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Ross MG, Kavasery MP, Cervantes MK, Han G, Horta B, Coca KP, Costa SO, Desai M. High-Fat, High-Calorie Breast Milk in Women with Overweight or Obesity and Its Association with Maternal Serum Insulin Concentration and Triglycerides Levels. CHILDREN (BASEL, SWITZERLAND) 2024; 11:141. [PMID: 38397253 PMCID: PMC10887191 DOI: 10.3390/children11020141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/25/2024]
Abstract
The childhood obesity epidemic continues to be a challenge. Maternal obesity and excessive infant weight gain are strong predictors of childhood obesity, which itself is a major risk factor for adult obesity. The primary source of nutrition during early life is breast milk, and its composition is impacted by maternal habitus and diet. We thus studied the relationship between maternal BMI, serum lipids and insulin, and breast milk fat and calorie content from foremilk to hindmilk. Women who were exclusively breastfeeding at 7-8 weeks postpartum were BMI classified as Normal (18.5-24.9, n = 9) and women with Overweight/Obese (OW/OB ≥ 25, n = 13). Maternal blood and continuous breast milk samples obtained from foremilk to hindmilk were analyzed, and infant milk intake was assessed. Women with OW/OB had significantly higher milk fat and calorie content in the first foremilk and last hindmilk sample as compared to Normal BMI women. Amongst all women, maternal serum triglycerides, insulin, and HOMA were significantly correlated with foremilk triglyceride concentration, suggesting that maternal serum triglyceride and insulin action contribute to human milk fat content. As the milk fat content of OW/OB women has caloric implications for infant growth and childhood obesity, these results suggest the potential for modulating milk fat content by a reduction in maternal serum lipids or insulin.
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Affiliation(s)
- Michael G. Ross
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles at Harbor-UCLA, Torrance, CA 90502, USA;
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
- Department of Obstetrics and Gynecology, Charles R. Drew University, Los Angeles, CA 90059, USA
| | - Manasa P. Kavasery
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
| | - MacKenzie K. Cervantes
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
| | - Guang Han
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
| | - Bernardo Horta
- School of Medicine, Universidade Federal de Pelotas, Pelotas 96010-610, Brazil;
| | - Kelly P. Coca
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo 04023-900, Brazil;
| | - Suleyma O. Costa
- Laboratory of Metabolic Disorders, School of Applied Sciences, University of Campinas, Campinas 13083-970, Brazil;
| | - Mina Desai
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles at Harbor-UCLA, Torrance, CA 90502, USA;
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
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Kim HH, Lee EJ, Kim JK. Rapid increase in the body mass index of very preterm infants is a risk factor for iron deficiency during infancy. Sci Rep 2023; 13:15526. [PMID: 37726416 PMCID: PMC10509161 DOI: 10.1038/s41598-023-42531-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/11/2023] [Indexed: 09/21/2023] Open
Abstract
Iron deficiency (ID) in very preterm infants born at 28-32 weeks of gestational age (GA) can lower mental and motor test scores. This study aimed to determine whether the rapid growth of very preterm infants might be associated with ID. Among 134 very preterm born between January 2014 and December 2020 at Jeonbuk National University Hospital and discharged home, 93 were included in this study. Rapid BMI increase (RBI) was defined as a z-score difference of > 1 standard deviation between birth and 8 months. ID occurred in 23 of 93 (24.7%) infants at 8 months of corrected age (CA). ID was more common in the RBI group (50%) than in the non-RBI group (18.7%). In the multivariate logistic regression corrected for GA, infants small for gestational age (SGA) (odds ratio [OR] 6.06, 95% confidence interval [CI] 1.34-30.21) and RBI by z-score (OR 4.26, 95% CI 1.28-14.65) were identified as independent risk factors for ID at 8 months of CA. Conclusively, both SGA and RBI in the early life of very preterm were risk factors for ID at 8 months of CA.
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Affiliation(s)
- Hyun Ho Kim
- Department of Pediatrics, Jeonbuk National University School of Medicine, Jeonju, South Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea
- Department of Statistics and Data Science, Korea National Open University, Seoul, South Korea
| | - Eun Jee Lee
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, South Korea
| | - Jin Kyu Kim
- Department of Pediatrics, Jeonbuk National University School of Medicine, Jeonju, South Korea.
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea.
- Department of Pediatrics, Jeonbuk National University Children's Hospital, 20 Geonjiro, Jeonju, 54907, South Korea.
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Carr T, Thompson AL, Benjamin-Neelon SE, Wasser HM, Ward DS. Confirmatory factor analysis of the infant feeding styles questionnaire in infant and toddler child care teachers. Appetite 2023; 183:106449. [PMID: 36621724 PMCID: PMC10041657 DOI: 10.1016/j.appet.2023.106449] [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: 11/04/2022] [Revised: 12/19/2022] [Accepted: 01/03/2023] [Indexed: 01/07/2023]
Abstract
Early childhood is a critical time of development. Caregiver feeding style, including of child care providers, has been implicated in influencing children's food preferences and obesity. A better understanding of the determinants of child care providers' feeding styles is important as children increasingly receive daily care and nutrition in child care centers. Valid instruments to measure provider feeding styles specifically for infants are needed. This study's objective was to validate, for use with child care providers, the Infant Feeding Styles Questionnaire (IFSQ), an instrument originally designed for parents of infants and toddlers. Study data came from the Baby Nutrition and Physical Activity Self-Assessment for Child Care (Baby NAP SACC) study, a cluster randomized trial, designed to evaluate the efficacy of a six-month-long obesity prevention intervention in child care centers. The IFSQ was administered at baseline and follow-up to infant and toddler teacher participants (n = 244). Scores for baseline IFSQ teacher responses (n = 219) were calculated for the 13 sub-constructs across the five feeding styles. We tested reliability with Cronbach's alpha coefficients and performed confirmatory factor analysis to examine factor loadings and goodness of fit characteristics, modifying constructs to achieve best fit. Reliability coefficients ranged from 0.42 to 0.82 for all sub-constructs. Goodness of fit indices for the final model ranged from: root mean square error of approximation (RMSEA) 0.000-0.082; comparative fit index (CFI) 0.943-1.000; Tucker-Lewis index (TLI) 0.906-1.000; and standardized root mean squared error (SRMR) 0.006-0.130. In a sample of racially diverse infant and toddler child care teachers, final models of the laissez-faire, pressuring, and responsive constructs and the restrictive-diet quality sub-construct performed well. Overall model fit was poor for the indulgence construct, but good for solely its corresponding belief items.
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Affiliation(s)
- Tara Carr
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Amanda L Thompson
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Department of Anthropology, University of North Carolina, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Heather M Wasser
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Dianne S Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
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Nazareth M, Pinto E, Severo M, Graça P, Lopes C, Rêgo C. Prevalence of nutritional inadequacy in children aged 12-36 months: EPACI Portugal 2012. NUTR BULL 2023; 48:101-114. [PMID: 36722373 DOI: 10.1111/nbu.12603] [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: 03/03/2022] [Revised: 12/20/2022] [Accepted: 01/03/2023] [Indexed: 02/02/2023]
Abstract
Adequate nutritional intake in the first years of life is crucial for future health. The purpose of this study is to assess the adequacy of nutritional intake in Portuguese toddlers. The EPACI Portugal 2012 is a cross-sectional study of a representative sample of toddlers (n = 2230), aged between 12 and 36 months. Data on diets were collected by trained interviewers. The current analysis included 853 children with full data from 3-day food diaries completed by parents/caregivers. Intakes of energy, macro- and micronutrients were estimated through Statistical Program to Assess Dietary Exposure (SPADE). Nutritional adequacy was evaluated using Dietary Reference Values established by the European Food Safety Authority. A large proportion of children exceeded the recommended energy intake. The median daily protein intake was 4.7 g/kg/day, five times more than that recommended. About 9% and 90% of the children consumed a lower proportion of energy than the lower limit of the Reference Intake range for carbohydrates and fat, respectively. Around a third consumed less fibre and magnesium and 100% less vitamin D than the recommended Adequate Intake (AI). Almost a third consumed less vitamin A than the recommended Average Requirement (AR) and 86% of the children showed excessive sodium consumption. Portuguese toddlers consumed a low proportion of energy from fat, had energy and protein intakes above the recommendations and excessive intakes of sodium, and inadequate intakes of vitamin A. Every child consumed less than the recommended AI for vitamin D.
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Affiliation(s)
- Margarida Nazareth
- Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina- Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
| | - Elisabete Pinto
- Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina- Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal.,EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit/ ITR - Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto, Porto, Portugal.,ICBAS - School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Pedro Graça
- EPIUnit/ ITR - Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto, Porto, Portugal.,Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Carla Lopes
- EPIUnit/ ITR - Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto, Porto, Portugal.,Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Carla Rêgo
- Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina- Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal.,Child and Adolescent Centre, CUF Hospital Porto, Porto, Portugal.,Center for Health Technology and Services Research (CINTESIS), Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
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Associations between Maternal Diet, Human Milk Macronutrients, and Breast-Fed Infant Growth during the First Month of Life in the SMILE Iwamizawa in Japan. Nutrients 2023; 15:nu15030654. [PMID: 36771361 PMCID: PMC9921570 DOI: 10.3390/nu15030654] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 02/01/2023] Open
Abstract
Maternal diet may affect human milk macronutrients, but it remains to be elucidated whether this is also influential in infant growth. This study aimed to examine (1) how maternal diet influences human milk macronutrients, and (2) to what extent the variation in milk macronutrients affects infant growth during the first month of life. In 71 Japanese lactating women, maternal dietary information was collected from the brief-type self-administered diet history questionnaire, and anthropometry of mother-infant dyads was collected from medical records. Macronutrients in milk were analyzed by a Human Milk Analyzer. Maternal retinol intake was associated with the carbohydrate content in human milk at 1-month postpartum (standardized β coefficient: 0.287; p = 0.038). Moreover, the energy content in human milk was associated with an increase in the weight standard deviation score based on the WHO growth standard at 1 month of age (standardized β coefficient: 0.399; p = 0.046). Nevertheless, the milk macronutrient was not associated with the risk of infant growth abnormalities. In conclusion, a part of the maternal diet impacts macronutrient contents in human milk, but milk macronutrients have a limited effect on infant growth only within the normal growth curve during the first month of life.
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Growth and body composition trajectories in infants meeting the WHO growth standards study requirements. Pediatr Res 2022; 92:1640-1647. [PMID: 35296784 DOI: 10.1038/s41390-022-02005-y] [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: 10/29/2021] [Revised: 02/13/2022] [Accepted: 02/15/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND While the World Health Organization (WHO) developed postnatal growth standards for infants, corresponding body composition data remains scarce. This study explores growth and body composition trajectories in infants meeting the WHO Multicentre Growth Reference Study (MGRS) eligibility criteria. STUDY DESIGN Infants enrolled in this longitudinal cohort underwent anthropometric and body composition measurement by air displacement plethysmography (ADP) at 6 weeks, 12 weeks, and 5 months postnatally. Age and sex-specific growth and body composition percentiles were generated using GAMLSS, with extrapolated data at 5 months for those exceeding ADP weight limits. We evaluated which anthropometric measure (body mass index (BMI), weight for length or mid upper arm circumference) was most closely related to adiposity. RESULTS Of the 225 infants with body composition measures, 187 met the WHO MGRS criteria. Their length and weight curves were comparable with WHO growth curves. Trajectory curves for fat and fat-free mass were developed. Of the anthropometric measures, BMI z score was most closely related to fat mass index z score at all timepoints. CONCLUSION This study presents body composition trajectories for infants meeting the WHO growth standard criteria. BMI z score is the best anthropometric metric to estimate adiposity in infants. IMPACT While postnatal growth standards derived from the WHO Multicentre Growth Reference Study (MGRS) exist for the routine clinical assessment of infant growth, this study fills the previous gap in the availability of corresponding body composition data for term-born, healthy, breastfed infants meeting the MGRS criteria. Extrapolation was used to obtain body composition values for infants exceeding the weight limit of the ADP device, to avoid construction of biased body composition curves. Sex-specific growth curves for fat mass, fat-free mass, fat mass index, and fat-free mass index are presented for a population meeting the World Health Organization growth standard criteria.
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Li P, Lu Y, Qie D, Feng L, He G, Yang S, Yang F. Early-life weight gain patterns of term small-for-gestational-age infants and the predictive ability for later childhood overweight/obesity: A prospective cohort study. Front Endocrinol (Lausanne) 2022; 13:1030216. [PMID: 36482989 PMCID: PMC9723138 DOI: 10.3389/fendo.2022.1030216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 10/31/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives We aimed to identify the weight gain patterns of small-for-gestational age (SGA) infants in early life and to explore the predictive value for later overweight/obesity in childhood. Methods We obtained data from a prospective cohort including term SGA infants born between January 2006 and November 2015 who received regular health care from birth to 5 years in West China Second University Hospital, Chengdu, China. A latent class growth analysis (LCGA) was applied to group children with similar growth trajectory patterns. Multiple logistic regression was performed to examine the association between weight gain patterns and later overweight/obesity. Results A total of 296 term SGA infants were finally included. Five weight gain trajectories were identified, including excessive rapid catch-up growth (ERCG) (class 1, 10.9%), rapid catch-up growth (RCG) (class 2, 17.9%), appropriate catch-up growth (ACG) (class 3, 53.0%), slow catch-up growth (SCG) (class 4, 13.4%) and almost no catch growth (NCG) (class 5, 4.8%). SGA infants in class 1 and class 2 had a higher BMI according to age- and sex-specific Z scores from 2-5 years of age. In addition, 25% of SGA infants in class 1 and 13.2% of SGA infants in class 2 were found to be overweight/obese at 2-5 years of age. After adjusting for confounders, we found that extremely rapid weight gain (class 1) in the first 2 years of life increased the risk of overweight/obesity by 2.1 times at 2 to 5 years of age (aOR=2.1, 95% CI: 1.3~4.8; P<0.05). Furthermore, the increment of ΔWAZ between 0 and 4 mo was prominently related to the risk of overweight/obesity at 2 to 5 years for term SGA infants (aOR=3.2, 95% CI: 1.7~8.1; P<0.001). A receiver operating characteristic (ROC) curve showed the area under curve (AUC) was 0.7, with a 95% confidence interval (CI) from 0.6 to 0.8 (P<0.001). Conclusions The extremely rapid weight gain pattern of term SGA infants in the first 2 years of life increased the risk of overweight/obesity at 2 to 5 years of age. It suggests monitoring weight gain across the infant period represents a first step towards primary prevention of childhood obesity.
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Affiliation(s)
- Ping Li
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) Ministry of Education, Chengdu, China
| | - You Lu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) Ministry of Education, Chengdu, China
| | - Di Qie
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) Ministry of Education, Chengdu, China
| | - Ling Feng
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) Ministry of Education, Chengdu, China
| | - Guoqian He
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) Ministry of Education, Chengdu, China
| | - Sufei Yang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) Ministry of Education, Chengdu, China
| | - Fan Yang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) Ministry of Education, Chengdu, China
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Early infancy growth, body composition and type of feeding in late and moderate preterms. Pediatr Res 2022:10.1038/s41390-022-02317-z. [PMID: 36183005 PMCID: PMC9526212 DOI: 10.1038/s41390-022-02317-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Late and moderate preterm (LMPT) infants are at risk for adverse later life outcomes. We determined the association between feeding method at enrolment and growth and body composition of LMPT infants until 3 months corrected age (3mCA). METHODS Infants born between 32+0 and 36+6 weeks of gestation (n = 107) were enrolled up to 4 weeks corrected age and stratified according to feeding at enrolment. We performed anthropometric measurements at enrolment, term equivalent age (TEA) and 3mCA, including skinfold measurements and body composition using dual X-ray absorptiometry (DEXA). RESULTS Feeding method at enrolment was associated with fat mass (FM) (breast 554.9 g, mixed 716.8 g, formula 637.7 g, p = 0.048), lean body mass (LM) (2512 g, 2853 g, 2722 g, respectively, p = 0.009) and lean mass index (LMI) (10.6 kg/m2, 11.6 kg/m2,11.2 kg/m2 respectively, p = 0.008) at TEA, but not 3mCA. Breastfed infants demonstrated greater increase in LM (breast 1707 g, mixed 1536 g, formula 1384 g, p = 0.03) and LMI (1.23 kg/m2, 0.10 kg/m2, 0.52 kg/m2, respectively, p = 0.022) between TEA and 3mCA. CONCLUSIONS Breastfed LMPT infants have lower FM and greater LM increase and LMI increase up to 3mCA compared to formula or mixed-fed infants. These findings stress the importance of supporting breastfeeding in this population. IMPACT Infants born late and moderate preterm age who are exclusively breastfed soon after birth gain more lean mass up to 3 months corrected age compared to mixed- or formula-fed infants. Breastfed infants have lower lean and fat mass at term equivalent age compared to mixed- and formula-fed infants. This is the first study exploring this population's growth and body composition in detail at 3 months corrected age. Our results underline the importance of supporting mothers to initiate and continue breastfeeding at least until 3 months corrected age.
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Chen F, Wang J, Liao Z, Zong X, Zhang T, Xie X, Liu G. Body Composition in Preschool Children and the Association With Prepregnancy Weight and Gestational Weight Gain: An Ambispective Cohort Study. Front Nutr 2022; 9:881452. [PMID: 35685884 PMCID: PMC9173682 DOI: 10.3389/fnut.2022.881452] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/28/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To describe the body composition in preschool children and to evaluate the association with prepregnancy BMI and gestational weight gain (GWG). Methods Children were recruited in their first year in kindergarten (3 years old) and followed up for the next 2 years. Information during pregnancy and birth was retrieved from medical records. Height, weight, fat mass, fat-free mass, and percentage of body fat (FM%) were measured through a bioelectrical impedance analysis for each child visit, and BMI, fat mass index (FMI), and fat-free mass index (FFMI) were calculated. Generalized linear mixed models (GLMMs) were used to evaluate the associations between prepregnancy weight, GWG, and adiposity indicators. Results A total of 3,329 single-birth 3-year-old children were recruited as the baseline population and were followed at 4 and 5 years old. During the 3 years of follow-up, the mean (±SD) values of BMI, FMI, FFMI, and FM% of the children were 15.6 (±1.6) kg/m2, 2.8 (±1.3) kg/m2, 12.8 (±0.7) kg/m2, and 17.2% (±5.8%), respectively. The prevalence rates of overweight and obesity in mothers before pregnancy were 16.6 and 3.2%, respectively. Mothers were divided into three groups based on GWG: appropriate (1,233, 37.0%), excessive (767, 23.0%), and insufficient (1,329, 39.9%). GLMMs analyses showed that the preschool children’s BMI, FMI, FFMI, and FM% were all significantly positively related to maternal prepregnancy BMI and GWG (all P < 0.001); the children of mothers who were overweight/obese before pregnancy were more likely to be overweight/obese, high FMI, high FFMI, and high FM% at preschool age (all P < 0.001); although maternal excessive GWG was not correlated with offspring’s overweight/obese (P = 0.156), the children of mothers with excessive GWG are more likely to have higher FMI, but not to be with a higher FFMI status than the children of mothers with appropriate GWG. For prepregnancy overweight/obese women, compared with the GWG-appropriate group, maternal excessive GWG was related to the risk of high FMI (coefficient = 0.388, 95% CI: 0.129–0.647) and high FM% (coefficient = 0.352, 95% CI: 0.097–0.607), but was not related to the risk of overweight/obese or high FFMI of the offspring at preschool age. Conclusion Fat mass index decreased with age, while FFMI increased with age among 3- to 5-year-old children. It is necessary to optimize maternal weight prior to conception and GWG management to improve the health outcomes of the offspring.
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Affiliation(s)
| | - Jing Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Zijun Liao
- Capital Institute of Pediatrics, Beijing, China
| | - Xinnan Zong
- Capital Institute of Pediatrics, Beijing, China
| | - Ting Zhang
- Capital Institute of Pediatrics, Beijing, China
| | | | - Gongshu Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
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Zhang M, Thieux M, Inocente CO, Vieux N, Arvis L, Villanueva C, Lin J, Plancoulaine S, Guyon A, Franco P. Characterization of rapid weight gain phenotype in children with narcolepsy. CNS Neurosci Ther 2022; 28:829-841. [PMID: 35212159 PMCID: PMC9062543 DOI: 10.1111/cns.13811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To characterize the rapid weight gain (RWG) phenotype associated with the onset of childhood narcolepsy and to determine whether it could constitute a marker of severity of the disease. METHODS RWG was defined using the BMI z-score slope reported to one year (>0.67 SD) from symptom onset to disease diagnosis. We compared the clinical, metabolic, and sleep characteristics between patients with or without RWG at diagnosis. Pharmacological management, anthropometric, and clinical progression were also evaluated during the follow-up. RESULTS A total of 84 de novo narcoleptic pediatric patients were included; their median age at diagnosis was 12.0 years; 59.5% boys, 90.5% cataplexy, and 98.7% HLA-DQB1*06:02, 57% had RWG profile. RWG patients were younger at diagnosis than non-RWG patients, despite a shorter diagnostic delay. They had a higher BMI z-score and a higher prevalence of obesity at diagnosis, but not at symptom onset, and higher adapted Epworth Sleepiness Scale and Insomnia Severity Index scores than non-RWG patients. No differences on nocturnal polysomnography and multiple sleep latency tests were found between groups at disease diagnosis. After a median follow-up of 5 years, RWG patients still had a higher BMI z-score and a higher prevalence of obesity despite benefiting from the same therapeutic management and displaying improvement in sleepiness and school difficulties. CONCLUSIONS Narcoleptic RWG patients were younger, sleepier, and the prevalence of obesity was higher at diagnosis despite a shorter diagnostic delay than that of non-RWG patients. These patients had also a higher risk of developing a long-term obesity, despite a positive progression of their narcoleptic symptoms. RGW could then represent a maker of a more severe phenotype of childhood narcolepsy, which should inspire a prompt and more offensive management to prevent obesity and its complications.
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Affiliation(s)
- Min Zhang
- Integrative Physiology of the Brain Arousal SystemsCRNLINSERM U1028CNRS UMR5292Université Claude Bernard Lyon 1LyonFrance
| | - Marine Thieux
- Integrative Physiology of the Brain Arousal SystemsCRNLINSERM U1028CNRS UMR5292Université Claude Bernard Lyon 1LyonFrance
- Pediatric Sleep UnitHôpital Femme Mère EnfantHospices Civils de Lyon & National Reference Center for NarcolepsyUniversité Claude Bernard Lyon 1LyonFrance
| | - Clara Odilia Inocente
- Integrative Physiology of the Brain Arousal SystemsCRNLINSERM U1028CNRS UMR5292Université Claude Bernard Lyon 1LyonFrance
| | - Noemie Vieux
- Pediatric Sleep UnitHôpital Femme Mère EnfantHospices Civils de Lyon & National Reference Center for NarcolepsyUniversité Claude Bernard Lyon 1LyonFrance
| | - Laura Arvis
- Pediatric Endocrinology UnitHôpital Femme Mère EnfantHospices Civils de LyonUniversité Claude Bernard Lyon 1LyonFrance
| | - Carine Villanueva
- Pediatric Endocrinology UnitHôpital Femme Mère EnfantHospices Civils de LyonUniversité Claude Bernard Lyon 1LyonFrance
| | - Jian‐Sheng Lin
- Integrative Physiology of the Brain Arousal SystemsCRNLINSERM U1028CNRS UMR5292Université Claude Bernard Lyon 1LyonFrance
| | | | - Aurore Guyon
- Pediatric Sleep UnitHôpital Femme Mère EnfantHospices Civils de Lyon & National Reference Center for NarcolepsyUniversité Claude Bernard Lyon 1LyonFrance
| | - Patricia Franco
- Integrative Physiology of the Brain Arousal SystemsCRNLINSERM U1028CNRS UMR5292Université Claude Bernard Lyon 1LyonFrance
- Pediatric Sleep UnitHôpital Femme Mère EnfantHospices Civils de Lyon & National Reference Center for NarcolepsyUniversité Claude Bernard Lyon 1LyonFrance
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11
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Fox K, Vadiveloo M, McCurdy K, Benjamin-Neelon SE, Østbye T, Tovar A. Maternal Stress and Excessive Weight Gain in Infancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5743. [PMID: 35565137 PMCID: PMC9105332 DOI: 10.3390/ijerph19095743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 12/03/2022]
Abstract
Rapid weight gain in infancy increases the risk of developing obesity early in life and contributes significantly to racial and ethnic disparities in childhood obesity. While maternal perceived stress is associated with childhood obesity, little is known about the impact it has on infant weight gain. Therefore, this study explores the impact of maternal perceived stress on change in weight-for-length (WFL) z-scores and the risk of rapid weight gain in infancy. We conducted a secondary data analysis of the longitudinal Nurture birth cohort (n = 666). Most mothers in the cohort were non-Hispanic/Latinx Black (71.6%). About one-half of mothers had a body mass index (BMI) greater than 25 prior to pregnancy, were unemployed, and had a low income. Most infants in the cohort were born full-term and were of normal weight. Data were collected at 3-, 6-, 9-, and 12-months postpartum. At each assessment, mothers completed the Cohen’s Perceived Stress Scale (PSS), and research assistants weighed and measured each infant. Tertiles were used to compare mothers with high and low perceived stress. A mixed model analysis of repeated measures assessed the associations between baseline perceived stress and the change in infant WFL z-scores over time. Log-binomial models assessed the association between baseline perceived stress and rapid weight gain, defined as a change in WFL z-score > 0.67 standard deviations from three to twelve months. Just under one-half of the infants (47%) experienced rapid weight gain between three and twelve months of age. Birthweight for gestational age (RR = 1.18, 95% CI = 1.08−1.29, p-value = 0.004), gestational age at birth (RR = 1.07, 95% CI = 1.01−1.14, p-value = 0.031), and weeks breastfed (0.99, 95% CI 0.99−1.00, p-value 0.044) were associated with risk of rapid weight gain in unadjusted analyses. WFL z-scores increased significantly over time, with no effect of perceived stress on change in WFL z-score or risk of rapid weight gain. Rapid weight gain in infancy was prevalent in this sample of predominately Black infants in the Southeastern US. We did not find evidence to support the hypothesis that maternal perceived stress influenced the risk of rapid weight gain. More work is needed to identify and assess the risk factors for rapid weight gain in infancy and to understand the role that maternal stress plays in the risk of childhood obesity so that prevention efforts can be targeted.
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Affiliation(s)
- Katelyn Fox
- Department of Nutrition and Food Science, University of Rhode Island, Kingston, RI 02881, USA;
| | - Maya Vadiveloo
- Department of Nutrition and Food Science, University of Rhode Island, Kingston, RI 02881, USA;
| | - Karen McCurdy
- Department of Human Development and Family Science, University of Rhode Island, Kingston, RI 02881, USA;
| | - Sara E. Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Truls Østbye
- Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710, USA;
| | - Alison Tovar
- Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA;
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12
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Rasmussen JM, Thompson PM, Entringer S, Buss C, Wadhwa PD. Fetal programming of human energy homeostasis brain networks: Issues and considerations. Obes Rev 2022; 23:e13392. [PMID: 34845821 DOI: 10.1111/obr.13392] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/29/2021] [Accepted: 10/24/2021] [Indexed: 02/07/2023]
Abstract
In this paper, we present a transdisciplinary framework and testable hypotheses regarding the process of fetal programming of energy homeostasis brain circuitry. Our model proposes that key aspects of energy homeostasis brain circuitry already are functional by the time of birth (with substantial interindividual variation); that this phenotypic variation at birth is an important determinant of subsequent susceptibility for energy imbalance and childhood obesity risk; and that this brain circuitry exhibits developmental plasticity, in that it is influenced by conditions during intrauterine life, particularly maternal-placental-fetal endocrine, immune/inflammatory, and metabolic processes and their upstream determinants. We review evidence that supports the scientific premise for each element of this formulation, identify future research directions, particularly recent advances that may facilitate a better quantification of the ontogeny of energy homeostasis brain networks, highlight animal and in vitro-based approaches that may better address the determinants of interindividual variation in energy homeostasis brain networks, and discuss the implications of this formulation for the development of strategies targeted towards the primary prevention of childhood obesity.
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Affiliation(s)
- Jerod M Rasmussen
- Development, Health and Disease Research Program, University of California, Irvine, California, USA.,Department of Pediatrics, University of California, Irvine, California, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Sonja Entringer
- Development, Health and Disease Research Program, University of California, Irvine, California, USA.,Department of Pediatrics, University of California, Irvine, California, USA.,Department of Medical Psychology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Departments of Psychiatry and Human Behavior, Obstetrics and Gynecology, Epidemiology, University of California, Irvine, California, USA
| | - Claudia Buss
- Development, Health and Disease Research Program, University of California, Irvine, California, USA.,Department of Pediatrics, University of California, Irvine, California, USA.,Department of Medical Psychology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Departments of Psychiatry and Human Behavior, Obstetrics and Gynecology, Epidemiology, University of California, Irvine, California, USA
| | - Pathik D Wadhwa
- Development, Health and Disease Research Program, University of California, Irvine, California, USA.,Department of Pediatrics, University of California, Irvine, California, USA.,Departments of Psychiatry and Human Behavior, Obstetrics and Gynecology, Epidemiology, University of California, Irvine, California, USA.,Department of Obstetrics and Gynecology, University of California, Irvine, California, USA.,Department of Epidemiology, University of California, Irvine, California, USA
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13
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Suglia SF, Appleton AA, Bleil ME, Campo RA, Dube SR, Fagundes CP, Heard-Garris NJ, Johnson SB, Slopen N, Stoney CM, Watamura SE. Timing, duration, and differential susceptibility to early life adversities and cardiovascular disease risk across the lifespan: Implications for future research. Prev Med 2021; 153:106736. [PMID: 34293381 PMCID: PMC8595689 DOI: 10.1016/j.ypmed.2021.106736] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 12/13/2022]
Abstract
Early life adversities (ELA), include experiences such as child maltreatment, household dysfunction, bullying, exposure to crime, discrimination, bias, and victimization, and are recognized as social determinants of cardiovascular disease (CVD). Strong evidence shows exposure to ELA directly impacts cardiometabolic risk in adulthood and emerging evidence suggests there may be continuity in ELA's prediction of cardiometabolic risk over the life course. Extant research has primarily relied on a cumulative risk framework to evaluate the relationship between ELA and CVD. In this framework, risk is considered a function of the number of risk factors or adversities that an individual was exposed to across developmental periods. The cumulative risk exposure approach treats developmental periods and types of risk as equivalent and interchangeable. Moreover, cumulative risk models do not lend themselves to investigating the chronicity of adverse exposures or consider individual variation in susceptibility, differential contexts, or adaptive resilience processes, which may modify the impact of ELA on CVD risk. To date, however, alternative models have received comparatively little consideration. Overall, this paper will highlight existing gaps and offer recommendations to address these gaps that would extend our knowledge of the relationship between ELA and CVD development. We focus specifically on the roles of: 1) susceptibility and resilience, 2) timing and developmental context; and 3) variation in risk exposure. We propose to expand current conceptual models to incorporate these factors to better guide research that examines ELA and CVD risk across the life course.
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Affiliation(s)
- Shakira F Suglia
- Department of Epidemiology, Emory University, Atlanta, GA, United States of America.
| | - Allison A Appleton
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Albany, NY, United States of America
| | - Maria E Bleil
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, United States of America
| | - Rebecca A Campo
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, United States of America
| | - Shanta R Dube
- Public Health Program, Levine College of Health Sciences, Wingate University, Wingate, NC, United States of America
| | - Christopher P Fagundes
- Department of Psychological Sciences, Rice University, Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States of America
| | - Nia J Heard-Garris
- Division of Advanced General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States of America
| | - Sara B Johnson
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, United States of America
| | - Catherine M Stoney
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, United States of America
| | - Sarah E Watamura
- Department of Psychology, University of Denver, Denver, CO, United States of America
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14
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Carney MC, Zhan X, Rangnekar A, Chroneos MZ, Craig SJC, Makova KD, Paul IM, Hicks SD. Associations between stool micro-transcriptome, gut microbiota, and infant growth. J Dev Orig Health Dis 2021; 12:876-882. [PMID: 33407969 PMCID: PMC8675179 DOI: 10.1017/s2040174420001324] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Rapid infant growth increases the risk for adult obesity. The gut microbiome is associated with early weight status; however, no study has examined how interactions between microbial and host ribonucleic acid (RNA) expression influence infant growth. We hypothesized that dynamics in infant stool micro-ribonucleic acids (miRNAs) would be associated with both microbial activity and infant growth via putative metabolic targets. Stool was collected twice from 30 full-term infants, at 1 month and again between 6 and 12 months. Stool RNA were measured with high-throughput sequencing and aligned to human and microbial databases. Infant growth was measured by weight-for-length z-score at birth and 12 months. Increased RNA transcriptional activity of Clostridia (R = 0.55; Adj p = 3.7E-2) and Burkholderia (R = -0.820, Adj p = 2.62E-3) were associated with infant growth. Of the 25 human RNAs associated with growth, 16 were miRNAs. The miRNAs demonstrated significant target enrichment (Adj p < 0.05) for four metabolic pathways. There were four associations between growth-related miRNAs and growth-related phyla. We have shown that longitudinal trends in gut microbiota activity and human miRNA levels are associated with infant growth and the metabolic targets of miRNAs suggest these molecules may regulate the biosynthetic landscape of the gut and influence microbial activity.
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Affiliation(s)
- Molly C Carney
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
| | - Xiang Zhan
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | | | - Maria Z Chroneos
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
| | - Sarah J C Craig
- Department of Biology, Eberly College of Science, Penn State University, University Park, PA, USA
| | - Kateryna D Makova
- Department of Biology, Eberly College of Science, Penn State University, University Park, PA, USA
| | - Ian M Paul
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Steven D Hicks
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
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15
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Bleil ME, Appelhans BM, Gregorich SE, Thomas AS, Hiatt RA, Roisman GI, Booth-LaForce C. Patterns of Early Life Weight Gain and Female Onset of Puberty. J Endocr Soc 2021; 5:bvab165. [PMID: 35274069 PMCID: PMC8900195 DOI: 10.1210/jendso/bvab165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Indexed: 11/19/2022] Open
Abstract
Context Prepubertal obesity is a well-established predictor of earlier pubertal onset, which is itself a risk factor for poor health and well-being. Identifying specific patterns of weight gain in early life may help explain differential risk for earlier pubertal onset. Objective The objective of the study was to examine patterns of weight gain across infancy and early childhood in relation to pubertal onset outcomes. Design, Setting, and Participants Participants were 426 girls in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, a longitudinal birth cohort of children and their families followed between birth and adolescence. Main Outcome Measures Three pubertal onset outcomes were examined, including age at menarche and ages at Tanner stage II for dimensions of breast and pubic hair development. Results In infancy (birth to 15 months), greater percent weight gain and higher birthweight predicted earlier pubertal onset for all outcomes (Ps < 0.05). In early childhood (24 months to grade 1), body mass index (BMI) trajectories reflecting BMI values that were persistently high or changed from low to high over time (vs BMI values that were stable at median or low levels), predicted younger ages at menarche and the onset of breast (Ps < 0.05), but not pubic hair (Ps > 0.05), development. All associations were independent of breastfeeding, maternal menarcheal age, and race/ethnicity. Conclusions Distinct patterns of early life weight gain predict differential risk for earlier onset puberty. Focusing on these patterns for earlier and more targeted intervention may help lessen life course linkages between prepubertal obesity, accelerated pubertal development, and negative postpubertal outcomes.
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Affiliation(s)
- Maria E Bleil
- Child, Family, & Population Health Nursing, University of Washington, Seattle, WA 98195, USA
| | - Bradley M Appelhans
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL 60612, USA
| | - Steven E Gregorich
- Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
| | - Alexis S Thomas
- Child, Family, & Population Health Nursing, University of Washington, Seattle, WA 98195, USA
| | - Robert A Hiatt
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA 94158, USA
| | - Glenn I Roisman
- Institute of Child Development, University of Minnesota, Minneapolis, MN 55455, USA
| | - Cathryn Booth-LaForce
- Child, Family, & Population Health Nursing, University of Washington, Seattle, WA 98195, USA
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16
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Ventura A, Hupp M, Lavond J. Mother-infant interactions and infant intake during breastfeeding versus bottle-feeding expressed breast milk. MATERNAL & CHILD NUTRITION 2021; 17:e13185. [PMID: 33939269 PMCID: PMC8476436 DOI: 10.1111/mcn.13185] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 03/01/2021] [Accepted: 03/08/2021] [Indexed: 11/26/2022]
Abstract
Bottle-fed infants are at higher risk for rapid weight gain compared with breastfed infants. Few studies have attempted to disentangle effects of feeding mode, milk composition and relevant covariates on feeding interactions and outcomes. The objective of the present study was to compare effects of breastfeeding directly at the breast versus bottle-feeding expressed breast milk on feeding interactions. Mothers with <6-month-old infants (n = 47) participated in two counterbalanced, feeding observations. Mothers breastfed their infants directly from the breast during one visit (breast condition) and bottle-fed their infants expressed breast milk during the other (bottle condition). Masked raters later coded videos using the Nursing Child Assessment Parent-Child Interaction Feeding Scale. Infant intake was assessed. Mothers self-reported sociodemographic characteristics, infant feeding patterns (i.e. percentage of daily feedings from bottles) and level of pressuring feeding style. Mother and infant behaviours were similar during breast and bottle conditions. Percent bottle-feeding moderated effects of condition on intake (P = 0.032): greater percent bottle-feeding predicted greater intake during the bottle compared with breast condition. Effects of feeding mode were not moderated by parity or pressuring feeding style, but, regardless of condition, multiparous mothers fed their infants more than primiparous mothers (P = 0.028), and pressuring feeding style was positively associated with infant intake (P = 0.045). Findings from the present study do not support the hypothesis that feeding mode directly impacts dyadic interaction for predominantly breastfeeding mothers and infants, but rather suggest between-subject differences in feeding experiences and styles predict feeding outcomes for this population.
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Affiliation(s)
- Alison Ventura
- Department of Kinesiology and Public Health, Center for Health ResearchCalifornia Polytechnic State UniversitySan Luis ObispoCaliforniaUSA
| | - Megan Hupp
- Department of Kinesiology and Public Health, Center for Health ResearchCalifornia Polytechnic State UniversitySan Luis ObispoCaliforniaUSA
| | - Joseph Lavond
- Department of StatisticsCalifornia Polytechnic State UniversitySan Luis ObispoCaliforniaUSA
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17
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Hudak KM, Benjamin-Neelon SE. Timing of WIC Enrollment and Responsive Feeding among Low-Income Women in the US. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147695. [PMID: 34300147 PMCID: PMC8305462 DOI: 10.3390/ijerph18147695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 11/16/2022]
Abstract
We examined associations between the timing of The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) enrollment and responsive feeding and assessed food security as a possible effect modifier. We used data from the nationally representative WIC Infant and Toddler Feeding Practices Study-2. Our sample includes women-infant dyads interviewed through the first 13 months of age (n = 1672). We dichotomized WIC enrollment as occurring prenatally or after childbirth. The responsive feeding outcome was feeding on demand versus feeding on schedule. We used covariate-adjusted logistic regressions. Of women, 61.8% had a high school education or less and 62.9% lived at 75% or less of the federal poverty guideline. The majority (84.5%) of women enrolled in WIC before childbirth. In unadjusted estimates, 34% of women who enrolled prenatally practiced responsive feeding, compared to 25% of women who enrolled after childbirth. We found no evidence of food security as an effect modifier. In adjusted estimates, women who enrolled in WIC prenatally had 78% higher odds of practicing responsive feeding (OR: 1.78, 95% CI: 1.16, 2.73), compared to women who enrolled after childbirth. Prenatal enrollment in WIC was associated with higher odds of responsive feeding. Future studies should examine how the timing of WIC enrollment relates to responsive feeding in older children and over time.
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Affiliation(s)
- Katelin M. Hudak
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Correspondence:
| | - Sara E. Benjamin-Neelon
- Lerner Center for Public Health Promotion, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
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18
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Bleil ME, Spieker SJ, Booth-LaForce C. Targeting Parenting Quality to Reduce Early Life Adversity Impacts on Lifespan Cardiometabolic Risk. Front Psychol 2021; 12:678946. [PMID: 34149571 PMCID: PMC8211431 DOI: 10.3389/fpsyg.2021.678946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/12/2021] [Indexed: 11/16/2022] Open
Abstract
Mounting evidence that early life adversity (ELA) exposures confer risk for cardiometabolic disease over the lifespan motivated this narrative review to examine parenting quality as a potential intervention target to reduce ELA exposures or mitigate their impact as a way of reducing or preventing cardiometabolic disease. We describe findings from the limited number of family-based intervention studies in ELA-exposed children that have tested parenting impacts on cardiometabolic health outcomes. We then describe the implications of this work and make recommendations for future research that will move this field forward.
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Affiliation(s)
- Maria E. Bleil
- Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, United States
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19
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Desai M, Ross MG. Maternal-infant nutrition and development programming of offspring appetite and obesity. Nutr Rev 2021; 78:25-31. [PMID: 33196091 PMCID: PMC7667467 DOI: 10.1093/nutrit/nuaa121] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In the United States and Mexico, the obesity epidemic represents a significant public health problem. Although obesity is often attributed to a Western-style, high-fat diet and decreased activity, there is now compelling evidence that this, in part, occurs because of the developmental programming effects resulting from exposure to maternal overnutrition. Human and animal studies demonstrate that maternal obesity and high-fat diet result in an increased risk for childhood and adult obesity. The potential programming effects of obesity have been partly attributed to hyperphagia, which occurs as a result of increased appetite with reduced satiety neuropeptides or neurons. However, depending on maternal nutritional status during the nursing period, the programmed hyperphagia and obesity can be exacerbated or prevented in offspring born to obese mothers. The underlying mechanism of this phenomenon likely involves the plasticity of the appetite regulatory center and thus presents an opportunity to modulate feeding and satiety regulation and break the obesity cycle.
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Affiliation(s)
- Mina Desai
- Department of Obstetrics and Gynecology, The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California, USA; and David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
| | - Michael G Ross
- Department of Obstetrics and Gynecology, The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California, USA; and David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
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20
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Wells JC, Davies PS, Hopkins M, Blundell JE. The "drive to eat" hypothesis: energy expenditure and fat-free mass but not adiposity are associated with milk intake and energy intake in 12 week infants. Am J Clin Nutr 2021; 114:505-514. [PMID: 33851194 PMCID: PMC8326050 DOI: 10.1093/ajcn/nqab067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/19/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Recent work has challenged the long-held assumption that appetite functions to maintain stable body mass and fat mass (FM), suggesting instead that appetite matches food intake to energy expenditure and its correlate, fat-free mass (FFM). Whether this scenario applies to young infants, in chronic positive energy balance, remains unknown. OBJECTIVES To test associations of components of energy expenditure and body composition with milk intake (MI) and energy intake (EI) in 12-week infants, by reanalyzing published cross-sectional data. METHODS Data were available for 48 infants. In addition to anthropometric measurements, we assessed MI and EI by test-weighing, sleeping metabolic rate (SMR) by indirect calorimetry, and FFM, FM, and total energy expenditure (TEE) by doubly labeled water. Mean parental height was calculated as a marker of infant growth drive. Correlation and multiple regression analyses were applied. RESULTS MI and EI correlated with FFM (r = 0.47 and 0.57, respectively; P < 0.01), but not FM (P > 0.6). MI and EI correlated with SMR (r = 0.42 and 0.53, respectively; P < 0.01) and TEE (r = 0.50 and 0.49, respectively; P < 0.01). SMR and TEE correlated with FFM (r = 0.41 and 0.42, respectively; P < 0.01), but not FM (P > 0.2). In a multiple regression analysis, MI was independently associated with TEE (partial r = 0.39) and FFM (partial r = 0.35). EI showed similar associations. Mean parental height was correlated with weight gain, MI, and EI. CONCLUSIONS As in adults, MI and EI in young infants were strongly associated with FFM and with total and sleeping components of energy expenditure, but not with fatness. The infant's growth drive contributed to these associations. This suggests that appetite is regulated by the rate of energy expenditure, the size of energy-using tissues, and tissue deposition rate, and that the high levels of body fat characteristic of infants may not constrain weight gain.
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Affiliation(s)
| | - Peter S Davies
- Child Health Research Centre, Centre for Children's Health Research, University of Queensland, South Brisbane, Australia
| | - Mark Hopkins
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - John E Blundell
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
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21
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Jones D, De Lucia Rolfe E, Rennie KL, Griep LMO, Kusinski LC, Hughes DJ, Brage S, Ong KK, Beardsall K, Meek CL. Antenatal Determinants of Childhood Obesity in High-Risk Offspring: Protocol for the DiGest Follow-Up Study. Nutrients 2021; 13:1156. [PMID: 33807319 PMCID: PMC8067255 DOI: 10.3390/nu13041156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/23/2021] [Accepted: 03/29/2021] [Indexed: 12/11/2022] Open
Abstract
Childhood obesity is an area of intense concern internationally and is influenced by events during antenatal and postnatal life. Although pregnancy complications, such as gestational diabetes and large-for-gestational-age birthweight have been associated with increased obesity risk in offspring, very few successful interventions in pregnancy have been identified. We describe a study protocol to identify if a reduced calorie diet in pregnancy can reduce adiposity in children to 3 years of age. The dietary intervention in gestational diabetes (DiGest) study is a randomised, controlled trial of a reduced calorie diet provided by a whole-diet replacement in pregnant women with gestational diabetes. Women receive a weekly dietbox intervention from enrolment until delivery and are blinded to calorie allocation. This follow-up study will assess associations between a reduced calorie diet in pregnancy with offspring adiposity and maternal weight and glycaemia. Anthropometry will be performed in infants and mothers at 3 months, 1, 2 and 3 years post-birth. Glycaemia will be assessed using bloodspot C-peptide in infants and continuous glucose monitoring with HbA1c in mothers. Data regarding maternal glycaemia in pregnancy, maternal nutrition, infant birthweight, offspring feeding behaviour and milk composition will also be collected. The DiGest follow-up study is expected to take 5 years, with recruitment finishing in 2026.
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Affiliation(s)
- Danielle Jones
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK; (D.J.); (S.B.); (K.K.O.)
- Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK; (L.C.K.); (D.J.H.)
| | - Emanuella De Lucia Rolfe
- NIHR Cambridge Biomedical Research Centre—Diet, Anthropometry and Physical Activity Group, MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK; (E.D.L.R.); (K.L.R.); (L.M.O.G.)
| | - Kirsten L. Rennie
- NIHR Cambridge Biomedical Research Centre—Diet, Anthropometry and Physical Activity Group, MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK; (E.D.L.R.); (K.L.R.); (L.M.O.G.)
| | - Linda M. Oude Griep
- NIHR Cambridge Biomedical Research Centre—Diet, Anthropometry and Physical Activity Group, MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK; (E.D.L.R.); (K.L.R.); (L.M.O.G.)
| | - Laura C. Kusinski
- Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK; (L.C.K.); (D.J.H.)
| | - Deborah J. Hughes
- Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK; (L.C.K.); (D.J.H.)
- Cambridge Universities NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK; (D.J.); (S.B.); (K.K.O.)
- NIHR Cambridge Biomedical Research Centre—Diet, Anthropometry and Physical Activity Group, MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK; (E.D.L.R.); (K.L.R.); (L.M.O.G.)
| | - Ken K. Ong
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK; (D.J.); (S.B.); (K.K.O.)
| | - Kathryn Beardsall
- Department of Paediatric Medicine, University of Cambridge, Cambridge CB2 0QQ, UK;
- Cambridge Universities NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - Claire L. Meek
- Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK; (L.C.K.); (D.J.H.)
- Cambridge Universities NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
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Savitsky B, Manor O, Lawrence G, Friedlander Y, Siscovick DS, Hochner H. Environmental mismatch and obesity in humans: The Jerusalem Perinatal Family Follow-Up Study. Int J Obes (Lond) 2021; 45:1404-1417. [PMID: 33762678 DOI: 10.1038/s41366-021-00802-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 03/04/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND According to the hypothesis of Gluckman and Hanson, mismatch between the developmental and postdevelopmental environments may lead to detrimental health impacts such as obesity. While several animal studies support the mismatch theory, there is a scarcity of evidence from human-based studies. OBJECTIVES Our study aims to examine whether a mismatch between the developmental and young-adult environments affect obesity in young adults of the Jerusalem Perinatal Family Follow-Up Study. METHODS Data from The Jerusalem Perinatal Family Follow-Up Study birth cohort was used to characterize early and late environments using offspring and parental sociodemographic and lifestyle information at birth, age 32 (n = 1140) and 42 (n = 404). Scores characterizing the early and late environments were constructed using factor analysis. To assess associations of mismatch with obesity, regression models were fitted using the first factor of each environment and adiposity measures at age 32 and 42. RESULTS Having a stable non-beneficial environment at birth and young-adulthood was most strongly associated with increased adiposity, while a stable beneficial environment was most favorable. The transition from a beneficial environment at birth to a less beneficial environment at young-adulthood was associated with higher obesity measures, including higher BMI (β = 0.979; 95% CI: 0.029, 1.929), waist circumference (β = 2.729; 95% CI: 0.317, 5.140) and waist-hip ratio (β = 0.017; 95% CI: 0.004, 0.029) compared with those experiencing a beneficial environment at both time points. Transition from a less beneficial environment at birth to a beneficial environment at adulthood was also associated with higher obesity measurements (BMI -β = 1.116; 95% CI: 0.085, 2.148; waist circumference -β = 2.736; 95% CI: 0.215, 5.256). CONCLUSIONS This study provides some support for the mismatch hypothesis. While there is indication that an accumulation of the effects of the non-beneficial environment has the strongest detrimental impact on obesity outcomes, our results also indicate that a mismatch between the developmental and later environments may result in maladaptation of the individual leading to obesity.
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Affiliation(s)
- B Savitsky
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel. .,Ashkelon Academic College, School of Health Sciences, Ashkelon, Israel.
| | - O Manor
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - G Lawrence
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Y Friedlander
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | | | - H Hochner
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel
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23
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Han J, Jiang Y, Huang J, Zhang Y, Zhang Y, Zhang Y, Chen X, Li Y, Yan W. Postnatal growth of preterm infants during the first two years of life: catch-up growth accompanied by risk of overweight. Ital J Pediatr 2021; 47:66. [PMID: 33726805 PMCID: PMC7968173 DOI: 10.1186/s13052-021-01019-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 03/02/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Early postanal growth of preterm infants has many effects on early and late health. However, evidence on growth pattern in Chinese preterm infant population during early life is insufficient. This study aims to describe the growth trajectory, catch-up growth, and risk of overweight of preterm infants during the first 2 years of life in a Chinese community population. METHODS All preterm infants (n = 10,624) received routine childcare in one primary maternal and child healthcare network in 8 years were included. Body weight and length/height at corrected age (CA) 40 weeks, CA 3 months, 6 months, 9 months, 12 months, 18 months, and 24 months were extracted and converted to z-scores based on the World Health Organization (WHO) standards. According to the intrauterine growth status, infants were divided into small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA) infants. Changes of z-score were used to describe the growth velocity. Generalized estimating equation (GEE) model was used to analyze growth trajectory trends over time. RESULTS Body weight and length/height were overall above the WHO standards during the first 2 years of life. Z-score increased significantly by 0.08 (95% CI: 0.06-0.10) in weight and 0.07 (95% CI: 0.04-0.09) in length/height from CA 40 weeks to 3 months and then levelled off until CA 24 months after adjustment. Almost 90% of AGA and LGA infants achieved growth targets (≥25th percentile of WHO standards), and over 85% of SGA infants achieved catch-up growth (≥10th percentile of WHO standards) before CA 24 months. However, the risk of overweight appeared during this period, with the proportion of infants with the risk of overweight being at the peak at CA 3 months (25.6% of all preterm infants and 39.4% of LGA infants). Growth trajectories of SGA showed increasing trends, but those of LGA showed decreasing trends during the first 2 years. CONCLUSIONS Body weight and length/height of preterm infants are above the WHO standards in the Chinese community population during the first 2 years of life. Catch-up growth is accompanied by risk of overweight as early as CA 3 months. (349 words).
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Affiliation(s)
- Junyan Han
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
- National Children's Medical Center, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
| | - Yuan Jiang
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
- National Children's Medical Center, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
| | - Jun Huang
- Shanghai Minhang District Maternal and Child Health Care Hospital, 805 Gudai Road, Minhang District, Shanghai, 201102, China
| | - Yue Zhang
- Shanghai Minhang District Maternal and Child Health Care Hospital, 805 Gudai Road, Minhang District, Shanghai, 201102, China
| | - Ying Zhang
- Shanghai Minhang District Maternal and Child Health Care Hospital, 805 Gudai Road, Minhang District, Shanghai, 201102, China
| | - Yi Zhang
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
- National Children's Medical Center, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
| | - Xiaotian Chen
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
- National Children's Medical Center, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
| | - Yun Li
- Shanghai Minhang District Maternal and Child Health Care Hospital, 805 Gudai Road, Minhang District, Shanghai, 201102, China.
| | - Weili Yan
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
- National Children's Medical Center, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
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24
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Growth patterns and breast milk/infant formula energetic efficiency in healthy infants up to 18 months of life: the COGNIS study. Br J Nutr 2021; 126:1809-1822. [PMID: 33602357 DOI: 10.1017/s000711452100057x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Type of feeding during early life influences growth trajectory and metabolic risk at later ages. Modifications in infant formula composition have led to evaluate their effects on growth and energetic efficiency (EE) compared with breast-feeding. Main goal was to analyse type of feeding potential effects during first months of life, plus its EE, on growth patterns in healthy formula fed (standard infant formula (SF) vs. experimental infant formula enriched with bioactive nutrients (EF)) and breastfed (BF) infants participating in the COGNIS RCT (http://www.ClinicalTrials.gov, Identifier: NCT02094547) up to 18 months of age. Infants follow-up to 18 months of age (n 141) fed with a SF (n 48), EF(n 56), or BF (n 37), were assessed for growth parameters using WHO standards. Growth velocity (GV) and catch-up were calculated to identify growth patterns. EE of breast milk/infant formula was also estimated. Infants' growth at 6 months showed higher length and lower head circumference gains in SF and EF infants than BF infants. Both weight-for-length and weight-for-age catch-up growth showed significant differences in formula fed groups compared with the BF. No significant differences in GV or catch-up were found at 6-12 and 12-18 months. Regarding EE, infant formula groups showed significantly lower weight and length gains/g of milk protein, and higher weight and length gains/g of milk lipids, than the BF infants. GV during first 6 months, which may be influenced by feeding, seems to be the main predictor of subsequent growth trajectory. Breast-feeding may have positive effects on growth programming due to its nutrients' EE.
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25
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Robinson N, Brown H, Antoun E, Godfrey KM, Hanson MA, Lillycrop KA, Crozier SR, Murray R, Pearce MS, Relton CL, Albani V, McKay JA. Childhood DNA methylation as a marker of early life rapid weight gain and subsequent overweight. Clin Epigenetics 2021; 13:8. [PMID: 33436068 PMCID: PMC7805168 DOI: 10.1186/s13148-020-00952-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 10/19/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND High early postnatal weight gain has been associated with childhood adiposity; however, the mechanism remains unknown. DNA methylation is a hypothesised mechanism linking early life exposures and subsequent disease. However, epigenetic changes associated with high early weight gain have not previously been investigated. Our aim was to investigate the associations between early weight gain, peripheral blood DNA methylation, and subsequent overweight/obese. Data from the UK Avon Longitudinal study of Parents and Children (ALSPAC) cohort were used to estimate associations between early postnatal weight gain and epigenome-wide DNA CpG site methylation (Illumina 450 K Methylation Beadchip) in blood in childhood (n = 125) and late adolescence (n = 96). High weight gain in the first year (a change in weight z-scores > 0.67), both unconditional (rapid weight gain) and conditional on birthweight (rapid thrive), was related to individual CpG site methylation and across regions using the meffil pipeline, with and without adjustment for cell type proportions, and with 5% false discovery rate correction. Variation in methylation at high weight gain-associated CpG sites was then examined with regard to body composition measures in childhood and adolescence. Replication of the differentially methylated CpG sites was sought using whole-blood DNA samples from 104 children from the UK Southampton Women's Survey. RESULTS Rapid infant weight gain was associated with small (+ 1% change) increases in childhood methylation (age 7) for two distinct CpG sites (cg01379158 (NT5M) and cg11531579 (CHFR)). Childhood methylation at one of these CpGs (cg11531579) was also higher in those who experienced rapid weight gain and were subsequently overweight/obese in adolescence (age 17). Rapid weight gain was not associated with differential DNA methylation in adolescence. Childhood methylation at the cg11531579 site was also suggestively associated with rapid weight gain in the replication cohort. CONCLUSIONS This study identified associations between rapid weight gain in infancy and small increases in childhood methylation at two CpG sites, one of which was replicated and was also associated with subsequent overweight/obese. It will be important to determine whether loci are markers of early rapid weight gain across different, larger populations. The mechanistic relevance of these differentially methylated sites requires further investigation.
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Affiliation(s)
- N Robinson
- Population Health Sciences, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, UK.
| | - H Brown
- Population Health Sciences, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - Elie Antoun
- Institute of Developmental Sciences, Biological Sciences and NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mark A Hanson
- Institute of Developmental Sciences, Biological Sciences and NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Karen A Lillycrop
- Institute of Developmental Sciences, Biological Sciences and NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Robert Murray
- Institute of Developmental Sciences, Biological Sciences and NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - M S Pearce
- Population Health Sciences, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - C L Relton
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - V Albani
- Population Health Sciences, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - J A McKay
- Department of Applied Sciences, Northumbria University, Newcastle upon Tyne, UK
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26
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Parent Perspectives on Implementing Health Behavior Recommendations for Their Infants. REPORTS 2020. [DOI: 10.3390/reports3040035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Little is known about the influence of parental values, preferences, and child achievement and health expectations on parent choices for their child’s rearing practices. We aimed to explore parents’ perceptions of immediate and future impact of health behavior decisions for their child and to understand factors associated with child-specific health behavior decisions. This pilot study included interviews with 25 parents of 9–24-month-old children attending well child care visits at a primary care practice. Questions assessed parental perceptions and attitudes in making health behavior changes now for their child’s future health. Themes suggest parents perceive many factors are involved, and intricately connected, in health behavior decision-making. Although almost all parents believed there is a connection between the foods they feed their child and achieving their goals, only half are willing to make a change. In addition, parents failed to consider the impact of the health practices they currently have with their children to influence the future acquisition of life skills and of healthy versus obesogenic behaviors. Our results add to the understanding of the process of health behavior change through anticipatory guidance. Study findings will be used to guide next steps towards refining our understanding of health and lifestyle change decisions made by parents.
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27
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Does early weaning shape future endocrine and metabolic disorders? Lessons from animal models. J Dev Orig Health Dis 2020; 11:441-451. [PMID: 32487270 DOI: 10.1017/s2040174420000410] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Obesity and its complications occur at alarming rates worldwide. Epidemiological data have associated perinatal conditions, such as malnutrition, with the development of some disorders, such as obesity, dyslipidemia, diabetes, and cardiovascular diseases, in childhood and adulthood. Exclusive breastfeeding has been associated with protection against long-term chronic diseases. However, in humans, the interruption of breastfeeding before the recommended period of 6 months is a common practice and can increase the risk of several metabolic disturbances. Nutritional and environmental changes within a critical window of development, such as pregnancy and breastfeeding, can induce permanent changes in metabolism through epigenetic mechanisms, leading to diseases later in life via a phenomenon known as programming or developmental plasticity. However, little is known regarding the underlying mechanisms by which precocious weaning can result in adipose tissue dysfunction and endocrine profile alterations. Here, the authors give a comprehensive report of the different animal models of early weaning and programming that can result in the development of metabolic syndrome. In rats, for example, pharmacological and nonpharmacological early weaning models are associated with the development of overweight and visceral fat accumulation, leptin and insulin resistance, and neuroendocrine and hepatic changes in adult progeny. Sex-related differences seem to influence this phenotype. Therefore, precocious weaning seems to be obesogenic for offspring. A better understanding of this condition seems essential to reducing the risk for diseases. Additionally, this knowledge can generate new insights into therapeutic strategies for obesity management, improving health outcomes.
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Maternal diet intervention before pregnancy primes offspring lipid metabolism in liver. J Transl Med 2020; 100:553-569. [PMID: 31748681 PMCID: PMC7102928 DOI: 10.1038/s41374-019-0344-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/17/2019] [Accepted: 10/22/2019] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) has a developmental origin and is influenced in utero. We aimed to evaluate if maternal diet intervention before pregnancy would be beneficial to reduce the risk of offspring NAFLD. In our study, female mice were either on a normal-fat diet (NF group), or a high-fat diet for 12 weeks and continued on this diet throughout pregnancy and lactation (HF group), or switched from HF-to-NF diet 1 week (H1N group), or 9 weeks (H9N group) before pregnancy. Compared with the NF offspring, the H1N and HF, but not the H9N offspring, displayed more severe hepatic steatosis and glucose intolerance. More specifically, an abnormal blood lipid panel was seen in the H1N offspring and abnormal hepatic free fatty acid composition was present in both the HF and H1N offspring, while the H9N offspring displayed both at normal levels. These physiological changes were associated with desensitized hepatic insulin/AKT signaling, increased expression of genes and proteins for de novo lipogenesis and cholesterol synthesis, decreased expression of genes and proteins for fatty acid oxidation, increased Pcsk9 expression, and hypoactivation of 5' AMP-activated protein kinase (AMPK) signaling in the HF and H1N offspring. However, these effects were completely or partially rescued in the H9N offspring. In summary, we found that early maternal diet intervention is effective in reducing the risk of offspring NAFLD caused by maternal HF diet. These findings provide significant support to develop effective diet intervention strategies and policies for prevention of obesity and NAFLD to promote optimal health outcomes for mothers and children.
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Pesch MH, Pont CM, Lumeng JC, McCaffery H, Tan CC. Mother and Infant Predictors of Rapid Infant Weight Gain. Clin Pediatr (Phila) 2019; 58:1515-1521. [PMID: 31556703 DOI: 10.1177/0009922819877875] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective. To examine characteristics of the infant and mother associated with rapid infant weight gain (RIWG). Methods. Electronic health records (N = 4626) of term infants born were reviewed. Multivariable logistic regression examined the presence of RIWG (vs not) using participant characteristics in the whole sample and in stratified groups. Results. The prevalence of RIWG was 18.7%. Predictors of RIWG were infant male sex, younger infant gestational age, firstborn (vs later born) status, maternal Black or Other (Asian, American Indian, etc), non-Hispanic race/ethnicity (vs White non-Hispanic), Medicaid (vs non-Medicaid insurance), and maternal cigarette smoking status (vs never smoker). The regression model explained between 7.0% and 11.4% of the variance in RIWG. There were few differences in predictors of RIWG in stratified samples. Conclusions. Early childhood obesity intervention efforts may target the modifiable risk factors for RIWG starting prenatally.
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Affiliation(s)
| | | | | | | | - Cin C Tan
- University of Michigan, Ann Arbor, MI, USA
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30
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Rotevatn TA, Overgaard C, Melendez-Torres GJ, Mortensen RN, Ullits LR, Høstgaard AMB, Torp-Pedersen C, Bøggild H. Infancy weight gain, parental socioeconomic position, and childhood overweight and obesity: a Danish register-based cohort study. BMC Public Health 2019; 19:1209. [PMID: 31477065 PMCID: PMC6720844 DOI: 10.1186/s12889-019-7537-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/22/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Rapid infant weight gain (RIWG) is a very strong predictor of childhood overweight and obesity (COO). Socioeconomic position (SEP) is also related to the risk of COO and parents of different SEP may differ in their reaction to accelerated infant weight gain. Together this could lead to differences in how weight gain and COO risk relate across SEP. This study aimed to analyse possible interaction of SEP and RIWG on COO risk. METHODS A register-based longitudinal cohort study followed 19,894 healthy, term infants, born in Denmark between December 2011 and May 2015. Logistic regression models were used to estimate odds ratios (OR) of COO risk at 2 years (22-26 months) of age with 95% confidence intervals (95% CI) for categories of infancy weight gain based on changes in weight-for-age z-scores between 0 and 8-10 months of age (slow (<- 0.67), mean (- 0.67-0.67), rapid (> 0.67-1.34) and very rapid (> 1.34)). Possible multiplicative and additive interaction of SEP (based on household income and maternal education) on the relationship between infancy weight gain and COO were analysed. RESULTS In total, 19.1 and 15.1% experienced rapid or very rapid weight gain, respectively, and 1497 (7.5%) children were classified with COO at follow-up. These prevalences were higher in those with lower levels of SEP. Adjusted OR for COO were 3.09 (95% CI [2.66-3.59]) and 7.58 (95% CI [6.51-8.83]) for rapid and very rapid weight gain, respectively, when household income was included in the model. Results were similar in the model including maternal education. No signs of interactions were detected on a multiplicative scale. Weak signs of additive interaction were present, but these values did not reach significance. CONCLUSION Both rapid and very rapid weight gain were associated with substantially higher risks of COO but these associations were not modified by SEP. This indicates that promotion of healthy weight gain should take place in all population groups irrespective of their SEP.
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Affiliation(s)
- Torill Alise Rotevatn
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 9220, Aalborg East, Denmark.
| | - Charlotte Overgaard
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 9220, Aalborg East, Denmark
| | - G J Melendez-Torres
- DECIPHer, Cardiff School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales, UK
| | - Rikke Nørmark Mortensen
- Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Søndre Skovvej 15, 9000, Aalborg, Denmark
| | - Line Rosenkilde Ullits
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 9220, Aalborg East, Denmark
| | - Anna Marie Balling Høstgaard
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 9220, Aalborg East, Denmark
| | - Christian Torp-Pedersen
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 9220, Aalborg East, Denmark.,Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Søndre Skovvej 15, 9000, Aalborg, Denmark
| | - Henrik Bøggild
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 9220, Aalborg East, Denmark.,Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Søndre Skovvej 15, 9000, Aalborg, Denmark
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31
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Ventura AK, Sheeper S, Levy J. Exploring Correlates of Infant Clarity of Cues During Early Feeding Interactions. J Acad Nutr Diet 2019; 119:1452-1461. [PMID: 31153959 PMCID: PMC6710109 DOI: 10.1016/j.jand.2019.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/17/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Recommendations aimed at reducing infants' risk for rapid weight gain primarily focus on promoting caregivers' use of responsive feeding practices and styles. These recommendations are grounded in the belief that infants will effectively signal hunger and satiation to their caregivers. To date, few studies have explored how variability in infants' communication of hunger and satiation may contribute to feeding interactions. OBJECTIVE Our aim was to explore variability in, and correlates of, infant clarity of cues during feeding interactions. DESIGN This was a cross-sectional study. PARTICIPANTS/SETTING Mother-infant dyads (n=86) were video-recorded during a typical feeding interaction within laboratory-based settings in Philadelphia, PA and San Luis Obispo, CA between June 2013 and June 2017. MAIN OUTCOME MEASURES Trained raters later coded videos using the Nursing Child Assessment Parent-Child Interaction Feeding Scale's Infant Clarity of Cues and Maternal Sensitivity to Cues subscales. Infant weight was assessed and standardized to sex- and age-specific z scores. Mothers completed questionnaires related to family demographics, infant feeding history, feeding styles, and infant temperament and eating behaviors. STATISTICAL ANALYSES PERFORMED Linear models were used to test for associations between clarity of cues and breastfeeding vs formula-feeding, maternal sensitivity and responsiveness, and feeding and weight outcomes. RESULTS Infants were approximately 15.5 weeks of age and 53% were female. Clarity of cues was not associated with infant sex, age, temperament, or eating behaviors. Breastfed and formula-fed infants exhibited similar clarity of cues (P=0.0636). Greater clarity of cues for infants was associated with greater maternal sensitivity to cues (P=0.0011) and responsive feeding style (P=0.0464) for mothers. Lower clarity of cues was associated with greater weight-for-age z score change for formula-fed infants, but not breastfed infants. CONCLUSIONS Efforts to promote responsive feeding may need to also consider infant clarity of cues. Further research is needed to understand the implications of associations between infant communication and responsive feeding.
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Feeding circuit development and early-life influences on future feeding behaviour. Nat Rev Neurosci 2019; 19:302-316. [PMID: 29662204 DOI: 10.1038/nrn.2018.23] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A wide range of maternal exposures - undernutrition, obesity, diabetes, stress and infection - are associated with an increased risk of metabolic disease in offspring. Developmental influences can cause persistent structural changes in hypothalamic circuits regulating food intake in the service of energy balance. The physiological relevance of these alterations has been called into question because maternal impacts on daily caloric intake do not persist to adulthood. Recent behavioural and epidemiological studies in humans provide evidence that the relative contribution of appetitive traits related to satiety, reward and the emotional aspects of food intake regulation changes across the lifespan. This Opinion article outlines a neurodevelopmental framework to explore the possibility that crosstalk between developing circuits regulating different modalities of food intake shapes future behavioural responses to environmental challenges.
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Tarik M, Ramakrishnan L, Sinha S, Sachdev HPS, Tandon N, Roy A, Bhargava SK. Association of birth outcomes and postnatal growth with adult leukocyte telomere length: Data from New Delhi Birth Cohort. MATERNAL AND CHILD NUTRITION 2019; 15:e12857. [PMID: 31216382 DOI: 10.1111/mcn.12857] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 05/23/2019] [Accepted: 06/05/2019] [Indexed: 12/12/2022]
Abstract
Born small for gestational age due to undernutrition in utero and subsequent catch-up growth is associated with risk of developing chronic diseases in adulthood. Telomere length has been shown to be a predictor of these age-related diseases and may be a link between birth size, a surrogate for foetal undernutrition, and adult chronic diseases. We assessed the relationship of leukocyte telomere length in adult life with birth outcomes and serial change in body mass index (BMI) from birth to adulthood. Leukocyte relative telomere length (RTL) was measured by MMqPCR in 1,309 subjects from New Delhi Birth Cohort who participated in two phases of the study between 2006-2009 (Phase 6) and 2012-2015 (Phase 7) at a mean age of 39.08 (±3.29), and its association with birth outcomes and conditional BMI gain at 2, 11, and 29 years was assessed in a mixed regression model. We did not find any significant association of RTL with body size at birth including birthweight, birth length, and birth BMI. Gestational age was positively associated with RTL (P = .017, multivariate model: P = .039). Conditional BMI gain at 2 and 11 years was not associated with RTL. BMI gain at 29 year was negatively associated with RTL in multivariate model (P = .015). Born small for gestational age was not associated with RTL in adulthood. Leukocyte telomere attrition was observed in those born before 37 weeks of gestational age as well as in those who gained weight as adults, which may predispose to chronic diseases.
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Affiliation(s)
- Mohamad Tarik
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Lakshmy Ramakrishnan
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Sikha Sinha
- Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India
| | - Harsh Pal Singh Sachdev
- Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Ambuj Roy
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
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Lavner JA, Stansfield BK, Beach SRH, Brody GH, Birch LL. Sleep SAAF: a responsive parenting intervention to prevent excessive weight gain and obesity among African American infants. BMC Pediatr 2019; 19:224. [PMID: 31277694 PMCID: PMC6610994 DOI: 10.1186/s12887-019-1583-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/12/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Responsive parenting interventions that shape parenting behaviors in the areas of sleep and soothing, appropriate and responsive feeding, and routines represent a promising approach to early obesity prevention and have demonstrated effectiveness in our previous trials. However, this approach has yet to be applied to the populations most at-risk for the development of early obesity, including African Americans. The Sleep SAAF (Strong African American Families) study is a two-arm randomized controlled clinical trial evaluating whether a responsive parenting intervention focused on promoting infant sleeping and self-soothing can prevent rapid weight gain during the first 16 weeks postpartum among first-born African American infants. The responsive parenting intervention is compared to a child safety control intervention. METHODS Three hundred first-time African American mothers and their full-term infants will be enrolled from one mother/baby nursery. Following initial screening and consent in the hospital, mothers and infants are visited at home by Community Research Associates for data collection visits at 1 week, 8 weeks, and 16 weeks postpartum and for intervention visits at 3 weeks and 8 weeks postpartum. The primary study outcome is a between-group comparison of infant conditional weight gain (CWG) scores from 3 weeks to 16 weeks; additional weight-related outcomes include differences in change in infants' weight for age over time and differences in infants' weight outcomes at age 16 weeks. Several other outcomes reflecting infant and maternal responses to intervention (e.g., sleeping, soothing, feeding, maternal self-efficacy, maternal depressive symptoms) are also assessed. DISCUSSION The Sleep SAAF trial can inform efforts to prevent rapid weight gain and reduce risk for obesity early in the lifespan among African Americans. TRIAL REGISTRATION NCT03505203 . Registered April 3, 2018 in clinicaltrials.gov .
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Affiliation(s)
| | | | - Steven R. H. Beach
- Department of Psychology and Center for Family Research, University of Georgia, Athens, USA
| | - Gene H. Brody
- Center for Family Research, University of Georgia, Athens, USA
| | - Leann L. Birch
- Department of Foods and Nutrition, University of Georgia, Athens, USA
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Roy SM, Fields DA, Mitchell JA, Hawkes CP, Kelly A, Wu GD, DeRusso PA, Elovitz MA, Ford E, Drigo D, Zemel BS, McCormack SE. Body Mass Index Is a Better Indicator of Body Composition than Weight-for-Length at Age 1 Month. J Pediatr 2019; 204:77-83.e1. [PMID: 30268397 PMCID: PMC6309630 DOI: 10.1016/j.jpeds.2018.08.007] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 07/24/2018] [Accepted: 08/07/2018] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To assess whether body mass index (BMI) provides a better assessment of measured adiposity at age 1 month compared with weight-for-length (WFL). STUDY DESIGN Participants were healthy term-born infants in the Infant Growth and Microbiome (n = 146) and the Baby Peas (n = 147) studies. Length, weight, and body composition by air displacement plethysmography were measured at 1 month. World Health Organization-based WFL and BMI z-scores were calculated. Within-cohort z-scores of percent fat-Z, fat mass-Z, fat mass/length2-Z, fat mass/length3-Z, fat-free mass-Z, and fat-free mass/length2-Z were calculated. Correlation and multiple linear regression (adjusted for birth weight) analyses tested the associations between body composition outcomes and BMI-Z vs WFL-Z. Quantile regression was used to test the stability of these associations across the distribution of body compositions. RESULTS The sample was 52% female and 56% African American. Accounting for birth weight, both BMI-Z and WFL-Z were strongly associated with fat mass-Z (coefficients 0.56 and 0.35, respectively), FM/L2-Z (0.73 and 0.51), and FM/L3-Z (0.79 and 0.58), with stronger associations for BMI-Z compared with WFL-Z (P < .05). Even after accounting statistically for birth weight, BMI-Z was persistently more strongly associated than WFL-Z with body composition outcomes across the distribution of body composition outcomes. CONCLUSIONS We demonstrate in 2 distinct cohorts that BMI is a better indicator of adiposity in early infancy compared with WFL. Our findings support the preferred use of BMI for growth and nutritional status assessment in infancy.
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Affiliation(s)
- Sani M Roy
- Division of Endocrinology and Diabetes, Cook Children's Medical Center, Fort Worth, TX; Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA.
| | - David A Fields
- Division of Endocrinology and Diabetes, Oklahoma University Health Sciences Center, Oklahoma City, OK
| | - Jonathan A Mitchell
- Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Colin P Hawkes
- Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Andrea Kelly
- Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Gary D Wu
- Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Patricia A DeRusso
- Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Michal A Elovitz
- Maternal and Child Health Research Center, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Eileen Ford
- Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Danielle Drigo
- Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Babette S Zemel
- Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Shana E McCormack
- Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Magee LA, Synnes AR, von Dadelszen P, Hutfield AM, Chanoine JP, Côté AM, Devlin AM, Dorling J, Gafni A, Ganzevoort W, Helewa ME, Hutton EK, Koren G, Lee SK, Mcarthur D, Rey E, Robinson WP, Roseboom TJ, Singer J, Wilson S, Moutquin JM. CHIPS-Child: Testing the developmental programming hypothesis in the offspring of the CHIPS trial. Pregnancy Hypertens 2018; 14:15-22. [PMID: 30527103 DOI: 10.1016/j.preghy.2018.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 04/26/2018] [Accepted: 04/28/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVES As a follow-up to the CHIPS trial (Control of Hypertension In Pregnancy Study) of 'less tight' (versus 'tight') control of maternal blood pressure in pregnancy, CHIPS-Child investigated potential developmental programming of maternal blood pressure control in pregnancy, by examining measures of postnatal growth rate and hypothalamic-pituitary adrenal (HPA) axis activation. METHODS CHIPS follow-up was extended to 12 ± 2 months corrected post-gestational age for anthropometry (weight, length, head/waist circumference). For eligible children with consent for a study visit, we collected biological samples (hair/buccal samples) to evaluate HPA axis function (hair cortisol levels) and epigenetic change (DNA methylation analysis of buccal cells). The primary outcome was 'change in z-score for weight' between birth and 12 ± 2 mos. Secondary outcomes were hair cortisol and genome-wide DNA methylation status. RESULTS Of 683 eligible babies, 183 (26.8%) were lost to follow-up, 83 (12.2%) declined, 3 (0.4%) agreed only to ongoing contact, and 414 (60.6%) consented. 372/414 (89.9%) had weight measured at 12mos. In 'less tight' (vs. 'tight') control, the primary outcome was similar [-0.26 (-0.53, +0.01); p = 0.14, padjusted = 0.06]; median (95% confidence interval) hair cortisol (N = 35 samples) was lower [-496 (-892, -100) ng/g; p = 0.02], and buccal swab DNA methylation (N = 16 samples) was similar. No differences in growth rate could be demonstrated up to 5 years. CONCLUSIONS Results demonstrate no compelling evidence for developmental programming of growth or the HPA axis. Clinicians should look to the clinical findings of CHIPS to guide practice. Researchers should seek to replicate these findings and extend outcomes to paediatric blood pressure and neurodevelopment.
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Affiliation(s)
- Laura A Magee
- Department of Women and Children's Health, King's College London, UK; School of Life Course Sciences, King's College London, UK.
| | - Anne R Synnes
- Department of Paediatrics, BC Children's Hospital, University of British Columbia, Vancouver, Canada.
| | - Peter von Dadelszen
- Department of Women and Children's Health, King's College London, UK; School of Life Course Sciences, King's College London, UK.
| | - Anna M Hutfield
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada; British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada.
| | - Jean-Pierre Chanoine
- Department of Paediatrics, BC Children's Hospital, University of British Columbia, Vancouver, Canada.
| | | | - Angela M Devlin
- Department of Paediatrics, BC Children's Hospital, University of British Columbia, Vancouver, Canada.
| | | | - Amiram Gafni
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.
| | - Wessel Ganzevoort
- Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, Netherlands.
| | | | - Eileen K Hutton
- Obstetrics and Gynaecology, McMaster University, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.
| | - Gideon Koren
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada
| | - Shoo K Lee
- Pediatrics, The Centre for Mother, Infant and Child Research, Sunnybrook Research Institute, University of Toronto, Canada.
| | - Dawn Mcarthur
- British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada.
| | - Evelyne Rey
- Medicine and Obstetrics and Gynaecology, University of Montreal, Canada.
| | - Wendy P Robinson
- Department of Medical Genetics, University of British Columbia, Canada.
| | - Tessa J Roseboom
- Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, Netherlands; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam, Netherlands.
| | - Joel Singer
- School of Population and Public Health, University of British Columbia, Canada
| | - Samantha Wilson
- Department of Medical Genetics, University of British Columbia, Canada.
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Mirza N, Phan TL, Tester J, Fals A, Fernandez C, Datto G, Estrada E, Eneli I. A Narrative Review of Medical and Genetic Risk Factors among Children Age 5 and Younger with Severe Obesity. Child Obes 2018; 14:443-452. [PMID: 29791184 PMCID: PMC6157342 DOI: 10.1089/chi.2017.0350] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Severe obesity defined as an age- and gender-specific body mass index ≥120% of the 95th percentile in children younger than 5 years is well recognized as a significant challenge for prevention and treatment. This article provides an overview of the prevalence, classification of obesity severity, patterns of weight gain trajectory, medical and genetic risk factors, and comorbid disorders among young children with an emphasis on severe obesity. Studies suggest rapid weight gain trajectory in infancy, maternal smoking, maternal gestational diabetes, and genetic conditions are associated with an increased risk for severe obesity in early childhood. Among populations of young children with severe obesity seeking care, co-morbid conditions such as dyslipidemia and fatty liver disease are present and families report behavioral concerns and developmental delays. Children with severe obesity by age 5 represent a vulnerable population of children at high medical risk and need to be identified early and appropriately managed.
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Affiliation(s)
- Nazrat Mirza
- Department of Pediatrics and Adolescent Medicine, Children's National Health System, and George Washington University, Washington, DC
| | - Thao-Ly Phan
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
- Division of Weight Management, Nemours Alfred I. duPont Hospital for Children, Wilmington, DE
| | - June Tester
- Division of Endocrinology, UCSF Benioff Children's Hospital Oakland, Oakland, CA
| | - Angela Fals
- Center for Child and Family Wellness, Florida Hospital for Children, Orlando, FL
| | - Cristina Fernandez
- Creighton University and Children's Hospital and Medical Center, Omaha, NE
| | - George Datto
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
- Division of Weight Management, Nemours Alfred I. duPont Hospital for Children, Wilmington, DE
| | - Elizabeth Estrada
- Pediatric Endocrinology, University of North Carolina, Chapel Hill, NC
| | - Ihuoma Eneli
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, and Ohio State University, Columbus, OH
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Xu H, Fu Q, Zhou Y, Xue C, Olson P, Lynch EC, Zhang KK, Wu C, Murano P, Zhang L, Xie L. A long-term maternal diet intervention is necessary to avoid the obesogenic effect of maternal high-fat diet in the offspring. J Nutr Biochem 2018; 62:210-220. [PMID: 30316166 DOI: 10.1016/j.jnutbio.2018.09.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 08/22/2018] [Accepted: 09/17/2018] [Indexed: 12/14/2022]
Abstract
Although a pre-pregnancy dietary intervention is believed to be able to prevent offspring obesity, research evidence is absent. We hypothesize that a long period of pre-pregnancy maternal diet transition from a high-fat (HF) diet to a normal-fat (NF) diet effectively prevents offspring obesity, and this preventive effect is independent of maternal body weight change. In our study, female mice were either continued on an NF diet (NF group) or an HF diet (HF group) until weaning, or switched from an HF to an NF for 1 week (H1N group), 5 weeks (H5N group) or 9 weeks (H9N group) before pregnancy. After weaning, the offspring were given the HF diet for 12 weeks to promote obesity. The mothers, regardless of which group, did not display maternal body weight change and glucose intolerance either before pregnancy or after weaning. Compared to the HF group, the H1N and H5N, but not the H9N, offspring developed glucose intolerance earlier, with more severely imbalanced glucose homeostasis. These offspring also displayed hepatocyte degeneration and significant adipocyte hypertrophy associated with higher expression of lipogenesis genes. The molecular mechanistic study showed blunted insulin signaling, overactivated adipocyte Akt signaling and hepatic AMPK signaling with enhanced lipogenesis genes in the H1N and H5N versus the NF offspring. However, maternal H9N diets normalized glucose and lipid metabolism of the offspring via resensitized insulin signaling and normalized Akt and AMPK signaling. In summary, we showed that a long-term maternal diet intervention effectively released the intergenerational obesogenic effect of maternal HF diet independent of maternal weight management.
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Affiliation(s)
- Huiting Xu
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, ND 58202; Hubei Cancer Hospital, Wuhan, Hubei 430079, China
| | - Qiang Fu
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, ND 58202; Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Yi Zhou
- Department of Nutrition and Food Sciences, Texas A&M University, College Station, TX 77843; Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Chengbin Xue
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, ND 58202; Campus Hospital, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Patrick Olson
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, ND 58202
| | - Ernest C Lynch
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, ND 58202
| | - Ke K Zhang
- Department of Pathology, University of North Dakota, Grand Forks, ND 58202; ND-INBRE Bioinfomatic Core, University of North Dakota, Grand Forks, ND 58202
| | - Chaodong Wu
- Department of Nutrition and Food Sciences, Texas A&M University, College Station, TX 77843
| | - Peter Murano
- Department of Nutrition and Food Sciences, Texas A&M University, College Station, TX 77843
| | - Lanjing Zhang
- Department of Pathology, University Medical Center of Princeton, Plainsboro, NJ, USA; Department of Chemical Biology, Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ, USA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Linglin Xie
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, ND 58202; Department of Nutrition and Food Sciences, Texas A&M University, College Station, TX 77843.
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Stifter CA, Moding KJ. Infant temperament and parent use of food to soothe predict change in weight-for-length across infancy: early risk factors for childhood obesity. Int J Obes (Lond) 2018; 42:1631-1638. [PMID: 29463917 PMCID: PMC6066452 DOI: 10.1038/s41366-018-0006-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/18/2017] [Accepted: 11/27/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Greater weight gain in infancy is a risk factor for childhood obesity. The present study examined the interaction between infant temperament and parent use of food to soothe infant distress (FTS) as predictors of weight gain across the first 2 years of life. SUBJECTS/METHODS A total of 160 mother-infant dyads were recruited into a longitudinal study. Infant temperament was assessed by parents through a questionnaire (surgency, negativity) and by observer ratings (surgency, irritability) during a laboratory visit when infants were 6 months old. Parents also completed a 3-day infant cry diary when their children were 6 months of age to assess when they used food in response to infant cry/fuss bouts. Infant weight/length was measured in the lab at 6 and 18 months. Multiple regressions were run to test the moderating effect of FTS on weight gain. RESULTS Significant interactions were revealed for both measures of surgency and parent FTS in predicting weight gain. Surgent infants whose parents had a greater tendency to use FTS had greater weight-for-length gain in 1 year than if their parents tended to use less FTS. The interaction between observer ratings of irritability and parent FTS was also significant but in an unexpected direction. CONCLUSIONS The findings point to the role of temperament, specifically surgency, in weight gain during infancy, but only if their parents used FTS. Surgency may have evoked this feeding practice that increased their health risk.
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Affiliation(s)
- Cynthia A Stifter
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, State College, PA, USA.
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Gridneva Z, Kugananthan S, Rea A, Lai CT, Ward LC, Murray K, Hartmann PE, Geddes DT. Human Milk Adiponectin and Leptin and Infant Body Composition over the First 12 Months of Lactation. Nutrients 2018; 10:nu10081125. [PMID: 30127292 PMCID: PMC6115716 DOI: 10.3390/nu10081125] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 08/17/2018] [Accepted: 08/17/2018] [Indexed: 12/26/2022] Open
Abstract
Human milk (HM) adipokines may influence infant feeding patterns, appetite regulation, and body composition (BC). The associations between concentrations/calculated daily intakes (CDI) of HM adipokines in the first 12 months postpartum and maternal/term infant BC, and infant breastfeeding parameters were investigated. BC of breastfeeding dyads (n = 20) was measured at 2, 5, 9, and/or 12 months postpartum with ultrasound skinfolds (infants) and bioimpedance spectroscopy (infants/mothers). 24-h milk intake and feeding frequency were measured along with whole milk adiponectin and skim and whole milk leptin (SML and WML) and CDI were calculated. Statistical analysis used linear regression/mixed effects models; results were adjusted for multiple comparisons. Adipokine concentrations did not associate with infant BC. Higher CDI of adiponectin were associated with lower infant fat-free mass (FFM; p = 0.005) and FFM index (FFMI; p = 0.009) and higher fat mass (FM; p < 0.001), FM index (FMI; p < 0.001), and %FM (p < 0.001). Higher CDI of SML were associated with higher infant FM (p < 0.001), FMI (p < 0.001), and %FM (p = 0.002). At 12 months, higher CDI of WML were associated with larger increases in infant adiposity (2–12 month: FM, p = 0.0006; %FM, p = 0.0004); higher CDI of SML were associated with a larger decrease in FFMI (5–12 months: p = 0.0004). Intakes of HM adipokines differentially influence development of infant BC in the first year of life, which is a critical window of infant programming and may potentially influence risk of later disease via modulation of BC.
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Affiliation(s)
- Zoya Gridneva
- School of Molecular Sciences, M310, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
| | - Sambavi Kugananthan
- School of Molecular Sciences, M310, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
- School of Human Sciences, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
| | - Alethea Rea
- Centre for Applied Statistics, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
| | - Ching Tat Lai
- School of Molecular Sciences, M310, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Brisbane, QLD 4072, Australia.
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
| | - Peter E Hartmann
- School of Molecular Sciences, M310, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
| | - Donna T Geddes
- School of Molecular Sciences, M310, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
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Kral TV, Chittams J, Bradley CB, Daniels JL, DiGuiseppi CG, Johnson SL, Pandey J, Pinto-Martin JA, Rahai N, Ramirez A, Schieve LA, Thompson A, Windham G, York W, Young L, Levy SE. Early life influences on child weight outcomes in the Study to Explore Early Development. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:954-962. [PMID: 30102071 DOI: 10.1177/1362361318791545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We examined associations between child body mass index at 2-5 years and maternal pre-pregnancy body mass index, gestational weight gain, and rapid weight gain during infancy in children with autism spectrum disorder, developmental delays, or population controls. The Study to Explore Early Development is a multi-site case-control study of children, aged 2-5 years, classified as autism spectrum disorder ( n = 668), developmental delays ( n = 914), or population controls ( n = 884). Maternal gestational weight gain was compared to the Institute of Medicine recommendations. Rapid weight gain was a change in weight-for-age z-scores from birth to 6 months > 0.67 standard deviations. After adjusting for case status, mothers with pre-pregnancy overweight/obesity were 2.38 times (95% confidence interval: 1.96-2.90) more likely, and mothers who exceeded gestational weight gain recommendations were 1.48 times (95% confidence interval: 1.17-1.87) more likely, to have an overweight/obese child than other mothers ( P < 0.001). Children with autism spectrum disorder showed the highest frequency of rapid weight gain (44%) and were 3.47 times (95% confidence interval: 1.85-6.51) more likely to be overweight/obese as children with autism spectrum disorder without rapid weight gain ( P < 0.001). Helping mothers achieve a healthy pre-pregnancy body mass index and gestational weight gain represent important targets for all children. Healthy infant growth patterns carry special importance for children at increased risk for an autism spectrum disorder diagnosis.
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Affiliation(s)
| | | | | | | | | | | | - Juhi Pandey
- 4 The Children's Hospital of Philadelphia, USA
| | | | | | | | | | | | | | | | | | - Susan E Levy
- 1 University of Pennsylvania, USA.,4 The Children's Hospital of Philadelphia, USA
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Lower Protein Intake Supports Normal Growth of Full-Term Infants Fed Formula: A Randomized Controlled Trial. Nutrients 2018; 10:nu10070886. [PMID: 29996492 PMCID: PMC6073440 DOI: 10.3390/nu10070886] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 06/29/2018] [Accepted: 07/05/2018] [Indexed: 12/11/2022] Open
Abstract
Infant formulas have been conventionally prepared with an excess of total protein in order to provide sufficient amounts of essential amino acids to the rapidly growing infant. However, this practice leads to higher than necessary protein intake during early infant development, inducing accelerated growth patterns correlated with the development of chronic diseases later in life. This study was aimed at assessing the safety of an infant formula enriched with bovine alpha-lactalbumin containing a total protein concentration very close to that of human milk, and determining its efficacy in the support of healthy infant growth from the first month to the fourth month of age. Healthy full-term infants ≤40 days of age were randomized in this controlled single blind trial to one of the following infant formulas: IF 1 (containing 1.0 g protein/dL; n = 30), IF 2 (containing 1.3 g protein/dL; n = 24), and IF 3 (containing 1.5 g protein/dL; n = 42). A control group consisting of exclusively breastfed infants (HM; n = 212) was included in the study. Anthropometric measurements and Z-scores were evaluated at baseline, at 1 month of age, and at 4 months of age. Weight gain (g/day) was similar in the IF 1 and the HM groups (p = 0.644), and it was significantly greater in the IF 2 and IF 3 groups than in the HM group. Growth patterns in both breastfed or IF-fed infants were in accordance with the World Health Organization (WHO) growth standards. At four months of age, the mean weight-for-age Z-score (WAZ) adjusted for initial value in the IF 1 group was similar to that of the HM group and significantly lower than that of the IF 2 and IF 3 groups (p = 0.031 and p = 0.014 for IF 2 and IF 3, respectively). Length-for-age (LAZ) adjusted for initial value was similar among all groups at four months of age. From 1 to 4 months of life, IF 1 containing 1.0 g protein/dL promotes growth and weight gain similar to those observed in exclusively breastfed infants. As this is a first approach to studying an IF containing total protein in a level below that recommended by international committees on nutrition, further investigations are needed to support these findings evaluating infant’s metabolic profile and growth in the long term.
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Ramirez-Silva I, Rivera JA, Trejo-Valdivia B, Stein AD, Martorell R, Romieu I, Barraza-Villarreal A, Avila-Jiménez L, Ramakrishnan U. Relative Weight Gain Through Age 4 Years Is Associated with Increased Adiposity, and Higher Blood Pressure and Insulinemia at 4-5 Years of Age in Mexican Children. J Nutr 2018; 148:1135-1143. [PMID: 29924321 PMCID: PMC6669951 DOI: 10.1093/jn/nxy068] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 11/10/2017] [Accepted: 03/12/2018] [Indexed: 12/25/2022] Open
Abstract
Background Rapid early weight gain has been associated with increased risk of obesity and cardiometabolic alterations, but evidence in low and middle-income countries is inconclusive. Objective We evaluated the relation between relative weight gain from 1 to 48 mo with adiposity and cardiometabolic risk factors at 4-5 y of age, and determined if adiposity is a mediator for cardiometabolic alterations. Methods We studied 428 Mexican children with anthropometric and blood pressure (BP) information from birth to 5 y of age from POSGRAD (Prenatal Omega-3 fatty acid Supplementation and child GRowth And Development), of whom 334 provided measures of adiposity and cardiometabolic risk markers at 4 y. We estimated relative weight gain by means of conditional weight-for-height z scores for the age intervals 1-6, 6-12, 12-24, and 24-48 mo. Associations between relative weight gain and adiposity and cardiometabolic risk markers (lipid profile, triglycerides, insulin, glucose, and BP) were analyzed by multivariate multiple linear models and path analysis. Results A 1-unit increase in conditional weight-for-height z score within each age interval was positively associated with adiposity at 5 y, with coefficients of 0.43-0.89 for body mass index (BMI) z score, 1.08-3.65 mm for sum of skinfolds, and 1.21-3.87 cm for abdominal circumference (all P < 0.01). Positive associations were documented from ages 6 to 48 mo with systolic BP (coefficient ranges: 1.19-1.78 mm Hg; all P < 0.05) and from ages 12 to 48 mo with diastolic BP (1.28-0.94 mm Hg; P < 0.05) at 5 y. Conditional weight-for-height z scores at 12-24 and 24-48 mo of age were more strongly associated with adiposity and BP relative to younger ages. A unit increase in conditional weight-for-height z scores from 12 to 24 mo was associated with 14% higher insulin levels (P < 0.05) at 4 y. Path analyses documented that the associations of conditional weight gain with BP were mediated by BMI and sum of skinfolds. Conclusion Relative weight gain at most periods during the first 4 y of life was associated with greater adiposity and higher systolic and diastolic BP at 5 y. These associations with BP were mediated by adiposity. Relative weight gain from 12 to 24 mo was associated with increased serum insulin concentrations at 4 y, but there were no associations with lipid profiles or glucose concentration.
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Affiliation(s)
| | | | | | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Isabelle Romieu
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | | | | | - Usha Ramakrishnan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
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Thomson JL, Tussing-Humphreys LM, Goodman MH, Landry AS. Infant activity and sleep behaviors in a maternal and infant home visiting project among rural, southern, African American women. Matern Health Neonatol Perinatol 2018; 4:10. [PMID: 29785275 PMCID: PMC5954454 DOI: 10.1186/s40748-018-0078-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 03/14/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Physical inactivity and inadequate amounts of sleep are two potential causes for excessive weight gain in infancy. Thus, parents and caregivers of infants need to be educated about decreasing infant sedentary behavior, increasing infant unrestrained floor time, as well as age specific recommended amounts of sleep for infants. The aims of this study were to determine if maternal knowledge about infant activity and sleep changed over time and to evaluate maternal compliance rates with expert recommendations for infant sleep in a two-arm, randomized, controlled, comparative impact trial. METHODS Pregnant women at least 18 years of age, less than 19 weeks pregnant, and residing in a lower Mississippi Delta county were recruited between March 2013 and December 2014. Postnatal data was collected from 54 participants between September 2013 and May 2016. McNemar's test of symmetry was used to determine if maternal knowledge changed over time, while generalized linear mixed models and Kaplan-Meier survival curves were used to assess compliance with expert recommendations for infant sleep. RESULTS The postnatal retention rate was 85%. Maternal knowledge significantly increased for correct infant sleep position (back) and beginning tummy time by one month of age. Odds of meeting sleep duration recommendations increased by 30% for every one month increase in infant age. Only 20% of the participants were compliant with the back to sleep recommendation for the first 12 months of their infant's life; median time to noncompliance was 7.8 months. CONCLUSIONS Although baseline knowledge concerning infant activity and sleep was high in this cohort of rural, Southern, African American mothers, compliance with recommendations was not optimal. TRIAL REGISTRATION The study was registered at clinicaltrials.gov (NCT01746394) on December 5, 2012.
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Affiliation(s)
- Jessica L. Thomson
- United States Department of Agriculture, Agricultural Research Service, 141 Experiment Station Road, Stoneville, MS 38776 USA
| | | | - Melissa H. Goodman
- United States Department of Agriculture, Agricultural Research Service, 141 Experiment Station Road, Stoneville, MS 38776 USA
| | - Alicia S. Landry
- Department of Family and Consumer Sciences, University of Central Arkansas, Conway, AR USA
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Nakagawa Y, Nakanishi T, Satake E, Matsushita R, Saegusa H, Kubota A, Natsume H, Shibata Y, Fujisawa Y. Postnatal BMI changes in children with different birthweights: A trial study for detecting early predictive factors for pediatric obesity. Clin Pediatr Endocrinol 2018; 27:19-29. [PMID: 29403153 PMCID: PMC5792818 DOI: 10.1297/cpe.27.19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 10/04/2017] [Indexed: 01/16/2023] Open
Abstract
The purpose of this study was to clarify the degree of early postnatal growth by birthweight and detect early predictive factors for pediatric obesity. Body mass index (BMI) and degree of obesity were examined in children in the fourth year of elementary school and second year of junior high school. Their BMI at birth and three years of age were also examined. Based on birthweight, participants were divided into three groups: low (< 2500 g), middle (2500-3500 g), and high (> 3500 g). Furthermore, according to the degree of obesity, they were divided into two groups: obese (20% ≤) and non-obese (20% >). The change of BMI from birth to three years of age (ΔBMI) showed a strong inverse relationship with birthweight and was significantly different among the three birthweight groups (low > middle > high). The ΔBMI and BMI at three years of age were higher in obese than in non-obese children and showed significant positive correlations with the degree of obesity. Early postnatal growth might be determined by birthweight and was higher in obese than in non-obese children. The ΔBMI from birth to three years of age and BMI at age of three years could be predictive factors for pediatric obesity.
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Affiliation(s)
- Yuichi Nakagawa
- Department of Internal Medicine and Pediatrics, Shiraume Toyooka Hospital, Shizuoka, Japan.,Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Toshiki Nakanishi
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Eiichiro Satake
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Rie Matsushita
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan.,Department of Pediatrics, Kikugawa General Hospital, Shizuoka, Japan
| | - Hirokazu Saegusa
- Department of Pediatrics, Enshu General Hospital, Shizuoka, Japan
| | - Akira Kubota
- Department of Pediatrics, Chutoen General Medical Center, Shizuoka, Japan
| | - Hiromune Natsume
- Department of Pediatrics, Kosai General Hospital, Shizuoka, Japan
| | - Yukinobu Shibata
- Department of Pediatrics, Hamamatsu Red Cross Hospital, Shizuoka, Japan
| | - Yasuko Fujisawa
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
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Sensitive Timing for Risk of Overweight Among Infants of Low-Income Hispanic Immigrants. J Pediatr Health Care 2018; 32:76-82. [PMID: 29056309 DOI: 10.1016/j.pedhc.2017.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 08/01/2017] [Indexed: 01/01/2023]
Abstract
INTRODUCTION This study examined the association between early weight gain (0-6 months) and risk for overweight, as defined by the Institute of Medicine, at 1 year among infants of low-income Hispanic immigrant mothers. METHOD Weight-for-age data were extracted from electronic medical records of 335 infants with gestations of 37 weeks or longer and birthweights appropriate for gestational age and without medical problems likely to interfere with growth or feeding. Logistic regression models were constructed to examine the impact of early weight changes on weight status at 1 year. RESULTS By 12 months, 36.7% of infants had crossed weight-for-age of 84.1% or greater on World Health Organization growth charts. In adjusted models, infants had 20.8 (95% confidence interval = [19.8, 44.0]) times the odds of reaching this benchmark at 1 year for each z score increase at 0 to 6 months. DISCUSSION The study highlights a time-sensitive opportunity for interventions to reduce risk for overweight for this vulnerable population.
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Association between supraclavicular brown adipose tissue composition at birth and adiposity gain from birth to 6 months of age. Pediatr Res 2017; 82:1017-1021. [PMID: 28723888 PMCID: PMC5685919 DOI: 10.1038/pr.2017.159] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 06/26/2017] [Indexed: 12/11/2022]
Abstract
BackgroundBrown adipose tissue (BAT) is associated with higher energy expenditure and lower adiposity in adults. However, the relationship between BAT composition and adiposity in early life is unknown. The objective of this study was to test the hypothesis that brown fat composition at birth is prospectively associated with adiposity gain during the first 6 months of postnatal life.MethodsN=35 healthy infants were followed up prospectively from intrauterine life and birth through 6 months of age. Dixon magnetic resonance imaging (MRI) scans were conducted during the neonatal period to characterize supraclavicular BAT composition. Dual-energy X-ray absorptiometry to assess total body composition was performed within the first and sixth months of life.ResultsAfter adjusting for potential confounding factors, a more brown-like composition (smaller fat fraction) of the supraclavicular BAT depot was associated with a smaller increase in percent body fat over the first 6 months of postnatal life.ConclusionsA more brown-like BAT composition at birth appears to be protective against excess adiposity gain in early life. Newborn BAT tissue may constitute a target for prevention strategies against the subsequent development of obesity.
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Infant feeding practices and dietary consumption of US infants and toddlers: National Health and Nutrition Examination Survey (NHANES) 2003–2012. Public Health Nutr 2017; 21:711-720. [DOI: 10.1017/s1368980017003184] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AbstractObjectiveTo compare infant and toddler anthropometric measurements, feeding practices and mean nutrient intakes by race/ethnicity and income.DesignCross-sectional analysis using general linear modelling. Ten years of survey data (2003–2012) were combined to compare anthropometric measurements, feeding practices and mean nutrient intakes from a nationally representative US sample.SettingThe 2003–2012 National Health and Nutrition Examination Survey (NHANES).SubjectsInfants and toddlers (n 3669) aged 0–24 months.ResultsRates of overweight were higher among Mexican-American infants and toddlers (P=0·002). There were also several differences in feeding practices among groups based on race/ethnicity. Cessation of breast-feeding occurred earlier for non-Hispanic black and Mexican-American v. non-Hispanic white infants (3·6 and 4·2 v. 5·3 months; P<0·0001; P=0·001). Age at first feeding of solids was earlier for white than Mexican-American infants (5·3 v. 5·7 months; P=0·02). There were differences in almost all feeding practices based on income, including the lowest-income infants stopped breast-feeding earlier than the highest-income infants (3·2 v. 5·8 months, P<0·0001). Several differences in mean nutrient intakes by both race/ethnicity and income were also identified.ConclusionsOur study indicates that disparities in overweight, feeding practices and mean nutrient intakes exist among infants and toddlers according to race/ethnicity, which cannot be disentangled from income.
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Body mass index trajectories during infancy and pediatric obesity at 6 years. Ann Epidemiol 2017; 27:708-715.e1. [DOI: 10.1016/j.annepidem.2017.10.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/25/2017] [Accepted: 10/04/2017] [Indexed: 11/21/2022]
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Associations Between Dietary Intake Before 6 Months of Age and Rapid Weight Gain Among HIV-exposed Uninfected Infants. J Pediatr Gastroenterol Nutr 2017; 65:e104-e109. [PMID: 28422809 DOI: 10.1097/mpg.0000000000001607] [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] [Indexed: 12/10/2022]
Abstract
INTRODUCTION HIV-exposed, uninfected (HEU) infants are potentially at risk for cardiovascular disease due to in utero exposures. Feeding practices of the infant could compound this risk. Few studies have, however, evaluated dietary intake of HEU infants. We determined dietary factors associated with rapid weight gain (RWG) among HEU infants from birth to 6 months followed at the University of Miami HIV Screening Program. METHODS In this cross-sectional analysis, logistic regression was used to determine dietary factors associated with RWG defined as a >0.67 SD change in weight-for-age z score from birth to assessment (0.3-6 months). Other covariates included demographics, birth, maternal and gestational characteristics, and antiretroviral exposures. RESULTS A total of 86 full-term HEU infants with a mean age of 3.4 months (SD 1.8 months) were included in this analysis. Fifty-five percent of mothers were obese. Overall, 39.5% of infants exhibited RWG. A significant association between consumption of infant cereal and RWG (odds ratio, 3.52; 95% confidence interval, 1.02-12.10) was found after adjusting for birth weight, current age, and energy intake. Those infants who consumed the highest tertile of protein were less likely to gain weight rapidly after adjusting for the same covariates (odds ratio, 0.15; 95% confidence interval, 0.02-0.94). CONCLUSIONS Overall differences in weight gain during early infancy are at least partly explained by means of infant feeding in young HEU infants in the United States. Dietary counseling for families of HEU should reinforce current feeding practice recommendations of the American Academy of Pediatrics.
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