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Isoyama Y, Nose-Ogura S, Ijitsu MJ, Kruse JGS, Nagai N, Kayaba M, Ogata H, Mangalam M, Kiyono K. Age- and height-dependent bias of underweight and overweight assessment standards for children and adolescents. Front Public Health 2024; 12:1379897. [PMID: 38721543 PMCID: PMC11076850 DOI: 10.3389/fpubh.2024.1379897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/03/2024] [Indexed: 05/15/2024] Open
Abstract
Background Precision in evaluating underweight and overweight status among children and adolescents is paramount for averting health and developmental issues. Existing standards for these assessments have faced scrutiny regarding their validity. This study investigates the age and height dependencies within the international standards set by the International Obesity Task Force (IOTF), relying on body mass index (BMI), and contrasts them with Japanese standards utilizing the percentage of overweight (POW). Method We scrutinized a comprehensive database comprising 7,863,520 children aged 5-17 years, sourced from the School Health Statistics Research initiative conducted by Japan's Ministry of Education, Culture, Sports, Science, and Technology. Employing the quantile regression method, we dissected the structure of weight-for-height distributions across different ages and sexes, quantifying the potentially biased assessments of underweight and overweight status by conventional criteria. Results Applying IOFT criteria for underweight assessment revealed pronounced height dependence in males aged 11-13 and females aged 10-11. Notably, a discernible bias emerged, wherein children in the lower 25th percentile were classified as underweight five times more frequently than those in the upper 25th percentile. Similarly, the overweight assessment displayed robust height dependence in males aged 8-11 and females aged 7-10, with children in the lower 25th percentile for height deemed obese four or five times more frequently than their counterparts in the upper 25th percentile. Furthermore, using the Japanese POW criteria for assessment revealed significant age dependence in addition to considerably underestimating the percentage of underweight and overweight cases under the age of seven. However, the height dependence for the POW criterion was smaller than the BMI criterion, and the difference between height classes was less than 3-fold. Conclusion Our findings underscore the intricacies of age-dependent changes in body composition during the growth process in children, emphasizing the absence of gold standards for assessing underweight and overweight. Careful judgment is crucial in cases of short or tall stature at the same age, surpassing sole reliance on conventional criteria results.
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Affiliation(s)
- Yosuke Isoyama
- Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Sayaka Nose-Ogura
- Japan High-Performance Sport Center, Department of Sports Medicine and Research, Japan Institute Sports Sciences, Tokyo, Japan
- Department of Obstetrics and Gynecology, University of Tokyo Hospital, Tokyo, Japan
| | | | | | - Narumi Nagai
- School of Human Science and Environment, University of Hyogo, Himeji, Japan
| | - Momoko Kayaba
- Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hitomi Ogata
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
| | - Madhur Mangalam
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, United States
| | - Ken Kiyono
- Graduate School of Engineering Science, Osaka University, Osaka, Japan
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Laru J, Ojaniemi M, Franks S, Järvelin MR, Korhonen E, Piltonen TT, Sebert S, Tapanainen JS, Morin-Papunen L. An optimal growth pattern during pregnancy and early childhood associates with better fertility in men. Eur J Endocrinol 2022; 187:847-858. [PMID: 36227734 PMCID: PMC9716397 DOI: 10.1530/eje-22-0385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/13/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aimed to evaluate the association between birth weight (BW), childhood and adolescent BMI, with reproductive capacity in men. DESIGN A prospective, population-based cohort study (Northern Finland birth cohort 1966). METHODS Around 6196 men born in 1966 were followed from birth to age 50 years. Weight and height were measured repeatedly by professionals. Reproductive capacity (infertility assessment, male factor infertility and infertility treatment by age 46 years) was evaluated by questionnaires at ages 31 and 46 years. The number of children by the age of 50 years was recovered from registers. After excluding the men who reported never having attempted to have children or not answering the question at age 31 or 46 years (n = 2041), 4128 men were included in the final study population. Results were adjusted for BW, BW for gestational age (GA), mother's smoking status, marital status, educational level and smoking status. RESULTS Being small for GA (10.5% vs 8.2%, P = 0.012) or having a lower BW (3495 g vs 3548 g, P = 0.003) were associated with childlessness. The association was however no longer significant after adjusting for marital status. Being underweight in early childhood was associated with an increased risk of infertility assessment (adjusted, aOR: 2.04(1.07-3.81)) and childlessness (aOR: 1.47(1.01-2.17)) compared to the normal weight group. Conversely, overweight or obesity in early childhood was associated with a decreased risk of infertility assessment (aOR: 0.60 (0.41-0.87)), treatment (aOR: 0.42 (0.25-0.70)) and male factor infertility (aOR: 0.45 (0.21-0.97)). BMI in mid-childhood or puberty had no association with infertility or childlessness. CONCLUSION In boys, an optimal growth trajectory during pregnancy and early childhood seems to be very important for life-long fertility.
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Affiliation(s)
- Johanna Laru
- Department of Obstetrics and Gynecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
| | - Marja Ojaniemi
- Department of Children and Adolescents, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
| | - Stephen Franks
- Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
- Correspondence should be addressed to S Franks;
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Department of Life Sciences, College of Health and Life Sciences, Brunel University, London, UK
- Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Elisa Korhonen
- Department of Obstetrics and Gynecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
| | - Terhi T Piltonen
- Department of Obstetrics and Gynecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
| | - Sylvain Sebert
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Juha S Tapanainen
- Department of Obstetrics and Gynecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Laure Morin-Papunen
- Department of Obstetrics and Gynecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
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Lee DS, Nitsche N, Barclay K. Body mass index in early adulthood and transition to first birth: Racial/ethnic and sex differences in the United States NLSY79 Cohort. POPULATION STUDIES 2022:1-21. [DOI: 10.1080/00324728.2022.2128396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | | | - Kieron Barclay
- Max Planck Institute for Demographic Research
- Swedish Collegium for Advanced Study
- Stockholm University
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Valge M, Meitern R, Hõrak P. Sexually antagonistic selection on educational attainment and body size in Estonian children. Ann N Y Acad Sci 2022; 1516:271-285. [PMID: 35815461 DOI: 10.1111/nyas.14859] [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: 11/29/2022]
Abstract
Natural selection is a key mechanism of evolution, which results from the differential reproduction of phenotypes. We describe fecundity selection at different parity transitions on 15 anthropometric traits and educational attainment in Estonian children sampled in the middle of 20th century. The direction of selection on educational attainment and bodily traits was sexually antagonistic, and it occurred via different parity transitions in boys and girls. Compared to boys with primary education, obtaining tertiary education was associated with 3.5 times and secondary education two times higher odds of becoming a father. Transition to motherhood was not related to educational attainment, while education above primary was associated with lower odds (OR = 0.5-0.7) to progression to parities above one and two. Selection on anthropometric traits occurred almost exclusively via childlessness in boys, while among the girls, most of the traits that were associated with becoming a mother were additionally associated with a transition from one child to higher parities. Male (but not female) fitness was thus primarily determined by traits related to mating success. Selection favored stronger and larger boys and smaller girls. Selection on girls favored some traits that associate with perceived femininity, while other feminine traits were selected against.
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Affiliation(s)
- Markus Valge
- Department of Zoology, University of Tartu, Tartu, Estonia
| | | | - Peeter Hõrak
- Department of Zoology, University of Tartu, Tartu, Estonia
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Qi X, Zhang M, Sun M, Luo D, Guan Q, Yu C. Restoring Impaired Fertility Through Diet: Observations of Switching From High-Fat Diet During Puberty to Normal Diet in Adulthood Among Obese Male Mice. Front Endocrinol (Lausanne) 2022; 13:839034. [PMID: 35518932 PMCID: PMC9063411 DOI: 10.3389/fendo.2022.839034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 03/02/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Obesity is associated with a decrease in testicular function, yet the effects and mechanisms relative to different stages of sexual development remain unclear. The aim of this study is to determine whether high-fat diet-induced obesity impairs male fertility during puberty and in adulthood, and to ascertain its underlying mechanisms. This study aims to further reveal whether restoring to a normal diet can improve impaired fertility. METHODS Male mice were divided into 6 groups: the group N and H exposed to a normal diet or high-fat diet during puberty. The group NN or NH were further maintained a normal diet or exposed to high-fat diet in adulthood, the group HH or HN were further maintained high-fat diet or switched to normal diet in adulthood. Metabolic parameters, fertility parameters, testicular function parameters, TUNEL staining and testicular function-related proteins were evaluated, respectively. RESULTS The fertility of the mice in the high-fat diet group was impaired, which validated by declines in pregnancy rates and litter weight loss. Further analysis demonstrated the increased level of oxidative stress, the increased number of spermatogenic cell apoptosis and decreased number of sperm and decreased acrosome integrity. The expression of steroidogenic acute regulatory (StAR) and spermatogenesis related proteins (WT-1) decreased. Fertility among the HN group recovered, accompanied by the recovery of metabolism, fertility and testicular function parameters, StAR and WT-1 expression. CONCLUSIONS The findings suggest that high-fat diet-induced obesity impairs male fertility during puberty and in adulthood. The loss of acrosome integrity, the increase of oxidative stress, the increase of cells apoptosis and the down-regulation of StAR and WT-1 may be the underlying mechanisms. Switching from high-fat diets during puberty to normal diets in adulthood can improve male fertility.
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Affiliation(s)
- Xiangyu Qi
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Shandong Provincial Hospital, Jinan, China
- Shandong Laboratory of Endocrinology and Lipid Metabolism, Shandong Provincial Hospital, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Shandong Provincial Hospital, Jinan, China
| | - Meijie Zhang
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Shandong Provincial Hospital, Jinan, China
- Shandong Laboratory of Endocrinology and Lipid Metabolism, Shandong Provincial Hospital, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Shandong Provincial Hospital, Jinan, China
- Jing’an District Center Hospital, Fudan University, Shanghai, China
| | - Mingqi Sun
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Shandong Provincial Hospital, Jinan, China
- Shandong Laboratory of Endocrinology and Lipid Metabolism, Shandong Provincial Hospital, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Shandong Provincial Hospital, Jinan, China
- General Practice, Jinan Forth People’s Hospital, Jinan, China
| | - Dandan Luo
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Shandong Provincial Hospital, Jinan, China
- Shandong Laboratory of Endocrinology and Lipid Metabolism, Shandong Provincial Hospital, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Shandong Provincial Hospital, Jinan, China
| | - Qingbo Guan
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Shandong Provincial Hospital, Jinan, China
- Shandong Laboratory of Endocrinology and Lipid Metabolism, Shandong Provincial Hospital, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Shandong Provincial Hospital, Jinan, China
| | - Chunxiao Yu
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Shandong Provincial Hospital, Jinan, China
- Shandong Laboratory of Endocrinology and Lipid Metabolism, Shandong Provincial Hospital, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Shandong Provincial Hospital, Jinan, China
- *Correspondence: Chunxiao Yu,
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Gottschalk MS, Eskild A, Hofvind S, Bjelland EK. The relation of number of childbirths with age at natural menopause: a population study of 310 147 women in Norway. Hum Reprod 2021; 37:333-340. [PMID: 34791235 PMCID: PMC8804328 DOI: 10.1093/humrep/deab246] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 10/15/2021] [Indexed: 11/23/2022] Open
Abstract
STUDY QUESTION Does age at natural menopause increase with increasing of number of childbirths? SUMMARY ANSWER Age at menopause increased with increasing number of childbirths up to three childbirths; however, we found no further increase in age at menopause beyond three childbirths. WHAT IS KNOWN ALREADY Pregnancies interrupt ovulation, and a high number of pregnancies have therefore been assumed to delay menopause. Previous studies have had insufficient statistical power to study women with a high number of childbirths. Thus, the shape of the association of number of childbirths with age at menopause remains unknown. STUDY DESIGN, SIZE, DURATION A retrospective population study of 310 147 women in Norway who were 50–69 years old at data collection. PARTICIPANTS/MATERIALS, SETTING, METHODS The data were obtained by two self-administered questionnaires completed by women attending BreastScreen Norway, a population-based screening program for breast cancer. The associations of number of childbirths with age at menopause were estimated as hazard ratios by applying Cox proportional hazard models, adjusting for the woman’s year of birth, cigarette smoking, educational level, country of birth, oral contraceptive use and body mass index. MAIN RESULTS AND THE ROLE OF CHANCE Women with three childbirths had the highest mean age at menopause (51.36 years; 95% CI: 51.33–51.40 years), and women with no childbirths had the lowest (50.55 years; 95% CI: 50.48–50.62 years). Thus, women with no childbirths had higher hazard ratio of reaching menopause compared to women with three childbirths (reference group) (adjusted hazard ratio, 1.24; 95% CI: 1.22–1.27). Beyond three childbirths, we estimated no further increase in age at menopause. These findings were confirmed in sub-analyses among (i) women who had never used hormonal intrauterine device and/or systemic menopausal hormonal therapy; (ii) women who were born before 1950 and (iii) women who were born in 1950 or after. LIMITATIONS, REASONS FOR CAUTION Information about age at menopause was based on self-reports. WIDER IMPLICATIONS OF THE FINDINGS If pregnancies truly delay menopause, one would expect that women with the highest number of childbirths had the highest age at menopause. Our results question the assumption that interrupted ovulation during pregnancy delays menopause. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the South-Eastern Norway Regional Health Authority [2016112 to M.S.G.] and by the Norwegian Cancer Society [6863294-2015 to E.K.B.]. The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Marthe S Gottschalk
- Correspondence address. Department of Obstetrics and Gynecology, Akershus University Hospital, PO Box 1000, N-1478 Lørenskog, Norway. Tel: +47-95926969; E-mail:
| | - Anne Eskild
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Solveig Hofvind
- Section of Mammographic Screening, Cancer Registry of Norway, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Elisabeth K Bjelland
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Laru J, Nedelec R, Koivuaho E, Ojaniemi M, Järvelin MR, Tapanainen JS, Franks S, Tolvanen M, Piltonen TT, Sebert S, Morin-Papunen L. BMI in childhood and adolescence is associated with impaired reproductive function-a population-based cohort study from birth to age 50 years. Hum Reprod 2021; 36:2948-2961. [PMID: 34364312 PMCID: PMC8643422 DOI: 10.1093/humrep/deab164] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 06/08/2021] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION What is the association between childhood and adolescent BMI and reproductive capacity in women? SUMMARY ANSWER Adolescent girls with obesity had an increased risk of infertility and childlessness in adulthood independently of their marital status or the presence of polycystic ovary syndrome (PCOS). WHAT IS KNOWN ALREADY Girls with obesity (BMI (kg/m2)>95th percentile) more often exhibit menstrual irregularities and infertility problems as compared to those with normal weight, and premenarcheal girls with obesity have an increased risk of childlessness and infertility in adulthood. Follow-up studies on the relation between childhood and adolescence growth patterns and fertility or parity throughout the reproductive life span are limited. STUDY DESIGN, SIZE, DURATION A prospective, population-based cohort study (the Northern Finland birth cohort 1966) was performed with 5889 women born in 1966 and followed from birth to age 50 years. Postal questionnaires at ages 31 and 46 years addressed questions on reproductive capacity evaluated by decreased fecundability, need for infertility assessment and treatment by 46 years of age. Childlessness and number of children by age 50 years were recovered from registers. Women who did not report ever having attempted to achieve pregnancy (n = 1507) were excluded. The final study population included 4382 women who attempted to achieve pregnancy before age 46 years. PARTICIPANTS/MATERIALS, SETTING, METHODS Data on BMI were collected by trained personnel at all stages. We assessed association with both prospectively measured BMI at various time points and with early adiposity phenotypes derived from linear mixed models including the timing and the BMI at adiposity peak (AP) and adiposity rebound (AR). Self-reported infertility assessments and treatments were assessed at ages 31 and 46 years. Data on deliveries were collected from the national birth register. Decreased fecundability was defined at age 31 years as time to achieve pregnancy over 12 months. Logistic regression analyses were conducted with adjustments for marital status, education level and smoking at age 31 years. Women with PCOS were excluded from stratification-based sensitivity analyses. Obesity at a specific age group was defined by having at least one BMI value above the 95th percentile during the related period. MAIN RESULTS AND THE ROLE OF CHANCE BMI at the age of AR (5-7 years) was not associated with fertility outcomes after adjustments, but girls with AR <5.1 years had a higher risk of remaining childless compared to girls with AR over 5.1 years (adjusted odds ratio (OR): 1.45 (1.10-1.92)). At ages 7-10 and 11-15 years, obesity was associated with decreased fecundability (adjusted OR 2.05 (1.26-3.35) and 2.04 (1.21-3.44), respectively) and a lower number of children. At age 11-15 years, both overweight and obesity were associated with a higher risk of childlessness (adjusted OR 1.56 (1.06-2.27), 1.77 (1.02-3.07), respectively), even after excluding women with PCOS. Underweight at age 11-15 years was associated with an increased risk for infertility treatment (adjusted OR 1.55 (1.02-2.36)) and a tendency for an increased risk for infertility assessment (adjusted OR 1.43 (0.97-2.10)) after excluding women with PCOS. LIMITATIONS, REASON FOR CAUTION Despite a high participation rate throughout the follow-up, some growth data for children over the different age groups were missing. Infertility outcomes were self-reported. A potential over-diagnosis of obesity may have reduced the significance of the association between childhood obesity and fertility outcomes, and the diagnosis of PCOS was self-reported. WIDER IMPLICATIONS OF THE FINDINGS This study supports previous results showing that girls with obesity in late childhood and in adolescence displayed reduced fertility and an increased risk of remaining childless in adulthood, independently of marital history and PCOS in adulthood. These findings corroborate the body of evidence for a causal relation between early adiposity and the reproductive functions in women. We recommend reinforcing the prevention of obesity in school-age girls to reduce the risk of impaired reproductive functions. STUDY FUNDING/COMPETING INTEREST(S) NFBC1966 received financial support from University of Oulu Grant no. 65354, Oulu University Hospital Grant no. 2/97, 8/97, Ministry of Health and Social Affairs Grant no. 23/251/97, 160/97, 190/97, National Institute for Health and Welfare, Helsinki Grant no. 54121, Regional Institute of Occupational Health, Oulu, Finland Grant no. 50621, 54231. The Finnish Medical Foundation, the North Ostrobothnia Regional Fund, the Academy of Finland (project grants 315921, 104781, 120315, 129269, 1114194, 24300796), Center of Excellence in Complex Disease Genetics and SALVE, the Sigrid Juselius Foundation, Biocenter Oulu, University Hospital Oulu and University of Oulu (75617), Jalmari ja Rauha Ahokkaan säätiö, The Finnish Medical Foundation, Medical Research Center Oulu, National Institute for Health Research (UK). M. R. J., S. S. and R. N. received funding by the Academy of Finland (#268336) and the European Union's Horizon 2020 research and innovation program (under Grant agreement no. 633595 for the DynaHEALTH action and GA 733206 for LifeCycle). The funders had no role in study design, in the collection, analysis and interpretation of the data, in the writing of the article and in the decision to submit it for publication. The authors have no conflict of interest to disclose. TRIAL REGISTRATION NUMBER N/A.
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Grants
- 54121 Department of Health
- Medical Research Council
- University of Oulu
- Oulu University Hospital
- Ministry of Health and Social Affairs
- National Institute for Health and Welfare, Helsinki
- Regional Institute of Occupational Health, Oulu, Finland
- The Finnish Medical Foundation, the North Ostrobothnia Regional Fund, the Academy of Finland
- Center of Excellence in Complex Disease Genetics and SALVE, the Sigrid Juselius Foundation, Biocenter Oulu, University Hospital Oulu and University of Oulu
- Jalmari ja Rauha Ahokkaan säätiö
- The Finnish Medical Foundation, Medical Research Center Oulu, National Institute for Health Research (UK)
- Academy of Finland
- European Union’s Horizon 2020 research and innovation program
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Affiliation(s)
- J Laru
- Department of Obstetrics and Gynaecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
| | - R Nedelec
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - E Koivuaho
- Department of Obstetrics and Gynaecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
| | - M Ojaniemi
- Department of Children and Adolescents, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
| | - M -R Järvelin
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK
- Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - J S Tapanainen
- Department of Obstetrics and Gynaecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - S Franks
- Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - M Tolvanen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - T T Piltonen
- Department of Obstetrics and Gynaecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
| | - S Sebert
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - L Morin-Papunen
- Department of Obstetrics and Gynaecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
- Correspondence address. PEDEGO Research Unit, Department of Obstetrics and Gynecology, Medical Research Center, Oulu University Hospital, University of Oulu, Kajaanintie 50, BOX 5000, 90014 Oulu, Finland. Tel: +358 8 3154109; E-mail: https://orcid.org/0000-0001-5987-7534
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Fang H, Guo Q, Ju L, Li S, Xu X, Piao W, Yu D, Zhao L. Weight Status and Self-Perception of Weight Among Women of Childbearing Age - China, 2015. China CDC Wkly 2021; 3:185-188. [PMID: 34595040 PMCID: PMC8393035 DOI: 10.46234/ccdcw2021.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/20/2021] [Indexed: 11/24/2022] Open
Abstract
SUMMARY What is already known about this topic? Both lean and obese women carry a risk for adverse pregnancy outcomes. Correct self-perception of body weight status is necessary for optimal weight control. What is added by this report? Data from the Nutrition and Chronic Disease Surveillance of Chinese Residents in 2015 were used in this study. The weight status and self-perception of weight among women of childbearing age in China were analyzed to provide basic data for improving the nutritional health of women of childbearing age. What are the implications for public health practice? Around 45% of women of childbearing age misperceive their body weight status. Future actions to improve body weight perception in women of childbearing age are necessary to increase the impact of public health campaigns focusing on a healthy body weight.
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Affiliation(s)
- Hongyun Fang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qiya Guo
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lahong Ju
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shujuan Li
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoli Xu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wei Piao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dongmei Yu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liyun Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
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10
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Gaskins AJ, Arvizu M, Mínguez-Alarcón L, Dadd R, Souter I, Chavarro JE. Substantial Weight Gain in Adulthood Is Associated with Lower Probability of Live Birth Following Assisted Reproduction. J Nutr 2021; 151:649-656. [PMID: 33438025 PMCID: PMC7948197 DOI: 10.1093/jn/nxaa371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/21/2020] [Accepted: 10/27/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Overweight and obesity among women have been associated with lower success of assisted reproduction technologies (ARTs). However, the relation of adolescent body weight and adult weight change to ART outcomes is not well understood. OBJECTIVE Our objective was to evaluate the associations of female BMI (in kg/m2) at 18 y and weight change from 18 y to current age with ART outcomes. METHODS We included 486 women in a prospective cohort at the Massachusetts General Hospital Fertility Center (2004-2018) who underwent 863 ART cycles. At study entry, height and weight were measured by research personnel. Women recalled their weight at 18 y. Restricted cubic splines were used to evaluate the associations between BMI at 18 y and weight change since 18 y and ART outcomes adjusting for age, race, education, smoking, and height and accounting for the correlated cycles within women. RESULTS Women had a median (range) BMI of 20.6 (14.8 to 36.4) at 18 y and 23.3 (16.1 to 45.8) at study entry. The median (range) weight change since 18 y was 7.4 kg (-12.1 to 60.1 kg). There was no association between BMI at 18 y and clinical ART outcomes. Long-term weight change had a nonlinear association with live birth such that higher weight gain since 18 y (particularly ≥15 kg) and weight loss were both associated with lower odds of live birth. The negative association between weight change and live birth was stronger in women ≥22.5 kg/m2 at 18 y such that each 10-kg increase was associated with a 30% (6%, 48%) lower odds of live birth. CONCLUSIONS Weight gain in adulthood is negatively associated with ART success, particularly among women who were heavier at 18 y. These results add to the growing literature supporting the benefits of preventing weight gain in adulthood on female fertility.
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Affiliation(s)
| | - Mariel Arvizu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lidia Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ramace Dadd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Irene Souter
- Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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11
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Canelón SP, Boland MR. A Systematic Literature Review of Factors Affecting the Timing of Menarche: The Potential for Climate Change to Impact Women's Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051703. [PMID: 32150950 PMCID: PMC7084472 DOI: 10.3390/ijerph17051703] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 01/17/2023]
Abstract
Menarche is the first occurrence of a woman’s menstruation, an event that symbolizes reproductive capacity and the transition from childhood into womanhood. The global average age for menarche is 12 years and this has been declining in recent years. Many factors that affect the timing menarche in girls could be affected by climate change. A systematic literature review was performed regarding the timing of menarche and four publication databases were interrogated: EMBASE, SCOPUS, PubMed, and Cochrane Reviews. Themes were identified from 112 articles and related to environmental causes of perturbations in menarche (either early or late), disease causes and consequences of perturbations, and social causes and consequences. Research from climatology was incorporated to describe how climate change events, including increased hurricanes, avalanches/mudslides/landslides, and extreme weather events could alter the age of menarche by disrupting food availability or via increased toxin/pollutant release. Overall, our review revealed that these perturbations in the timing of menarche are likely to increase the disease burden for women in four key areas: mental health, fertility-related conditions, cardiovascular disease, and bone health. In summary, the climate does have the potential to impact women’s health through perturbation in the timing of menarche and this, in turn, will affect women’s risk of disease in future.
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Affiliation(s)
- Silvia P. Canelón
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA ;
| | - Mary Regina Boland
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA ;
- Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, PA 19104, USA
- Center for Excellence in Environmental Toxicology, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Correspondence:
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12
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Lassek WD, Gaulin SJC. Do the Low WHRs and BMIs Judged Most Attractive Indicate Higher Fertility? EVOLUTIONARY PSYCHOLOGY 2018; 16:1474704918800063. [PMID: 30296846 PMCID: PMC10480809 DOI: 10.1177/1474704918800063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 08/20/2018] [Indexed: 12/30/2022] Open
Abstract
We examine the widely accepted view that very low waist-hip ratios and low body mass indices (BMIs) in women in well-nourished populations are judged attractive by men because these features reliably indicate superior fertility. In both subsistence and well-nourished populations, relevant studies of fertility do not support this view. Rather studies indicate lower fertility in women with anthropometric values associated with high attractiveness. Moreover, low maternal BMI predisposes to conditions that compromise infant survival. Consistent with these findings from the literature, new data from a large U.S. sample of women past reproductive age show that women with lower BMIs in the late teens had fewer live births, controlling for education, marital history, and race. They also had later menarche and earlier menopause compared with women with higher youth BMIs. In addition, data from the 2013 U.S. natality database show that mothers with lower prepregnancy BMIs have an increased risk of producing both low-birth-weight and preterm infants controlling for other relevant variables-conditions that would have adversely affected fitness over almost all of human evolution. Thus, a review of the relevant literature and three new tests fail to support the view that highly attractive women are more fertile.
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Affiliation(s)
- William D. Lassek
- Department of Anthropology, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Steven J. C. Gaulin
- Department of Anthropology, University of California at Santa Barbara, Santa Barbara, CA, USA
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13
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He Y, Tian J, Oddy WH, Dwyer T, Venn AJ. Association of childhood obesity with female infertility in adulthood: a 25-year follow-up study. Fertil Steril 2018; 110:596-604.e1. [DOI: 10.1016/j.fertnstert.2018.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/24/2018] [Accepted: 05/10/2018] [Indexed: 11/26/2022]
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14
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Jacobs MB, Bazzano LA, Pridjian G, Harville EW. Childhood adiposity and fertility difficulties: the Bogalusa Heart Study. Pediatr Obes 2017; 12:477-484. [PMID: 27350648 PMCID: PMC5589511 DOI: 10.1111/ijpo.12168] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 05/30/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Adult obesity is associated with infertility; however, childhood obesity has received little consideration. OBJECTIVES The present study sought to evaluate the impact of childhood adiposity on fertility. METHODS Associations between childhood adiposity and self-reported fertility difficulties were estimated among women participating in a long-term study of cardiovascular risks and reproductive health (n = 1061). RESULTS Participants with obesity between ages 9 and 12 were more likely to report fertility difficulties (adjusted relative risk [aRR], 1.82, 95% CI 1.17-2.82) and inability to become pregnant when trying (aRR = 1.94, 95% CI 1.22-3.08) as were those with obesity prior to age 9 (aRR = 1.76, 95% CI 1.04-2.97). Similar associations were seen among those ever overweight or obese in childhood. High subscapular skinfold thickness (age < 12) increased risk of receiving help becoming pregnant (aRR = 2.16, 95% CI 1.15-4.06), inability to become pregnant (aRR = 1.46, 95% CI 1.05-2.04) and any fertility difficulties (aRR = 1.56, 95% CI 1.13-2.14); associations for triceps skinfold were attenuated. Participants with increased adiposity also had fewer pregnancies and live births. Effects persisted, excluding women with polycystic ovarian syndrome. CONCLUSIONS This study supports an association between childhood adiposity and infertility, not solely driven by polycystic ovarian syndrome.
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Affiliation(s)
- M. B. Jacobs
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA,Department of Biostatistics and Study Methodology, Children’s National Health System, Children’s Research Institute, Washington, USA
| | - L. A. Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA
| | - G. Pridjian
- Department of Obstetrics and Gynecology, Tulane University School of Medicine, New Orleans, USA
| | - E. W. Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA
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15
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Abiad F, Awwad J, Abbas HA, Zebian D, Ghazeeri G. Management of weight loss in obesity-associated male infertility: a spotlight on bariatric surgery. HUM FERTIL 2017; 20:227-235. [PMID: 28460579 DOI: 10.1080/14647273.2017.1317369] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In recent years, there has been a paralleled increase between male obesity and infertility rates. Obesity is associated with impaired hypothalamic-pituitary-gonadal axis, aberrant semen parameters, and subfertility or infertility. Weight loss is strongly recommended for the management of obesity-associated infertility. Lifestyle modifications that include caloric restriction and increased physical activity have a short-lived impact. Bariatric surgery is a better and more durable weight loss alternative. Comprehensive information about the benefits of weight loss on obesity-associated male infertility following bariatric surgery is still emerging. In this review, we discuss the hormonal, physical and environmental mechanism contributing to obesity-associated infertility. We then assess weight loss approaches, which include lifestyle modification, medical and surgical approaches, that can improve fertility in obese men. This review focuses also on bariatric surgery for the management of obese men seeking fertility treatment. Anecdotal evidence suggesting that bariatric surgery can impair fertility is also discussed.
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Affiliation(s)
- Firass Abiad
- a Department of General Surgery , American University of Beirut Medical Center , Beirut , Lebanon
| | - Johnny Awwad
- b Department of Obstetrics and Gynecology , American University of Beirut Medical Center , Beirut , Lebanon
| | - Hussein A Abbas
- b Department of Obstetrics and Gynecology , American University of Beirut Medical Center , Beirut , Lebanon
| | - Dina Zebian
- c Department of Emergency Medicine , American University of Beirut , Beirut , Lebanon
| | - Ghina Ghazeeri
- b Department of Obstetrics and Gynecology , American University of Beirut Medical Center , Beirut , Lebanon
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16
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Coall DA, Tickner M, McAllister LS, Sheppard P. Developmental influences on fertility decisions by women: an evolutionary perspective. Philos Trans R Soc Lond B Biol Sci 2016; 371:20150146. [PMID: 27022073 DOI: 10.1098/rstb.2015.0146] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2016] [Indexed: 01/19/2023] Open
Abstract
Developmental environments are crucial for shaping our life course. Elements of the early social and biological environments have been consistently associated with reproduction in humans. To date, a strong focus has been on the relationship between early stress, earlier menarche and first child birth in women. These associations, found predominately in high-income countries, have been usefully interpreted within life-history theory frameworks. Fertility, on the other hand--a missing link between an individual's early environment, reproductive strategy and fitness--has received little attention. Here, we synthesize this literature by examining the associations between early adversity, age at menarche and fertility and fecundity in women. We examine the evidence that potential mechanisms such as birth weight, childhood body composition, risky health behaviours and developmental influences on attractiveness link the early environment and fecundity and fertility. The evidence that menarche is associated with fertility and fecundity is good. Currently, owing to the small number of correlational studies and mixed methodologies, the evidence that early adversity predicts fecundity and fertility is not conclusive. This area of research is in its infancy; studies examining early adversity and adult fertility decisions that can also examine likely biological, social and psychological pathways present opportunities for future fertility research.
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Affiliation(s)
- D A Coall
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, Western Australia, Australia
| | - M Tickner
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - L S McAllister
- Department of Anthropology, University of California, Santa Barbara, CA 93106, USA
| | - P Sheppard
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
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17
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Does the number of siblings affect health in midlife? Evidence from the Swedish Prescribed Drug Register. DEMOGRAPHIC RESEARCH 2016. [DOI: 10.4054/demres.2016.35.43] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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18
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Agirbasli M, Tanrikulu AM, Berenson GS. Metabolic Syndrome: Bridging the Gap from Childhood to Adulthood. Cardiovasc Ther 2016; 34:30-6. [PMID: 26588351 DOI: 10.1111/1755-5922.12165] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Childhood and adolescence are particularly vulnerable periods of life to the effects of cardiometabolic risk and later development of atherosclerosis, hypertension, and diabetes mellitus. Developing countries with limited resources suffer most heavily from the consequences of cardiometabolic risk in children and its future implications to the global health burden. A better understanding of mechanisms leading to cardiometabolic risk in early life may lead to more effective prevention and intervention strategies to reduce metabolic stress in children and later disease. Longitudinal "tracking" studies of cardiometabolic risk in children provide a tremendous global resource to direct prevention strategies for cardiovascular disease. In this review, we will summarize the pathophysiology, existing definitions for cardiometabolic risk components in children. Screening and identifying children and adolescents of high cardiometabolic risk and encouraging them and their families through healthy lifestyle changes should be implemented to as a global public health strategy.
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Affiliation(s)
- Mehmet Agirbasli
- Department of Cardiology, Medeniyet University Medical School, Istanbul, Turkey
| | - Azra M Tanrikulu
- Department of Cardiology, Maltepe State Hospital, Istanbul, Turkey
| | - Gerald S Berenson
- Bogalusa Heart Study, Tulane Center of Cardiovascular Health, Tulane University Health Sciences Center, New Orleans, LA, USA
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19
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Abstract
OBJECTIVE To evaluate whether weight change since age 18 years, current body mass index (BMI), and BMI at age 18 years are associated with fecundity. METHODS Our study included 1,950 women in the Nurses' Health Study 3 (2010-2014), a prospective cohort study, currently attempting pregnancy. Height, current weight, and weight at age 18 years were self-reported on the baseline questionnaire. Every 3-6 months thereafter, women reported the current duration of their pregnancy attempt. Multivariable-accelerated failure time models were used to estimate the time ratios and 95% confidence intervals (CIs). RESULTS For every 5-kg increase in body weight from age 18 years, current duration of pregnancy attempt increased by 5% (95% CI 3-7%). Compared with women who maintained weight, the adjusted median current duration was 0.5 months shorter in those who lost weight, 0.3 months longer for those who gained 4-9.9 kg and 10-19.9 kg, and 1.4 months longer for those who gained 20 kg or more (P trend ≤.001). The adjusted time ratio (95% CI) for a 5-kg/m increase in current BMI was 1.08 (1.04-1.12). After multivariable adjustment (including adjustment for current BMI), being underweight at age 18 years (BMI less than 18.5) was associated with a longer current duration of pregnancy attempt compared with normal-weight women (time ratio 1.25, 95% CI 1.07-1.47); however, being overweight or obese at age 18 years was not associated with fecundity. CONCLUSION Gaining weight in adulthood, being overweight or obese in adulthood, and being underweight at age 18 years were associated with a modest reduction in fecundity. LEVEL OF EVIDENCE II.
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20
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Stokes VJ, Anderson RA, George JT. How does obesity affect fertility in men - and what are the treatment options? Clin Endocrinol (Oxf) 2015; 82:633-8. [PMID: 25138694 DOI: 10.1111/cen.12591] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 06/02/2014] [Accepted: 08/12/2014] [Indexed: 11/29/2022]
Abstract
Adiposity is associated with reduced fertility in men. The aetiology is multifactorial, with obese men at greater risk of suffering from impaired spermatogenesis, reduced circulating testosterone levels, erectile dysfunction and poor libido. The diagnosis and treatment of reduced fertility observed in obese men therefore requires insight into the underlying pathology, which has hormonal, mechanical and psychosocial aspects. This article summarises the current epidemiological, experimental and clinical trial evidence from the perspective of a practicing clinician. The following conclusions and recommendations can be drawn: Obesity is associated with low serum testosterone concentrations, but treatment with exogenous testosterone is likely to adversely impact on fertility. It is important to discuss this with men prior to initiation of testosterone therapy. Obesity adversely affects sperm concentration and may affect sperm quality. However, whether or not weight loss will correct these factors remain to be established. Oestrogen receptor modulators (and aromatase inhibitors) are unlicensed in the treatment for male hypogonadism and/or infertility. These treatments should hence be considered experimental approach until ongoing clinical trials report their outcomes.
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Affiliation(s)
- Victoria J Stokes
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
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21
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22
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Jacobsen BK, Knutsen SF, Oda K, Fraser GE. Body mass index at age 20 and subsequent childbearing: the Adventist Health Study-2. J Womens Health (Larchmt) 2013; 22:460-6. [PMID: 23611121 DOI: 10.1089/jwh.2012.3727] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Some epidemiological, clinical, and laboratory studies suggest that underweight and obesity impact fertility. METHODS This is cross-sectional study of 33,159 North American Adventist women, who were nulliparous at age 20 years and who, as a group, have a healthy lifestyle. Logistic regression analysis was used to assess how body mass index (BMI, kg/m(2)) at age 20 was related to never becoming pregnant, never giving birth to a living child, or not giving birth to a second or third child. RESULTS A total of 4954 (15%) of the women reported never becoming pregnant (nulligravidity) and 7461 (23%) women remained nulliparous. Underweight (BMI<18.5 kg/m(2)) at age 20 was associated with approximately 13% increased risk of nulligravidity or nulliparity. Women with BMI≥32.5 kg/m(2) when aged 20 had 2.5 (95% CI: 2.0, 3.1) times increased odds of nulliparity compared to women with BMI 20-24.9 kg/m(2). Increased risk was found for all groups of overweight women (BMI≥25 kg/m(2)). However, if the women gave birth to one live child after age 20, BMI≥32.5 kg/m(2) at age 20 had less impact (OR 1.6 [95% CI: 1.2, 2.2]) on the likelihood of not delivering a second child. In women who delivered two living children, obesity at age 20 had no bearing on the odds of having a third child. CONCLUSIONS Obesity and, to a lesser extent, underweight at age 20 increases the nulliparity rate. The results underscore the importance of a healthy weight in young women.
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Affiliation(s)
- Bjarne K Jacobsen
- Department of Community Medicine, University of Tromsø, Tromsø, N-9037 Tromsø, Norway.
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23
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Kościński K. Attractiveness of women’s body: body mass index, waist–hip ratio, and their relative importance. Behav Ecol 2013. [DOI: 10.1093/beheco/art016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
Epidemiologic studies have established that cardiovascular (CV) risk factors including obesity are identifiable in childhood. Childhood risk factors are predictive of adult cardiac risk and even premature death [Franks et al. (2010) N Engl J Med 362:485-493]. In the United States, CV diseases remains the leading causes of death. In fact, heart disease has become the major cause of death worldwide, surpassing undernutrition and infectious diseases, largely related to obesity in childhood [Wang and Lobstein (2006) Int J Pediatr Obes 1:11-25]. The concept that adult heart diseases begin in childhood is an outgrowth of extensive long-term epidemiologic studies in youth, that is, the Bogalusa Heart Study [Berenson et al. (1986) Causation of cardiovascular risk factors in children: Perspectives on cardiovascular risk in early life, Raven Press Books Ltd].
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Affiliation(s)
- Gerald S Berenson
- The Tulane Center for Cardiovascular Health, Tulane University Health Sciences Center, New Orleans, Louisiana, USA.
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Updates on the relation of weight excess and reproductive function in men: sleep apnea as a new area of interest. Asian J Androl 2011; 14:77-81. [PMID: 22138900 DOI: 10.1038/aja.2011.64] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Obesity has a negative effect on male reproductive function. It is associated with low testosterone levels and alteration in gonadotropin secretion. Male obesity has been linked to reduced male fertility. Data regarding the relation of obesity to sperm parameters are conflicting in terms of the nature and magnitude of the effect. New areas of interest are emerging that can help explain the variation in study results, such as genetic polymorphism and sleep apnea. Sleep disorders have been linked to altered testosterone production and hypogonadism in men. It was also correlated to erectile dysfunction. The relation of sleep disorders to male fertility and sperm parameters remains to be investigated. Men with hypogonadism and infertility should be screened for sleep apnea. Treatment of obesity and sleep apnea improves testosterone levels and erectile function.
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Skjærvø GR, Bongard T, Viken Å, Stokke BG, Røskaft E. Wealth, status, and fitness: a historical study of Norwegians in variable environments. EVOL HUM BEHAV 2011. [DOI: 10.1016/j.evolhumbehav.2010.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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27
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Bakos HW, Henshaw RC, Mitchell M, Lane M. Paternal body mass index is associated with decreased blastocyst development and reduced live birth rates following assisted reproductive technology. Fertil Steril 2011; 95:1700-4. [DOI: 10.1016/j.fertnstert.2010.11.044] [Citation(s) in RCA: 170] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Revised: 11/11/2010] [Accepted: 11/11/2010] [Indexed: 11/27/2022]
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Berenson GS, Agirbasli M, Nguyen QM, Chen W, Srinivasan SR. Glycemic status, metabolic syndrome, and cardiovascular risk in children. Med Clin North Am 2011; 95:409-17, ix. [PMID: 21281842 DOI: 10.1016/j.mcna.2010.11.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The metabolic syndrome and adult manifestation of prediabetes and diabetes are major public health problems that begin in childhood. Prevention must be considered as a serious public health issue. Health education and health promotion of school children needs incorporation as a community effort.
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Affiliation(s)
- Gerald S Berenson
- Tulane Center for Cardiovascular Health, Tulane University Health Sciences Center, 1440 Canal Street, Suite 1829, New Orleans, LA 70112, USA.
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Schooling CM, Jiang C, Zhang W, Lam TH, Cheng KK, Leung GM. Size Does Matter: Adolescent Build and Male Reproductive Success in the Guangzhou Biobank Cohort Study. Ann Epidemiol 2011; 21:56-60. [DOI: 10.1016/j.annepidem.2010.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Revised: 05/17/2010] [Accepted: 05/19/2010] [Indexed: 10/19/2022]
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30
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Chavarro JE, Toth TL, Wright DL, Meeker JD, Hauser R. Body mass index in relation to semen quality, sperm DNA integrity, and serum reproductive hormone levels among men attending an infertility clinic. Fertil Steril 2010; 93:2222-31. [PMID: 19261274 PMCID: PMC2864498 DOI: 10.1016/j.fertnstert.2009.01.100] [Citation(s) in RCA: 285] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2008] [Revised: 12/15/2008] [Accepted: 01/09/2009] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To examine the association between body weight and measures of male reproductive potential. DESIGN Cross-sectional study. SETTING Fertility clinic in an academic medical center. PATIENT(S) Four hundred eighty-three male partners of subfertile couples. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Standard semen analysis, sperm DNA fragmentation, and serum levels of reproductive hormones. RESULT(S) As expected, body mass index (BMI) was positively related to estradiol levels and inversely related to total testosterone and sex hormone-binding glogulin (SHBG) levels. There was also a strong inverse relation between BMI and inhibin B levels and a lower testosterone:LH ratio among men with a BMI > or = 35 kg/m(2). Body mass index was unrelated to sperm concentration, motility, or morphology. Ejaculate volume decreased steadily with increasing BMI levels. Further, men with BMI > or = 35 kg/m(2) had a lower total sperm count (concentration x volume) than normal weight men (adjusted difference in the median [95% confidence interval] = -86 x 10(6) sperm [-134, -37]). Sperm with high DNA damage were significantly more numerous in obese men than in normal-weight men. CONCLUSION(S) These data suggest that despite major differences in reproductive hormone levels with increasing body weight, only extreme levels of obesity may negatively influence male reproductive potential.
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Affiliation(s)
- Jorge E Chavarro
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
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McAllister EJ, Dhurandhar NV, Keith SW, Aronne LJ, Barger J, Baskin M, Benca RM, Biggio J, Boggiano MM, Eisenmann JC, Elobeid M, Fontaine KR, Gluckman P, Hanlon EC, Katzmarzyk P, Pietrobelli A, Redden DT, Ruden DM, Wang C, Waterland RA, Wright SM, Allison DB. Ten putative contributors to the obesity epidemic. Crit Rev Food Sci Nutr 2009; 49:868-913. [PMID: 19960394 PMCID: PMC2932668 DOI: 10.1080/10408390903372599] [Citation(s) in RCA: 431] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The obesity epidemic is a global issue and shows no signs of abating, while the cause of this epidemic remains unclear. Marketing practices of energy-dense foods and institutionally-driven declines in physical activity are the alleged perpetrators for the epidemic, despite a lack of solid evidence to demonstrate their causal role. While both may contribute to obesity, we call attention to their unquestioned dominance in program funding and public efforts to reduce obesity, and propose several alternative putative contributors that would benefit from equal consideration and attention. Evidence for microorganisms, epigenetics, increasing maternal age, greater fecundity among people with higher adiposity, assortative mating, sleep debt, endocrine disruptors, pharmaceutical iatrogenesis, reduction in variability of ambient temperatures, and intrauterine and intergenerational effects as contributing factors to the obesity epidemic are reviewed herein. While the evidence is strong for some contributors such as pharmaceutical-induced weight gain, it is still emerging for other reviewed factors. Considering the role of such putative etiological factors of obesity may lead to comprehensive, cause specific, and effective strategies for prevention and treatment of this global epidemic.
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Affiliation(s)
- Emily J McAllister
- Department of Infections and Obesity, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA.
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Semen quality and reproductive hormones according to birthweight and body mass index in childhood and adult life: two decades of follow-up. Fertil Steril 2009; 94:610-8. [PMID: 19328465 DOI: 10.1016/j.fertnstert.2009.01.142] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2008] [Revised: 01/12/2009] [Accepted: 01/21/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the association between childhood body mass index (BMI), birth weight, and adulthood BMI, and adult semen quality and level of reproductive hormones. DESIGN Follow-up study. SETTING From a pregnancy cohort established in 1984-1987. PATIENT(S) 347 out of 5,109 sons were selected for a study conducted 2005 to 2006. INTERVENTION(S) Semen and blood samples were related to information on BMI in boys (5-8 years), birth weight, and adult BMI. MAIN OUTCOME MEASURE(S) Semen characteristics and reproductive hormones. RESULT(S) Neither childhood BMI, birth weight, nor adulthood BMI were significantly associated with semen quality. Men with the 33% highest childhood BMI had 15% lower sex hormone binding globulin, 8% lower testosterone, and 16% lower FSH than men with the 33% lowest childhood BMI. Men with high adulthood BMI had 14% lower testosterone, 9% lower inhibin B, 31% lower sex hormone binding globulin, and 20% higher estradiol than men with low adulthood BMI. CONCLUSION(S) The results do not indicate an effect of childhood BMI, birth weight, or adult BMI on semen quality, but the exposure contrast in our study was limited. The hormonal status was affected by adult BMI.
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Urban/rural differences in body weight: Evidence for social selection and causation hypotheses in Finland. Soc Sci Med 2009; 68:867-75. [DOI: 10.1016/j.socscimed.2008.12.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2007] [Indexed: 11/20/2022]
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Hoeger K, Davidson K, Kochman L, Cherry T, Kopin L, Guzick DS. The impact of metformin, oral contraceptives, and lifestyle modification on polycystic ovary syndrome in obese adolescent women in two randomized, placebo-controlled clinical trials. J Clin Endocrinol Metab 2008; 93:4299-306. [PMID: 18728175 PMCID: PMC2582568 DOI: 10.1210/jc.2008-0461] [Citation(s) in RCA: 164] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
CONTEXT Polycystic ovary syndrome (PCOS) presents in adolescence, and obesity is a common finding. The benefits and risks of alternate approaches to the management of PCOS in obese adolescent women are not clear. OBJECTIVE We investigated the effects of metformin, oral contraceptives (OCs), and/or lifestyle modification in obese adolescent women with PCOS. DESIGN Two small, randomized, placebo-controlled clinical trials were performed. PATIENTS AND PARTICIPANTS A total of 79 obese adolescent women with PCOS participated. INTERVENTIONS In the single treatment trial, subjects were randomized to metformin, placebo, a lifestyle modification program, or OC. In the combined treatment trial, all subjects received lifestyle modification and OC and were randomized to metformin or placebo. MAIN OUTCOME MEASURES Serum concentrations of androgens and lipids were measured. RESULTS Lifestyle modification alone resulted in a 59% reduction in free androgen index with a 122% increase in SHBG. OC resulted in a significant decrease in total testosterone (44%) and free androgen index (86%) but also resulted in an increase in C-reactive protein (39.7%) and cholesterol (14%). The combination of lifestyle modification, OC, and metformin resulted in a 55% decrease in total testosterone, as compared to 33% with combined treatment and placebo, a 4% reduction in waist circumference, and a significant increase in HDL (46%). CONCLUSIONS In these preliminary trials, both lifestyle modification and OCs significantly reduce androgens and increase SHBG in obese adolescents with PCOS. Metformin, in combination with lifestyle modification and OC, reduces central adiposity, reduces total testosterone, and increases HDL, but does not enhance overall weight reduction.
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Affiliation(s)
- Kathleen Hoeger
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 668, Rochester, New York 14642, USA.
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Jokela M, Elovainio M, Kivimäki M. Lower fertility associated with obesity and underweight: the US National Longitudinal Survey of Youth. Am J Clin Nutr 2008; 88:886-93. [PMID: 18842772 DOI: 10.1093/ajcn/88.4.886] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND It has been hypothesized that body weight predicts the number of children that a person will have: obese and underweight persons are hypothesized to have fewer children than do their normal-weight counterparts. OBJECTIVE We aimed to prospectively examine the association between body weight in young adulthood and achieved fertility in later life. DESIGN A representative national sample of 12 073 American young adults (aged 17-24 y in 1981) were followed through 2004 (19 survey waves of the National Longitudinal Survey of Youth). RESULTS Obese young women and men were less likely to have their first child by the age of 47 y than were their normal-weight counterparts [relative risk (RR) = 0.69; 95% CI: 0.61, 0.78 in women; RR = 0.75; 95% CI: 0.66, 0.84 in men). Obesity also predicted a lower probability of having more than one child, particularly for women. These associations were partly explained by a lower probability that obese participants will marry. Underweight men were less likely to have the first, second, third, and fourth child than were normal-weight men (RRs = 0.75-0.88; 95% CIs: 0.61, 0.95). These associations were largely explained by the lower marriage probability of underweight men. Obese women and men and underweight men were less likely to have as many children in adulthood as they had desired as young adults. CONCLUSIONS Obesity may be an important risk factor for lower fertility because of its social and possibly biological effect on reproductive behavior. Further data are needed to assess whether this association holds in more recent cohorts.
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Affiliation(s)
- Markus Jokela
- Department of Epidemiology and Public Health, University College London, London, UK.
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