The impact of lifestyle and socioeconomic parameters on body fat level in early childhood

A predictive model combining clinical characteristics and nutritional risk factors for overall survival after umbilical cord blood transplantation

BACKGROUND

Umbilical cord blood transplantation (UCBT) is a curable therapy for hematological disease; however, the impact of nutritional status on UCBT outcomes remains controversial. To evaluate the joint effect of clinical characteristics and nutritional status on the prognosis of patients who underwent UCBT, we screened various factors to establish a predictive model of overall survival (OS) after UCBT.

METHODS

We performed an integrated clinical characteristic and nutritional risk factor analysis and established a predictive model that could be used to identify UCBT recipients with poor OS. Internal validation was performed by using the bootstrap method with 500 repetitions.

RESULTS

Four factors, including disease status, conditioning regimen, calf skinfold thickness and albumin level, were identified and used to develop a risk score for OS, which showed a positive predictive value of 84.0%. A high-risk score (≥ 2.225) was associated with inferior 3-year OS post-UCBT [67.5% (95% CI 51.1-79.4%), P = 0.001]. Then, we built a nomogram based on the four factors that showed good discrimination with a C-index of 0.833 (95% CI 0.743-0.922). The optimism-corrected C-index value of the bootstrapping was 0.804. Multivariate analysis suggested that a high calf skinfold thickness (≥ 20.5 mm) and a low albumin level (< 33.6 g/L) conferred poor disease-free survival (DFS).

CONCLUSION

The predictive model combining clinical and nutritional factors could be used to predict OS in UCBT recipients, thereby promoting preemptive treatment.

Paths towards a healthier BMI among short and adequate sleepers: A pathway network analysis considering movement behaviors in low-income preschoolers

INTRODUCTION

Short sleep duration has been seen as a predictor of higher body mass index (BMI) in youth. Sleep duration varies substantially along early childhood, and the paths towards a healthier BMI, considering the other movement behaviors (physical activity-PA and screen time) are unexplored in preschoolers.

AIM

To construct a sleep-BMI model to capture the direct and indirect paths to intervening towards a healthier BMI, according to low-income preschoolers' compliance with the other movement behaviors.

METHODS

Two hundred and seventy two preschoolers (4.5 ± 0.0; 138 boys) participated in the study. Sleep and screen time (ST) were assessed in a face-to-face interview with primary caregivers. PA was assessed using accelerometer (wGT3X-BT). Preschoolers were categorized as compliant or not with sleep, screen time, total and moderate to vigorous PA recommendations. BMIz-score was calculated according to preschoolers' sex and age. All the assessed variables, besides sex and age were included in a Network Pathway Analysis (NPA) according to age as nodes.

RESULTS

At 3 years old, a direct and negative path between sleep-BMIz score was observed. At four and 5 years old, this relationship became positive. Further, girls were more compliant with sleep, ST and total PA recommendations. Total PA (TPA) showed the highest expected influence value in the general, 3 and 4 years old NPA.

CONCLUSION

The NPA analysis showed different directions for the relationship between sleep and BMIz score, according to age. Intervention strategies to a healthier BMI among preschoolers compliant or not with sleep recommendations should focus in increasing TPA.

The impact of neonatal parameters and parental factors on body fat level in early childhood

Parental and pregnancy characteristics can affect proportions and tissue composition of the child's bodyand thereforecan influence their present and future health, as well as overall wellbeing. The aim of this study was to examine the differences between selected parental and birth-related parameters among preschool (3-7 years of age) children of varying adiposity status (n=541 girls and n=571 boys).The research was carried out in 20 randomly selected kindergartens in Krakow (Poland). Thickness of 6 skinfolds (biceps, triceps, subscapular, suprailiac, abdominal and calf) was measured. Sum of skinfolds was calculated and participants were divided into low, normal or high body fat groups. Birth-related characteristics were obtained using a questionnaire filled out by the children's parents. Children of mothers who gained the most gestational weight were characterised by high adiposity. Preschoolers with the highest birth weight, body length and head circumference had the greatest adiposity. Children of relatively younger mothers had higher body fat, in comparison to the rest of the study group. Parents of preschoolers in the high adiposity category were characterised by a greater body mass, compared to the parents of children in other body fat groups and that boys with the highest adiposity relatively more often had a close relative with obesity. Children in varying adiposity categories differed in terms of some birth-related factors. Particular attention should be paid to familial and parental characteristics, because they may influence the child's predisposition to excess adiposity deposition later in life.