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Mäki P, Levälahti E, Lehtinen-Jacks S, Laatikainen T. Overweight and Obesity in Finnish Children by Parents' Socioeconomic Position-A Registry-Based Study. Int J Public Health 2023; 68:1605901. [PMID: 37719660 PMCID: PMC10502218 DOI: 10.3389/ijph.2023.1605901] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 08/07/2023] [Indexed: 09/19/2023] Open
Abstract
Objectives: To examine associations between parents' socioeconomic position (SEP) and child overweight and obesity, using registry data. Methods: Data (final n = 194,423) on children's height, weight and parents' SEP were drawn from the national Register of Primary Health Care Visits (Avohilmo) and Statistics Finland. Risk ratios for bernoulli-distributed overweight (RROW) and obesity (RROB) according to SEP were estimated using generalized linear models and using a log -link. Results: The risk for obesity was lower in boys from high-income families (RROB 0.76), for overweight and obesity was lower in boys (RROW 0.72, RROB 0.58) and girls (RROW 0.72, RROB 0.54) with highly educated fathers, in boys (RROW 0.79, RROB 0.58) and girls (RROW 0.78, RROB 0.56) with high-educated mothers and in boys (RROW 0.85, RROB 0.77) and girls (RROW 0.80, RROB 0.69) living in urban areas, as compared to low-income families, low-educated parents, and rural residence, respectively. Conclusion: The risk of overweight and obesity was increased in children with low SEP or rural residence. Administrative registers are a valid approach to monitor childhood obesity by parents' SEP.
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Affiliation(s)
- Päivi Mäki
- Health and Well-Being Promotion Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Esko Levälahti
- Health and Well-Being Promotion Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Susanna Lehtinen-Jacks
- The Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Division of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Tiina Laatikainen
- Health and Well-Being Promotion Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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2
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Li R, Kajanoja J, Tuulari JJ, Karlsson L, Karlsson H, Karukivi M. Relationships between alexithymia and food addiction: The Finnish version of Yale Food Addiction Scale and preliminary test of its psychometric properties. Front Psychol 2023; 14:1067872. [PMID: 36743252 PMCID: PMC9893275 DOI: 10.3389/fpsyg.2023.1067872] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/06/2023] [Indexed: 01/20/2023] Open
Abstract
Background It has long been suggested that addictive behaviors are associated with alexithymia, a personality trait characterized by difficulties in emotional awareness and expression. However, little is known about the role of alexithymia in food addiction. Objectives The aim of this study was to investigate the relationship between alexithymia and food addiction. As part of the study, the validity of the Finnish version of Yale Food Addiction Scale (YFAS-F) was also investigated. Methods The sample consisted of 360 parents from the FinnBrain Birth Cohort Study. The structural validity of the YFAS-F was evaluated by confirmatory factor analysis (CFA). Exploratory factor analysis (EFA) was used to explore the structure when proposed models were not supported by CFA. The associations of alexithymia as measured by the 20-item Toronto Alexithymia Scale and food addiction were examined using regression analyses followed by structural equation modeling. Results Higher alexithymia was associated with more food addiction by conducting linear regression analysis (B = 0.013, p = 0.011) and structural equation modeling (β = 0.24, p < 0.001). Furthermore, a single-factor model for the 8 criteria of the YFAS-F was supported by CFA and showed acceptable internal reliability (KR-20 = 0.72), and a three-factor solution for the 20 items of the scale was suggested by EFA with good internal reliability (McDonald's ω = 0.91 for the YFAS-F, 0.91 for component 1, 0.87 for component 2, and Spearman-Brown coefficient = 0.89 for component 3). Conclusion The current study determined a significant relationship between alexithymia and food addiction, which suggests alexithymia as a relevant factor for food addiction and may provide clinical implications for interventions. Moreover, the YFAS-F appeared to be a valid and reliable tool to evaluate food addiction in our Finnish general population sample. Further studies on the psychometric properties of the YFAS-F in more diverse populations are recommended.
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Affiliation(s)
- Ru Li
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland,Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland,*Correspondence: Ru Li, ✉
| | - Jani Kajanoja
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland,Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland,Department of Psychiatry, Satakunta Hospital District, Pori, Finland
| | - Jetro J. Tuulari
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland,Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland,Turku Collegium for Science, Medicine and Technology, TCSMT, University of Turku, Turku, Finland
| | - Linnea Karlsson
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland,Center for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland,Department of Pediatrics and Adolescent Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Hasse Karlsson
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland,Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland,Center for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
| | - Max Karukivi
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland,Department of Adolescent Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
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Kontola K, Oksanen P, Huhtala H, Jussila A. Increasing incidence of inflammatory bowel disease with greatest change among the elderly: a nationwide study in Finland, 2000-2020. J Crohns Colitis 2022; 17:706-711. [PMID: 36420953 DOI: 10.1093/ecco-jcc/jjac177] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS The incidence of inflammatory bowel disease (IBD) is stabilising in many western countries. Some still show increasing incidence. Our objective was to determine the latest trends in IBD incidence and prevalence in Finland and compare these among different age groups and between different geographical areas. METHODS We used a nationwide registry of the Social Insurance Institute of Finland to identify new IBD cases during the period 2000-2020. Crude, age-specific and age-standardised incidence rates were calculated. Prevalence was estimated using valid reimbursements from the same database in 2000-2020. RESULTS We identified 42,498 new IBD cases. The crude annual incidence increased in ulcerative colitis (UC) from 20 to 35 (IRR 1.03, CI 1.02-1.03), in Crohn's disease (CD) from 8 to 13 (IRR 1.02, CI 1.02-1.03) and in IBD overall from 28 to 48 per 100,000 person-years (IRR 1.02, CI 1.02-1.03). Men had higher incidence than women in UC, but in CD the incidence was equal. The incidence of IBD increased in all age groups, except for small children. The increase in both UC and CD was most marked among the elderly aged over 70. A north-south gradient was discernible. The crude prevalence of IBD increased from 376 to 972 per 100,000 (PRR 1.05, CI 1.05-1.05). CONCLUSIONS The incidence of IBD, UC and CD is increasing in Finland. The increase is most notable in the elderly. Current prevalence of IBD is 1%.
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Affiliation(s)
- Kristi Kontola
- Department of Internal Medicine, Hospital District of South Ostrobothnia, Finland
| | - Pia Oksanen
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, Finland
| | - Airi Jussila
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Finland
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Antikainen L, Jääskeläinen J, Nordman H, Voutilainen R, Huopio H. Boys but Not Girls Exposed to Maternal Gestational Diabetes Mellitus Have Unfavorable Fat Distribution. Horm Res Paediatr 2022; 94:194-200. [PMID: 34515128 DOI: 10.1159/000518739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/27/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Maternal gestational diabetes mellitus (GDM) and overweight are associated with an increased risk of obesity and the metabolic syndrome in the adult offspring. We studied the influence of maternal GDM on prepubertal children's body composition and bone mineral biochemistry. METHODS A total of 134 prepubertal Caucasian children (age range 4.4-9.7 years) were studied in a controlled cross-sectional study. Seventy-six children had been exposed to maternal GDM and 58 children born after a normal pregnancy served as controls. The outcome variables were body fat %, android fat %, gynoid fat %, android/gynoid fat ratio, bone mineral density (BMD), bone mineral content (BMC), muscle mass, lean mass (LM) and serum 25-hydroxyvitamin D, ionized calcium, phosphate, and alkaline phosphatase concentrations. RESULTS There were no differences in body fat %, android fat %, BMD, BMC, muscle mass, or LM between the study groups. Gynoid fat % was higher in the GDM than control children (p = 0.03). Android fat %, gynoid fat %, and android/gynoid fat ratio were higher in the GDM boys than control boys (p = 0.046, 0.037, and 0.038) respectively, but no differences were found between the GDM and control girls. CONCLUSIONS Boys exposed to maternal GDM presented with more unfavorable fat distribution than their controls, whereas no difference was found between the girls. Otherwise, the differences in body composition were minimal between prepubertal GDM and control children.
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Affiliation(s)
- Leena Antikainen
- Department of Pediatrics, University of Eastern Finland, Kuopio, Finland.,Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
| | - Jarmo Jääskeläinen
- Department of Pediatrics, University of Eastern Finland, Kuopio, Finland.,Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
| | - Henrikki Nordman
- Department of Pediatrics, University of Eastern Finland, Kuopio, Finland
| | - Raimo Voutilainen
- Department of Pediatrics, University of Eastern Finland, Kuopio, Finland.,Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
| | - Hanna Huopio
- Department of Pediatrics, University of Eastern Finland, Kuopio, Finland.,Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
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Häkkänen P, But A, Ketola E, Laatikainen T. Weight transitions and psychosocial factors: A longitudinal cohort study of Finnish primary school children with overweight. Prev Med Rep 2020; 20:101239. [PMID: 33304771 PMCID: PMC7710645 DOI: 10.1016/j.pmedr.2020.101239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/16/2020] [Accepted: 10/20/2020] [Indexed: 11/23/2022] Open
Abstract
Children most probably stayed in their initial weight category. Probabilities of transitioning across weight categories differ between genders. Girls of nuclear families transition to obesity at a lower rate than their peers. Experiences of crises and bullying are related to obesity development among boys. Multistate models are useful for analyzing childhood obesity development.
For targeted prevention and treatment of childhood obesity, primary health care needs methods to identify children potentially developing obesity. The objectives of this study were to examine transitions across weight categories and their association with psychosocial family- and school-related factors, data on which were retrieved from health records. This longitudinal cohort study comprised 507 Finnish children with overweight, identified from a random sample of 2000 sixth graders in Helsinki in 2013. We applied Markov multistate models to analyze the transition rates over six primary school years between BMI SDS categories of normal weight, overweight and obesity, as assessed by Finnish BMI-for-age reference, and to examine relations between transition rates and family- and school-related factors. Among 3116 pairs of consecutive growth measurements from 225 girls and 282 boys aged 6–14, 719 transitions from weight category to another occurred. The highest 1-year probabilities were 0.76 for girls to stay in overweight and 0.80 for boys to stay in obesity. Transitions from normal weight to overweight and from obesity to overweight were more probable than vice versa. Transitions from overweight into obesity were among girls associated with older age (HR 2.63) and divorced or single parents (HR 2.29), as well as among boys with experiences of crises (HR 2.40) and being bullied (HR 1.66). Factors identifiable in school health care and associated with the probability of transition towards obesity should be considered when planning individual support and intervention programs.
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Viljakainen H, Dahlström E, Figueiredo R, Sandholm N, Rounge TB, Weiderpass E. Genetic risk score predicts risk for overweight and obesity in Finnish preadolescents. Clin Obes 2019; 9:e12342. [PMID: 31595703 PMCID: PMC6900004 DOI: 10.1111/cob.12342] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 09/04/2019] [Indexed: 12/12/2022]
Abstract
Common genetic variants predispose to obesity with varying contribution by age. We incorporated known genetic variants into genetic risk scores (GRSs) and investigated their associations with overweight/obesity and central obesity in preadolescents. Furthermore, we compared GRSs with lifestyle factors, and tested if they predict the change in body size and shape in a 4-year follow-up. We utilized 1142 subjects from the Finnish Health in Teens (Fin-HIT) cohort. Overweight and obesity were defined with age- and gender-specific body mass index (BMI) z-score (BMIz), while central obesity by the waist-to-height ratio (WHtR). Background data on parental language, eating habits, leisure-time physical activity (LTPA) and sleep duration were included. Genotyping was performed with the Metabochip platform. Weighted, standardized GRSs were derived. Of the11-year-old children, 25.5% were at least overweight and 90.8% had Finnish speaking background. BMI-GRS was associated with higher risk for overweight with odds ratio (95% confidence interval) of 1.39 (1.20; 1.60) and obesity 1.41 (1.08; 1.83), but not with central obesity. BMI-GRS was weakly and inversely associated with the changes in BMIz and WHtR in the 4-year follow-up. Waist-to-hip ratio-GRS was not related to any obesity measures at baseline nor in the follow-up. The effect of BMI-GRS is similar to that of low LTPA on overweight. An interaction between parental language and BMI-GRS was noted (P = .019): BMI-GRS associated more strongly with overweight in Swedish than in Finnish speakers. We further identified two suggestive genetic variants near LOC101926977 and LOC105369677 associated with BMIz in preadolescents which were replicated in the adult population. In preadolescents, known genetic predisposing factors induce a risk for overweight comparable to low LTPA. However, the GRS was poor in predicting short-term changes in BMI or WHtR.
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Affiliation(s)
- Heli Viljakainen
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Emma Dahlström
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Department of Nephrology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Rejane Figueiredo
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Niina Sandholm
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Department of Nephrology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Trine B Rounge
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Department of Research, Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
| | - Elisabete Weiderpass
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Department of Research, Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
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Association of dietary habits with restorative dental treatment need and BMI among Finnish conscripts: a cross-sectional epidemiological study. Public Health Nutr 2019; 22:3009-3016. [PMID: 31387657 DOI: 10.1017/s1368980019001873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Processed foods and fatty, sugary snacking products, such as fizzy drinks and desserts, have become more popular, causing a desire to replace meals with snacks worldwide. High-sugar and fat-rich food components have been reported to be associated with increased level of dental caries as well as underweight and overweight. The aim of the present cross-sectional population-based study was to analyse the eating behaviours of young, healthy Finnish males in association with oral health and BMI, considering self-reported and residential background factors. DESIGN Cross-sectional study. SETTING Finnish Defence Forces, Finland. PARTICIPANTS The used clinical data were gathered from 13 564 Finnish conscripts born in the beginning of the 1990s through clinical check-ups. In addition, about 8700 of the conscripts answered a computer-assisted questionnaire ('Oral Health of the Conscripts 2011' data) about their background information and health habits. RESULTS There was distinct variation in dietary patterns. Eating breakfast, regular physical exercise and daily tooth brushing all decreased the odds for restorative dental treatment need (decayed teeth), whereas smoking and drinking fizzy drinks for quenching thirst increased it. Eating breakfast and dinner were each associated with lower BMI, but smoking increased the odds for higher BMI (≥25 kg/m2). CONCLUSIONS Regular, proper meals and especially eating breakfast decreased the odds for both dental caries and high BMI (≥25 kg/m2).
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8
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Single-parenthood and perceived income insufficiency as challenges for meal patterns in childhood. Appetite 2018; 127:10-20. [PMID: 29678498 DOI: 10.1016/j.appet.2018.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 02/28/2018] [Accepted: 04/06/2018] [Indexed: 11/22/2022]
Abstract
Family is an important setting for development of eating behaviour in childhood. The aim of this study was to investigate associations and direct and indirect pathways between family socioeconomic position (SEP) factors, family type and meal patterns in childhood on weekdays (4-6 meals a day, breakfast skipping, and family dinner). The cross-sectional LATE study was carried out in Finland in 2007-2009. Our dataset comprised 2864 school-aged children (aged ca 7-16 years). Associations between parental BMI, education, labor market status, perceived income sufficiency, family type and childhood meal patterns were first examined by bivariate and multivariate regression analyses separately for children (aged 7-11 years; N = 1920) and adolescents (14-16 years; N = 944). To identify direct and indirect pathways between SEP factors, family type and the three meal pattern variables path analysis was performed. The present study showed that family resources in terms of family type and perceived income sufficiency seemed important in meal patterns in childhood. On the other hand the previously reported strong associations between parental education and meal patterns seemed to a large extend to be mediated through family type. Both children and adolescents living in families experiencing income insufficiency had an increased risk of skipping breakfast and not eating the recommended 4-6 meals a day. Family type and especially single-parenthood was associated with breakfast skipping and fewer family dinners in both age groups and with not-recommended meal frequency among children (7-11 y), respectively. This study showed that there are socioeconomic and family type inequalities in meal patterns in childhood and they are more pronounced during childhood compared with adolescence.
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Mustila T, Raitanen J, Keskinen P, Luoto R. A pragmatic controlled trial to prevent childhood obesity within a risk group at maternity and child health-care clinics: results up to six years of age (the VACOPP study). BMC Pediatr 2018; 18:89. [PMID: 29486763 PMCID: PMC5828437 DOI: 10.1186/s12887-018-1065-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 02/15/2018] [Indexed: 02/02/2023] Open
Abstract
Background Obesity in childhood appears often during the toddler years. The prenatal environment influences obesity risk. Maternal gestational diabetes, the child’s diet, and physical activity in the first few years have an important role in subsequent weight gain. A study was conducted to evaluate effectiveness of a primary health-care lifestyle counselling intervention in prevention of childhood obesity up to 6 years of age. Methods The study was a controlled pragmatic trial to prevent childhood obesity and was implemented at maternity and child health-care clinics. The participants (n = 185) were mothers at risk of gestational diabetes mellitus with their offspring born between 2008 and 2010. The prenatal intervention, started at the end of the first trimester of pregnancy, consisted of counselling on diet and physical activity by municipal health-care staff. The intervention continued at yearly appointments with a public health-nurse at child health-care clinics. The paper reports the offspring weight gain results for 2–6 years of age. Weight gain up to 6 years of age was assessed as BMI standard deviation scores (SDS) via a mixed-effect linear regression model. The proportion of children at 6 years with overweight/obesity was assessed as weight-for-height percentage and ISO-BMI. Priority was not given to power calculations, because of the study’s pragmatic nature. Results One hundred forty seven children’s (control n = 76/85% and intervention n = 71/56%) weight and height scores were available for analysis at 6 years of age. There was no significant difference in weight gain or overweight/obesity proportions between the groups at 6 years of age, but the proportion of children with obesity in both groups was high (assessed as ISO-BMI 9.9% and 11.8%) relative to prevalence in this age group in Finland. Conclusion As the authors previously reported, the intervention-group mothers had lower prevalence of gestational diabetes mellitus, but a decrease in obesity incidence before school age among their offspring was not found. The authors believe that an effective intervention should start before conception, continuing during pregnancy and the postpartum period through the developmentally unique child’s first years. Trial registration ClinicalTrials.gov NCT00970710. Registered 1 September 2009. Retrospectively registered.
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Affiliation(s)
- Taina Mustila
- Seinäjoki Central Hospital, Hanneksenrinne 7, 60220, Seinäjoki, Finland.
| | - Jani Raitanen
- UKK Institute for Health Promotion, Tampere, Finland.,Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Päivi Keskinen
- Pediatric Research Centre, 33014 University of Tampere, Tampere, Finland.,Tampere University Hospital, 33521, Tampere, Finland
| | - Riitta Luoto
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
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10
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Hakola L, Takkinen HM, Niinistö S, Ahonen S, Erlund I, Rautanen J, Veijola R, Ilonen J, Toppari J, Knip M, Virtanen SM, Lehtinen-Jacks S. Maternal fatty acid intake during pregnancy and the development of childhood overweight: a birth cohort study. Pediatr Obes 2017; 12 Suppl 1:26-37. [PMID: 27378525 DOI: 10.1111/ijpo.12170] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 05/24/2016] [Accepted: 06/07/2016] [Indexed: 01/20/2023]
Abstract
BACKGROUND Maternal diet during pregnancy may contribute to the risk of offspring adiposity. OBJECTIVES The objective of the study is to explore the associations between maternal antenatal dietary fatty acid intake and the risk of offspring overweight and obesity at the ages of 2 to 7 years. METHODS In a prospective Finnish birth cohort with 3807 mother-child pairs, maternal diet in late pregnancy was assessed with a food frequency questionnaire. Intakes of total fatty acids and individual saturated, monounsaturated and polyunsaturated fatty acids (PUFAs) were calculated. Generalized estimating equation models were used to study the associations of maternal dietary variables with repeatedly measured offspring overweight and obesity. RESULTS In girls, maternal intake ratio of n-6:n-3 PUFAs had a U-shaped association with obesity (adjusted OR for the lowest 2.0 [95% CI 1.27-3.20] and the highest 1.7 [1.03-2.73] vs. the two middle quartiles of n-6:n-3 PUFAs, p = 0.01). In boys, arachidonic acid (20:4n-6): docosahexaenoic acid + eicosapentaenoic acid ratio was associated with obesity (adjusted OR for the lowest 1.0 [0.60-1.57] and the highest 0.5 [0.26-0.88] vs. the two middle quartiles, p = 0.02). Saturated fatty acids and monounsaturated fatty acids were not associated with overweight or obesity in either sex. CONCLUSIONS Maternal intakes of PUFAs in late pregnancy were associated with risk of later obesity differently in girls and boys.
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Affiliation(s)
- L Hakola
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - H-M Takkinen
- School of Health Sciences, University of Tampere, Tampere, Finland.,Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - S Niinistö
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - S Ahonen
- School of Health Sciences, University of Tampere, Tampere, Finland.,Department of Health, National Institute for Health and Welfare, Helsinki, Finland.,The Science Center of Pirkanmaa Hospital District, Tampere, Finland
| | - I Erlund
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - J Rautanen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - R Veijola
- Department of Pediatrics, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - J Ilonen
- Immunogenetics Laboratory, University of Turku and Turku University Hospital, Turku, Finland
| | - J Toppari
- Department of Physiology, Institute of Biomedicine, University of Turku, Turku, Finland.,Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - M Knip
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Programs Unit, University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland.,Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - S M Virtanen
- School of Health Sciences, University of Tampere, Tampere, Finland.,Department of Health, National Institute for Health and Welfare, Helsinki, Finland.,The Science Center of Pirkanmaa Hospital District, Tampere, Finland.,Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - S Lehtinen-Jacks
- School of Health Sciences, University of Tampere, Tampere, Finland.,Department of Health, National Institute for Health and Welfare, Helsinki, Finland
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Rounge TB, Page CM, Lepistö M, Ellonen P, Andreassen BK, Weiderpass E. Genome-wide DNA methylation in saliva and body size of adolescent girls. Epigenomics 2016; 8:1495-1505. [DOI: 10.2217/epi-2016-0045] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Aim: We performed an epigenome-wide association study within the Finnish Health in Teens cohort to identify differential DNA methylation and its association with BMI in adolescents. Materials & methods: Differential DNA methylation analyses of 3.1 million CpG sites were performed in saliva samples from 50 lean and 50 heavy adolescent girls by genome-wide targeted bisulfite-sequencing. Results: We identified 100 CpG sites with p-values < 0.000524, seven regions by ‘bumphunting’ and five CpG islands that differed significantly between the two groups. The ten CpG sites and regions most strongly associated with BMI substantially overlapped with obesity- and insulin-related genes, including MC2R, IGFBPL1, IP6K1 and IGF2BP1. Conclusion: Our findings suggest an association between the saliva methylome and BMI in adolescence.
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Affiliation(s)
- Trine B Rounge
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Christian M Page
- Department of Neurology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Noncommunicable Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Maija Lepistö
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Pekka Ellonen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Bettina K Andreassen
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Elisabete Weiderpass
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
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12
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Jääsaari P, Tolvanen M, Niinikoski H, Karjalainen S. Advanced dental maturity of Finnish 6- to 12-yr-old children is associated with high energy intake. Eur J Oral Sci 2016; 124:465-471. [DOI: 10.1111/eos.12292] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Päivi Jääsaari
- Institute of Dentistry; University of Turku; Turku Finland
- Department of Oral and Maxillofacial Diseases; Turku University Hospital; Turku Finland
| | - Mimmi Tolvanen
- Institute of Dentistry; University of Turku; Turku Finland
| | - Harri Niinikoski
- Departments of Pediatrics and Physiology; University of Turku; Turku Finland
- Department of Paediatrics and Adolescent Medicine; Turku University Hospital; Turku Finland
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Tompuri TT. Metabolic equivalents of task are confounded by adiposity, which disturbs objective measurement of physical activity. Front Physiol 2015; 6:226. [PMID: 26321958 PMCID: PMC4531232 DOI: 10.3389/fphys.2015.00226] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 07/27/2015] [Indexed: 11/13/2022] Open
Abstract
Physical activity refers any bodily movements produced by skeletal muscles that expends energy. Hence the amount and the intensity of physical activity can be assessed by energy expenditure. Metabolic equivalents of task (MET) are multiplies of the resting metabolism reflecting metabolic rate during exercise. The standard MET is defined as 3.5 ml/min/kg. However, the expression of energy expenditure by body weight to normalize the size differences between subjects causes analytical hazards: scaling by body weight does not have a physiological, mathematical, or physical rationale. This review demonstrates by examples that false methodology may cause paradoxical observations if physical activity would be assessed by body weight scaled values such as standard METs. While standard METs are confounded by adiposity, lean mass proportional measures of energy expenditure would enable a more truthful choice to assess physical activity. While physical activity as a behavior and cardiorespiratory fitness or adiposity as a state represents major determinants of public health, specific measurements of health determinants must be understood to enable a truthful evaluation of the interactions and their independent role as a health predictor.
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Affiliation(s)
- Tuomo T. Tompuri
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University HospitalKuopio, Finland
- Institute of Biomedicine/Physiology, School of Medicine, University of Eastern FinlandKuopio, Finland
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Rajput N, Tuohy P, Mishra S, Smith A, Taylor B. Overweight and obesity in 4-5-year-old children in New Zealand: results from the first 4 years (2009-2012) of the B4School Check programme. J Paediatr Child Health 2015; 51:334-43. [PMID: 25157848 DOI: 10.1111/jpc.12716] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/14/2014] [Indexed: 11/30/2022]
Abstract
AIM We describe the prevalence of overweight and obesity in four-year-old children in New Zealand, variations with ethnicity and socio-economic status, and changes over the study duration using body mass index (BMI) measurements collected as part of the B4School Check programme. METHODS Demographic and BMI data were extracted for all children measured between 2009 and 2012. Overweight and obesity rates were estimated using International Obesity Task Force (IOTF) 2012 standards and the 85th (overweight) and 95th (obese) percentiles for BMI-for-age of the World Health Organization (WHO) 2006, Centers for Disease Control and Prevention 2000 and UK 1990 reference standards. RESULTS A total of 168,744 BMI measurements were included in the analysis with a coverage rate of 66.5%. Mean BMI was 16.30 kg/m(2) in girls and 16.44 kg/m(2) in boys. Mean BMI z-score (WHO 2006 standards) was 0.601 in girls and 0.785 in boys. Using WHO 2006 standards, 16.9% of girls and 19.6% of boys were overweight and 13.8% of girls and 18.7% of boys were obese. Using IOTF standards, 18.3% of girls and 16.2% of boys were overweight and 5.7% of girls and 4.7% of boys were found obese. Prevalence of overweight and obesity was higher in Pacific and Maori children and those living in more socio-economically deprived areas than other children. No definite time-trends were observed over the study duration. CONCLUSIONS The study reaffirms the high prevalence of overweight and obesity in pre-school children in New Zealand, and demonstrates the variations in prevalence when using different reference standards.
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Yang J, Lernmark Å, Uusitalo UM, Lynch KF, Veijola R, Winkler C, Larsson HE, Rewers M, She JX, Ziegler AG, Simell OG, Hagopian WA, Akolkar B, Krischer JP, Vehik K. Prevalence of obesity was related to HLA-DQ in 2-4-year-old children at genetic risk for type 1 diabetes. Int J Obes (Lond) 2014; 38:1491-6. [PMID: 24694666 PMCID: PMC4185013 DOI: 10.1038/ijo.2014.55] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 02/11/2014] [Accepted: 03/21/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Body size is postulated to modulate type 1 diabetes as either a trigger of islet autoimmunity or an accelerator to clinical onset after seroconversion. As overweight and obesity continue to rise among children, the aim of this study was to determine whether human leukocyte antigen DQ (HLA-DQ) genotypes may be related to body size among children genetically at risk for type 1 diabetes. METHODS Repeated measures of weight and height were collected from 5969 children 2-4 years of age enrolled in The Environmental Determinants of Diabetes in the Young prospective study. Overweight and obesity was determined by the International Obesity Task Force cutoff values that correspond to body mass index (BMI) of 25 and 30 kg m(-)(2) at age 18. RESULTS The average BMI was comparable across specific HLA genotypes at every age point. The proportion of overweight was not different by HL A, but percent obesity varied by age with a decreasing trend among DQ2/8 carriers (P for trend=0.0315). A multivariable regression model suggested DQ2/2 was associated with higher obesity risk at age 4 (odds ratio, 2.41; 95% confidence interval, 1.21-4.80) after adjusting for the development of islet autoantibody and/or type 1 diabetes. CONCLUSIONS The HLA-DQ2/2 genotype may predispose to obesity among 2-4-year-old children with genetic risk for type 1 diabetes.
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Affiliation(s)
- Jimin Yang
- Pediatrics Epidemiology Center, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Åke Lernmark
- Department of Clinical Sciences, Lund University/CRC, Skåne University Hospital SUS, Malmö, Sweden
| | - Ulla M. Uusitalo
- Pediatrics Epidemiology Center, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Kristian F. Lynch
- Pediatrics Epidemiology Center, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Riitta Veijola
- Institute of Clinical Medicine, Department of Pediatrics, University of Oulu, Oulu, Finland
| | - Christiane Winkler
- Institute of Diabetes Research, Helmholtz Zentrum München, and Klinikum rechts der Isar, Technische Universität München, and Forschergruppe Diabetes e.V. Neuherberg, Germany
| | - Helena Elding Larsson
- Department of Clinical Sciences, Lund University/CRC, Skåne University Hospital SUS, Malmö, Sweden
| | - Marian Rewers
- Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, Colorado
| | - Jin-Xiong She
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Georgia Regents University, Augusta, Georgia
| | - Anette G. Ziegler
- Institute of Diabetes Research, Helmholtz Zentrum München, and Klinikum rechts der Isar, Technische Universität München, and Forschergruppe Diabetes e.V. Neuherberg, Germany
| | - Olli G. Simell
- Department of Pediatrics, University of Turku, Turku, Finland
| | | | - Beena Akolkar
- National Institute of Diabetes & Digestive & Kidney Diseases, Bethesda, MD
| | - Jeffrey P. Krischer
- Pediatrics Epidemiology Center, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Kendra Vehik
- Pediatrics Epidemiology Center, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, Florida
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Hohwü L, Gissler M, Sjöberg A, Biehl AM, Kristjansson AL, Obel C. Prevalence of overweight in 2 to 17 year-old children and adolescents whose parents live separately: a Nordic cross-sectional study. BMC Public Health 2014; 14:1216. [PMID: 25420881 PMCID: PMC4289363 DOI: 10.1186/1471-2458-14-1216] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 11/18/2014] [Indexed: 11/24/2022] Open
Abstract
Background Comparative data of parental separation and childhood overweight has not been available before across the Nordic countries. The aim of this study was to examine the within-country prevalence and association between parental cohabitation and overweight in Nordic children. Methods A cross-sectional survey of 2-17-year-old children was conducted in 2011, titled: “NordChild”. A random sample of 3,200 parents in each of the Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden were invited to participate in the study with parents of 6,609 children accepting to give answers about their children’s health and welfare including information on height and weight of each child and parental cohabitation (response rate 41.5%). The group differences in prevalence and adjusted odds ratio (OR) for overweight, with corresponding 95% confidence intervals (CI) were performed in children whose parents lived separately. Additionally, a missing data analysis was performed to determine whether the adjusted estimates might result from confounding or selection bias. Results A significant difference was observed in Iceland between children whose parents live separately compared to those who live with both parents (difference: 9.4%, 95% CI: 2.8; 15.9) but no such difference was observed in Denmark, Finland, Norway and Sweden. No significant odds of overweight were observed in children whose parents lived separately compared to children in normal weight at the time of study; Denmark: OR 1.03 (95% CI: 0.42; 2.53), Finland: OR 1.27 (95% CI: 0.74; 2.20), Iceland: OR 1.50 (95% CI: 0.79; 2.84), Norway: OR 1.46 (95% CI: 0.81; 2.62), and Sweden: 1.07 (95% CI: 0.61; 1.86). The missing data analysis indicated that the findings in Norway, Finland and Iceland were partly observed due to selection effects, whereas the adjustment in Denmark was due to confounding. The crude OR for overweight was higher in the 2-9-year-old group than in the 10-17-year-old group whose parents lived separately in Iceland, Norway and Sweden. Conclusions No association between parental cohabitation and overweight in Nordic children was found. Our finding of greater prevalence of overweight in Icelandic children whose parents live separately may be an indication that the welfare system in Iceland is separating from the other Nordic countries.
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Affiliation(s)
- Lena Hohwü
- Section for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark.
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Tompuri T, Lintu N, Savonen K, Laitinen T, Laaksonen D, Jääskeläinen J, Lakka TA. Measures of cardiorespiratory fitness in relation to measures of body size and composition among children. Clin Physiol Funct Imaging 2014; 35:469-77. [PMID: 25164157 DOI: 10.1111/cpf.12185] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 07/03/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the exercise testing measures of cardiorespiratory fitness need to be scaled by body size or composition to enable comparison between individuals. Traditionally used weight-proportional measures are potentially confounded by body adiposity that hampers their interpretation and applicability in the clinical assessment of cardiorespiratory fitness. OBJECTIVE We aimed to find the most appropriate measure of body size or composition for scaling of measures of cardiorespiratory fitness among children. METHODS We assessed body weight and height, maximal workload (W MAX ) and maximal oxygen uptake (VO2 MAX ) using cycle ergometer exercise test with respiratory gas analysis and body lean mass (LM) and fat mass (FM) by dual-energy X-ray absorptiometry and by bioimpedance analysis among 38 children. The data were analysed using Pearson's coefficients for correlation and stepwise linear regression models. RESULTS Lean mass (r > 0.54) and height (r > 0.51) had stronger positive correlations with absolute W MAX and VO2 MAX than weight (r > 0.30) in girls and boys. None of the measures of body size or composition correlated with LM-proportional W MAX or VO2 MAX in girls or boys. Only LM correlated positively with height-proportional W MAX (r = 0.65) and VO2 MAX (r = 0.71) in boys. FM correlated negatively with weight-proportional W MAX (r < -0.58) and VO2 MAX (r < -0.64) in girls and boys. FM was even stronger determinant of weight-proportional W MAX (β = -0.68) and VO2 MAX (β = -0.61) than exercise performance in multivariate linear regression models. CONCLUSIONS While assessing cardiorespiratory fitness, LM is the most appropriate measure of body size or composition for scaling of W MAX and VO2 MAX, because scaling by body weight introduces confounding by body adiposity.
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Affiliation(s)
- Tuomo Tompuri
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.,Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio, Finland
| | - Niina Lintu
- Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio, Finland
| | - Kai Savonen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.,Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - David Laaksonen
- Department of Internal Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Jarmo Jääskeläinen
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Timo A Lakka
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.,Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio, Finland.,Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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Affiliation(s)
- Alan A Jackson
- NIHR Southampton Biomedical Research Centre, Southampton General Hospital (MP113), , Southampton, UK
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Magnusson M, Sørensen TIA, Olafsdottir S, Lehtinen-Jacks S, Holmen TL, Heitmann BL, Lissner L. Social Inequalities in Obesity Persist in the Nordic Region Despite Its Relative Affluence and Equity. Curr Obes Rep 2014; 3:1-15. [PMID: 24533235 PMCID: PMC3920028 DOI: 10.1007/s13679-013-0087-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Social inequalities in overweight and obesity (OWOB) have persisted in the affluent and reputedly egalitarian Nordic countries. In this review we examine associations between socioeconomic position (SEP) and OWOB, and secular trends in such associations. Determinants and possible causes of the relations are discussed together with opportunities to cope with OWOB as a public health problem. The findings show a persisting inverse social gradient. An interaction between SEP and gender is noted for adults in Denmark, Finland and Iceland and for children in Sweden. There are overall tendencies for increased inequality, however no consistent trend for an increased social gradient in OWOB. Reasons that increased inequality does not unequivocally mirror in a steepened social gradient in obesity may include methodological questions as well as societal efforts to counteract obesity. Multi-level efforts are needed to prevent OWOB.
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Affiliation(s)
- Maria Magnusson
- />Department of Public Health and Community Medicine, University of Gothenburg, Box 454, 405 30 Gothenburg, Sweden
| | - Thorkild I. A. Sørensen
- />Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital – Part of the Copenhagen University Hospital, Copenhagen, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
- />Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Steingerdur Olafsdottir
- />Department of Food and Nutrition, and Sport Science, University of Gothenburg, Laroverksgatan 5, Box 320, 405 30 Gothenburg, Sweden
| | - Susanna Lehtinen-Jacks
- />School of Health Sciences (HES) Medisiinarinkatu 3, University of Tampere, 33014 Tampere, Finland
- />Nutrition Unit, National Institute for Health and Welfare, Mannerheimintie 166, 00280 Helsinki, Finland
| | - Turid Lingaas Holmen
- />HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Forskningsveien 2, 7600 Levanger, Norway
| | - Berit Lilienthal Heitmann
- />Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital – Part of the Copenhagen University Hospital, Copenhagen, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
- />National Institute of Public Health, University of Southern Denmark, Odense M, Denmark
| | - Lauren Lissner
- />Department of Public Health and Community Medicine, University of Gothenburg, Box 454, 405 30 Gothenburg, Sweden
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Maternal overweight impacts infant feeding patterns--the STEPS Study. Eur J Clin Nutr 2013; 68:43-9. [PMID: 24219892 DOI: 10.1038/ejcn.2013.229] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 09/01/2013] [Accepted: 09/24/2013] [Indexed: 02/01/2023]
Abstract
OBJECTIVES We examined how maternal overweight impacts full breastfeeding (BF), total duration of BF and the age of introduction of complementary foods (CFs) and whether these have effect on children's growth from 0 to 2 years. SUBJECTS/METHODS From 1797 families participating in the STEPS Study, 848 children had data on BF and anthropometric data at 13 months and 2 years of age and were included in this study. Data on BF and CFs were collected using a self-administered follow-up diary. Information regarding maternal weight, height, pregnancy and delivery were received from maternity clinics and the National Longitudinal Census Files. The children's weight and length/height were recorded during the study visits at 13 months and 2 years. RESULTS Overweight women breastfed fully (2.2 vs 2.8 months, P<0.0001) and totally (7.4 vs 9.0 months, P<0.0001) for a shorter time and introduced CFs earlier (4.1 vs 4.3 months, P=0.02) than normal weight women. Children of overweight women were heavier and had a higher body mass index at 2 years than children of normal weight women. At 2 years of age 30% of boys and 17% of girls were overweight or obese. However, children's obesity risk was not increased by maternal overweight (odds ratio (OR) 1.04, P=0.12). Longer duration of full BF (OR 0.86, P=0.04) and partial BF (OR 0.91, P=0.02) and delayed introduction of CFs (OR 0.69, P=0.03) were protective against obesity. CONCLUSIONS Our study suggests that women who were overweight or obese before pregnancy breastfed for a shorter time and introduced CFs earlier than normal weight women, which may further impact children's growth.
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Mustila T, Raitanen J, Keskinen P, Saari A, Luoto R. Pragmatic controlled trial to prevent childhood obesity in maternity and child health care clinics: pregnancy and infant weight outcomes (the VACOPP Study). BMC Pediatr 2013; 13:80. [PMID: 23688259 PMCID: PMC3664621 DOI: 10.1186/1471-2431-13-80] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 05/15/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND According to current evidence, the prevention of obesity should start early in life. Even the prenatal environment may expose a child to unhealthy weight gain; maternal gestational diabetes is known to be among the prenatal risk factors conducive to obesity. Here we report the effects of antenatal dietary and physical activity counselling on pregnancy and infant weight gain outcomes. METHODS The study was a non-randomised controlled pragmatic trial aiming to prevent childhood obesity, the setting being municipal maternity health care clinics. The participants (n = 185) were mothers at risk of developing gestational diabetes mellitus and their offspring. The children of the intervention group mothers were born between 2009 and 2010, and children of the control group in 2008. The intervention started between 10-17 gestational weeks and consisted of individual counselling on diet and physical activity by a public health nurse, and two group counselling sessions by a dietician and a physiotherapist. The expectant mothers also received a written information leaflet to motivate them to breastfeed their offspring for at least 6 months. We report the proportion of mothers with pathological glucose tolerance at 26-28 weeks' gestation, the mother's gestational weight gain (GWG) and newborn anthropometry. Infant weight gain from 0 to 12 months of age was assessed as weight-for-length standard deviation scores (SDS) and mixed effect linear regression models. RESULTS Intervention group mothers had fewer pathological oral glucose tolerance test results (14.6% vs. 29.2%; 95% CI 8.9 to 23.0% vs. 20.8 to 39.4%; p-value 0.016) suggesting that the intervention improved gestational glucose tolerance. Mother's GWG, newborn anthropometry or infant weight gain did not differ significantly between the groups. CONCLUSION Since the intervention reduced the prevalence of gestational diabetes mellitus, it may have the potential to diminish obesity risk in offspring. However, results from earlier studies suggest that the possible effect on the offspring's weight gain may manifest only later in childhood. TRIAL REGISTRATION Clinical Trials gov: NCT00970710.
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Affiliation(s)
- Taina Mustila
- Seinäjoki Central Hospital, Hanneksenrinne 7, 60220 Seinäjoki, Finland
| | - Jani Raitanen
- UKK Institute for Health Promotion,33501 Tampere, Finland
- Tampere School of Health Sciences, University of Tampere, Tampere, Finland
| | - Päivi Keskinen
- Pediatric Research Centre, University of Tampere, 33014 Tampere, Finland
- Tampere University Hospital, 33521 Tampere, Finland
| | - Antti Saari
- Kuopio University Hospital, Kuopio, Finland
- University of Eastern Finland, Kuopio, Finland
| | - Riitta Luoto
- UKK Institute for Health Promotion,33501 Tampere, Finland
- National Institute for Health and Welfare, 00271 Helsinki, Finland
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Juutilainen A, Kastarinen H, Antikainen R, Peltonen M, Salomaa V, Tuomilehto J, Jousilahti P, Sundvall J, Laatikainen T, Kastarinen M. Trends in estimated kidney function: the FINRISK surveys. Eur J Epidemiol 2012; 27:305-13. [PMID: 22286717 DOI: 10.1007/s10654-012-9652-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Accepted: 01/13/2012] [Indexed: 01/09/2023]
Abstract
We evaluated the temporary trend in estimated glomerular filtration rate (eGFR) of subjects aged from 25 to 74 years between two cross-sectional population surveys in 2002 and in 2007. The mean eGFR across age-groups, the prevalences of eGFR categories, and the prevalence of chronic kidney disease (CKD) stage 3–5 defined by eGFR\60 mL/min/1.73 m2 were defined in sex- and age-specific groups using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Study equation. The eGFR decreased from year 2002 to 2007 across the age-groups in both genders. The prevalence of CKD stage 3–5 (eGFR\60 mL/min/1.73) increased in women from 1.8 to 3.1% (P=0.017), but not in men. In the combined analysis of both genders, CKD stage 3–5 was markedly more common in 2007 compared to 2002, with odds ratio (OR) 1.59 (95% confidence interval (CI) 1.22–2.08) remaining significant after adjusting the model for age, gender, study area, hypertension, obesity, prior cardiovascular disease, and diabetes mellitus, and being at lowest when only age, gender and waist circumference were included in the model (OR 1.34; 95% CI 1.02–1.76). To conclude, the mean eGFR decreased significantly during 2002–2007 in both sexes, and CKD stage 3–5 increased in women. This trend was concurrent with increases in mean waist circumference and in the prevalence of diabetes mellitus.
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Affiliation(s)
- Auni Juutilainen
- Institute of Clinical Medicine/Internal Medicine, Universityof Eastern Finland, and Department of Medicine, Kuopio University Hospital, P.O.B. 1777, 70211 Kuopio, Finland.
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Abstract
In this paper we set out to explore the prevalence of child undernutrition found in community studies in affluent societies, but a preliminary literature review revealed that, in the absence of a gold standard method of diagnosis, the prevalence largely depends on the measure, threshold and the growth reference used, as well as age. We thus go on to explore describe the common clinical ‘syndromes’ of child undernutrition: wasting, stunting and failure to thrive (weight faltering) and how we have used data from two population-based cohort studies, this paper to explore how much these different ‘syndromes’ overlap and the extent to which they reflect true undernutrition. This analysis revealed that when more than one definition is applied to the same children, a majority are below the lower threshold for only one measure. However, those with both weight faltering and low BMI in infancy, go on in later childhood to show growth and body composition patterns suggestive of previous undernutrition. In older children there is even less overlap and most children with either wasting or low fat seem to be simply growing at one extreme of the normal range. We conclude that in affluent societies the diagnosis of undernutrition is only robust when it relies on a combination of both, that is decline in weight or BMI centile and wasting.
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