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Martenies SE, Oloo A, Magzamen S, Ji N, Khalili R, Kaur S, Xu Y, Yang T, Bastain TM, Breton CV, Farzan SF, Habre R, Dabelea D. Independent and joint effects of neighborhood-level environmental and socioeconomic exposures on body mass index in early childhood: The environmental influences on child health outcomes (ECHO) cohort. ENVIRONMENTAL RESEARCH 2024; 253:119109. [PMID: 38751004 DOI: 10.1016/j.envres.2024.119109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 04/19/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024]
Abstract
Past studies support the hypothesis that the prenatal period influences childhood growth. However, few studies explore the joint effects of exposures that occur simultaneously during pregnancy. To explore the feasibility of using mixtures methods with neighborhood-level environmental exposures, we assessed the effects of multiple prenatal exposures on body mass index (BMI) from birth to age 24 months. We used data from two cohorts: Healthy Start (n = 977) and Maternal and Developmental Risks from Environmental and Social Stressors (MADRES; n = 303). BMI was measured at delivery and 6, 12, and 24 months and standardized as z-scores. We included variables for air pollutants, built and natural environments, food access, and neighborhood socioeconomic status (SES). We used two complementary statistical approaches: single-exposure linear regression and quantile-based g-computation. Models were fit separately for each cohort and time point and were adjusted for relevant covariates. Single-exposure models identified negative associations between NO2 and distance to parks and positive associations between low neighborhood SES and BMI z-scores for Healthy Start participants; for MADRES participants, we observed negative associations between O3 and distance to parks and BMI z-scores. G-computations models produced comparable results for each cohort: higher exposures were generally associated with lower BMI, although results were not significant. Results from the g-computation models, which do not require a priori knowledge of the direction of associations, indicated that the direction of associations between mixture components and BMI varied by cohort and time point. Our study highlights challenges in assessing mixtures effects at the neighborhood level and in harmonizing exposure data across cohorts. For example, geospatial data of neighborhood-level exposures may not fully capture the qualities that might influence health behavior. Studies aiming to harmonize geospatial data from different geographical regions should consider contextual factors when operationalizing exposure variables.
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Affiliation(s)
- Sheena E Martenies
- Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA; Division of Nutritional Sciences, University of Illinois Urbana-Champaign, Urbana, IL, USA; Family Resiliency Center, University of Illinois Urbana-Champaign, Urbana, IL, USA.
| | - Alice Oloo
- Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Sheryl Magzamen
- Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | - Nan Ji
- Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Roxana Khalili
- Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Simrandeep Kaur
- Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Yan Xu
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA
| | - Tingyu Yang
- Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Theresa M Bastain
- Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carrie V Breton
- Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Shohreh F Farzan
- Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rima Habre
- Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA
| | - Dana Dabelea
- Epidemiology, Colorado School of Public Health, Aurora, CO, USA; Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Yang Z, Lai J. Gestational weight gain velocity during each trimester is critical for both maternal health and birth outcomes in China. MATERNAL & CHILD NUTRITION 2024; 20:e13597. [PMID: 38415378 PMCID: PMC11168350 DOI: 10.1111/mcn.13597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Affiliation(s)
- Zhenyu Yang
- National Institute for Nutrition and HealthChinese Center for Disease Control and PreventionBeijingChina
| | - Jianqiang Lai
- Chinese Center for Disease Control and PreventionBeijingChina
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Dugandzic R, Konstantelos N, Yu Y, Lavigne E, Srugo S, Lang JJ, Larsen K, Pollock T, Villeneuve P, Thomson EM, MacPherson M, Dales R, Cakmak S. Associations between paediatric obesity, chemical mixtures and environmental factors, in a national cross-sectional study of Canadian children. Pediatr Obes 2024:e13117. [PMID: 38872449 DOI: 10.1111/ijpo.13117] [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: 03/02/2023] [Revised: 12/19/2023] [Accepted: 02/19/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Whilst single chemical exposures are suspected to be obesogenic, the combined role of chemical mixtures in paediatric obesity is not well understood. OBJECTIVES We aimed to evaluate the potential associations between chemical mixtures and obesity in a population-based sample of Canadian children. METHODS We ascertained biomonitoring and health data for children aged 3-11 from the cross-sectional Canadian Health Measures Survey from 2007 to 2019. Several chemicals of interest were measured in blood or urine and paediatric obesity was defined based on measured anthropometrics. Using quantile-based G computational analysis, we quantified the effects of three chemical mixtures selected a priori. Models were adjusted for sociodemographic and environmental factors identified through a directed acyclic graph. Results are presented through adjusted relative risks (RR) with 95% confidence intervals (95% CI). RESULTS We included 9147 children. Of these, 24.1% were overweight or obese. Exposure to the mixture of bisphenol A, acrylamide, glycidamide, metals, parabens and arsenic increased the risk of childhood overweight or obesity by 45% (95% CI 1.09, 1.93), obesity by 109% (95% CI 1.27, 3.42) and central obesity by 82% (95% CI 1.30, 2.56). CONCLUSIONS Our findings support the role of early childhood chemical exposures in paediatric obesity and the potential combined effects of chemicals.
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Affiliation(s)
- Rose Dugandzic
- Office of Environmental Health, Health Canada, Ottawa, Ontario, Canada
| | - Natalia Konstantelos
- Office of Environmental Health, Health Canada, Ottawa, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Yamei Yu
- Office of Environmental Health, Health Canada, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Eric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Sebastian Srugo
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Justin J Lang
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Kristian Larsen
- Office of Environmental Health, Health Canada, Ottawa, Ontario, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
- Department of Geography and Planning, University of Toronto, Toronto, Ontario, Canada
- Department of Geography and Environmental Studies, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Tyler Pollock
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Paul Villeneuve
- School of Mathematics and Statistics, Carleton University, Ottawa, Ontario, Canada
| | - Errol M Thomson
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Robert Dales
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Sabit Cakmak
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
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Zhang X, Liu J, Ni Y, Yi C, Fang Y, Ning Q, Shen B, Zhang K, Liu Y, Yang L, Li K, Liu Y, Huang R, Li Z. Global Prevalence of Overweight and Obesity in Children and Adolescents: A Systematic Review and Meta-Analysis. JAMA Pediatr 2024:2819322. [PMID: 38856986 PMCID: PMC11165417 DOI: 10.1001/jamapediatrics.2024.1576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/17/2024] [Indexed: 06/11/2024]
Abstract
Importance Overweight and obesity in childhood and adolescence is a global health issue associated with adverse outcomes throughout the life course. Objective To estimate worldwide prevalence of overweight and obesity in children and adolescents from 2000 to 2023 and to assess potential risk factors for and comorbidities of obesity. Data Sources MEDLINE, Web of Science, Embase, and Cochrane. Study Selection The inclusion criteria were: (1) studies provided adequate information, (2) diagnosis based on body mass index cutoffs proposed by accepted references, (3) studies performed on general population between January 2000 and March 2023, (4) participants were younger than 18 years. Data Extraction and Synthesis The current study was performed in accordance with the Meta-analysis of Observational Studies in Epidemiology guidelines. DerSimonian-Laird random-effects model with Free-Tukey double arcsine transformation was used for data analysis. Sensitivity analysis, meta-regression, and subgroup analysis of obesity among children and adolescents were conducted. Main Outcomes and Measures Prevalence of overweight and obesity among children and adolescents assessed by World Health Organization, International Obesity Task Force, the US Centers for Disease Control and Prevention, or other national references. Results A total of 2033 studies from 154 different countries or regions involving 45 890 555 individuals were included. The overall prevalence of obesity in children and adolescents was 8.5% (95% CI 8.2-8.8). We found that the prevalence varied across countries, ranging from 0.4% (Vanuatu) to 28.4% (Puerto Rico). Higher prevalence of obesity among children and adolescents was reported in countries with Human Development Index scores of 0.8 or greater and high-income countries or regions. Compared to 2000 to 2011, a 1.5-fold increase in the prevalence of obesity was observed in 2012 to 2023. Substantial differences in rates of obesity were noted when stratified by 11 risk factors. Children and adolescents with obesity had a high risk of depression and hypertension. The pooled estimates of overweight and excess weight in children and adolescents were 14.8% (95% CI 14.5-15.1) and 22.2% (95% CI 21.6-22.8), respectively. Conclusions and Relevance This study's findings indicated 1 of 5 children or adolescents experienced excess weight and that rates of excess weight varied by regional income and Human Development Index. Excess weight among children and adolescents was associated with a mix of inherent, behavioral, environmental, and sociocultural influences that need the attention and committed intervention of primary care professionals, clinicians, health authorities, and the general public.
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Affiliation(s)
- Xinyue Zhang
- Division of Thyroid Surgery, Department of General Surgery, Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
- Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Jiaye Liu
- Division of Thyroid Surgery, Department of General Surgery, Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Frontiers Medical Center, Tianfu Jincheng Laboratory, Sichuan University, Chengdu, China
| | - Yinyun Ni
- Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Cheng Yi
- Division of Thyroid Surgery, Department of General Surgery, Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Yiqiao Fang
- Division of Thyroid Surgery, Department of General Surgery, Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Qingyang Ning
- Division of Thyroid Surgery, Department of General Surgery, Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Bingbing Shen
- Division of Thyroid Surgery, Department of General Surgery, Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Kaixiang Zhang
- Division of Thyroid Surgery, Department of General Surgery, Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Yang Liu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Lin Yang
- Department of Gynecology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Kewei Li
- Department of Pediatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yong Liu
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Rui Huang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Zhihui Li
- Division of Thyroid Surgery, Department of General Surgery, Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
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5
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Panzeri C, Pecoraro L, Dianin A, Sboarina A, Arnone OC, Piacentini G, Pietrobelli A. Potential Micronutrient Deficiencies in the First 1000 Days of Life: The Pediatrician on the Side of the Weakest. Curr Obes Rep 2024; 13:338-351. [PMID: 38512555 DOI: 10.1007/s13679-024-00554-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE OF REVIEW This study is to examine potential micronutrient deficiencies and any need for supplementation in children following specific diet plans in the first 1000 days of life. RECENT FINDINGS Optimal nutrition in the first 1000 days of life has a lifelong positive impact on child development. Specific intrauterine and perinatal factors, pathological conditions, and dietary restrictions can represent potential risk factors for micronutrient deficiencies in the first 1000 days of life, which can have negative systemic consequences. Preterm and low-birth-weight infants are intrinsically at risk because of immature body systems. Children affected by cystic fibrosis are prone to malnutrition because of intestinal malabsorption. The risk of micronutrient deficiency can increase in various situations, including but not limited to children following selective dietary regimens (vegetarian and vegan diets and children affected by specific neuropsychiatric conditions) or specific dietary therapies (children affected by food allergies or specific metabolic disorders and children following restricted diet as a part of therapeutic approach, i.e., ketogenic diet for epilepsy). In light of this situation, the micronutrient status in these categories of children should be investigated in order to tailor strategies specific to the individual's metabolic needs, with a particular focus on deficiencies which can impair or delay the physical and cognitive development of children, namely, vitamin B12, vitamin D and folic acid, as well as oligo-elements such as iron, zinc, calcium, sodium, magnesium, and phosphorus, and essential fatty acids such as omega-3. Identification of micronutrient deficiency in the first 1000 days of life and timely supplementation proves essential to prevent their long-term consequences.
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Affiliation(s)
- Carolà Panzeri
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, P.Le Stefani, 1 - 37126, Verona, Italy
| | - Luca Pecoraro
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, P.Le Stefani, 1 - 37126, Verona, Italy.
| | - Alice Dianin
- Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Pediatric Clinic, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Andrea Sboarina
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, P.Le Stefani, 1 - 37126, Verona, Italy
| | - Olivia C Arnone
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, P.Le Stefani, 1 - 37126, Verona, Italy
| | - Giorgio Piacentini
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, P.Le Stefani, 1 - 37126, Verona, Italy
| | - Angelo Pietrobelli
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, P.Le Stefani, 1 - 37126, Verona, Italy
- Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA
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Chen M, Strodl E, Yang W, Yin X, Wen G, Sun D, Xian D, Zhao Y, Chen W. Independent and Joint Effects of Prenatal Incense-Burning Smoke Exposure and Children's Early Outdoor Activity on Preschoolers' Obesity. TOXICS 2024; 12:329. [PMID: 38787109 PMCID: PMC11126066 DOI: 10.3390/toxics12050329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/18/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024]
Abstract
Incense burning is a significant source of indoor air pollution in many Asian regions. There is emerging evidence that maternal prenatal exposure to incense-burning smoke may be a risk factor for childhood obesity. We aimed to extend this new line of research by investigating the independent and joint effect of incense-burning smoke exposure, and children's outdoor activity in early life, on preschoolers' obesity. A total of 69,637 mother-child dyads were recruited from all kindergartens in the Longhua District of Shenzhen, China. Information on sociodemographic characteristics, maternal exposure to incense-burning smoke (IBS) during pregnancy, and frequency and duration of outdoor activity at the age of 1-3 years was collected by a self-administered questionnaire. In addition, the heights and weights of the children were measured by the research team. Logistic regression models and cross-over analyses were conducted to investigate the independent and combined effects of maternal exposure to incense-burning smoke during pregnancy and children's early outdoor activity on obesity in preschoolers. We found that prenatal exposure to incense-burning smoke increased the risk of the presence of obesity in preschoolers' (AOR = 1.13, 95% CI = 1.03-1.23). Additionally, lower frequencies (<3 times/week) or shorter durations (<60 min/time) of outdoor activity from the age of 1-3 years were significantly associated with the presence of obesity, with AORs of 1.24 (95% CI =1.18-1.32) and 1.11 (95% CI = 1.05-1.17), respectively. Furthermore, the cross-over analysis showed that prenatal exposure to IBS combined with a lower frequency of early outdoor activity (AOR = 1.47, 95% CI = 1.31-1.66) or a shorter duration of outdoor activity during ages of 1-3 years (AOR = 1.22, 95% CI = 1.07-1.39) increased the risk of obesity in preschoolers. Finally, additive interactions between prenatal exposure to IBS and postnatal outdoor activity on obesity were identified. Our study indicates that maternal exposure to incense-burning smoke during pregnancy and early lower postanal outdoor activity may independently and jointly increase the risk of obesity among preschoolers.
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Affiliation(s)
- Meimei Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China;
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD 4059, Australia;
| | - Weikang Yang
- Women’s and Children’s Hospital of Longhua District of Shenzhen, Shenzhen 518110, China
| | - Xiaona Yin
- Women’s and Children’s Hospital of Longhua District of Shenzhen, Shenzhen 518110, China
| | - Guomin Wen
- Women’s and Children’s Hospital of Longhua District of Shenzhen, Shenzhen 518110, China
| | - Dengli Sun
- Women’s and Children’s Hospital of Longhua District of Shenzhen, Shenzhen 518110, China
| | - Danxia Xian
- Women’s and Children’s Hospital of Longhua District of Shenzhen, Shenzhen 518110, China
| | - Yafen Zhao
- Women’s and Children’s Hospital of Longhua District of Shenzhen, Shenzhen 518110, China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China;
- School of Health Management, Xinhua College of Guangzhou, Guangzhou 510080, China
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Azevedo-Martins AK, Santos MP, Abayomi J, Ferreira NJR, Evangelista FS. The Impact of Excessive Fructose Intake on Adipose Tissue and the Development of Childhood Obesity. Nutrients 2024; 16:939. [PMID: 38612973 PMCID: PMC11013923 DOI: 10.3390/nu16070939] [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: 12/08/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 04/14/2024] Open
Abstract
Worldwide, childhood obesity cases continue to rise, and its prevalence is known to increase the risk of non-communicable diseases typically found in adults, such as cardiovascular disease and type 2 diabetes mellitus. Thus, comprehending its multiple causes to build healthier approaches and revert this scenario is urgent. Obesity development is strongly associated with high fructose intake since the excessive consumption of this highly lipogenic sugar leads to white fat accumulation and causes white adipose tissue (WAT) inflammation, oxidative stress, and dysregulated adipokine release. Unfortunately, the global consumption of fructose has increased dramatically in recent years, which is associated with the fact that fructose is not always evident to consumers, as it is commonly added as a sweetener in food and sugar-sweetened beverages (SSB). Therefore, here, we discuss the impact of excessive fructose intake on adipose tissue biology, its contribution to childhood obesity, and current strategies for reducing high fructose and/or free sugar intake. To achieve such reductions, we conclude that it is important that the population has access to reliable information about food ingredients via food labels. Consumers also need scientific education to understand potential health risks to themselves and their children.
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Affiliation(s)
- Anna Karenina Azevedo-Martins
- Group of Study in Endocrinology and Metabolism, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo 03828-000, Brazil; (M.P.S.); (N.J.R.F.); (F.S.E.)
| | - Matheus Pedro Santos
- Group of Study in Endocrinology and Metabolism, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo 03828-000, Brazil; (M.P.S.); (N.J.R.F.); (F.S.E.)
| | - Julie Abayomi
- School of Medicine and Nutrition, Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk L39 4QP, UK;
| | - Natália Juliana Ramos Ferreira
- Group of Study in Endocrinology and Metabolism, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo 03828-000, Brazil; (M.P.S.); (N.J.R.F.); (F.S.E.)
| | - Fabiana S. Evangelista
- Group of Study in Endocrinology and Metabolism, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo 03828-000, Brazil; (M.P.S.); (N.J.R.F.); (F.S.E.)
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8
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AlTarrah D, Lanigan J, Feehan J, Al Dhaheri AS, Shah SM, Cheikh Ismail L, Singhal A. Infant feeding practices and risk of preschool obesity in AlAin, UAE: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002803. [PMID: 38330043 PMCID: PMC10852324 DOI: 10.1371/journal.pgph.0002803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/20/2024] [Indexed: 02/10/2024]
Abstract
Early childhood obesity is serious public health problem, and poses a risk of obesity in later life. The study aimed to investigate whether infant feeding affects risk of overweight and obesity in preschool children in the United Arab Emirates (UAE). A cross-sectional study was carried out. Data was collected in a kindergarten in Al Ain, UAE. One hundred and fifty parents and preschool children aged 2 to 6 years participated in the study. Univariate and multivariate linear regression were used to investigate associations. A longer duration of breastfeeding and later introduction of complementary foods were associated with a lower BMI z-score in preschool children. Each month of any breastfeeding was associated with a lower BMI z-score in the unadjusted model (β = -0.03; 95% CI -0.05, -0.01; p = 0.01), and each month increase in the age of introducing complementary foods was associated with a lower BMI z-score in the unadjusted model (β = -0.43; 95% CI: -0.60 to-0.027; p<0.001). These associations remained after adjustment for potential confounding factors (age, sex, maternal BMI, maternal education level, mother's age, social class, father's BMI) for duration of breastfeedinig (β = -0.02; 95% CI: -0.05 to 0.00; p<0.001) and age of complementary feeding (β = -0.39; 95% CI: -0.57 to-0.21; p<0.001). Poor infant feeding practices (shorter duration of breastfeedinig and early introduction of complementary foods) were found to be associated with higher BMI in preschool children. Promoting appropriate proper infant feeding practices in line with recommendations could be one strategy to help prevent childhood obesity in the UAE.
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Affiliation(s)
- Dana AlTarrah
- Department of Social and Behavioral Sciences, Faculty of Public Health, Kuwait University, Kuwait City, Kuwait
| | - Julie Lanigan
- Joint institution UCL Great Ormond Street Hospital, Institute of Child Health, University College London, London, United Kingdom
| | - Jack Feehan
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Ayesha S. Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Syed M. Shah
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Women’s and Reproductive Health, University of Oxford, Nuffield, Oxford, United Kingdom
| | - Atul Singhal
- Joint institution UCL Great Ormond Street Hospital, Institute of Child Health, University College London, London, United Kingdom
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Li Z, Fang Y, Zhang N, Zhu W, Chang S, Zhou S, Zhang M, Ma G. Evaluating Childhood Overweight- and Obesity-Related Food Marketing Policies in China Using the Food-Environment Policy Index (Food-EPI). Nutrients 2024; 16:482. [PMID: 38398807 PMCID: PMC10893324 DOI: 10.3390/nu16040482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
OBJECTIVE Addressing the increasing global health issue of childhood obesity, exacerbated by pervasive food marketing, this study critically evaluated China's food marketing policies in comparison with international best practices, aiming to uncover policy content and implementation gaps and inform policy enhancement strategies. METHOD Three key indicators were utilized from the Healthy Food-Environment Policy Index (Food-EPI)'s food promotion domain. A panel of experts (n = 13) from academic institutions, China Centers for Disease Control and Prevention, and the food industry assessed the Chinese government's policy scores and implementation levels concerning food marketing. Benchmarked against international best practices using the Food-EPI process, this evaluation encompassed context analysis, data collection, evidence-based policy action, government validation, policy rating, scoring, and results translation for government and stakeholders. The three chosen indicators specifically addressed childhood overweight- and obesity-related food marketing in broadcast media (Indicator 1), non-broadcast media (Indicator 2), and child gathering settings (Indicator 3). RESULTS Specifically, Indicator 1, the Single Food Marketing Indicator Score was measured at 2.31 ± 0.38, with an accompanying Food Marketing Policy Implementation Percentage of 46.2%, and Low Implementation Level. For non-broadcast mediums (Indicator 2), these metrics were gauged at 1.77 ± 0.27, 35.4%, and Low Implementation Level, respectively. In child gathering settings (Indicator 3), for efforts curbing unhealthy food promotion, a score of 2.77 ± 0.27, an implementation percentage of 55.4%, and Medium Implementation Level was obtained. Cumulatively, the overarching efficacy of food marketing policy enforcement was determined to be suboptimal, with the consolidated figures being Total Food Marketing Score as 2.28 ± 0.97, Total Food Marketing Policy Implementation Percentage as 45.6%, and Total Food Marketing Policy Implementation Level as Low. CONCLUSION Like many countries, China's food marketing policies and implementation have room for improvement when compared to international best practices. Recommendations include emphasizing nutritional legislation, fostering stakeholder collaboration, bolstering public health campaigns, and leveraging technology for stringent enforcement.
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Affiliation(s)
- Zhenhui Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (Z.L.); (Y.F.); (N.Z.); (W.Z.); (S.Z.)
| | - Yujie Fang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (Z.L.); (Y.F.); (N.Z.); (W.Z.); (S.Z.)
| | - Na Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (Z.L.); (Y.F.); (N.Z.); (W.Z.); (S.Z.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Wenli Zhu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (Z.L.); (Y.F.); (N.Z.); (W.Z.); (S.Z.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Suying Chang
- Child Health Development Section, United Nations International Children’s Emergency Fund (UNICEF) Office for China, 12 Sanlitun Lu, Chaoyang District, Beijing 100600, China;
| | - Shuyi Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (Z.L.); (Y.F.); (N.Z.); (W.Z.); (S.Z.)
| | - Man Zhang
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
- School of Nursing, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (Z.L.); (Y.F.); (N.Z.); (W.Z.); (S.Z.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
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10
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Pires AM. The potential for health education to target cardiovascular risk factors at an age when it really matters. Rev Port Cardiol 2024:S0870-2551(24)00012-X. [PMID: 38316179 DOI: 10.1016/j.repc.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 02/07/2024] Open
Affiliation(s)
- António Manuel Pires
- Diretor do Serviço de Cardiologia Pediátrica do Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
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11
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Leung AKC, Wong AHC, Hon KL. Childhood Obesity: An Updated Review. Curr Pediatr Rev 2024; 20:2-26. [PMID: 35927921 DOI: 10.2174/1573396318666220801093225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/05/2022] [Accepted: 05/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Childhood obesity is an important and serious public health problem worldwide. OBJECTIVE This article aims to familiarize physicians with the evaluation, management, and prevention of childhood. METHODS A PubMed search was conducted in May, 2021, in Clinical Queries using the key terms "obesity" OR "obese". The search included clinical trials, randomized controlled trials, case-control studies, cohort studies, meta-analyses, observational studies, clinical guidelines, case reports, case series, and reviews. The search was restricted to English literature and children. The information retrieved from the above search was used in the compilation of the present article. RESULTS Most obese children have exogenous obesity characterized by a growth rate for height above the 50th percentile, normal intelligence, normal genitalia, and lack of historical or physical evidence of an endocrine abnormality or a congenital syndrome. Obese children are at risk for dyslipidemia, hypertension, diabetes mellitus, non-alcoholic fatty liver disease, obstructive sleep apnea, psychosocial disturbances, impaired quality of life, and shorter life expectancy. The multitude of serious comorbidities necessitates effective treatment modalities. Dietary modification, therapeutic exercise, and behavioral modification are the fundamentals of treatment. Pharmacotherapy and/or bariatric surgery should be considered for obese individuals who do not respond to the above measures and suffer from a serious comorbid condition. CONCLUSION Childhood obesity, once established, is often refractory to treatment. Most treatment programs lead to a brief period of weight loss, followed by rapid re-accumulation of the lost weight after the termination of therapy. As such, preventive activity is the key to solving the problem of childhood obesity. Childhood obesity can be prevented by promoting a healthy diet, regular physical activity, and lifestyle modification. Parents should be encouraged to get involved in school and community programs that improve their children's nutritional status and physical activity.
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Affiliation(s)
- Alexander K C Leung
- Department of Pediatrics, The University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Alex H C Wong
- Department of Family Medicine, The University of Calgary, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong, China
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12
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Sewpaul R, Awe OO, Dogbey DM, Sekgala MD, Dukhi N. Classification of Obesity among South African Female Adolescents: Comparative Analysis of Logistic Regression and Random Forest Algorithms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:2. [PMID: 38276791 PMCID: PMC10815679 DOI: 10.3390/ijerph21010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND This study evaluates the performance of logistic regression (LR) and random forest (RF) algorithms to model obesity among female adolescents in South Africa. METHODS Data was analysed on 375 females aged 15-17 from the South African National Health and Nutrition Examination Survey 2011/2012. The primary outcome was obesity, defined as body mass index (BMI) ≥ 30 kg/m2. A total of 31 explanatory variables were included, ranging from socio-economic, demographic, family history, dietary and health behaviour. RF and LR models were run using imbalanced data as well as after oversampling, undersampling, and hybrid sampling of the data. RESULTS Using the imbalanced data, the RF model performed better with higher precision, recall, F1 score, and balanced accuracy. Balanced accuracy was highest with the hybrid data (0.618 for RF and 0.668 for LR). Using the hybrid balanced data, the RF model performed better (F1-score = 0.940 for RF vs. 0.798 for LR). CONCLUSION The model with the highest overall performance metrics was the RF model both before balancing the data and after applying hybrid balancing. Future work would benefit from using larger datasets on adolescent female obesity to assess the robustness of the models.
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Affiliation(s)
- Ronel Sewpaul
- Public Health, Societies and Belonging, Human Sciences Research Council, Merchant House, 2 Dock Rail Road, Cape Town 8001, South Africa
| | - Olushina Olawale Awe
- Institute of Mathematics, Statistics and Scientific Computing (IMECC), University of Campinas, Campinas 13083-859, Brazil
| | - Dennis Makafui Dogbey
- Medical Biotechnology and Immunotherapy Research Unit, Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa
| | | | - Natisha Dukhi
- Public Health, Societies and Belonging, Human Sciences Research Council, Merchant House, 2 Dock Rail Road, Cape Town 8001, South Africa
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13
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Schratz LM, Larkin O, Dos Santos N, Martin C. Caregiver Influences on Eating Behaviors in Children: An Opportunity for Preventing Obesity. Curr Atheroscler Rep 2023; 25:1035-1045. [PMID: 38032429 DOI: 10.1007/s11883-023-01171-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE OF REVIEW This review seeks to define caregiver practices that impact childhood eating behaviors and identify ways to utilize these relationships to prevent childhood obesity. RECENT FINDINGS Childhood obesity, which correlates with adult obesity and increased cardiovascular risk, is increasing in prevalence and severity. Caregivers play a significant role in shaping a child's eating behaviors and their predisposition to obesity. Maternal influences during pregnancy and infancy impact a child's future food preferences. Caregiver feeding styles (authoritarian, authoritative, indulgent, and uninvolved) are associated with distinct effects on children's eating behaviors and self-regulation. Authoritative feeding styles promote child autonomy while setting boundaries in the feeding environment. Early caregiver education and coaching regarding nutrition and feeding practices is beneficial to establishing healthy eating behaviors for children. Various caregivers, including parents, grandparents, siblings, teachers, and others, influence a child's eating habits at different stages of development. These caregivers can both positively and negatively impact a child's diet. Comprehensive interventions involving these various caregivers to promote healthy eating practices in children is ideal. Such interventions should be sensitive to cultural and environmental factors. Childhood obesity is a complex issue with long-term health effects. Early intervention using comprehensive approaches including all caregivers, community support, and public policies to address the social determinants of health will be beneficial. Future research should focus on valid outcome measures and equitable interventions that encompass all aspects of a child's life.
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Affiliation(s)
- Lorraine M Schratz
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA.
| | - Olivia Larkin
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA
| | - Nilse Dos Santos
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA
| | - Christine Martin
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA
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14
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Atwah A, Koshak E, Shalabi MS, Alsulami A, Alsaedi AS, Alharbi O, Almalki Z, Moamina A. Childhood Obesity May Be Linked to Feeding Habits and Screen Time. Cureus 2023; 15:e50933. [PMID: 38249252 PMCID: PMC10800011 DOI: 10.7759/cureus.50933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Background Childhood obesity is an alarming health problem. Early feeding habits and factors are among the etiological factors contributing to obesity. Objectives The objective of this study is to evaluate the correlation between breastfeeding, alongside other relevant factors, and their potential role as preventative measures against obesity. Methods A cross-sectional hospital-based study was conducted on children who attended a pediatric clinic. Demographic, clinical, and anthropometric measurements were taken from the hospital records. A questionnaire was completed by parents telephonically. Overweight was identified as a body mass index (BMI) of > 85-95% and obesity as a BMI of > 95%. Results A total of 101 children, with a mean age of 8.88 ± 4.01 (range one to 18) years, were involved, of whom 58.4% were boys. A high BMI (overweight or obese) was found in 30 (29.7%) children. The highest BMIs were among soft drink consumers [two children (66.7%) consumed daily and eight children (40%) consumed monthly], high birth weight in two children (40%), cow's milk formula feeding in eight children (38%), and weekly fast food consumption in 18 children (35%), none of these were statistically significant. Nevertheless, there was a significant association between mean electronic device usage and high (204.5 ± 164.76 hours) and normal BMI (147.61 ± 110.24 hours) (p-value < 0.05). Conclusion This small cross-sectional study shows that almost one-third of the included children were overweight or obese, which is comparable to what has been published in the literature. Moreover, there was a potential link between some factors and obesity, especially screen time, which may contribute to the controversial literature.
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Affiliation(s)
- Ali Atwah
- Pediatrics, King Abdulaziz University Faculty of Medicine, Rabigh, SAU
| | - Emad Koshak
- Internal Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | | | | | - Ahmed S Alsaedi
- Medicine, King Abdulaziz University Faculty of Medicine, Rabigh, SAU
| | - Osama Alharbi
- Pediatrics, King Abdulaziz University Faculty of Medicine, Rabigh, SAU
| | - Ziyad Almalki
- Pediatrics, King Abdulaziz University Faculty of Medicine, Rabigh, SAU
| | - Ahmed Moamina
- Pediatrics, King Abdulaziz University Faculty of Medicine, Rabigh, SAU
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15
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Börnhorst C, Ahrens W, De Henauw S, Hunsberger M, Molnár D, Moreno LA, Russo P, Schreuder A, Sina E, Tornaritis M, Vandevijvere S, Veidebaum T, Vrijkotte T, Wijnant K, Wolters M. Age-Specific Quantification of Overweight/Obesity Risk Factors From Infancy to Adolescence and Differences by Educational Level of Parents. Int J Public Health 2023; 68:1605798. [PMID: 38033763 PMCID: PMC10684735 DOI: 10.3389/ijph.2023.1605798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 10/26/2023] [Indexed: 12/02/2023] Open
Abstract
Objectives: To explore the age-dependent associations between 26 risk factors and BMI in early life, and differences by parental educational level. Methods: Data of 10,310 children (24,155 measurements) aged 2-16 years participating in a multi-centre European cohort from 2007 to 2014 were utilized. Trajectories of overweight/obesity risk factors and their age-specific associations with BMI were estimated using polynomial mixed-effects models. Results: Exposure to most unfavourable factors was higher in the low/medium compared to the high education group, e.g., for PC/TV time (12.6 vs. 10.6 h/week). Trajectories of various risk factors markedly changed at an age of 9-11 years. Having a family history of obesity, maternal BMI, pregnancy weight gain and birth weight were positively associated with BMI trajectories throughout childhood/adolescence in both education groups; associations of behavioural factors with BMI were small. Parental unemployment and migrant background were positively associated with BMI in the low/medium education group. Conclusion: Associations of risk factors with BMI trajectories did not essentially differ by parental education except for social vulnerabilities. The age period of 9-11 years may be a sensitive period for adopting unfavourable behaviours.
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Affiliation(s)
- Claudia Börnhorst
- Leibniz Institute for Prevention Research and Epidemiology (BIPS), Bremen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology (BIPS), Bremen, Germany
- Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Monica Hunsberger
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Denéz Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Luis A. Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Paola Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Anton Schreuder
- Amsterdam University Medical Center, Amsterdam, Netherlands
- Department of Social Medicine Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Elida Sina
- Leibniz Institute for Prevention Research and Epidemiology (BIPS), Bremen, Germany
| | | | | | - Thomas Veidebaum
- Estonian Centre of Behavioral and Health Sciences, National Institute for Health Development, Tallinn, Estonia
| | | | - Kathleen Wijnant
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Maike Wolters
- Leibniz Institute for Prevention Research and Epidemiology (BIPS), Bremen, Germany
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16
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Ndumele CE, Rangaswami J, Chow SL, Neeland IJ, Tuttle KR, Khan SS, Coresh J, Mathew RO, Baker-Smith CM, Carnethon MR, Despres JP, Ho JE, Joseph JJ, Kernan WN, Khera A, Kosiborod MN, Lekavich CL, Lewis EF, Lo KB, Ozkan B, Palaniappan LP, Patel SS, Pencina MJ, Powell-Wiley TM, Sperling LS, Virani SS, Wright JT, Rajgopal Singh R, Elkind MSV. Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association. Circulation 2023; 148:1606-1635. [PMID: 37807924 DOI: 10.1161/cir.0000000000001184] [Citation(s) in RCA: 49] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Cardiovascular-kidney-metabolic health reflects the interplay among metabolic risk factors, chronic kidney disease, and the cardiovascular system and has profound impacts on morbidity and mortality. There are multisystem consequences of poor cardiovascular-kidney-metabolic health, with the most significant clinical impact being the high associated incidence of cardiovascular disease events and cardiovascular mortality. There is a high prevalence of poor cardiovascular-kidney-metabolic health in the population, with a disproportionate burden seen among those with adverse social determinants of health. However, there is also a growing number of therapeutic options that favorably affect metabolic risk factors, kidney function, or both that also have cardioprotective effects. To improve cardiovascular-kidney-metabolic health and related outcomes in the population, there is a critical need for (1) more clarity on the definition of cardiovascular-kidney-metabolic syndrome; (2) an approach to cardiovascular-kidney-metabolic staging that promotes prevention across the life course; (3) prediction algorithms that include the exposures and outcomes most relevant to cardiovascular-kidney-metabolic health; and (4) strategies for the prevention and management of cardiovascular disease in relation to cardiovascular-kidney-metabolic health that reflect harmonization across major subspecialty guidelines and emerging scientific evidence. It is also critical to incorporate considerations of social determinants of health into care models for cardiovascular-kidney-metabolic syndrome and to reduce care fragmentation by facilitating approaches for patient-centered interdisciplinary care. This presidential advisory provides guidance on the definition, staging, prediction paradigms, and holistic approaches to care for patients with cardiovascular-kidney-metabolic syndrome and details a multicomponent vision for effectively and equitably enhancing cardiovascular-kidney-metabolic health in the population.
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Santibáñez Cárcamo C, Silva Gómez R. [Factors associated with the development of malnutrition due to excess in children]. NUTR HOSP 2023. [PMID: 37929834 DOI: 10.20960/nh.04861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
INTRODUCTION malnutrition due to excess is a serious public health problem currently affecting 53 % of children and adolescents in Chile. The early identification of associated factors is key in prevention and necessary to guide interventions from early stages of life. OBJECTIVE to identify factors associated with the development of malnutrition due to excess in three-year-old children under control at Ancora Family Health. METHODS a case-control study was carried out in three Ancora Family Health Centers located in the communes of La Pintana and Puente Alto; it included 133 children and their mothers. Factors dependent on the child and the mother were analyzed and their importance in the development of malnutrition due to excess was determined. RESULTS logistic regression showed maternal smoking during pregnancy as a risk factor (OR = 4.065, 95 % CI: 1.119-14.770, p = 0.033) and as protective factors birth weight < 4,000 g (OR = 0.112, 95 % CI: 0.026-0.483, p = 0.003) and weight gain during the first year of life < 6.4 kg in women and < 6.9 kg in men (OR = 0.060, 95 % CI: 0.017-0.210, p = 0.000). CONCLUSIONS the most important risk factor was maternal smoking and the protective factors were birth weight and weight gain in the first year. Health programs and public policies should focus on modifiable factors such as smoking during pregnancy and adequate weight gain in the first year of life.
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Jeong S, Yun SB, Park SY, Mun S. Understanding cross-data dynamics of individual and social/environmental factors through a public health lens: explainable machine learning approaches. Front Public Health 2023; 11:1257861. [PMID: 37954048 PMCID: PMC10639162 DOI: 10.3389/fpubh.2023.1257861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/09/2023] [Indexed: 11/14/2023] Open
Abstract
Introduction The rising prevalence of obesity has become a public health concern, requiring efficient and comprehensive prevention strategies. Methods This study innovatively investigated the combined influence of individual and social/environmental factors on obesity within the urban landscape of Seoul, by employing advanced machine learning approaches. We collected 'Community Health Surveys' and credit card usage data to represent individual factors. In parallel, we utilized 'Seoul Open Data' to encapsulate social/environmental factors contributing to obesity. A Random Forest model was used to predict obesity based on individual factors. The model was further subjected to Shapley Additive Explanations (SHAP) algorithms to determine each factor's relative importance in obesity prediction. For social/environmental factors, we used the Geographically Weighted Least Absolute Shrinkage and Selection Operator (GWLASSO) to calculate the regression coefficients. Results The Random Forest model predicted obesity with an accuracy of >90%. The SHAP revealed diverse influential individual obesity-related factors in each Gu district, although 'self-awareness of obesity', 'weight control experience', and 'high blood pressure experience' were among the top five influential factors across all Gu districts. The GWLASSO indicated variations in regression coefficients between social/environmental factors across different districts. Conclusion Our findings provide valuable insights for designing targeted obesity prevention programs that integrate different individual and social/environmental factors within the context of urban design, even within the same city. This study enhances the efficient development and application of explainable machine learning in devising urban health strategies. We recommend that each autonomous district consider these differential influential factors in designing their budget plans to tackle obesity effectively.
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Affiliation(s)
- Siwoo Jeong
- Convergence Institute of Human Data Technology, Jeonju University, Jeonju, Republic of Korea
- Department of Sports Rehabilitation Medicine, Kyungil University, Gyeongsan, Republic of Korea
| | - Sung Bum Yun
- Urban Strategy Research Division, Seoul Institute of Technology, Seoul, Republic of Korea
| | - Soon Yong Park
- Urban Strategy Research Division, Seoul Institute of Technology, Seoul, Republic of Korea
| | - Sungchul Mun
- Convergence Institute of Human Data Technology, Jeonju University, Jeonju, Republic of Korea
- Department of Industrial Engineering, Jeonju University, Jeonju, Republic of Korea
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19
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Warkentin S, Santos AC, Oliveira A. Weight trajectories from birth to 5 years and child appetitive traits at 7 years of age: a prospective birth cohort study. Br J Nutr 2023; 130:1278-1288. [PMID: 36690498 DOI: 10.1017/s0007114523000272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Rapid prenatal and postnatal weight gain seem to alter appetite regulation and hypothalamic functions through different pathways; however, little is known on how early life growth trajectories may influence appetitive traits in school-age. We aimed to explore the associations between weight trajectories from birth to 5 years and appetitive traits at 7. Participants were from the Generation XXI birth cohort (n 3855). Four weight trajectories were investigated: 'normal weight gain' (closely overlaps the 50th percentile in the weight-for-age curve), 'weight gain during infancy' (low birth weight and weight gain mainly during infancy), 'weight gain during childhood' (continuous weight gain since birth) and 'persistent weight gain' (always showing higher weight than the average). Appetitive traits were assessed through the Children's Eating Behaviour Questionnaire. Associations were tested using generalised linear models, adjusted for maternal and child characteristics. Compared with 'normal weight gain', those in the other growth trajectories showed greater enjoyment of food and eating in response to food stimuli (i.e. Food Responsiveness) but were less able to compensate for prior food intake and ate faster at 7 (i.e. less Satiety Responsiveness and Slowness in Eating). Also, those with 'weight gain during infancy' showed to have greater Emotional Overeating and less Emotional Undereating and were fussier. Associations were stronger if greater weight gain occurred during infancy. Early infancy seems to be a sensitive period in the development of later appetitive traits. The control of rapid growth during infancy, besides strategies focused on the overall environment where children are living, is necessary.
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Affiliation(s)
- Sarah Warkentin
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto (Institute of Public Health of the University of Porto), Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Ana Cristina Santos
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto (Institute of Public Health of the University of Porto), Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto (Institute of Public Health of the University of Porto), Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
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Bagatini NC, Feil Pinho CD, Leites GT, da Cunha Voser R, Gaya AR, Santos Cunha GD. Effects of cardiorespiratory fitness and body mass index on cardiometabolic risk factors in schoolchildren. BMC Pediatr 2023; 23:454. [PMID: 37689621 PMCID: PMC10492303 DOI: 10.1186/s12887-023-04266-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 08/23/2023] [Indexed: 09/11/2023] Open
Abstract
INTRODUCTION High levels of physical fitness established during childhood and adolescence have been associated with positive effects on cardiometabolic risk factors (CMRF), which persist into adulthood. Conversely, a sedentary lifestyle, overweight, and obesity during this period are considered public health problems. These conditions tend to worsen in adulthood, increasing the incidence of chronic diseases, deteriorating CMRF, and consequently leading to higher comorbidity and mortality rates. OBJECTIVE To investigate the effect of cardiorespiratory fitness (CRF) and body mass index (BMI) on CMRF in children and adolescents. METHODS The sample consisted of 49 schoolchildren of both sexes aged 10-17 years. Anthropometric assessments, CRF test, muscle strength test, and blood pressure (BP) measurement were conducted. Participants were allocated into groups based on BMI (eutrophic, overweight, obese), and CRF levels (low-fit, normal-fit, and high-fit). RESULTS Obese individuals had lower CRF values compared to the eutrophic and overweight groups. The cardiometabolic risk profile (CMRP) was significantly higher in the obese group compared to the eutrophic group but showed no significant difference compared to the overweight group. The hight-fit group had lower CMRP values compared to the low-fit group. CONCLUSIONS Higher BMI and CRF values had negative and positive effects on CMRF and CMRP in schoolchildren, respectively. Overweight or obese schoolchildren with low levels of CRF constitute an unfavourable cardiometabolic risk profile.
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Affiliation(s)
- Natália Carvalho Bagatini
- School of Physical Education, Physiotherapy and Dance, Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Carolina Dertzbocher Feil Pinho
- School of Physical Education, Physiotherapy and Dance, Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Rogério da Cunha Voser
- School of Physical Education, Physiotherapy and Dance, Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Anelise Reis Gaya
- School of Physical Education, Physiotherapy and Dance, Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Giovani Dos Santos Cunha
- School of Physical Education, Physiotherapy and Dance, Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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21
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Zhang HZ, Wang DS, Wu SH, Huang GF, Chen DH, Ma HM, Zhang YT, Guo LH, Lin LZ, Gui ZH, Liu RQ, Hu LW, Yang JW, Zhang WJ, Dong GH. The association between childhood adiposity in northeast China and anthropogenic heat flux: A new insight into the comprehensive impact of human activities. Int J Hyg Environ Health 2023; 254:114258. [PMID: 37703624 DOI: 10.1016/j.ijheh.2023.114258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/13/2023] [Accepted: 09/06/2023] [Indexed: 09/15/2023]
Abstract
Anthropogenic heat has been reported to have significant health impacts, but research on its association with childhood adiposity is still lacking. In this study, we matched the 2008-2012 average anthropogenic heat flux, as simulated by a grid estimation model using inventory methods, with questionnaire and measurement data of 49,938 children randomly recruited from seven cities in Northeast China in 2012. After adjusting for social demographic and behavioral factors, we used generalized linear mixed-effect models to assess the association between anthropogenic heat flux and adiposity among children. We also examined the effect modification of various social demographic and behavioral confounders. We found that each 10 W/m2 increase in total anthropogenic heat flux and that from the industry source was associated with an increase of 5.82% (95% CI = 0.84%-11.05%) and 6.62% (95% CI = 0.87%-12.70%) in the odds of childhood adiposity. Similarly, the excess rate of adiposity among children were 5.26% (95% CI = -1.33%-12.29%) and 8.51% (95% CI = 2.24%-15.17%) per 1 W/m2 increase in the anthropogenic heat flux from transportation and buildings, and was 7.94% (95% CI = 2.28%-13.91%) per 0.001 W/m2 increase in the anthropogenic heat flux from human metabolism. We also found generally greater effect estimates among female children and children who were exposed to passive smoking during pregnancy, born by caesarean section, non-breastfed/mixed-fed, or lived within 20 m adjacent to the main road. The potential deleterious effect of anthropogenic heat exposure on adiposity among children may make it a new but major threat to be targeted by future mitigation strategies.
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Affiliation(s)
- Hong-Zhi Zhang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Dao-Sen Wang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Si-Han Wu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Guo-Feng Huang
- Department of Air Quality Forecasting and Early Warning, Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangdong Environmental Protection Key Laboratory of Atmospheric Secondary Pollution, Guangzhou, 510308, China
| | - Duo-Hong Chen
- Department of Air Quality Forecasting and Early Warning, Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangdong Environmental Protection Key Laboratory of Atmospheric Secondary Pollution, Guangzhou, 510308, China
| | - Hui-Min Ma
- State Key Laboratory of Organic Geochemistry and Guangdong Key Laboratory of Environmental Protection and Resources Utilization, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou, 510640, China
| | - Yun-Ting Zhang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Li-Hao Guo
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Li-Zi Lin
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zhao-Huan Gui
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Ru-Qing Liu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Li-Wen Hu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Jie-Wen Yang
- Guangzhou Social Welfare Institution, Guangzhou, 510520, China.
| | - Wang-Jian Zhang
- Department of Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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22
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Kök Şan C, Gökçay GF. Nutritional aspects of commercial infant and toddler food products sold in Turkey. Nutr Health 2023:2601060231194652. [PMID: 37574810 DOI: 10.1177/02601060231194652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Background: In recent years, there has been an increase in the variety and consumption of commercial infant and toddler food products. Aim: The aim of this study is to evaluate the nutritional profiles of commercial infant and toddler food products sold in Turkey. Methods: A cross-sectional survey of the nutritional composition of products available at in-store and online supermarkets in Turkey was derived from the nutritional information panel on the product label or information provided on manufacturer websites in March 2023. The targeted age group, package type, serving size, ingredients list, and nutrition information (energy [kcal], protein [g], total fat [g], carbohydrate [g], dietary fiber [g], total sugar [g], and sodium [mg] per 100 g) were recorded. Results: Of the 189 products identified, more than 90% (n = 47) of the first foods were fruit-based, while 2% (n = 4) contained only vegetables. Almost half of the products (n = 89, 49%) contained added sugar or sweeteners, 41 (22%) had added sugar, and 1 in 3 products (n = 68, 36%) had sugar from fruit-based sources. One in 10 products (n = 18, 9.5%) contained added salt while 40% of the products (n = 76) were above the WHO Europe sodium standards. Almost half of the products (n = 6, 46%) targeting the 12 months older age group were pureed foods using squeeze pouch packaging. Conclusions: The majority of commercial infant and toddler food products did not adhere to nutrition guidelines. There is a need for stronger composition standards for commercial infant and toddler food products by reducing sugar and sodium content, reducing the use of fruits and sweet vegetables, and increasing the variety of products containing different types of vegetables.
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Affiliation(s)
- Cansu Kök Şan
- Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gülden F Gökçay
- Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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23
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Rodríguez-Cano AM, Piña-Ramírez O, Rodríguez-Hernández C, Mier-Cabrera J, Villalobos-Alcazar G, Estrada-Gutierrez G, Cardona-Pérez A, Coronado-Zarco A, Perichart-Perera O. Development and validation of anthropometric-based fat-mass prediction equations using air displacement plethysmography in Mexican infants. Eur J Clin Nutr 2023; 77:748-756. [PMID: 37055482 PMCID: PMC10335931 DOI: 10.1038/s41430-023-01285-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND/OBJECTIVES Fat-mass (FM) assessment since birth using valid methodologies is crucial since excessive adiposity represents a risk factor for adverse metabolic outcomes. AIM To develop infant FM prediction equations using anthropometry and validate them against air-displacement plethysmography (ADP). SUBJECTS/METHODS Clinical, anthropometric (weight, length, body-mass index -BMI-, circumferences, and skinfolds), and FM (ADP) data were collected from healthy-term infants at 1 (n = 133), 3 (n = 105), and 6 (n = 101) months enrolled in the OBESO perinatal cohort (Mexico City). FM prediction models were developed in 3 steps: 1) Variable Selection (LASSO regression), 2) Model behavior evaluation (12-fold cross-validation, using Theil-Sen regressions), and 3) Final model evaluation (Bland-Altman plots, Deming regression). RESULTS Relevant variables in the FM prediction models included BMI, circumferences (waist, thigh, and calf), and skinfolds (waist, triceps, subscapular, thigh, and calf). The R2 of each model was 1 M: 0.54, 3 M: 0.69, 6 M: 0.63. Predicted FM showed high correlation values (r ≥ 0.73, p < 0.001) with FM measured with ADP. There were no significant differences between predicted vs measured FM (1 M: 0.62 vs 0.6; 3 M: 1.2 vs 1.35; 6 M: 1.65 vs 1.76 kg; p > 0.05). Bias were: 1 M -0.021 (95%CI: -0.050 to 0.008), 3 M: 0.014 (95%CI: 0.090-0.195), 6 M: 0.108 (95%CI: 0.046-0.169). CONCLUSION Anthropometry-based prediction equations are inexpensive and represent a more accessible method to estimate body composition. The proposed equations are useful for evaluating FM in Mexican infants.
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Affiliation(s)
- Ameyalli M Rodríguez-Cano
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México
| | - Omar Piña-Ramírez
- Bioinformatics and Statistical Analysis Department, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México
| | - Carolina Rodríguez-Hernández
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México
| | - Jennifer Mier-Cabrera
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México
| | - Gicela Villalobos-Alcazar
- Neonatal Ward, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México
| | - Guadalupe Estrada-Gutierrez
- Research Division, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México
| | - Arturo Cardona-Pérez
- General Director, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México
| | - Alejandra Coronado-Zarco
- Neonatology Division, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México
| | - Otilia Perichart-Perera
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México.
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24
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Gilbert L, Quansah DY, Arhab A, Schenk S, Gross J, Lanzi S, Stuijfzand B, Lacroix A, Horsch A, Puder JJ. Effect of the MySweetheart randomized controlled trial on birth, anthropometric and psychobehavioral outcomes in offspring of women with GDM. Front Endocrinol (Lausanne) 2023; 14:1148426. [PMID: 37351105 PMCID: PMC10284133 DOI: 10.3389/fendo.2023.1148426] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/22/2023] [Indexed: 06/24/2023] Open
Abstract
Introduction Gestational diabetes mellitus (GDM) may negatively affect offspring outcomes. A lifestyle intervention may therefore not only improve maternal, but also offspring outcomes. The effects of lifestyle interventions on birth, anthropometric, and psychobehavioral outcomes in offspring of women with GDM need further evidence. Design The MySweetheart trial is a monocentric single-blind randomized controlled trial in 211 women with GDM. It tested the effect of a pre- and postpartum multidimensional interdisciplinary lifestyle and psychosocial intervention focusing on both the mothers and their infants and its effects on maternal (primary outcomes) and offspring (secondary outcomes) metabolic and psychobehavioral outcomes compared with guidelines-based usual-care. This paper focuses on offspring's birth, anthropometric, and maternal report of psychobehavioral outcomes at singular timepoints. Methods Women with GDM aged ≥18 years, between 24-32 weeks of gestation, speaking French or English were included and randomly allocated to either the intervention or to an active guidelines-based usual-care group using a 1:1 allocation ratio. The intervention lasted from pregnancy until 1 year postpartum and focused on improving diet, physical activity, and mental health in the mother. For the offspring it focused on supporting breastfeeding, delaying the timing of introduction of solid foods, reducing the consumption of sweetened beverages, increasing physical activity of the family, and improving parental responsiveness to infant distress, hunger, satiety and sleeping cues, and difficult behavior. Results Adverse birth and neonatal outcomes rarely occurred overall. There were no differences between groups in offspring birth, neonatal, anthropometric, or psychobehavioral outcomes up to one year. After adjustments for maternal age and the offspring's sex and age, there was a borderline significant between-group difference in birth length (β:-0.64, CI:-1.27; -0.01, p: 0.05), i.e., offspring of mothers in the intervention group were born 0.64 cm shorter compared to those in the usual-care group. Conclusion This is the first pre- and postpartum multidimensional interdisciplinary lifestyle and psychosocial intervention in GDM focusing on both the mother and the offspring. It did not lead to a significant improvement in most birth, anthropometric, and psychobehavioral outcomes in offspring of women with GDM. ClinicalTrials.gov Identifier: NCT02890693.
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Affiliation(s)
- Leah Gilbert
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Obstetric Service, Department Woman-Mother-Child, Interdisciplinary GDM Group Lausanne, Lausanne University Hospital, Lausanne, Switzerland
| | - Dan Yedu Quansah
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Amar Arhab
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Sybille Schenk
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Justine Gross
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Stefano Lanzi
- Service d’angiologie, Département Cœur-Vaisseaux, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Bobby Stuijfzand
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Alain Lacroix
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Neonatology Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Jardena J. Puder
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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25
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Mohd Saat NZ, Abd Talib R, Alarsan SF, Saadeh N, Shahrour G. Risk Factors of Overweight and Obesity Among School Children Aged 6 to 18 Years: A Scoping Review. NUTRITION AND DIETARY SUPPLEMENTS 2023; Volume 15:63-76. [DOI: 10.2147/nds.s420370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
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26
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Nezondet C, Gandrieau J, Bourrelier J, Nguyen P, Zunquin G. The Effectiveness of a Physical Literacy-Based Intervention for Increasing Physical Activity Levels and Improving Health Indicators in Overweight and Obese Adolescents (CAPACITES 64). CHILDREN (BASEL, SWITZERLAND) 2023; 10:956. [PMID: 37371188 DOI: 10.3390/children10060956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/19/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023]
Abstract
Recently, the concept of Physical Literacy (PL) has emerged as a key concept for promoting active behavior and improving health indicators in adolescents. Overweight and obese adolescents have a low level of Physical Activity (PA), low cardiorespiratory capacity, and high Body Fat percentage (%BF). However, the development of PL in the interest of health improvement has never been studied in overweight and obese adolescents. The objective of this study was to evaluate the impact of an intervention developing PL in overweight and obese adolescents in order to increase their (PA) and improve their health. The study was a prospective, single-arm, non-randomized interventional study. The intervention brings together different actions in PA and dietary education in different adolescent living environments. The study took place over a 9-month period with two data collection times (0; +9 months) and measured Body Mass Index (BMI) and BMI z score, %BF and Skeletal Muscle Mass (%SMM), Moderate-to-Vigorous intensity Physical Activity (MVPA) by accelerometry, CRF, as well as PL by the CAPL-2 tool. Thirteen adolescents (age 11.7 (±1.09) years old) improved their PL scores (+8.3 (±9.3) pts; p ≤ 0.01). BMI z score (-0.3 (±0.3), p ≤ 0.01), their %BF (-3.8 (±4.9); p ≤ 0.01), their CRF (+1.5 (±1.7) mL·min·kg-1; p ≤ 0.01), and their MVPA (+4.6 (±13.7) min/day; p = 0.36). Initiating multidimensional interventions to develop PL in overweight and obese adolescents may be a promising prospect to enable an increase in their MVPA and improve their long-term health. Longer-term randomized controlled interventional studies are needed to confirm these findings.
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Affiliation(s)
- Charlie Nezondet
- Laboratoire Mouvement, Equilibre, Performance, Santé (MEPS), Université de Pau et des Pays de l'Adour, Campus Montaury, EA 4445, 64600 Anglet, France
| | - Joseph Gandrieau
- L'unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS), Université de Lille, URL 7369, 59000 Lille, France
- Laboratoire Motricité Humaine Expertise Sport Santé (LAMHESS), UPR 6312, 06000 Nice, France
| | - Julien Bourrelier
- Cognition, Action et Plasticité Sensorimotrice, INSERM UMR 1093, Université UFR STAPS Bourgogne, 21000 Dijon, France
| | - Philippe Nguyen
- Departement "Unité Transversale des Activités Physiques pour la Santé" (UTAPS), Centre Hospitalier de la Côte Basque (CHCB), 64100 Bayonne, France
| | - Gautier Zunquin
- Laboratoire Mouvement, Equilibre, Performance, Santé (MEPS), Université de Pau et des Pays de l'Adour, Campus Montaury, EA 4445, 64600 Anglet, France
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27
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Lister NB, Baur LA, Felix JF, Hill AJ, Marcus C, Reinehr T, Summerbell C, Wabitsch M. Child and adolescent obesity. Nat Rev Dis Primers 2023; 9:24. [PMID: 37202378 DOI: 10.1038/s41572-023-00435-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 05/20/2023]
Abstract
The prevalence of child and adolescent obesity has plateaued at high levels in most high-income countries and is increasing in many low-income and middle-income countries. Obesity arises when a mix of genetic and epigenetic factors, behavioural risk patterns and broader environmental and sociocultural influences affect the two body weight regulation systems: energy homeostasis, including leptin and gastrointestinal tract signals, operating predominantly at an unconscious level, and cognitive-emotional control that is regulated by higher brain centres, operating at a conscious level. Health-related quality of life is reduced in those with obesity. Comorbidities of obesity, including type 2 diabetes mellitus, fatty liver disease and depression, are more likely in adolescents and in those with severe obesity. Treatment incorporates a respectful, stigma-free and family-based approach involving multiple components, and addresses dietary, physical activity, sedentary and sleep behaviours. In adolescents in particular, adjunctive therapies can be valuable, such as more intensive dietary therapies, pharmacotherapy and bariatric surgery. Prevention of obesity requires a whole-system approach and joined-up policy initiatives across government departments. Development and implementation of interventions to prevent paediatric obesity in children should focus on interventions that are feasible, effective and likely to reduce gaps in health inequalities.
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Affiliation(s)
- Natalie B Lister
- Children's Hospital Westmead Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
- Weight Management Services, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Andrew J Hill
- Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
| | - Claude Marcus
- Division of Paediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Thomas Reinehr
- Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany
| | - Carolyn Summerbell
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Martin Wabitsch
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Centre, Ulm, Germany
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28
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Zembura M, Lula P, Matusik P. Ten-Year Differences in Nutritional Status and Obesity-Related Risk Factors in Polish Preschool Children. CHILDREN 2023; 10:children10040636. [PMID: 37189885 DOI: 10.3390/children10040636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/20/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
The aim of this study was to assess ten-year differences in nutritional statuses and obesity prevalences between populations of preschool children from Katowice, Poland, examined in 2007 and 2017, and to determine factors associated with overweight and obesity in preschool children. A cross-sectional questionnaire was conducted among parents and legal guardians of 276 preschool children in 2007 and 259 preschool children in 2017. Basic anthropometric measurements were performed. Overall, the prevalence of overweight and obesity among our sample of Polish preschool children (median age 5.25 year) was 16.82%, whereas 4.49% of children were obese. No significant differences in the number of overweight and obese children were observed when comparing the years 2017 to 2007. Overall body mass index (BMI) z-score was significantly lower in this group of children from 2017. However, median values of the BMI z-score were higher in two of the weight categories (overweight and obesity) in 2017. The child’s BMI z-score was positively correlated with birth weight (r = 0.1, p < 0.05). The BMI z-score was positively correlated with maternal BMI, paternal BMI, and maternal pregnancy weight gain, r = 0.24 p < 0.01; r = 0.16 p < 0.01; r = 0.12 p < 0.05, respectively. A decrease in overweight and obesity prevalence over the past decade and higher median values of BMI z-scores in the group of children with excessive weight in 2017 were observed. Birth weight, maternal BMI, paternal BMI, and maternal pregnancy weight gain all correlate positively with a child’s BMI z-score.
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29
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Poveda NE, Adair LS, Martorell R, Patel SA, Ramirez-Zea M, Bhargava SK, Bechayda SA, Carba DB, Kroker-Lobos MF, Horta BL, Lima NP, Mazariegos M, Menezes AMB, Norris SA, Nyati LH, Richter LM, Sachdev H, Wehrmeister FC, Stein AD. Growth patterns in childhood and adolescence and adult body composition: a pooled analysis of birth cohort studies from five low and middle-income countries (COHORTS collaboration). BMJ Open 2023; 13:e068427. [PMID: 36921951 PMCID: PMC10030655 DOI: 10.1136/bmjopen-2022-068427] [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] [Indexed: 03/17/2023] Open
Abstract
OBJECTIVE We examined associations among serial measures of linear growth and relative weight with adult body composition. DESIGN Secondary data analysis of prospective birth cohort studies. SETTINGS Six birth cohorts from Brazil, Guatemala, India, the Philippines and South Africa. PARTICIPANTS 4173 individuals followed from birth to ages 22-46 years with complete and valid weight and height at birth, infancy, childhood and adolescence, and body composition in adult life. EXPOSURES Birth weight and conditional size (standardised residuals of height representing linear growth and of relative weight representing weight increments independent of linear size) in infancy, childhood and adolescence. PRIMARY OUTCOME MEASURES Body mass index, fat mass index (FMI), fat-free mass index (FFMI), fat mass/fat-free mass ratio (FM/FFM), and waist circumference in young and mid-adulthood. RESULTS In pooled analyses, a higher birth weight and relative weight gains in infancy, childhood and adolescence were positively associated with all adult outcomes. Relative weight gains in childhood and adolescence were the strongest predictors of adult body composition (β (95% CI) among men: FMI (childhood: 0.41 (0.26 to 0.55); adolescence: 0.39 (0.27 to 0.50)), FFMI (childhood: 0.50 (0.34 to 0.66); adolescence: 0.43 (0.32 to 0.55)), FM/FFM (childhood: 0.31 (0.16 to 0.47); adolescence: 0.31 (0.19 to 0.43))). Among women, similar patterns were observed, but, effect sizes in adolescence were slightly stronger than in childhood. Conditional height in infancy was positively associated with FMI (men: 0.08 (0.03 to 0.14); women: 0.11 (0.07 to 0.16)). Conditional height in childhood was positively but weakly associated with women's adiposity. Site-specific and sex-stratified analyses showed consistency in the direction of estimates, although there were differences in their magnitude. CONCLUSIONS Prenatal and postnatal relative weight gains were positive predictors of larger body size and increased adiposity in adulthood. A faster linear growth in infancy was a significant but weak predictor of higher adult adiposity.
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Affiliation(s)
- Natalia E Poveda
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Linda S Adair
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Shivani A Patel
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Manuel Ramirez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - Santosh K Bhargava
- Department of Pediatrics, Safdarjang Hospital and Vardhman Mahavir Medical College, New Delhi, India
| | - Sonny A Bechayda
- Office of Population Studies Foundation, University of San Carlos - Talamban Campus, Cebu City, The Philippines
| | - Delia B Carba
- Office of Population Studies Foundation, University of San Carlos - Talamban Campus, Cebu City, The Philippines
| | - Maria F Kroker-Lobos
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - Bernardo Lessa Horta
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Natália Peixoto Lima
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Mónica Mazariegos
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | | | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Lukhanyo H Nyati
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Linda M Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Harshpal Sachdev
- Senior Consultant Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India
| | - Fernando C Wehrmeister
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Czarnobay SA, Kroll C, Corrêa CB, Mastroeni SSBS, Mastroeni MF. Predictors of excess body weight concurrently affecting mother-child pairs: a 6 year follow-up. J Public Health (Oxf) 2023; 45:e10-e21. [PMID: 34977946 DOI: 10.1093/pubmed/fdab399] [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: 02/15/2021] [Revised: 11/04/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We examined the predictors of excess body weight (EBW) concurrently affecting mother-child pairs after delivery during 6 years of follow-up. METHODS Prospective cohort study conducted on 435 mother-child pairs. Data were collected at four time points: at birth in the maternity hospital; 1-2 years old, 4-5 years old and 6 years old at the participant's home. Poisson regression analysis was used to examine the predictors of maternal-child EBW: mothers with excessive gestational weight gain (GWG) and large-for-gestational age (LGA) baby (>90th percentile) at baseline and mothers with body mass index (BMI) ≥ 25 kg/m2 and a child > 85th percentile. RESULTS The adjusted analysis showed that the risk of mother-child pairs concurrently having EBW increased with increasing pre-pregnancy BMI (RR = 2.4 and RR = 3.3 for pre-pregnancy BMI 25-30 and ≥30 kg/m2, respectively, P < 0.01). Excessive GWG and LGA infants were also significant predictors of EBW concurrently affecting mother-child pairs (RR = 2.2 and RR = 2.3, respectively, P < 0.01). CONCLUSION Excessive pre-pregnancy BMI, excessive GWG and LGA status were strong predictors of EBW concurrently affecting mother-child pairs over 6 years of follow-up. Public policies must be established primarily before/during pregnancy to avoid an EBW cycle in the same family over the years.
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Affiliation(s)
- Sandra Ana Czarnobay
- Postgraduate Program in Health and Environment, University of Joinville Region - UNIVILLE, Joinville, Santa Catarina, CEP 89.219-710, Brazil
| | - Caroline Kroll
- Postgraduate Program in Health and Environment, University of Joinville Region - UNIVILLE, Joinville, Santa Catarina, CEP 89.219-710, Brazil
| | - Cecília Burigo Corrêa
- Postgraduate Program in Health and Environment, University of Joinville Region - UNIVILLE, Joinville, Santa Catarina, CEP 89.219-710, Brazil
| | - Silmara S B S Mastroeni
- Department of Health Sciences, University of Joinville Region - UNIVILLE, Joinville, Santa Catarina, CEP 89.219-710, Brazil
| | - Marco F Mastroeni
- Postgraduate Program in Health and Environment, University of Joinville Region - UNIVILLE, Joinville, Santa Catarina, CEP 89.219-710, Brazil.,Department of Health Sciences, University of Joinville Region - UNIVILLE, Joinville, Santa Catarina, CEP 89.219-710, Brazil
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31
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Hampl SE, Hassink SG, Skinner AC, Armstrong SC, Barlow SE, Bolling CF, Avila Edwards KC, Eneli I, Hamre R, Joseph MM, Lunsford D, Mendonca E, Michalsky MP, Mirza N, Ochoa ER, Sharifi M, Staiano AE, Weedn AE, Flinn SK, Lindros J, Okechukwu K. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics 2023; 151:e2022060640. [PMID: 36622115 DOI: 10.1542/peds.2022-060640] [Citation(s) in RCA: 199] [Impact Index Per Article: 199.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/10/2023] Open
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Joint Effects of Prenatal Folic Acid Supplement with Prenatal Multivitamin and Iron Supplement on Obesity in Preschoolers Born SGA: Sex Specific Difference. Nutrients 2023; 15:nu15020380. [PMID: 36678251 PMCID: PMC9863758 DOI: 10.3390/nu15020380] [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: 12/24/2022] [Revised: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
Prenatal maternal nutrient supplementation has been reported to be associated with offspring obesity, but the reports are inconsistent and have mainly ignored the differences between the total children population and children born small for gestational age (SGA). This study aimed to examine the joint effects of folic acid, iron, and multivitamin supplementation during pregnancy on the risk of obesity in preschoolers born SGA. A total of 8918 children aged 3-6.5 years born SGA were recruited from Longhua District in Shenzhen of China in 2021. Their mothers completed a structured questionnaire about the child's and parents' socio-demographic characteristics, maternal prepregnant obesity, and mothers' prenatal supplementation of folic acid, iron, and multivitamin. In addition, the children's current weight and height were measured by trained nurses. Logistic regression models were used to analyze the associations between prenatal supplementations and the current presence of childhood obesity. After controlling for potential confounders, the results of the logistic regression analysis showed that prenatal supplement of folic acid (OR = 0.72, 95% CI = 0.55~0.93) was associated with a lower likelihood of being an obese preschooler born SGA. In contrast, the ingestion of multivitamin or iron supplements during pregnancy did not seem to be related to the likelihood of childhood obesity in preschoolers born SGA. Moreover, cross-over analysis of prenatal folic acid and multivitamin obtained significant negative associations of prenatal folic acid supplement only (OR = 0.73, 95% CI = 0.55~0.97) and combination supplement of folic acid and multivitamin (OR = 0.67, 95% CI = 0.50~0.90) with obesity of preschoolers born SGA; while the cross-over analysis of prenatal folic acid and iron observed significant negative associations between obesity of preschoolers born SGA and a combination supplement of folic acid and iron (OR = 0.70, 95% CI = 0.52~0.96). Furthermore, the aforementioned significant associations were only found in girls and not in boys when the analyses were stratified by sex. Our findings suggest that the prenatal folic acid supplementation may decrease the risk of obesity in preschool girls born SGA, and that this effect may be modified by prenatal multivitamin or iron supplementation.
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Domingos DS, Troster EJ, Vieira TCA. Content validation of a questionnaire to assess the knowledge of pediatricians, family, and community physicians on obesity. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 41:e2022063. [PMID: 36921177 PMCID: PMC10013993 DOI: 10.1590/1984-0462/2023/41/2022063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 11/16/2022] [Indexed: 03/17/2023]
Abstract
OBJECTIVE The aim of this study was to validate the content of a questionnaire in order to assess the attitudes and practices in childcare consultations, knowledge on overweight and obesity, their risk factors, and barriers in addressing the issue by pediatricians and family physicians. METHODS The Delphi technique was used, with the objective of reaching a consensus on a certain subject, through experts' opinions. The content validity index (CVI) of each item, axis, and questionnaire was calculated. The inter-rater reliability was calculated using an agreement coefficient suitable for the answer distribution such as Gwet's AC2 with ordinal weight. RESULTS A total of 63 experts were invited to assess and give their opinion on the questionnaire. In all, 52 accepted the invitation and analyzed the instrument. After two rounds, the questionnaire reached the proper CVI for the study and was considered complete, with its final version having 40 questions, a final index of 95%, and an inter-rate reliability of 0.905. CONCLUSIONS This instrument, developed to assess attitudes and practices, knowledge, and barriers found in addressing the obesity by primary care physicians, obtained a CVI greater than 0.8 and an excellent agreement coefficient of the 52 judges. Therefore, its content can be considered validated.
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Affiliation(s)
| | - Eduardo Juan Troster
- Universidade de São Paulo, São Paulo, SP, Brazil.,Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, SP, Brazil
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Fangupo L, Daniels L, Taylor R, Glover M, Taungapeau F, Sa'u S, Cutfield W, Taylor B. The care of infants with rapid weight gain: Should we be doing more? J Paediatr Child Health 2022; 58:2143-2149. [PMID: 36259748 PMCID: PMC10092129 DOI: 10.1111/jpc.16247] [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: 07/04/2022] [Revised: 09/27/2022] [Accepted: 10/02/2022] [Indexed: 11/28/2022]
Abstract
Rapid weight gain (RWG) during infancy is a known risk factor for later childhood obesity. It can be measured using a range of definitions across various time periods in the first 2 years of life. In recent years, some early childhood obesity prevention trials have included a focus on preventing RWG during infancy, with modest success. Overall, RWG during infancy remains common, yet little work has examined whether infants with this growth pattern should receive additional care when it is identified in health-care settings. In this viewpoint, we contend that RWG during infancy should be routinely screened for in health-care settings, and when identified, viewed as an opportunity for health-care professionals to instigate non-stigmatising discussions with families about RWG and general healthy practices for their infants. If families wish to engage, we suggest that six topics from early life obesity prevention studies (breastfeeding, formula feeding, complementary feeding, sleep, responsive parenting, and education around growth charts and monitoring) could form the foundations of conversations to help them establish and maintain healthy habits to support their infant's health and well-being and potentially lower the risk of later obesity. However, further work is needed to develop definitive guidelines in this area, and to address other gaps in the literature, such as the current lack of a standardised definition for RWG during infancy and a clear understanding of the time points over which it should be measured.
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Affiliation(s)
- Louise Fangupo
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Lisa Daniels
- Department of Medicine, University of Otago, Dunedin, New Zealand.,Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - Rachael Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand.,A Better Start National Science Challenge, University of Auckland, Auckland, New Zealand
| | - Marewa Glover
- Papaharakeke International Ltd, Auckland, New Zealand
| | | | | | - Wayne Cutfield
- A Better Start National Science Challenge, University of Auckland, Auckland, New Zealand.,The Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Barry Taylor
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand.,A Better Start National Science Challenge, University of Auckland, Auckland, New Zealand
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35
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Sugar reduction in beverages: Current trends and new perspectives from sensory and health viewpoints. Food Res Int 2022; 162:112076. [DOI: 10.1016/j.foodres.2022.112076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 10/08/2022] [Accepted: 10/22/2022] [Indexed: 11/22/2022]
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36
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Chen C, Zhou C, Liu S, Jiao X, Wang X, Zhang Y, Yu X. Association between Suboptimal 25-Hydroxyvitamin D Status and Overweight/Obesity in Infants: A Prospective Cohort Study in China. Nutrients 2022; 14:nu14224897. [PMID: 36432582 PMCID: PMC9698418 DOI: 10.3390/nu14224897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
This study aimed to investigate whether 25-hydroxyvitamin D (25(OH)D) concentrations are correlated to overweight/obesity in infants and to explore a threshold of 25(OH)D. A total of 1205 six-month-old infants from two community hospitals in Shanghai were randomly recruited, and 925 of them were followed up at 12 months. Concentration of 25(OH)D, weight, and length were measured at two time points. Overweight/obesity was defined as a weight-for-length Z-score >97th percentile. The prevalence of overweight/obesity at 6 and 12 months was 6.88% and 5.26%, respectively. The occurrence of vitamin D (VitD) deficiency (<20 ng/mL) at 6 and 12 months was 6.56% and 2.05%, respectively. Concentration of 25(OH)D at the corresponding age was negatively associated with weight-for-length percentile (WLP) at both 6 (adjusted β: −0.14; 95% CI: −0.27, −0.02; p = 0.02) and 12 months (adjusted β: −0.22; 95% CI: −0.41, −0.02; p = 0.03), while the relationship between 25(OH)D at 6 months and WLP at 12 months was nonlinear, where 35 ng/mL was identified as an inflection point. Those with a concentration of 25(OH)D <35 ng/mL at 6 months had a higher risk of overweight/obesity (adjusted OR: 1.42; 95% CI: 1.06, 1.91; p = 0.02) compared to the group with a concentration of 25(OH)D ≥35 ng/mL. Moreover, a concentration of 25(OH)D <35 ng/mL at two time points significantly increased the risk of overweight/obesity at 12 months compared to the group with 25(OH)D concentration ≥35 ng/mL at two time points (adjusted OR: 2.91; 95% CI: 1.13, 7.46; p = 0.03). A suboptimal 25(OH)D concentration <35 ng/mL significantly increases the risk of overweight/obesity in infants.
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Affiliation(s)
- Chen Chen
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Chunyan Zhou
- Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Shijian Liu
- Department of Clinical Epidemiology and Biostatistics, Children Health Advocacy Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Xianting Jiao
- Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Xirui Wang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Yue Zhang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Xiaodan Yu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- MOE-Shanghai Key Lab of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
- Correspondence:
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Moore THM, Phillips S, Heslehurst N, Hodder RK, Dawson S, Gao Y, Hesketh K, Summerbell CD. Interventions to prevent obesity in children under 2 years old. Hippokratia 2022. [DOI: 10.1002/14651858.cd015324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Theresa HM Moore
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Sophie Phillips
- Department of Sport and Exercise Sciences; Durham University; Durham UK
- Fuse - Centre for Translational Research in Public Health; Newcastle Upon Tyne UK
| | - Nicola Heslehurst
- Fuse - Centre for Translational Research in Public Health; Newcastle Upon Tyne UK
- Population Health Sciences Institute; Newcastle University; Newcastle upon Tyne UK
| | - Rebecca K Hodder
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- School of Medicine and Public Health; The University of Newcastle; Callaghan Australia
- National Centre of Implementation Science; The University of Newcastle; Callaghan Australia
- Population Health Research Program; Hunter Medical Research Institute; New Lambton Heights Australia
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Yang Gao
- Department of Sport, Physical Education and Health; Hong Kong Baptist University; Kowloon Hong Kong
| | - Kathryn Hesketh
- MRC Epidemiology Unit; University of Cambridge; Cambridge UK
| | - Carolyn D Summerbell
- Department of Sport and Exercise Sciences; Durham University; Durham UK
- Fuse - Centre for Translational Research in Public Health; Newcastle Upon Tyne UK
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Hu Z, Han L, Liu J, Fowke JH, Han JC, Kakhniashvili D, LeWinn KZ, Bush NR, Mason WA, Zhao Q. Prenatal metabolomic profiles mediate the effect of maternal obesity on early childhood growth trajectories and obesity risk: the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study. Am J Clin Nutr 2022; 116:1343-1353. [PMID: 36055779 PMCID: PMC9630879 DOI: 10.1093/ajcn/nqac244] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/26/2022] [Accepted: 08/30/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Maternal prepregnancy obesity is an important risk factor for offspring obesity, which may partially operate through prenatal programming mechanisms. OBJECTIVES The study aimed to systematically identify prenatal metabolomic profiles mediating the intergenerational transmission of obesity. METHODS We included 450 African-American mother-child pairs from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study pregnancy cohort. LC-MS was used to conduct metabolomic profiling on maternal plasma samples of the second trimester. The childhood growth outcomes of interest included BMI trajectories from birth to age 4 y (rising-high-, moderate-, and low-BMI trajectories) as well as overweight/obesity (OWO) risk at age 4 y. Mediation analysis was conducted to identify metabolite mediators linking maternal OWO and childhood growth outcomes. The potential causal effects of maternal OWO on metabolite mediators were examined using the Mendelian randomization (MR) method. RESULTS Among the 880 metabolites detected in the maternal plasma during pregnancy, 14 and 11 metabolites significantly mediated the effects of maternal prepregnancy OWO on childhood BMI trajectories and the OWO risk at age 4 y, respectively, and 5 mediated both outcomes. The MR analysis suggested 6 of the 20 prenatal metabolite mediators might be causally influenced by maternal prepregnancy OWO, most of which are from the pathways related to the metabolism of amino acids (hydroxyasparagine, glutamate, and homocitrulline), sterols (campesterol), and nucleotides (N2,N2-dimethylguanosine). CONCLUSIONS Our study provides further evidence that prenatal metabolomic profiles might mediate the effect of maternal OWO on early childhood growth trajectories and OWO risk in offspring. The metabolic pathways, including identified metabolite mediators, might provide novel intervention targets for preventing the intrauterine development of obesity in the offspring of mothers with obesity.
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Affiliation(s)
- Zunsong Hu
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Luhang Han
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jiawang Liu
- Medicinal Chemistry Core, Office of Research, University of Tennessee Health Science Center, Memphis, TN, USA; Department of Pharmaceutical Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jay H Fowke
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Joan C Han
- Departments of Pediatrics and Physiology, University of Tennessee Health Science Center, and Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA; Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, New York, NY, USA
| | - David Kakhniashvili
- Proteomics and Metabolomics Core, Office of Research, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - W Alex Mason
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Qi Zhao
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
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Birth Weight and Body Composition as Determined by Isotopic Dilution with Deuterium Oxide in 6- to 8-Year-Old South African Children. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101597. [PMID: 36291533 PMCID: PMC9600216 DOI: 10.3390/children9101597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/11/2022] [Accepted: 10/19/2022] [Indexed: 11/18/2022]
Abstract
Low and high birth weight (BW) are associated with obesity later in life; however, this association has not been extensively studied in African countries. This study determines the association between BW and body composition derived from deuterium oxide (D2O) dilution in 6- to 8-year-old South African children (n = 91; 40 boys, 51 girls). BW was recorded retrospectively from the children’s Road-to-Health cards. Weight and height were measured using standard procedures, and D2O dilution was used to determine total body water and, subsequently, to determine body fat. Fatness was classified using the McCarthy centiles, set at 2nd, 85th, and 95th (underfat, overfat and obese). BW correlated with body composition measures, such as body weight (r = 0.23, p = 0.03), height (r = 0.33, p < 0.001), and fat free mass (FFM; r = 0.27, p = 0.01). When multiple regression analysis was employed, BW significantly and positively associated with FFM (β = 0.24, p = 0.013; 95% CI: 0.032; 0.441) and fat mass (β = 0.21, p = 0.02, 95%CI: 0.001; 0.412) in girls and boys combined. A total of 13% of the children had a low BW, with 21% being overweight and 17% obese. More girls than boys were overweight and obese. Intervention strategies that promote healthy uterine growth for optimal BW are needed in order to curb the global obesity pandemic.
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Mexitalia M, Ardian RY, Pratiwi R, Panunggal B. Correlation of maternal dietary intake with breast milk composition and infant growth. Nutr Health 2022:2601060221129118. [PMID: 36164676 DOI: 10.1177/02601060221129118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Maternal dietary intake during the period of lactation has an impact on infants growth. Macronutrients in breast milk are affected by several factors such as maternal dietary intake and maternal nutritional status. This study aims to prove the association between maternal protein and fat intake with the composition of breast milk and growth of infants (age 0-6 months). Methods: Prospective study was conducted for 6 months in 41 mother-infant pairs who were exclusively breastfed, and visited to hospitals or health centres. The mothers age is <40 years old with normal and single pregnancy. The breast milk was collected and analyzed using Human Milk Analyzer. Results: There was a negative correlation between maternal protein intake and breast milk composition at 3 months old infants (p = 0.042), between fat intake with HAZ score at 2 weeks (p = 0.048), and between protein intake with HAZ score at 3 months (p = 0.049). Finally, there was a significant increase in WAZ and HAZ score in all sample groups. Although the maternal protein intake of our subjects were only at 83% of Indonesian's RDA average, the protein composition of breast milk and the growth of the infants was sufficient. Conclusion: There is correlation between maternal dietary intake with the composition of breastmilk and infant growth. Even though the calories and protein intake of the mother is lower than the RDA, the breast milk is still sufficient for the growth of infants aged 0-6 months who are exclusively breastfed.
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Affiliation(s)
- Maria Mexitalia
- Department of Pediatrics, 95450Faculty of Medicine, Diponegoro University/Dr Kariadi Hospital, Indonesia
| | - Rendy Yoga Ardian
- Department of Pediatrics, 95450Faculty of Medicine, Diponegoro University/Dr Kariadi Hospital, Indonesia
| | - Rina Pratiwi
- Department of Pediatrics, 95450Faculty of Medicine, Diponegoro University/Dr Kariadi Hospital, Indonesia
| | - Binar Panunggal
- Department of Nutrition Science, 95450Faculty of Medicine, Diponegoro University, Indonesia
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Demmelmair H, Fleddermann M, Koletzko B. Infant Feeding Choices during the First Post-Natal Months and Anthropometry at Age Seven Years: Follow-Up of a Randomized Clinical Trial. Nutrients 2022; 14:nu14193900. [PMID: 36235553 PMCID: PMC9572598 DOI: 10.3390/nu14193900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
The Belgrade–Munich Infant Milk Trial (BeMIM) randomized healthy term infants into either a protein-reduced intervention infant formula (IF) group, with an α-lactalbumin-enriched whey and long-chain polyunsaturated fatty acids, or a control infant formula (CF) group. A non-randomized breastfed group (BF) was studied for reference. We assessed the long-term effects of these infant feeding choices on growth measures until the age of seven years. Weight, standing height, head circumference, and percent body fat (using skinfolds and bioelectrical impedance) were determined with standardized methods. A total of 161 children out of the 256 completers of the initial study (63%) participated in the seven-year follow-up. Children in the three study groups did not differ in their anthropometric measures, including body mass index (IF 16.1 ± 2.6, CF: 15.6 ± 1.7, BF: 15.6 ± 2.5 kg/m2, mean ± SD). IGF-1 serum concentrations determined at the age of 4 months contributed to explaining the variances in weight (p = 0.001), height (p = 0.001) and BMI (p = 0.035) z-scores at the age of seven years, whereas insulin levels at four months did not. Different feeding choices during the first four months of life leading to higher energy efficiency and increased growth with IF did not affect later growth outcomes at an early school age. Diet-induced modulation of IGF-1 in the first months of life may have lasting programming effects on later growth.
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Affiliation(s)
- Hans Demmelmair
- Dr. Von Hauner Children’s Hospital, University of Munich Medical Centre, Ludwig-Maximilians-Universiät München, 80337 Munich, Germany
- Correspondence: (H.D.); (B.K.)
| | | | - Berthold Koletzko
- Dr. Von Hauner Children’s Hospital, University of Munich Medical Centre, Ludwig-Maximilians-Universiät München, 80337 Munich, Germany
- Correspondence: (H.D.); (B.K.)
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42
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Fragmented day-night cycle induces reduced light avoidance, excessive weight gain during early development, and binge-like eating during adulthood in mice. Physiol Behav 2022; 253:113851. [PMID: 35609722 DOI: 10.1016/j.physbeh.2022.113851] [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: 12/09/2021] [Revised: 04/28/2022] [Accepted: 05/19/2022] [Indexed: 11/23/2022]
Abstract
Fragmented day-night (FDN) cycles are environments in which multiple periods of light and dark alternate across a 24 h period. Exposure to FDN cycles disrupts circadian rhythms, resulting in period lengthening and alterations to mood in mice. A constant light environment, which also induces period lengthening, is linked to mood and metabolic disturbances and disruption to the development of the circadian clock. This study aims to determine how exposure to the FDN cycle impacts development in mice, with the hypothesis that there would be similar and adverse effects as observed in constant light conditions. Our study used CD-1 mice reared under the FDN cycle compared to the commonly used 12 h light: 12 h dark consolidated day-night cycle. During the first week of development, mouse pups reared under the FDN cycle gained bodyweight at a faster rate and did not avoid aberrant light exposure in comparison to 12:12 LD reared mouse pups. Developmental exposure to the FDN cycle lasted two weeks, and then mice were transferred to the 12:12 LD cycle, where after 2 weeks, bodyweight was similar between FDN reared and 12:12 LD reared mice at 1-month and 2-months old. When re-exposed to the FDN cycle during adulthood, FDN reared pups exhibited binge-like eating behaviors and reduced light avoidance. This study shows that the unnatural distribution of light and dark across the 24 h day can cause disruptions during early development that can reappear during adulthood when placed in the same stressful light-dark environment as adults.
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Abstract
PURPOSE OF REVIEW Approximately 370 million children and adolescents worldwide showed overweight or obesity in 2016. The risk of developing severe comorbidities depends on the age of onset and the duration of obesity. This review discusses available methodologies to detect excess body fat in children as well as the early life factors that predict excess body fat and its development. RECENT FINDINGS Factors, such as parental nutritional status, maternal weight gain during pregnancy, maternal malnutrition, maternal smoking during pregnancy, low and high birth weight, rapid weight gain, and short infant sleep duration have been independently and positively associated with neonatal, infant, and children adiposity. Early detection of excess body fat in children through the use of various tools is the first step in preventing nutrition-related diseases in adulthood. SUMMARY The early detection of excess body fat and the implementation of efficient interventions to normalize the weight of children and adolescents at obesity risk are essential to prevent diseases in adult life.
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Affiliation(s)
- Diana Paola Córdoba-Rodríguez
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá DC, Colombia
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2)Universidad de Zaragoza, Zaragoza, Spain
| | - Gerardo Rodriguez
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2)Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Red de Salud Materno Infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, Madrid, Spain
- Área de Pediatría, Universidad de Zaragoza, Zaragoza, Spain
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2)Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III Madrid, Madrid, Spain
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44
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Wilson DK, Zarrett N, Sweeney AM. The Importance of Addressing Multilevel Transactional Influences of Childhood Obesity to Inform Future Health Behavior Interventions. Pediatr Clin North Am 2022; 69:657-669. [PMID: 35934492 DOI: 10.1016/j.pcl.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We provide a transactional model of health for understanding the early risk of obesity in youth. This model argues that positive health is construed through the choices and actions that youth take within the range of resources and constraints of their biological and contextual situations across time. Social, cognitive, affective, and behavioral regulatory/motivational processes within the child mediate the relation between life experiences and health outcomes and obesity pathways are influenced by cumulative risk or protective processes for health promotion/compromising behaviors influencing health. We provide evidence-based examples of multilevel approaches to obesity prevention and treatment and highlight recommendations for future health behavior interventions.
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Affiliation(s)
- Dawn K Wilson
- Department of Psychology, Barnwell College, University of South Carolina, Columbia, SC 29208, USA.
| | - Nicole Zarrett
- Department of Psychology, Barnwell College, University of South Carolina, Columbia, SC 29208, USA
| | - Allison M Sweeney
- College of Nursing, University of South Carolina, 1601 Greene Street, Columbia, SC 29208, USA
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45
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Iglesia Altaba I, Larqué E, Mesa MD, Blanco-Carnero JE, Gomez-Llorente C, Rodríguez-Martínez G, Moreno LA. Early Nutrition and Later Excess Adiposity during Childhood: A Narrative Review. Horm Res Paediatr 2022; 95:112-119. [PMID: 34758469 DOI: 10.1159/000520811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 11/09/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Studies on childhood obesity mainly focus on the genetic component and on the lifestyle that may be associated with the development of obesity. However, the study of perinatal factors in their programming effect toward future obesity in children or adults is somewhat more recent, and there are still mechanisms to be disentangled. SUMMARY In this narrative review, a comprehensive route based on the influence of some early factors in life in the contribution to later obesity development is presented. Maternal pre-pregnancy BMI and gestational weight gain have been pointed out as independent determinants of infant later adiposity. Lifestyle interventions could have an impact on pregnant mothers through epigenetic mechanisms capable of redirecting the genetic expression of their children toward a future healthy weight and body composition and dietary-related microbiome modifications in mothers and newborns might also be related. After birth, infant feeding during the first months of life is directly associated with its body composition and nutritional status. From this point of view, all the expert committees in the world are committed to promote exclusive breastfeeding up to 6 months of age and to continue at least until the first year of life together with complementary feeding based on healthy dietary patterns such as Mediterranean Diet. KEY MESSAGES To develop future effective programs to tackle early obesity, it is necessary not only by controlling lifestyle behaviors like infant feeding but also understanding the role of other mechanisms like the effect of perinatal factors such as maternal diet during pregnancy, epigenetics, or microbiome.
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Affiliation(s)
- Iris Iglesia Altaba
- Aragon Health Research Institute, University of Zaragoza, Zaragoza, Spain.,Maternal-Infant and Developmental Health Network (SAMID), RETICS Carlos III Health Institute (ISCIII), Madrid, Spain.,Growth, Exercise, Nutrition and Development (GENUD), Faculty of Health Sciences, University of Zaragoza, and Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
| | - Elvira Larqué
- Maternal-Infant and Developmental Health Network (SAMID), RETICS Carlos III Health Institute (ISCIII), Madrid, Spain.,Department of Physiology, Murcia University, Murcia, Spain
| | - María Dolores Mesa
- Maternal-Infant and Developmental Health Network (SAMID), RETICS Carlos III Health Institute (ISCIII), Madrid, Spain.,Department of Biochemistry and Molecular Biology II, School of Pharmacy. Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Center, University of Granada, Granada, Spain.,ibs.GRANADA, Biosanitary Research Institute, Granada, Spain
| | | | - Carolina Gomez-Llorente
- Department of Biochemistry and Molecular Biology II, School of Pharmacy. Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Center, University of Granada, Granada, Spain.,ibs.GRANADA, Biosanitary Research Institute, Granada, Spain.,Center for Biomedical Research on Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Gerardo Rodríguez-Martínez
- Aragon Health Research Institute, University of Zaragoza, Zaragoza, Spain.,Maternal-Infant and Developmental Health Network (SAMID), RETICS Carlos III Health Institute (ISCIII), Madrid, Spain.,Growth, Exercise, Nutrition and Development (GENUD), Faculty of Health Sciences, University of Zaragoza, and Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Department of Pediatrics, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Luis A Moreno
- Aragon Health Research Institute, University of Zaragoza, Zaragoza, Spain.,Growth, Exercise, Nutrition and Development (GENUD), Faculty of Health Sciences, University of Zaragoza, and Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Center for Biomedical Research on Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
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46
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Shriver LH, Eagleton S, Lawless MC, Buehler C, Wideman L, Leerkes EM. Infant appetite and weight gain in early infancy: Moderating effects of controlling feeding styles. Appetite 2022; 176:106139. [PMID: 35718312 DOI: 10.1016/j.appet.2022.106139] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 11/19/2022]
Abstract
Excessive infant weight gain is a strong predictor of later obesity. While controlling feeding has been linked to negative weight outcomes, research has not considered associations between infant appetite and maternal feeding simultaneously in relation to infant weight. This longitudinal study examined infant food responsiveness and slowness in eating as predictors of infant weight outcomes and tested controlling feeding styles (restrictive and pressuring) as moderators. Data came from a diverse sample of mothers and their infants participating in an ongoing longitudinal study. Mothers (n = 159) reported infant appetite and feeding styles at 2 postnatal timepoints (2-month visits and 6-month visits). The infant weight outcomes included change in weight-for-age z-scores (WAZ-change) and rapid weight gain (RIWG; WAZ-change ≥ 0.67 SD) from birth to the second postnatal visit. Data were analyzed using hierarchical multiple and logistic regressions, controlling for birthweight, gestational age, maternal race/ethnicity, feeding mode, and residing with an intimate partner. Over 25% of infants exhibited RIWG. Greater infant food responsiveness predicted both greater infant weight gain and RIWG status. Infant food responsiveness and slowness in eating interacted with controlling feeding styles in a unique way. Infants with higher food responsiveness whose mothers were less restrictive had greater weight gain (b = 0.61, p < 0.001) and increased probability of RIWG (b = 2.71, p < 0.01) than infants with more restrictive mothers. Higher slowness in eating was associated with a lower RIWG probability among infants of mothers with lower pressuring feeding (b = -1.86, p < 0.05). For infants with a large appetite, some level of restrictive feeding may be beneficial for preventing excessive weight gain while pressuring may exacerbate the positive association between faster eating and RIWG.
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Affiliation(s)
- Lenka H Shriver
- Nutrition, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Sally Eagleton
- Human Development and Family Studies, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Megan C Lawless
- School of Medicine, Pediatrics, University of Colorado-Anschutz Medical Campus, Aurora, CO, 80045, USA.
| | - Cheryl Buehler
- Human Development and Family Studies, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Laurie Wideman
- Kinesiology, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Esther M Leerkes
- Human Development and Family Studies, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
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47
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Meng M, Jiang Y, Lin J, Zhang J, Wang G, Zhu Q, Lin Q, Jiang F. The mediating effect of DNA methylation in the association between maternal sleep during pregnancy and offspring adiposity status: a prospective cohort study. Clin Epigenetics 2022; 14:66. [PMID: 35596190 PMCID: PMC9123687 DOI: 10.1186/s13148-022-01284-w] [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: 02/21/2022] [Accepted: 04/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background Childhood overweight/obesity is a global public health concern. It is important to identify its early-life risk factors. Maternal poor sleep is common in late pregnancy, and previous studies indicated that poor sleep may influence the offspring’s adiposity status. However, very few studies in humans investigated the effect of the different sleep parameters (sleep quantity, quality, and timing) on the offspring’s adiposity indicators, and long-term studies are even more scarce. In addition, the underlying mechanism remains unclear. The present study therefore aimed to examine the association between the three maternal sleep dimensions in the late pregnancy and the offspring adiposity indicators and to explore the potential mediating effect of the cord blood DNA methylation in the above association. Methods Included participants in the current study were 2211 healthy pregnant women with singleton gestation from the Shanghai Birth Cohort (SBC) and Shanghai Sleep Birth Cohort (SSBC). Maternal nighttime sleep duration, quality, and midpoint (an indicator of circadian rhythm) were assessed by the same instrument in both cohorts during late pregnancy, and the offspring’s body mass index (BMI) and subcutaneous fat (SF) were measured at 2 years old. Additionally, in 231 SSBC samples, the genome-wide DNA methylation levels were measured using the Illumina Infinium Methylation EPIC BeadChip. The multivariate linear regression was used to determine the associations between the maternal sleep parameters and the offspring adiposity indicators. The epigenome-wide association study was conducted to identify the maternal sleep-related CpG sites. The mediation analysis was performed to evaluate the potential intermediate role of DNA methylation in the association between maternal sleep and offspring adiposity indicators. Results The mean maternal nighttime sleep duration and the sleep midpoint for combined cohorts were 9.24 ± 1.13 h and 3.02 ± 0.82, respectively, and 24.5% of pregnant women experienced poor sleep quality in late pregnancy. After adjusting for the covariates, the maternal later sleep midpoint was associated with the increased SF in offspring (Coef. = 0.62, 95% CI 0.37–0.87, p < 0.001) at 2 years old. However, no significant associations of the nighttime sleep duration or sleep quality with the offspring adiposity indicators were found. In the SSBC sample, 45 differential methylated probes (DMPs) were associated with the maternal sleep midpoint, and then, we observed 10 and 3 DMPs that were also associated with the offspring’s SF and BMI at 2 years, of which cg04351668 (MARCH9) and cg12232388 significantly mediated the relationship of sleep midpoint and SF and cg12232388 and cg12225226 mediated the sleep midpoint–BMI association, respectively. Conclusions Maternal later sleep timing in late pregnancy was associated with higher childhood adiposity in the offspring. Cord blood DNA methylation may play a mediation role in that relationship. Supplementary Information The online version contains supplementary material available at 10.1186/s13148-022-01284-w.
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Affiliation(s)
- Min Meng
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dong Fang Road, Shanghai, 200127, China.,Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Yanrui Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dong Fang Road, Shanghai, 200127, China.,Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Jianfei Lin
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dong Fang Road, Shanghai, 200127, China.,Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China.,School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Guanghai Wang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dong Fang Road, Shanghai, 200127, China.,Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China.,Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, 201602, China
| | - Qi Zhu
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dong Fang Road, Shanghai, 200127, China.,Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Qingmin Lin
- School of Life Science and Biotechnology, Shanghai Jiao Tong University, 800 Dong Chuan Road, Shanghai, 200240, China.
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dong Fang Road, Shanghai, 200127, China. .,Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China. .,Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, 201602, China.
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48
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Tsai SY, Tung YC, Wu WW, Lee CC. Sleep pattern regularity and measures of infant weight and length during the first 6 months. J Pediatr Nurs 2022; 64:e102-e108. [PMID: 34996681 DOI: 10.1016/j.pedn.2021.12.022] [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: 09/14/2021] [Revised: 12/19/2021] [Accepted: 12/22/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To examine the association between sleep pattern regularity and measures of weight and length in infants. DESIGN AND METHODS This was a prospective observational study conducted in a university-affiliated children's hospital in northern Taiwan. A total of 316 healthy infants recruited during their 6-month well-child checkups had their weight and recumbent length measured, and wore an actigraph on the ankle for a week. Based on average weekday, weekend, and all-week sleep durations, infants were categorized into 3 groups: regular sleep, weekend catch-up sleep, and weekend sleep curtailment. General linear model analyses were performed with the 3 sleep regularity groups as the primary predictor variable of interest and infant anthropometry as the dependent variable. RESULTS At risk of overweight, overweight, and obese was present in a total of 62 (19.6%) infants. In both unadjusted and adjusted models, infants in the weekend catch-up sleep group (30.4%) and those in the weekend sleep curtailment group (34.5%) had significantly higher weight-to-length ratios, body mass index, weight-for-age z-scores, and weight velocity of 6-month increments z-scores when compared with infants in the regular sleep group (35.1%, all p < 0.05). CONCLUSIONS Differences in weekday-weekend sleep exist as early as in the first 6 months of life, and both catch-up sleep and sleep curtailment over the weekend is associated with higher measures of weight and length in infants. PRACTICE IMPLICATIONS Sleep assessments in well-child checkups should include not only global assessments of average sleep duration but also address sleep patterns and their regularity.
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Affiliation(s)
- Shao-Yu Tsai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Yi-Ching Tung
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Wen Wu
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chien-Chang Lee
- Department of Emergency Medicine, National Taiwan University, Taipei, Taiwan
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49
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Papadimitriou A, Marakaki C, Papadimitriou DT. Growth variations with opposite clinical outcomes and the emerging role of IGF-1. Trends Endocrinol Metab 2022; 33:359-370. [PMID: 35331614 DOI: 10.1016/j.tem.2022.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 12/15/2022]
Abstract
Normal growth pattern variations [i.e., constitutional advancement and constitutional delay of growth and puberty (CAGP and CDGP)] are the mirror image of each other and are associated with early puberty (EP) and delayed puberty (DP), respectively. Differences between CAGP and CDGP relate not only to auxological characteristics (height, weight) but also to insulin-like growth factor-1 (IGF-1). IGF-1 levels in CAGP are above average whereas in CDGP they are below average, suggesting a role for IGF-1 in the induction of these growth patterns. Herein, we provide data suggesting that early activation of the growth hormone (GH)/IGF-1 axis induces the growth pattern of CAGP. Moreover, we suggest that IGF-1 is a decisive factor for the release of the gonadotropin-releasing hormone (GnRH) inhibition brake that occurs in prepuberty. It is therefore crucial for puberty onset.
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Affiliation(s)
- Anastasios Papadimitriou
- Pediatric Endocrinology Unit, Third Department of Pediatrics, National and Kapodistrian University of Athens, 'Attikon' University Hospital, Haidari, Athens, Greece.
| | - Chrisanthi Marakaki
- Pediatric Endocrinology Unit, Third Department of Pediatrics, National and Kapodistrian University of Athens, 'Attikon' University Hospital, Haidari, Athens, Greece
| | - Dimitrios T Papadimitriou
- Pediatric-Adolescent Endocrinology and Diabetes, Athens Medical Center, Marousi and Endocrine Unit, Aretaeion University Hospital, Athens, Greece
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50
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Gomahr J, Julian V, Thivel D, Maruszczak K, Schneider AM, Weghuber D. Childhood obesity prevention: what can be achieved? Curr Opin Clin Nutr Metab Care 2022; 25:223-231. [PMID: 35256565 DOI: 10.1097/mco.0000000000000831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Childhood obesity is a pandemic generating an enormous individual and socioeconomic burden worldwide. This narrative review summarizes recent evidence on successful and recommended prevention strategies according to age groups and different levels of interventions. RECENT FINDINGS Effective prevention of childhood obesity is feasible and most successful early in life up to preschool age, and it should include a multicomponent approach, integrating individuals, family and society. Trials that improve nutrition and/or enhance physical activity are the cornerstones of childhood obesity prevention on an individual level. However, their efficacy is determined by the combination of interventions for the target age group. Further, improving family support and sleep, as well as reducing screen time, lead to favourable results. Many research gaps remain, including a lack of effective interventions for high-risk groups. SUMMARY As a multifactorial condition, childhood obesity requires a multicomponent approach. Interventions should be developmental stage-specific and adjusted to the setting. Current research gaps need to be targeted by future trials, with a special focus on the benefit of the most vulnerable groups. From a systems response perspective, a paradigm shift from interventions focusing on the individual to approaches that target society as a whole is warranted.
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Affiliation(s)
- Julian Gomahr
- Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
| | - Valérie Julian
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand
| | - David Thivel
- Laboratory AME2P, University of Clermont Auvergne, Aubiere, Franoe
| | - Katharina Maruszczak
- Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
| | - Anna-Maria Schneider
- Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
| | - Daniel Weghuber
- Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
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