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Flores LA, Datta Banik S, Cameron N, Fragoso IJ. Growth in height and its association with overweight and obesity in Mexican children: an evaluation based on a nationally representative sample (ENSANUT 2018). Front Public Health 2024; 12:1339195. [PMID: 38572009 PMCID: PMC10989078 DOI: 10.3389/fpubh.2024.1339195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/31/2024] [Indexed: 04/05/2024] Open
Abstract
The present study aimed to estimate the height growth curve for Mexican boys and girls based on their body mass index (BMI) status (normal and overweight/obese) and to develop a height Lambda, Mu, and Sigma (LMS) growth reference for Mexican children aged 2 to 18 years. Methods Chronological age and height records (7,097 boys and 6,167 girls) were obtained from the Mexican National Survey of Health and Nutrition database. Height growth curves were fitted using the Preece-Baines 1 (PB1) model and the LMS method. Results Age at peak height velocity (APHV) was 12.4 and 12.7 years for overweight-obese and normal-weight boys, respectively, and was 9.6 and 10.4 years for overweight-obese and normal-weight girls, respectively. Growth velocity was higher at the age of take-off (TO) in overweight-obese children than in normal-weight children (5.2 cm/year vs. 5 cm/year in boys and 6.1 cm/year vs. 5.6 cm/year in girls); nevertheless, the growth velocity at APHV was higher for normal-weight children than for overweight-obese children (7.4 cm/year vs. 6.6 cm/year in boys and 6.8 cm/year vs. 6.6 cm/year in girls, respectively). Distance curves developed in the present study and by the World Health Organization (WHO) using LMS showed similar values for L and S parameters and a higher M value compared with the WHO reference values. Conclusion This study concluded that overweight-obese children had earlier APHV and lower PHV than normal-weight children. Furthermore, Mexican children and adolescents were shorter than the WHO growth reference by age and sex.
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Affiliation(s)
| | - Sudip Datta Banik
- Center for Research and Advanced Studies - Mérida Unit, Merida, Mexico
| | - Noel Cameron
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
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Klahs KJ, Dertinger JE, Mello GT, Thapa K, Sandler AB, Garcia EJJ, Parnes N. Epidemiologic investigation of pediatric distal humerus fractures: An American insurance claims database study. World J Orthop 2024; 15:52-60. [PMID: 38293264 PMCID: PMC10824061 DOI: 10.5312/wjo.v15.i1.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/28/2023] [Accepted: 12/19/2023] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND Distal humerus elbow fractures are one of the most common traumatic fractures seen in pediatric patients and present as three main types: Supracondylar (SC), lateral condyle (LC), and medial epicondyle (ME) fractures. AIM To evaluate the epidemiology of pediatric distal humerus fractures (SC, LC, and ME) from an American insurance claims database. METHODS A retrospective review was performed on patients 17 years and younger with the ICD 9 and 10 codes for SC, LC and ME fractures based on the IBM Truven MarketScan® Commercial and IBM Truven MarketScan Medicare Supplemental databases. Patients from 2015 to 2020 were queried for treatments, patient age, sex, length of hospitalization, and comorbidities. RESULTS A total of 1133 SC, 154 LC, and 124 ME fractures were identified. SC fractures had the highest percentage of operation at 83%, followed by LC (78%) and ME fractures (41%). Male patients were, on average, older than female patients for both SC and ME fractures. CONCLUSION In the insurance claims databases used, SC fractures were the most reported, followed by LC fractures, and finally ME fractures. Age was identified to be a factor for how a pediatric distal humerus fractures, with patients with SC and LC fractures being younger than those with ME fractures. The peak age per injury per sex was similar to reported historic central tendencies, despite reported trends for younger physiologic development.
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Affiliation(s)
- Kyle Jay Klahs
- Department of Orthopaedic Surgery, Texas Tech University Health Sciences-El Paso, El Paso, TX 79905, United States
| | - Jake E Dertinger
- Medical School, California Health Sciences University College of Osteopathic Medicine, Clovis, CA 93611, United States
| | - Grant T Mello
- Medical School, California Health Sciences University College of Osteopathic Medicine, Clovis, CA 93611, United States
| | - Kevin Thapa
- Undergraduate School, Binghampton University, Vestal, NY 13902, United States
| | - Alexis B Sandler
- Department of Orthopaedic Surgery, Texas Tech University Health Sciences-El Paso, El Paso, TX 79905, United States
| | - E'Stephan J Jesus Garcia
- Department of Orthopaedic Surgery, William Beaumont Army Medical Center, Fort Bliss, TX 79918, United States
| | - Nata Parnes
- Department of Orthopaedic Surgery, Carthage Area Hospital, Carthage, NY 13619, United States
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Pereira A, Ferrer P, Binder A, Rojas J, Michels KB, Corvalán C, Mericq V. Association Between Markers of Adiposity During Childhood and Puberty Onset in Latino Girls. J Clin Endocrinol Metab 2023; 108:e1272-e1281. [PMID: 37226986 DOI: 10.1210/clinem/dgad294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/11/2023] [Accepted: 05/22/2023] [Indexed: 05/26/2023]
Abstract
CONTEXT Prepubertal adiposity is associated with earlier puberty. It is unclear when this association starts, if all adiposity markers are similarly associated, and whether all pubertal milestones are similarly affected. OBJECTIVE To evaluate the association between different adiposity markers during childhood and the timing of different pubertal milestones in Latino girls. DESIGN, SETTING, AND PARTICIPANTS Longitudinal follow-up of 539 female participants of the Chilean Growth and Obesity Cohort recruited from childcare centers (mean age 3.5 years) from the southeast area of Santiago, Chile. Participants were singletons born between 2002 and 2003 within the normal birthweight range. Since 2006, a trained dietitian measured weight, height, waist circumference (WC) and skinfolds to estimate body mass index (BMI) Centers for Disease Control and Prevention percentiles, central obesity, percentage of fat mass (%FM), and fat mass index (FMI, fat mass/height2). MAIN OUTCOME Since 2009, sexual maturation was assessed every 6 months to assess age at (1) thelarche, (2) pubarche, (3) menarche, and (4) peak height velocity (PHV). RESULTS At thelarche, 12.5% were obese and 2% had central obesity. The median age of pubarche, menarche, and PHV were all associated with markers of adiposity at different time points during childhood whereas thelarche only with %FM and FMI. Adiposity clusters models showed that children with trajectories of high WC, %FM, and FMI during childhood were related with earlier thelarche, pubarche, menarche, and PHV but BMI trajectories only with menarche and PHV. CONCLUSIONS Higher WC, %FM, and FMI were associated with earlier age at thelarche, pubarche, menarche, and PHV. The effect of BMI was less consistent.
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Affiliation(s)
- Ana Pereira
- Institute of Nutrition and Food Technology, University of Chile, 7830490 Santiago, Chile
| | - Pedro Ferrer
- Institute of Nutrition and Food Technology, University of Chile, 7830490 Santiago, Chile
| | - Alexandra Binder
- Population Sciences in the Pacific Program (Cancer Epidemiology), University of Hawai'i Cancer Center, Honolulu, HI 96822, USA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA 90095-1772, USA
| | - Joanna Rojas
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Atacama, 1530000 Copiapó, Chile
| | - Karin B Michels
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA 90095-1772, USA
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, 79110 Freiburg, Germany
| | - Camila Corvalán
- Institute of Nutrition and Food Technology, University of Chile, 7830490 Santiago, Chile
| | - Verónica Mericq
- Institute of Maternal and Child Research, Faculty of Medicine, University of Chile, 8360160 Santiago, Chile
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Arrona-Palacios A, Díaz-Morales JF, Duffy JF. The influence of a permanent double-shift school start time on adolescent sleep and chronotype across different age groups. Chronobiol Int 2023; 40:850-863. [PMID: 37212086 DOI: 10.1080/07420528.2023.2215343] [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: 11/28/2022] [Revised: 03/27/2023] [Accepted: 05/12/2023] [Indexed: 05/23/2023]
Abstract
The main objective of this study was to explore the differences in sleep habits and chronotype across different age groups in Mexican adolescents attending a permanent double-shift school system. This cross-sectional study consisted of 1,969 (1,084 girls) students from public elementary, secondary, and high schools, as well as undergraduate university students from Mexico. Age range was 10-22 [15.33 ± 3.28 (mean ± SD)] years, 988 morning shift and 981 afternoon shift students. Questions regarding usual self-reported bedtime and rise time were collected, and from that, estimates for time in bed, midpoint of sleep, social jetlag, and chronotype were evaluated. Afternoon shift students reported later rise times, bedtimes, midpoint of sleep, and longer time in bed on school days than morning shift students, as well as less social jetlag. Overall, afternoon shift students reported a later chronotype than morning shift students. Peak lateness of chronotype in afternoon shift students was at age 15, with girls peaking at age 14 and boys at age 15. Meanwhile, morning shift students reported peak lateness of chronotype around age 20. In this study, adolescents from different age ranges attending an extremely delayed school start time reported adequate sleep compared with adolescents attending a fixed morning school start time. In addition, the analysis presented in this study seems to suggest that the peak of late chronotype may be influenced by school start times.
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Affiliation(s)
- Arturo Arrona-Palacios
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Writing Lab, Institute for the Future of Education, Tecnologico de Monterrey, Monterrey, Mexico
| | - Juan F Díaz-Morales
- Department of Social Psychology, Work and Individual Differences, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Jeanne F Duffy
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Diet and Nutrients Intakes during Infancy and Childhood in Relation to Early Puberty: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14235004. [PMID: 36501034 PMCID: PMC9739867 DOI: 10.3390/nu14235004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/17/2022] [Accepted: 11/19/2022] [Indexed: 11/27/2022] Open
Abstract
The onset of puberty has become earlier over the decades, and nutrients and diet are related to the timing of puberty onset. Hence, we aimed to investigate the association between diet or nutrients in infancy, childhood and early puberty. PubMed, Embase, and Cochrane library were searched systematically up to 15 April 2022. The pooled relative risks (RRs) or regression coefficients (beta) were estimated using the random-effect model or fixed-effect model according to the heterogeneity between studies. Twenty-two articles on diet or nutrients in childhood and six about breastfeeding in infancy were included. The prolonged breastfeeding duration in infancy could reduce the risk of early menarche (beta 0.31, 95% CI: 0.01, 0.60, p = 0.045). The high intake of yogurt was associated with a 35% reduction in the risk of earlier menarche (RR 0.65, 95% CI: 0.47, 0.89, p = 0.008). Girls with severe food insecurity experienced later menarche (RR 0.81, 95% CI: 0.67, 0.98, p = 0.027). Conversely, due to the high intake of protein, the risk of early menarche increased by 8% (RR 1.08, 95% CI: 1.01, 1.16, p = 0.016). High intake of yogurt, longer duration of breastfeeding, and food insecurity decreased the possibility of earlier menarche, while high intake of protein increased that risk. As a modifiable factor, diet and nutrients in infancy and childhood provide new insights into the future prevention of early puberty.
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Aghaee S, Deardorff J, Quesenberry CP, Greenspan LC, Kushi LH, Kubo A. Associations Between Childhood Obesity and Pubertal Timing Stratified by Sex and Race/Ethnicity. Am J Epidemiol 2022; 191:2026-2036. [PMID: 35998084 PMCID: PMC10144668 DOI: 10.1093/aje/kwac148] [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: 11/23/2021] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 02/01/2023] Open
Abstract
Earlier puberty has been associated with numerous adverse mental, emotional, and physical health outcomes. Obesity is a known risk factor for earlier puberty in girls, but research with boys has yielded inconsistent findings. We examined sex- and race/ethnicity-specific associations between childhood obesity and puberty in a multiethnic cohort of 129,824 adolescents born at a Kaiser Permanente Northern California medical facility between 2003 and 2011. We used Weibull regression models to explore associations between childhood obesity and breast development onset (thelarche) in girls, testicular enlargement onset (gonadarche) in boys, and pubic hair development onset (pubarche) in both sexes, adjusting for important confounders. Clear dose-response relationships were observed. Boys with severe obesity had the greatest risk for earlier gonadarche (hazard ratio = 1.23, 95% confidence limit: 1.15, 1.32) and pubarche (hazard ratio = 1.44, 95% confidence limit: 1.34, 1.55), while underweight boys had delayed puberty compared with peers with normal body mass index. A similar dose-response relationship was observed in girls. There were significant interactions between childhood body mass index and race/ethnicity. Childhood obesity is associated with earlier puberty in both boys and girls, and the magnitude of the associations may vary by race/ethnicity. Prevention of childhood obesity may delay pubertal timing and mitigate health risks associated with both conditions.
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Affiliation(s)
| | | | | | | | | | - Ai Kubo
- Correspondence to Dr. Ai Kubo, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (e-mail: )
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Massara P, Spiegel-Feld C, Hamilton J, Maguire JL, Birken C, Bandsma R, Comelli EM. Association between gut MIcrobiota, GROWth and Diet in peripubertal children from the TARGet Kids! cohort (The MiGrowD) study: protocol for studying gut microbiota at a community-based primary healthcare setting. BMJ Open 2022; 12:e057989. [PMID: 35534076 PMCID: PMC9086606 DOI: 10.1136/bmjopen-2021-057989] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION The gut microbiota interacts with diet to affect body health throughout the life cycle. Critical periods of growth, such as infancy and puberty, are characterised by microbiota remodelling and changes in dietary habits. While the relationship between gut microbiota and growth in early life has been studied, our understanding of this relationship during puberty remains limited. Here, we describe the MIcrobiota, GROWth and Diet in peripubertal children (The MiGrowD) study, which aims to assess the tripartite growth-gut microbiota-diet relationship at puberty. METHODS AND ANALYSIS The MiGrowD study will be a cross-sectional, community-based study involving children 8-12 years participating in the TARGet Kids! COHORT TARGet Kids! is a primary healthcare practice-based research network in Canada. Children will be asked to provide a stool sample, complete two non-consecutive 24-hour dietary recalls and a pubertal self-assessment based on Tanner Stages. Anthropometry will also be conducted. The primary outcome is the association between gut microbiota composition and longitudinal growth from birth until entry into the study. Anthropometrics data from birth will be from the data collected prospectively through TARGet Kids!. Body mass index z-scores will be calculated according to WHO. The secondary outcome is the association between gut microbiota, diet and pubertal stage. ETHICS AND DISSEMINATION Ethics approval has been obtained by the Hospital for Sick Children and St. Michael's Hospital-Unity Health, and the University of Toronto. Results will be disseminated in the public and academic sector, including participants, TARGet Kids! primary healthcare physicians teams, scientists via participation in the TARGet Kids! science and physician meetings, conferences and publications in peer-reviewed journals. The MiGrowD study results will help researchers understand the relationships underlying growth, gut microbiota and pubertal maturation in children.
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Affiliation(s)
- Paraskevi Massara
- Department of Nutritional Sciences, University of Toronto, Temerty Faculty of Medicine, Ontario, Toronto, Canada
- Translational Medicine Program, The Hospital for Sick Children, Ontario, Toronto, Canada
| | - Carolyn Spiegel-Feld
- Translational Medicine Program, The Hospital for Sick Children, Ontario, Toronto, Canada
| | - Jill Hamilton
- Department of Pediatrics, University of Toronto, Temerty Faculty of Medicine, Ontario, Toronto, Canada
- Division of Endocrinology, The Hospital for Sick Children, Ontario, Toronto, Canada
| | - Jonathon L Maguire
- Department of Nutritional Sciences, University of Toronto, Temerty Faculty of Medicine, Ontario, Toronto, Canada
- Li Ka Shing Knowledge Institute, Unity Health Toronto, Ontario, Toronto, Canada
| | - Catherine Birken
- Department of Nutritional Sciences, University of Toronto, Temerty Faculty of Medicine, Ontario, Toronto, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Joannah and Brian Lawson Center for Child Nutrition, University of Toronto, Ontario, Toronto, Canada
- Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Robert Bandsma
- Department of Nutritional Sciences, University of Toronto, Temerty Faculty of Medicine, Ontario, Toronto, Canada
- Translational Medicine Program, The Hospital for Sick Children, Ontario, Toronto, Canada
| | - Elena M Comelli
- Department of Nutritional Sciences, University of Toronto, Temerty Faculty of Medicine, Ontario, Toronto, Canada
- Joannah and Brian Lawson Center for Child Nutrition, University of Toronto, Ontario, Toronto, Canada
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Lu D, Aleknaviciute J, Kamperman AM, Tamimi RM, Ludvigsson JF, Valdimarsdóttir UA, Bertone-Johnson ER. Association Between Childhood Body Size and Premenstrual Disorders in Young Adulthood. JAMA Netw Open 2022; 5:e221256. [PMID: 35258576 PMCID: PMC8905384 DOI: 10.1001/jamanetworkopen.2022.1256] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/21/2021] [Indexed: 12/21/2022] Open
Abstract
Importance Emerging data suggest that more than two-thirds of premenstrual disorders (PMDs), including premenstrual syndrome and premenstrual dysphoric disorder, have symptom onset during the teen years. Adulthood adiposity has been associated with PMDs; however, the association with childhood and adolescent body size is unknown. Objective To examine the association between childhood and adolescent body size and risk of PMDs in young adulthood. Design, Setting, and Participants This prospective cohort study included 6524 US female participants from the Growing Up Today Study (1996-2013). Data were analyzed from February 26, 2020, to June 23, 2021. Exposures Body mass index (BMI) was estimated using self-reported height and weight through adolescence and converted to BMI for age (z score). Main Outcomes and Measures In 2013, premenstrual symptoms and identified PMDs were assessed with a validated scale based on the Calendar of Premenstrual Experiences. The associations of BMI for age with PMDs and premenstrual symptoms were examined using log-binomial and linear regressions, respectively. Results Among 6524 participants (mean [SD] age, 26 [3.5] years; 6108 [93.6%] White), 1004 (15.4%) met the criteria for a PMD. Baseline BMI for age reported at a mean (SD) age of 12.7 (1.1) years was associated with increased risk of PMDs (confounding-adjusted relative risk, 1.09 per unit of z score; 95% CI, 1.03-1.15) and higher burden of premenstrual symptoms (β = 0.06; 95% CI, 0.04-0.08). Associations were particularly pronounced for premenstrual dysphoric disorder and for PMDs with symptom onset before 20 years of age and remained in the absence of psychiatric comorbidities, including depression, anxiety, and disordered eating behavior. When analyzing BMI change over time, individuals with high BMI throughout adolescence had a higher burden of premenstrual symptoms (β = 0.17; 95% CI, 0.08-0.27) compared with those with normal BMI throughout adolescence. Individuals with high BMI early followed by a mild decrease later did not report higher premenstrual symptoms (β = 0.06; 95% CI, 0.00-0.12). Conclusions and Relevance In this cohort study, childhood body size was associated with PMD risk and premenstrual symptoms in young adulthood. These findings suggest that maintaining a normal body mass in childhood may be considered for lowering the burden of PMDs in adulthood.
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Affiliation(s)
- Donghao Lu
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jurate Aleknaviciute
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Astrid M. Kamperman
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Rulla M. Tamimi
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
| | - Jonas F. Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatrics, Örebro University Hospital, Örebro, Sweden
| | - Unnur A. Valdimarsdóttir
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik
| | - Elizabeth R. Bertone-Johnson
- School of Public Health and Health Sciences, Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst
- School of Public Health and Health Sciences, Department of Health Promotion and Policy, University of Massachusetts, Amherst
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Chavarro JE. Invited Commentary: Childhood Adiposity and the Onset of Puberty-It Turns Out There Is More to Be Learned. Am J Epidemiol 2022; 191:17-19. [PMID: 34104948 DOI: 10.1093/aje/kwab174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/11/2021] [Accepted: 06/03/2021] [Indexed: 11/14/2022] Open
Abstract
The literature on the relationship between adiposity and the onset of puberty is extensive, both in size and in the length of time this question has been alive in the biomedical literature. It is easy to wonder, then, whether there is anything new to be learned in this crowded field. In this issue of the Journal, Deardorff et al. (Am J Epidemiol. 2022;191(1):7-16) show that it is still possible to innovate in this area. The authors report on the relationship between body mass index at age 5 years and a variety of markers of the onset of puberty. Consistent with the current literature, they show no association between body mass index at age 5 and pubertal onset in boys. They also show an association between obesity at age 5 with earlier onset of secondary sexual characteristics in girls, making an important subject-matter contribution that addresses many of the concerns of the existing literature in assigning causality. At the same time, the authors make an important, although less evident contribution to the practice of epidemiology for studies where the assessment of pubertal status is of interest.
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Rautava S, Turta O, Vahtera J, Pentti J, Kivimäki M, Pearce J, Kawachi I, Rautava P, Lagström H. Neighborhood Socioeconomic Disadvantage and Childhood Body Mass Index Trajectories From Birth to 7 Years of Age. Epidemiology 2022; 33:121-130. [PMID: 34669629 PMCID: PMC8614531 DOI: 10.1097/ede.0000000000001420] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 09/06/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The epidemic of increasing childhood overweight and obesity is a major global health concern, with local contextual factors identified as possible contributors. Robust research is needed to establish an evidence base supporting health policy decisions to reverse the trend. We aimed to examine the association between neighborhood socioeconomic disadvantage and trajectories of body mass index (BMI) from birth to age 7. METHODS The present study included 11,023 children born within the Southwest Finland Birth Cohort who were free of severe conditions affecting growth with adequate exposure and growth data. We obtained child growth data until school age from municipal follow-up clinics. We based cumulative childhood neighborhood socioeconomic disadvantage on the average annual income, unemployment, and level of education in a residential area defined using a geographic grid at a spatial resolution of 250 m by 250 m. RESULTS Cumulative neighborhood socioeconomic disadvantage was associated with distinct childhood BMI z score trajectories from birth to age 7. Despite being born in the lowest BMI z scores, children growing up in disadvantaged neighborhoods subsequently exhibited a trajectory of increasing BMI z scores starting at 4 years of age, ending up with a higher risk of overweight at the end of the follow-up (30%) as compared with children living in more affluent neighborhoods (22%). The corresponding risk of obesity was 5 % for those in affluent neighborhoods and 9 % and those in disadvantaged neighborhoods. CONCLUSION Cumulative exposure to neighborhood socioeconomic disadvantage is independently associated with unfavorable BMI development and obesity in childhood.
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Affiliation(s)
- Samuli Rautava
- From the Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland
- Department of Pediatrics, University of Helsinki and New Children’s Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Olli Turta
- From the Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Jaana Pentti
- Department of Public Health, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
- Clinicum, Faculty of Medicine and Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Jamie Pearce
- Centre for Research on Environment, Society & Health, School of GeoSciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Päivi Rautava
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
- Turku University Hospital, Research Services, Turku, Finland
| | - Hanna Lagström
- Department of Public Health, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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Aris IM, Rifas-Shiman SL, Mínguez-Alarcón L, Sordillo JE, Hivert MF, Oken E, Chavarro JE. Association of mode of delivery with offspring pubertal development in Project Viva: a prospective pre-birth cohort study in the USA. Hum Reprod 2021; 37:54-65. [PMID: 34755186 PMCID: PMC8730300 DOI: 10.1093/humrep/deab235] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/04/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Is cesarean delivery associated with earlier offspring pubertal development? SUMMARY ANSWER We identified that boys born by cesarean delivery developed puberty earlier, evidenced by an earlier age at peak height velocity and earlier attainment of puberty score > 1, than boys born by vaginal delivery. WHAT IS KNOWN ALREADY Cesarean delivery is posited to have long-term effects on health outcomes. However, few studies have examined whether mode of delivery is related to pubertal development. STUDY DESIGN, SIZE, DURATION Prospective pre-birth cohort study consisting of 1485 mother-child pairs enrolled during pregnancy from obstetric practices and followed up until early adolescence (median age 12.9 years). Participant inclusion required data on mode of delivery and at least one measure of pubertal development. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants are children from the Project Viva study. We abstracted information on delivery mode from electronic medical records from children followed since birth (1999-2002) and examined the following markers of pubertal development: age at peak height velocity (APHV); age at menarche (girls only); parent-reported pubertal development score; and child-reported pictograph Tanner pubic hair staging. We used multivariable regression models to examine associations of delivery mode with these four pubertal indices, adjusting for the following confounders: demographic and socioeconomic factors; maternal height, pre-pregnancy BMI, total gestational weight gain, pregnancy conditions, parity, and maternal age at menarche; paternal height and BMI; gestational age at delivery and birthweight-for-gestational-age z-score. MAIN RESULTS AND THE ROLE OF CHANCE In this study, 23.2% of children were born by cesarean delivery. Girls had an earlier APHV, had a higher pubertal score throughout childhood and in early adolescence, and were more likely to attain puberty score >1 and Tanner pubic hair Stage >1 earlier compared to boys. Mean (SD) age at menarche in girls was 12.4 (1.0) years. Boys born by cesarean delivery had significantly earlier APHV (β -0.23 years; 95% CI -0.40, -0.05) and higher risk of earlier attainment of puberty score > 1 (hazard ratio 1.09; 95% CI 1.01, 1.19) than boys born by vaginal delivery, after adjusting for confounders. These associations were not mediated by pre-pubertal BMI and were similar for planned (no labor) and unplanned (labor) cesarean delivery. No associations were observed between delivery mode and time to attain Tanner pubic hair Stage > 1 in boys. In girls, mode of delivery was not associated with any of the measured pubertal development markers. LIMITATIONS, REASONS FOR CAUTION This study used, as secondary outcomes, parent- and child-reported measures of pubertal development, which may be more prone to error and misclassification than information collected by trained observers or physicians during clinical examinations. The findings may also not be generalizable to populations from different settings, because all participants lived in one geographic area, were well educated, and had health care. WIDER IMPLICATIONS OF THE FINDINGS Our findings provide support for cesarean delivery as a potential indicator of identifying children who are likely to experience earlier pubertal development; however, more studies are needed to confirm or refute these observations. STUDY FUNDING/COMPETING INTEREST(S) The project was funded by grants from the National Institutes of Health. The authors have no financial relationships or competing interests to disclose. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Lidia Mínguez-Alarcón
- Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joanne E Sordillo
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jorge E Chavarro
- Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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