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The effect of different socio-economic and working conditions on body size and proportions: A case study on adults from Samsun, Turkey. J Biosoc Sci 2022:1-20. [PMID: 36226660 DOI: 10.1017/s0021932022000232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Conditions in the early stages of life shape body size and proportions. This study includes individuals who came from different socio-economic conditions and worked in physically demanding jobs in childhood. By determining the body sizes of these individuals and evaluating the proportional relationships between several groups, the goal was to understand the effect levels of socio-economic levels and working conditions on the body. For this purpose, an anthropometric study was conducted on 623 males and females between the ages of 20 and 45 living in Samsun, Turkey. The study sample consisted of four different groups. It was divided into two main groups of high and low socio-economic level, and the low socio-economic group was divided into two subgroups of heavy-worker and nonheavy-worker. The results demonstrated that socio-economic differences in the size and proportions of the individuals were statistically significant (p<0.05). The high socio-economic group had the highest values in all measures. External factors affected the lower limbs more than the upper limbs. The measurement most affected by these factors was leg length. Longer legs characterized the high socio-economic group, while longer arms characterized both low socio-economic groups. The relative differences observed can be said to derive from the distal limbs. This finding was valid for both sexes. The average values were close to each other in the low socio-economic group, for which the aim was to comprehend the effects of heavy working conditions. However, differences in proportional relationships were more significant. In this context, it was seen that heavy labour also affected growth, in addition to the well-known factors encountered during the growth period, such as nutrition, health, and illness. The observed changes were more significant in males than in females. Thus, it can be said that males were more affected by physiological and physical conditions.
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Shirley MK, Cole TJ, Arthurs OJ, Clark CA, Wells JC. Developmental origins of variability in pelvic dimensions: Evidence from nulliparous South Asian women in the United Kingdom. Am J Hum Biol 2020; 32:e23340. [PMID: 31755611 PMCID: PMC7154657 DOI: 10.1002/ajhb.23340] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/19/2019] [Accepted: 09/17/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Pelvic growth may be sensitive to early-life nutrition, with implications for maternal risk of obstructed labor. However, the "developmental origins" of adult pelvic variability require further investigation. We tested whether adult pelvic dimensions are associated with two components of height, indexing different periods of linear growth: tibia length, a proxy for early postnatal growth, and height-residual (height regressed on tibia length), a proxy for later growth. We also tested whether adult pelvic dimensions are associated with birth weight, a marker of nutritional investment in utero. METHODS In this cross-sectional study, data were obtained on 68 nulliparous young women of South Asian ancestry. Pelvic dimensions (bi-iliac and bi-acetabular breadth, anteroposterior pelvic inlet and outlet, interspinous and intertuberous diameter) were measured using magnetic resonance imaging. Height and tibia length were measured manually. Birth weight and gestational age were obtained by recall. Multivariable regression models were fitted with a given pelvic dimension regressed on height-residual, tibia, and birth weight, with the latter adjusted for gestational age. RESULTS Controlling for birth weight, height-residual was predictive of bi-acetabular breadth, bi-iliac breadth, and the pelvic inlet, while tibia length significantly predicted all dimensions except interspinous diameter. Controlling for the linear growth variables, birth weight was predictive of bi-iliac breadth only. CONCLUSIONS Markers of linear growth during both early and later development were associated with adult pelvic dimensions, whereas size at birth was poorly predictive. Efforts to reduce stunting in early life may facilitate the attainment of maximum potential growth for both height and the pelvis.
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Affiliation(s)
- Meghan K. Shirley
- UCL Great Ormond Street Institute of Child HealthLondonUK
- School of Public HealthUniversity of São PauloSão PauloBrazil
| | - Tim J. Cole
- UCL Great Ormond Street Institute of Child HealthLondonUK
| | - Owen J. Arthurs
- UCL Great Ormond Street Institute of Child HealthLondonUK
- Department of RadiologyGreat Ormond Street HospitalLondonUK
| | - Chris A. Clark
- UCL Great Ormond Street Institute of Child HealthLondonUK
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Eisenberg DTA, Rej PH, Duazo P, Carba D, Hayes MG, Kuzawa CW. Testing for paternal influences on offspring telomere length in a human cohort in the Philippines. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2019; 171:520-528. [PMID: 31845317 DOI: 10.1002/ajpa.23983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Telomeres, emerging biomarkers of aging, are comprised of DNA repeats located at chromosomal ends that shorten with cellular replication and age in most human tissues. In contrast, spermatocyte telomeres lengthen with age. These changes in telomere length (TL) appear to be heritable, as older paternal ages of conception (PAC) predict longer offspring TL. Mouse-model studies raise questions about the potential for effects of paternal experiences on human offspring TL, as they suggest that smoking, inflammation, DNA damage, and stressors all shorten sperm TL. Here, we examined whether factors from the paternal environment predict offspring TL as well as interact with PAC to predict offspring TL. MATERIALS AND METHODS Using data from the Philippines, we tested if smoking, psychosocial stressors, or shorter knee height (a measure of early life adversity) predict shorter offspring TL. We also tested if these interacted with PAC in predicting offspring TL. RESULTS While we did not find the predicted associations, we observed a trend toward fathers with shorter knee height having offspring with longer TL. In addition, we found that knee height interacted with PAC to predict offspring TL. Specifically, fathers with shorter knee heights showed a stronger positive effect of PAC on offspring TL. DISCUSSION While the reasons for these associations remain uncertain, shorter knee height is characteristic of earlier puberty. Since spermatocyte TL increases with the production of sperm, we speculate that individuals with earlier puberty, and its concomitant commencement of production of sperm, had more time to accumulate longer sperm telomeres.
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Affiliation(s)
- Dan T A Eisenberg
- Department of Anthropology, University of Washington, Seattle, Washington.,Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington
| | - Peter H Rej
- Department of Anthropology, University of Washington, Seattle, Washington
| | - Paulita Duazo
- USC-Office of Population Studies Foundation, Inc., University of San Carlos, Cebu City, Philippines
| | - Delia Carba
- USC-Office of Population Studies Foundation, Inc., University of San Carlos, Cebu City, Philippines
| | - M Geoffrey Hayes
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.,Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.,Department of Anthropology, Northwestern University, Chicago, IL
| | - Christopher W Kuzawa
- Department of Anthropology, Northwestern University, Chicago, IL.,Institute for Policy Research, Northwestern University, Chicago, IL
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Nandi A, Behrman JR, Black MM, Kinra S, Laxminarayan R. Relationship between early-life nutrition and ages at menarche and first pregnancy, and childbirth rates of young adults: Evidence from APCAPS in India. MATERNAL AND CHILD NUTRITION 2019; 16:e12854. [PMID: 31141837 PMCID: PMC7038893 DOI: 10.1111/mcn.12854] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 05/02/2019] [Accepted: 05/21/2019] [Indexed: 01/28/2023]
Abstract
India's Integrated Child Development Services (ICDS) provides daily supplementary nutrition and other public health services to women and children. We estimated associations between exposure to early‐childhood ICDS nutrition and adult reproductive outcomes. During 1987–1990, a balanced protein–calorie supplement called “upma”—made from locally available corn–soya ingredients—was rolled out by subdistricts near Hyderabad and offered to pregnant women and children under age 6 years. In a controlled trial, 15 villages received the supplement and 14 did not. We used data from a 2010–2012 resurvey of adults born during the trial (n = 715 in intervention and n = 645 in control arms). We used propensity score matching methods to estimate the associations between birth in an intervention village and menarcheal age, age at first pregnancy, and fertility of adults. We found that women born in the intervention group during the trial, as compared with the control group, had menarche 0.45 (95% confidence interval [CI: 0.22, 0.68]; p < .001) years later and first pregnancy 0.53 (95% CI [0.04, 1.02]; p < .05) years later. Married women from the intervention group had menarche 0.36 (95% CI [0.09, 0.64]; p < .01) years later, first cohabitation with partner 0.8 (95% CI [0.27, 1.33]; p < .01) years later, and first pregnancy 0.53 (95% CI [0.04, 1.02]; p < .05) years later than married women in the control group. There was no significant difference between intervention and control group women regarding whether they had at least one childbirth or the total number of children born. The findings were similar when we employed inverse propensity score weighted regression models.
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Affiliation(s)
- Arindam Nandi
- Center for Disease Dynamics, Economics & Policy, Washington, DC, Washington, District of Columbia
| | - Jere R Behrman
- Departments of Economics and Sociology, Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Maureen M Black
- RTI International, Research Triangle Park, North Carolina.,Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics & Policy, New Delhi, New Delhi, India.,Princeton Environmental Institute, Princeton University, Princeton, New Jersey
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Nandi A, Behrman JR, Kinra S, Laxminarayan R. Early-Life Nutrition Is Associated Positively with Schooling and Labor Market Outcomes and Negatively with Marriage Rates at Age 20-25 Years: Evidence from the Andhra Pradesh Children and Parents Study (APCAPS) in India. J Nutr 2018; 148:140-146. [PMID: 29378047 PMCID: PMC6289970 DOI: 10.1093/jn/nxx012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 09/07/2017] [Accepted: 10/10/2017] [Indexed: 11/14/2022] Open
Abstract
Background India's Integrated Child Development Services (ICDS) is among the world's largest public nutritional programs, providing daily nutritional supplements and other public health and educational services to pregnant and nursing women, children aged <6 y, and adolescent girls. Objective We estimated the long-term association between early-childhood ICDS nutrition and adult outcomes. Methods We used follow-up data from a controlled nutritional trial conducted during 1987-1990 in 29 villages near the city of Hyderabad. In 15 intervention villages, a balanced protein-calorie supplement-made from locally available corn-soya ingredients and called upma-was offered to pregnant women and to children <6 y old. No supplement was offered in the 14 control villages. During 2010-2012, adults born during the trial were re-surveyed (n = 715 in the intervention arm and n = 645 in the control arm). We used probit regression and propensity score-matching methods to estimate the association between birth in an intervention village and rates of secondary and graduate education completion, marriage, and employment or enrollment in higher education of these adults. Results Adults born in the intervention group during the trial, compared with the control group, were 9% (95% CI: 0.04, 0.14; P < 0.01) more likely to complete secondary school and 11% (95% CI: 0.06, 0.15; P < 0.01) more likely to complete graduate education, were 6% (95% CI: -0.11, -0.01; P < 0.05) less likely to be ever-married at age 20-25 y, and were 5% (95% CI: 0, 0.11; P < 0.05) more likely to be employed or enrolled in higher education. The estimated associations for graduate education completion and employment-study rates were greater for men, whereas the associations for secondary education and ever-married rates were greater for women. Conclusion Exposure to nutritional supplement in utero or during the first 3 y of life was associated with improved adult educational and employment outcomes and lower marriage rates in India.
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Affiliation(s)
- Arindam Nandi
- Tata Centre for Development, University of Chicago, Chicago, IL
- Center for Disease Dynamics, Economics, and Policy, Washington, DC
| | - Jere R Behrman
- Departments of Economics, Sociology, and Population Studies Center, University of Pennsylvania, Philadelphia, PA
- Departments of Sociology, and Population Studies Center, University of Pennsylvania, Philadelphia, PA
- Departments of Population Studies Center, University of Pennsylvania, Philadelphia, PA
| | - Sanjay Kinra
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics, and Policy, New Delhi, India
- Princeton Environmental Institute, Princeton University, Princeton, NJ
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Sohn K. The Association between Height and Hypertension in Indonesia. ECONOMICS AND HUMAN BIOLOGY 2017; 27:74-83. [PMID: 28550808 DOI: 10.1016/j.ehb.2017.04.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 03/28/2017] [Accepted: 04/19/2017] [Indexed: 06/07/2023]
Abstract
There is growing interest in the influence of early-life conditions on the development of disease. Among diseases in adulthood, hypertension is particularly important for the developing world because considerably more people there are and will be afflicted with the disease than in the developed world and hypertensives there are often unaware of their disease status. We employed height as a proxy for the influence of early-life conditions and estimated the relation between height and hypertension status in Indonesia. We analysed 9,597 men and 10,143 women, aged 25-70. We employed a linear probability model to relate height to hypertension status by sex and age. When we controlled for an array of covariates, a 10cm increase in height was related to an approximately 7% point reduction in the likelihood of being hypertensive for both men and women. This is about a quarter of the prevalence of hypertension in Indonesia. This relation was linear and stronger among older individuals. In addition, the pre- and post-pubertal environments (measured by leg and trunk lengths, respectively) contributed similarly to hypertension. Further evidence suggests that women are more likely to be hypertensive at older ages because they are on average shorter than men.
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Affiliation(s)
- Kitae Sohn
- Department of Economics, Konkuk University. 120 Neungdong-ro. Gwangjin-gu, Seoul, 05029, South Korea; School of Economics and Finance, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
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Nandi A, Ashok A, Kinra S, Behrman JR, Laxminarayan R. Early Childhood Nutrition Is Positively Associated with Adolescent Educational Outcomes: Evidence from the Andhra Pradesh Child and Parents Study (APCAPS). J Nutr 2016; 146:806-813. [PMID: 26962175 PMCID: PMC4807645 DOI: 10.3945/jn.115.223198] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 10/09/2015] [Accepted: 01/15/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND India's Integrated Child Development Scheme, which provides supplementary nutrition and other public health services to >91 million women and children aged <6 y, is the largest program of its kind in the world. OBJECTIVE We estimated the long-term associations of maternal and early childhood nutrition provided under the Integrated Child Development Scheme with educational outcomes when the children became adolescents. METHODS We used longitudinal data from a controlled nutrition trial conducted near the city of Hyderabad, India. From 1987 to 1990, a balanced protein-energy supplement (corn-soya meal, called upma) was offered to pregnant women and children aged <6 y in 15 intervention villages, whereas no supplementation was offered in 14 control villages. Both groups had equal access to other public programs such as immunization and anemia control in pregnancy. Children born during the original trial period were resurveyed (654 intervention and 511 control group children) in 2003-2005. We used propensity score matching methods to correct for estimation bias in our regression models to assess the associations of supplementary nutrition with school enrollment, schooling grades completed, and academic test performance of these adolescents. RESULTS Children born in intervention villages were 7.8% (95% CI: 0.1%, 15.4%; P < 0.05) more likely to be enrolled in school and completed 0.84 (95% CI: 0.28, 1.39; P < 0.005) more schooling grades than children born in control villages. We found no association between supplementary nutrition and academic performance, as measured by school test scores. CONCLUSION Offering a nutritional supplement to pregnant women and children <6 y of age during the Hyderabad Nutrition Trial was associated with improved school enrollment and completion of more schooling grades when the children became adolescents.
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Affiliation(s)
- Arindam Nandi
- Center for Disease Dynamics, Economics & Policy, Washington, DC;,Public Health Foundation of India, Gurgaon, India
| | - Ashvin Ashok
- Center for Disease Dynamics, Economics & Policy, Washington, DC
| | - Sanjay Kinra
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jere R Behrman
- Departments of Economics and Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA; and
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics & Policy, Washington, DC;,Public Health Foundation of India, Gurgaon, India;,Princeton Environmental Institute, Princeton University, Princeton, NJ,To whom correspondence should be addressed. E-mail:
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Poh BK, Wong JE, Norimah AK, Deurenberg P. Differences in Body Build in Children of Different Ethnic Groups and their Impact on the Prevalence of Stunting, Thinness, Overweight, and Obesity. Food Nutr Bull 2016; 37:3-13. [PMID: 26769039 DOI: 10.1177/0379572115626025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The prevalence of stunting, thinness, overweight, and obesity among children differs by ethnicity. It is not known whether differences in body build across the ethnic groups influence the interpretation of nutritional parameters. OBJECTIVE To explore the differences in body build across the 5 main ethnic groups in Malaysia and to determine whether differences in body build have an impact on the interpretation of nutrition indicators. METHODS A total of 3227 children aged 2.0 to 12.9 years who participated in the South East Asian Nutrition Surveys (SEANUTS) in Malaysia were included in this analysis. Body weight, height, sitting height, wrist and knee breadths, and biceps and subscapular skinfolds were measured, and relative leg length, slenderness index, and sum of skinfolds were calculated. Z scores for height-for-age (HAZ) and body mass index-for-age (BAZ) were calculated using the World Health Organization (WHO) 2007 growth standards. RESULTS Differences in relative leg length and slenderness across the ethnic groups were correlated with HAZ and BAZ. Correction for differences in body build did, in some ethnic groups, have significant impact on the prevalence of stunting, thinness, overweight, and obesity, and the pattern of prevalence across ethnic groups changed. CONCLUSION At the population level, corrections for body build had only minor and mostly nonsignificant effects on prevalence, but at an individual level, corrections for body build placed a substantial number of children in different height or weight categories. Whether these misclassifications warrant additional assessment of body build in clinical practice will need further investigation.
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Affiliation(s)
- Bee Koon Poh
- Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Jyh Eiin Wong
- Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Ota E, Hori H, Mori R, Tobe-Gai R, Farrar D. Antenatal dietary education and supplementation to increase energy and protein intake. Cochrane Database Syst Rev 2015:CD000032. [PMID: 26031211 DOI: 10.1002/14651858.cd000032.pub3] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Gestational weight gain is positively associated with fetal growth, and observational studies of food supplementation in pregnancy have reported increases in gestational weight gain and fetal growth. OBJECTIVES To assess the effects of education during pregnancy to increase energy and protein intake, or of actual energy and protein supplementation, on energy and protein intake, and the effect on maternal and infant health outcomes. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2015), reference lists of retrieved studies and contacted researchers in the field. SELECTION CRITERIA Randomised controlled trials of dietary education to increase energy and protein intake, or of actual energy and protein supplementation, during pregnancy. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion and assessed risk of bias. Two review authors independently extracted data and checked for accuracy. Extracted data were supplemented by additional information from the trialists we contacted. MAIN RESULTS We examined 149 reports corresponding to 65 trials. Of these trials, 17 were included, 46 were excluded, and two are ongoing. Overall, 17 trials involving 9030 women were included. For this update, we assessed methodological quality of the included trials using the standard Cochrane criteria (risk of bias) and the GRADE approach. The overall risk of bias was unclear. Nutritional education (five trials, 1090 women) Women given nutritional education had a lower relative risk of having a preterm birth (two trials, 449 women) (risk ratio (RR) 0.46, 95% CI 0.21 to 0.98, low-quality evidence), and low birthweight (one trial, 300 women) (RR 0.04, 95% CI 0.01 to 0.14). Head circumference at birth was increased in one trial (389 women) (mean difference (MD) 0.99 cm, 95% CI 0.43 to 1.55), while birthweight was significantly increased among undernourished women in two trials (320 women) (MD 489.76 g, 95% CI 427.93 to 551.59, low-quality evidence), but did not significantly increase for adequately nourished women (MD 15.00, 95% CI -76.30 to 106.30, one trial, 406 women). Protein intake increased significantly (three trials, 632 women) (protein intake: MD +6.99 g/day, 95% CI 3.02 to 10.97). No significant differences were observed on any other outcomes such as neonatal death (RR 1.28, 95% CI 0.35 to 4.72, one trial, 448 women, low-quality evidence), stillbirth (RR 0.37, 95% CI 0.07 to 1.90, one trial, 431 women, low-quality evidence), small-for-gestational age (RR 0.97, 95% CI 0.45 to 2.11, one trial, 404 women, low-quality evidence) and total gestational weight gain (MD -0.41, 95% CI -4.41 to 3.59, two trials, 233 women). There were no data on perinatal death. Balanced energy and protein supplementation (12 trials, 6705 women)Risk of stillbirth was significantly reduced for women given balanced energy and protein supplementation (RR 0.60, 95% CI 0.39 to 0.94, five trials, 3408 women, moderate-quality evidence), and the mean birthweight was significantly increased (random-effects MD +40.96 g, 95% CI 4.66 to 77.26, Tau² = 1744, I² = 44%, 11 trials, 5385 women, moderate-quality evidence). There was also a significant reduction in the risk of small-for-gestational age (RR 0.79, 95% CI 0.69 to 0.90, I² = 16%, seven trials, 4408 women, moderate-quality evidence). No significant effect was detected for preterm birth (RR 0.96, 95% CI 0.80 to 1.16, five trials, 3384 women, moderate-quality evidence) or neonatal death (RR 0.68, 95% CI 0.43 to 1.07, five trials, 3381 women, low-quality evidence). Weekly gestational weight gain was not significantly increased (MD 18.63, 95% CI -1.81 to 39.07, nine trials, 2391 women, very low quality evidence). There were no data reported on perinatal death and low birthweight. High-protein supplementation (one trial, 1051 women)High-protein supplementation (one trial, 505 women), was associated with a significantly increased risk of small-for-gestational age babies (RR 1.58, 95% CI 1.03 to 2.41, moderate-quality evidence). There was no significant effect for stillbirth (RR 0.81, 95% CI 0.31 to 2.15, one trial, 529 women), neonatal death (RR 2.78, 95% CI 0.75 to 10.36, one trial, 529 women), preterm birth (RR 1.14, 95% CI 0.83 to 1.56, one trial, 505 women), birthweight (MD -73.00, 95% CI -171.26 to 25.26, one trial, 504 women) and weekly gestational weight gain (MD 4.50, 95% CI -33.55 to 42.55, one trial, 486 women, low-quality evidence). No data were reported on perinatal death. Isocaloric protein supplementation (two trials, 184 women)Isocaloric protein supplementation (two trials, 184 women) had no significant effect on birthweight (MD 108.25, 95% CI -220.89 to 437.40) and weekly gestational weight gain (MD 110.45, 95% CI -82.87 to 303.76, very low-quality evidence). No data reported on perinatal mortality, stillbirth, neonatal death, small-for-gestational age, and preterm birth. AUTHORS' CONCLUSIONS This review provides encouraging evidence that antenatal nutritional education with the aim of increasing energy and protein intake in the general obstetric population appears to be effective in reducing the risk of preterm birth, low birthweight, increasing head circumference at birth, increasing birthweight among undernourished women, and increasing protein intake. There was no evidence of benefit or adverse effect for any other outcome reported.Balanced energy and protein supplementation seems to improve fetal growth, and may reduce the risk of stillbirth and infants born small-for-gestational age. High-protein supplementation does not seem to be beneficial and may be harmful to the fetus. Balanced-protein supplementation alone had no significant effects on perinatal outcomes.The results of this review should be interpreted with caution. The risk of bias was either unclear or high for at least one category examined in several of the included trials, and the quality of the evidence was low for several important outcomes. Also, as the anthropometric characteristics of the general obstetric population is changing, those developing interventions aimed at altering energy and protein intake should ensure that only those women likely to benefit are included. Large, well-designed randomised trials are needed to assess the effects of increasing energy and protein intake during pregnancy in women whose intake is below recommended levels.
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Affiliation(s)
- Erika Ota
- Department of Health Policy, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan, 157-8535
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10
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Sohn K. Is leg length a biomarker of early life conditions? Evidence from a historically short population. Am J Hum Biol 2015; 27:538-45. [DOI: 10.1002/ajhb.22682] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 12/21/2014] [Accepted: 12/29/2014] [Indexed: 11/08/2022] Open
Affiliation(s)
- Kitae Sohn
- Department of Economics; Konkuk University; 120 Neungdong-ro Gwangjin-gu Seoul 143-701 South Korea
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11
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Franke D, Thomas L, Steffens R, Pavičić L, Gellermann J, Froede K, Querfeld U, Haffner D, Živičnjak M. Patterns of growth after kidney transplantation among children with ESRD. Clin J Am Soc Nephrol 2014; 10:127-34. [PMID: 25352379 DOI: 10.2215/cjn.02180314] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Poor linear growth is a frequent complication of CKD. This study evaluated the effect of kidney transplantation on age-related growth of linear body segments in pediatric renal transplant recipients who were enrolled from May 1998 until August 2013 in the CKD Growth and Development observational cohort study. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Linear growth (height, sitting height, arm and leg lengths) was prospectively investigated during 1639 annual visits in a cohort of 389 pediatric renal transplant recipients ages 2-18 years with a median follow-up of 3.4 years (interquartile range, 1.9-5.9 years). Linear mixed-effects models were used to assess age-related changes and predictors of linear body segments. RESULTS During early childhood, patients showed lower mean SD scores (SDS) for height (-1.7) and a markedly elevated sitting height index (ratio of sitting height to total body height) compared with healthy children (1.6 SDS), indicating disproportionate stunting (each P<0.001). After early childhood a sustained increase in standardized leg length and a constant decrease in standardized sitting height were noted (each P<0.001), resulting in significant catch-up growth and almost complete normalization of sitting height index by adult age (0.4 SDS; P<0.01 versus age 2-4 years). Time after transplantation, congenital renal disease, bone maturation, steroid exposure, degree of metabolic acidosis and anemia, intrauterine growth restriction, and parental height were significant predictors of linear body dimensions and body proportions (each P<0.05). CONCLUSIONS Children with ESRD present with disproportionate stunting. In pediatric renal transplant recipients, a sustained increase in standardized leg length and total body height is observed from preschool until adult age, resulting in restoration of body proportions in most patients. Reduction of steroid exposure and optimal metabolic control before and after transplantation are promising measures to further improve growth outcome.
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Affiliation(s)
- Doris Franke
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Children's Hospital, Hannover Medical School, Hannover, Germany
| | - Lena Thomas
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Children's Hospital, Hannover Medical School, Hannover, Germany
| | - Rena Steffens
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Children's Hospital, Hannover Medical School, Hannover, Germany
| | - Leo Pavičić
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia; and
| | - Jutta Gellermann
- Department of Pediatric Nephrology, Charité University Hospital, Berlin, Germany
| | - Kerstin Froede
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Children's Hospital, Hannover Medical School, Hannover, Germany
| | - Uwe Querfeld
- Department of Pediatric Nephrology, Charité University Hospital, Berlin, Germany
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Children's Hospital, Hannover Medical School, Hannover, Germany
| | - Miroslav Živičnjak
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Children's Hospital, Hannover Medical School, Hannover, Germany;
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Abstract
The dramatic rise in childhood obesity has driven the demand for tools better able to assess and define obesity and risk for related co-morbidities. In addition, the early life origins of non-communicable diseases including type 2 diabetes are associated with subtle alterations in growth and body composition, including total and regional body fatness, limb/trunk length and skeletal muscle mass (SMM). Consequently improved tools based on national reference data, which capture these body components must be developed as the limitations of BMI as a measure of overweight and obesity and associated cardiometabolic risk are now recognised. Furthermore, waist circumference as a measure of abdominal fatness in children is now endorsed by the International Diabetes Federation and National Institute for Clinical and Health Excellence for diagnostic and monitoring purposes. The present paper aims to review the research on growth-related variations in body composition and proportions, together with how national references for percentage body fat, SMM and leg/trunk length have been developed. Where collection of these measures is not possible, alternative proxy measures including thigh and hip circumferences are suggested. Finally, body ratios including the waist:height and muscle:fat ratios are highlighted as potential measures of cardiometabolic disease risk. In conclusion, a collection of national references for individual body measures have been produced against which children and youths can be assessed. Collectively, they have the capacity to build a better picture of an individual's phenotype, which represents their risk for cardiometabolic disease beyond that of the capability of BMI.
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13
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Regnault N, Kleinman KP, Rifas-Shiman SL, Langenberg C, Lipshultz SE, Gillman MW. Components of height and blood pressure in childhood. Int J Epidemiol 2014; 43:149-59. [PMID: 24413933 DOI: 10.1093/ije/dyt248] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In children being taller is associated with higher blood pressure (BP), but few studies have divided height into its components: trunk and leg length. We examined the associations of total height, trunk length and leg length with systolic BP (SBP), diastolic BP (DBP) and pulse pressure (PP) at early childhood and mid-childhood visits, as well as change between the two visits. METHODS We obtained five measures of SBP and DBP at the early childhood visit (N = 1153, follow-up rate = 54%) and at the mid-childhood visit (N = 1086, follow-up rate = 51%) respectively, in Project Viva, a US cohort study. We measured total height and sitting height (a measure of trunk length that includes head and neck) and calculated leg length as the difference between the two. Using mixed models, we adjusted the cross-sectional analyses for leg length when trunk length was the exposure of interest, and vice versa. We also adjusted for maternal race/ethnicity, child age, sex, overall adiposity and BP measurement conditions. RESULTS At the mid-childhood visit, total height was positively associated with SBP [0.34 (0.24; 0.45) mmHg/cm] but not with DBP [0.07 (-0.003; 0.15)]. In models examining trunk and leg length separately, each was positively associated with SBP [0.72 (0.52; 0.92) and 0.33 (0.16; 0.49) respectively]. In a fully adjusted model with both leg and trunk length, only trunk length remained associated with BP. For a given leg length, a 1-cm increment in trunk length was associated with a 0.63-mmHg (0.42; 0.83) higher SBP and a 0.17-mmHg (0.02; 0.31) higher DBP. For a given trunk length, however, the associations of leg length with SBP [0.13 (-0.03; 0.30)] and with DBP [0.002 (-0.11; 0.12)] were null. These patterns were similar at the early childhood visit. CONCLUSIONS Children with greater trunk lengths have higher BPs, perhaps because of the additional pressure needed to overcome gravity to perfuse the brain.
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Affiliation(s)
- Nolwenn Regnault
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA, MRC Epidemiology Unit, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA and Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
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14
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Kwok MK, Leung GM, Lam TH, Leung SSL, Schooling CM. Grandparental education, parental education and child height: evidence from Hong Kong's "Children of 1997" birth cohort. Ann Epidemiol 2013; 23:475-84. [PMID: 23889857 DOI: 10.1016/j.annepidem.2013.05.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 05/24/2013] [Accepted: 05/29/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE Adult height is the sum of growth during fetal, infancy, childhood, and puberty, controlled by different biological factors. In long-term developed Western populations, height is positively associated with socioeconomic position, but less clearly so in recently developing populations. We aimed to elucidate socioeconomic influences on height at different growth phases. METHODS We examined the associations of parents' education and grandparents' education with birth weight and height gain z-scores during infancy (birth to <2 years), childhood (2 to <8 years), and puberty (8 to <14 years) adjusted for parents' height using generalized estimating equations in Hong Kong's "Children of 1997" birth cohort (n = 8264). RESULTS Parents' education, but not grandparents', was positively associated with birth weight (z-score, 0.07; 95% confidence interval [CI] 0.01-0.12 for grade ≥12 compared with grade ≤9) and height gain during infancy (0.11; 95% CI, 0.05-0.18), adjusted for gender, gestational age, initial size, parity, parents' age, parents' birthplace, and parents' height. Conversely, similarly adjusted, grandparents' education, but not parents', was associated with height gain during childhood (0.11; 95% CI, 0.04-0.18). CONCLUSIONS Parental education was associated with fetal and infant, but not childhood, linear growth, suggesting the mechanism underlying socioeconomic influences on height at different growth phases may be contextually specific.
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Affiliation(s)
- Man Ki Kwok
- Life Course and Lifestyle Epidemiology Group, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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15
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Kinra S, Radha Krishna KV, Kuper H, Rameshwar Sarma KV, Prabhakaran P, Gupta V, Walia GK, Bhogadi S, Kulkarni B, Kumar A, Aggarwal A, Gupta R, Prabhakaran D, Reddy KS, Smith GD, Ben-Shlomo Y, Ebrahim S. Cohort profile: Andhra Pradesh Children and Parents Study (APCAPS). Int J Epidemiol 2013; 43:1417-24. [PMID: 24019421 PMCID: PMC4190511 DOI: 10.1093/ije/dyt128] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The Andhra Pradesh Children and Parents Study (APCAPS) was originally established to study the long-term effects of early-life undernutrition on risk of cardiovascular disease. Its aims were subsequently expanded to include trans-generational influences of other environmental and genetic factors on chronic diseases in rural India. It builds on the Hyderabad Nutrition Trial (HNT) conducted in 1987–90 to compare the effects on birthweight of a protein-calorie supplement for pregnant women and children. The index children of HNT and their mothers were retraced and examined in 2003–05, and the children re-examined as young adults aged 18–21 years in 2009–10. The cohort was expanded to include both parents and siblings of the index children in a recently completed follow-up conducted in 2010–12 (N = ∼6225 out of 10 213 participants). Recruitment of the remaining residents of these 29 villages (N = ∼55 000) in Ranga Reddy district of Andhra Pradesh is now under way. Extensive data on socio-demographic, lifestyle, medical, anthropometric, physiological, vascular and body composition measures, DNA, stored plasma, and assays of lipids and inflammatory markers on APCAPS participants are available. Details of how to access these data are available from the corresponding author.
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Affiliation(s)
- Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
| | - K V Radha Krishna
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
| | - Hannah Kuper
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
| | - K V Rameshwar Sarma
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
| | - Poornima Prabhakaran
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
| | - Vipin Gupta
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
| | - Gagandeep Kaur Walia
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
| | - Santhi Bhogadi
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
| | - Bharati Kulkarni
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
| | - Aniket Kumar
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
| | - Aastha Aggarwal
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
| | - Ruby Gupta
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
| | - Dorairaj Prabhakaran
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
| | - K Srinath Reddy
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
| | - George Davey Smith
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
| | - Yoav Ben-Shlomo
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
| | - Shah Ebrahim
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK, National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India, Public Health Foundation of India, New Delhi, India, School of Social and Community Medicine, University of Bristol, Bristol, UK, Department of Anthropology, University of Delhi, Delhi, India, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia and Centre for Chronic Disease Control, New Delhi, India
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16
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Kulkarni B, Kuper H, Taylor A, Wells JC, Radhakrishna KV, Kinra S, Ben-Shlomo Y, Smith GD, Ebrahim S, Byrne NM, Hills AP. Development and validation of anthropometric prediction equations for estimation of lean body mass and appendicular lean soft tissue in Indian men and women. J Appl Physiol (1985) 2013; 115:1156-62. [PMID: 23950165 PMCID: PMC3798815 DOI: 10.1152/japplphysiol.00777.2013] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Lean body mass (LBM) and muscle mass remain difficult to quantify in large epidemiological studies due to the unavailability of inexpensive methods. We therefore developed anthropometric prediction equations to estimate the LBM and appendicular lean soft tissue (ALST) using dual-energy X-ray absorptiometry (DXA) as a reference method. Healthy volunteers (n = 2,220; 36% women; age 18-79 yr), representing a wide range of body mass index (14–44 kg/m2), participated in this study. Their LBM, including ALST, was assessed by DXA along with anthropometric measurements. The sample was divided into prediction (60%) and validation (40%) sets. In the prediction set, a number of prediction models were constructed using DXA-measured LBM and ALST estimates as dependent variables and a combination of anthropometric indices as independent variables. These equations were cross-validated in the validation set. Simple equations using age, height, and weight explained >90% variation in the LBM and ALST in both men and women. Additional variables (hip and limb circumferences and sum of skinfold thicknesses) increased the explained variation by 5–8% in the fully adjusted models predicting LBM and ALST. More complex equations using all of the above anthropometric variables could predict the DXA-measured LBM and ALST accurately, as indicated by low standard error of the estimate (LBM: 1.47 kg and 1.63 kg for men and women, respectively), as well as good agreement by Bland-Altman analyses (Bland JM, Altman D.Lancet 1: 307–310, 1986). These equations could be a valuable tool in large epidemiological studies assessing these body compartments in Indians and other population groups with similar body composition.
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Affiliation(s)
- Bharati Kulkarni
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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17
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Ponsonby AL, Lucas RM, Dear K, van der Mei I, Taylor B, Chapman C, Coulthard A, Dwyer T, Kilpatrick TJ, McMichael AJ, Pender MP, Valery PC, Williams D. The physical anthropometry, lifestyle habits and blood pressure of people presenting with a first clinical demyelinating event compared to controls: The Ausimmune study. Mult Scler 2013; 19:1717-25. [DOI: 10.1177/1352458513483887] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Introduction: Lifestyle factors prior to a first clinical demyelinating event (FCD), a disorder often preceding the development of clinically definite multiple sclerosis (MS), have not previously been examined in detail. Past tobacco smoking has been consistently associated with MS. Methods: This was a multicentre incident case-control study. Cases ( n = 282) were aged 18–59 years with an FCD and resident within one of four Australian centres (from latitudes 27°S to 43°S), from 1 November 2003 to 31 December 2006. Controls ( n = 558) were matched to cases on age, sex and study region, without CNS demyelination. Exposures measured included current and past tobacco and marijuana, alcohol and beverage use, physical activity patterns, blood pressure and physical anthropometry. Results: A history of smoking ever was associated with FCD risk (AOR 1.89 (95%CL 1.82, 3.52)). Marijuana use was not associated with FCD risk after adjusting for confounders such as smoking ever but the estimates were imprecise because of a low prevalence of use. Alcohol consumption was common and not associated with FCD risk. No case-control differences in blood pressure or physical anthropometry were observed. Conclusions: Past tobacco smoking was positively associated with a risk of FCD but most other lifestyle factors were not. Prevention efforts against type 2 diabetes and cardiovascular disease by increasing physical activity and reducing obesity are unlikely to alter MS incidence, and more targeted campaigns will be required.
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Affiliation(s)
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, The Australian National University, Australia
| | - Keith Dear
- National Centre for Epidemiology and Population Health, The Australian National University, Australia
| | | | - Bruce Taylor
- Menzies Research Institute Tasmania, Australia
- Otago University, New Zealand
| | | | - Alan Coulthard
- The University of Queensland and Royal Brisbane and Women’s Hospital, Australia
| | | | | | - Anthony J McMichael
- National Centre for Epidemiology and Population Health, The Australian National University, Australia
| | - Michael P Pender
- The University of Queensland and Royal Brisbane and Women’s Hospital, Australia
| | - Patricia C Valery
- Menzies School of Health Research, Charles Darwin University, Australia
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18
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Pomeroy E, Stock JT, Stanojevic S, Miranda JJ, Cole TJ, Wells JCK. Trade-offs in relative limb length among Peruvian children: extending the thrifty phenotype hypothesis to limb proportions. PLoS One 2012; 7:e51795. [PMID: 23272169 PMCID: PMC3521697 DOI: 10.1371/journal.pone.0051795] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 11/12/2012] [Indexed: 12/03/2022] Open
Abstract
Background and Methods Both the concept of ‘brain-sparing’ growth and associations between relative lower limb length, childhood environment and adult disease risk are well established. Furthermore, tibia length is suggested to be particularly plastic under conditions of environmental stress. The mechanisms responsible are uncertain, but three hypotheses may be relevant. The ‘thrifty phenotype’ assumes that some components of growth are selectively sacrificed to preserve more critical outcomes, like the brain. The ‘distal blood flow’ hypothesis assumes that blood nutrients decline with distance from the heart, and hence may affect limbs in relation to basic body geometry. Temperature adaptation predicts a gradient of decreased size along the limbs reflecting decreasing tissue temperature/blood flow. We examined these questions by comparing the size of body segments among Peruvian children born and raised in differentially stressful environments. In a cross-sectional sample of children aged 6 months to 14 years (n = 447) we measured head circumference, head-trunk height, total upper and lower limb lengths, and zeugopod (ulna and tibia) and autopod (hand and foot) lengths. Results Highland children (exposed to greater stress) had significantly shorter limbs and zeugopod and autopod elements than lowland children, while differences in head-trunk height were smaller. Zeugopod elements appeared most sensitive to environmental conditions, as they were relatively shorter among highland children than their respective autopod elements. Discussion The results suggest that functional traits (hand, foot, and head) may be partially protected at the expense of the tibia and ulna. The results do not fit the predictions of the distal blood flow and temperature adaptation models as explanations for relative limb segment growth under stress conditions. Rather, our data support the extension of the thrifty phenotype hypothesis to limb growth, and suggest that certain elements of limb growth may be sacrificed under tough conditions to buffer more functional traits.
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Affiliation(s)
- Emma Pomeroy
- Division of Biological Anthropology, Department of Archaeology and Anthropology, University of Cambridge, Cambridge, United Kingdom.
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19
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Ota E, Tobe-Gai R, Mori R, Farrar D. Antenatal dietary advice and supplementation to increase energy and protein intake. Cochrane Database Syst Rev 2012:CD000032. [PMID: 22972038 DOI: 10.1002/14651858.cd000032.pub2] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Gestational weight gain is positively associated with fetal growth, and observational studies of food supplementation in pregnancy have reported increases in gestational weight gain and fetal growth. OBJECTIVES To assess the effects of advice during pregnancy to increase energy and protein intake, or of actual energy and protein supplementation, on energy and protein intakes, and the effect on maternal and infant health outcomes. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (22 July 2011) and contacted researchers in the field. We updated the search on 12 July 2012 and added the results to the awaiting classification section of the review. SELECTION CRITERIA Randomised controlled trials of dietary advice to increase energy and protein intake, or of actual energy and protein supplementation, during pregnancy. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion and assessed risk of bias. Two review authors independently extracted data and checked for accuracy. Extracted data were supplemented by additional information from the trialists we contacted. MAIN RESULTS We examined 110 reports corresponding to 46 trials. Of these trials, 15 were included, 30 were excluded, and one is ongoing. Overall, 15 trials involving 7410 women were included.Nutritional advice (four trials, 790 women)Women given nutritional advice had a lower relative risk of having a preterm birth (two trials, 449 women) (risk ratio (RR) 0.46, 95% CI 0.21 to 0.98 ), head circumference at birth was increased in one trial (389 women) (mean difference (MD) 0.99 cm, 95% CI 0.43 to 1.55) and protein intake increased (three trials, 632 women) (protein intake: MD +6.99 g/day, 95% CI 3.02 to 10.97). No significant differences were observed on any other outcomes.Balanced energy and protein supplementation (11 trials, 5385 women)Risk of stillbirth was significantly reduced for women given balanced energy and protein supplementation (RR 0.62, 95% CI 0.40 to 0.98, five trials, 3408 women), mean birthweight was significantly increased (random-effects MD +40.96 g, 95% CI 4.66 to 77.26 , Tau(2)= 1744, I(2) = 44%, 11 trials, 5385 women). There was also a significant reduction in the risk of small-for-gestational age (RR 0.79, 95% CI 0.69 to 0.90, I(2) = 16%, seven trials, 4408 women). No significant effect was detected for preterm birth or neonatal death.High-protein supplementation (one trial, 1051 women)High-protein supplementation (one trial, 505 women), was associated with a significantly increased risk of small-for-gestational age babies (RR 1.58, 95% CI 1.03 to 2.41).Isocaloric protein supplementation (two trials, 184 women)Isocaloric protein supplementation (two trials,184 women) had no significant effect on birthweight and weekly gestational weight gain. AUTHORS' CONCLUSIONS This review provides encouraging evidence that antenatal nutritional advice with the aim of increasing energy and protein intake in the general obstetric population appears to be effective in reducing the risk of preterm birth, increasing head circumference at birth and increasing protein intake, there was no evidence of benefit or adverse effect for any other outcome reported.Balanced energy and protein supplementation seems to improve fetal growth, and may reduce the risk of stillbirth and infants born small-for-gestational age. High-protein supplementation does not seem to be beneficial and may be harmful to the fetus. Balanced-protein supplementation alone had no significant effects on perinatal outcomes.The results of this review should be interpreted with caution, the risk of bias was either unclear or high for at least one category examined in several of the included trials and the quality of the evidence was low for several important outcomes. Also the anthropometric characteristics of the general obstetric population is changing, therefore, those developing interventions aimed at altering energy and protein intake should ensure that only those women likely to benefit are included. Large, well designed randomised trials are needed to assess the effects of increasing energy and protein intake during pregnancy in women whose intake is below recommended levels.
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Affiliation(s)
- Erika Ota
- Department of GlobalHealth Policy, Graduate School ofMedicine, The University of Tokyo, Tokyo, Japan.
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Smits MM, Boyko EJ, Utzschneider KM, Leonetti DL, McNeely MJ, Suvag S, Wright LA, Fujimoto WY, Kahn SE. Arm length is associated with type 2 diabetes mellitus in Japanese-Americans. Diabetologia 2012; 55:1679-84. [PMID: 22361981 PMCID: PMC3678981 DOI: 10.1007/s00125-012-2500-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Accepted: 01/23/2012] [Indexed: 01/14/2023]
Abstract
AIMS/HYPOTHESIS The aim of the study was to examine the association of type 2 diabetes mellitus with arm length as a marker for early life environment and development. METHODS This was a cross-sectional analysis of 658 second- and third-generation Japanese-Americans (349 men and 309 women). Different arm length (total, upper and forearm length) and leg length (total and lower leg length) measurements were performed. Type 2 diabetes was defined by the use of hypoglycaemic medication, fasting plasma glucose (FPG) ≥ 7 mmol/l or glucose at 2 h ≥ 11.1 mmol/l during an OGTT. Persons meeting the criteria for impaired glucose tolerance were excluded from these analyses (FPG <7 mmol/l and 2 h glucose during an OGGT <11.1 but ≥ 7.8 mmol/l). Multivariable logistic regression was used to estimate associations between prevalence of diabetes and limb length while adjusting for possible confounders. RESULTS A total of 145 individuals had diabetes. On univariate analysis, arm and leg length were not associated with diabetes. After adjustment for age, sex, computed tomography-measured intra-abdominal fat area, height, weight, smoking status and family history of diabetes, total arm length and upper arm length were inversely related to diabetes (OR for a 1 SD increase 0.49, 95% CI 0.29, 0.84 for total arm length, and OR 0.56, 95% CI 0.36, 0.87 for upper arm length). Forearm length, height and leg length were not associated with diabetes after adjustment for confounding variables. CONCLUSIONS/INTERPRETATION Our findings of associations between arm lengths and prevalence of type 2 diabetes supports a role for factors that determine bone growth or their correlates in the development of this condition.
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Affiliation(s)
- M M Smits
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA, USA
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Matijasevich A, Howe LD, Tilling K, Santos IS, Barros AJD, Lawlor DA. Maternal education inequalities in height growth rates in early childhood: 2004 Pelotas birth cohort study. Paediatr Perinat Epidemiol 2012; 26:236-49. [PMID: 22471683 PMCID: PMC3491696 DOI: 10.1111/j.1365-3016.2011.01251.x] [Citation(s) in RCA: 22] [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] [Indexed: 11/30/2022]
Abstract
Socio-economic inequalities in attained height have been reported in many countries. The aim of this study was to explore the age at which maternal education inequalities in child height emerge among children from a middle-income country. Using data from the 2004 Pelotas cohort study from Brazil we modelled individual height growth trajectories in 2106 boys and 1947 girls from birth to 4 years using a linear spline mixed-effects model. We examined the associations of maternal education with birth length and trajectories of growth in length/height, and explored the effect of adjusting for a number of potential confounder or mediator factors. We showed linear and positive associations of maternal education with birth length and length/height growth rates at 0-3 months and 12-29/32 months with very little association at 3-12 months, particularly in boys. By age 4 years the mean height of boys was 101.06 cm (SE = 0.28) in the lowest and 104.20 cm (SE = 0.15) in the highest education category (mean difference 3.14 cm, SE = 0.32, P < 0.001). Among girls the mean height was 100.02 cm (SE = 0.27) and 103.03 cm (SE = 0.15) in the lowest and highest education categories, respectively (mean difference 3.01 cm, SE = 0.31, P < 0.001). For both boys and girls there was on average a 3-cm difference between the extreme education categories. Adjusting for maternal height reduced the observed birth length differences across maternal education categories, but differences in postnatal growth rates persisted. Our data demonstrate an increase in the absolute and relative inequality in height after birth; inequality increases from approximately 0.2 standard deviations of birth length to approximately 0.7 standard deviations of height at age 4, indicating that height inequality, which was already present at birth, widened through differential growth rates to age 2 years.
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Affiliation(s)
- Alicia Matijasevich
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, RuaMarechal Deodoro 1160, Pelotas, Brazil.
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Corsi DJ, Subramanyam MA, Subramanian SV. Commentary: Measuring nutritional status of children. Int J Epidemiol 2011; 40:1030-6. [PMID: 21724577 DOI: 10.1093/ije/dyr108] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Daniel J Corsi
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
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