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Titmuss A, Barzi F, Barr ELM, Webster V, Wood A, Kelaart J, Kirkwood M, Connors C, Boyle JA, Moore E, Oats J, McIntyre HD, Zimmet P, Brown ADH, Shaw JE, Craig ME, Maple-Brown LJ. Association between maternal hyperglycemia in pregnancy and offspring anthropometry in early childhood: the pandora wave 1 study. Int J Obes (Lond) 2023; 47:1120-1131. [PMID: 37608089 PMCID: PMC10599996 DOI: 10.1038/s41366-023-01366-6] [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: 01/13/2023] [Revised: 07/30/2023] [Accepted: 08/10/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND In-utero hyperglycemia exposure influences later cardiometabolic risk, although few studies include women with pre-existing type 2 diabetes (T2D) or assess maternal body mass index (BMI) as a potential confounder. OBJECTIVE To explore the association of maternal T2D and gestational diabetes mellitus (GDM) with childhood anthropometry, and the influence of maternal BMI on these associations. METHODS The PANDORA cohort comprises women (n = 1138) and children (n = 1163). Women with GDM and T2D were recruited from a hyperglycemia in pregnancy register, and women with normoglycemia from the community. Wave 1 follow-up included 423 children, aged 1.5-5 years (median follow-up age 2.5 years). Multivariable linear regression assessed associations between maternal antenatal variables, including BMI and glycemic status, with offspring anthropometry (weight, height, BMI, skinfold thicknesses, waist, arm and head circumferences). RESULTS Greater maternal antenatal BMI was associated with increased anthropometric measures in offspring independent of maternal glycemic status. After adjustment, including for maternal BMI, children exposed to maternal GDM had lower mean weight (-0.54 kg, 95% CI: -0.99, -0.11), BMI (-0.55 kg/m2, 95% CI: -0.91, -0.20), head (-0.52 cm, 95% CI: -0.88, -0.16) and mid-upper arm (-0.32 cm, 95% CI: -0.63, -0.01) circumferences, and greater mean suprailiac skinfold (0.78 mm, 95% CI: 0.13, 1.43), compared to children exposed to normoglycemia. Adjustment for maternal BMI strengthened the negative association between GDM and child weight, BMI and circumferences. Children exposed to maternal T2D had smaller mean head circumference (-0.82 cm, 95% CI: -1.33, -0.31) than children exposed to normoglycemia. Maternal T2D was no longer associated with greater child mean skinfolds (p = 0.14) or waist circumference (p = 0.18) after adjustment for maternal BMI. CONCLUSIONS Children exposed to GDM had greater suprailiac skinfold thickness than unexposed children, despite having lower mean weight, BMI and mid-upper arm circumference, and both GDM and T2D were associated with smaller mean head circumference. Future research should assess whether childhood anthropometric differences influence lifetime cardiometabolic and neurodevelopmental risk.
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Affiliation(s)
- Angela Titmuss
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
- Paediatric Department, Division of Women, Child and Youth, Royal Darwin Hospital, Darwin, NT, Australia.
| | - Federica Barzi
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Poche Centre for Indigenous Health, University of Queensland, Brisbane, QLD, Australia
| | - Elizabeth L M Barr
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Clinical and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Vanya Webster
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Anna Wood
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Endocrinology Department, Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
| | - Joanna Kelaart
- Aboriginal Health Domain, Baker Heart and Diabetes Institute, Alice Springs, NT, Australia
| | - Marie Kirkwood
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | | | - Jacqueline A Boyle
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Elizabeth Moore
- Public Health Unit, Aboriginal Medical Services Alliance of Northern Territory, Darwin, NT, Australia
| | - Jeremy Oats
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - H David McIntyre
- Faculty of Medicine, Mater Medical Research Institute, University of Queensland, Brisbane, QLD, Australia
| | - Paul Zimmet
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Alex D H Brown
- University of South Australia, Adelaide, SA, Australia
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
- Australian National University, Canberra, ACT, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - Jonathan E Shaw
- Clinical and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Maria E Craig
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Louise J Maple-Brown
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Endocrinology Department, Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
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Wahi G, Wilson J, Burning M, George S, Hill P, Homer J, Jacobs L, Lickers A, Smoke S, Davis AD, Desai D, Jack SM, Williams N, de Souza RJ, Anand SS. Impact of Maternal Health Behaviours and Social Conditions on Infant Diet at Age 1-Year: Results from a Prospective Indigenous Birth Cohort in Ontario, Canada. Nutrients 2022; 14:nu14091736. [PMID: 35565704 PMCID: PMC9102994 DOI: 10.3390/nu14091736] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/06/2022] [Accepted: 04/14/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Understanding the impact of maternal health behaviours and social conditions on childhood nutrition is important to inform strategies to promote health during childhood. Objective: To describe how maternal health sociodemographic factors (e.g., socioeconomic status, education), health behaviours (e.g., diet), and traditional health care use during pregnancy impact infant diet at age 1-year. Methods: Data were collected from the Indigenous Birth Cohort (ABC) study, a prospective birth cohort formed in partnership with an Indigenous community-based Birthing Centre in southwestern Ontario, Canada. 110 mother-infant dyads are included in the study and were enrolled between 2012 and 2017. Multiple linear regression analyses were performed to understand factors associated with infant diet scores at age 1-year, with a higher score indicating a diet with more healthy foods. Results: The mean age of women enrolled during pregnancy was 27.3 (5.9) years. Eighty percent of mothers had low or moderate social disadvantage, 47.3% completed more than high school education, and 70% were cared for by a midwife during their pregnancy. The pre-pregnancy body mass index (BMI) was <25 in 34.5% of women, 15.5% of mothers smoked during pregnancy, and 14.5% of mothers had gestational diabetes. Being cared for by an Indigenous midwife was associated with a 0.9-point higher infant diet score (p = 0.001) at age 1-year, and lower maternal social disadvantage was associated with a 0.17-point higher infant diet quality score (p = 0.04). Conclusion: This study highlights the positive impact of health care provision by Indigenous midwives and confirms that higher maternal social advantage has a positive impact on child nutrition.
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Affiliation(s)
- Gita Wahi
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4K1, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada; (S.M.J.); (R.J.d.S.); (S.S.A.)
- Correspondence:
| | - Julie Wilson
- Six Nations Birthing Centre, Six Nations of the Grand River, Ohsweken, ON N0A 1M0, Canada; (J.W.); (M.B.); (S.G.); (P.H.); (J.H.); (L.J.); (A.L.); (S.S.)
| | - Melanie Burning
- Six Nations Birthing Centre, Six Nations of the Grand River, Ohsweken, ON N0A 1M0, Canada; (J.W.); (M.B.); (S.G.); (P.H.); (J.H.); (L.J.); (A.L.); (S.S.)
| | - Stephanie George
- Six Nations Birthing Centre, Six Nations of the Grand River, Ohsweken, ON N0A 1M0, Canada; (J.W.); (M.B.); (S.G.); (P.H.); (J.H.); (L.J.); (A.L.); (S.S.)
| | - Phyllis Hill
- Six Nations Birthing Centre, Six Nations of the Grand River, Ohsweken, ON N0A 1M0, Canada; (J.W.); (M.B.); (S.G.); (P.H.); (J.H.); (L.J.); (A.L.); (S.S.)
| | - Janet Homer
- Six Nations Birthing Centre, Six Nations of the Grand River, Ohsweken, ON N0A 1M0, Canada; (J.W.); (M.B.); (S.G.); (P.H.); (J.H.); (L.J.); (A.L.); (S.S.)
| | - Laurie Jacobs
- Six Nations Birthing Centre, Six Nations of the Grand River, Ohsweken, ON N0A 1M0, Canada; (J.W.); (M.B.); (S.G.); (P.H.); (J.H.); (L.J.); (A.L.); (S.S.)
| | - Ashley Lickers
- Six Nations Birthing Centre, Six Nations of the Grand River, Ohsweken, ON N0A 1M0, Canada; (J.W.); (M.B.); (S.G.); (P.H.); (J.H.); (L.J.); (A.L.); (S.S.)
| | - Sharon Smoke
- Six Nations Birthing Centre, Six Nations of the Grand River, Ohsweken, ON N0A 1M0, Canada; (J.W.); (M.B.); (S.G.); (P.H.); (J.H.); (L.J.); (A.L.); (S.S.)
| | - Albertha D. Davis
- Six Nations Health Services, Six Nations of the Grant River, Ohsweken, ON N0A 1M0, Canada;
| | - Dipika Desai
- Population Health Research Institute, Hamilton, ON L8L 2X2, Canada;
| | - Susan M. Jack
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada; (S.M.J.); (R.J.d.S.); (S.S.A.)
- School of Nursing, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Natalie Williams
- Chanchlani Research Centre, Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada;
| | - Russell J. de Souza
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada; (S.M.J.); (R.J.d.S.); (S.S.A.)
- Population Health Research Institute, Hamilton, ON L8L 2X2, Canada;
| | - Sonia S. Anand
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada; (S.M.J.); (R.J.d.S.); (S.S.A.)
- Population Health Research Institute, Hamilton, ON L8L 2X2, Canada;
- Chanchlani Research Centre, Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada;
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Lloyd-Johnsen C, Eades S, McNamara B, D'Aprano A, Goldfeld S. A global perspective of Indigenous child health research: a systematic review of longitudinal studies. Int J Epidemiol 2021; 50:1554-1568. [PMID: 33864092 DOI: 10.1093/ije/dyab074] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Rigorously designed longitudinal studies can inform how best to reduce the widening health gap between Indigenous and non-Indigenous children. METHODS A systematic review was performed to identify and present the breadth and depth of longitudinal studies reporting the health and well-being of Indigenous children (aged 0-18 years) globally. Databases were searched up to 23 June 2020. Study characteristics were mapped according to domains of the life course model of health. Risk of bias was assessed using the National Institutes of Health (NIH) Study Quality Assessment Tools. Reported level of Indigenous involvement was also appraised; PROSPERO registration CRD42018089950. RESULTS From 5545 citations, 380 eligible papers were included for analysis, representing 210 individual studies. Of these, 41% were located in Australia (n = 88), 22.8% in the USA (n = 42), 11.9% in Canada (n = 25) and 10.9% in New Zealand (n = 23). Research tended to focus on either health outcomes (50.9%) or health-risk exposures (43.8%); 55% of studies were graded as 'good' quality; and 89% of studies made at least one reference to the involvement of Indigenous peoples over the course of their research. CONCLUSIONS We identified gaps in the longitudinal assessment of cultural factors influencing Indigenous child health at the macrosocial level, including connection to culture and country, intergenerational trauma, and racism or discrimination. Future longitudinal research needs to be conducted with strong Indigenous leadership and participation including holistic concepts of health. This is critical if we are to better understand the systematic factors driving health inequities experienced by Indigenous children globally.
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Affiliation(s)
- Catherine Lloyd-Johnsen
- Centre for Community Child Health, Royal Children's Hospital, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Sandra Eades
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Bridgette McNamara
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Anita D'Aprano
- Centre for Community Child Health, Royal Children's Hospital, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Royal Children's Hospital, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
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Shanmuganathan M, Kroezen Z, Gill B, Azab S, de Souza RJ, Teo KK, Atkinson S, Subbarao P, Desai D, Anand SS, Britz-McKibbin P. The maternal serum metabolome by multisegment injection-capillary electrophoresis-mass spectrometry: a high-throughput platform and standardized data workflow for large-scale epidemiological studies. Nat Protoc 2021; 16:1966-1994. [PMID: 33674789 DOI: 10.1038/s41596-020-00475-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/24/2020] [Indexed: 01/31/2023]
Abstract
A standardized data workflow is described for large-scale serum metabolomic studies using multisegment injection-capillary electrophoresis-mass spectrometry. Multiplexed separations increase throughput (<4 min/sample) for quantitative determination of 66 polar/ionic metabolites in serum filtrates consistently detected (coefficient of variance (CV) <30%) with high frequency (>75%) from a multi-ethnic cohort of pregnant women (n = 1,004). We outline a validated protocol implemented in four batches over a 7-month period that includes details on preventive maintenance, sample workup, data preprocessing and metabolite authentication. We achieve stringent quality control (QC) and robust batch correction of long-term signal drift with good mutual agreement for a wide range of metabolites, including serum glucose as compared to a clinical chemistry analyzer (mean bias = 11%, n = 668). Control charts for a recovery standard (mean CV = 12%, n = 2,412) and serum metabolites in QC samples (median CV = 13%, n = 202) demonstrate acceptable intermediate precision with a median intraclass coefficient of 0.87. We also report reference intervals for 53 serum metabolites from a diverse population of women in their second trimester of pregnancy.
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Affiliation(s)
- Meera Shanmuganathan
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario, Canada
| | - Zachary Kroezen
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario, Canada
| | - Biban Gill
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario, Canada
| | - Sandi Azab
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario, Canada
| | - Russell J de Souza
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.,Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Koon K Teo
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Stephanie Atkinson
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Padmaja Subbarao
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Dipika Desai
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sonia S Anand
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.,Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada.,Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Philip Britz-McKibbin
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario, Canada.
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5
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Zulyniak MA, de Souza RJ, Shaikh M, Ramasundarahettige C, Tam K, Williams N, Desai D, Lefebvre DL, Gupta M, Subbarao P, Becker AB, Mandhane PJ, Turvey SE, Moraes T, Azad MB, Teo KK, Sears MR, Anand SS. Ethnic differences in maternal diet in pregnancy and infant eczema. PLoS One 2020; 15:e0232170. [PMID: 32407330 PMCID: PMC7224524 DOI: 10.1371/journal.pone.0232170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 04/08/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The global prevalence of childhood eczema has increased over the last few decades, with a marked increase in high-income countries. Differences in prevalence of childhood eczema between countries and ethnicities suggest that genetic and early modifiable environmental factors, such as dietary intake, may underlie this observation. To investigate the association between pregnancy diet and infant eczema in a consortium of prospective Canadian birth cohorts predominantly comprised of white Europeans and South Asians. METHODS We evaluated the association of maternal dietary patterns reported during pregnancy (assessed at 24-28 weeks gestation using a semi-quantitiative food-frequency questionnaire) with parent-reported physician-diagnosed infant eczema at 1-year from 2,160 mother-infant pairs. Using three dietary patterns ("Western", "plant-based", and "Balanced") previously derived in this cohort using principal component analysis, we used multivariable logistic regression to determine the association of these dietary patterns with infant eczema, adjusted for potential confounders. RESULTS We observed a lower odds of eczema in the full sample combining white Europeans and South Asians with greater adherence to a plant-based (OR = 0.65; 95% CI: 0.55, 0.76; <0.001) and Western dietary pattern (OR = 0.73; 95% CI: 0.60, 0.89; P<0.01), after adjusting for other known predictors of eczema, including ethnicity, which was not significant. No associations were observed for the balanced diet. An interaction between the Western diet and ethnicity was observed (P<0.001). Following stratification by ethnicity, a protective association between the plant-based diet and infant eczema was confirmed in both white Europeans (OR = 0.59; 95% CI: 0.47, 0.74; P<0.001) and South Asians (OR = 0.77; 95% CI: 0.61, 0.97; P = 0.025). In white Europeans only, a Western diet was associated with a lower odds of infant eczema (OR = 0.69; 95% CI: 0.56, 0.87; P = 0.001) while a balanced diet increased the odds of infant eczema (OR = 1.23; 95% CI: 1.02, 1.49; P = 0.03). Beyond a plant-based diet, no significant associations with other dietary patterns were observed in South Asians. CONCLUSION A plant-based diet during pregnancy is associated with a lowered odds of infant eczema at 1 year in all participants. Future studies of the components of plant-based diet which underlie the lower risk of eczema are needed.
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Affiliation(s)
- Michael A. Zulyniak
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Russell J. de Souza
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Mateen Shaikh
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | | | - Keith Tam
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Natalie Williams
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Dipika Desai
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Diana L. Lefebvre
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Milan Gupta
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Canadian Collaborative Research Network, Brampton, Ontario, Canada
| | - Padmaja Subbarao
- Hospital for Sick Children & Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Allan B. Becker
- Department of Immunology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Piushkumar J. Mandhane
- Department of Paediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Stuart E. Turvey
- Department of Paediatrics, Faculty of Medicine, BC Children’s Hospital and Child and Family Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Theo Moraes
- Hospital for Sick Children & Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Meghan B. Azad
- Department of Pediatrics and Child Health, Health Sciences Centre, Children’s Hospital, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Koon K. Teo
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Malcolm R. Sears
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sonia S. Anand
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
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6
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Wahi G, Wilson J, Oster R, Rain P, Jack SM, Gittelsohn J, Kandasamy S, de Souza RJ, Martin CL, Toth E, Anand SS. Strategies for Promoting Healthy Nutrition and Physical Activity Among Young Children: Priorities of Two Indigenous Communities in Canada. Curr Dev Nutr 2020; 4:nzz137. [PMID: 31938762 PMCID: PMC6949274 DOI: 10.1093/cdn/nzz137] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/20/2019] [Accepted: 11/26/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Indigenous people in Canada carry a disproportionate burden of obesity and obesity-related diseases compared with non-Indigenous Canadians, which could be related to intergenerational trauma exposures. Implementing effective health promotion strategies to improve nutrition and physical activity behaviors during early childhood could be a strategy to mitigate the burden of intergenerational trauma exposures that have the potential to impact the trajectory to obesity and related complications throughout the lifecycle. OBJECTIVES The aim of this study was to support 2 Indigenous communities in identifying priorities and strategies for promoting healthy nutrition and physical activity for young children. METHODS Using a formative approach, we conducted a 2-phase study that started with 2 community engagement workshops (n = 37 participants), followed by a qualitative descriptive study. In this latter study, in-depth interviews were conducted with a purposeful sample of 23 community parents, health care providers, and traditional knowledge holders. Data from both study phases were analyzed and synthesized using conventional content analysis. RESULTS To promote healthy nutrition and physical activity among young children living in Indigenous communities, it was identified that the primary pathway to health and well-being must prioritize the integration of knowledge about Indigenous ways of life including traditional Indigenous foods and physical activities. Participants also identified individual/family and community/contextual factors that ultimately influence the nutrition and physical activity of children in their communities. CONCLUSIONS Informed by this formative study conducted to better understand community members' strategies for healthy eating and physical activity for young children, we argue for the continued recognition of the unique Indigenous context, incorporating the history of inequity and injustice and looking toward Indigenous-led interventions that incorporate this history and ways of life as solutions in the future.
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Affiliation(s)
- Gita Wahi
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Julie Wilson
- Six Nations Health Services, Six Nations of the Grand River, Ohsweken, Ontario, Canada
| | - Richard Oster
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Patricia Rain
- Maskwacis Health Services, Samson Cree Nation, Maskwacis, Alberta, Canada
| | - Susan M Jack
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Joel Gittelsohn
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sujane Kandasamy
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Russell J de Souza
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Cindy L Martin
- Six Nations Health Services, Six Nations of the Grand River, Ohsweken, Ontario, Canada
| | - Ellen Toth
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Sonia S Anand
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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7
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Welch JR, Ferreira AA, Tavares FG, Lucena JRM, Gomes de Oliveira MV, Santos RV, Coimbra CEA. The Xavante Longitudinal Health Study in Brazil: Objectives, design, and key results. Am J Hum Biol 2019; 32:e23339. [PMID: 31654538 PMCID: PMC7154686 DOI: 10.1002/ajhb.23339] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/28/2019] [Accepted: 09/17/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE The Xavante Longitudinal Health Study was developed to permit granular tracking of contemporary health challenges faced by indigenous communities in Brazil, taking into consideration ongoing historical processes that may be associated with increases in child undernutrition, adult obesity, and cardiovascular disease risks. METHODS This was an open-cohort study with six semiannual data collection waves from 2009 to 2012. The study was undertaken in two Xavante villages, Pimentel Barbosa and Etênhiritipá, State of Mato Grosso, Central Brazil. No sampling technique was used. Data collection placed emphasis on growth and nutrition of children under five and nutrition status, blood pressure, and blood glucose levels of adolescents and adults. RESULTS Baseline data collection began in July/August 2009 with a population census (656 individuals). Between the first and final waves, the study population increased by 17%. At baseline, stunting and wasting was elevated for most age groups <10 years. Overweight, obesity, and increased risk of metabolic complications were expressive among individuals >17 years, disproportionately affecting females. Anemia was elevated in most age groups, especially among females. Mean systolic and diastolic blood pressure was moderate. The overall prevalence of high blood pressure was relatively low. CONCLUSIONS Our findings reveal marked health disparities relative to the Brazilian national population and a complex dietary health epidemiology involving the double burden of malnutrition, rapidly changing nutritional indicators, and elevated metabolic disease risk. The topically broad multidisciplinary focus permitted construction of the richest longitudinal data set of socio-epidemiological information for an indigenous population in Brazil.
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Affiliation(s)
- James R Welch
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Aline A Ferreira
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Felipe G Tavares
- Escola de Enfermagem Aurora de Afonso Costa, Universidade Federal Fluminense, Niterói, Brazil
| | - J Rodolfo M Lucena
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Ricardo V Santos
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Museu Nacional, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos E A Coimbra
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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8
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The influence of maternal and infant nutrition on cardiometabolic traits: novel findings and future research directions from four Canadian birth cohort studies. Proc Nutr Soc 2019; 78:351-361. [PMID: 31140389 DOI: 10.1017/s0029665119000612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A mother's nutritional choices while pregnant may have a great influence on her baby's development in the womb and during infancy. There is evidence that what a mother eats during pregnancy interacts with her genes to affect her child's susceptibility to poor health outcomes including childhood obesity, pre-diabetes, allergy and asthma. Furthermore, after what an infant eats can change his or her intestinal bacteria, which can further influence the development of these poor outcomes. In the present paper, we review the importance of birth cohorts, the formation and early findings from a multi-ethnic birth cohort alliance in Canada and summarise our future research directions for this birth cohort alliance. We summarise a method for harmonising collection and analysis of self-reported dietary data across multiple cohorts and provide examples of how this birth cohort alliance has contributed to our understanding of gestational diabetes risk; ethnic and diet-influences differences in the healthy infant microbiome; and the interplay between diet, ethnicity and birth weight. Ongoing work in this birth cohort alliance will focus on the use of metabolomic profiling to measure dietary intake, discovery of unique diet-gene and diet-epigenome interactions, and qualitative interviews with families of children at risk of metabolic syndrome. Our findings to-date and future areas of research will advance the evidence base that informs dietary guidelines in pregnancy, infancy and childhood, and will be relevant to diverse and high-risk populations of Canada and other high-income countries.
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9
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Miettunen J, Haapea M, Björnholm L, Huhtaniska S, Juola T, Kinnunen L, Lehtiniemi H, Lieslehto J, Rautio N, Nordström T. Psychiatric research in the Northern Finland Birth Cohort 1986 - a systematic review. Int J Circumpolar Health 2019; 78:1571382. [PMID: 30744507 PMCID: PMC6374936 DOI: 10.1080/22423982.2019.1571382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The Northern Finland Birth Cohort 1986 is a large population-based birth cohort, which aims to promote health and wellbeing of the population. In this paper, we systematically review the psychiatric research performed in the cohort until today, i.e. at the age of 32 years of the cohort (2018). We conducted a systematic literature search using the databases of PubMed and Scopus and complemented it with a manual search. We found a total of 94 articles, which were classified as examining ADHD, emotional and behavioural problems, psychosis risk or other studies relating to psychiatric subjects. The articles are mainly based on two large comprehensive follow-up studies of the cohort and several substudies. The studies have often used also nationwide register data. The studies have found several early predictors for the aforementioned psychiatric outcomes, such as problems at pregnancy and birth, family factors in childhood, physical inactivity and substance use in adolescence. There are also novel findings relating to brain imaging and cognition, for instance regarding familial risk of psychosis in relation to resting state functional MRI. The Northern Finland Birth Cohort 1986 has been utilised frequently in psychiatric research and future data collections are likely to lead to new scientifically important findings. Abbreviations: attention deficit hyperactivity disorder (ADHD); magnetic resonance imaging (MRI)
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Affiliation(s)
- Jouko Miettunen
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Marianne Haapea
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland.,c Department of Psychiatry , Oulu University Hospital , Oulu , Finland
| | - Lassi Björnholm
- c Department of Psychiatry , Oulu University Hospital , Oulu , Finland.,d Department of Psychiatry , Research Unit of Clinical Neuroscience, University of Oulu , Oulu , Finland
| | - Sanna Huhtaniska
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland
| | - Teija Juola
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland
| | - Lotta Kinnunen
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Heli Lehtiniemi
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland.,e Northern Finland Birth Cohorts, Faculty of Medicine , University of Oulu , Oulu , Finland
| | - Johannes Lieslehto
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Nina Rautio
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Tanja Nordström
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland.,e Northern Finland Birth Cohorts, Faculty of Medicine , University of Oulu , Oulu , Finland
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10
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Nolan AM, Stewart LA. Chronic Health Conditions Among Incoming Canadian Federally Sentenced Women. JOURNAL OF CORRECTIONAL HEALTH CARE 2018; 23:93-103. [PMID: 28100145 DOI: 10.1177/1078345816685707] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Over a 13-month period, health data on all consecutive incoming Canadian federally sentenced women offenders were collected and analyzed ( N = 280). The most common health conditions cited were back pain, head injury, hepatitis C virus (HCV), and asthma. Rates of chronic health problems were generally similar to those of their male offender counterparts, with the notable exception of HCV, which was higher for women. Aboriginal women offenders had particularly high rates of HCV. The study provides valuable information on the self-reported physical health status of federally sentenced women offenders that can be used as a benchmark to examine health trends over time.
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Affiliation(s)
- Amanda M Nolan
- 1 Correctional Service of Canada, Ottawa, Ontario, Canada
| | - Lynn A Stewart
- 1 Correctional Service of Canada, Ottawa, Ontario, Canada
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11
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Zulyniak MA, de Souza RJ, Shaikh M, Desai D, Lefebvre DL, Gupta M, Wilson J, Wahi G, Subbarao P, Becker AB, Mandhane P, Turvey SE, Beyene J, Atkinson S, Morrison KM, McDonald S, Teo KK, Sears MR, Anand SS. Does the impact of a plant-based diet during pregnancy on birth weight differ by ethnicity? A dietary pattern analysis from a prospective Canadian birth cohort alliance. BMJ Open 2017; 7:e017753. [PMID: 29138203 PMCID: PMC5695448 DOI: 10.1136/bmjopen-2017-017753] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Birth weight is an indicator of newborn health and a strong predictor of health outcomes in later life. Significant variation in diet during pregnancy between ethnic groups in high-income countries provides an ideal opportunity to investigate the influence of maternal diet on birth weight. SETTING Four multiethnic birth cohorts based in Canada (the NutriGen Alliance). PARTICIPANTS 3997 full-term mother-infant pairs of diverse ethnic groups who had principal component analysis-derived diet pattern scores-plant-based, Western and health-conscious-and birth weight data. RESULTS No associations were identified between the Western and health-conscious diet patterns and birth weight; however, the plant-based dietary pattern was inversely associated with birth weight (β=-67.6 g per 1-unit increase; P<0.001), and an interaction with non-white ethnicity and birth weight was observed. Ethnically stratified analyses demonstrated that among white Europeans, maternal consumption of a plant-based diet associated with lower birth weight (β=-65.9 g per 1-unit increase; P<0.001), increased risk of small-for-gestational age (SGA; OR=1.46; 95% CI 1.08 to 1.54;P=0.005) and reduced risk of large-for-gestational age (LGA; OR=0.71; 95% CI 0.53 to 0.95;P=0.02). Among South Asians, maternal consumption of a plant-based diet associated with a higher birth weight (β=+40.5 g per 1-unit increase; P=0.01), partially explained by cooked vegetable consumption. CONCLUSIONS Maternal consumption of a plant-based diet during pregnancy is associated with birth weight. Among white Europeans, a plant-based diet is associated with lower birth weight, reduced odds of an infant born LGA and increased odds of SGA, whereas among South Asians living in Canada, a plant-based diet is associated with increased birth weight.
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Affiliation(s)
- Michael A Zulyniak
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Russell J de Souza
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Mateen Shaikh
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Dipika Desai
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Diana L Lefebvre
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Milan Gupta
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Canadian Cardiovascular Research Network, Brampton, Ontario, Canada
| | - Julie Wilson
- Six Nations Health Services, Ohsweken, Ontario, Canada
| | - Gita Wahi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Padmaja Subbarao
- Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Allan B Becker
- Department of Immunology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Piush Mandhane
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Stuart E Turvey
- Department of Paediatrics, Faculty of Medicine, University of British Columbia, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Joseph Beyene
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Stephanie Atkinson
- Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada
| | | | - Sarah McDonald
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Koon K Teo
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Malcolm R Sears
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sonia S Anand
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
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12
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de Souza RJ, Zulyniak MA, Desai D, Shaikh MR, Campbell NC, Lefebvre DL, Gupta M, Wilson J, Wahi G, Atkinson SA, Teo KK, Subbarao P, Becker AB, Mandhane PJ, Turvey SE, Sears MR, Anand SS. Harmonization of Food-Frequency Questionnaires and Dietary Pattern Analysis in 4 Ethnically Diverse Birth Cohorts. J Nutr 2016; 146:2343-2350. [PMID: 27708121 DOI: 10.3945/jn.116.236729] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 09/09/2016] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Canada is an ethnically diverse nation, which introduces challenges for health care providers tasked with providing evidence-based dietary advice. OBJECTIVES We aimed to harmonize food-frequency questionnaires (FFQs) across 4 birth cohorts of ethnically diverse pregnant women to derive robust dietary patterns to investigate maternal and newborn outcomes. METHODS The NutriGen Alliance comprises 4 prospective birth cohorts and includes 4880 Canadian mother-infant pairs of predominantly white European [CHILD (Canadian Healthy Infant Longitudinal Development) and FAMILY (Family Atherosclerosis Monitoring In earLY life)], South Asian [START (SouTh Asian birth cohoRT)-Canada], or Aboriginal [ABC (Aboriginal Birth Cohort)] origins. CHILD used a multiethnic FFQ based on a previously validated instrument designed by the Fred Hutchinson Cancer Research Center, whereas FAMILY, START, and ABC used questionnaires specifically designed for use in white European, South Asian, and Aboriginal people, respectively. The serving sizes and consumption frequencies of individual food items within the 4 FFQs were harmonized and aggregated into 36 common food groups. Principal components analysis was used to identify dietary patterns that were internally validated against self-reported vegetarian status and externally validated against a modified Alternative Healthy Eating Index (mAHEI). RESULTS Three maternal dietary patterns were identified-"plant-based," "Western," and "health-conscious"-which collectively explained 29% of the total variability in eating habits observed in the NutriGen Alliance. These patterns were strongly associated with self-reported vegetarian status (OR: 3.85; 95% CI: 3.47, 4.29; r2 = 0.30, P < 0.001; for a plant-based diet), and average adherence to the plant-based diet was higher in participants in the fourth quartile of the mAHEI than in the first quartile (mean difference: 46.1%; r2 = 0.81, P < 0.001). CONCLUSION Dietary data collected by using FFQs from ethnically diverse pregnant women can be harmonized to identify common dietary patterns to investigate associations between maternal dietary intake and health outcomes.
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Affiliation(s)
- Russell J de Souza
- Departments of Clinical Epidemiology and Biostatistics, .,Department of Nutritional Sciences and.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | | | - Dipika Desai
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | | | | | | | - Milan Gupta
- Medicine, and.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Julie Wilson
- Six Nations Health Services, Ohsweken, Ontario, Canada
| | - Gita Wahi
- Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Padmaja Subbarao
- Hospital for Sick Children and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Allan B Becker
- Department of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Piushkumar J Mandhane
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; and
| | - Stuart E Turvey
- British Columbia Children's Hospital and Child and Family Research Institute, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Sonia S Anand
- Departments of Clinical Epidemiology and Biostatistics.,Medicine, and.,Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
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13
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Zhou G, Li Q, Huang L, Wu Y, Wu M, Wang WC. Quality Analysis of DNA from Cord Blood Buffy Coat: The Best Neonatal DNA Source for Epidemiological Studies? Biopreserv Biobank 2016; 14:165-71. [PMID: 26885947 DOI: 10.1089/bio.2015.0075] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Guangdi Zhou
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qin Li
- Department of Obstetrics and Gynecology, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai, China
| | - Lisu Huang
- Department of Pediatrics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhang Wu
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Meiqin Wu
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiye C. Wang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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14
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Factors Affecting Underweight and Obesity Among Elementary School Children in South Korea. Asian Nurs Res (Korean Soc Nurs Sci) 2015; 9:298-304. [PMID: 26724238 DOI: 10.1016/j.anr.2015.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 04/02/2015] [Accepted: 07/22/2015] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The purpose of the study was to determine factors associated with underweight and obesity in elementary school children in Korea. METHODS Study participants included 4,895 children attending 59 elementary schools across Korea. Children were grouped into underweight [< 5% body mass index (BMI)-for-age], normal weight (5%-85% BMI-for-age), and overweight/obese (≥ 85% BMI-for age). The questionnaire included demographic characteristics, health status, and diet and exercise behavior of children, and environmental characteristics of schools. RESULTS Twelve percent of the children were overweight or obese. The results showed that demographic (age and gender), health status (atopic dermatitis and poor subjective health), and the characteristics of diet and exercise (unbalanced diet and diet experiences) were associated with underweight (p < .05), while demographic (age and gender), health status (poor subjective health), behavioral characteristics (fast food consumption and diet experiences), and school environmental characteristics (rural area) were associated with overweight/obesity (p < .05). CONCLUSIONS Programs and interventions to reduce underweight and overweight/obesity in Korean elementary schools must consider behavioral and environmental characteristics of children.
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15
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Valera B, Sohani Z, Rana A, Poirier P, Anand SS. The ethnoepidemiology of obesity. Can J Cardiol 2014; 31:131-41. [PMID: 25661548 DOI: 10.1016/j.cjca.2014.10.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/02/2014] [Accepted: 10/06/2014] [Indexed: 12/25/2022] Open
Abstract
The prevalence of overweight and obesity varies significantly across ethnic groups and among aboriginal people in Canada and appears to be increasing overall in children and youth, which will have significant health consequences in the future. Individual health behaviours, genetic predisposition, and community-level factors all contribute to the high burden of overweight and obesity across communities in Canada. Preliminary studies indicate that individuals who live in neighbourhoods in Canada with increased walkability, fewer fast food outlets, and higher socioeconomic status have lower rates of overweight/obesity when compared with other neighbourhoods. However, more research is required to understand the impact of community level factors on overweight/obesity trends in Canadian ethnic groups, including children and youth, and aboriginal people.
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Affiliation(s)
- Beatriz Valera
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Québec, Canada
| | - Zahra Sohani
- Population Genomics Program, Department of Clinical Epidemiology & Biostatistics, Hamilton, Ontario, Canada; Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada
| | - Ayesha Rana
- Population Genomics Program, Department of Clinical Epidemiology & Biostatistics, Hamilton, Ontario, Canada; Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada
| | - Paul Poirier
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Québec, Canada; Faculté de pharmacie de l'Université Laval, Québec, Québec, Canada
| | - Sonia S Anand
- Population Genomics Program, Department of Clinical Epidemiology & Biostatistics, Hamilton, Ontario, Canada; Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
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