Body composition, dietary intake, and energy expenditure in nonobese, prepubertal children of obese and nonobese biological mothers

Parental Influence on Models of Primary Prevention of Cardiovascular Disease in Children

BACKGROUND

Lifestyle behaviors such as overeating and physical inactivity contribute significantly to CVD, the leading cause of morbidity and mortality among adults globally. CVD risk factors that begin in children often track into adulthood. Parents are believed to influence the health behaviors of their children.

OBJECTIVE

To review the literature on parental influence on children's health beliefs and behaviors, particularly eating and exercise behaviors as indicators of CV health, school-based CVD risk reduction programs, and racial/ethnic, gender and socioeconomic considerations for models of primary prevention of CVD in children.

METHODS

Seventeen studies that included parents as either a source of information, change agent or participant in a CVD risk reduction intervention were identified searching the Medline, CINAHL and PsycINFO databases from 1980 through 2002.

RESULTS

Children's lifestyle health beliefs and behaviors are significantly influenced by positive parental modeling and involvement in exercise and healthy eating; parental influence on children's behavior lasts beyond adolescence; parents are effective teachers of health habits at home when prompted by health educators; and parental influences vary by ethnicity/race, socioeconomics and gender.

CONCLUSIONS

A broader base of knowledge that is socioculturally sensitive must be developed about what parents and children believe is healthy, how parents model beliefs and behaviors for their children, and how to build self-efficacy for positive health behaviors.

Trends in the association of parental history of obesity over 60 years

OBJECTIVE

The association of familial as compared to genetic factors in the current obesogenic environment, compared with earlier, leaner time periods, is uncertain.

METHODS

Participants from the Framingham Heart Study were classified according to parental obesity status in the Original, Offspring, and Third Generation cohorts; mean BMI levels were estimated and we compared the association of parental history across generations. Finally, a genetic risk score comprised of 32 well-replicated single nucleotide polymorphisms for BMI was examined in association with BMI levels in 1948, 1971, and 2002.

RESULTS

BMI was 1.49 kg/m2 higher per each affected parent among the Offspring, and increased to 2.09 kg/m2 higher among the Third Generation participants (P-value for the cohort comparison=0.007). Parental history of obesity was associated with increased weight gain (P < 0.0001) and incident obesity (P = 0.009). Despite a stronger association of parental obesity with offspring BMI in more contemporary time periods, we observed no change in the effect size of a BMI genetic risk score from 1948 to 2002 (P = 0.11 for test of trend across the time periods).

CONCLUSIONS

The association of parental obesity has become stronger in more contemporary time period, whereas the association of a BMI genetic risk score has not changed.

Maternal obesity: how big an impact does it have on offspring prenatally and during postnatal life?

Obesity is increasing at an epidemic rate in women of reproductive age. Not only does obesity during pregnancy lead to increased maternal health concerns, it is also linked to an increase in adiposity and components of the metabolic syndrome in the children and grandchildren of obese women. The potential transgenerational impact of maternal obesity on the health of future generations will undoubtedly result in increasing healthcare costs for society. This review will describe what is known about the specific impacts of maternal obesity on offspring in the human population as well as discuss how controlled animal experiments have shed light on the specific physiological mechanisms involved. Furthermore, preliminary experiments are presented describing potential dietary methods for preventing obesity-induced programming of offspring health concerns in postnatal life.

Dietary sources of fiber intake and its association with socio-economic factors among Flemish preschool children

The objectives were to assess total dietary fiber intake, identify the major sources of dietary fiber, and examine its association with socio-economic factors among Flemish preschoolers. Three-day estimated dietary records were collected from a representative sample of preschoolers 2.5-6.5 years old (n = 661; 338 boys, 323 girls). The mean dietary fiber intake (13.4 g/d) was lower than the intake level recommended by the Belgian Superior Health Council (70% boys and 81% girls below the guidelines). The most important contributor was the group of bread and cereals (29.5%), followed by fruits (17.8%), potatoes and grains (16.0%), energy-dense, low-nutritious foods (12.4%), and vegetables (11.8%). Multiple linear regression analyses showed that total fiber intake was associated with maternal education and parents' employment. Overall, fiber intakes from high-nutritious foods (vegetables and fruits) were higher in preschoolers of higher educated mothers and those with one or both parents being employed. In conclusion, the majority of the preschoolers had dietary fiber intakes below the recommended level. Hence, dietary fiber should be promoted among parents of preschoolers and low socio-economic status families should be addressed in particular.

Dietary intakes and familial history of obesity

PURPOSE

To compare dietary intakes of individuals with and without familial history of obesity (FHO) with recommendations from Canada's Food Guide to Healthy Eating (CFGHE).

METHODS

This cross-sectional study recruited 197 women and 129 men with a body mass index of less than 30kg/m(2) from the Quebec City metropolitan area. A dietitian obtained their dietary intakes, using a food frequency questionnaire.

RESULTS

Daily energy, macronutrient, and fibre intakes were not significantly different between individuals with and without FHO. No significant differences in the proportion of individuals who achieved the minimum CFGHE recommendations were observed between individuals with and without FHO.

CONCLUSIONS

Findings of our study suggest that individuals with and without FHO have comparable dietary intakes when compared to Canadian dietary guidelines.

Metformin treatment for four years to reduce total and visceral fat in low birth weight girls with precocious pubarche

CONTEXT AND OBJECTIVE

A low birth weight (LBW) tends to be followed by overweight due to an excess of fat, including visceral fat. LBW girls with precocious pubarche (PP) (pubic hair < 8 yr) are at high risk for developing an adipose state of hyperinsulinemic androgen excess that leads toward early menarche. We explored the effects of insulin sensitization with metformin in LBW-PP girls. SETTING, DESIGN, PATIENTS, INTERVENTION: Prepubertal LBW girls with PP (mean body weight 2.4 kg; age 7.9 yr; body mass index 18.4 kg/m(2)) were studied. Girls were randomly assigned to remain untreated (n=19) or receive metformin for 4 yr (n = 19; 425 mg/d for 2 yr, then 850 mg/d for 2 yr).

MAIN OUTCOMES

At the start and after 4 yr, height, weight, fasting insulin, glucose, IGF-I, testosterone, lipids, leptin, high molecular weight adiponectin, body composition by absorptiometry, abdominal fat partitioning (only 4 yr) by magnetic resonance imaging, and menarcheal status were determined.

RESULTS

Metformin-treated girls gained on average 5.5 kg (or approximately 50%) less fat, after 4 yr were less insulin resistant and less hyperandrogenic, had lower IGF-I levels and a less atherogenic lipid profile, and were less likely to be post-menarcheal than untreated girls, whereas their gain in height, lean mass, and bone mineral density were similar. After 4 yr, untreated girls had more visceral fat, a higher ratio of visceral-to-sc fat, and a higher leptin-to-high molecular weight adiponectin ratio (all approximately 50% higher) than metformin-treated girls.

CONCLUSION

Long-term metformin treatment appears to reduce total and visceral fat in LBW-PP girls, and to delay menarche without attenuating linear growth, thereby opening the perspective that adult height may be increased.

State of the Art Reviews: Development of Fitness in Children: The Influence of Gender and Physical Activity

The influences of gender and physical activity on the development of fitness are reviewed from early childhood to late adolescence. Changes in parameters of fitness prior to puberty are driven predominantly by neuroendocrine-mediated factors, although physical activity level may be influenced largely by sociocultural factors prior to and following puberty. Thus, it is still unclear to what extent environment versus genetics accounts for gender differences in fitness. Future studies need to account for all factors known to explain gender differences in fitness to better differentiate intrinsic versus environmental causes. Consequently, one must consider if and to what extent a gender comparison study actually reveals true, inherent gender differences compared with sociocultural and/or cultural influences. Nevertheless, differences in fitness between girls and boys that are influenced by sociocultural factors should be considered when devising programs to promote physical activity and enhance fitness in youth. Fundamentally, the role of parents and primary caregivers in modeling physical activity and influencing the fitness level of their child cannot be overestimated.

Mechanical Efficiency of Normal-Weight Prepubertal Boys Predisposed to Obesity

PURPOSE

To compare 1) energy expenditure during rest and during submaximal exercise, and 2) the mechanical efficiency of normal-weight boys liable to obesity with normal-weight boys who are not liable to obesity.

METHODS

Two groups of prepubertal boys, aged 9-12 yr were compared, one with both parents of normal weight (NP, 20 < or = BMI < or = 27, N = 20) and the other (N = 20) with one obese parent (OP, BMI > or = 30).

RESULTS

No significant differences were found between the two groups in the anthropometric measurements (means +/- SD): body mass (32.9 +/- 5.4 and 31.5 +/- 3.1 kg, NP and OP, respectively), stature (141.0 +/- 6.2 and 140.0 +/- 5.5 cm, NP and OP, respectively), and body fat (16.6 +/- 3.5 and 15.1 +/- 3.5%, NP and OP, respectively). Likewise, there were no differences in the reported physical activity habits. No differences were observed in the resting metabolic rate values between the two groups (5.071 +/- 0.351 and 4.956 +/- 0.386 MJ x d(-1) , NP and OP, respectively). Submaximal VO2 at 30, 45, and 60 W was similar in the two groups (0.63 +/- 0.05, 0.78 +/- 0.06, and 0.92 +/- 0.08; and 0.63 +/- 0.06, 0.78 +/- 0.08, and 0.95 +/- 0.08 L x min(-1), NP and OP, respectively). Likewise, the mechanical efficiency, calculated at 30, 45, and 60 W was similar in both groups (19.5 +/- 2.3, 21.8 +/- 2.2, 23.4 +/- 2.5%; and 19.5 +/- 3.0, 21.9 +/- 2.9, 22.6 +/- 2.5%, NP and OP, respectively. No differences were found between groups in their VO2peak (38.4 +/- 3.8 and 40.4 +/- 4.9 mL x kg(-1) x min(-1), NP and OP, respectively).

CONCLUSION

These data suggest that energy expenditure during rest and exercise may not be used to predict future obesity in normal-weight prepubertal boys predisposed to obesity.

The relationship between parental nutritional status and overweight children/adolescents in Rio de Janeiro, Brazil

BACKGROUND

The association between overweight parents and overweight children/adolescents was investigated in Rio de Janeiro, Brazil between 1995 and 1996, controlling for the influence of socio-economic and demographic factors.

METHODS

Data were obtained from a two-stage, residence-based, random sample survey of children and adolescents aged 6-19 years and their parents. Body mass index (BMI) was used to classify nutritional status. Initially, a logistic regression model was built, using an indicator of parental weight (maternal BMI) as one of the independent variables and the child/adolescent's BMI as the dependent variable. Following that, the association between socio-economic and demographic variables and overweight children/adolescents was analysed in a univariate analysis. These variables were pre-selected for inclusion in the logistic model, provided that their levels of statistical significance were below P=0.25, and were added to the model individually according to the order of association strength in the univariate analysis. Finally, variables were retained in this model at a significance level of P=0.05.

RESULTS

This study found that 20.7% of girls and 26.9% of boys were overweight, with a larger prevalence among children aged less than 9 years. In addition to maternal BMI, the predictors of overweight children and adolescents were age, gender and the number of people in a house.

CONCLUSIONS

These results demonstrate the relationship between maternal nutritional status and overweight children and adolescents, suggesting that obesity-prevention programmes should be focused on the family.

Longitudinal calcium intake is negatively related to children's body fat indexes

OBJECTIVE

To determine if dietary calcium was negatively related to children's body fat (BF), if BF indexes and calcium intakes changed over time, and to identify variables related to BF and calcium intake.

DESIGN

Percent BF and kg BF were assessed by dual energy x-ray absorptiometry (DEXA) in 8-year-old children. In a prospective design, height, weight, dietary intakes, and related variables were monitored longitudinally from ages 2 months to 8 years during in-home interviews.

SUBJECTS

Fifty-two white children, (n=25 boys, 27 girls) participated in a longitudinal study with their mothers. At 8 years of age, mean BMI was 17.3+/-2.1 (standard deviation) for boys and 17.1+/-2.5 for girls.

ANALYSES

Regression analysis of all variables, followed by further regression analysis on selected models.

RESULTS

At 8 years, percent BF was 22.7+/-6.7 for boys and 26.2+/-7.9 for girls, as assessed by DEXA. Dietary calcium (mg) and polyunsaturated fat intake (g) were negatively related to percent BF (P=.02 to.04) in 3 statistical models, which predicted 28% to 34% of the variability in BF among children. Variables positively associated with percent BF were total dietary fat (g) or saturated fat (g), female gender, sedentary activity (hours/day), father's BMI, and mothers' percent BF. Calcium intakes were significantly correlated over time. Dietary variety was positively related to calcium intake, and intakes of carbonated beverages and other sweetened beverages were negatively related.

APPLICATIONS/CONCLUSIONS

Children should be strongly encouraged to regularly include calcium-rich foods and beverages in their diets.

Characteristic lifestyles in 6-year-old children with obese parents: Results of the toyama birth cohort study

OBJECTIVE

The aim of this study was to identify characteristic lifestyles in children with obese parents.

METHODS

8,030 children (4,072 males and 3,958 females) aged 6 to 7 years were investigated. A questionnaire relating to the lifestyles of children was distributed through elementary schools for completion by parents. The heights and weights of parents were self-reported. A parent with a body mass index (weight in kilograms divided by the square of height in meters) greater than the 90th percentile for gender (26.7 kg/m(2) for fathers and 24.3 kg/m(2) for mothers) was defined as an obese parent. A chi-square test for each trend was applied to evaluate an increasing trend in the frequency or level of each lifestyle in children with obese parents.

RESULTS

Children with obese parents were significantly associated with increasing trends in the proportions categorized by irregular intake of breakfast, faster eating, longer TV watching, and shorter sleeping hours.

CONCLUSIONS

These lifestyles are considered to be possible risk factors for the development of obesity. These characteristic lifestyles observed in children with obese parents could strengthen the relationship between child and parental body compositions, in addition to the genetic predisposition to obesity in children with obese parents. These findings indicate that education with lifestyle modification for obese parents will be required to prevent further weight gain in children with obese parents.