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Aljahdali AA, Cantoral A, Peterson KE, Perng W, Mercado-García A, Téllez-Rojo MM, Ramírez-Silva CI, Jansen EC. Breastfeeding Duration and Cardiometabolic Health during Adolescence: A Longitudinal Analysis. J Pediatr 2024; 265:113768. [PMID: 37802388 DOI: 10.1016/j.jpeds.2023.113768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/04/2023] [Accepted: 09/29/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE To investigate the longitudinal association between breastfeeding duration and cardiometabolic health, using repeated measures study design among children and adolescents. STUDY DESIGN This study included 634 offsprings aged 10 to 21 years (52% female) from the Early Life Exposure in Mexico to Environmental Toxicants birth cohort followed up to four time points during adolescence. Breastfeeding duration was prospectively quantified using questionnaires during early childhood. Cardiometabolic risk factors, body composition, and weight-related biomarkers were assessed as outcomes during adolescent follow-up visits. Sex-stratified linear mixed-effects models were used to model the association between quartiles of breastfeeding duration and outcomes, adjusting for age and additional covariates. RESULTS Median breastfeeding duration was 7 months (minimum = 0, maximum = 36). Boys in the second quartile (median breastfeeding = 5 months) had lower total fat mass % (β (SE) -3.2 (1.5) P = .037), and higher lean mass % (3.1 (1.6) P = .049) and skeletal muscle mass % (1.8 (0.8) P = .031) compared with the reference group (median breastfeeding = 2 months). A positive linear trend between breastfeeding duration and trunk lean mass % (0.1 (0.04) P = .035) was found among girls. No association was found with other cardiometabolic indicators. CONCLUSION Despite sex-specific associations of breastfeeding duration with body composition, there was a lack of substantial evidence for the protective effects of breastfeeding against impaired cardiometabolic health during adolescence among Mexican youth. Further longitudinal studies with a robust assessment of breastfeeding are recommended.
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Affiliation(s)
- Abeer A Aljahdali
- Department of Clinical Nutrition, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI
| | | | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI; Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI.
| | - Wei Perng
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Adriana Mercado-García
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Erica C Jansen
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI
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Saldanha Filho N, Reuter CP, Renner JDP, Barbian CD, de Castro Silveira JF, de Borba Schneiders L, Pohl HH. Low levels of cardiorespiratory fitness and abdominal resistance are associated with metabolic risk in schoolchildren. J Pediatr Endocrinol Metab 2019; 32:455-460. [PMID: 31042640 DOI: 10.1515/jpem-2018-0236] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 03/07/2019] [Indexed: 01/07/2023]
Abstract
Background Low levels of physical fitness are associated with metabolic disorders in adults. However, this relationship has been little explored in children and adolescents. The aim of the present study was to investigate whether there is an association between physical fitness related to health and the presence of metabolic risk in schoolchildren. Methods The sample for this cross-sectional study was composed of 1251 schoolchildren of both genders between 7 and 17 years of age. Three indicators of physical fitness related to health were evaluated: cardiorespiratory fitness (CRF), flexibility and abdominal resistance. The continuous metabolic syndrome score (cMetS) was calculated by using the sum of the Z scores of the following indicators: body mass index (BMI), systolic blood pressure, glucose, total cholesterol, high- and low-density lipoprotein cholesterol (HDL-c and LDL-c) and triglycerides. Subsequently, the cMetS was dichotomized, considering the presence or absence of metabolic risk. The data were analyzed using prevalence ratio (PR) values and 95% confidence intervals (CI), using Poisson regression. Results A higher prevalence of metabolic risk was found among students with low levels of CRF (PR: 1.48; CI: 1.10-1.98) and abdominal resistance (PR: 1.45; CI: 1.08-1.95). No association with flexibility was found. Conclusions Low levels of CRF and abdominal resistance are associated with the presence of metabolic risk in schoolchildren.
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Affiliation(s)
- Neri Saldanha Filho
- Postgraduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil.,Department of Physical Education and Health, University of Santa Cruz do Sul - UNISC, Santa Cruz do Sul, Brazil
| | - Cézane Priscila Reuter
- Postgraduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil.,Department of Physical Education and Health, University of Santa Cruz do Sul - UNISC, Av. Independência, 2293 - Bl. 42, s. 4201, Santa Cruz do Sul, RS 96815-900, Brazil, Phone: +55 (51) 3717-7603, Fax: +55 (51) 3717-1855
| | - Jane Dagmar Pollo Renner
- Postgraduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil.,Department of Biology and Pharmacy, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Cláudia Daniela Barbian
- Postgraduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | | | - Letícia de Borba Schneiders
- Postgraduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Hildegard Hedwig Pohl
- Postgraduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil.,Department of Physical Education and Health, University of Santa Cruz do Sul - UNISC, Santa Cruz do Sul, Brazil
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Yu HJ, Cai LB, Yang XH, Yuan S, Li QX, He QQ. Cardiorespiratory Fitness Attenuates the Obesity Risk in Chinese Children Who Have Parents with Overweight/Obesity. J Pediatr 2018; 200:150-154.e1. [PMID: 29934025 DOI: 10.1016/j.jpeds.2018.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/06/2018] [Accepted: 05/09/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To evaluate the impact of parental weight status and offspring cardiorespiratory fitness on the risk of obesity among Chinese children. STUDY DESIGN This cross-sectional study was conducted in Wuhan, China from May to June 2010. Children's height, weight, and waist circumference were measured for assessing their total and central obesity. Their cardiorespiratory fitness was determined by the 20-m shuttle-run test. We calculated parental body mass index according to self-reported height and weight, and divided it into normal weight or overweight/obesity. Multivariable logistic regression model was applied to estimate the combined relationships of cardiorespiratory fitness and parental weight status with the risk of obesity of children. RESULTS A total of 587 Chinese children (343 boys and 244 girls) aged 9.6 (0.7) years participated in this study. Compared with those who had low cardiorespiratory fitness and at least 1 parent with overweight/obesity, children who had high cardiorespiratory fitness and at least 1 parent with overweight/obesity reported lower risks of total obesity (OR 0.12, 95% CI .05-0.30) and central obesity (OR .09, 95% CI .04-0.20), and children who had high cardiorespiratory fitness and no parent with overweight/obesity were 89% (OR 0.11, 95% CI .05-0.24) less likely to have total obesity and 92% (OR .08, 95% CI .04-0.16) less likely to have central obesity (all P < .001). CONCLUSIONS High level of cardiorespiratory fitness among children could attenuate the influence of parental obesity on their offspring's weight status.
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Affiliation(s)
- Hong-Jie Yu
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Long-Biao Cai
- Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Xu-Hao Yang
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Shuai Yuan
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Qing-Xiao Li
- Department of Applied Economics, University of Minnesota, Saint Paul, MN
| | - Qi-Qiang He
- School of Health Sciences, Wuhan University, Wuhan, China.
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Wisnieski L, Kerver J, Holzman C, Todem D, Margerison-Zilko C. Breastfeeding and Risk of Metabolic Syndrome in Children and Adolescents: A Systematic Review. J Hum Lact 2018; 34:515-525. [PMID: 29100483 DOI: 10.1177/0890334417737038] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The beneficial effect of breastfeeding on individual components of the metabolic syndrome in children and adolescents has been reported, but it is unknown if there is an association between being breastfed and metabolic syndrome as a whole. Research aim: This systematic review was performed to assess quality and strength of evidence for the association between being breastfed and the development of metabolic syndrome in children and adolescents. METHODS Articles were obtained from searches using PubMed and Embase databases, as well as from secondary searches through reference lists. Study quality was assessed using a three-level quality rating system. RESULTS Of 11 studies reviewed, 7 found a protective association between breastfeeding and metabolic syndrome and 4 found no association. There was no clear dose-response relationship between duration of breastfeeding and metabolic syndrome risk and insufficient evidence to demonstrate an added effect of being exclusively breastfed. The overall quality of the articles was moderate. In general, lower quality articles found no significant association, whereas higher quality articles found a significant association. CONCLUSION Our review demonstrated a limited amount of high-quality research on the relationship between being breastfed and development of metabolic syndrome in children and adolescents. The evidence presented in this review suggests that being breastfed may be protective against metabolic syndrome, but further research with improvements in study design, such as improved measurement of breastfeeding and the use of prospectively collected data, will improve our understanding of this relationship.
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Affiliation(s)
- Lauren Wisnieski
- 1 Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Jean Kerver
- 1 Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Claudia Holzman
- 1 Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - David Todem
- 1 Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Claire Margerison-Zilko
- 1 Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
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Urban-Rural Differences in Cardiovascular Disease Risk Factors: A Cross-Sectional Study of Schoolchildren in Wuhan, China. PLoS One 2015; 10:e0137615. [PMID: 26352586 PMCID: PMC4564102 DOI: 10.1371/journal.pone.0137615] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 08/19/2015] [Indexed: 02/06/2023] Open
Abstract
Background China’s rapid population growth and urban migration has developed healthcare inequity across the urban-rural divide. Past studies comparing cardiovascular disease (CVD) risk factor prevalence amongst urban-rural Chinese children are sparse and conflicting. We examined the association between urban-rural residence and risk of offspring CVD in Chinese children. Methods A cross-sectional study was conducted in Wuhan, China, during May and June 2010. CVD risk factors include; waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), triglycerides (TG), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, body mass index (BMI), cardiorespiratory fitness (CRF), metabolic syndrome (MetS), and metabolic risk score (MRS). Analysis of covariance and multivariable logistic regression were used to estimate associations between urban-rural residence and offspring CVD risks. Findings A total of 579 Chinese children (338 boys and 241 girls) aged 9.6 (0.7) years participated in this study. Rural boys had significantly lower CRF and higher FBG, TG, and MRS, while urban boys had significantly higher LDL and DBP. Rural girls had significantly higher BMI, FBG, and TG, as well as lower CRF. Rural children were at increased risks for decreased CRF, elevated MRS, and TG, (OR:2.04, 95%CI:1.29–3.25), (OR:2.33, 95%CI:1.50–3.62), and (OR:2.40, 95%CI:1.62–3.57), respectively. Rural girls and mothers were at increased risks for overweight(OR:7.19, 95%CI:1.64–31.6)/obesity (OR:1.683, 95%CI:1.01–2.82). However, rural boys and fathers were less likely to have overweight(OR:0.62, 95%CI:0.34–1.12)/obesity (OR:0.68, 95%CI:0.48–0.97). Conclusions Rural residence was significantly associated with increased CVD risks amongst Chinese children. It is important to provide interventions aiming at China’s urban-rural healthcare inequity and community-based approaches that reduce familial CVD risk.
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McCarthy K, Ye YL, Yuan S, He QQ. Parental weight status and offspring cardiovascular disease risks: a cross-sectional study of Chinese children. Prev Chronic Dis 2015; 12:E01. [PMID: 25569694 PMCID: PMC4290097 DOI: 10.5888/pcd12.140384] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Introduction Prevalence of childhood obesity in China is increasing, and parental weight is a risk factor for the development of obesity in children. We examined the relationship of parental body weight status with risk of offspring cardiovascular disease (CVD) in Chinese children. Method We conducted a cross-sectional study in Wuhan, China, during May and June 2010. Parental body mass index (BMI) was calculated according to self-reported height and weight. Offspring CVD risk factors, including BMI, waist circumference, blood pressure, fasting glucose, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, cardiorespiratory fitness (CRF), and metabolic risk score (MRS), were assessed through anthropometric measures, blood samples, and a CRF test. Multiple linear regression and analysis of covariance were used to examine the effects of maternal and paternal weight status on offspring CVD risks. Results A total of 580 Chinese children (339 boys and 241 girls, mean [standard deviation] age, 9.6 [0.7] years) participated in the study. Maternal BMI was significantly associated with offspring elevated BMI (β = 0.134, P = .002), waist circumference (β = 0.253, P = .04), and decreased CRF (β = −0.134, P = .01). Paternal BMI was significantly associated with elevated offspring BMI (β = 0.161, P < .001), waist circumference (β = 0.404, P < .001), triglycerides (β = 0.017, P = .03), MRS (β = 0.084, P = .03), and decreased CRF (β = −0.174, P < .001). BMI (P < .001), waist circumference (P < .001), and MRS (P < .05) were positively associated with additional overweight/obese parents, whereas CRF was negatively associated (P < .001). Conclusion Parental weight status was significantly associated with increased risk of CVD in their children, and the association was stronger for paternal weight status.
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Affiliation(s)
- Kayne McCarthy
- School of Public Health, Wuhan University, Wuhan, P. R. China and University of Hawaii Office of Public Health Studies, Honolulu, Hawaii
| | - Yong-ling Ye
- School of Public Health, Wuhan University, Wuhan, P. R. China
| | - Shuai Yuan
- School of Public Health, Wuhan University, Wuhan, P. R. China
| | - Qi-qiang He
- School of Public Health/Global Health Institute, Wuhan University, Donghu Rd, No. 185, Wuhan, Hubei Province, 430071, P.R. China. E-mail:
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González-Jiménez E, Montero-Alonso MA, Schmidt-RioValle J, García-García CJ, Padez C. Metabolic syndrome in Spanish adolescents and its association with birth weight, breastfeeding duration, maternal smoking, and maternal obesity: a cross-sectional study. Eur J Nutr 2014; 54:589-97. [PMID: 25052543 DOI: 10.1007/s00394-014-0740-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 07/08/2014] [Indexed: 02/06/2023]
Abstract
PURPOSE The metabolic syndrome (MetS) in adolescents is a growing problem. The objectives were to verify the association among early predictors such as birth weight, breastfeeding, maternal weight status, smoking during pregnancy, and the development of MetS. METHODS A cross-sectional study was performed of 976 children and adolescents, 10-15 years of age, at schools in the provinces of Granada and Almeria (Spain). For this purpose, we analyzed the physical characteristics as well as the biochemical markers of the participants with a view to ascertaining the prevalence of the MetS. Relevant data were also extracted from the clinical histories of their mothers. RESULTS It was found that 3.85% of the female subjects and 5.38% of the male subjects in the sample population suffered from MetS. In both sexes, there was an association between birth weight and positive MetS diagnosis (OR 1.27). For both males and females, there was an inverse association between the length of time that they had been breastfed and positive MetS diagnosis (OR1-3 months 3.16; OR4-6 months 1.70; OR(>6 months) 0.13). There was also a significant association between maternal weight (OR(overweight )30.79; OR(obesity) 49.36) and cigarette consumption during pregnancy (OR 1.47) and the subsequent development of MetS in the children of these mothers. CONCLUSIONS Those subjects born with a higher than average birth weight had a greater risk of developing MetS in childhood and adolescence. Breastfeeding children for longer than 6 months protected them from MetS in their early years as well as in their teens. Other risk factors for MetS were maternal smoking during pregnancy as well as maternal overweight and obesity.
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Affiliation(s)
- Emilio González-Jiménez
- Department of Nursing, Faculty of Nursing, University of Granada, C/Santander No 1, 52071, Melilla, Spain,
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