Childhood body weight in relation to morbidity from cardiovascular disease and cancer in older adulthood: 67-year follow-up of participants in the 1947 Scottish Mental Survey

Trends and predictions in the physical shape of Chinese preschool children from 2000 to 2020

Objective

To explore physical shape changes in preschool children from 2000 to 2020, and forecast development trends over the next 10 years.

Method

The grey GM (1,1) prediction model was used to fit the physical shape indicators of preschool children in China from 2000 to 2020, and then the longitudinal change trend of physical shape was compared and analyzed. Finally, the development trend of physical shape in China in 2025 and 2030 was predicted.

Results

(1) During the period from 2000 to 2020, the height, weight and chest circumference of Chinese preschool children all increased rapidly. Specifically, the weight of male and female children increased by 1.8 kg and 1.6 kg, their chest circumference increased by 1.6 cm and 1.5 cm, respectively, and both their heights increased by 3.6 cm. Among these indicators, the older the age, the greater the growth rate. It is expected that all the indicators will continue to grow rapidly over the next 10 years, but the growth rate will slow. (2) From 2000 to 2020, the growth rate of weight was higher than that of height, and BMI showed an increasing trend. The obesity detection rates in boys and girls increased by 5.6 and 2.8%, respectively. Over the next 10 years, the incidence of obesity is expected to increase by 3.8% in boys and 2.8% in girls. (3) Improvement in the growth and development of preschool children in China has a certain correlation with the rapid growth of China's economy,less physical activity, education and other factors.

Conclusion

Over the past 20 years, the growth and nutritional status of Chinese preschoolers have improved dramatically, but overweight and obesity remain. Overweight and obesity rates are expected to continue to increase rapidly over the next 10 years, particularly among boys, and effective measures should be taken to control the obesity epidemic.

Association between early childhood caries and diet quality among Chinese children aged 2-5 years

Background

Early childhood caries (ECC) is a major oral problem affecting the health and wellbeing of children worldwide. Diet quality is a better predictor of ECC risk than single foods or specific nutrients. The purposes of this study were to assess the associations between ECC and diet quality among 2- to 5-year-old Chinese children.

Methods

A total of 150 eligible children were included in this study. The decayed, missing, or filled surface (dmfs) score was recorded for each child by dental examination. All participants were divided into three groups based on their age and dmfs score [the caries-free group, the ECC group, and the severe early childhood caries (S-ECC) group]. Parents were invited to complete a questionnaire on the general characteristics and oral health behaviors of the participants. The information of 24-h dietary intake from each child was captured via a mobile APP. The Chinese diet balance index for preschool children (DBI_C) indicators score, high bound score (HBS), low bound score (LBS), and diet quality distance (DQD) score were calculated to assess the diet quality of study subjects. The associations of ECC with HBS, LBS, DQD score, and DBI_C indicators score were analyzed by Mann-Whitney U test and multivariable logistic regression analysis.

Results

In this study, 21, 31, and 98 children were diagnosed with caries-free, ECC, and S-ECC, respectively. Statistical analysis revealed that the risk of ECC and S-ECC were significantly increased with the DQD score (OR = 1.283 and 1.287, respectively), but both were not associated with HBS and LBS (P > 0.05). In the meantime, the risk of ECC and S-ECC were significantly increased with the Grains score (OR = 1.623 and 1.777, respectively), and significantly decreased with the Food diversity score (OR = 0.271 and 0.315, respectively). Moreover, the risk of S-ECC also significantly decreased with the Vegetables score (OR = 0.137).

Conclusion

Both ECC and S-ECC were associated with a high degree of dietary imbalance and grains intake as well as a low degree of food diversity among Chinese children aged 2-5 years. In addition, S-ECC was also associated with a low degree of vegetable intake.

Associations between body mass index and height during childhood and adolescence and the risk of coronary heart disease in adulthood: A systematic review and meta-analysis

Body mass index (BMI) at child and adolescent ages is positively associated with adult coronary heart disease (CHD) whereas height at these ages may be inversely associated with CHD. However, potential effects of age, sex, and socioeconomic status on associations between BMI and CHD are less investigated. We conducted a systematic review and meta-analysis of BMI and height at ages 2-19 years in relation to adult CHD and examined effects of age, sex, socioeconomic status, and other factors. Twenty-two studies on BMI and five on height were included, comprising 5,538,319 individuals and 69,830 CHD events. Random effects meta-analyses were conducted. Child and adolescent BMI were positively associated with CHD (hazard ratio = 1.12; 95% confidence interval [CI] [1.01, 1.25] per standard deviation [SD]), and categorical analyses supported these findings. The associations did not significantly differ by age, sex, or by adjustment for socioeconomic status. Child and adolescent height were inversely associated with CHD (hazard ratio = 0.87; 95% CI [0.81, 0.93] per SD), and categorical analyses agreed. Insufficient studies on height precluded subgroup analyses. Heterogeneity was generally high in all analyses. We found that BMI in youth is positively associated with adult CHD regardless of sex or adjustment for socioeconomic status whereas height is inversely associated with later risk of CHD.

Ethnicity, socioeconomic status and the nutritional status of Chinese children and adolescents: Findings from three consecutive national surveys between 2005 and 2014

BACKGROUND

Economic development has brought rapid shifts in the food environment of Chinese children and adolescents.

OBJECTIVES

To assess the changes in childhood nutritional status across ethnic groups and economic status from 2005 to 2014.

METHODS

664 094 Chinese Han and 224 151 ethnic minority children and adolescents aged 7 to 18 years were assessed in three national cross-sectional surveys (2005, 2010 and 2014). Gross domestic product (GDP) per capita of each ethnic group was categorized into four strata of socioeconomic status. To assess ethnic disparities at each time point, we used logistic regression to estimate the prevalence odds ratios (OR) for thinness, overweight and obesity in the 24 ethnic minority groups vs Han Chinese.

RESULTS

Children in the two upper economic strata (over about US$4000 GDP per capita) had a high prevalence of overweight and obesity, while those in the two lower economic strata (below US$4000 GDP per capita) had a high prevalence of thinness. From 2005 to 2014, the prevalence of thinness decreased from 18.6% to 13.1% in Han children, and from 20.4% to 17.1% in ethnic minority students. At the same time, the prevalence of overweight and obesity increased from 10.4% to 17.7% in Han children, and from 4.3% to 9.2% in ethnic minority students, respectively.

CONCLUSIONS

A rapid nutritional transition has occurred from 2005 to 2014 with shifts from thinness to overweight and obesity in both Han and ethnic minority children and adolescents, reflecting local GDP per capita.

Validity of self-reported recall of anthropometric measures in early life: A systematic review and meta-analysis

Overweight and obesity in early life are risk factors for many adult-onset chronic diseases. The objective of this study was to assess the validity of self-reported recall of early life anthropometric measures. A systematic review was conducted by searching four electronic databases (PubMed, ProQuest, EMBASE, and MEDLINE). Studies were eligible if they evaluated the validity or reliability of self-reported recall by adults of their own body mass index, height, and/or weight during earlier life periods. Meta-analyses were conducted to pool correlation coefficients and mean differences. There were 15 studies included with a total of 17 477 participants. The mean pooled difference between self-reported recall of BMI compared with prospective measures was 0.06 kg/m² (95% CI, -0.62 to 0.73), and the pooled correlation coefficient was 0.72 (95% CI, 0.65-0.79). Self-reported weight was also strongly correlated with reference standard measures (pooled r = 0.83; 95% CI, 0.72-0.90) with a small mean difference (0.87 kg; 95% CI, 0.19-1.56; I² = 91%). Despite significant heterogeneity, the findings from this review suggest self-reported recall of early life body mass index, height, and weight may be valid measures. This evidence may inform life-course epidemiology studies considering the use of retrospective assessment of self-reported anthropometry.

Trajectories of body mass index, from adolescence to older adulthood, and pancreatic cancer risk; a population-based case-control study in Ontario, Canada

Purpose

Pancreatic cancer has the highest fatality rate of all cancers. Adulthood obesity is an established risk factor for pancreatic cancer; however, life-course obesity is not well understood. The aim of this study was to evaluate the association between body mass index (BMI) trajectories throughout the life-course and pancreatic cancer risk.

Methods

A population-based case–control study was conducted (2011–2013) in Ontario, Canada. Cases were recruited from the Ontario pancreas cancer study (n = 310) and controls from the Ontario cancer risk factor study (n = 1258). Questionnaires captured self-reported height and weight at four timepoints (adolescence, 20 s, 30–40 s, 50–60 s). BMI trajectories were identified using latent class growth mixture modeling. Odds ratios (OR) and 95% confidence intervals (CI) were estimated from multivariable logistic regression.

Results

Five BMI trajectories were identified: stable-normal weight (38.9%), progressively overweight (42.2%), persistent overweight (12.6%), progressive obesity (4.2%), and persistent obesity (2.1%). The persistent overweight (OR = 1.55; 95% CI 1.02, 2.39) and progressive obesity trajectories (OR = 1.49; 95% CI 0.77, 2.87) compared to stable-normal weight were associated with increased odds of pancreatic cancer. When BMI was evaluated separately the strongest associations with pancreatic cancer emerged in young and mid-adulthood.

Conclusion

BMI trajectories characterized by overweight in early adulthood were associated with increased pancreatic cancer risk suggesting a life-course approach to disease risk.

Electronic supplementary material

The online version of this article (10.1007/s10552-019-01197-9) contains supplementary material, which is available to authorized users.

Childhood Body Mass Index Is Associated with Risk of Adult Colon Cancer in Men: An Association Modulated by Pubertal Change in Body Mass Index

BACKGROUND

The relative contribution of childhood and pubertal body mass index (BMI) for the risk of adult colorectal cancer is not known. The aim of this study was to evaluate the independent associations for childhood BMI and pubertal BMI change with risk of colorectal cancer in men.

METHODS

We included 37,663 men born in 1946 to 1961 who had weight and height measured at 8 (childhood) and 20 (young adult age) years of age available from the BMI Epidemiology Study. Information on colorectal cancer was retrieved from the Swedish National Patient Register (257 cases of colon cancer and 159 cases of rectal cancer).

RESULTS

Childhood BMI at 8 years of age [HR, 1.19 per SD increase; 95% confidence interval (CI), 1.06-1.33], but not pubertal BMI change (HR, 1.02; 95% CI, 0.90-1.15), was associated with increased risk of colon cancer. Due to a significant interaction between childhood BMI and pubertal BMI change (P < 0.001), we stratified the analyses according to the median of pubertal BMI change. Childhood BMI was associated with risk of colon cancer in individuals with a pubertal BMI change above, but not below, the median (above: HR = 1.48, 95% CI, 1.26-1.74; below: HR = 0.95, 95% CI, 0.80-1.12). Neither childhood BMI nor pubertal BMI change was associated with rectal cancer.

CONCLUSIONS

High childhood BMI was associated with increased risk of colon cancer only if it was followed by a pubertal BMI increase above the median.

IMPACT

Further studies should evaluate prepubertal childhood BMI in relation to pubertal BMI change and BMI in middle age for the risk of colon cancer.

BMI change during puberty and the risk of heart failure

AIM

Hospitalization for heart failure amongst younger men has increased. The reason for this is unknown but it coincides with the obesity epidemic. The aim of this study was to evaluate the association between childhood BMI (Body Mass Index) and BMI change during puberty for risk of adult heart failure in men.

METHODS

Using the BMI Epidemiology Study (BEST), a population-based study in Gothenburg, Sweden, we collected information on childhood BMI at age 8 years and BMI change during puberty (BMI at age 20 - BMI at 8) for men born 1945-1961, followed until December 2013 (n = 37 670). BMI was collected from paediatric growth charts and mandatory military conscription tests. Information on heart failure was retrieved from high-quality national registers (342 first hospitalizations for heart failure).

RESULTS

BMI change during puberty was independently of childhood BMI associated with risk of heart failure in a nonlinear J-shaped manner. Subjects in the upper quartile of BMI change during puberty (Q4) had more than twofold increased risk of heart failure compared with subjects in Q1 [HR (Hazard Ratio) = 2.29, 95% CI (Confidence Interval) 1.68-3.12]. Childhood BMI was not independently associated with risk of heart failure. Boys developing overweight during puberty (HR 3.14; 95% CI 2.25-4.38) but not boys with childhood overweight that normalized during puberty (HR 1.12, 95% CI 0.63-2.00) had increased risk of heart failure compared with boys without childhood or young adult overweight.

CONCLUSION

BMI change during puberty is a novel risk factor for adult heart failure in men.

Plasma adrenomedullin level in children with obesity: relationship to left ventricular function

BACKGROUND

Obese children are at increased risk for abnormal cardiac structure and function. Little is known about adrenomedullin (AM), a cytokine produced in various organs and tissues, as a biomarker of cardiac hypertrophy in obese children. This study aimed to assess the plasma AM levels in a cohort of obese children and its relationship to left ventricular (LV) functions.

METHODS

The study included 60 obese children and 60 non-obese children matched for age and gender as control group. Blood pressure, serum lipid profile, fasting glucose, insulin and plasma AM and the homeostatic model assessment of insulin resistance (HOMA-IR) were measured. Cardiac dimensions and LV functions were assessed using conventional echocardiography.

RESULTS

Compared to control subjects, obese children had higher blood pressure (P = 0.01), insulin (P = 0.001), HOMA-IR (P = 0.001), and AM (P = 0.001). Moreover, obese children had higher LV mass index (LVMI) (P = 0.001), indicating LV hypertrophy; prolonged isovolumic relaxation times (P = 0.01), prolonged mitral deceleration time (DcT) (P = 0.01) and reduced ratio of mitral E-to-mitral A-wave peak velocity (P = 0.01), indicating LV diastolic dysfunction. Laboratory abnormalities were only present in children with LV hypertrophy. In multivariate analysis in obese children with LV hypertrophy, AM levels were positively correlated with LVMI [odds ratio (OR) 1.14, 95% confidence interval (Cl) 1.08-1.13, P = 0.0001] and mitral DcT (OR 2.25, 95% CI 1.15-2.05, P = 0.01) in the presence of higher blood pressure and HOMA-IR. A cut-off value of AM at 52 pg/mL could differentiate obese children with and without left ventricular hypertrophy at a sensitivity of 94.32% and specificity of 92.45%.

CONCLUSIONS

Plasma AM levels may be elevated in obese children particularly those with LV hypertrophy and is correlated with higher blood pressure and insulin resistance. Measurement of plasma AM levels in obese children may help to identify those at high risk of developing LV hypertrophy and dysfunction.

Associations between childhood body size and seventeen adverse outcomes: analysis of 65,057 European women

Large childhood body size has been consistently shown to be associated with decreased breast cancer risk. However, it is important to consider the effects of a large childhood body size on other adult diseases. It is not clear if the associations between childhood body size and adult diseases will persist if they later attain healthy weight. The associations between body size at age 7 and 17 adverse outcomes in adulthood were examined using Cox models in a Swedish study of 65,057 women. Large body size at age 7, when compared to small body size, was associated with decreased risk for breast cancer (HR [95% CI]: 0.81 [0.70–0.93]) and increased risks for anorexia (2.13 [1.63–2.77]) and bulimia (1.91 [1.35–2.70]). Neither adjusting for adult BMI nor restricting the dataset to lean adults (BMI < 25 kg/m²) attenuated the associations. While large body size at age 7 by itself was positively associated with increased risks of diabetes (1.34 [1.16–1.55]), PCOS (1.69 [1.13–2.51]) and hypertension (before age 60), the associations were no longer significant after controlling for adult BMI. No clear associations were found with the remaining adverse outcomes (cervical, uterine, melanoma, colon cancer, depression, ovarian cyst, stroke, hyperlipidemia, heart failure, myocardial infarction, and angina pectoris).

Association of Childhood Body Mass Index and Change in Body Mass Index With First Adult Ischemic Stroke

Importance

The incidence of ischemic stroke among young adults is rising and is potentially due to an increase in stroke risk factors occurring at younger ages, such as obesity.

Objectives

To investigate whether childhood body mass index (BMI) and change in BMI are associated with adult ischemic stroke and to assess whether the associations are age dependent or influenced by birth weight.

Design, Setting, and Participants

This investigation was a population-based cohort study of schoolchildren born from 1930 to 1987, with follow-up through national health registers from 1977 to 2012 in Denmark. Participants were 307 677 individuals (8899 ischemic stroke cases) with measured weight and height at ages 7 to 13 years. The dates of the analysis were September 1, 2015, to May 27, 2016.

Main Outcomes and Measures

Childhood BMI, change in BMI, and birth weight. Ischemic stroke events were divided into early (≤55 years) or late (>55 years) age at diagnosis.

Results

The study cohort comprised 307 677 participants (approximately 49% female and 51% male). During the study period, 3529 women and 5370 men experienced an ischemic stroke. At all ages from 7 to 13 years, an above-average BMI z score was positively associated with early ischemic stroke. At age 13 years, a BMI z score of 1 was associated with hazard ratios (HRs) of 1.26 (95% CI, 1.11-1.43) in women and 1.21 (95% CI, 1.10-1.33) in men. No significant associations were found for below-average BMI z scores. Among children with above-average BMI z scores at age 7 years, a score increase of 0.5 from ages 7 to 13 years was positively associated with early ischemic stroke in women (HR, 1.10; 95% CI, 1.01-1.20) and in men (HR, 1.08; 95% CI, 1.00-1.16). Similarly, among children with below-average BMI z scores at age 7 years, a score increase of 0.5 from ages 7 to 13 years was positively associated with early ischemic stroke in women (HR, 1.14; 95% CI, 1.06-1.23) and in men (HR, 1.10; 95% CI, 1.04-1.18). Adjusting for birth weight minimally affected the associations.

Conclusions and Relevance

Independent of birth weight, above-average childhood BMI and increases in BMI during childhood are positively associated with early adult ischemic stroke. To avoid the occurrence of early ischemic stroke associated with childhood overweight and obesity, these results suggest that all children should be helped to attain and maintain healthy weights.

Childhood body mass index and height in relation to site-specific risks of colorectal cancers in adult life

As colorectal cancers have a long latency period, their origins may lie early in life. Therefore childhood body mass index (BMI; kg/m²) and height may be associated with adult colorectal cancer. Using a cohort design, 257,623 children from The Copenhagen School Health Records Register born from 1930 to 1972 with measured heights and weights at ages 7 to 13 years were followed for adult colon and rectal adenocarcinomas by linkage to the Danish Cancer Registry. Hazard ratios (HRs) with 95% confidence intervals (CI) were estimated by Cox proportional hazard regressions. During follow-up, 2676 colon and 1681 rectal adenocarcinomas were diagnosed. No sex differences were observed in the associations between child BMI or height and adult colon or rectal cancers. Childhood BMI and height were positively associated with colon cancer; at age 13 years the HRs were 1.09 (95% CI 1.04-1.14) and 1.14 (95% CI 1.09-1.19) per z-score, respectively. Children who were persistently taller or heavier than average, had increased risk of colon cancer. Similarly, growing taller or gaining more weight than average was positively associated with colon cancer. No associations were observed between BMI or height and rectal cancer. Childhood BMI and height, along with above average change during childhood are significantly and positively associated with adult colon cancers, but not with rectal cancer, suggesting different etiologies.

Genetically predicted high body mass index is associated with increased gastric cancer risk

Epidemiological studies have linked body mass index (BMI) with risk of gastrointestinal cancers. However, for gastric cancer, the relationship is more controversial. In particular, it is unclear whether the observed association is due to confounding or bias inherent in conventional observational studies. To investigate whether BMI is causally associated with gastric cancer risk, we applied Mendelian randomization using individual-level data from 2631 gastric cancer cases and 4373 cancer-free controls. We derived a weighted genetic risk score (wGRS) using 37 BMI-associated genetic variants as an instrumental variable. We used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) for associations between genetically predicted BMI and gastric cancer risk. We observed that higher genetically determined BMI was associated with increased gastric cancer risk (per standard deviation (SD) increase in the wGRS: OR=1.07, 95% CI: 1.02-1.13, P=4.94 × 10^-3). Compared with individuals in the bottom tertile of the BMI wGRS, those in the top tertile had 1.14-fold (95% CI: 1.01-1.29) increased risk of developing gastric cancer. Sensitivity analyses using alternative causal inference measures demonstrated consistent association. Our study indicated that genetically high BMI was associated with increased gastric cancer risk, suggesting that high BMI may have a causal role in the etiology of gastric cancer.