Research Unit, Umeå University, Umeå, Sweden
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Obstetrics and Gynaecology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Malin Barman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Biology and Biological Engineering, Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
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11
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Zamora AN, Marchlewicz E, Téllez-Rojo MM, Burant CF, Cantoral A, Song PXK, Mercado A, Dolinoy DC, Peterson KE. Trimester two gestational exposure to bisphenol A and adherence to mediterranean diet are associated with adolescent offspring oxidative stress and metabolic syndrome risk in a sex-specific manner. Front Nutr 2022; 9:961082. [PMID: 36276834 PMCID: PMC9579372 DOI: 10.3389/fnut.2022.961082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/09/2022] [Indexed: 01/25/2023] Open
Abstract
Background Exposure to prenatal bisphenol A (BPA) and Mediterranean Diet Score (MDS) has been linked to metabolic risk in child offspring. It remains unclear if independent and interactive effects persist in adolescence. Methods We examined prenatal BPA and MDS on adolescent offspring metabolic syndrome risk score (MRS) and 8-isoprostane (8-iso), a biomarker of oxidative stress. Data from maternal-adolescent dyads from a Mexico City cohort were utilized, including trimester-specific prenatal BPA from spot urine and MDS from food frequency questionnaires. Offspring socio-demographic data and biomarkers to estimate MRS and 8-iso were obtained during peri-adolescence. Results Adjusted linear regression models examined associations between trimester-specific BPA, MDS, and BPA*MDS on outcomes. Sex-stratified analyses revealed a significant association between MDS with increased 8-iso (β = 0.064, p < 0.05), and a marginal association between trimester two BPA with increased 8-iso (β = 0.237), while MDS modified the marginal association between BPA and 8-iso in females (β = 0.046). A negative, marginal association was observed between trimester two BPA and MRS (β = - 0.728), while BPA * MDS was marginally, positively associated with MRS (β = 0.152) in males. Conclusions Study findings indicate that trimester two prenatal BPA and maternal adherence to a Mediterranean diet may have sexually dimorphic effects on adolescent offspring oxidative stress and metabolic syndrome risk.
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Affiliation(s)
- Astrid N Zamora
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Elizabeth Marchlewicz
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Martha M Téllez-Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Charles F Burant
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States.,Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, United States
| | | | - Peter X K Song
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Adriana Mercado
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Dana C Dolinoy
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States.,Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States.,Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
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12
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LeBlanc ES, Smith NX, Vesco KK, Hillier TA, Stevens VJ. Weight Loss Prior to Pregnancy and Early Gestational Glycemia: Prepare, a Randomized Clinical Trial. J Clin Endocrinol Metab 2021; 106:e5001-e5010. [PMID: 34313765 PMCID: PMC8787851 DOI: 10.1210/clinem/dgab547] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Women with elevated body mass index are encouraged to lose weight before pregnancy, but no trials have tested the effects of prepregnancy weight loss on risk of developing gestational diabetes. OBJECTIVE This work aims to determine whether prepregnancy weight loss improved the early metabolic environment as measured by early gestational diabetes diagnosis. METHODS This was a secondary analysis of a pragmatic randomized clinical trial conducted between May 2015 and October 2019 in an integrated health system that encouraged first-trimester gestational diabetes screening for high-risk women, including those with obesity. Women aged 18 to 40 years with a body mass index (BMI) greater than or equal to 27 who were planning pregnancy were randomly assigned to a behavioral weight loss intervention or usual care. Clinical care decisions and data collection were blind to condition assignment. We compared rates of diagnosis with gestational diabetes in early pregnancy between the groups using logistic regression. RESULTS Of 326 participants, 168 (89 in the intervention and 79 in usual care) had singleton pregnancies during the study period. At baseline, mean age was 31.3 ± 3.5 years and BMI was 34.8 ± 5.8. Fifty-nine (66%) intervention participants and 57 (72%) usual care participants underwent early screening. Among those, intervention participants were 73% less likely to be diagnosed with gestational diabetes than usual care participants (adjusted odds ratio [aOR], 0.27; 95% CI, 0.09-0.80). There was no difference in diagnosis of gestational diabetes in later pregnancy (aOR, 1.08; 95% CI, 0.41-2.81). CONCLUSION Participation in a prepregnancy weight loss intervention led to lower rates of gestational diabetes diagnosis in early pregnancy. This suggests positive effects of prepregnancy weight loss on the early metabolic environment, a critical factor in offspring metabolic risk.
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Affiliation(s)
- Erin S LeBlanc
- Correspondence: Erin S. LeBlanc, MD, Kaiser Permanente, Center for Health Research, 3800 N Interstate Ave, Portland, OR 97227, USA.
| | - Ning X Smith
- Kaiser Permanente, Center for Health Research, Portland, Oregon, USA
| | - Kimberly K Vesco
- Kaiser Permanente, Center for Health Research, Portland, Oregon, USA
| | - Teresa A Hillier
- Kaiser Permanente, Center for Health Research, Portland, Oregon, USA
| | - Victor J Stevens
- Kaiser Permanente, Center for Health Research, Portland, Oregon, USA
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13
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Cao C, Sun S, Li J, Song C, Meng Q, Shi B, Shan A. Lycopene modulates lipid metabolism in rats and their offspring under a high-fat diet. Food Funct 2021; 12:8960-8975. [PMID: 34378595 DOI: 10.1039/d1fo01039e] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The purpose of this study was to investigate the effects of lycopene supplementation on lipid metabolism in rats and their offspring. The experiment was conducted on 60 female rats divided into four groups: normal diet, normal diet with 200 mg kg-1 lycopene, high-fat diet, and high-fat diet with 200 mg kg-1 lycopene. The plasma levels of TG, LDL-C, AST and ALT in female rats fed a high-fat diet were significantly increased (P < 0.05). Lycopene supplementation reduced the plasma TG, LEP and AST levels (P < 0.05). In addition, the activity of ACC and mRNA expression of SREBP1c, FAS, PPARγ, CPT1, HMGCR, ACC, PLIN1 and FATP1 in the liver were also increased after feeding a high-fat diet (P < 0.05), whereas the expression of HSL was decreased (P < 0.05). Lycopene increased the activity of HSL and the expression of ATGL in the liver (P < 0.05), and the activity of ACC and mRNA expression of HMGCR and ACC were decreased (P < 0.05). For the offspring, maternal feeding of a high-fat diet reduced the plasma HDL-C levels (P < 0.05), but lycopene supplementation reduced the plasma TC levels (P < 0.05). Maternal high-fat diet also decreased the activity of HSL and the expression of CD36, PLIN1 and FATP1 in the liver while increasing the expression of PPARγ (P < 0.05). Maternal lycopene supplementation decreased the activities of ACC and FAS in the liver and decreased the expression of PPARγ, ACC and PLIN1 (P < 0.05). Maternal feeding of a high-fat diet increased the level of oxidative stress in the liver, the level of blood lipids in plasma and the rate of lipid production in the liver of rats and their offspring. Maternal lycopene supplementation can reduce the level of oxidative stress in rats and their offspring, reduce the level of blood lipids in plasma, and also reduce the rate of lipid production in the liver of rats and offspring.
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Affiliation(s)
- Chunyu Cao
- Institute of Animal Nutrition, Northeast Agricultural University, Harbin, 150030, P. R. China.
| | - Shishuai Sun
- Institute of Animal Nutrition, Northeast Agricultural University, Harbin, 150030, P. R. China.
| | - Jibo Li
- Institute of Animal Nutrition, Northeast Agricultural University, Harbin, 150030, P. R. China.
| | - Chunsheng Song
- Institute of Animal Nutrition, Northeast Agricultural University, Harbin, 150030, P. R. China.
| | - Qingwei Meng
- Institute of Animal Nutrition, Northeast Agricultural University, Harbin, 150030, P. R. China.
| | - Baoming Shi
- Institute of Animal Nutrition, Northeast Agricultural University, Harbin, 150030, P. R. China.
| | - Anshan Shan
- Institute of Animal Nutrition, Northeast Agricultural University, Harbin, 150030, P. R. China.
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14
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Rifas-Shiman SL, Huh SY, Martin RM, Kramer M, Patel R, Bogdanovich N, Vilchuck K, Thompson J, Oken E. Delivery by caesarean section and offspring adiposity and cardio-metabolic health at ages 6.5, 11.5 and 16 years: results from the PROBIT cohort in Belarus. Pediatr Obes 2021; 16:e12783. [PMID: 33660413 DOI: 10.1111/ijpo.12783] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 02/01/2021] [Accepted: 02/08/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Caesarean delivery has been associated with later adiposity, perhaps via early programming or perhaps because of residual confounding by maternal or birth characteristics. OBJECTIVES Examine associations of caesarean delivery with adiposity and cardio-metabolic biomarkers. METHODS Observational analysis of 15 069 children in the PROBIT cohort in Belarus. We examined measures of child anthropometry and blood pressure at 6.5, 11.5 and 16 years and fasting blood (11.5 years). RESULTS Caesarean-delivered children were slightly heavier at 6.5 (mean BMI 15.8 vs. 15.6 kg/m2 ), 11.5 (18.4 vs. 18.2) and 16 years (21.5 vs. 21.3). After adjustment for prenatal characteristics including maternal third trimester BMI, however, we observed no association of caesarean versus vaginal delivery with child BMI (β 0.05 kg/m2 ; 95%CI: -0.03, 0.14), sum of skinfolds (0.14 mm; -0.13, 0.42), waist circumference (-0.07 cm; -0.23, 0.10), obesity (OR 0.99; 0.76, 1.29), or systolic (-0.20 mmHg; -0.70, 0.30) or diastolic (-0.17 mmHg, -0.60, 0.26) blood pressure at 6.5 years; results were similar at 11.5 and 16 years. At 11.5 years, we observed a modest association of caesarean delivery with fasting insulin (0.33 mU/L; 0.00, 0.65). CONCLUSIONS Caesarean delivery had little or no association with adiposity or related cardio-metabolic biomarkers in childhood. Adjustment for maternal BMI attenuated all outcome effect estimates.
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Affiliation(s)
- Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Susanna Y Huh
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Richard M Martin
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,National Institute for Health Research Bristol Biomedical Research Centre, University of Bristol, Bristol, UK
| | - Michael Kramer
- Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Rita Patel
- Department of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Natalia Bogdanovich
- Department of Obstetrics, National Research and Applied Medicine Mother and Child Centre, Minsk, Belarus
| | - Konstanin Vilchuck
- Department of Obstetrics, National Research and Applied Medicine Mother and Child Centre, Minsk, Belarus
| | - Jennifer Thompson
- Division of Chronic Disease Research Across the Lifecourse, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
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15
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Kahn S, Wainstock T, Sheiner E. Maternal obesity and offspring's cardiovascular morbidity - Results from a population based cohort study. Early Hum Dev 2020; 151:105221. [PMID: 33128960 DOI: 10.1016/j.earlhumdev.2020.105221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/27/2020] [Accepted: 10/02/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To investigate whether maternal obesity poses a risk for long-term cardiovascular morbidity in the offspring. STUDY DESIGN Data were analyzed from a non-selective population of all infants born between the years 1991-2014 at the tertiary Soroka University Medical Center (SUMC), the sole hospital in the southern region of Israel. Offspring's cardiovascular morbidity from childbirth up to eighteen years old was compared among children whom their mothers were with and without obesity (maternal pre-pregnancy body mass index (BMI) ≥30 kg/m2). Kaplan-Meier survival curve was used to compare cumulative incidence of cardiovascular hospitalizations. Cox proportional hazards model was used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for long-term cardiovascular hospitalizations. RESULTS A total of 242,342 deliveries met the inclusion criteria, 3290 (1.36%) had a BMI > 30 kg/m2. Total cardiovascular hospitalizations were comparable between the study groups (1.1% vs. 0.6%, OR = 1.79; 1.28-2.50). The Kaplan-Meier survival curve exhibited a difference in the cumulative incidence of total cardiovascular hospitalizations of the offspring (log-rank test, p < 0.001). In the Cox multi-variable analysis, a significant association was noted between obesity and cardiovascular morbidity even after adjustment for confounders such as maternal age, gestational age, hypertension and diabetes (adjusted HR = 1.59, 95% Cl 1.14-2.21). CONCLUSION Maternal obesity is an independent risk factor for long-term cardiovascular morbidity in the offspring.
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Affiliation(s)
- Shani Kahn
- The Goldman Medical School at the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Tamar Wainstock
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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16
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Hu Y, Wu Q, Han L, Zou Y, Hong D, Liu J, Zhu Y, Zhu Q, Chen D, Qi L, Liang Z. Association between maternal gestational weight gain and preterm birth according to body mass index and maternal age in Quzhou, China. Sci Rep 2020; 10:15863. [PMID: 32985582 PMCID: PMC7522279 DOI: 10.1038/s41598-020-72949-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 08/24/2020] [Indexed: 11/09/2022] Open
Abstract
The aim of this study is to investigate the association between maternal gestational weight gain (GWG) and preterm birth according to pre-pregnancy body mass index (BMI) and maternal age. We did a cohort, hospital-based study in Quzhou, South China, from 1 Jan 2018 to 30 June 2019. We selected 4274 singleton live births in our analysis, 315 (7.4%) of which were preterm births. In the overall population, excess GWG was significantly associated with a decreased risk of preterm birth compared with adequate GWG (adjusted OR 0.81 [95% CI 0.72-0.91]), and the risk varied by increasing maternal age and pre-pregnancy BMI. Interestingly, underweight women who older than 35 years with excess GWG had significantly increased odds of preterm birth compared with adequate GWG in underweight women aged 20-29 years (2.26 [1.06-4.85]) and normal weight women older than 35 years (2.23 [1.13-4.39]). Additionally, low GWG was positively and significantly associated with preterm birth overall (1.92 [1.47-2.50]). Among normal weight women category, compared with adequate GWG women aged 20-29 years did, those older than 20 years with low GWG, had significantly higher odds of preterm birth, which increased with maternal age (1.80 [1.16-2.79] in 20-29 years, 2.19 [1.23-3.91] in 30-34 years, 3.30 [1.68-6.46] in ≫ 35 years). In conclusion, maternal GWG was significantly associated with the risk of preterm birth, but the risk varied by pre-pregnancy BMI and maternal age.
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Affiliation(s)
- Ying Hu
- Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China.,Quzhou Maternal and Child Health Hospital, Quzhou Maternal and Child Medical Association, Zhejiang University, Hangzhou, China
| | - Qi Wu
- Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Luyang Han
- Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Yuqing Zou
- Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China.,Quzhou Maternal and Child Health Hospital, Quzhou Maternal and Child Medical Association, Zhejiang University, Hangzhou, China
| | - Die Hong
- Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Jia Liu
- Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Yuying Zhu
- Quzhou Maternal and Child Health Hospital, Quzhou Maternal and Child Medical Association, Zhejiang University, Hangzhou, China
| | - Qiumin Zhu
- Quzhou Maternal and Child Health Hospital, Quzhou Maternal and Child Medical Association, Zhejiang University, Hangzhou, China
| | - Danqing Chen
- Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
| | - Zhaoxia Liang
- Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China. .,Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
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17
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Moore BF, Harrall KK, Sauder KA, Glueck DH, Dabelea D. Neonatal Adiposity and Childhood Obesity. Pediatrics 2020; 146:peds.2020-0737. [PMID: 32796097 PMCID: PMC7461209 DOI: 10.1542/peds.2020-0737] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/24/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES To explore the longitudinal association of neonatal adiposity (fat mass percentage) with BMI trajectories and childhood overweight and obesity from ages 2 to 6 years. METHODS We studied 979 children from the Healthy Start cohort. Air displacement plethysmography was used to estimate fat mass percentage. Child weight and recumbent length or standing height were abstracted from medical records. Overweight and obesity were defined as BMI levels ≥85th percentile for age and sex. Mixed-effects models were used to examine the association between neonatal fat mass percentage and BMI trajectories from age 2 to 6 years. We tested for effect modification by sex, race and/or ethnicity, and breastfeeding duration. We estimated the proportion of children classified as overweight or obese at specific levels of neonatal fat mass percentage (mean ± SD). RESULTS The mean neonatal adiposity level was 9.1% ± 4.0%. Child BMI levels differed by neonatal adiposity. Each SD increase in neonatal adiposity resulted in a 0.12 higher overall BMI level between ages 2 to 6 years (95% confidence interval: 0.03 to 0.20; P < .01), and this association was not modified by offspring sex, race and/or ethnicity, or breastfeeding duration. Increasing neonatal adiposity was associated with an increasing proportion of childhood overweight and obesity by age 5 years (P = .02). CONCLUSIONS We provide novel evidence that higher neonatal adiposity is significantly associated with higher overall BMI levels and an increased likelihood of overweight or obesity from ages 2 to 6 years. Because various prenatal exposures may specifically influence offspring fat accretion, neonatal adiposity may be a useful surrogate end point for prenatal interventions aimed at reducing future childhood overweight and obesity.
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Affiliation(s)
- Brianna F. Moore
- Department of Epidemiology, Human Genetics, and
Environmental Sciences, School of Public Health, The University of Texas Health
Science Center at Houston, Austin Regional Campus, Austin, Texas;,Lifecourse Epidemiology of Adiposity and Diabetes
Center and
| | | | - Katherine A. Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes
Center and,Department of Pediatrics, School of Medicine,
University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Deborah H. Glueck
- Department of Pediatrics, School of Medicine,
University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes Center and .,Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado; and
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18
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Nehab SR, Villela LD, Soares FVM, Abranches AD, Araújo DMR, da Silva LML, Amaral YNV, Junior SCG, Meio MDBB, Moreira ME. Gestational weight gain and body composition of full-term newborns and infants: a cohort study. BMC Pregnancy Childbirth 2020; 20:474. [PMID: 32819310 PMCID: PMC7439530 DOI: 10.1186/s12884-020-03145-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 07/30/2020] [Indexed: 11/24/2022] Open
Abstract
Background The association between gestational weight gain and neonatal body composition has been inconsistent, exposing the need for further research. The aim of this study was to evaluate whether gestational weight gain influences the body composition of full-term newborns and infants up to 4 months old. Methods A cohort study was performed with 124 participants divided into categories of gestational weight gain according to the 2009 Institute of Medicine guidelines. The anthropometric and body composition data of newborns and infants acquired using air displacement plethysmography (PeaPod®) were collected at 96 h, 1 month, 2 months and 4 months of life. In the statistical analysis, the chi-square test was used to analyze categorical variables, and ANOVA was used to analyze numerical variables. Univariate analysis was performed, and the absolute and relative frequencies of the categorical variables, as well as mean and standard deviation of the numerical variables, were obtained. Bivariate analysis was performed for the categories of gestational weight gain and gestational and neonatal characteristics. When adjustments to gestational hypertension, gestational diabetes, and pregestational body mass index (BMI) were analyzed by linear regression, gestational weight gain remained a significant variable for newborn percent fat mass. For all analyses, a significance level of 5% was adopted. Results Gestational weight gain was adequate in 33.8% of the participants, excessive in 41.1% and insufficient in 25%. Women with excessive weight gain had higher pregestational BMIs and a higher incidence of gestational hypertension. Their newborns had a higher body mass, body fat mass in grams and percent fat mass than the infants born to mothers with adequate or insufficient gestational weight gain. No significant differences were observed in body composition at 1, 2 and 4 months of life during infant follow-up. Conclusion Excessive gestational weight gain may alter the body composition of newborns at birth. Further studies are required to better evaluate infant follow-up. Trial registration Clinical Trial Registry: NCT00875251 on April 3, 2009.
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Affiliation(s)
- Sylvia R Nehab
- Instituto Fernandes Figueira - Fiocruz, Avenida Rui Barbosa 716- Flamengo, Rio de Janeiro, RJ, Brazil
| | - Letícia D Villela
- Instituto Fernandes Figueira - Fiocruz, Avenida Rui Barbosa 716- Flamengo, Rio de Janeiro, RJ, Brazil
| | - Fernanda V M Soares
- Instituto Fernandes Figueira - Fiocruz, Avenida Rui Barbosa 716- Flamengo, Rio de Janeiro, RJ, Brazil
| | - Andrea D Abranches
- Instituto Fernandes Figueira - Fiocruz, Avenida Rui Barbosa 716- Flamengo, Rio de Janeiro, RJ, Brazil
| | - Daniele M R Araújo
- Instituto Fernandes Figueira - Fiocruz, Avenida Rui Barbosa 716- Flamengo, Rio de Janeiro, RJ, Brazil
| | - Leila M L da Silva
- Instituto Fernandes Figueira - Fiocruz, Avenida Rui Barbosa 716- Flamengo, Rio de Janeiro, RJ, Brazil
| | - Yasmin N V Amaral
- Instituto Fernandes Figueira - Fiocruz, Avenida Rui Barbosa 716- Flamengo, Rio de Janeiro, RJ, Brazil
| | - Saint Clair G Junior
- Instituto Fernandes Figueira - Fiocruz, Avenida Rui Barbosa 716- Flamengo, Rio de Janeiro, RJ, Brazil
| | - Maria Dalva B B Meio
- Instituto Fernandes Figueira - Fiocruz, Avenida Rui Barbosa 716- Flamengo, Rio de Janeiro, RJ, Brazil
| | - Maria Elisabeth Moreira
- Instituto Fernandes Figueira - Fiocruz, Avenida Rui Barbosa 716- Flamengo, Rio de Janeiro, RJ, Brazil.
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19
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Kislal S, Shook LL, Edlow AG. Perinatal exposure to maternal obesity: Lasting cardiometabolic impact on offspring. Prenat Diagn 2020; 40:1109-1125. [PMID: 32643194 DOI: 10.1002/pd.5784] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 06/25/2020] [Accepted: 07/05/2020] [Indexed: 12/11/2022]
Abstract
Evidence from epidemiological, clinical, and animal model studies clearly demonstrates that prenatal and lactational maternal obesity and high-fat diet consumption are associated with cardiometabolic morbidity in offspring. Fetal and offspring sex may be an important effect modifier. Adverse offspring cardiometabolic outcomes observed in the setting of maternal obesity include an increased risk for obesity, features of metabolic syndrome (hypertension, hyperglycemia and insulin resistance, hyperlipidemia, increased adiposity), and non-alcoholic fatty liver disease. This review article synthesizes human and animal data linking maternal obesity and high-fat diet consumption in pregnancy and lactation to adverse cardiometabolic outcomes in offspring. We review key mechanisms underlying skeletal muscle, adipose tissue, pancreatic, liver, and central brain reward programming in obesity-exposed offspring, and how such malprogramming contributes to offspring cardiometabolic morbidity.
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Affiliation(s)
- Sezen Kislal
- Vincent Center for Reproductive Biology, Massachusetts General Hospital Research Institute, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Lydia L Shook
- Division of Maternal-Fetal Medicine, Department of Ob/Gyn, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrea G Edlow
- Vincent Center for Reproductive Biology, Massachusetts General Hospital Research Institute, Massachusetts General Hospital, Boston, Massachusetts, USA.,Division of Maternal-Fetal Medicine, Department of Ob/Gyn, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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20
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Zhou B, Yuan Y, Wang K, Niu W, Zhang Z. Interaction effects of significant risk factors on overweight or obesity among 7222 preschool-aged children from Beijing. Aging (Albany NY) 2020; 12:15462-15477. [PMID: 32741774 PMCID: PMC7467379 DOI: 10.18632/aging.103701] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 07/06/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES We aimed to identify potential risk factors, both individually and interactively, associated with overweight and obesity among preschool-aged children, and further to create a risk prediction nomogram model. RESULTS After graded multivariable adjustment, maternal body mass index (BMI) (odds ratio, 95% confidence interval, P under China criteria: 1.07, 1.05 to 1.10, <0.001), maternal pre-pregnancy BMI (1.08, 1.05 to 1.10, <0.001), breastfeeding duration (0.86, 0.76 to 0.98, 0.019), and sleep duration (0.95, 0.90 to 1.00, 0.042) were found to be independently and consistently associated with the significant risk of childhood overweight or obesity under three different growth criteria. Further analyses revealed the four significant factors acted in an additive manner, especially for the interaction between maternal obesity, sleep duration, and breastfeeding. Finally, a risk prediction nomogram model was created for childhood overweight or obesity based on significant and conventional attributes under each criterion. CONCLUSIONS Our findings provide evidence that the four significant factors are associated with the risk of childhood overweight or obesity in an additive manner. METHODS Using a stratified cluster random sampling strategy, 7222 preschool-aged children were analyzed. Childhood overweight and obesity are defined according to the China criteria and two widely-used international growth criteria.
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Affiliation(s)
- Bo Zhou
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Pediatrics, China–Japan Friendship Hospital, Beijing, China
| | - Yuan Yuan
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Pediatrics, China–Japan Friendship Hospital, Beijing, China
| | - Kundi Wang
- Department of Pediatrics, China–Japan Friendship Hospital, Beijing, China
| | - Wenquan Niu
- Institute of Clinical Medical Sciences, China–Japan Friendship Hospital, Beijing, China
| | - Zhixin Zhang
- International Medical Services, China–Japan Friendship Hospital, Beijing, China
- Department of Pediatrics, China–Japan Friendship Hospital, Beijing, China
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21
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Guo T, Luo F, Lin Q. You are affected by what your parents eat: Diet, epigenetics, transgeneration and intergeneration. Trends Food Sci Technol 2020. [DOI: 10.1016/j.tifs.2020.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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22
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Serapio S, Ahlsson F, Larsson A, Kunovac Kallak T. Second Trimester Maternal Leptin Levels Are Associated with Body Mass Index and Gestational Weight Gain but not Birth Weight of the Infant. Horm Res Paediatr 2020; 92:106-114. [PMID: 31655800 DOI: 10.1159/000503422] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 09/16/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Obesity is increasing among the pregnant population. Leptin has an important role in the regulation of energy balance and hunger. The aim of this study was to investigate the association between maternal leptin levels with maternal obesity, gestational weight gain (GWG), single nucleotide polymorphisms (SNPs) within the leptin gene, and the age-adjusted birth weight of the child. MATERIAL AND METHODS Maternal leptin levels (n = 740) and SNPs (n = 504) were analyzed in blood samples taken within the Uppsala Biobank of Pregnant women at pregnancy weeks 16-19. RESULTS Maternal leptin levels differed significantly between body mass index (BMI) groups. Normal weight women had the lowest median leptin levels and levels increased with each BMI group. Leptin SNP genotype was not associated with leptin levels or BMI. There was also no association between maternal leptin levels and age-adjusted birth weight of the child except for a negative association between leptin levels and birth weight in the morbid obese group. DISCUSSION/CONCLUSION Maternal BMI was identified as the best positive explanatory factor for maternal leptin levels. Leptin was a strong positive explanatory factor for GWG. Birth weight of children of uncomplicated pregnancies was, however, dependent on maternal height, BMI, GWG, and parity but not leptin levels, except for in morbid obese women where a negative association between maternal leptin levels and birth weight was found. We speculate that this indicates altered placental function, not manifested in pregnancy complication. We conclude that maternal leptin levels do not affect the birth weight of the child more than BMI, GWG, and parity.
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Affiliation(s)
- Solveig Serapio
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Fredrik Ahlsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
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23
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Tylavsky FA, Ferrara A, Catellier DJ, Oken E, Li X, Law A, Dabelea D, Rundle A, Gilbert-Diamond D, Hivert MF, Breton CV, Cassidy-Bushrow AE, Mueller NT, Hunt KJ, Arteaga SS, Lombo T, Mahabir S, Ruden D, Sauder K, Hedderson MM, Zhu Y, Polk S, Mihalopoulos NL, Vos M, Pyles L, Roary M, Aschner J, Karagas MR, Trasande L. Understanding childhood obesity in the US: the NIH environmental influences on child health outcomes (ECHO) program. Int J Obes (Lond) 2020; 44:617-627. [PMID: 31649277 PMCID: PMC7060502 DOI: 10.1038/s41366-019-0470-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 09/18/2019] [Accepted: 09/27/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Few resources exist for prospective, longitudinal analysis of the relationships between early life environment and later obesity in large diverse samples of children in the United States (US). In 2016, the National Institutes of Health launched the Environmental influences on Child Health Outcomes (ECHO) program to investigate influences of environmental exposures on child health and development. We describe demographics and overweight and obesity prevalence in ECHO, and ECHO's potential as a resource for understanding how early life environmental factors affect obesity risk. METHODS In this cross-sectional study of 70 extant US and Puerto Rico cohorts, 2003-2017, we examined age, race/ethnicity, and sex in children with body mass index (BMI) data, including 28,507 full-term post-birth to <2 years and 38,332 aged 2-18 years. Main outcomes included high BMI for age <2 years, and at 2-18 years overweight (BMI 85th to <95th percentile), obesity (BMI ≥ 95th percentile), and severe obesity (BMI ≥ 120% of 95th percentile). RESULTS The study population had diverse race/ethnicity and maternal demographics. Each outcome was more common with increasing age and varied with race/ethnicity. High BMI prevalence (95% CI) was 4.7% (3.5, 6.0) <1 year, and 10.6% (7.4, 13.7) for 1 to <2 years; overweight prevalence increased from 13.9% (12.4, 15.9) at 2-3 years to 19.9% (11.7, 28.2) at 12 to <18 years. ECHO has the statistical power to detect relative risks for 'high' BMI ranging from 1.2 to 2.2 for a wide range of exposure prevalences (1-50%) within each age group. CONCLUSIONS ECHO is a powerful resource for understanding influences of chemical, biological, social, natural, and built environments on onset and trajectories of obesity in US children. The large sample size of ECHO cohorts adopting a standardized protocol for new data collection of varied exposures along with longitudinal assessments will allow refined analyses to identify drivers of childhood obesity.
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Affiliation(s)
- Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | | | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Xiuhong Li
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrew Law
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Dana Dabelea
- Departments of Epidemiology and Pediatrics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Denver, CO, USA
| | - Andrew Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Carrie V Breton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Noel T Mueller
- Welch Center for Epidemiology, Prevention and Clinical Research, Johns Hopkins University Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kelly J Hunt
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - S Sonia Arteaga
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Tania Lombo
- NIH Office of the Director, ECHO Program, Bethesda, MD, USA
| | - Somdat Mahabir
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Doug Ruden
- Department of Obstetrics and Gynecology, Institute of Environmental Health Sciences, Wayne State University, Detroit, MI, USA
| | - Katherine Sauder
- Departments of Pediatrics and Epidemiology, University of Colorado, Denver, CO, USA
| | - Monique M Hedderson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Sarah Polk
- Department of Pediatrics and Centro SOL, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Miriam Vos
- Department of Pediatrics, Emory University, Atlanta, GA, USA
| | - Lee Pyles
- Department of Pediatrics, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Mary Roary
- National Institute of Nursing Research and Environmental Influences on Child Health Outcomes Program, National Institutes of Health, Rockville, MD, USA
| | - Judy Aschner
- Department of Pediatrics and Obstetrics, Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Leonardo Trasande
- Departments of Pediatrics, Environmental Medicine and Population Health, NYU School of Medicine, New York, NY, USA.
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Di Cesare M, Sorić M, Bovet P, Miranda JJ, Bhutta Z, Stevens GA, Laxmaiah A, Kengne AP, Bentham J. The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action. BMC Med 2019; 17:212. [PMID: 31760948 PMCID: PMC6876113 DOI: 10.1186/s12916-019-1449-8] [Citation(s) in RCA: 460] [Impact Index Per Article: 92.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 10/23/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND In recent decades, the prevalence of obesity in children has increased dramatically. This worldwide epidemic has important consequences, including psychiatric, psychological and psychosocial disorders in childhood and increased risk of developing non-communicable diseases (NCDs) later in life. Treatment of obesity is difficult and children with excess weight are likely to become adults with obesity. These trends have led member states of the World Health Organization (WHO) to endorse a target of no increase in obesity in childhood by 2025. MAIN BODY Estimates of overweight in children aged under 5 years are available jointly from the United Nations Children's Fund (UNICEF), WHO and the World Bank. The Institute for Health Metrics and Evaluation (IHME) has published country-level estimates of obesity in children aged 2-4 years. For children aged 5-19 years, obesity estimates are available from the NCD Risk Factor Collaboration. The global prevalence of overweight in children aged 5 years or under has increased modestly, but with heterogeneous trends in low and middle-income regions, while the prevalence of obesity in children aged 2-4 years has increased moderately. In 1975, obesity in children aged 5-19 years was relatively rare, but was much more common in 2016. CONCLUSIONS It is recognised that the key drivers of this epidemic form an obesogenic environment, which includes changing food systems and reduced physical activity. Although cost-effective interventions such as WHO 'best buys' have been identified, political will and implementation have so far been limited. There is therefore a need to implement effective programmes and policies in multiple sectors to address overnutrition, undernutrition, mobility and physical activity. To be successful, the obesity epidemic must be a political priority, with these issues addressed both locally and globally. Work by governments, civil society, private corporations and other key stakeholders must be coordinated.
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Affiliation(s)
| | - Maroje Sorić
- University of Zagreb, Trg Republike Hrvatske 14, 10000, Zagreb, Croatia.,University of Ljubljana, Kongresni trg 12, 1000, Ljubljana, Slovenia
| | - Pascal Bovet
- Center for Primary Care and Public Health, Secteur Croisettes/Bâtiment SC-B, Route de la Corniche 2, 1066 Epalinges, Lausanne, Switzerland.,Ministry of Health, Hospital Road, Victoria, Republic of Seychelles
| | - J Jaime Miranda
- Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martín de Porres, 15102, Lima, Peru
| | - Zulfiqar Bhutta
- Aga Khan University, National Stadium Rd, Karachi, 74800, Pakistan
| | - Gretchen A Stevens
- Independent consultant, Los Angeles, USA.,c/o: School of Mathematics, Statistics and Actuarial Science, University of Kent, Giles Lane, Canterbury, CT2 7NZ, UK
| | - Avula Laxmaiah
- ICMR-National Institute of Nutrition, Beside Tarnaka Metro Station, Osmania University PO, Hyderabad, Telangana, 500007, India
| | - Andre-Pascal Kengne
- South African Medical Research Council, Francie Van Zijl Dr, Parow Valley, Cape Town, 7501, South Africa
| | - James Bentham
- University of Kent, Giles Lane, Canterbury, CT2 7NZ, UK.
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Bradford B, Cronin R, McKinlay C, Thompson J, McCowan L. Maternally perceived fetal movement patterns: The influence of body mass index. Early Hum Dev 2019; 140:104922. [PMID: 31739267 DOI: 10.1016/j.earlhumdev.2019.104922] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 10/06/2019] [Accepted: 10/26/2019] [Indexed: 01/27/2023]
Abstract
BACKGROUND Maternal reports of decreased fetal movements are associated with adverse pregnancy outcome, but there are conflicting data about perception of fetal movements in women with obesity. AIM To compare perceived fetal movements in women with obesity (body mass index [BMI] ≥30 kg/m2) and women with normal BMI (<25 kg/m2). MATERIAL AND METHODS Data from two separate pregnancy studies were used for this analysis; the Healthy Mums and Babies (HUMBA) trial, which recruited women with obesity and the Multicentre Stillbirth Study (MCSS), which recruited women from a general obstetric population. Fetal movement data were collected using identical interviewer-administered questionnaire in each study. We compared fetal movement strength, frequency and pattern between HUMBA and MCSS women with obesity and MCSS women with normal BMI. RESULTS Participants were 233 women with obesity and 149 with normal BMI. Mean (SD) gestation at interview was similar between groups (36.9 [2.2] vs 36.6 [0.9], P = 0.06). Perceived fetal movement strength and frequency did not differ between groups. In both women with obesity and normal BMI, a diurnal fetal movement pattern was present, with the majority reporting strong or moderate movements in the evening (88.7% vs 99.3%) and at night-time (92.1% vs 93.1%). Women with obesity, were more likely to report strong fetal movements when hungry (29.1% vs 17.7%, P = 0.001) and quiet fetal movements after eating (47.4% vs 32.0%, P = 0.001). CONCLUSIONS In women with obesity compared to normal BMI, strength and frequency of fetal movements were similar, although patterns were altered in relation to maternal meals.
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Affiliation(s)
- Billie Bradford
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Robin Cronin
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Christopher McKinlay
- Liggins Institute, University of Auckland, Auckland, New Zealand; Kids First Neonatal Care, Counties Manukau Health, Auckland, New Zealand
| | - John Thompson
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Lesley McCowan
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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26
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Josey MJ, McCullough LE, Hoyo C, Williams-DeVane C. Overall gestational weight gain mediates the relationship between maternal and child obesity. BMC Public Health 2019; 19:1062. [PMID: 31391077 PMCID: PMC6686549 DOI: 10.1186/s12889-019-7349-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/22/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Approximately 17% of children in the U.S. are obese. Children that are overweight or obese are also more likely to be obese as adults and suffer from various chronic diseases and premature death. Maternal obesity can affect the weight status of her offspring through intrauterine mechanisms like excessive gestational weight gain (GWG). Current literature shows a positive association between maternal weight status and GWG on child obesity, yet the direct and indirect effects have not been decomposed or quantified. The purpose of this study was to estimate the effect of maternal obesity on child obesity, mediated by GWG, which is a modifiable risk factor. METHODS The study participants were a birth cohort of offspring from women who received prenatal care in the Duke/Durham Regional health care system in Durham, NC between 2005 and 2009. Anthropomorphic data was collected via electronic medical records (EMRs) during each voluntary visit to a health care facility. The exposure of interest was maternal obesity, measured by pre-pregnancy body mass index, the mediator was GWG, dichotomized into excessive and not excessive based on maternal prenatal BMI, and the outcome was child obesity at age 4, measured as BMI z-scores from the last recorded height and weight. A counterfactual theory-based product method analysis estimated the mediated effects of GWG, adjusted for maternal race, socioeconomic status, and smoking status. RESULTS Of the 766 children, 25% were overweight or obese, and among all mothers, 25 and 31% were overweight and obese, respectively. Maternal BMI was associated with an overall increase of 0.04 in offspring z-score. The proportion of the effect of maternal obesity on child age 4 obesity mediated by GWG was 8.1%. CONCLUSION GWG, in part, mediated the relationship between maternal BMI and childhood adiposity. Even when the mediator is fixed, children are at an increased risk of a higher BMI if the mother is obese. These findings highlight an important public health education opportunity to stress the impact of a pre-pregnancy weight and excessive GWG on the risk of child obesity for all mothers.
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Affiliation(s)
- Michele J. Josey
- Arnold School of Public Health, Department of Epidemiology & Biostatistics, University of South Carolina, 915 Greene Street, Columbia, SC USA
- Biomedical and Biological Sciences Department, Bioinformatics Genomics Computational Chemistry Core, Biomedical/Biotechnology Research Institute, North Carolina Central University, 1801 Fayetteville Street, Durham, NC USA
| | - Lauren E. McCullough
- Rollins School of Public Health, Department of Epidemiology, Emory University, 1518 Clifton Rd, NE, Atlanta, GA USA
| | - Cathrine Hoyo
- Department of Biological Sciences, Integrated Health Sciences Facility Core, Center for Human Health and The Environment, Epidemiology and Environment Epigenomics Laboratory, North Carolina State University, Raleigh, USA
| | - ClarLynda Williams-DeVane
- Biomedical and Biological Sciences Department, Bioinformatics Genomics Computational Chemistry Core, Biomedical/Biotechnology Research Institute, North Carolina Central University, 1801 Fayetteville Street, Durham, NC USA
- Department of Mathematics and Computer Science, Fisk University, 1000 17th Ave, Nashville, TN USA
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27
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Bastain TM, Chavez T, Habre R, Girguis MS, Grubbs B, Toledo-Corral C, Amadeus M, Farzan SF, Al-Marayati L, Lerner D, Noya D, Quimby A, Twogood S, Wilson M, Chatzi L, Cousineau M, Berhane K, Eckel SP, Lurmann F, Johnston J, Dunton GF, Gilliland F, Breton C. Study Design, Protocol and Profile of the Maternal And Developmental Risks from Environmental and Social Stressors (MADRES) Pregnancy Cohort: a Prospective Cohort Study in Predominantly Low-Income Hispanic Women in Urban Los Angeles. BMC Pregnancy Childbirth 2019; 19:189. [PMID: 31146718 PMCID: PMC6543670 DOI: 10.1186/s12884-019-2330-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 05/03/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The burden of childhood and adult obesity disproportionally affects Hispanic and African-American populations in the US, and these groups as well as populations with lower income and education levels are disproportionately affected by environmental pollution. Pregnancy is a critical developmental period where maternal exposures may have significant impacts on infant and childhood growth as well as the future health of the mother. We initiated the "Maternal And Developmental Risks from Environmental and Social Stressors (MADRES)" cohort study to address critical gaps in understanding the increased risk for childhood obesity and maternal obesity outcomes among minority and low-income women in urban Los Angeles. METHODS The MADRES cohort is specifically examining whether pre- and postpartum environmental exposures, in addition to exposures to psychosocial and built environment stressors, lead to excessive gestational weight gain and postpartum weight retention in women and to perturbed infant growth trajectories and increased childhood obesity risk through altered psychological, behavioral and/or metabolic responses. The ongoing MADRES study is a prospective pregnancy cohort of 1000 predominantly lower-income, Hispanic women in Los Angeles, CA. Enrollment in the MADRES cohort is initiated prior to 30 weeks gestation from partner community health clinics in Los Angeles. Cohort participants are followed through their pregnancies, at birth, and during the infant's first year of life through a series of in-person visits with interviewer-administered questionnaires, anthropometric measurements and biospecimen collection as well as telephone interviews conducted with the mother. DISCUSSION In this paper, we outline the study rationale and data collection protocol for the MADRES cohort, and we present a profile of demographic, health and exposure characteristics for 291 participants who have delivered their infants, out of 523 participants enrolled in the study from November 2015 to October 2018 from four community health clinics in Los Angeles. Results from the MADRES cohort could provide a powerful rationale for regulation of targeted chemical environmental components, better transportation and urban design policies, and clinical recommendations for stress-coping strategies and behavior to reduce lifelong obesity risk.
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Affiliation(s)
- Theresa M Bastain
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA, 90032, USA.
| | - Thomas Chavez
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA, 90032, USA
| | - Rima Habre
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA, 90032, USA
| | - Mariam S Girguis
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA, 90032, USA
| | - Brendan Grubbs
- Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Claudia Toledo-Corral
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA, 90032, USA.,Department of Public Health, California State University Northridge, Los Angeles, CA, USA
| | - Milena Amadeus
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA, 90032, USA
| | - Shohreh F Farzan
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA, 90032, USA
| | - Laila Al-Marayati
- Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.,Eisner Health, Los Angeles, CA, USA
| | | | - David Noya
- South Central Family Health Center, Los Angeles, CA, USA
| | - Alyssa Quimby
- Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Sara Twogood
- Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Melissa Wilson
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA, 90032, USA
| | - Leda Chatzi
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA, 90032, USA
| | - Michael Cousineau
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA, 90032, USA
| | - Kiros Berhane
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA, 90032, USA
| | - Sandrah P Eckel
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA, 90032, USA
| | | | - Jill Johnston
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA, 90032, USA
| | - Genevieve F Dunton
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA, 90032, USA.,Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Frank Gilliland
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA, 90032, USA
| | - Carrie Breton
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA, 90032, USA
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28
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Martin CL, Vladutiu CJ, Zikry TM, Grace MR, Siega-Riz AM. Maternal lipid levels during pregnancy and child weight status at 3 years of age. Pediatr Obes 2019; 14:e12485. [PMID: 30516000 PMCID: PMC6545288 DOI: 10.1111/ijpo.12485] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/21/2018] [Accepted: 09/30/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND The intrauterine environment is critical in the development of child obesity. OBJECTIVE To investigate the association between maternal lipid levels during pregnancy and child weight status. METHODS Maternal lipid levels (total cholesterol, high-density and low-density lipoprotein cholesterol, triglycerides) collected from fasting blood samples collected at less than 20 and 24-29 weeks' gestation and child weight status at age 3 were examined prospectively among 183 mother-child dyads enrolled in the Pregnancy, Infection, and Nutrition. Measured height and weight at 3 years were used to calculate age- and sex-specific body mass index z-scores. Child risk of overweight/obesity was defined as body mass index greater than or equal to 85th percentile for age and sex. Regression models estimated the association between maternal lipid levels and child body mass index z-score and risk of being affected by overweight/obesity, respectively. RESULTS Higher triglyceride levels at less than 20 and 24-29 weeks of pregnancy were associated with higher body mass index z-scores (β = 0.23; 95% CI: 0.07-0.38 and β = 0.15; 95% CI: 0.01-0.29; respectively) after adjusting for confounders. There was no evidence of an association between total or low-density lipoprotein cholesterol and child weight status at age 3. CONCLUSIONS Early childhood body mass index may be influenced by maternal triglyceride levels during pregnancy.
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Affiliation(s)
- Chantel L. Martin
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Catherine J. Vladutiu
- Department of Obstetrics & Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC
- Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, Maryland
| | - Tarek M. Zikry
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Matthew R. Grace
- Department of Obstetrics & Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC
- Department of Obstetric and Gynecology, University of Tennessee Health Sciences Center College of Medicine, Nashville, TN
| | - Anna Maria Siega-Riz
- School of Nursing and Departments of Public Health Sciences and Obstetrics & Gynecology, University of Virginia School of Medicine, Charlottesville, VA
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Maternal and neonatal outcomes according to gestational weight gain in twin pregnancies: Are the Institute of Medicine guidelines associated with better outcomes? Eur J Obstet Gynecol Reprod Biol 2019; 234:190-194. [DOI: 10.1016/j.ejogrb.2019.01.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 01/06/2019] [Accepted: 01/08/2019] [Indexed: 11/15/2022]
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30
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Maternal glycemic index and glycemic load in pregnancy and offspring metabolic health in childhood and adolescence-a cohort study of 68,471 mother-offspring dyads from the Danish National Birth Cohort. Eur J Clin Nutr 2018; 73:1049-1062. [PMID: 30250133 DOI: 10.1038/s41430-018-0316-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 07/27/2018] [Accepted: 08/17/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND High glycemic index (GI) and glycemic load (GL) as indicators of carbohydrate quality and quantity have been found to increase risk of metabolic outcomes in adults. Whether carbohydrate quality may influence metabolic programming already in early life is unknown. We examined the association of maternal GI and GL with offspring body mass index (BMI) in the first 7 years of life among 68,471 mother-offspring dyads from the Danish National Birth Cohort (DNBC). In a sub-cohort of offspring with clinical data (n = 1234) that included 608 dyads exposed to gestational diabetes mellitus (GDM), we also examined the relation to metabolic health at 9-16 years. METHODS Maternal GI and GL were quantified using a mid-pregnancy food frequency questionnaire. We used birth weight and length to calculate offspring's ponderal index. Age- and sex-specific BMI z scores at 5 mo, 12 mo, and 7 y were standardized against WHO reference data. In the clinical cohort, we quantified body composition, HOMA-IR, and HOMA-B. We used multivariable mixed linear and Poisson regression to model the associations. RESULTS Median (IQR) of GI and GL were 83 (63-111) and 241 (180-333) g/day, respectively. We found that GI (Q4 vs. Q1:1.09, 95%CI: 1.03, 1.15) and GL (Q4 vs. Q1:1.10, 95%CI: 1.05, 1.16) modestly increased the relative risk of large-for gestational age (LGA). In the clinical sub-cohort, we observed a potential increase in offspring HOMA-IR, adiposity, and metabolic syndrome z score with higher maternal GI and GI. These associations were stronger among the GDM-exposed offspring, but the CI included the null value. CONCLUSION We found associations of GI and GL in pregnancy with offspring LGA. Potential long-term benefits to offspring exposed to GDM need to be confirmed in larger, well-powered studies.
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31
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Chen Y, Liu Y, Zhang Y, Hu R, Qian Z, Xian H, Vaughn MG, Liu M, Cao S, Gan Y, Zhang B. Gestational Weight Gain per Pre-Pregnancy Body Mass Index and Birth Weight in Twin Pregnancies: A Cohort Study in Wuhan, China. Sci Rep 2018; 8:12496. [PMID: 30131497 PMCID: PMC6104075 DOI: 10.1038/s41598-018-29774-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 07/18/2018] [Indexed: 02/07/2023] Open
Abstract
To assess the relationship between gestational weight gain (GWG) of twin-pregnancy women and twin birth weights, as well as to evaluate whether pre-pregnancy body mass index (BMI) influences this relationship. A cohort study was conducted in Wuhan, China, between 1/01/2011 and 8/31/2017. Women with twin pregnancies who delivered live and non-malformed twins were included (6,925 women and 13,850 infants), based on the Wuhan Maternal and Child Health Management Information System. Logistic regression models were employed to examine the association between GWG and paired small for gestational age (SGA, defined as birth weight <10th percentile for gestational age and sex)/SGA and linear regression models were utilized to explore the relationship between GWG and sum of birth weights. The associations of GWG based on both the IOM and Chinese recommendations and SGA/SGA pairs were obtained, as well as the stratified analyses by pre-pregnancy BMI. Additionally, the sum birth weight of one twin pair increased by 15.88 g when the GWG increased by 1 kg. GWG below the IOM and Chinese recommendations was associated with an increased risk of SGA/SGA pairs in all pre-pregnancy BMI categories. However, in underweight, overweight, and obese women, the association between GWG above the IOM and Chinese recommendations and SGA/SGA pairs changed with adjustment.
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Affiliation(s)
- Yawen Chen
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Hongkong Road, Wuhan, 430014, Hubei, People's Republic of China
| | - Yan Liu
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Hongkong Road, Wuhan, 430014, Hubei, People's Republic of China
| | - Yiming Zhang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Hongkong Road, Wuhan, 430014, Hubei, People's Republic of China
| | - Ronghua Hu
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Hongkong Road, Wuhan, 430014, Hubei, People's Republic of China
| | - Zhengmin Qian
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO, 63104, United States of America
| | - Hong Xian
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO, 63104, United States of America
| | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Tegeler Hall, 3550 Lindell Boulevard, Saint Louis, MO, 63103, United States of America
| | - Mingzhu Liu
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Hongkong Road, Wuhan, 430014, Hubei, People's Republic of China
| | - Shiyi Cao
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, NO. 13 Hangkong Road, Wuhan, 430030, Hubei, People's Republic of China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, NO. 13 Hangkong Road, Wuhan, 430030, Hubei, People's Republic of China
| | - Bin Zhang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Hongkong Road, Wuhan, 430014, Hubei, People's Republic of China.
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Mohamad M, Loy SL, Lim PY, Wang Y, Soo KL, Mohamed HJJ. Maternal Serum and Breast Milk Adiponectin: The Association with Infant Adiposity Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1250. [PMID: 29895806 PMCID: PMC6025015 DOI: 10.3390/ijerph15061250] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 12/21/2022]
Abstract
The prevalence of childhood obesity is increasing at an alarming rate in Malaysia. Metabolic changes during pregnancy are critical to the development of infant adiposity, due to imbalanced adipokines production. Hence, we aimed to investigate the association of maternal serum and breast milk adipokines with infant adiposity development. The study was conducted from April 2010 until December 2012. A total of 155 healthy pregnant mothers aged 19 to 40 years were recruited during the first and second trimester in Kelantan, Malaysia. Data consisted of maternal sociodemographic details, anthropometry and clinical biochemistry analysis; and the infant’s anthropometry and feeding patterns. Maternal fasting serum and breast milk samples were analysed for adiponectin and leptin levels. Data collection was performed in the second and third trimester of pregnancy, and continued with follow-up visits at birth, two, six, and 12 months postpartum. Multiple linear regression (MLR) analyses were performed to examine the associations between maternal serum and breast milk adiponectin and leptin and infant adiposity development. MLR models showed that, in the first year, as maternal serum and breast milk adiponectin increased, infant weight, BMI-for-age Z scores and abdominal circumference significantly decreased (p < 0.05). Maternal serum and/or breast milk adiponectin was associated with first-year infant adiposity development.
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Affiliation(s)
- Marhazlina Mohamad
- School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu 21300, Malaysia.
| | - See Ling Loy
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore 229899, Singapore.
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang 43400, Malaysia.
| | - Yu Wang
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Kah Leng Soo
- Nutrition and Dietetics Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia.
| | - Hamid Jan Jan Mohamed
- Nutrition and Dietetics Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia.
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Moore BF, Sauder KA, Starling AP, Hebert JR, Shivappa N, Ringham BM, Glueck DH, Dabelea D. Proinflammatory Diets during Pregnancy and Neonatal Adiposity in the Healthy Start Study. J Pediatr 2018; 195:121-127.e2. [PMID: 29217099 PMCID: PMC6363107 DOI: 10.1016/j.jpeds.2017.10.030] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 09/26/2017] [Accepted: 10/12/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate the association between dietary inflammatory index (DII) scores during pregnancy and neonatal adiposity. STUDY DESIGN The analysis included 1078 mother-neonate pairs in Healthy Start, a prospective prebirth cohort. Diet was assessed using repeated 24-hour dietary recalls. DII scores were obtained by summing nutrient intakes, which were standardized to global means and multiplied by inflammatory effect scores. Air displacement plethysmography measured fat mass and fat-free mass within 72 hours of birth. Linear and logistic models evaluated the associations of DII scores with birth weight, fat mass, fat-free mass, and percent fat mass, and with categorical outcomes of small- and large-for-gestational age. We tested for interactions with prepregnancy BMI and gestational weight gain. RESULTS The interaction between prepregnancy BMI and DII was statistically significant for birth weight, neonatal fat mass, and neonatal percent fat mass. Among neonates born to obese women, each 1-unit increase in DII was associated with increased birth weight (53 g; 95% CI, 20, 87), fat mass (20 g; 95% CI, 7-33), and percent fat mass (0.5%; 95% CI, 0.2-0.8). No interaction was detected for small- and large-for-gestational age. Each 1-unit increase in DII score was associated a 40% increase in odds of a large-for-gestational age neonate (1.4; 95% CI, 1.0-2.0; P = .04), but not a small-for-gestational age neonate (1.0; 95% CI, 0.8-1.2; P = .80). There was no evidence of an interaction with gestational weight gain. CONCLUSIONS Our findings support the hypothesis that an increased inflammatory milieu during pregnancy may be a risk factor for neonatal adiposity. TRIAL REGISTRATION Clinicaltrials.gov: NCT02273297.
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Affiliation(s)
- Brianna F Moore
- Department of Epidemiology, Colorado School of Public Health, Aurora CO, USA
| | - Katherine A Sauder
- Department of Pediatrics, University of Colorado School of Medicine, Aurora CO, USA
| | - Anne P Starling
- Department of Epidemiology, Colorado School of Public Health, Aurora CO, USA
| | - James R Hebert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA,Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA,Connecting Health Innovations, LLC, Columbia, SC
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA,Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA,Connecting Health Innovations, LLC, Columbia, SC
| | - Brandy M Ringham
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora CO, USA
| | - Deborah H Glueck
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora CO, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO.
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Clarke MA, Joshu CE. Early Life Exposures and Adult Cancer Risk. Epidemiol Rev 2018; 39:11-27. [PMID: 28407101 DOI: 10.1093/epirev/mxx004] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 01/19/2017] [Indexed: 12/14/2022] Open
Abstract
Very little is known about the influence of early life exposures on adult cancer risk. The purpose of this narrative review was to summarize the epidemiologic evidence relating early life tobacco use, obesity, diet, and physical activity to adult cancer risk; describe relevant theoretical frameworks and methodological strategies for studying early life exposures; and discuss policies and research initiatives focused on early life. Our findings suggest that in utero exposures may indirectly influence cancer risk by modifying biological pathways associated with carcinogenesis; however, more research is needed to firmly establish these associations. Initiation of exposures during childhood and adolescence may impact cancer risk by increasing duration and lifetime exposure to carcinogens and/or by acting during critical developmental periods. To expand the evidence base, we encourage the use of life course frameworks, causal inference methods such as Mendelian randomization, and statistical approaches such as group-based trajectory modeling in future studies. Further, we emphasize the need for objective exposure biomarkers and valid surrogate endpoints to reduce misclassification. With the exception of tobacco use, there is insufficient evidence to support the development of new cancer prevention policies; however, we highlight existing policies that may reduce the burden of these modifiable risk factors in early life.
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Abraham M, Collins CA, Flewelling S, Camazine M, Cahill A, Cade WT, Duncan JG. Mitochondrial inefficiency in infants born to overweight African-American mothers. Int J Obes (Lond) 2018; 42:1306-1316. [PMID: 29568109 PMCID: PMC6054813 DOI: 10.1038/s41366-018-0051-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 01/05/2018] [Accepted: 01/22/2018] [Indexed: 01/21/2023]
Abstract
Background Currently 20–35% of pregnant women are obese, posing a major health risk for mother and fetus. It is postulated that an abnormal maternal-fetal nutritional environment leads to adverse metabolic programming, resulting in altered substrate metabolism in the offspring and predisposing to risks of obesity and diabetes later in life. Data indicate that oocytes from overweight animals have abnormal mitochondria. We hypothesized that maternal obesity is associated with altered mitochondrial function in healthy neonatal offspring. Methods Overweight and obese (Body mass index, (BMI) ≥ 25 kg/m2, n=14) and lean (BMI < 25 kg/m2, n=8), African American pregnant women carrying male fetuses were recruited from the Barnes Jewish Hospital obstetric clinic. Maternal and infant data were extracted from medical records. Infants underwent body composition testing in the first days of life. Circumcision skin was collected for isolation of fibroblasts. Fibroblast cells were evaluated for mitochondrial function, metabolic gene expression, nutrient uptake and oxidative stress. Results Skin fibroblasts of infants born to overweight mothers had significantly higher mitochondrial respiration without a concurrent increase in ATP production, indicating mitochondrial inefficiency. These fibroblasts had higher levels of reactive oxygen species and evidence of oxidative stress. Evaluation of gene expression in offspring fibroblasts revealed altered expression of multiple genes involved in fatty acid and glucose metabolism and mitochondrial respiration in infants of overweight mothers. Conclusion This study demonstrates altered mitochondrial function and oxidative stress in skin fibroblasts of infants born to overweight mothers. Future studies are needed to determine the long-term impact of this finding on the metabolic health of these children.
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Affiliation(s)
- Manjusha Abraham
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Christina A Collins
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Scott Flewelling
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Maraya Camazine
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Alison Cahill
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA
| | - W Todd Cade
- Department of Physical Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Jennifer G Duncan
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA.
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Brownell M, Nickel NC, Chartier M, Enns JE, Chateau D, Sarkar J, Burland E, Jutte DP, Taylor C, Katz A. An Unconditional Prenatal Income Supplement Reduces Population Inequities In Birth Outcomes. Health Aff (Millwood) 2018; 37:447-455. [DOI: 10.1377/hlthaff.2017.1290] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Marni Brownell
- Marni Brownell is a professor at the Manitoba Centre for Health Policy, University of Manitoba, in Winnipeg
| | - Nathan C. Nickel
- Nathan C. Nickel is an assistant professor at the Manitoba Centre for Health Policy
| | - Mariette Chartier
- Mariette Chartier is an assistant professor at the Manitoba Centre for Health Policy
| | - Jennifer E. Enns
- Jennifer E. Enns is a postdoctoral fellow at the Manitoba Centre for Health Policy
| | - Dan Chateau
- Dan Chateau is an assistant professor at the Manitoba Centre for Health Policy
| | - Joykrishna Sarkar
- Joykrishna Sarkar is a data analyst at the Manitoba Centre for Health Policy
| | - Elaine Burland
- Elaine Burland is a research associate at the Manitoba Centre for Health Policy
| | - Douglas P. Jutte
- Douglas P. Jutte is an associate professor at the School of Public Health, University of California, Berkeley, and an adjunct scientist at the Manitoba Centre for Health Policy
| | - Carole Taylor
- Carole Taylor is a data analyst at the Manitoba Centre for Health Policy
| | - Alan Katz
- Alan Katz is a professor at the Manitoba Centre for Health Policy
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Cancel-Tirado DI, Feeney SL, Washburn IJ, Greder KA, Sano Y. Health, Well-being, and Health Care Access in Rural Communities: Comparing Latino and Non-Latino White Low-income Families. FAMILY & COMMUNITY HEALTH 2018; 41:73-82. [PMID: 29461355 DOI: 10.1097/fch.0000000000000193] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study explores how low-income rural Latino children and their mothers differ from their non-Latino white counterparts in terms of health, well-being, and health care access. A subsample of non-Latino white (n = 201) and Latino (n = 157) children and their mothers was drawn from the Rural Families Speak about Health Project, a multistate, cross-sectional data set developed through mixed purposive sampling methods. Findings suggest that Latino children's families were disadvantaged in terms of child health and access to health care, whereas non-Latino white children's families were disadvantaged in terms of child behavior problems and maternal health and depression.
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Affiliation(s)
- Doris I Cancel-Tirado
- Division of Health and Exercise Science, Western Oregon University, Monmouth (Dr Cancel-Tirado); Family and Consumer Science, Central Washington University, Ellensburg (Dr Feeney); Human Development and Family Science, Oklahoma State University, Stillwater (Dr Washburn); Human Development and Family Studies, Iowa State University, Ames (Dr Greder); and Human Development, Washington State University, Vancouver (Dr Sano)
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Farpour-Lambert NJ, Ells LJ, Martinez de Tejada B, Scott C. Obesity and Weight Gain in Pregnancy and Postpartum: an Evidence Review of Lifestyle Interventions to Inform Maternal and Child Health Policies. Front Endocrinol (Lausanne) 2018; 9:546. [PMID: 30319539 PMCID: PMC6168639 DOI: 10.3389/fendo.2018.00546] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 08/28/2018] [Indexed: 12/16/2022] Open
Abstract
Background: Maternal obesity, excessive gestational weight gain (GWG) and post-partum weight retention (PPWR) constitute new public health challenges, due to the association with negative short- and long-term maternal and neonatal outcomes. The aim of this evidence review was to identify effective lifestyle interventions to manage weight and improve maternal and infant outcomes during pregnancy and postpartum. Methods: A review of systematic reviews and meta-analyses investigating the effects of lifestyle interventions on GWG or PPWR was conducted (Jan 2009-2018) via electronic searches in the databases Medline, Pubmed, Web of Science and Cochrane Library using all keywords related to obesity/weight gain/loss, pregnancy or postpartum and lifestyle interventions;15 relevant reviews were selected. Results: In healthy women from all BMI classes, diet and physical activity interventions can decrease: GWG (mean difference -1.8 to -0.7 kg, high to moderate-quality evidence); the risks of GWG above the IOM guidelines (risk ratio [RR] 0.72 to 0.80, high to low-quality evidence); pregnancy-induced hypertension (RR 0.30 to 0.66, low to very low-quality evidence); cesarean section (RR 0.91 to 0.95; high to moderate-quality evidence) and neonatal respiratory distress syndrome (RR 0.56, high-quality evidence); without any maternal/fetal/neonatal adverse effects. In women with overweight/obesity, multi-component interventions can decrease: GWG (-0.91 to -0.63 kg, moderate to very low-quality evidence); pregnancy-induced hypertension (RR 0.30 to 0.66, low-quality evidence); macrosomia (RR 0.85, 0.73 to 1.0, moderate-quality evidence) and neonatal respiratory distress syndrome (RR 0.47, 0.26 to 0.85, moderate-quality evidence). Diet is associated with greater reduction of the risks of GDM, pregnancy-induced hypertension and preterm birth, compared with any other intervention. After delivery, combined diet and physical activity interventions reduce PPWR in women of any BMI (-2.57 to -2.3 kg, very low quality evidence) or with overweight/obesity (-3.6 to -1.22, moderate to very low-quality-evidence), but no other effects were reported. Conclusions: Multi-component approaches including a balanced diet with low glycaemic load and light to moderate intensity physical activity, 30-60 min per day 3-5 days per week, should be recommended from the first trimester of pregnancy and maintained during the postpartum period. This evidence review should help inform recommendations for health care professionals and women of child-bearing age.
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Affiliation(s)
- Nathalie J. Farpour-Lambert
- Obesity Prevention and Care Program “Contrepoids,” Service of Therapeutic Education for Chronic Diseases, Department of Community Medicine, Primary Care and Emergency, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Pediatric Sports Medicine Consultation, Service of General Pediatrics, Department of Child and Adolescent, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- *Correspondence: Nathalie J. Farpour-Lambert
| | - Louisa J. Ells
- School of Health and Social Care, Teesside University, Middlesbrough, United Kingdom
| | - Begoña Martinez de Tejada
- Service of Obstetrics, Department of Gynaecology and Obstetrics, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Courtney Scott
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
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Leonard SA, Rasmussen KM, King JC, Abrams B. Trajectories of maternal weight from before pregnancy through postpartum and associations with childhood obesity. Am J Clin Nutr 2017; 106:1295-1301. [PMID: 28877895 PMCID: PMC5657288 DOI: 10.3945/ajcn.117.158683] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 08/08/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Prepregnancy body mass index [BMI (in kg/m2)], gestational weight gain, and postpartum weight retention may have distinct effects on the development of child obesity, but their combined effect is currently unknown.Objective: We described longitudinal trajectories of maternal weight from before pregnancy through the postpartum period and assessed the relations between maternal weight trajectories and offspring obesity in childhood.Design: We analyzed data from 4436 pairs of mothers and their children in the National Longitudinal Survey of Youth 1979 (1981-2014). We used latent-class growth modeling in addition to national recommendations for prepregnancy BMI, gestational weight gain, and postpartum weight retention to create maternal weight trajectory groups. We used modified Poisson regression models to assess the associations between maternal weight trajectory group and offspring obesity at 3 age periods (2-5, 6-11, and 12-19 y).Results: Our analysis using maternal weight trajectories based on either latent-class results or recommendations showed that the risk of child obesity was lowest in the lowest maternal weight trajectory group. The differences in obesity risk were largest after 5 y of age and persisted into adolescence. In the latent-class analysis, the highest-order maternal weight trajectory group consisted almost entirely of women who were obese before pregnancy and was associated with a >2-fold increase in the risk of offspring obesity at ages 6-11 y (adjusted RR: 2.39; 95% CI: 1.97, 2.89) and 12-19 y (adjusted RR: 2.74; 95% CI: 2.13, 3.52). In the analysis with maternal weight trajectory groups based on recommendations, the risk of child obesity was consistently highest for women who were overweight or obese at the beginning of pregnancy.Conclusion: These findings suggest that high maternal weight across the childbearing period increases the risk of obesity in offspring during childhood, but high prepregnancy BMI has a stronger influence than either gestational weight gain or postpartum weight retention.
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Affiliation(s)
| | | | - Janet C King
- Nutrition and Metabolism Center, Children’s Hospital Oakland Research Institute, Oakland, CA
| | - Barbara Abrams
- Division of Epidemiology, University of California, Berkeley, CA
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Ash T, Agaronov A, Young T, Aftosmes-Tobio A, Davison KK. Family-based childhood obesity prevention interventions: a systematic review and quantitative content analysis. Int J Behav Nutr Phys Act 2017; 14:113. [PMID: 28836983 PMCID: PMC5571569 DOI: 10.1186/s12966-017-0571-2] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 08/16/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND A wide range of interventions has been implemented and tested to prevent obesity in children. Given parents' influence and control over children's energy-balance behaviors, including diet, physical activity, media use, and sleep, family interventions are a key strategy in this effort. The objective of this study was to profile the field of recent family-based childhood obesity prevention interventions by employing systematic review and quantitative content analysis methods to identify gaps in the knowledge base. METHODS Using a comprehensive search strategy, we searched the PubMed, PsycIFO, and CINAHL databases to identify eligible interventions aimed at preventing childhood obesity with an active family component published between 2008 and 2015. Characteristics of study design, behavioral domains targeted, and sample demographics were extracted from eligible articles using a comprehensive codebook. RESULTS More than 90% of the 119 eligible interventions were based in the United States, Europe, or Australia. Most interventions targeted children 2-5 years of age (43%) or 6-10 years of age (35%), with few studies targeting the prenatal period (8%) or children 14-17 years of age (7%). The home (28%), primary health care (27%), and community (33%) were the most common intervention settings. Diet (90%) and physical activity (82%) were more frequently targeted in interventions than media use (55%) and sleep (20%). Only 16% of interventions targeted all four behavioral domains. In addition to studies in developing countries, racial minorities and non-traditional families were also underrepresented. Hispanic/Latino and families of low socioeconomic status were highly represented. CONCLUSIONS The limited number of interventions targeting diverse populations and obesity risk behaviors beyond diet and physical activity inhibit the development of comprehensive, tailored interventions. To ensure a broad evidence base, more interventions implemented in developing countries and targeting racial minorities, children at both ends of the age spectrum, and media and sleep behaviors would be beneficial. This study can help inform future decision-making around the design and funding of family-based interventions to prevent childhood obesity.
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Affiliation(s)
- Tayla Ash
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, SPH-2 655 Huntington Avenue, Boston, 02115 USA
- Harvard T.H. Chan School of Public Health, Department of Nutrition, Kresge Building 677 Huntington Avenue, Boston, 02115 USA
| | - Alen Agaronov
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, SPH-2 655 Huntington Avenue, Boston, 02115 USA
| | - Ta’Loria Young
- Harvard T.H. Chan School of Public Health, University of Texas at Austin, 110 Inner Campus Drive, Austin, 78705 USA
| | - Alyssa Aftosmes-Tobio
- Harvard T.H. Chan School of Public Health, Department of Nutrition, Kresge Building 677 Huntington Avenue, Boston, 02115 USA
| | - Kirsten K. Davison
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, SPH-2 655 Huntington Avenue, Boston, 02115 USA
- Harvard T.H. Chan School of Public Health, Department of Nutrition, Kresge Building 677 Huntington Avenue, Boston, 02115 USA
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Luecken LJ, Jewell SL, MacKinnon DP. Prediction of Postpartum Weight in Low-Income Mexican-Origin Women From Childhood Experiences of Abuse and Family Conflict. Psychosom Med 2017; 78:1104-1113. [PMID: 27583713 PMCID: PMC5096993 DOI: 10.1097/psy.0000000000000391] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The postpartum period represents a crucial transition period in which weight gain or loss can affect lifetime obesity risk. This study examined the prevalence of obesity and the influence of childhood abuse and family conflict on postpartum weight among low-income Mexican-origin women. Depressive symptoms and partner support were evaluated as mediators. METHODS At a prenatal assessment, low-income Mexican-origin women (N = 322; mean [SD] age, 27.8 [6.5]) reported on childhood abuse and family conflict. Weight was measured 7 times between 6 weeks and 2 years postpartum and calculated as body mass index. Regression and growth models were used to estimate the impact of childhood abuse, childhood family conflict, partner support, and depressive symptoms on weight and weight change. RESULTS Higher family conflict predicted higher weight across the first (β = .12; p = .037) and second (β = .16; p = .012) postpartum years. Family conflict (β = .17; p = .018) and low partner support (β = -.16; p = .028) also predicted increasing weight in the first year. Partner support partially mediated the effect of childhood abuse on weight change in the first year (p = .031). Depressive symptomatology mediated the effects of childhood abuse and family conflict on weight status in the second year (abuse: p = .005; conflict: p = .023). CONCLUSIONS For low-income Mexican-origin women with a history of childhood abuse or high family conflict, depression and low partner support may be important targets for obesity prevention efforts in the postpartum period.
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Affiliation(s)
- Linda J Luecken
- From the Department of Psychology, Arizona State University, Tempe, Arizona
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Moore BF, Sauder KA, Starling AP, Ringham BM, Glueck DH, Dabelea D. Exposure to secondhand smoke, exclusive breastfeeding and infant adiposity at age 5 months in the Healthy Start study. Pediatr Obes 2017; 12 Suppl 1:111-119. [PMID: 28868814 PMCID: PMC5608262 DOI: 10.1111/ijpo.12233] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 06/03/2017] [Accepted: 06/22/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Infant adiposity may be influenced by several environmental risk factors, but few studies have explored these interactions. OBJECTIVE To examine the interaction between exposure to secondhand smoke and breastfeeding exclusivity on adiposity at age 5 months. METHODS We studied 813 mother-offspring pairs from the longitudinal Healthy Start study. Fat mass and fat-free mass were measured by air displacement plethysmography. Linear regression analyses were used to estimate the association between household smokers (none, any) with fat mass, fat-free mass, percent fat mass, weight-for-age z-score, weight-for-length z-score and BMI-for-age z-score as separate outcomes. Interaction terms between household smokers and breastfeeding exclusivity (<5 months, ≥5 months) were added to separate models. RESULTS The combination of exposure to secondhand smoke and a lack of exclusive breastfeeding was associated with increased adiposity at age 5 months. For example, within the not exclusively breastfed strata, exposure to secondhand smoke was associated with increased fat mass (0.1 kg; 95% CI: 0.0-0.2; P = 0.05). Conversely, within the exclusively breastfed strata, there was virtually no difference in fat mass between exposed and non-exposed infants (coefficient: -0.1; 95% CI: -0.3-0.1; P = 0.25). CONCLUSIONS Our findings may inform new public health strategies with potential relevance for both smoking cessation and obesity prevention.
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Affiliation(s)
- Brianna F Moore
- Department of Epidemiology, Colorado School of Public Health, Aurora CO, USA
| | - Katherine A Sauder
- Department of Pediatrics, University of Colorado School of Medicine, Aurora CO, USA
| | - Anne P Starling
- Department of Epidemiology, Colorado School of Public Health, Aurora CO, USA
| | - Brandy M Ringham
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora CO, USA
| | - Deborah H Glueck
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora CO, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, Aurora CO, USA,Department of Pediatrics, University of Colorado School of Medicine, Aurora CO, USA
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Bhavadharini B, Anjana RM, Deepa M, Jayashree G, Nrutya S, Shobana M, Malanda B, Kayal A, Belton A, Joseph K, Rekha K, Uma R, Mohan V. Gestational Weight Gain and Pregnancy Outcomes in Relation to Body Mass Index in Asian Indian Women. Indian J Endocrinol Metab 2017; 21:588-593. [PMID: 28670545 PMCID: PMC5477449 DOI: 10.4103/ijem.ijem_557_16] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
AIM The aim of the study was to compare the weight gain during pregnancy (using Institute of Medicine guidelines) among Asian Indians across different body mass index (BMI) categories (using World Health Organization Asia Pacific BMI cut points) and to compare the pregnancy outcomes in each of the different BMI categories. METHODOLOGY Retrospective records of 2728 pregnant women attending antenatal clinics and private maternity centers in Chennai, South India, from January 2011 to January 2014 were studied. Pregnancy outcomes were analyzed in relation to BMI and weight gain across different BMI categories. RESULTS Overweight and obese women who gained more weight during pregnancy were at high risk of delivering macrosomic infants (overweight - odds ratio [OR]: 2.3, 95% confidence interval [CI]: 1.1-5.2, P = 0.02 and obese - OR: 1.6, 95% CI: 1.1-2.4, P = 0.01). In addition, obese women who gained more weight were also at high risk of preterm labor (OR: 2.1, 95% CI: 1.1-3.8; P = 0.01), cesarean section (OR: 1.9, 95% CI: 1.4-2.5; P < 0.001), and preeclampsia (OR: 2.8, 95% CI: 1.1-7.2, P = 0.03). Normal weight and overweight women who gained less weight had a protective effect from cesarean section and macrosomia. CONCLUSIONS Overweight/obese women who gained more weight than recommended are at a high risk of developing adverse pregnancy outcomes. Normal and overweight women who gained weight less than recommended have low risk for cesarean section and macrosomia. However, they have a higher (statistically insignificant) risk for low birth weight and preterm birth. This highlights the need for gaining adequate weight during pregnancy.
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Affiliation(s)
- Balaji Bhavadharini
- Department of Diabetology and Epidemiology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Ranjit Mohan Anjana
- Department of Diabetology and Epidemiology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Mohan Deepa
- Department of Diabetology and Epidemiology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Gopal Jayashree
- Department of Obstetrics and Gynecology, Seethapathy Clinic and Hospital, Chennai, Tamil Nadu, India
| | - Subramanyam Nrutya
- Department of Obstetrics and Gynecology, Seethapathy Clinic and Hospital, Chennai, Tamil Nadu, India
| | - Mahadevan Shobana
- Department of Obstetrics and Gynecology, Seethapathy Clinic and Hospital, Chennai, Tamil Nadu, India
| | - Belma Malanda
- Department of Policy and Programmes, International Diabetes Federation, Brussels, Belgium
| | - Arivudainambi Kayal
- Department of Policy and Programmes, International Diabetes Federation, Brussels, Belgium
| | - Anne Belton
- Department of Policy and Programmes, International Diabetes Federation, Brussels, Belgium
| | - Kurian Joseph
- Department of Obstetrics and Gynecology, Joseph Nursing Home, Chennai, Tamil Nadu, India
| | - Kurian Rekha
- Department of Obstetrics and Gynecology, Joseph Nursing Home, Chennai, Tamil Nadu, India
| | - Ram Uma
- Department of Obstetrics and Gynecology, Seethapathy Clinic and Hospital, Chennai, Tamil Nadu, India
| | - Viswanathan Mohan
- Department of Diabetology and Epidemiology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
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Pécheux O, Garabedian C, Mizrahi S, Cordiez S, Deltombe S, Deruelle P. Conséquences maternelles et néonatales de la prise de poids pendant les grossesses gémellaires : les recommandations IOM 2009 traduisent-elles de meilleures issues ? ACTA ACUST UNITED AC 2017; 45:366-372. [DOI: 10.1016/j.gofs.2017.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/17/2017] [Indexed: 10/19/2022]
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45
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Starling AP, Sauder KA, Kaar JL, Shapiro AL, Siega-Riz AM, Dabelea D. Maternal Dietary Patterns during Pregnancy Are Associated with Newborn Body Composition. J Nutr 2017; 147:1334-1339. [PMID: 28539412 DOI: 10.3945/jn.117.248948] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 03/11/2017] [Accepted: 04/26/2017] [Indexed: 01/04/2023] Open
Abstract
Background: Maternal dietary intake during pregnancy may influence offspring growth and adiposity. Specific dietary patterns associated with newborn adiposity have not been identified.Objective: We aimed to identify patterns of maternal dietary intake associated with gestational weight gain (GWG) and fasting glucose during pregnancy and to evaluate whether adherence to these patterns is associated with newborn adiposity.Methods: In the Healthy Start prospective cohort, dietary intake during pregnancy was assessed via 24-h recalls. Reduced-rank regression identified dietary patterns predictive of GWG and fasting glucose. Associations between dietary patterns and newborn fat mass, fat-free mass, and adiposity were estimated by using linear regression models among 764 ethnically diverse mother-infant pairs.Results: Two dietary patterns were identified. Pattern 1, correlated with greater GWG (r = 0.22, P < 0.01), was characterized by a higher consumption of poultry, nuts, cheese, fruits, whole grains, added sugars, and solid fats. Greater adherence to pattern 1 (upper compared with lower tertile) predicted a greater newborn fat-free mass (61 g; 95% CI: 12, 110 g) but no difference in fat mass or adiposity. Pattern 2, correlated with greater maternal fasting glucose (r = 0.16, P < 0.01), was characterized by a higher consumption of eggs, starchy vegetables, solid fats, fruits, and nonwhole grains and a lower consumption of dairy foods, dark-green vegetables, and whole grains. Greater adherence to pattern 2 was associated with a greater newborn birth weight (80 g; 95% CI: 15, 145 g), fat mass (33 g; 95% CI: 8, 59 g), and adiposity (0.9%; 95% CI: 0.3%, 1.6%).Conclusions: Among pregnant women, adherence to a dietary pattern characterized by an intake of poultry, nuts, cheese, and whole grains was associated with greater GWG but not maternal fasting glucose or newborn adiposity. Adherence to a pattern characterized by an intake of eggs, starchy vegetables, and nonwhole grains was associated with higher maternal fasting glucose and greater newborn adiposity. Maternal dietary patterns during pregnancy may influence newborn body composition.
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Affiliation(s)
| | - Katherine A Sauder
- Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO; and
| | - Jill L Kaar
- Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO; and
| | | | - Anna Maria Siega-Riz
- Departments of Public Health Sciences and Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA
| | - Dana Dabelea
- Departments of Epidemiology and.,Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO; and
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46
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Lundqvist A, Sandström H, Bäckström T. The relationship between weight gain during pregnancy and allopregnanolone levels: a longitudinal study. Endocr Connect 2017; 6:253-259. [PMID: 28381564 PMCID: PMC5632720 DOI: 10.1530/ec-17-0046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 04/05/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Large weight gain during pregnancy is a risk factor for complications for mother and fetus. Hunger and satiety are regulated in the hypothalamus, where the gamma-amino-butyric acid system (GABA) has an important role. Allopregnanolone, a progesterone metabolite, increases during pregnancy and is a potent GABA-A receptor modulating steroid. Allopregnanolone has been shown to induce overeating in rodents. The aim was to investigate whether there is a relationship between weight gain and allopregnanolone concentrations during pregnancy in humans. DESIGN A longitudinal, cohort study. METHODS Pregnant women (n = 56) were recruited in primary care in northern Sweden. Allopregnanolone concentrations in plasma were measured using radioimmunoassay and weight was measured in gestational weeks 12 and 35. RESULTS Weight increase correlated significantly to allopregnanolone in late pregnancy increase (rs = 0.320; P = 0.016), indicating a positive relationship between weight increase and allopregnanolone increase. A positive relationship was also noted between allopregnanolone in the 35th gestational week and weight increase. Women who gained ≥11 kg during pregnancy showed higher allopregnanolone concentrations in week 35 and higher increase compared to women who increased <11 kg (P = 0.006 and P = 0.009 resp.). There was no difference in weight or allopregnanolone concentrations at the onset of pregnancy. CONCLUSIONS The results show a relationship between weight gain during pregnancy and increase in allopregnanolone concentrations.
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Affiliation(s)
- Anette Lundqvist
- Department of Public Health and Clinical MedicineFamily Medicine, Umeå University, Umeå, Sweden
| | - Herbert Sandström
- Department of Public Health and Clinical MedicineFamily Medicine, Umeå University, Umeå, Sweden
| | - Torbjörn Bäckström
- Department of Clinical SciencesObstetrics and Gynecology, Umeå University, Umeå, Sweden
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Zaborska KE, Edwards G, Austin C, Wareing M. The Role of O-GlcNAcylation in Perivascular Adipose Tissue Dysfunction of Offspring of High-Fat Diet-Fed Rats. J Vasc Res 2017; 54:79-91. [PMID: 28376507 PMCID: PMC5569708 DOI: 10.1159/000458422] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 01/27/2017] [Indexed: 12/31/2022] Open
Abstract
Perivascular adipose tissue (PVAT), which reduces vascular contractility, is dysfunctional in the male offspring of rats fed a high-fat diet (HFD), partially due to a reduced NO bioavailability. O-GlcNAcylation of eNOS decreases its activity, thus we investigated the role of O-GlcNAcylation in the prenatal programming of PVAT dysfunction. Female Sprague-Dawley rats were fed either a control (10% fat) or an obesogenic HFD (45% fat) diet for 12 weeks prior to mating, and throughout pregnancy and lactation. Offspring were weaned onto the control diet and were killed at 12 and 24 weeks of age. Mesenteric arteries from the 12-week-old offspring of HFD dams (HFDO) contracted less to U46619; these effects were mimicked by glucosamine in control arteries. PVAT from 12- and 24-week-old controls, but not from HFDO, exerted an anticontractile effect. Glucosamine attenuated the anticontractile effect of PVAT in the vessels from controls but not from HFDO. AMP-activated protein kinase (AMPK) activation (with A769662) partially restored an anticontractile effect in glucosamine-treated controls and HFDO PVAT. Glucosamine decreased AMPK activity and expression in HFDO PVAT, although phosphorylated eNOS expression was only reduced in that from males. The loss of anticontractile effect of HFDO PVAT is likely to result from increased O-GlcNAcylation, which decreased AMPK activity and, in males, decreased NO bioavailability.
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Affiliation(s)
- Karolina E Zaborska
- Institute of Cardiovascular Sciences, University of Manchester, Manchester, UK
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Villanueva-Ortega E, Garcés-Hernández M, Garibay Nieto G. Pre- and post-natal nutritional factors in the metabolic regulation of obesity. REVISTA MÉDICA DEL HOSPITAL GENERAL DE MÉXICO 2017. [DOI: 10.1016/j.hgmx.2016.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Chang T, Moniz MH, Plegue MA, Sen A, Davis MM, Villamor E, Richardson CR. Characteristics of women age 15-24 at risk for excess weight gain during pregnancy. PLoS One 2017; 12:e0173790. [PMID: 28291802 PMCID: PMC5349657 DOI: 10.1371/journal.pone.0173790] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 02/27/2017] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Excess weight gain during pregnancy is a serious health concern among young pregnant women in the US. This study aimed to characterize young women at highest risk for gaining over the recommended amount of weight during pregnancy. METHODS Using a database that is representative of births in large U.S. cities, The Fragile Families and Child Wellbeing Study, we identified mothers of singleton term-infants age 15-24 years at the time of delivery. Institute of Medicine guidelines were used to categorize each mother's weight gain as less than, within, or more than recommended during pregnancy. Multinomial logistic regression models for weight gain category were performed, controlling for age, race/ethnicity, federal poverty level (FPL), health status, and prepregnancy BMI. RESULTS Among the weighted sample (n = 1,034, N = 181,375), the mean (SD) age was 21 (3) years, 32% were black, 39% were Hispanic, 44% reported income under the Federal Poverty Level, 45% were overweight or obese before pregnancy, and 55% gained more weight than recommended during pregnancy. Women who were overweight or obese before pregnancy were at increased risk for gaining more pregnancy weight than recommended, compared to normal-weight women (adjusted Relative Risk Ratio (RRR) = 3.82, p = 0.01; RRR = 3.27, p = 0.03, respectively). Hispanics were less likely than non-Hispanics to gain more weight than recommended (RRR = 0.39, p = 0.03). CONCLUSIONS The majority of mothers ages 15-24 gained excess weight during pregnancy, a strong risk factor for later obesity. Prepregnancy overweight or obesity and non-Hispanic ethnicity predicted excess pregnancy weight gain. Interventions and policies should target these high-risk young women to prevent excess weight gain.
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Affiliation(s)
- Tammy Chang
- Department of Family Medicine, Medical School, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Michelle H. Moniz
- Department of Obstetrics and Gynecology, Medical School, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Melissa A. Plegue
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Ananda Sen
- Department of Family Medicine and Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Matthew M. Davis
- Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, United States of America
| | - Eduardo Villamor
- Department of Epidemiology, School of Public Health and Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Caroline R. Richardson
- Department of Family Medicine, Medical School, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States of America
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50
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O'brien CM, Poprzeczny A, Dodd JM. Implications of maternal obesity on fetal growth and the role of ultrasound. Expert Rev Endocrinol Metab 2017; 12:45-58. [PMID: 30058877 DOI: 10.1080/17446651.2017.1271707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Over fifty percent of women entering pregnancy are overweight or obese. This has a significant impact on short and long term maternal and infant health outcomes, and the intergenerational effects of obesity are now a major public health problem globally. Areas covered: There are two major pathways contributing to fetal growth. Glucose and insulin directly affect growth, while other substrates such as leptin, adiponectin and insulin-like growth factors indirectly influence growth through structural and morphological effects on the placenta, uteroplacental blood flow, and regulation of placental transporters. Advances in ultrasonography over the past decade have led to interest in the prediction of the fetus at risk of overgrowth and adiposity utilizing both standard ultrasound biometry and fetal body composition measurements. However, to date there is no consensus regarding the definition of fetal overgrowth, its reporting, and clinical management. Expert commentary: Maternal dietary intervention targeting the antenatal period appear to be too late to sufficiently affect fetal growth. The peri-conceptual period and early pregnancy are being evaluated to determine if the intergenerational effects of maternal obesity can be altered to improve newborn, infant and child health.
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Affiliation(s)
- Cecelia M O'brien
- a School of Paediatrics and Reproductive Health, and Robinson Research Institute , University of Adelaide , Adelaide , Australia
- b Maternal Fetal Medicine Unit , John Hunter Hospital , Newcastle , Australia
| | - Amanda Poprzeczny
- a School of Paediatrics and Reproductive Health, and Robinson Research Institute , University of Adelaide , Adelaide , Australia
- c Department of Obstetrics and Gynaecology , Lyell McEwin Hospital , Adelaide , Australia
| | - Jodie M Dodd
- a School of Paediatrics and Reproductive Health, and Robinson Research Institute , University of Adelaide , Adelaide , Australia
- d Department of Perinatal Medicine, Women's and Babies Division , Women's and Children's Hospital , Adelaide , Australia
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