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Karami S, Mousavi SN, Shapouri R, Naderloo H, Heidarzadeh S, Afshar D. Breast milk dominant phyla and probiotic bacteria in the obese lactating women compared with normal weights. Sci Rep 2024; 14:19199. [PMID: 39160300 PMCID: PMC11333490 DOI: 10.1038/s41598-024-70070-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 08/12/2024] [Indexed: 08/21/2024] Open
Abstract
The main purpose was to determine the abundance of dominant phyla, Bifidobacterium spp., and Lactobacillus in breast milk of obese mothers versus normal-weights in fourth month of lactation in Iranian population. Sixty health women at the fourth month of breastfeeding, aged 18-40 years, were included and categorized based on body mass index (BMI) to the obese (BMI ≥ 30 kg/m2) and normal-weights (18.5 ≤ BMI ≤ 24.9). Bacterial DNA was extracted and qPCR of the 16S region was performed after human milk donation in a sterile condition. A multiple linear mixed model was used to determine the effective factors on the phyla population. Bifidobacterium spp. was significantly higher in milk of normal-weight group than the obese. The current weight showed a significant effect on the Actinobacteria abundance in milk. The Bacteroidetes and Firmicutes were significantly lower in mother's milk with cesarean section (p = 0.04). Pre-pregnancy obesity decreased the Firmicutes and Lactobacillus abundance in maternal milk (p = 0.04 and p = 0.01). The Actinobacteria and Bifidobacterium spp. showed a significant effect on infant's height (p = 0.008 and p = 0.04). The maternal current and pre-pregnancy weight showed an important effect on abundance of Actinobacteria and Bifidobacterium spp., as the good phyla and genus in milk which are associated with the infant's height.
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Affiliation(s)
- Shahla Karami
- Department of Microbiology, Biology Research Center, Zanjan Branch, Islamic Azad University, Zanjan, Iran
| | - Seyedeh Neda Mousavi
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Khorramshahr Blv, Honarestan St., 3rd Shaban St., Shahid Avval Ave, Zanjan, Iran.
| | - Reza Shapouri
- Department of Microbiology, Biology Research Center, Zanjan Branch, Islamic Azad University, Zanjan, Iran.
| | - Hasti Naderloo
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Khorramshahr Blv, Honarestan St., 3rd Shaban St., Shahid Avval Ave, Zanjan, Iran
| | - Siamak Heidarzadeh
- Department of Microbiology and Virology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Davoud Afshar
- Department of Microbiology and Virology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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Rossiter C, Cheng H, Denney-Wilson E. Primary healthcare professionals' role in monitoring infant growth: A scoping review. J Child Health Care 2023:13674935231165897. [PMID: 36963017 DOI: 10.1177/13674935231165897] [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] [Indexed: 03/26/2023]
Abstract
Excessive weight gain in infancy is an established risk for childhood obesity. Primary healthcare professionals have regular contact with infants and are well placed to monitor their growth. This review explores primary healthcare professionals' practice in monitoring growth for infants from birth to 2 years, addressing assessment methods, practitioner confidence and interventions for unhealthy weight gain. Reviewers searched four databases for studies of primary healthcare professionals working in high-income countries that reported on practice monitoring infant growth. Thirty-six eligible studies documented health professionals' practice with infants. While most clinicians regularly weighed and measured infants, some did not record measurements comprehensively. Growth monitoring occurred regularly during well-child visits but was less common during unscheduled visits. Some participants were less proficient at interpreting growth trajectories or lacked confidence in detecting excessive weight gain and in communicating concerns to parents. Few interventions addressed unhealthy growth among infants. Primary healthcare professionals require support to monitor growth trajectories effectively, to communicate appropriately with parents and to engage them in developing healthy behaviours early. Strategies are also required to monitor infants not regularly attending primary health care.
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Affiliation(s)
- Chris Rossiter
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, 522555The University of Sydney, New South Wales, Australia
| | - Heilok Cheng
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, 522555The University of Sydney, New South Wales, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, New South Wales, Australia
- Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH-Translate CRE), Australia
| | - Elizabeth Denney-Wilson
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, 522555The University of Sydney, New South Wales, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, New South Wales, Australia
- Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH-Translate CRE), Australia
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Zysman-Colman Z, Munsar Z, Sheikh S, Rubenstein RC, Kelly A. Infant Body Mass Index or Weight-for-Length and Risk of Undernutrition in Childhood Among Children with Cystic Fibrosis. J Pediatr 2022; 243:116-121.e3. [PMID: 34871592 DOI: 10.1016/j.jpeds.2021.11.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/12/2021] [Accepted: 11/23/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare performance of weight-for-length and body mass index as estimators of undernutrition in children with cystic fibrosis (CF). STUDY DESIGN We analyzed pediatric anthropometric data from the Cystic Fibrosis Foundation Patient Registry. Undernutrition was defined by weight-for-length z score (WFLZ) or body mass index z score (BMIZ) ≤-1 (15th-percentile). Group 1, reference group, consisted of subjects with both BMIZ and WFLZ >-1; group 2: BMIZ ≤-1 and WFLZ >-1; group 3: BMIZ >-1 and WFLZ ≤-1; and group 4: BMIZ and WFLZ ≤-1. Group differences in length-for-age-Z across ages 2-24 months were tested using generalized estimating equations. The association of group at age 2 months with BMIZ <-1 at age 6 years was tested using logistic regression adjusted for demographic and disease characteristics. RESULTS Overall, 163 482 anthropometric measurements were available from 12 640 individuals, of whom 16.8% were discordant for undernutrition status at age 2 months. Discordance (1.5%-10%) was less common with increasing age. Length-for-age-Z was lower in group 2 than group 1 and group 3 between birth and 24 months (P < .05). Odds of WFLZ-defined undernourished at 2 months were lower for shorter individuals (OR 1.5, CI 1.4-1.6, P < .001). Undernutrition risk at age 6 years was greater for group 2 vs group 3 (OR 1.9 vs 1.0, P < .001). CONCLUSIONS Infants with cystic fibrosis classified as undernourished by BMIZ, but not WFLZ, had greater risk of undernourished status later in childhood. Infants with low BMIZ but normal WFLZ tended to be shorter, suggesting BMIZ may better capture undernourished status than WFLZ in shorter infants.
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Affiliation(s)
- Zofia Zysman-Colman
- Division of Respiratory Medicine, Centre Hospitalier Universitaire Sainte Justine, Montreal, Quebec, Canada
| | - Zoya Munsar
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Saba Sheikh
- Division of Pulmonary Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Ronald C Rubenstein
- Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, MO
| | - Andrea Kelly
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA.
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Ruiz Brunner MDLM, Cuestas E, Heinen F, Schroeder AS. Growth in infants, children and adolescents with unilateral and bilateral cerebral palsy. Sci Rep 2022; 12:1879. [PMID: 35115566 PMCID: PMC8813947 DOI: 10.1038/s41598-022-05267-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 11/26/2021] [Indexed: 11/09/2022] Open
Abstract
To compare growth patterns during infancy, childhood and adolescence in children with unilateral and bilateral cerebral palsy (CP) phenotype and to assess the association with gross motor impairment, dysphagia and gestational age. We retrospectively studied 389 children with CP from a single center population in Munich, Germany. 1536 measurements of height and weight were tabulated and z-scored from 6 to 180 months of age. Generalized linear mixed model were used to examine the association between growth, GMFCS, dysphagia and gestational age by CP phenotype. Children with unilateral CP tend to grow similarly to their typically developed peers. In the main effect model, bilateral CP phenotype was significantly associated with decreased mean z-scores for height (β [95% CI] - 0.953 [- 1.145, - 0.761], p < 0.001), weight (- 0.999 [- 1.176, - 0.807], p < 0.001) and BMI (β [95% CI] - 0.437 [- 0.799, - 0.075]), compared with unilateral CP phenotype. This association remained significant in the interaction models. The height-for-age z-scores, weight-for-age decreased z-scores and BMI-for-age z-scores of children with bilateral CP and GMFCS III-V or dysphagia decreased more significantly than those of children with unilateral CP. Preterm birth was not significantly associated with decreased growth in height, weight and BMI. Reduced growth in children with bilateral CP was strongly associated with moderate to severe impairment in gross motor function (GMFCS III-V) and dysphagia.
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Affiliation(s)
- Maria de Las Mercedes Ruiz Brunner
- Instituto de Investigación en Ciencias de la Salud, Universidad Nacional de Córdoba, Consejo Nacional de Investigaciones Científicas y Técnicas, Bv de la Reforma S/N, Pabellón de Biología Celular, Ciudad Universitaria, CP: 5016, Córdoba, Argentina.
- Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, University Hospital of Munich (LMU), Hauner Children's Hospital, Munich, Germany.
| | - Eduardo Cuestas
- Instituto de Investigación en Ciencias de la Salud, Universidad Nacional de Córdoba, Consejo Nacional de Investigaciones Científicas y Técnicas, Bv de la Reforma S/N, Pabellón de Biología Celular, Ciudad Universitaria, CP: 5016, Córdoba, Argentina
- Cátedra de Clínica Pediátrica, Hospital Nuestra Señora de la Misericordia, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Florian Heinen
- Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, University Hospital of Munich (LMU), Hauner Children's Hospital, Munich, Germany
| | - Andreas Sebastian Schroeder
- Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, University Hospital of Munich (LMU), Hauner Children's Hospital, Munich, Germany.
- Ludwig Maximilian University of Munich (LMU), Hauner Children's Hospital, Paediatric Neurology, Developmental Medicine, Lindwurmstr. 4, 80337, Munich, Germany.
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LeCroy MN, Bryant M, Albrecht SS, Siega‐Riz AM, Ward DS, Cai J, Stevens J. Obesogenic home food availability, diet, and BMI in Pakistani and White toddlers. MATERNAL & CHILD NUTRITION 2021; 17:e13138. [PMID: 33470030 PMCID: PMC8189220 DOI: 10.1111/mcn.13138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 12/12/2022]
Abstract
Individuals of South Asian ethnicity have an increased risk for obesity and related diseases. Foods available in the home during the first 1000 days (conception to 24 months old) are an important determinant of diet, yet no study has examined the association of early-life home food availability (HFA) with later diet and obesity risk in South Asian households. We examined whether obesogenic HFA at 18 months of age is associated with dietary intake and body mass index (BMI) at 36 months of age in low-income Pakistani and White households in the United Kingdom. In this prospective birth cohort study (Born in Bradford 1000), follow-up assessments occurred at 18 (n = 1032) and 36 (n = 986) months of age. Variety and quantity of snack foods and sugar-sweetened beverages (SSBs) in the home and consumed were measured using the HFA Inventory Checklist and food frequency questionnaires, respectively. BMI was calculated using measured length/height and weight. Multinomial logistic regression models examined associations between HFA and tertiles of dietary intake, and multivariable linear regression models assessed associations between HFA and BMI. Pakistani households had a greater variety and quantity of snack foods and SSBs available compared with White households. Variety and quantity of snack foods and SSBs in the home at 18 months were positively associated with children's intake of these items at 36 months, but associations between HFA and BMI were null. Reducing obesogenic HFA during the first 1000 days may promote the development of more healthful diets, though this may not be associated with lower obesity risk during toddlerhood.
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Affiliation(s)
- Madison N. LeCroy
- Department of Nutrition, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineNew YorkNew YorkUSA
| | - Maria Bryant
- National Institute for Health Research Career Development Fellow, Clinical Trials Research Unit, Leeds Institute of Clinical Trials ResearchUniversity of LeedsLeedsUK
| | - Sandra S. Albrecht
- Department of Nutrition, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Carolina Population CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkNew YorkUSA
| | - Anna Maria Siega‐Riz
- School of NursingUniversity of VirginiaCharlottesvilleVirginiaUSA
- Departments of Nutrition and Biostatistics and Epidemiology, School of Public Health and Health SciencesUniversity of Massachusetts AmherstAmherstMassachusettsUSA
| | - Dianne S. Ward
- Department of Nutrition, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - June Stevens
- Departments of Nutrition and Epidemiology, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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Zysman-Colman ZN, Kilberg MJ, Harrison VS, Chesi A, Grant SFA, Mitchell J, Sheikh S, Hadjiliadis D, Rickels MR, Rubenstein RC, Kelly A. Genetic potential and height velocity during childhood and adolescence do not fully account for shorter stature in cystic fibrosis. Pediatr Res 2021; 89:653-659. [PMID: 32386398 PMCID: PMC7649126 DOI: 10.1038/s41390-020-0940-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 02/27/2020] [Accepted: 04/27/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Despite improved health, shorter stature is common in cystic fibrosis (CF). We aimed to describe height velocity (HV) and contribution of height-related genetic variants to height (HT) in CF. METHODS HV cohort: standard deviation scores (-Z) for HT, mid-parental height-adjusted HT (MPAH), and HV were generated using our Pediatric Center's CF Foundation registry data. HV-Z was compared with population means at each age (5-17 y), the relationship of HV-Z with HT-Z assessed, and HT-Z compared with MPAH-Z. GRS cohort: HT genetic risk-Z (HT-GRS-Z) were determined for pancreatic exocrine sufficient (PS) and insufficient (PI) youth and adults from our CF center and their relationships with HT-Z assessed. RESULTS HV cohort: average HV-Z was normal across ages in our cohort but was 1.5× lower (p < 0.01) for each SD decrease in HT-Z. MPAH-Z was lower than HT-Z (p < 0.001). GRS cohort: HT-GRS-Z more strongly correlated with HT-Z and better explained height variance in PS (rho = 0.42; R2= 0.25) vs. PI (rho = 0.27; R2 = 0.11). CONCLUSIONS Despite shorter stature compared with peers and mid-parental height, youth with CF generally have normal linear growth in mid- and late childhood. PI tempered the heritability of height. These results suggest that, in CF, final height is determined early in life in CF and genetic potential is attenuated by other factors. IMPACT Children with CF remain shorter than their healthy peers despite advances in care. Our study demonstrates that children with CF have persistent shorter stature from an early age and fail to reach their genetic potential despite height velocities comparable to those of average maturing healthy peers and similar enrichment in known height increasing single-nucleotide polymorphisms (SNPs). Genetic risk scores better explained variability in pancreatic sufficient than in pancreatic insufficient individuals, suggesting that other modifying factors are in play for pancreatic insufficient individuals with CF. Given the CF Foundation's recommendation to target not only normal body mass index, but normal height percentiles as well, this study adds valuable insight to this discussion.
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Affiliation(s)
| | - Marissa J. Kilberg
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Victor S. Harrison
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Alessandra Chesi
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Struan F. A. Grant
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA,Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Jonathan Mitchell
- Division of Gastroenterology, Hepatology and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Saba Sheikh
- Division of Pulmonary Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Denis Hadjiliadis
- Division of Pulmonary and Critical Care Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Michael R. Rickels
- Division of Endocrinology, Diabetes & Metabolism, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Ronald C. Rubenstein
- Division of Pulmonary Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA,corresponding author: Ronald C. Rubenstein, Pulmonary Medicine and Cystic Fibrosis Center, The Children’s Hospital of Philadelphia, Abramson Research Center Room 410A, 34th & Civic Center Blvd, Philadelphia, PA 19104, Phone: 215-590-1281, Fax: 215-590-1283,
| | - Andrea Kelly
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA
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Agreement in Infant Growth Indicators and Overweight/Obesity between Community and Clinical Care Settings. J Acad Nutr Diet 2020; 121:493-500. [PMID: 33339762 DOI: 10.1016/j.jand.2020.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 10/13/2020] [Accepted: 11/11/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Infants from low-income backgrounds receive nutrition care from both community and clinical care settings. However, mothers accessing these services have reported receiving conflicting messages related to infant growth between settings, although this has not been examined quantitatively. OBJECTIVE Describe the agreement in infant growth assessments between community (Special Supplemental Nutrition Program for Women, Infants, and Children) and clinical (primary care providers) care settings. DESIGN A cross-sectional, secondary data analysis of infant growth measures abstracted from electronic data management systems. PARTICIPANTS AND SETTING Participants included a convenience sample of infants (N = 129) from northeastern Pennsylvania randomized to the WEE Baby Care study from July 2016 to May 2018. Infants had complete anthropometric data from both community and clinical settings at age 6.2 ± 0.4 months. Average time between assessments was 2.7 ± 1.9 weeks. MAIN OUTCOME MEASURES Limits of agreement and bias in weight-for-age, length-for-age, weight-for-length, and body-mass-index-for-age z scores as well as cross-context equivalence in weight status between care settings. STATISTICAL ANALYSIS PERFORMED Bland-Altman analyses were used to describe the limits of agreement and bias in z scores between care settings. Cross-context equivalence was examined by dichotomizing infants' growth indicators at the 85th and 95th percentile cut-points and cross-tabulating equivalent and discordant categorization between settings. RESULTS Strongest agreement was observed for weight-for-age z scores (95% limits of agreement -0.41 to 0.54). However, the limits of agreement intervals for growth indicators that included length were wider, suggesting weaker agreement. There was a high level of inconsistency for classification of overweight/obesity using weight-for-length z scores, with 15.5% (85th percentile cut-point) and 11.6% (95th percentile cut-point) discordant categorization between settings, respectively. CONCLUSIONS Infant growth indicators that factor in length could contribute to disagreement in the interpretation of infant growth between settings. Further investigation into the techniques, standards, and training protocols for obtaining infant growth measurements across care settings is required.
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Nair N, Merhar S, Wessel J, Hall E, Kingma PS. Factors that Influence Longitudinal Growth from Birth to 18 Months of Age in Infants with Gastroschisis. Am J Perinatol 2020; 37:1438-1445. [PMID: 31365930 DOI: 10.1055/s-0039-1693988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE This study aimed to investigate factors that influence growth in infants with gastroschisis. STUDY DESIGN Growth parameters at birth, discharge, 6, 12, and 18 months of age were collected from 42 infants with gastroschisis. RESULTS The mean z-scores for weight, length, and head circumference were below normal at birth and decreased between birth and discharge. Lower gestational age correlated with a worsening change in weight z-score from birth to discharge (rho 0.38, p = 0.01), but not with the change in weight z-score from discharge to 18 months (rho 0.04, p = 0.81). There was no correlation between the day of life when the enteral feeds were started and the change in weight z-score from birth to discharge (rho 0.12, p = 0.44) or discharge to 18 months (rho -0.15, p = 0.41). CONCLUSION Our study demonstrates that infants with gastroschisis experience a significant decline in weight z-score between birth and discharge, and start to catch up on all growth parameters after discharge. Prematurity in gastroschisis infants is associated with a greater risk for weight loss during this time. This information emphasizes the importance of minimizing weight loss prior to discharge in premature infants with gastroschisis and highlights the need for optimal management strategies for these infants.
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Affiliation(s)
- Nitya Nair
- Division of Neonatology, Perinatal and Pulmonary Biology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Stephanie Merhar
- Division of Neonatology, Perinatal and Pulmonary Biology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jacqueline Wessel
- Division of Nutrition Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Eric Hall
- Division of Neonatology, Perinatal and Pulmonary Biology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Paul S Kingma
- Division of Neonatology, Perinatal and Pulmonary Biology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Cincinnati Fetal Center, Division of Pediatric General Thoracic and Fetal Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Messito MJ, Mendelsohn AL, Katzow MW, Scott MA, Vandyousefi S, Gross RS. Prenatal and Pediatric Primary Care-Based Child Obesity Prevention Program: A Randomized Trial. Pediatrics 2020; 146:e20200709. [PMID: 32883807 PMCID: PMC7546096 DOI: 10.1542/peds.2020-0709] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To determine impact of a primary care-based child obesity prevention intervention beginning during pregnancy on early childhood weight outcomes in low-income Hispanic families. METHODS A randomized controlled trial comparing mother-infant pairs receiving either standard care or the Starting Early Program providing prenatal and postpartum nutrition counseling and nutrition parenting support groups targeting key obesity-related feeding practices in low-income groups. Primary outcomes were reduction in weight-for-age z-scores (WFAzs) from clinical anthropometric measures, obesity prevalence (weight for age ≥95th percentile), and excess weight gain (WFAz trajectory) from birth to age 3 years. Secondary outcomes included dose effects. RESULTS Pregnant women (n = 566) were enrolled in the third trimester; 533 randomized to intervention (n = 266) or control (n = 267). Also, 358 children had their weight measured at age 2 years; 285 children had weight measured at age 3 years. Intervention infants had lower mean WFAz at 18 months (0.49 vs 0.73, P = .04) and 2 years (0.56 vs 0.81, P = .03) but not at 3 years (0.63 vs 0.59, P = .76). No group differences in obesity prevalence were found. When generalized estimating equations were used, significant average treatment effects were detected between 10-26 months (B = -0.19, P = .047), although not through age 3 years. In within group dose analyses at 3 years, obesity rates (26.4%, 22.5%, 8.0%, P = .02) decreased as attendance increased with low, medium, and high attendance. CONCLUSIONS Mean WFAz and growth trajectories were lower for the intervention group through age 2 years, but there were no group differences at age 3. Further study is needed to enhance sustainability of effects beyond age 2.
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Affiliation(s)
| | - Alan L Mendelsohn
- Developmental and Behavioral Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine and
| | - Michelle W Katzow
- Division of General Pediatrics, Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Marc A Scott
- Department of Applied Statistics, Social Science, and Humanities, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York; and
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Li YF, Lin SJ, Chiang TL. Timing of rapid weight gain and its effect on subsequent overweight or obesity in childhood: findings from a longitudinal birth cohort study. BMC Pediatr 2020; 20:293. [PMID: 32532342 PMCID: PMC7291582 DOI: 10.1186/s12887-020-02184-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 06/01/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rapid weight gain (RWG) has been recognized as an important determinant of childhood obesity. This study aims to explore the RWG distribution among children at six-month intervals from birth to two years old and to examine the association of RWG in each interval with overweight or obesity development in preschool- and school-aged children. METHODS Data were obtained from the Taiwan Birth Cohort Study, which is a nationally representative sample of 24,200 children who participated in a face-to-face survey. A total of 17,002 children had complete data both for weight and height at each of the five measurement time periods. Multivariable logistic regression models quantified the relationship between RWG and childhood overweight or obesity. RESULTS A total of 17.5% of children experienced rapid weight gain in the first six months of age, compared to only 1.8% of children from 18-24 months. RWG was significantly associated with an increased risk of developing overweight or obesity at 36 months (RWG birth-6 months: OR = 2.6, 95% CI: 2.3-2.8; RWG 18-24 months: OR = 3.7, 95% CI: 2.9-4.6), 66 months (RWG birth-6 months: OR = 2.2, 95% CI: 2.0-2.4; RWG 18-24 months: OR = 2.3, 95% CI: 1.8-2.8), and 8 years of age (RWG birth-6 months: OR = 1.7, 95% CI: 1.6-1.9; RWG 18-24 months: OR = 2.4, 95% CI: 2.0-3.0). CONCLUSIONS Childhood RWG increased the risk of subsequent overweight or obesity, regardless of the specific time interval at which RWG occurred before the age of two years. The results reinforce the importance of monitoring childhood RWG continuously and show the risks of childhood RWG with respect to the development of overweight or obesity at preschool and school ages.
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Affiliation(s)
- Yi-Fan Li
- Division of Clinical Chinese Medicine, National Research Institute of Chinese Medicine, Ministry of Health and Welfare in Taiwan, Taipei, Taiwan
| | - Shio-Jean Lin
- Department of Pediatrics, Chi Mei Medical Center, Taipei, Taiwan
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Room 620, No. 17, Xu-Zhou Road, Taipei, Taiwan, 10055, Taiwan.
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De Rubeis V, Bayat S, Griffith LE, Smith BT, Anderson LN. Validity of self-reported recall of anthropometric measures in early life: A systematic review and meta-analysis. Obes Rev 2019; 20:1426-1440. [PMID: 31184422 DOI: 10.1111/obr.12881] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/09/2019] [Accepted: 04/26/2019] [Indexed: 01/03/2023]
Abstract
Overweight and obesity in early life are risk factors for many adult-onset chronic diseases. The objective of this study was to assess the validity of self-reported recall of early life anthropometric measures. A systematic review was conducted by searching four electronic databases (PubMed, ProQuest, EMBASE, and MEDLINE). Studies were eligible if they evaluated the validity or reliability of self-reported recall by adults of their own body mass index, height, and/or weight during earlier life periods. Meta-analyses were conducted to pool correlation coefficients and mean differences. There were 15 studies included with a total of 17 477 participants. The mean pooled difference between self-reported recall of BMI compared with prospective measures was 0.06 kg/m2 (95% CI, -0.62 to 0.73), and the pooled correlation coefficient was 0.72 (95% CI, 0.65-0.79). Self-reported weight was also strongly correlated with reference standard measures (pooled r = 0.83; 95% CI, 0.72-0.90) with a small mean difference (0.87 kg; 95% CI, 0.19-1.56; I2 = 91%). Despite significant heterogeneity, the findings from this review suggest self-reported recall of early life body mass index, height, and weight may be valid measures. This evidence may inform life-course epidemiology studies considering the use of retrospective assessment of self-reported anthropometry.
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Affiliation(s)
- Vanessa De Rubeis
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sawila Bayat
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Brendan T Smith
- Department of Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Laura N Anderson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
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Early childhood linear growth faltering in low-income and middle-income countries as a whole-population condition: analysis of 179 Demographic and Health Surveys from 64 countries (1993-2015). LANCET GLOBAL HEALTH 2018; 5:e1249-e1257. [PMID: 29132614 PMCID: PMC5695758 DOI: 10.1016/s2214-109x(17)30418-7] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 09/06/2017] [Accepted: 09/20/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND The causes of early childhood linear growth faltering (known as stunting) in low-income and middle-income countries remain inadequately understood. We aimed to determine if the progressive postnatal decline in mean height-for-age Z score (HAZ) in low-income and middle-income countries is driven by relatively slow growth of certain high-risk children versus faltering of the entire population. METHODS Distributions of HAZ (based on WHO growth standards) were analysed in 3-month age intervals from 0 to 36 months of age in 179 Demographic and Health Surveys from 64 low-income and middle-income countries (1993-2015). Mean, standard deviation (SD), fifth percentiles, and 95th percentiles of the HAZ distribution were estimated for each age interval in each survey. Associations between mean HAZ and SD, fifth percentile, and 95th percentile were estimated using multilevel linear models. Stratified analyses were performed in consideration of potential modifiers (world region, national income, sample size, year, or mean HAZ in the 0-3 month age band). We also used Monte Carlo simulations to model the effects of subgroup versus whole-population faltering on the HAZ distribution. FINDINGS Declines in mean HAZ from birth to 3 years of age were accompanied by declines in both the fifth and 95th percentiles, leading to nearly symmetrical narrowing of the HAZ distributions. Thus, children with relatively low HAZ were not more likely to have faltered than taller same-age peers. Inferences were unchanged in surveys regardless of world region, national income, sample size, year, or mean HAZ in the 0-3 month age band. Simulations showed that the narrowing of the HAZ distribution as mean HAZ declined could not be explained by faltering limited to a growth-restricted subgroup of children. INTERPRETATION In low-income and middle-income countries, declines in mean HAZ with age are due to a downward shift in the entire HAZ distribution, revealing that children across the HAZ spectrum experience slower growth compared to the international standard. Efforts to mitigate postnatal linear growth faltering in low-income and middle-income countries should prioritise action on community-level determinants of childhood HAZ trajectories. FUNDING Bill & Melinda Gates Foundation.
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Figueroa Pedraza D. Food and nutrition surveillance system in municipalities of paraíba: data reliability, coverage and management's perception. REVISTA FACULTAD NACIONAL DE SALUD PÚBLICA 2017. [DOI: 10.17533/udea.rfnsp.v35n3a02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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14
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Sun C, Foskey RJ, Allen KJ, Dharmage SC, Koplin JJ, Ponsonby AL, Lowe AJ, Matheson MC, Tang MLK, Gurrin L, Wake M, Sabin M. The Impact of Timing of Introduction of Solids on Infant Body Mass Index. J Pediatr 2016; 179:104-110.e1. [PMID: 27663213 DOI: 10.1016/j.jpeds.2016.08.064] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 08/03/2016] [Accepted: 08/19/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To evaluate the associations between breastfeeding duration, age at solids introduction, and their interaction in relation to infant (age 9-15 months) above normal body mass index (BMI). STUDY DESIGN Cross-sectional, population-based study with 3153 infants from Melbourne (2007-2011). Above normal BMI (z score > 2, equivalent to >97.7th percentile) defined using the World Health Organization standard. RESULTS Both longer duration of full and any (full or partial) breastfeeding were associated with lower odds of above normal BMI (eg, aOR, 0.37 [95% CI, 0.22-0.60] for full breastfeeding 4-5 months versus 0-1 months). Compared with introduction of solids at 5-6 months, both early and delayed introduction were associated with increased odds of above normal BMI (aOR for 4 months, 1.75 [95% CI, 1.10-2.80] and for ≥7 months, 2.64 [95% CI, 1.26-5.54] versus 6 months). Such associations differ by breastfeeding status at 4 months (interaction P = .08). Early introduction of solids was associated with increased odds of above normal BMI in both infants fully or partially breastfed for ≥4 months (aOR, 3.66; 95% CI, 1.41-9.51) and those breastfed for <4 months (aOR, 3.11; 95% CI, 1.39-6.97). Introduction of solids at ≥7 months was associated with increased odds of above normal BMI (aOR, 5.79; 95% CI, 1.91-17.49) among infants breastfed for <4 months only. CONCLUSION Introduction of solids at 5-6 months, compared with either early or delayed introduction, is associated with decreased odds of above normal BMI at 1 year of age, regardless of infants' breastfeeding status at 4 months. These results may have implications for public health guidelines with regard to recommendations about the optimal timing of the introduction of solid foods in infancy.
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Affiliation(s)
- Cong Sun
- Environmental and Genetic Epidemiology Research Group, Murdoch Childrens Research Institute (MCRI), Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Katrina J Allen
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia; Centre for Food and Allergy Research, MCRI, Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia; Institute of Inflammation and Repair, University of Manchester, Manchester, UK.
| | - Shyamali C Dharmage
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer J Koplin
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia; Centre for Food and Allergy Research, MCRI, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Anne-Louise Ponsonby
- Environmental and Genetic Epidemiology Research Group, Murdoch Childrens Research Institute (MCRI), Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Adrian J Lowe
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Melanie C Matheson
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Mimi L K Tang
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia; Allergy and Immune Disorders, MCRI, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Lyle Gurrin
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Melissa Wake
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia; Centre for Community Child Health, MCRI, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Matthew Sabin
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia; Centre for Hormone Research, MCRI, Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Victoria, Australia
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Strand KM, Dahlseng MO, Lydersen S, Rø TB, Finbråten AK, Jahnsen RB, Andersen GL, Vik T. Growth during infancy and early childhood in children with cerebral palsy: a population-based study. Dev Med Child Neurol 2016; 58:924-30. [PMID: 26992128 DOI: 10.1111/dmcn.13098] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2016] [Indexed: 12/17/2022]
Abstract
AIM To describe growth in infancy and early childhood in children with cerebral palsy (CP). METHOD One hundred and four children with CP born at minimum 36 weeks' gestation in 2002 to 2010 were included. Prospectively collected growth data were requested from public health clinics. We calculated standard deviation (SD) scores (z-scores) for weight and height for 12 set age points for each child from birth to 5 years, and for head circumference from birth to 12 months. RESULTS Children with CP had normal growth in weight and height if they were born non-small for gestational age (non-SGA) or had mild motor impairments (i.e. Gross Motor Function Classification System [GMFCS] I-II), whereas children born SGA or with severe motor impairments (GMFCS III-V) had reduced growth (p<0.001). Children with feeding difficulties in infancy had reduced growth in weight and height throughout early childhood, while children without feeding difficulties had normal growth. Head circumference growth decreased most severely among children born SGA, who had mean z-scores of -3.0 (95% confidence interval [CI] -3.7 to -2.2) at 1 year. INTERPRETATION Children with mild CP had normal growth in weight and height until 5 years, and in head circumference during infancy. Feeding difficulties in infancy and being born SGA were strongly associated with reduced growth.
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Affiliation(s)
- Kristin Melheim Strand
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Magnus O Dahlseng
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Stian Lydersen
- The Regional Centre for Child and Adolescent Mental Health, NTNU, Trondheim, Norway
| | - Torstein B Rø
- Department of Pediatrics, St Olavs University Hospital, Trondheim, Norway
| | - Ane-Kristine Finbråten
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | | | - Guro L Andersen
- The Cerebral Palsy Register of Norway, Vestfold Hospital Trust, Tønsberg, Norway
| | - Torstein Vik
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Furlong KR, Anderson LN, Kang H, Lebovic G, Parkin PC, Maguire JL, O'Connor DL, Birken CS. BMI-for-Age and Weight-for-Length in Children 0 to 2 Years. Pediatrics 2016; 138:peds.2015-3809. [PMID: 27343232 DOI: 10.1542/peds.2015-3809] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To determine the agreement between weight-for-length and BMI-for-age in children 0 to <2 years by using research-collected data, examine factors that may affect agreement, and determine if agreement differs between research- and routinely collected data. METHODS Cross-sectional data on healthy, term-born children (n = 1632) aged 0 to <2 years attending the TARGet Kids! practice-based research network in Toronto, Canada (December 2008-October 2014) were collected. Multiple visits for each child were included. Length (cm) and weight (kg) measurements were obtained by trained research assistants during research visits, and by nonresearch staff during all other visits. BMI-for-age z-scores were compared with weight-for-length z-scores (the criterion measure). RESULTS The correlation between weight-for-length and BMI-for-age was strong (r = 0.986, P < .0001) and Bland-Altman plots revealed good agreement (difference = -0.08, SD = 0.20, P = .91). A small proportion (6.3%) of observations were misclassified and most misclassifications occurred near the percentile cutoffs. There were no differences by age and sex. Agreement was similar between research- and routinely collected data (r = 0.99, P < .001; mean difference -0.84, SD = 0.20, P = .67). CONCLUSIONS Weight-for-length and BMI-for-age demonstrated high agreement with low misclassification. BMI-for-age may be an appropriate indicator of growth in the first 2 years of life and has the potential to be used from birth to adulthood. Additional investigation is needed to determine if BMI-for-age in children <2 years is associated with future health outcomes.
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Affiliation(s)
- Kayla R Furlong
- Child Health and Evaluative Sciences, Research Institute, and
| | - Laura N Anderson
- Child Health and Evaluative Sciences, Research Institute, and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Huiying Kang
- Dalla Lana School of Public Health, The Applied Research Centre of the Li Ka Shing Knowledge Institute, and
| | - Gerald Lebovic
- The Applied Research Centre of the Li Ka Shing Knowledge Institute, and Institute of Health Policy, Management, and Evaluation, and
| | - Patricia C Parkin
- Child Health and Evaluative Sciences, Research Institute, and Institute of Health Policy, Management, and Evaluation, and Paediatric Outcomes Research Team, Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada; Departments of Paediatrics and
| | - Jonathon L Maguire
- The Applied Research Centre of the Li Ka Shing Knowledge Institute, and Institute of Health Policy, Management, and Evaluation, and Paediatric Outcomes Research Team, Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada; Departments of Paediatrics and Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;and Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Deborah L O'Connor
- Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;and
| | - Catherine S Birken
- Child Health and Evaluative Sciences, Research Institute, and Institute of Health Policy, Management, and Evaluation, and Paediatric Outcomes Research Team, Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada; Departments of Paediatrics and
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Wright J, Fairley L, McEachan R, Bryant M, Petherick E, Sahota P, Santorelli G, Barber S, Lawlor DA, Taylor N, Bhopal R, Cameron N, West J, Hill A, Summerbell C, Farrin A, Ball H, Brown T, Farrar D, Small N. Development and evaluation of an intervention for the prevention of childhood obesity in a multiethnic population: the Born in Bradford applied research programme. PROGRAMME GRANTS FOR APPLIED RESEARCH 2016. [DOI: 10.3310/pgfar04060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BackgroundThere is an absence of evidence about interventions to prevent or treat obesity in early childhood and in South Asian populations, in whom risk is higher.ObjectivesTo study patterns and the aetiology of childhood obesity in a multiethnic population and develop a prevention intervention.DesignA cohort of pregnant women and their infants was recruited. Measures to compare growth and identify targets for obesity prevention, sensitive to ethnic differences, were collected. A feasibility randomised controlled trial (RCT) was undertaken.SettingBradford, UK.ParticipantsA total of 1735 mothers, 933 of whom were of South Asian origin.InterventionA feasibility trial of a group-based intervention aimed at overweight women, delivered ante- and postnatally, targeting key modifiable lifestyle behaviours to reduce infant obesity.Main outcome measuresThe feasibility and acceptability of the pilot intervention.Data sourcesRoutine NHS data and additional bespoke research data.Review methodsA systematic review of diet and physical activity interventions to prevent or treat obesity in South Asian children and adults.ResultsRoutine measures of growth were accurate. The prevalence of risk factors differed between mothers of white British ethnicity and mothers of Pakistani ethnicity and weight and length growth trajectories differed between Pakistani infants and white British infants. Prediction equations for risk of childhood obesity were developed. An evidence-based intervention was evaluated in a pilot RCT and was found to be feasible and acceptable.LimitationsThis was a single-centre observational study and a pilot evaluation.ConclusionsThe programme has been successful in recruiting a unique multiethnic childhood obesity cohort, which has provided new evidence about modifiable risk factors and biethnic growth trajectories. A novel group-based behavioural change intervention has been developed and successfully piloted. A multisite cluster RCT is required to evaluate effectiveness.Trial registrationCurrent Controlled Trials ISRCTN56735429.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.
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Affiliation(s)
- John Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Lesley Fairley
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Maria Bryant
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Emily Petherick
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Pinki Sahota
- School of Health and Wellbeing, Leeds Beckett University, Leeds, UK
| | - Gillian Santorelli
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Sally Barber
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Debbie A Lawlor
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Natalie Taylor
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Raj Bhopal
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Noel Cameron
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Jane West
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Andrew Hill
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Carolyn Summerbell
- Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, UK
| | - Amanda Farrin
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Helen Ball
- Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, UK
| | - Tamara Brown
- Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, UK
| | - Diane Farrar
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Neil Small
- Faculty of Health Studies, University of Bradford, Bradford, UK
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Li YF, Lin SJ, Lin KC, Chiang TL. Growth References of Preschool Children Based on the Taiwan Birth Cohort Study and Compared to World Health Organization Growth Standards. Pediatr Neonatol 2016; 57:53-9. [PMID: 26143021 DOI: 10.1016/j.pedneo.2015.03.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 03/04/2015] [Accepted: 03/20/2015] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND To develop new growth references for height, weight, and body mass index (BMI) for children aged 0-5 years in the Taiwan Birth Cohort Study (TBCS) and to compare these references with both 1997 Taiwan references and World Health Organization (WHO) standards. METHODS Data were obtained from the TBCS of a nationally representative sample of 24,200 children. A total of 18,466 children completed the baseline survey at 6 months of age and three follow-up surveys at 18 months, 3 years, and 5.5 years of age. The modified LMS method was used to construct percentile curves by sex, including length/height for age, weight for age, and BMI for age. RESULTS TBCS children of both sexes were shorter and lighter at birth compared with 1997 Taiwan references and WHO standards. The growth patterns of TBCS children were close to those of the 1997 Taiwan references after 6 months of age. Compared with WHO standards, however, TBCS children were heavier after 6 months of age. CONCLUSION This study has developed TBCS references to monitor the growth of children in Taiwan, whose weight growth patterns differed from those "prescribed" by WHO standards.
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Affiliation(s)
- Yi-Fan Li
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Shio-Jean Lin
- Department of Pediatrics, Chi-Mei Hospital, Tainan, Taiwan
| | - Kuan-Chia Lin
- Department of Health Care Management, College of Healthcare and Management, National Taipei University of Nursing Health Sciences, Taipei, Taiwan
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
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Bonuck K, Chervin RD, Howe LD. Sleep-disordered breathing, sleep duration, and childhood overweight: a longitudinal cohort study. J Pediatr 2015; 166:632-9. [PMID: 25499598 PMCID: PMC4344922 DOI: 10.1016/j.jpeds.2014.11.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 10/06/2014] [Accepted: 11/03/2014] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To examine independent associations between sleep-disordered breathing (SDB), sleep duration from birth through 6.75 years, and body mass index (BMI) through 15 years of age in a population-based cohort. STUDY DESIGN The Avon Longitudinal Study of Parents and Children collected parent questionnaire data on child sleep duration and SDB symptoms from birth through 6.75 years and child BMI from the Avon Longitudinal Study of Parents and Children research clinics (n = 1899). For SDB, logistic regression models-minimal, confounder, and confounder + sleep duration adjusted-examined associations with BMI at 7, 10, and 15 years of age. For short sleep duration (≤10th percentile), comparable SDB-adjusted models examined associations with BMI at 15 years of age. RESULTS Children with the worst SDB symptoms vs asymptomatic children, had increased odds of overweight at 7 (OR = 2.08, 95% CI = 1.04-4.17), 10 (OR = 1.79, 95% CI = 1.02-3.16), and 15 years of age (OR = 2.25, 95% CI = 1.27-3.97) in models adjusted for sleep duration. Similarly, short sleep duration at ≈5-6 years was associated with overweight at 15 years, independent of SDB. Children with short sleep duration at 4.75 years were more likely to be overweight at 15 years in minimally (OR = 2.21, 95% CI = 1.52-3.20), confounder (OR = 1.99, 95% CI = 1.34-2.96), and SDB-adjusted (OR = 2.04, 95% CI = 1.36-3.04) models. CONCLUSIONS Both SDB and short sleep duration significantly and independently increase children's odds of becoming overweight. Findings underscore the potential importance of early identification and remediation of SDB, along with insufficient sleep, as strategies for reducing childhood obesity.
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Affiliation(s)
- Karen Bonuck
- Department of Family Medicine and Social Medicine, Albert Einstein College of Medicine, Bronx, NY.
| | - Ronald D Chervin
- Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI
| | - Laura D Howe
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom; School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
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