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Ma R, Wang P, Zhu Y, Zhang L, Yang D, Xu M, Shao Z, Zhu P. Prenatal exposure to PM 2.5 and its composition on child growth trajectories in the first two years: A Prospective Birth Cohort Study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024:124896. [PMID: 39241954 DOI: 10.1016/j.envpol.2024.124896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 09/01/2024] [Accepted: 09/03/2024] [Indexed: 09/09/2024]
Abstract
The findings on the relationship between prenatal exposure to particulate matter with aerodynamic diameter ≤2.5 μm (PM2.5) and its constituent and children's growth trajectories are inconsistent. This association's sensitive exposure time window and possible gender differences remain unclear. Our aim was to determine the association between prenatal exposure to PM2.5 and its component and children's growth trajectories by the age of two. From 2015 to 2021, 6407 mother-infant pairs were enrolled in the study. The PM2.5 include sulfate (SO42-), nitrate (NO3-), ammonium (NH4+), organic matter (OM), and black carbon (BC), from the ChinaHighAirPollutants (CHAP) datasets. Children were followed at birth, 1, 3, 6, 9, 12, 18, and 24 months. Population-based and individual-based methods were used to simulate child growth trajectories: slow growth, normal growth, and rapid growth. The distributed lags modeling was used to identify sensitive time windows for the effects of prenatal exposure to PM2.5 and its components on child growth. Sex-stratified analyses estimated sex differences. Median concentrations [interquartile ranges (IQRs)] were 57.46(17.3), 10.59(3.8), 14.26(4.4), 8.69(2.8), 13.05(3.4), and 2.53(0.7) μg/m3 for PM2.5, SO42-, NO3-, NH4+, OM, and BC, respectively. Compared with the normal growth trajectory group, exposure to PM2.5 was significantly associated with a higher risk of rapid growth trajectory in boys (ORs with 95% CI for the entire, first trimester, and second trimester of pregnancy, respectively: 1.016[1.006,1.025], 1.007[1.002,1.011], 1.007[1.002,1.011]). Exposure to PM2.5 was significantly associated with a higher risk of slow growth trajectory in girls (ORs with 95% CI for the entire, second trimester, and third trimester of pregnancy, respectively: 1.010 [1.001,1.018], 1.006 [1.001,1.011], 1.007 [1.002,1.012]). Prenatal PM2.5 and its composition exposure was positively associated with BMI peak in boys (βs with 95% CI for PM2.5, SO42-, NO3-, NH4+, OM, BC: 0.004[0.000,0.007], 0.025[0.006,0.044], 0.012[0.002,0.023], 0.022[0.004,0.039], 0.016[0.001,0.031], 0.082[0.005,0.159]), and not statistically significant in girls. We observed a more pronounced BC effect in our cohort. Prenatal exposure to PM2.5 and its component, especially at 10-22 weeks of gestation, is associated with a higher risk of rapid growth in boys and a risk of slow growth in girls.
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Affiliation(s)
- Ruirui Ma
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Center for Big Data and Population Health of IHM, Anhui MedicalUniversity, Hefei 230032, Anhui,China; Anhui Provincial Key Laboratory of Population Health and Aristogenic, Anhui Medical University, Hefei, China
| | - Peng Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Center for Big Data and Population Health of IHM, Anhui MedicalUniversity, Hefei 230032, Anhui,China; Anhui Provincial Key Laboratory of Population Health and Aristogenic, Anhui Medical University, Hefei, China
| | - Yuanyuan Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Center for Big Data and Population Health of IHM, Anhui MedicalUniversity, Hefei 230032, Anhui,China; Anhui Provincial Key Laboratory of Population Health and Aristogenic, Anhui Medical University, Hefei, China
| | - Lei Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Center for Big Data and Population Health of IHM, Anhui MedicalUniversity, Hefei 230032, Anhui,China; Anhui Provincial Key Laboratory of Population Health and Aristogenic, Anhui Medical University, Hefei, China
| | - Dongjian Yang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Min Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Center for Big Data and Population Health of IHM, Anhui MedicalUniversity, Hefei 230032, Anhui,China; Anhui Provincial Key Laboratory of Population Health and Aristogenic, Anhui Medical University, Hefei, China
| | - Ziyu Shao
- Hefei City Maternal and Child Health & Family Planning Service Center, Hefei, China.
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Center for Big Data and Population Health of IHM, Anhui MedicalUniversity, Hefei 230032, Anhui,China; Anhui Provincial Key Laboratory of Population Health and Aristogenic, Anhui Medical University, Hefei, China.
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Astono J, Poulsen KO, Larsen RA, Jessen EV, Sand CB, Rasmussen MA, Sundekilde UK. Metabolic maturation in the infant urine during the first 3 months of life. Sci Rep 2024; 14:5697. [PMID: 38459082 PMCID: PMC10924096 DOI: 10.1038/s41598-024-56227-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/04/2024] [Indexed: 03/10/2024] Open
Abstract
The infant urine metabolome provides a body metabolic snapshot, and the sample collection can be done without stressing the fragile infant. 424 infant urine samples from 157 infants were sampled longitudinally at 1-, 2-, and 3 months of age. 49 metabolites were detected using proton nuclear magnetic resonance spectroscopy. Data were analyzed with multi- and univariate statistical methods to detect differences related to infant age-stage, gestational age, mother's pre-pregnancy BMI, C-section, infant birth weight, and infant sex. Significant differences were identified between age-stage (pbonferoni < 0.05) in 30% (15/49) of the detected metabolites. Urine creatinine increased significantly from 1 to 3 months. In addition, myo-inositol, taurine, methionine, and glucose seem to have conserved levels within the individual over time. We calculated a urine metabolic maturation age and found that the metabolic age at 3 months is negatively correlated to weight at 1 year. These results demonstrate that the metabolic maturation can be observed in urine metabolome with implications on infant growth and specifically suggesting that the systematic age effect on creatinine promotes caution in using this as normalization of other urine metabolites.
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Affiliation(s)
- Julie Astono
- Department of Food Science, Aarhus University, Agro Food Park 48, Aarhus N, Denmark.
| | - Katrine O Poulsen
- Department of Food Science, Aarhus University, Agro Food Park 48, Aarhus N, Denmark
- Sino-Danish Center, Niels Jensens Vej 2, Building 1190, Aarhus, Denmark
| | - Rikke A Larsen
- Department of Food Science, Aarhus University, Agro Food Park 48, Aarhus N, Denmark
| | - Emma V Jessen
- Department of Food Science, Aarhus University, Agro Food Park 48, Aarhus N, Denmark
| | - Chatrine B Sand
- Department of Food Science, Aarhus University, Agro Food Park 48, Aarhus N, Denmark
| | - Morten A Rasmussen
- Department of Food Science, University of Copenhagen, Rolighedsvej 26, Frederiksberg, Denmark
- COPSAC, Herlev-Gentofte Hospital, Ledreborg Alle 28, Gentofte, Denmark
| | - Ulrik K Sundekilde
- Department of Food Science, Aarhus University, Agro Food Park 48, Aarhus N, Denmark.
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Czarnobay SA, Kroll C, Corrêa CB, Mastroeni SSBS, Mastroeni MF. Predictors of excess body weight concurrently affecting mother-child pairs: a 6 year follow-up. J Public Health (Oxf) 2023; 45:e10-e21. [PMID: 34977946 DOI: 10.1093/pubmed/fdab399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 11/04/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We examined the predictors of excess body weight (EBW) concurrently affecting mother-child pairs after delivery during 6 years of follow-up. METHODS Prospective cohort study conducted on 435 mother-child pairs. Data were collected at four time points: at birth in the maternity hospital; 1-2 years old, 4-5 years old and 6 years old at the participant's home. Poisson regression analysis was used to examine the predictors of maternal-child EBW: mothers with excessive gestational weight gain (GWG) and large-for-gestational age (LGA) baby (>90th percentile) at baseline and mothers with body mass index (BMI) ≥ 25 kg/m2 and a child > 85th percentile. RESULTS The adjusted analysis showed that the risk of mother-child pairs concurrently having EBW increased with increasing pre-pregnancy BMI (RR = 2.4 and RR = 3.3 for pre-pregnancy BMI 25-30 and ≥30 kg/m2, respectively, P < 0.01). Excessive GWG and LGA infants were also significant predictors of EBW concurrently affecting mother-child pairs (RR = 2.2 and RR = 2.3, respectively, P < 0.01). CONCLUSION Excessive pre-pregnancy BMI, excessive GWG and LGA status were strong predictors of EBW concurrently affecting mother-child pairs over 6 years of follow-up. Public policies must be established primarily before/during pregnancy to avoid an EBW cycle in the same family over the years.
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Affiliation(s)
- Sandra Ana Czarnobay
- Postgraduate Program in Health and Environment, University of Joinville Region - UNIVILLE, Joinville, Santa Catarina, CEP 89.219-710, Brazil
| | - Caroline Kroll
- Postgraduate Program in Health and Environment, University of Joinville Region - UNIVILLE, Joinville, Santa Catarina, CEP 89.219-710, Brazil
| | - Cecília Burigo Corrêa
- Postgraduate Program in Health and Environment, University of Joinville Region - UNIVILLE, Joinville, Santa Catarina, CEP 89.219-710, Brazil
| | - Silmara S B S Mastroeni
- Department of Health Sciences, University of Joinville Region - UNIVILLE, Joinville, Santa Catarina, CEP 89.219-710, Brazil
| | - Marco F Mastroeni
- Postgraduate Program in Health and Environment, University of Joinville Region - UNIVILLE, Joinville, Santa Catarina, CEP 89.219-710, Brazil.,Department of Health Sciences, University of Joinville Region - UNIVILLE, Joinville, Santa Catarina, CEP 89.219-710, Brazil
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Floyd B, Battles HT, White S, Loch C, McFarlane G, Guatelli-Steinberg D, Mahoney P. Longitudinal changes in juvenile and adolescent body mass indices before, during, and after the COVID-19 lockdown in New Zealand. Am J Hum Biol 2023; 35:e23861. [PMID: 36642922 DOI: 10.1002/ajhb.23861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE This study uses longitudinal data from school children in Dunedin, New Zealand, to evaluate impacts of COVID-19 lockdown measures on changes in body mass (BMI, kg/m2 ). Impacts are assessed using two non-mutually exclusive hypotheses. The "structured days" hypothesis holds that children tend to alter sleep patterns, reduce activity and increase snacking when not in structured environments. The bidirectional hypothesis proposes that over-weight or obese children are predisposed to further gains in unstructured settings. METHODS Juveniles and adolescents (n = 95, 60% female) were recruited from Dunedin schools. Repeated measures analyses assessed variation in intra-individual change in BMI during four periods: P1 (before summer break), P2 (during summer break), P3 (during the COVID-19 lockdown), and P4 (after the lockdown ended). The model also examined if these changes were influenced by participants' sex or body size early in the first period assessed using log-transformed BMI, log-transformed weight, height, or lower leg length. RESULTS Repeated measures analyses of per month gains in BMI (kg/m2 ) during the four periods revealed consistent period (p ≤ .001), period by sex (p ≤ .010), and period by body size (p ≤ .001) interactions across all four body size proxies. Both sexes experienced the greatest gains during the lockdown (P3), but differed in response to their summer break (P2). CONCLUSION Results are mostly consistent with the "structured days" hypothesis, but challenge the bidirectional hypothesis as defined. Further research better characterizing risks of gains in adiposity are needed.
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Affiliation(s)
- Bruce Floyd
- School of Social Sciences, University of Auckland, New Zealand
| | | | - Sophie White
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Carolina Loch
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Gina McFarlane
- School of Anthropology and Conservation, University of Kent, Canterbury, UK
| | | | - Patrick Mahoney
- School of Anthropology and Conservation, University of Kent, Canterbury, UK
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Welten M, Wijga AH, Hamoen M, Gehring U, Koppelman GH, Twisk JW, Raat H, Heymans MW, de Kroon ML. Dynamic prediction model to identify young children at high risk of future overweight: Development and internal validation in a cohort study. Pediatr Obes 2020; 15:e12647. [PMID: 32400070 PMCID: PMC7507129 DOI: 10.1111/ijpo.12647] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 02/08/2020] [Accepted: 04/02/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Primary prevention of overweight is to be preferred above secondary prevention, which has shown moderate effectiveness. OBJECTIVE To develop and internally validate a dynamic prediction model to identify young children in the general population, applicable at every age between birth and age 6, at high risk of future overweight (age 8). METHODS Data were used from the Prevention and Incidence of Asthma and Mite Allergy birth cohort, born in 1996 to 1997, in the Netherlands. Participants for whom data on the outcome overweight at age 8 and at least three body mass index SD scores (BMI SDS) at the age of ≥3 months and ≤6 years were available, were included (N = 2265). The outcome of the prediction model is overweight (yes/no) at age 8 (range 7.4-10.5 years), defined according to the sex- and age-specific BMI cut-offs of the International Obesity Task Force. RESULTS After backward selection in a Generalized Estimating Equations analysis, the prediction model included the baseline predictors maternal BMI, paternal BMI, paternal education, birthweight, sex, ethnicity and indoor smoke exposure; and the longitudinal predictors BMI SDS, and the linear and quadratic terms of the growth curve describing a child's BMI SDS development over time, as well as the longitudinal predictors' interactions with age. The area under the curve of the model after internal validation was 0.845 and Nagelkerke R2 was 0.351. CONCLUSIONS A dynamic prediction model for overweight was developed with a good predictive ability using easily obtainable predictor information. External validation is needed to confirm that the model has potential for use in practice.
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Affiliation(s)
- Marieke Welten
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research InstituteVU University Medical CenterAmsterdamThe Netherlands
| | - Alet H. Wijga
- Centre for Prevention and Health Services ResearchNational Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
| | - Marleen Hamoen
- Department of Public Health, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences (IRAS)Utrecht UniversityUtrechtThe Netherlands
| | - Gerard H. Koppelman
- Groningen Research Institute for Asthma and COPDUniversity of GroningenGroningenThe Netherlands,Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's HospitalUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
| | - Jos W.R. Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research InstituteVU University Medical CenterAmsterdamThe Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Martijn W. Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research InstituteVU University Medical CenterAmsterdamThe Netherlands
| | - Marlou L.A. de Kroon
- Department of Public Health, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands,Department of Health Sciences, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
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6
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Vlasblom E, van Grieken A, Beltman M, L’Hoir MP, Raat H, Boere-Boonekamp MM. Parenting support to prevent overweight during regular well-child visits in 0-3 year old children (BBOFT+ program), a cluster randomized trial on the effectiveness on child BMI and health behaviors and parenting. PLoS One 2020; 15:e0237564. [PMID: 32810194 PMCID: PMC7437453 DOI: 10.1371/journal.pone.0237564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 07/28/2020] [Indexed: 01/22/2023] Open
Abstract
Background Prevention of overweight during early childhood seems promising. Objective To evaluate the effectiveness of the parenting-based BBOFT+ overweight prevention program on child BMI, child health behavior and parenting behavior among 0–36 month old children. BBOFT+ is an acronym for the key healthy lifestyle behaviors that are targeted in the BBOFT+ intervention: breastfeeding (B), daily breakfast (B), daily going outdoors (O), limiting sweet beverages (in Dutch, F) and minimal TV or computer time (T), complemented with healthy sleep behavior and improvement of parenting skills (+). Methods A cluster randomized controlled trial in newborn children visiting well-baby clinics, comparing the BBOFT+ intervention (N = 901) with care as usual (CAU) (N = 1094). In both groups, parents received regular well-child visits (±11 visits in the first 3 years). In the intervention group, care was supplemented with the BBOFT+ program, which focuses on improving parenting skills from birth onwards to increase healthy behavior. Questionnaires were filled in at child's age 2–4 weeks, 6, 14 and 36 months. In multivariate analyses we corrected for child’s birthweight, age, ethnic background, mother’s educational level and BMI. Results No differences were found in weight status at 36 months between intervention and control group children. At 6 months, BBOFT+ parents reported their child drinking less sweet beverages than control parents (48% vs 54%;p = .027), and going outdoors daily with their child less often (57% vs 62%;p = .03). At 14 months, more BBOFT+ parents than control parents reported to have breastfed for six months or longer (32% vs 29%;p = .022). At 36 months, more BBOFT+ parents than control parents reported their child going outside daily (78% vs 72%;p = .011) and having less TV/computer time on week- (38% vs 46%;p = .001) and weekend days (48% vs 56%;p = .002). Also, BBOFT+ parents reported having more parental control than control parents (3.92 vs 3.89;p = .02). No significant differences were found for daily breakfast, sleep duration and parenting practices in adjusted analyses. Conclusion The BBOFT+ overweight prevention program showed small improvements in parent-reported child health behaviors, compared to care as usual; no effect was observed on child BMI. The identified modifiable elements are potentially relevant for interventions that aim to prevent overweight.
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Affiliation(s)
- Eline Vlasblom
- Department of Child Health, TNO, Leiden, The Netherlands
- * E-mail:
| | - Amy van Grieken
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Maaike Beltman
- Department of Child Health, TNO, Leiden, The Netherlands
| | - Monique P. L’Hoir
- Department of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
- Department of Public Health Services of North- and East-Gelderland (GGDNOG), Warnsveld, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Magda M. Boere-Boonekamp
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands
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Larsson MW, Lind MV, Larnkjær A, Due AP, Blom IC, Wells J, Lai CT, Mølgaard C, Geddes DT, Michaelsen KF. Excessive Weight Gain Followed by Catch-Down in Exclusively Breastfed Infants: An Exploratory Study. Nutrients 2018; 10:E1290. [PMID: 30213080 PMCID: PMC6164044 DOI: 10.3390/nu10091290] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/07/2018] [Accepted: 09/10/2018] [Indexed: 12/14/2022] Open
Abstract
Some infants experience excessive weight gain (EWG) during exclusive breastfeeding, but causes and consequences are unknown. The objective was to identify factors associated with early EWG. Infants with EWG (HW-group) were examined at 5, 9 and 18 mo and compared to a breastfed group with normal weight gain (NW-group). Anthropometry, body composition, milk and blood samples, and milk intake were measured. Mean body-mass-index-for-age z-scores (BAZ) increased 1.93 from birth to 5 mo in the HW-group (n = 13) while the NW-group (n = 17) was unchanged (-0.01). The HW-group had 70% more fat mass at 5 mo, and then showed marked catch-down in BAZ from 5 to 18 mo (-0.84). Milk intake at 5⁻6 mo did not differ between the groups. In the HW-group milk-leptin was lower at 5 mo and serum-leptin was considerably higher at 5 and 9 mo compared to the NW-group. Serum-leptin at 5 mo was positively associated with weight-for-age z-score (WAZ) and fat mass and negatively with WAZ change from 5 to 9 mo. In conclusion, breastfed infants with EWG had catch-down growth when other foods were introduced. Low milk-leptin in the HW-group may have stimulated appetite and milk intake when weight gain was high. High serum-leptin in the HW-group suggests early leptin resistance, which could impact cerebral regulation of energy intake. Larger studies are needed to confirm these results.
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Affiliation(s)
- Melanie W Larsson
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark.
- Department of Nursing and Nutrition, University College Copenhagen, Sigurdsgade 26, 2200 N, Copenhagen, Denmark.
| | - Mads V Lind
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark.
| | - Anni Larnkjær
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark.
| | - Anette P Due
- Department of Nursing and Nutrition, University College Copenhagen, Sigurdsgade 26, 2200 N, Copenhagen, Denmark.
| | - Irina C Blom
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark.
| | - Jonathan Wells
- UCL Institute of Child Health, University College London, 30 Guilford St, London WC1N 1EH, UK.
| | - Ching T Lai
- School of molecular Sciences, University of Western Australia, 35 Stirling Hwy, Crawley WA 6009, Australia.
| | - Christian Mølgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark.
| | - Donna T Geddes
- School of molecular Sciences, University of Western Australia, 35 Stirling Hwy, Crawley WA 6009, Australia.
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark.
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Complementary food - important components of the child’s ration: effects on health and ways of optimization. ACTA ACUST UNITED AC 2018. [DOI: 10.17816/ped9222-29] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Relevance of the research. Timing, order and sequence of complementary feeding remain the subject of discussion until now. The aim of the study. Estimate influence of different outlines of introduction of complementary foods on nutritional status and food behavior in children of first year of life.
Materials and methods. Examined 96 children in age of 4-6 months during introduction of complementary foods. Main group – 50 children (27 breast-feed (BF) children and 23 on milk formulas (MF)), in whose diet were introduced only complementary foods, which were made in special factories. Comparison group – 46 children (33 – BF and 13 – MF) received complementary foods made at home and in special factories. Duration of follow-up was 3 months. Physical examination, mother’s diary analysis, evaluation of tolerance of complementary foods, bacteriological examination of feces.
Results. On the background of introduction of complementary foods in the main group, increased the number of children with normal fatness (BF from 66.8% to 74.2%, MF from 82.7 to 88.4%), in comparison group, their number decreased (BF from 84.8% to 78.8%, MF from 69.3 to 62.3%). In the main group when a child refuses a product, mother continues offer it insistently. 61.5% of children began to eat unloved product at the end of first year of life. In comparison group, where mother changed unloved product at once, only 25% of children began to relate to it positively. In the main group dyspeptic disorders were mild in 4% of children. In in comparison group prevailed diarrheal syndrome, related to contamination with pathogenic strains of E. coli in 13% of children.
Conclusions. Using of industrial made complimentary foods according to the optimal order, with determined mothers perseverance provides equalization of fatness, allows to form a correct food behavior and decreases risk of intestinal colonization by pathogenic microorganisms.
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Leung M, Perumal N, Mesfin E, Krishna A, Yang S, Johnson W, Bassani DG, Roth DE. Metrics of early childhood growth in recent epidemiological research: A scoping review. PLoS One 2018; 13:e0194565. [PMID: 29558499 PMCID: PMC5860780 DOI: 10.1371/journal.pone.0194565] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 03/06/2018] [Indexed: 11/18/2022] Open
Abstract
Metrics to quantify child growth vary across studies of the developmental origins of health and disease. We conducted a scoping review of child growth studies in which length/height, weight or body mass index (BMI) was measured at ≥ 2 time points. From a 10% random sample of eligible studies published between Jan 2010-Jun 2016, and all eligible studies from Oct 2015-June 2016, we classified growth metrics based on author-assigned labels (e.g., 'weight gain') and a 'content signature', a numeric code that summarized the metric's conceptual and statistical properties. Heterogeneity was assessed by the number of unique content signatures, and label-to-content concordance. In 122 studies, we found 40 unique metrics of childhood growth. The most common approach to quantifying growth in length, weight or BMI was the calculation of each child's change in z-score. Label-to-content discordance was common due to distinct content signatures carrying the same label, and because of instances in which the same content signature was assigned multiple different labels. In conclusion, the numerous distinct growth metrics and the lack of specificity in the application of metric labels challenge the integration of data and inferences from studies investigating the determinants or consequences of variations in childhood growth.
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Affiliation(s)
- Michael Leung
- Research Institute and Centre for Global Child Health, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Canada
| | - Nandita Perumal
- Research Institute and Centre for Global Child Health, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Elnathan Mesfin
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Aditi Krishna
- Research Institute and Centre for Global Child Health, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Canada
| | - Seungmi Yang
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, United Kingdom
| | - Diego G. Bassani
- Research Institute and Centre for Global Child Health, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Daniel E. Roth
- Research Institute and Centre for Global Child Health, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Canada
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10
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Welten M, de Kroon MLA, Renders CM, Steyerberg EW, Raat H, Twisk JWR, Heymans MW. Repeatedly measured predictors: a comparison of methods for prediction modeling. Diagn Progn Res 2018; 2:5. [PMID: 31093555 PMCID: PMC6460730 DOI: 10.1186/s41512-018-0024-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/09/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In literature, not much emphasis has been placed on methods for analyzing repeatedly measured independent variables, even less so for the use in prediction modeling specifically. However, repeated measurements could especially be interesting for the construction of prediction models. Therefore, our objective was to evaluate different methods to model a repeatedly measured independent variable and a long-term fixed outcome variable into a prediction model. METHODS Six methods to handle a repeatedly measured predictor were applied to develop prediction models. Methods were evaluated with respect to the models' predictive quality (explained variance R 2 and the area under the curve (AUC)) and their properties were discussed. The models included overweight and BMI-standard deviation score (BMI-SDS) at age 10 years as outcome and seven BMI-SDS measurements between 0 and 5.5 years as longitudinal predictor. Methods for comparison encompassed developing models including: all measurements; a single (here: the last) measurement; a mean or maximum value of all measurements; changes between subsequent measurements; conditional measurements; and growth curve parameters. RESULTS All methods, except for using the maximum or mean, resulted in prediction models for overweight of similar predictive quality, with adjusted Nagelkerke R 2 ranging between 0.230 and 0.244 and AUC ranging between 0.799 and 0.807. Continuous BMI-SDS prediction showed similar results. CONCLUSIONS The choice of method depends on hypothesized predictor-outcome associations, available data, and requirements of the prediction model. Overall, the growth curve method seems to be the most flexible method capable of incorporating longitudinal predictor information without loss in predictive quality.
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Affiliation(s)
- Marieke Welten
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Marlou L. A. de Kroon
- Department of Public Health, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Carry M. Renders
- Department of Health Sciences, Amsterdam Public Health Research Institute, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Ewout W. Steyerberg
- Department of Public Health, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Jos W. R. Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Martijn W. Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
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11
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Kay MC, Wasser H, Adair LS, Thompson AL, Siega‐Riz AM, Suchindran CM, Bentley ME. Consumption of obesogenic foods in non-Hispanic black mother-infant dyads. MATERNAL & CHILD NUTRITION 2018; 14:e12482. [PMID: 28627126 PMCID: PMC6651737 DOI: 10.1111/mcn.12482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/12/2017] [Accepted: 05/18/2017] [Indexed: 01/29/2023]
Abstract
Obesity continues to be a problem in the United States. Of particular concern is the epidemic of early childhood obesity. A significant predictor of child diet is maternal diet, but little is known about this relationship during infancy. This study examined the association between maternal and infant consumption of key food groups from 6 to 18 months using data from the Infant Care, Feeding, and Risk of Obesity Study, a prospective cohort of 217 non-Hispanic black, low-income, first-time mothers. Using data from 24-hr dietary recalls collected during in-home visits at 6, 9, 12, and 18 months, we assessed longitudinal associations between mother and child intake of both energy-dense, nutrient-poor (obesogenic) food groups and fibre-, nutrient-rich food groups using random intercept logistic regression. Both mothers and their infants had high intake of sugar-sweetened beverages, desserts, and sweets and low intake of vegetables and whole grains. Infant consumption of key food groups was strongly associated with maternal consumption, suggesting the need for focused interventions to target maternal diet as a pathway to decreasing risk for the establishment of poor dietary patterns early in life.
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Affiliation(s)
- Melissa C. Kay
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Heather Wasser
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Linda S. Adair
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Amanda L. Thompson
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of AnthropologyUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Anna Maria Siega‐Riz
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of Public Health SciencesUniversity of VirginiaUSA
| | - Chirayath M. Suchindran
- Department of BiostatisticsUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Margaret E. Bentley
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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12
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Horodynski MA, Pierce SJ, Reyes-Gastelum D, Olson B, Shattuck M. Feeding Practices and Infant Growth: Quantifying the Effects of Breastfeeding Termination and Complementary Food Introduction on BMI z-Score Growth Velocity through Growth Curve Models. Child Obes 2017; 13:490-498. [PMID: 28767287 DOI: 10.1089/chi.2017.0079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Infant feeding practices are a focus of early obesity prevention. We tested whether infant growth velocity increased after breastfeeding termination and complementary food introduction. METHODS Our secondary analysis included a sample of 547 mother-infant dyads from a longitudinal randomized controlled trial conducted in Michigan and Colorado. Infant anthropometrics at birth, baseline, and 6- and 12-month follow-up were standardized to BMI-for-age z-score (ZBMI) according to World Health Organization (WHO) growth charts. We used growth curve models with time-varying predictors to quantify effects of breastfeeding termination and timing of complementary food introduction on growth velocity. RESULTS Median breastfeeding duration was 2.0 months [confidence interval (CI) = 2.0-2.5]; median introduction of complementary foods occurred at 3.0 months (CI = 2.8-3.2). Breastfed infants not yet introduced to complementary foods had an average ZBMI growth velocity of 0.050 (CI = -0.013 to 0.113) z-score units per month [zpm], not significantly faster than WHO growth trajectory (p = 0.118) defined as 0 zpm. Breastfeeding termination had negligible effect on ZBMI growth velocity (γ11 = 0.001, CI = -0.027 to 0.030, p = 0.927). Introduction of complementary foods increased ZBMI growth velocity relative to an average child in the sample, but not significantly (γ12 = 0.033, CI = -0.034 to 0.100, p = 0.334). Growth velocities for infants receiving complementary foods both before and after breastfeeding termination were significantly faster than the WHO growth trajectory (0.083 zpm, CI = 0.052-0.114, and 0.084 zpm, CI = 0.064-0.105, respectively, p's < 0.001). CONCLUSIONS Average postcomplementary food introduction growth velocity was significantly higher than WHO growth trajectory, but did not differ from the sample's initial average trajectory. Growth curve models can accurately estimate effects of feeding practices on infant growth to direct obesity prevention efforts.
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Affiliation(s)
| | - Steven J Pierce
- 2 Center for Statistical Training and Consulting, Michigan State University , East Lansing, MI
| | - David Reyes-Gastelum
- 4 Department of Counseling, Educational Psychology, and Special Education, Michigan State University , East Lansing, MI
| | - Beth Olson
- 3 Department of Nutritional Sciences, College of Agricultural and Life Sciences, University of Wisconsin-Madison , Madison, WI
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13
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Sehgal A, Crispi F, Skilton MR, de Boode WP. Clinician performed ultrasound in fetal growth restriction: fetal, neonatal and pediatric aspects. J Perinatol 2017; 37:1251-1258. [PMID: 28837134 DOI: 10.1038/jp.2017.119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/02/2017] [Accepted: 06/26/2017] [Indexed: 11/09/2022]
Abstract
Fetal growth restriction (FGR) affects 7-10% pregnancies. Conventional and tissue Doppler imaging has noted cardiac compromise during fetal and early neonatal periods in this cohort. In this article, we discuss the use of salient ultrasound parameters across age groups. During fetal life, certain feto-placental sonographic parameters have been linked to adverse perinatal outcomes and are predictive of later life hypertension. During the early postnatal period altered morphometry (hypertrophied and globular hearts) with sub-clinical impairment of cardiac function has been noted in both term and preterm infants with FGR. Vascular imaging has noted thickened and stiffer arteries in association with significantly elevated blood pressure. Similar findings in the pediatric age groups indicate persistence of these alterations, and have formed the basis of intervention studies. Assessment methodology and clinical relevance of these parameters, especially in designing and monitoring of intervention strategies is discussed. Frontline care givers (obstetricians and neonatologists) are increasingly using point of care ultrasound to discern these manifestations of FGR during the sub-clinical phase.
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Affiliation(s)
- A Sehgal
- Neonatologist, Monash Newborn, Monash Children's Hospital, Monash University, Melbourne, VIC, Australia.,Department of Paediatrics, Monash University, Melbourne, VIC, Australia
| | - F Crispi
- BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Boden Institute, IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - M R Skilton
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Camperdown, NSW, Australia
| | - W-P de Boode
- Department of Neonatology, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
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14
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Breast-feeding duration for the prevention of excess body weight of mother-child pairs concurrently: a 2-year cohort study. Public Health Nutr 2017. [PMID: 28625232 DOI: 10.1017/s1368980017001239] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To examine the association between breast-feeding duration and the risk of excess body weight (children >85th percentile, mothers BMI≥25·0 kg/m2) concurrently in mother-child pairs two years after delivery. DESIGN Prospective cohort study in Joinville, Brazil. Multivariable logistic regression was used to examine the independent relationship between breast-feeding duration and risk of excess body weight. SETTING Brazilian public maternity hospital. SUBJECTS Three hundred and five mother-child pairs. RESULTS At 2-year follow-up, 23·6 % of mother-child pairs had excess body weight. Children breast-fed for <2 months were more likely to have excess body weight than children breast-fed for ≥6 months (OR=2·4; 95 % CI 1·1, 5·1). Breast-feeding for <2 months was also associated with a greater likelihood of maternal excess body weight compared with those who breast-fed for ≥6 months (OR=2·9; 95 % CI 1·1, 8·1). There was a progressive increase in the likelihood of mother-child pairs having excess body weight as breast-feeding duration decreased. In addition to breast-feeding duration, other independent determinants of excess body weight were pre-pregnancy weight, gestational weight gain and number of pregnancies in mothers, and birth weight in children. CONCLUSIONS Breast-feeding for a longer duration has a parallel protective effect on the risk of excess body weight in mother-child pairs two years after birth. Since members of the same family could be influenced by the same risk factors, continued promotion and support of breast-feeding may help to attenuate the rising prevalence of overweight in mother-child pairs.
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15
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Wen LM, Rissel C, Baur LA, Hayes AJ, Xu H, Whelan A, Hua M, Shaw M, Phongsavan P. A 3-Arm randomised controlled trial of Communicating Healthy Beginnings Advice by Telephone (CHAT) to mothers with infants to prevent childhood obesity. BMC Public Health 2017; 17:79. [PMID: 28088203 PMCID: PMC5237545 DOI: 10.1186/s12889-016-4005-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 12/26/2016] [Indexed: 11/16/2022] Open
Abstract
Background With an increasing prevalence of obesity in young children globally, there is an urgent need for the development of effective early interventions. A previous Healthy Beginnings Trial using a nurse-led home visiting program has demonstrated that providing mothers with evidence-based advice can improve maternal practice regarding obesity prevention, and can reduce Body Mass Index (BMI) in the first few years of life. However, the costs for scale-up of home visiting limit its population reach. This trial aims to determine the efficacy of Communicating Healthy Beginnings Advice by Telephone (CHAT) to mothers with infants in improving infant feeding practices and preventing the early onset of childhood overweight and obesity. Methods/Design We propose a 3-arm randomised controlled trial (RCT) with a consecutive sample of 1056 mothers with their newborn children in New South Wales (NSW) Australia. Pregnant women who are between weeks 28 and 34 of their pregnancy will be invited to participate in the CHAT trial. Informed consent will be obtained, and after baseline data collection, participants will be randomly allocated to the telephone intervention, text messaging intervention, or the control group. The intervention comprises telephone consultations or text messages, together with 6 intervention packages being mailed at specific times from the third trimester of pregnancy until 12 months post birth. The main trial outcome measures include a) duration of breastfeeding, b) timing of introduction of solids, c) nutrition behaviours, physical activity and television viewing, and d) weight and BMI z-score at 12 and 24 months, e) cost-effectiveness, as well as f) feasibility and acceptability of the interventions. Discussion The results will ascertain whether early intervention using telephone consultation or text messaging together with staged mailed intervention resources can be feasible and effective in improving infant feeding practices, physical activity and reducing children’s BMI in the early years of life. If proven to be feasible, effective as well as cost-effective, the trial results will inform a series of recommendations for policy and practice related to promoting healthy infant feeding and physical activity in young children in the first years of life. Trial registration The CHAT Trial is registered with the Australian Clinical Trial Registry (ACTRN12616001470482p). It was registered on October 21, 2016.
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Affiliation(s)
- Li Ming Wen
- Health Promotion Unit, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia. .,Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, Australia. .,Charles Perkins Centre, University of Sydney, Camperdown, Australia.
| | - Chris Rissel
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, Australia.,Office of Preventive Health, Ministry of Health, Camperdown, NSW, Australia
| | - Louise A Baur
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, Australia.,Discipline of Child & Adolescent Health, University of Sydney, Camperdown, Australia
| | - Alison J Hayes
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, Australia
| | - Huilan Xu
- Health Promotion Unit, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia
| | - Anna Whelan
- Health Promotion Unit, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, Australia
| | - Myna Hua
- Health Promotion Unit, South Eastern Sydney Local Health District, Camperdown, NSW, Australia
| | - Miranda Shaw
- Community Health Services, Sydney Local Health District, Camperdown, NSW, Australia
| | - Philayrath Phongsavan
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, Australia
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16
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Lampl M, Mummert A, Schoen M. Promoting Healthy Growth or Feeding Obesity? The Need for Evidence-Based Oversight of Infant Nutritional Supplement Claims. Healthcare (Basel) 2016; 4:E84. [PMID: 27845744 PMCID: PMC5198126 DOI: 10.3390/healthcare4040084] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/10/2016] [Accepted: 10/27/2016] [Indexed: 12/28/2022] Open
Abstract
The Developmental Origins of Health and Disease (DOHaD) model recognizes growth in infancy and childhood as a fundamental determinant of lifespan health. Evidence of long-term health risks among small neonates who subsequently grow rapidly poses a challenge for interventions aiming to support healthy growth, not merely drive weight gain. Defining healthy growth beyond "getting bigger" is essential as infant and young child feeding industries expand. Liquid-based nutritional supplements, originally formulated for undernourished children, are increasingly marketed for and consumed by children generally. Clarifying the nature of the evidentiary base on which structure/function claims promoting "healthy growth" are constructed is important to curb invalid generalizations. Evidence points to changing social beliefs and cultural practices surrounding supplementary feeding, raising specific concerns about the long-term health consequences of an associated altered feeding culture, including reduced dietary variety and weight gain. Reassessing the evidence for and relevance of dietary supplements' "promoting healthy growth" claims for otherwise healthy children is both needed in a time of global obesity and an opportunity to refine intervention approaches among small children for whom rapid subsequent growth in early life augments risk for chronic disease. Scientific and health care partnerships are needed to consider current governmental oversight shortfalls in protecting vulnerable populations from overconsumption. This is important because we may be doing more harm than good.
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Affiliation(s)
- Michelle Lampl
- Center for the Study of Human Health, Emory University, Atlanta, GA 30322, USA.
- Department of Anthropology, Emory University, Atlanta, GA 30322, USA.
| | - Amanda Mummert
- Department of Anthropology, Emory University, Atlanta, GA 30322, USA.
| | - Meriah Schoen
- Center for the Study of Human Health, Emory University, Atlanta, GA 30322, USA.
- Department of Nutrition, Georgia State University, Atlanta, GA 30302, USA.
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17
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Santos S, Gaillard R, Oliveira A, Barros H, Abrahamse-Berkeveld M, van der Beek EM, Hofman A, Jaddoe VWV. Associations of Infant Subcutaneous Fat Mass with Total and Abdominal Fat Mass at School-Age: The Generation R Study. Paediatr Perinat Epidemiol 2016; 30:511-20. [PMID: 27225335 PMCID: PMC5496673 DOI: 10.1111/ppe.12307] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Skinfold thickness enables the measurement of overall and regional subcutaneous fatness in infancy and may be associated with total and abdominal body fat in later childhood. We examined the associations of subcutaneous fat in infancy with total and abdominal fat at school-age. METHODS In a population-based prospective cohort study among 821 children, we calculated total subcutaneous fat (sum of biceps, triceps, suprailiacal, and subscapular skinfold thicknesses) and central-to-total subcutaneous fat ratio (sum of suprailiacal and subscapular skinfold thicknesses/total subcutaneous fat) at 1.5 and 24 months. At 6 years, we measured fat mass index (total fat/height(3) ), central-to-total fat ratio (trunk fat/total fat), and android-to-gynoid fat ratio (android fat/gynoid fat) by dual-energy X-ray absorptiometry and preperitoneal fat mass area by abdominal ultrasound. RESULTS Central-to-total subcutaneous fat ratio at 1.5 months was positively associated with fat mass index and central-to-total fat ratio at 6 years, whereas both total and central-to-total subcutaneous fat ratio at 24 months were positively associated with all childhood adiposity measures. A 1-standard-deviation scores higher total subcutaneous fat at 24 months was associated with an increased risk of childhood overweight (odds ratio 1.70, 95% confidence interval 1.36, 2.12). These associations were weaker than those for body mass index and stronger among girls than boys. CONCLUSIONS Subcutaneous fat in infancy is positively associated with total and abdominal fat at school-age. Our results also suggest that skinfold thicknesses add little value to estimate later body fat, as compared with body mass index.
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Affiliation(s)
- Susana Santos
- EPI-Unit, Institute of Public Health, University of Porto, Porto, Portugal,The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Romy Gaillard
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Andreia Oliveira
- EPI-Unit, Institute of Public Health, University of Porto, Porto, Portugal,Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - Henrique Barros
- EPI-Unit, Institute of Public Health, University of Porto, Porto, Portugal,Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | | | - Eline M van der Beek
- Nutricia Research, Danone Nutricia Early Life Nutrition, Utrecht, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vincent WV Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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18
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Nicklaus S. The role of food experiences during early childhood in food pleasure learning. Appetite 2016; 104:3-9. [DOI: 10.1016/j.appet.2015.08.022] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 06/18/2015] [Accepted: 08/18/2015] [Indexed: 10/23/2022]
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Uesugi KH, Dattilo AM, Black MM, Saavedra JM. Design of a Digital-Based, Multicomponent Nutrition Guidance System for Prevention of Early Childhood Obesity. J Obes 2016; 2016:5067421. [PMID: 27635257 PMCID: PMC5007363 DOI: 10.1155/2016/5067421] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 06/21/2016] [Accepted: 07/17/2016] [Indexed: 12/02/2022] Open
Abstract
Interventions targeting parenting focused modifiable factors to prevent obesity and promote healthy growth in the first 1000 days of life are needed. Scale-up of interventions to global populations is necessary to reverse trends in weight status among infants and toddlers, and large scale dissemination will require understanding of effective strategies. Utilizing nutrition education theories, this paper describes the design of a digital-based nutrition guidance system targeted to first-time mothers to prevent obesity during the first two years. The multicomponent system consists of scientifically substantiated content, tools, and telephone-based professional support delivered in an anticipatory and sequential manner via the internet, email, and text messages, focusing on educational modules addressing the modifiable factors associated with childhood obesity. Digital delivery formats leverage consumer media trends and provide the opportunity for scale-up, unavailable to previous interventions reliant on resource heavy clinic and home-based counseling. Designed initially for use in the United States, this system's core features are applicable to all contexts and constitute an approach fostering healthy growth, not just obesity prevention. The multicomponent features, combined with a global concern for optimal growth and positive trends in mobile internet use, represent this system's future potential to affect change in nutrition practice in developing countries.
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Affiliation(s)
| | - Anne M. Dattilo
- Nestlé Nutrition, 12 Vreeland Road, Florham Park, NJ 07932, USA
| | - Maureen M. Black
- Department of Pediatrics, University of Maryland School of Medicine, 737 W Lombard Street No. 161, Baltimore, MD 21201, USA
- RTI International, East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709-2194, USA
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20
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Human fetal growth restriction: a cardiovascular journey through to adolescence. J Dev Orig Health Dis 2016; 7:626-635. [DOI: 10.1017/s2040174416000337] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Intrauterine growth restriction has been noted to adversely impact morbidity and mortality in the neonatal period as well as cardiovascular well-being in adolescence and adulthood. Recent data based on a wide range of ultrasound parameters during fetal and neonatal life has noted early and persistent involvement of the cardiovascular system. Some of these measures are predictive of long-term morbidities. Assessment of vascular mechanics is a new and novel concept in this population, and opens up avenues for diagnosis, monitoring and evaluation of the likely effectiveness of interventions. Prevention of these adverse vascular and cardiac outcomes secondary to fetal growth restriction may be feasible and of clinical relevance. This review focuses on growth restriction in humans with respect to cardiovascular remodeling and dysfunction during fetal life, persistence of functional cardiac impairment during early childhood and adolescence, and possible preventive strategies.
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21
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de Kroon ML, Wijga A, Vergouwe Y, Heijmans MW, Jaddoe VW, Twisk JW, Raat H. Prediction of Preadolescent Overweight and Poor Cardiometabolic Outcome in Children up to 6 Years of Age: Research Protocol. JMIR Res Protoc 2016; 5:e85. [PMID: 27339755 PMCID: PMC4937175 DOI: 10.2196/resprot.5158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 01/22/2016] [Accepted: 01/22/2016] [Indexed: 12/27/2022] Open
Abstract
Background Dynamic risk estimations may enable targeting primary prevention of overweight and overweight-related adverse cardiometabolic outcome in later life, potentially serving as a valuable addition to universal primary prevention. This approach seems particularly promising in young children, as body mass index (BMI) changes at a young age are highly predictive of these outcomes, and parental lifestyle interventions at a young age are associated with improved long-term outcome. Objective This paper describes the design of our study, which aims to develop digitized tools that can be implemented in the Dutch Child Health Care (CHC) system or by pediatricians for children up to 6 years of age. These tools will enable (1) dynamically predicting the development of overweight, hypertension or prehypertension, low high-density lipoprotein cholesterol (HDL-C) values, and high total cholesterol to HDL-C ratio by early adolescence and (2) identifying children who are likely to have poor cardiometabolic outcome by the age of 5-6 years and by the age of 10 years. Methods Data will be obtained from the Generation R (n=7893) and Prevention and Incidence of Asthma and Mite Allergy (PIAMA; n=3963) cohorts, two Dutch prenatally recruited cohorts. We will select candidate predictors that can be assessed during the first visit and/or during subsequent visits to the CHC center or pediatrician, including sex; parental age, education level, and BMI; smoking exposure; ethnicity; birth weight; gestational age; breastfeeding versus formula feeding; and growth data through the age of 6 years. We will design dynamic prediction models that can be updated with new information obtained during subsequent CHC visits, allowing each measurement to be added to the model. Performance of the model will be assessed in terms of discrimination and calibration. Finally, the model will be validated both internally and externally using the combined cohort data and then converted into a computer-assisted tool called ProCOR (Prediction Of Child CardiOmetabolic Risk). Results This is an ongoing research project financed by the Dutch government. The first results are expected in 2016. Conclusions This study may contribute to the national implementation of digitized tools for assessing the risk of overweight and related cardiometabolic outcome in young children, enabling targeted primary prevention, ultimately yielding relevant health gains and improved resource allocation.
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Affiliation(s)
- Marlou La de Kroon
- Erasmus University Medical Center, Department of Public Health, Rotterdam, Netherlands.
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Machuca H, Arevalo S, Hackley B, Applebaum J, Mishkin A, Heo M, Shapiro A. Well Baby Group Care: Evaluation of a Promising Intervention for Primary Obesity Prevention in Toddlers. Child Obes 2016; 12:171-8. [PMID: 27035857 DOI: 10.1089/chi.2015.0212] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Nationally, approximately 24% of preschool children are overweight or obese, with low-income communities disproportionately affected. Few interventions to prevent obesity in children at greatest risk have demonstrated positive results. Therefore, we evaluated the effectiveness of a novel group well-child care intervention for primary obesity prevention at age 2 years. METHODS Well Baby Group (WBG) is an alternative to traditional well-child care offered at a federally qualified health center in the South Bronx. Facilitated by a pediatrician and nutritionist, WBG fosters positive dietary behaviors, responsive parenting and feeding practices, and peer support during the first 18 months of life. Multivariable logistic regression was conducted to test the effect of WBG on rates of overweight/obesity at 2 years (BMI-for-age ≥85th percentile) using a nonrandomized comparison group of children receiving traditional care at our center over the same period. RESULTS Characteristics of mothers and infants were comparable between intervention (n = 47) and comparison (n = 140) groups. Children enrolled in WBG were significantly less likely to be overweight/obese at 2 years than children receiving traditional well-child care (2.1% vs. 15.0%; OR 0.12; 95% CI 0.02-0.94; p = 0.02). In multivariable regression analysis, WBG remained a significant independent protective factor (OR 0.12; 95% CI 0.02-0.93; p = 0.04), adjusting for birthweight and parity. CONCLUSIONS WBG, a replicable model integrated into primary care visits, affords a unique opportunity to intervene consistently and early, providing families in at-risk communities with increased provider time, intensive education, and ongoing support. Further study of group well-child care for primary obesity prevention is warranted to confirm the effectiveness of the model.
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Affiliation(s)
- Hildred Machuca
- 1 Community Pediatric Programs, A Partnership of Montefiore and Children's Health Fund , Bronx, NY
| | - Sandra Arevalo
- 1 Community Pediatric Programs, A Partnership of Montefiore and Children's Health Fund , Bronx, NY
| | - Barbara Hackley
- 1 Community Pediatric Programs, A Partnership of Montefiore and Children's Health Fund , Bronx, NY
| | - Jo Applebaum
- 1 Community Pediatric Programs, A Partnership of Montefiore and Children's Health Fund , Bronx, NY
| | - Arielle Mishkin
- 1 Community Pediatric Programs, A Partnership of Montefiore and Children's Health Fund , Bronx, NY
| | - Moonseong Heo
- 2 Department of Epidemiology and Population Health, Albert Einstein College of Medicine , Bronx, NY
| | - Alan Shapiro
- 1 Community Pediatric Programs, A Partnership of Montefiore and Children's Health Fund , Bronx, NY
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Wills AK, Strand BH, Glavin K, Silverwood RJ, Hovengen R. Regression models for linking patterns of growth to a later outcome: infant growth and childhood overweight. BMC Med Res Methodol 2016; 16:41. [PMID: 27059178 PMCID: PMC4826511 DOI: 10.1186/s12874-016-0143-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 04/01/2016] [Indexed: 12/26/2022] Open
Abstract
Background Regression models are widely used to link serial measures of anthropometric size or changes in size to a later outcome. Different parameterisations of these models enable one to target different questions about the effect of growth, however, their interpretation can be challenging. Our objective was to formulate and classify several sets of parameterisations by their underlying growth pattern contrast, and to discuss their utility using an expository example. Methods We describe and classify five sets of model parameterisations in accordance with their underlying growth pattern contrast (conditional growth; being bigger v being smaller; becoming bigger and staying bigger; growing faster v being bigger; becoming and staying bigger versus being bigger). The contrasts are estimated by including different sets of repeated measures of size and changes in size in a regression model. We illustrate these models in the setting of linking infant growth (measured on 6 occasions: birth, 6 weeks, 3, 6, 12 and 24 months) in weight-for-height-for-age z-scores to later childhood overweight at 8y using complete cases from the Norwegian Childhood Growth study (n = 900). Results In our expository example, conditional growth during all periods, becoming bigger in any interval and staying bigger through infancy, and being bigger from birth were all associated with higher odds of later overweight. The highest odds of later overweight occurred for individuals who experienced high conditional growth or became bigger in the 3 to 6 month period and stayed bigger, and those who were bigger from birth to 24 months. Comparisons between periods and between growth patterns require large sample sizes and need to consider how to scale associations to make comparisons fair; with respect to the latter, we show one approach. Conclusion Studies interested in detrimental growth patterns may gain extra insight from reporting several sets of growth pattern contrasts, and hence an approach that incorporates several sets of model parameterisations. Co-efficients from these models require careful interpretation, taking account of the other variables that are conditioned on. Electronic supplementary material The online version of this article (doi:10.1186/s12874-016-0143-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrew K Wills
- School of Clinical Sciences & School of Oral & Dental Sciences, University of Bristol, Bristol, UK. .,Norwegian Institute of Public Health, Oslo, Norway.
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Lindkvist M, Ivarsson A, Silfverdal SA, Eurenius E. Associations between toddlers' and parents' BMI, in relation to family socio-demography: a cross-sectional study. BMC Public Health 2015; 15:1252. [PMID: 26679345 PMCID: PMC4683751 DOI: 10.1186/s12889-015-2602-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 12/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is well established that the pregnancy and the first years of life are important for future childhood health and body weight. Even though current evidence suggests that both parents are important for childhood health, the influence that parents' BMI and socio-demography has on toddlers' BMI has so far received little attention. This study aimed to increase our knowledge on the association between toddlers' and parents' BMI, in relation to family socio-demography. Further, the aim was to investigate the interaction between the mothers' and fathers' BMI in relation to their child's BMI. METHODS A total of 697 children with a median age of 18 months (range 16-24 months) participated in the study along with their mothers (n = 697) and fathers (n = 674). As regards representability, our parental sample had a lower proportion of immigrants and the parents were more gainfully employed compared to parents in the rest of Sweden (when the child was 18 months old). The parents completed a questionnaire on parental and child health. Data on parental weight, height, and socio-demographics were recorded along with the child's weight and height measured at an ordinary child health care visit. We used the thresholds for children's BMI that were recommended for surveillance by the Royal College of Paediatrics and Child Health in 2012 based on the WHO reference population. RESULTS Among the toddlers, 33 % had a BMI above the WHO 85(th) percentile and 14 % had a BMI above the WHO 95(th) percentile. The probability of a toddler having a BMI above the WHO 95(th) percentile was significantly increased if either the mother or father was overweight (BMI ≥ 25 kg/m(2)). Furthermore, we found a positive synergistic effect between the mother and father being overweight and their child having a BMI above the WHO 85(th) percentile. No associations were found between the toddlers' BMI and the family's socio-demographics, but there were associations between the parents' BMI and the family's socio-demographics. CONCLUSION High BMI is common even in toddlers in this population. The risk increases if one parent is overweight, and it increases even more if both parents are overweight. The results in this study confirm the importance of considering familial risk factors when examining child health and BMI at ordinary child health care visits already at an early age.
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Affiliation(s)
- Marie Lindkvist
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, SE, 901 87, Umeå, Sweden. .,Department of Statistics, USBE, Umeå University, SE, 901 87, Umeå, Sweden.
| | - Anneli Ivarsson
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, SE, 901 87, Umeå, Sweden.
| | - Sven Arne Silfverdal
- Department of Clinical Science, Paediatrics, Umeå University, SE, 901 87, Umeå, Sweden.
| | - Eva Eurenius
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, SE, 901 87, Umeå, Sweden.
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van der Willik EM, Vrijkotte TGM, Altenburg TM, Gademan MGJ, Kist-van Holthe J. Exclusively breastfed overweight infants are at the same risk of childhood overweight as formula fed overweight infants. Arch Dis Child 2015; 100:932-7. [PMID: 26044134 DOI: 10.1136/archdischild-2015-308386] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 05/13/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND AND OBJECTIVE Several early life determinants play a role in childhood obesity. Rapid weight gain and overweight in infancy increases the risk while breast feeding seems to protect against childhood overweight. However, should we worry about exclusively breastfed overweight infants? The aim of the study is to examine the association of feeding type (exclusive breast feeding (EBF), formula feeding or mixed feeding) and overweight at the age of 6 months with the risk of overweight at the age of 5-6 years. METHODS The Amsterdam Born Children and their Development study is a large prospective population-based birth cohort study conducted in Amsterdam, the Netherlands. Children with complete information pertaining to feeding type and weight status at the age of 6 months and 5-6 years were included (N=3367). EBF was defined as receiving only breast feeding for at least 3 months. Overweight at the ages of 6 months and 5-6 years were defined by the WHO child growth standards and the International Obesity Task Force guidelines, respectively. The association of feeding type and overweight at 6 months with overweight at 5-6 years was assessed using logistic regression analyses. RESULTS Overweight infants have a 4.10-fold (95% CI 2.91 to 5.78) higher odds of childhood overweight compared with those who were not overweight, independent of feeding type. EBF did not affect the association between infant overweight and childhood overweight. CONCLUSIONS Overweight in infancy increases the odds of childhood overweight, equally for exclusively breastfed and formula fed infants. Overweight prevention should start before or at birth and applies to formula fed children as well as exclusively breastfed children.
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Affiliation(s)
- Esmee M van der Willik
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research-VU University Medical Center, Amsterdam, The Netherlands
| | - Tanja G M Vrijkotte
- Department Public Health, Academic Medical Center, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research-VU University Medical Center, Amsterdam, The Netherlands
| | - Maaike G J Gademan
- Department Public Health, Academic Medical Center, Amsterdam, The Netherlands
| | - Joana Kist-van Holthe
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research-VU University Medical Center, Amsterdam, The Netherlands
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Affiliation(s)
- Scott A Lorch
- Department of Pediatrics, The Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania;Center for Outcomes Research, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; andLeonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
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Jensen SM, Ritz C, Ejlerskov KT, Mølgaard C, Michaelsen KF. Infant BMI peak, breastfeeding, and body composition at age 3 y. Am J Clin Nutr 2015; 101:319-25. [PMID: 25646329 DOI: 10.3945/ajcn.114.092957] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND With the increasing focus on obesity, growth patterns in infancy and early childhood have gained much attention. Although the adiposity rebound has been in focus because of a shown association with adult obesity, not much has been published about the infant peak in body mass index (BMI). OBJECTIVE This study links age and BMI at infant peak to duration of breastfeeding and body composition at 3 y of age. DESIGN Frequent weight and height measurements for 311 Danish children in the SKOT (Complementary and Young Child Feeding - Impact on Short and Long Term Development and Health; in Danish) cohort were used to estimate BMI growth curves for the age span from 14 d to 19 mo by using a nonlinear mixed-effects model. BMI growth velocity before peak and age and BMI at peak were derived from the subject-specific models. Information about pregnancy and breastfeeding was assessed from background questionnaires. Assessment of body composition at age 3 y was made based on bioelectrical impedance, weight, and height. RESULTS A longer duration of exclusive breastfeeding was associated with an earlier peak in infant BMI (P = 0.0003) and a lower prepeak velocity (P < 0.0001). BMI level at peak and prepeak velocity was positively associated with fat and fat-free mass at age 3 y (all P < 0.0001), whereas a later age at peak was associated with a lower fat mass, fat mass index, and fat-free mass index at age 3 y (all P < 0.001). CONCLUSIONS BMI peak characteristics are strongly associated with both duration of exclusive breastfeeding and body composition at 3 y of age. Thus, a better knowledge of characteristics and determinants of the early BMI peak is likely to improve our understanding of early development of obesity.
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Affiliation(s)
- Signe M Jensen
- From the Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | - Christian Ritz
- From the Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | - Katrine T Ejlerskov
- From the Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | - Christian Mølgaard
- From the Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | - Kim F Michaelsen
- From the Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
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Tracking of body size from birth to 7 years of age and factors associated with maintenance of a high body size from birth to 7 years of age – the Norwegian Mother and Child Cohort study (MoBa). Public Health Nutr 2014; 18:1746-55. [DOI: 10.1017/s1368980014002419] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo examine tracking of body size among children participating in the Norwegian Mother and Child Cohort Study (MoBa) from birth to 7 years of age and additionally to explore child and parental characteristics associated with maintenance of a high body size in this period of life.DesignAnthropometric data at birth and at 1, 3 and 7 years of age were collected by questionnaires addressed to the mother.SettingParticipants were recruited from all over Norway during the period 1999–2008.SubjectsA total of 3771 children had complete anthropometric data at birth and at 1, 3 and 7 years of age; the sample includes children born between 2002 and 2004.ResultsCohen’s weighted kappa pointed to fair (0·36) to moderate (0·43) tracking of body size from birth to 7 years of age. Generalized estimating equations further indicated that children in the highest tertile of ponderal index at birth had nearly one unit higher BMI (kg/m2) at the age of 7 years compared with children in other tertiles of ponderal index at birth. Having parents with high BMI (≥25·0 kg/m2) increased the odds of having a stable high body size from birth to 7 years of age; moreover, girls had significantly higher odds compared with boys.ConclusionsThe study indicates fair to moderate tracking of body size from birth to 7 years of age. From a public health perspective, early prevention of childhood overweight and obesity seems to be especially important among children of parents having a high BMI.
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29
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Wen LM, Baur LA, Rissel C, Xu H, Simpson JM. Correlates of body mass index and overweight and obesity of children aged 2 years: findings from the healthy beginnings trial. Obesity (Silver Spring) 2014; 22:1723-30. [PMID: 24415528 DOI: 10.1002/oby.20700] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 12/17/2013] [Accepted: 12/27/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE We sought to determine early life factors that predict body mass index (BMI) and overweight/obesity of children aged 2 years. METHODS A longitudinal and prospective analysis was conducted with 330 first-time mothers and their newborns. Children's weight and length were measured at 2 years. Main factors of interest included reported infant feeding practices, children's fruit/vegetable consumption, and television (TV) time. Maternal demographic data, weight and height, and smoking status were collected by face-to-face interview at baseline. Multiple linear and logistic regression models were run to determine factors that predicted BMI or overweight/obesity of children aged 2 years, respectively. RESULTS At age 2 years, 242 remained in the study (retention rate 73%). Mean (SD) BMI of children was 16.87 kg/m(2) (1.62), with 14% classified as overweight/obese. Factors predicting lower child BMI were longer breastfeeding duration, less TV viewing time, and lower child's birth weight as well as maternal healthy prepregnancy weight status. Factors predicting children's overweight/obesity status were shorter breastfeeding duration, earlier introduction of solid food, and maternal overweight or obesity. CONCLUSIONS At 2 years of age, longer breastfeeding duration was associated with lower BMI, while greater TV viewing time was associated with higher BMI, after adjusting for other factors. Early introduction of solids and maternal overweight or obesity were independently associated with overweight or obesity.
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Affiliation(s)
- Li Ming Wen
- Sydney School of Public Health, Sydney Medical School, University of Sydney, New South Wales, Australia; Health Promotion Service, South Western Sydney & Sydney Local Health Districts, New South Wales, Australia
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Bjerregaard LG, Rasmussen KM, Michaelsen KF, Skytthe A, Mortensen EL, Baker JL, Sørensen TIA. Effects of body size and change in body size from infancy through childhood on body mass index in adulthood. Int J Obes (Lond) 2014; 38:1305-11. [PMID: 24942870 DOI: 10.1038/ijo.2014.108] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 05/19/2014] [Accepted: 06/10/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Weight and weight gain throughout infancy are related to later obesity, but whether the strength of the associations varies during the infancy period is uncertain. AIMS Our aims were to identify the period of infancy when change in body weight has the strongest association with adult body mass index (BMI) and also the extent to which these associations during infancy are mediated through childhood BMI. METHODS The Copenhagen Perinatal Cohort, in which participants were followed from birth through 42 years of age, provided information on weight at 12 months and BMI at 42 years for 1633 individuals. Information on weight at birth, 2 weeks, 1, 2, 3, 4 and 6 months was retrieved from health visitors' records and information on BMI at ages 7 and 13 years from school health records. The associations of infant weight and weight gain standard deviation scores (SDS) with adult BMI-SDS were analyzed using multiple linear regression and path analysis. RESULTS Higher-weight-SDS at all ages from birth to an age 12 months were associated with higher-BMI-SDS at 42 years (regression coefficients 0.08-0.12). Infant weight gain-SDS was associated with greater BMI-SDS at 42 years only between birth and 3 months (0.09, 95% confidence intervals (CI) 0.04, 0.15) driven by an association between 2 and 3 months (0.12, 95% CI: 0.04, 0.20). The latter was partly mediated through later BMI in the path analysis. Infant weight gain-SDS between 3 and 12 months was not associated with greater BMI-SDS at 42 years. CONCLUSIONS Faster weight gain during only the first 3 months of infancy was associated with increased adult BMI, although not in a consistent monthly pattern. Adult BMI is more sensitive to high weight gain during early infancy than late infancy, but not specifically to the first month of life.
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Affiliation(s)
- L G Bjerregaard
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - K M Rasmussen
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - K F Michaelsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - A Skytthe
- Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - E L Mortensen
- 1] Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark [2] Institute of Public Health and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - J L Baker
- 1] Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark [2] Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - T I A Sørensen
- 1] Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark [2] Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Weight gain in infancy is associated with carotid extra-medial thickness in later childhood. Atherosclerosis 2014; 233:370-374. [DOI: 10.1016/j.atherosclerosis.2014.01.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 01/07/2014] [Accepted: 01/10/2014] [Indexed: 01/16/2023]
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Skilton MR, Marks GB, Ayer JG, Garden FL, Garnett SP, Harmer JA, Leeder SR, Toelle BG, Webb K, Baur LA, Celermajer DS. Weight gain in infancy and vascular risk factors in later childhood. Pediatrics 2013; 131:e1821-8. [PMID: 23713097 DOI: 10.1542/peds.2012-2789] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We hypothesized that early weight gain would be associated with incident obesity, higher blood pressure, systemic inflammation, and arterial wall thickening in later childhood. METHODS A longitudinal birth cohort was recruited antenatally from 2 maternity hospitals in Sydney, Australia, between September 1997 and December 1999. Three hundred ninety-five nondiabetic children who were followed to age 8 years had complete data for early weight gain and arterial wall thickness. RESULTS Independent predictors of excess early weight gain (age 0-18 months; adjusted for height gain) included male gender (0.411 kg [SE: 0.103], P < .001), fewer weeks' gestation (-0.121 kg [SE: 0.044] per week, P = .006), birth length (0.156 kg [SE: 0.024] per cm, P < .001), and failure to breastfeed to 6 months of age (0.498 kg [SE: 0.108], P < .001). Early height-adjusted weight gain was significantly associated with later childhood overweight (odds ratio [OR]: 1.67 [95% confidence interval (CI): 1.26 to 2.20] per kg) and obesity (OR: 2.07 [95% CI: 1.53 to 2.79] per kg), excess central adiposity (OR: 1.54 [95% CI: 1.20 to 1.98] per kg), higher systolic blood pressure (1.24 mm Hg [SE: 0.33] per kg, P < .001), higher C-reactive protein (0.17 mg/dL [SE: 0.06] per 100% increase in weight gain, P = .006), and greater carotid intima-media thickness (0.012 mm [SE: 0.004] per kg, P = .002). CONCLUSIONS Early postnatal weight gain from birth to age 18 months is significantly associated with later childhood overweight and obesity, excess central adiposity, and greater arterial wall thickness.
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Campbell KJ, Lioret S, McNaughton SA, Crawford DA, Salmon J, Ball K, McCallum Z, Gerner BE, Spence AC, Cameron AJ, Hnatiuk JA, Ukoumunne OC, Gold L, Abbott G, Hesketh KD. A parent-focused intervention to reduce infant obesity risk behaviors: a randomized trial. Pediatrics 2013; 131:652-60. [PMID: 23460688 DOI: 10.1542/peds.2012-2576] [Citation(s) in RCA: 195] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess the effectiveness of a parent-focused intervention on infants' obesity-risk behaviors and BMI. METHODS This cluster randomized controlled trial recruited 542 parents and their infants (mean age 3.8 months at baseline) from 62 first-time parent groups. Parents were offered six 2-hour dietitian-delivered sessions over 15 months focusing on parental knowledge, skills, and social support around infant feeding, diet, physical activity, and television viewing. Control group parents received 6 newsletters on nonobesity-focused themes; all parents received usual care from child health nurses. The primary outcomes of interest were child diet (3 × 24-hour diet recalls), child physical activity (accelerometry), and child TV viewing (parent report). Secondary outcomes included BMI z-scores (measured). Data were collected when children were 4, 9, and 20 months of age. RESULTS Unadjusted analyses showed that, compared with controls, intervention group children consumed fewer grams of noncore drinks (mean difference = -4.45; 95% confidence interval [CI]: -7.92 to -0.99; P = .01) and were less likely to consume any noncore drinks (odds ratio = 0.48; 95% CI: 0.24 to 0.95; P = .034) midintervention (mean age 9 months). At intervention conclusion (mean age 19.8 months), intervention group children consumed fewer grams of sweet snacks (mean difference = -3.69; 95% CI: -6.41 to -0.96; P = .008) and viewed fewer daily minutes of television (mean difference = -15.97: 95% CI: -25.97 to -5.96; P = .002). There was little statistical evidence of differences in fruit, vegetable, savory snack, or water consumption or in BMI z-scores or physical activity. CONCLUSIONS This intervention resulted in reductions in sweet snack consumption and television viewing in 20-month-old children.
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Affiliation(s)
- Karen J Campbell
- Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood 3125, Australia.
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Morandi A, Meyre D, Lobbens S, Kleinman K, Kaakinen M, Rifas-Shiman SL, Vatin V, Gaget S, Pouta A, Hartikainen AL, Laitinen J, Ruokonen A, Das S, Khan AA, Elliott P, Maffeis C, Gillman MW, Järvelin MR, Froguel P. Estimation of newborn risk for child or adolescent obesity: lessons from longitudinal birth cohorts. PLoS One 2012; 7:e49919. [PMID: 23209618 PMCID: PMC3509134 DOI: 10.1371/journal.pone.0049919] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 10/15/2012] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Prevention of obesity should start as early as possible after birth. We aimed to build clinically useful equations estimating the risk of later obesity in newborns, as a first step towards focused early prevention against the global obesity epidemic. METHODS We analyzed the lifetime Northern Finland Birth Cohort 1986 (NFBC1986) (N = 4,032) to draw predictive equations for childhood and adolescent obesity from traditional risk factors (parental BMI, birth weight, maternal gestational weight gain, behaviour and social indicators), and a genetic score built from 39 BMI/obesity-associated polymorphisms. We performed validation analyses in a retrospective cohort of 1,503 Italian children and in a prospective cohort of 1,032 U.S. children. RESULTS In the NFBC1986, the cumulative accuracy of traditional risk factors predicting childhood obesity, adolescent obesity, and childhood obesity persistent into adolescence was good: AUROC = 0·78[0·74-0.82], 0·75[0·71-0·79] and 0·85[0·80-0·90] respectively (all p<0·001). Adding the genetic score produced discrimination improvements ≤1%. The NFBC1986 equation for childhood obesity remained acceptably accurate when applied to the Italian and the U.S. cohort (AUROC = 0·70[0·63-0·77] and 0·73[0·67-0·80] respectively) and the two additional equations for childhood obesity newly drawn from the Italian and the U.S. datasets showed good accuracy in respective cohorts (AUROC = 0·74[0·69-0·79] and 0·79[0·73-0·84]) (all p<0·001). The three equations for childhood obesity were converted into simple Excel risk calculators for potential clinical use. CONCLUSION This study provides the first example of handy tools for predicting childhood obesity in newborns by means of easily recorded information, while it shows that currently known genetic variants have very little usefulness for such prediction.
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Affiliation(s)
- Anita Morandi
- Unité Mixte de Recherche 8199, Centre National de Recherche Scientifique (CNRS) and Pasteur Institute, Lille, France
- Regional Centre for Juvenile Diabetes, Obesity and Clinical Nutrition, University of Verona, Verona, Italy
| | - David Meyre
- Unité Mixte de Recherche 8199, Centre National de Recherche Scientifique (CNRS) and Pasteur Institute, Lille, France
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
| | - Stéphane Lobbens
- Unité Mixte de Recherche 8199, Centre National de Recherche Scientifique (CNRS) and Pasteur Institute, Lille, France
| | - Ken Kleinman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America
| | - Marika Kaakinen
- Institute of Health Sciences and Biocenter, University of Oulu, Oulu, Finland
| | - Sheryl L. Rifas-Shiman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America
| | - Vincent Vatin
- Unité Mixte de Recherche 8199, Centre National de Recherche Scientifique (CNRS) and Pasteur Institute, Lille, France
| | - Stefan Gaget
- Unité Mixte de Recherche 8199, Centre National de Recherche Scientifique (CNRS) and Pasteur Institute, Lille, France
| | - Anneli Pouta
- Department of Children, Young People and Families, National Institute for Health and Welfare, Helsinki, Finland
- Institute of Clinical Medicine/Obstetrics and Gynecology, University of Oulu, Oulu, Finland
| | - Anna-Liisa Hartikainen
- Institute of Clinical Medicine/Obstetrics and Gynecology, University of Oulu, Oulu, Finland
| | - Jaana Laitinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Aimo Ruokonen
- Department of Clinical Sciences and Clinical Chemistry, University of Oulu, Oulu, Finland
| | - Shikta Das
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Anokhi Ali Khan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
- Centre for Environment and Health, School of Public Health, Imperial College, London, United Kingdom
| | - Claudio Maffeis
- Regional Centre for Juvenile Diabetes, Obesity and Clinical Nutrition, University of Verona, Verona, Italy
| | - Matthew W. Gillman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America
| | - Marjo-Riitta Järvelin
- Institute of Health Sciences and Biocenter, University of Oulu, Oulu, Finland
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
- Centre for Environment and Health, School of Public Health, Imperial College, London, United Kingdom
- Department of Life Course and Services, National Institute for Health and Welfare, Oulu, Finland
| | - Philippe Froguel
- Unité Mixte de Recherche 8199, Centre National de Recherche Scientifique (CNRS) and Pasteur Institute, Lille, France
- Department of Genomics of Common Disease, School of Public Health, Imperial College, London, United Kingdom
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Korndewal MJ, Geurts van Kessel WMH, Jak LG, Uiterwaal CSPM, Rövekamp MH, van der Ent CK. Influence of obesity on nocturnal oxygen saturation in young children. Eur J Pediatr 2012; 171:1687-93. [PMID: 22875313 DOI: 10.1007/s00431-012-1806-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Revised: 07/14/2012] [Accepted: 07/20/2012] [Indexed: 10/28/2022]
Abstract
UNLABELLED Obesity is increasing worldwide and it is accompanied by major health effects. In adults and school-aged children, obesity is associated with decreased respiratory function, which may lead to disturbed sleeping and subsequently difficulties in concentration and behavioural disorders. The evidence for the association between obesity and decreased respiratory function in younger children is scarce. To explore the association between body weight and nocturnal respiratory function in young children, 1 to 3 years old, nocturnal pulse oximetry was performed at home. Children with tonsillar hypertrophy were excluded. Percentage of time with oxygen saturation (SpO(2)) <95 % was measured and its association with body mass index (BMI) for age z scores was analysed. Pulse oximetric data of 51 children, including 18 children with a BMI for age above +2 standard deviations, were obtained for this study. Linear regression analysis, correction for gender and parental smoking, showed a positive association between the natural logarithm of SpO(2) <95 % and BMI for age z score [regression coefficient (β) 0.19, 95 % confidence interval 0.00-0.39]. CONCLUSION In young children, higher body weight is associated with a decrease in nocturnal oxygen saturation.
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Affiliation(s)
- Marjolein J Korndewal
- Department of Pediatrics, Gelre Hospitals, Postbus 9014, 7300 DS Apeldoorn, The Netherlands.
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Abstract
Obesity is associated with risk of pulmonary disease, and adversely affects lung function. The parallel increase in obesity and asthma suggests the two conditions are linked; indeed, they can worsen each other. Obesity and inadequate asthma control are associated with poor quality of life, and place a high economic burden on public health. Although the obesity-lung interaction is a major issue for basic research and clinical studies, various questions remain unanswered. Do intrauterine and early life factors impact on the development of obesity and lung disease? If so, can this be prevented? Asthma is generally more severe in obese subjects, but is adiposity a driver of a new asthma phenotype that features greater morbidity and mortality, worse control and decreased response to medications? Obese individuals have small lung volumes, hence their airway calibre is reduced and airway resistance is increased. What puzzles physicians is whether peripheral airways undergo remodelling, which would increase bronchoconstriction. Obese asthmatics respond suboptimally to anti-inflammatory treatment, which raises the question: 'what drug for what patient?' Life expectancy is decreased in obesity and in chronic pulmonary disorders, but does obesity protect against or trigger chronic obstructive pulmonary disease? The time has come to find answers to these questions.
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Affiliation(s)
- F Santamaria
- Department of Paediatrics, Federico II University, Naples, Italy
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Andersen LG, Holst C, Michaelsen KF, Baker JL, Sørensen TIA. Weight and weight gain during early infancy predict childhood obesity: a case-cohort study. Int J Obes (Lond) 2012; 36:1306-11. [PMID: 22907690 DOI: 10.1038/ijo.2012.134] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Infant weight and weight gain are positively associated with later obesity, but whether there is a particular critical time during infancy remains uncertain. OBJECTIVE The aim was to investigate when and how weight and weight gain during infancy become associated with childhood obesity. METHODS In a cohort representing 28 340 children born from 1959-67 and measured in Copenhagen schools, 962 obese children (2007 World Health Organization criteria), were compared with a 5% randomly selected sub-cohort of 1417 children. Information on weight at birth, 2 weeks, 1, 2, 3, 4, 6 and 9 months was retrieved from health visitors' records. Odds ratios and 95% confidence intervals (CI) for childhood obesity by tertiles of weight at each age and by change in tertiles of weight between two consecutive measurements were estimated using multivariate logistic regression with adjustment for indicators of socioeconomic status, preterm birth, and breastfeeding. RESULTS Compared with children in the middle weight-tertile, children with a weight in the upper tertile had a 1.36-fold (CI, 1.10-1.69) to 1.72-fold (CI, 1.36-2.18) higher risk of childhood obesity from birth through 9 months, whereas children in the lower weight-tertile had almost half the risk of obesity from 2 through 9 months. The risk of childhood obesity associated with change in weight-tertile in each interval was stable at ∼1.5-fold per weight-tertile increase throughout infancy. CONCLUSIONS Infant weight and weight gain are associated with obesity in childhood already during the first months of life. Determinants of weight gain shortly after birth may be a suitable target for prevention of obesity.
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Affiliation(s)
- L G Andersen
- Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark.
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Wen LM, Baur LA, Simpson JM, Rissel C, Wardle K, Flood VM. Effectiveness of home based early intervention on children's BMI at age 2: randomised controlled trial. BMJ 2012; 344:e3732. [PMID: 22735103 PMCID: PMC3383864 DOI: 10.1136/bmj.e3732] [Citation(s) in RCA: 192] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the effectiveness of a home based early intervention on children's body mass index (BMI) at age 2. DESIGN Randomised controlled trial. SETTING The Healthy Beginnings Trial was conducted in socially and economically disadvantaged areas of Sydney, Australia, during 2007-10. PARTICIPANTS 667 first time mothers and their infants. INTERVENTION Eight home visits from specially trained community nurses delivering a staged home based intervention, one in the antenatal period, and seven at 1, 3, 5, 9, 12, 18 and 24 months after birth. Timing of the visits was designed to coincide with early childhood developmental milestones. MAIN OUTCOME MEASURES The primary outcome was children's BMI (the healthy BMI ranges for children aged 2 are 14.12-18.41 for boys and 13.90-18.02 for girls). Secondary outcomes included infant feeding practices and TV viewing time when children were aged 2, according to a modified research protocol. The data collectors and data entry staff were blinded to treatment allocation, but the participating mothers were not blinded. RESULTS 497 mothers and their children (75%) completed the trial. An intention to treat analysis in all 667 participants recruited, and multiple imputation of BMI for the 170 lost to follow-up and the 14 missing, showed that mean BMI was significantly lower in the intervention group (16.53) than in the control group (16.82), with a difference of 0.29 (95% confidence interval -0.55 to -0.02; P=0.04). CONCLUSIONS The home based early intervention delivered by trained community nurses was effective in reducing mean BMI for children at age 2. TRIAL REGISTRATION Australian Clinical Trial Registry No 12607000168459.
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Affiliation(s)
- Li Ming Wen
- School of Public Health, Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia.
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Mustila T, Raitanen J, Keskinen P, Saari A, Luoto R. Lifestyle counselling targeting infant's mother during the child's first year and offspring weight development until 4 years of age: a follow-up study of a cluster RCT. BMJ Open 2012; 2:e000624. [PMID: 22307101 PMCID: PMC3274719 DOI: 10.1136/bmjopen-2011-000624] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To investigate the effect of intensified lifestyle counselling targeting infants' mothers on offspring weight development during the first 4 years of life. DESIGN AND SETTING Follow-up of a cluster-randomised controlled trial in primary care child health clinics during 2004-2006 in Finland. Participants received a follow-up survey during 2010 concerning weight and height measurements of their offspring. Number of clusters was six and the response rate to the follow-up 71.9% (N=64/89). PARTICIPANTS The participants (N=89) were mothers of infants aged 2-10 months. INTERVENTION The intervention included individual counselling on diet and physical activity when the infant was 2-10 months of age and an option to attend supervised group exercise sessions. PRIMARY AND SECONDARY OUTCOME MEASURES The authors analysed the secondary outcome of the intervention study: the weight development of the offspring. The primary outcome was the proportion of women returning to their prepregnancy weight by 10 months post partum, reported earlier. RESULTS Multilevel mixed effect non-linear regression models included group, age of the child and interaction between group and age of the child. The increase of BMI z-score between 24 and 48 months was slower among the intervention group offspring (-0.034 to -0.002, p=0.028) as compared with control group. Z-scores for weight-for-length/height did not differ between groups when the period 0-48 months was analysed (p=0.23) but for the period of 24-48 months, between-group differences were significant (p=0.012). CONCLUSIONS Lifestyle counselling targeting mothers during the child's first year may be effective in slowing offspring weight gain until 4 years of age. However, larger studies are needed to confirm the findings which may have the potential in combatting the obesity epidemic. TRIAL REGISTRATION NUMBER Current Controlled Trials ISRCTN21512277.
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Affiliation(s)
- Taina Mustila
- Department of Pediatrics, Central Hospital of Seinäjoki, Seinäjoki, Finland
| | - Jani Raitanen
- UKK Institute for Health Promotion, Tampere, Finland
- Tampere School of Health Sciences, University of Tampere, Tampere, Finland
| | - Päivi Keskinen
- Pediatric Research Centre, University of Tampere, Tampere, Finland
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | - Antti Saari
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
| | - Riitta Luoto
- UKK Institute for Health Promotion, Tampere, Finland
- National institute for Health and Welfare, Department of children, young people and families, Helsinki, Finland
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