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Melnick EM, Doom JR. "Associations between maternal perceptions of social support and adolescent weight status: A longitudinal analysis". SSM Popul Health 2024; 25:101647. [PMID: 38495803 PMCID: PMC10943960 DOI: 10.1016/j.ssmph.2024.101647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/12/2024] [Accepted: 02/27/2024] [Indexed: 03/19/2024] Open
Abstract
Social support is a well-established predictor of improved physical health outcomes among adults. Establishing whether maternal social support may have an inter-generational positive impact on their child's physical health will provide important information for developing potential interventions and policies. Elevated body mass index (BMI) is one indicator of child health that is linked to increased risk for cardiovascular disease and other morbidities later in life. There is some evidence that maternal social support is associated with improved child and adolescent weight status; however, no studies have examined whether specific aspects of social support are more impactful than others or whether support availability is differentially impactful across developmental stages. The present study examined whether maternal perceptions of specific types of social support (i.e., financial support, non-monetary instrumental support, partner emotional support, and having a close supportive contact) were associated with lower adolescent BMI z-scores using longitudinal data collected over a 15-year period from the Future of Families and Child Wellbeing Study (n = 3146), which includes a high proportion of families experiencing socioeconomic disadvantage. Findings from linear regression models using specific types of social support measured across six waves of data collected over a 15-year period indicated that maternal perceptions of greater financial support were associated with lower adolescent BMI z-scores at 15 years (B = -0.05, 95% CI: -0.10, -0.004, P = 0.04), while the other types of support were not. Additional timing analyses demonstrated that perceived financial support during late childhood to adolescence was associated with lower adolescent BMI z-scores (B = -0.06, 95% CI: -0.11, -0.01, P = 0.01), whereas associations between support during infancy and early childhood were not detected. Study findings provide important insights for developing interventions and policies that improve maternal social supports to benefit child health.
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Affiliation(s)
- Emily M. Melnick
- Department of Psychiatry, University of Colorado Anschutz, 13001 E 17th Pl, Aurora, CO, 80045, USA
- Department of Psychology, University of Denver, 2155 S. Race St., Denver, CO, 80210, USA
| | - Jenalee R. Doom
- Department of Psychology, University of Denver, 2155 S. Race St., Denver, CO, 80210, USA
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2
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Alemany M. The Metabolic Syndrome, a Human Disease. Int J Mol Sci 2024; 25:2251. [PMID: 38396928 PMCID: PMC10888680 DOI: 10.3390/ijms25042251] [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: 12/01/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
This review focuses on the question of metabolic syndrome (MS) being a complex, but essentially monophyletic, galaxy of associated diseases/disorders, or just a syndrome of related but rather independent pathologies. The human nature of MS (its exceptionality in Nature and its close interdependence with human action and evolution) is presented and discussed. The text also describes the close interdependence of its components, with special emphasis on the description of their interrelations (including their syndromic development and recruitment), as well as their consequences upon energy handling and partition. The main theories on MS's origin and development are presented in relation to hepatic steatosis, type 2 diabetes, and obesity, but encompass most of the MS components described so far. The differential effects of sex and its biological consequences are considered under the light of human social needs and evolution, which are also directly related to MS epidemiology, severity, and relations with senescence. The triggering and maintenance factors of MS are discussed, with especial emphasis on inflammation, a complex process affecting different levels of organization and which is a critical element for MS development. Inflammation is also related to the operation of connective tissue (including the adipose organ) and the widely studied and acknowledged influence of diet. The role of diet composition, including the transcendence of the anaplerotic maintenance of the Krebs cycle from dietary amino acid supply (and its timing), is developed in the context of testosterone and β-estradiol control of the insulin-glycaemia hepatic core system of carbohydrate-triacylglycerol energy handling. The high probability of MS acting as a unique complex biological control system (essentially monophyletic) is presented, together with additional perspectives/considerations on the treatment of this 'very' human disease.
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Affiliation(s)
- Marià Alemany
- Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Catalonia, Spain
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3
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Lindsay AC, Caires T, Le Q, Nogueira DL, Tavares Machado MM, Greaney ML. Where Do Brazilian Immigrant Parents Obtain Information to Support the Healthful Energy Balance-related Behaviors of Their Preschool-age Children?: A Cross-sectional Study. AMERICAN JOURNAL OF HEALTH EDUCATION 2021. [DOI: 10.1080/19325037.2021.2001775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
| | | | - Qun Le
- Rutgers University, the State University of New Jersey
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Homs C, Berruezo P, Según G, Estrada L, de Bont J, Riera-Romaní J, Carrillo-Álvarez E, Schröder H, Milà R, Gómez SF. Family-based intervention to prevent childhood obesity among school-age children of low socioeconomic status: study protocol of the FIVALIN project. BMC Pediatr 2021; 21:246. [PMID: 34020614 PMCID: PMC8139065 DOI: 10.1186/s12887-021-02697-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 05/04/2021] [Indexed: 12/12/2022] Open
Abstract
Background Childhood obesity represents a global public health crisis: the number of obese children and adolescents (aged 519years) worldwide has risen tenfold in the past four decades. The vast majority of overweight and obese children live in high-income countries, and low socio-economic status (SES) is a significant risk factor. Family Based Interventions (FBI) have demonstrated positive results in preventing obesity, although these results are strongly influenced by SES. Moreover, we still poorly understand how FBI can determine a positive trend in weight status in low-income communities. Therefore, there is an urgent need to define and evaluate innovative and multi-target projects to reduce obesity risk behaviors and health inequalities and the present study aims to present the study protocol of FIVALIN a FBI that pretends to achieve this goal. Methods We will conduct a quasi-experimental design within 60 Community Child Centers (CCC) in Barcelona metropolitan area. Each cluster (CCC) will be assigned by convenience to the intervention and control groups. For the whole study, a total of 810 children aged 812years and 600 parents will be recruited during 3 consecutive editions (1st 2019/2020; 2nd 2020/2021; 3rd 2021/2022) of 10months each. The action is a regular multicomponent health-promotion intervention targeting children, families, and CCC. All activities are based on the Motivational Interviewing (MI) approach and will focus on promoting good dietary habits, physical activity, appropriate screen time and sleep duration, and psychological well-being. The control group participate in a unique workshop on general awareness of healthy lifestyles for families. We will perform a comparative analysis of the evolution of weight status, healthy lifestyles, and socioeconomic variables, between the intervention and control groups. Discussion There is a need for more evidence on how to target and evaluate holistic interventions in low SES families. Our multi-targeting intervention for obesity prevention tackles risky behaviors that go beyond diet and physical activity (PA). Therefore, future interventions can effectively promote all the behavioral domains that determine trends in the weight status. Trial registration ISRCTN Registry: ISRCRN12682870. Registered 9 July 2020. Retrospectively registered. Protocol version: 30 April 2021, version 5. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02697-x.
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Affiliation(s)
- C Homs
- Gasol Foundation, Sant Boi de Llobregat, Spain.,Faculty of Psychology, PSITIC Research Group, Education and Sport Sciences Blanquerna - Universitat Ramon Llull, Císter, 34 08032, Barcelona, Spain
| | - P Berruezo
- Gasol Foundation, Sant Boi de Llobregat, Spain
| | - G Según
- Gasol Foundation, Sant Boi de Llobregat, Spain
| | - L Estrada
- Gasol Foundation, Los Angeles, CA, USA
| | - J de Bont
- ISGlobal, Barcelona, Spain.,CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.,Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - J Riera-Romaní
- Faculty of Psychology, PSITIC Research Group, Education and Sport Sciences Blanquerna - Universitat Ramon Llull, Císter, 34 08032, Barcelona, Spain
| | - E Carrillo-Álvarez
- Global Research on Wellbeing (GRoW) research group, Blanquerna School of Health Sciences - Universitat Ramon Llull, Padilla, 326-332 08025, Barcelona, Spain
| | - H Schröder
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain.,Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - R Milà
- Global Research on Wellbeing (GRoW) research group, Blanquerna School of Health Sciences - Universitat Ramon Llull, Padilla, 326-332 08025, Barcelona, Spain
| | - S F Gómez
- Gasol Foundation, Sant Boi de Llobregat, Spain. .,GREpS, Health Education Research Group, Nursing and Physiotherapy Department, University of Lleida, Lleida, Spain.
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Rossiter C, Cheng H, Appleton J, Campbell KJ, Denney-Wilson E. Addressing obesity in the first 1000 days in high risk infants: Systematic review. MATERNAL AND CHILD NUTRITION 2021; 17:e13178. [PMID: 33780128 PMCID: PMC8189222 DOI: 10.1111/mcn.13178] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 12/11/2022]
Abstract
Early intervention is critical for addressing the challenge of childhood obesity. Yet many preventive interventions do not target infants most at risk of future overweight or obesity. This systematic review examines interventions delivered before 2 years that aim to ameliorate excess weight gain among infants at high risk of overweight or obesity, due to sociodemographic characteristics, parental weight or health status, infant feeding or health behaviours. We searched six databases for interventions: (a) delivered before age two, (b) specifically aimed at infants at high risk of childhood obesity and (c) that reported outcomes by weight status beyond 28 days. The search identified over 27,000 titles, and 49 papers from 38 studies met inclusion criteria: 10 antenatal interventions, 16 postnatal and 12 conducted both before and after birth. Nearly all targeted infant and/or maternal nutrition. Studies varied widely in design, obesity risk factors, outcomes and quality. Overall, nine interventions of varying quality reported some evidence of significantly improved child weight trajectory, although effects tended to diminish over time. Interventions that improved weight outcomes tended to engage parents for a longer period, and most offered health professional input and support. Two studies of limited quality reported significantly worse weight outcomes in the intervention group.
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Affiliation(s)
- Chris Rossiter
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Heilok Cheng
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jessica Appleton
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Institute for Women, Children and their Families, Sydney, New South Wales, Australia.,Tresillian Family Care Centres, Belmore, New South Wales, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Victoria, Australia
| | - Elizabeth Denney-Wilson
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Institute for Women, Children and their Families, Sydney, New South Wales, Australia
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Somaraki M, Eli K, Sorjonen K, Ek A, Sandvik P, Nowicka P. Changes in parental feeding practices and preschoolers’ food intake following a randomized controlled childhood obesity trial. Appetite 2020; 154:104746. [DOI: 10.1016/j.appet.2020.104746] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 04/03/2020] [Accepted: 05/16/2020] [Indexed: 12/14/2022]
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Rapson J, Conlon C, Ali A. Nutrition Knowledge and Perspectives of Physical Activity for Pre-Schoolers amongst Early Childhood Education and Care Teachers. Nutrients 2020; 12:nu12071984. [PMID: 32635381 PMCID: PMC7400386 DOI: 10.3390/nu12071984] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 12/14/2022] Open
Abstract
Caregivers’ nutrition and physical activity knowledge is recognised as being important for children’s health and body size. Identifying knowledge gaps amongst caregivers may inform professional development and obesity-prevention strategies in childcare settings. This cross-sectional validated online questionnaire aimed to measure current early childhood education and care (ECEC) teachers’ nutrition knowledge for pre-schoolers (2–5-year-olds) and related perspectives. Teachers’ (n = 386) knowledge of nutrition was lacking: The overall score was 22.56 ± 2.83 (mean ± SD), or 61% correct. Increased years of experience significantly predicted an increase in knowing that national nutrition and physical activity guidelines exist (B = 0.02 [95% CI, 0.00–0.03], r2 = 0.13, p = 0.033). Teachers’ increased agreement in feeling they were confident talking about nutrition to parents significantly predicted an increase in overall nutrition knowledge scores (B = 0.34 [95% CI, 0.06–0.63], r2 = 0.15, p = 0.019). The belief that ECEC teachers play a vital role in promoting pre-schoolers’ healthy eating and physical activity was widespread. Common knowledge barriers included a lack of staff training, confidence, and resources. ECEC teachers may lack nutrition knowledge for pre-schoolers, particularly in regard to basic nutrition recommendations (servings, food/beverage choices, and portion sizes).
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Affiliation(s)
| | | | - Ajmol Ali
- Correspondence: ; Tel.: +64-9-213-6414
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8
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Impact of a nutrition education programme on preschool children's willingness to consume fruits and vegetables. Public Health Nutr 2020; 23:1846-1853. [PMID: 32340640 DOI: 10.1017/s1368980019005032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate the impact of a preschool-based nutrition education programme consisting of twelve 'hands on' nutrition education lessons delivered during the school year on young children's willingness to consume fruits and vegetables. DESIGN Quasi-experimental, pre-post design including the collection of plate waste evaluation data at the start and end of the 2015-2016 school year within two groups: (1) randomly selected classrooms receiving the intervention and (2) within conveniently sampled preschool classrooms not receiving the intervention serving as a comparison group. SETTING Centre-based preschool programmes serving low-income families in the Denver metro area. PARTICIPANTS Three- to five-year-old children in preschool classrooms participating in the intervention during the 2015-2016 school year (n 308) and children enrolled in comparison classrooms (n 215). RESULTS Repeated-measures logit models assessed whether increases in the odds of consuming small samples of fruits and vegetables between Time 1 (pre-intervention) and Time 2 (post-intervention) were different for children within the intervention group compared with the comparison group. Analyses showed that the change over time in consumption of the three vegetable samples varied by intervention status with greater change occurring among children within the intervention group (edamame: P = 0·001; cauliflower: P ≤ 0·0001 and red pepper: P ≤ 0·0001). Unlike vegetables, the change over time in consumption of the two fruit samples was not different between children within the intervention and comparison groups. CONCLUSIONS An experiential-learning nutrition education programme can positively influence eating behaviours of low-income preschoolers in a centre-based setting by increasing willingness to consume vegetables.
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9
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Bridge GL, Willis TA, Evans CEL, Roberts KPJ, Rudolf M. The impact of HENRY on parenting and family lifestyle: Exploratory analysis of the mechanisms for change. Child Care Health Dev 2019; 45:850-860. [PMID: 31209923 DOI: 10.1111/cch.12694] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 05/17/2019] [Accepted: 06/07/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Childhood obesity is a major public health concern. In the United Kingdom, a quarter of children are overweight or obese at age 5 years. Overweight and obese children are more likely to develop serious health issues such as diabetes later in life. Consequently, there is an urgent need for effective, early obesity prevention and intervention. This study investigated the impact of an 8-week child obesity intervention-HENRY (Health Exercise Nutrition for the Really Young)-designed to help parents with preschool children develop the skills and knowledge needed to improve family lifestyle and well-being. We were particularly interested in exploring the potential mechanisms by which HENRY may have a positive impact. METHOD Focus groups (n = 7, total participants = 39) were completed with mothers attending the HENRY programme at one of seven locations across England. They took place within 2 weeks of programme completion. Follow-up telephone interviews were completed with a subsample of participants (n = 10) between 17 and 21 weeks later. RESULTS Parents consistently reported enhanced self-efficacy in terms of improved confidence in their ability to encourage healthier behaviours such as eating fruit and vegetables and increasing physical activity, and improvements to family health behaviours. Many changes were reportedly sustained at follow-up. Data provided insights into the potential mechanisms that created the conditions for the positive changes. Participants described the importance of mutual support, being listened to by facilitators, and encouragement to identify their own ideas. Their comments indicated the success of a solution-focused, strength-based, partnership approach to supporting family lifestyle change. CONCLUSION The results of this study contribute to the body of evidence suggesting that HENRY may have a positive impact on parenting and family lifestyle behaviour. Although data were collected in 2011, the findings contribute to an understanding of the components of effective obesity prevention in young children.
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Affiliation(s)
- Gemma L Bridge
- Leeds Business School, Leeds Beckett University, Leeds, UK
| | - Thomas A Willis
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Charlotte E L Evans
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | | | - Mary Rudolf
- Azrieli Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel
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Chiavaroli V, Gibbins JD, Cutfield WS, Derraik JGB. Childhood obesity in New Zealand. World J Pediatr 2019; 15:322-331. [PMID: 31079339 DOI: 10.1007/s12519-019-00261-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 04/15/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Paediatric obesity has reached epidemic proportions globally, resulting in significant adverse effects on health and wellbeing. Early life events, including those that happen before, during, and after pregnancy can predispose children to later obesity. The purpose of this review is to examine the magnitude of obesity among New Zealand children and adolescents, and to determine their underlying risk factors and associated comorbidities. DATA SOURCES PubMed, Web of Science, and Google Scholar searches were performed using the key terms "obesity", "overweight", "children", "adolescents", and "New Zealand". RESULTS Obesity is a major public health concern in New Zealand, with more than 33% of children and adolescents aged 2-14 years being overweight or obese. Obesity disproportionately affects Māori (New Zealand's indigenous population) and Pacific children and adolescents, as well as those of lower socioeconomic status. New Zealand's obesity epidemic is associated with numerous health issues, including cardiometabolic, gastrointestinal, and psychological problems, which also disproportionately affect Māori and Pacific children and adolescents. Notably, a number of factors may be useful to identify those at increased risk (such as demographic and anthropometric characteristics) and inform possible interventions. CONCLUSIONS The prevalence of overweight and obese children and adolescents in New Zealand is markedly high, with a greater impact on particular ethnicities and those of lower socioeconomic status. Alleviating the current burden of pediatric obesity should be a key priority for New Zealand, for the benefit of both current and subsequent generations. Future strategies should focus on obesity prevention, particularly starting at a young age and targeting those at greatest risk.
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Affiliation(s)
| | - John D Gibbins
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand. .,A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand. .,Endocrinology Department, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China.
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand. .,A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand. .,Endocrinology Department, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China. .,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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11
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Cai M, Loy SL, Tan KH, Godfrey KM, Gluckman PD, Chong YS, Shek LPC, Cheung YB, Lek N, Lee YS, Chan SY, Chan JKY, Yap F, Ang SB. Association of Elective and Emergency Cesarean Delivery With Early Childhood Overweight at 12 Months of Age. JAMA Netw Open 2018; 1:e185025. [PMID: 30646378 PMCID: PMC6324378 DOI: 10.1001/jamanetworkopen.2018.5025] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPORTANCE Global cesarean delivery (CD) rates have more than doubled over the past 2 decades, with an increasing contribution from elective CDs. Cesarean delivery has been linked to early childhood overweight and obesity, but limited studies have examined elective and emergency CDs separately. OBJECTIVE To investigate whether elective or emergency CD was associated with risk of early childhood overweight. DESIGN, SETTING, AND PARTICIPANTS Data were drawn from the Growing Up in Singapore Toward Healthy Outcomes (GUSTO) study, an ongoing prospective mother-child birth cohort study. Participants were pregnant women aged 18 years or older with homogeneous parental ethnic background in their first trimester recruited between June 2009 and September 2010 (n = 1237) at 2 major public hospitals in Singapore. Those with type 1 diabetes or undergoing chemotherapy or psychotropic drug treatment were excluded. Data analysis commenced in October 2017. EXPOSURES Delivery mode obtained from clinical records. Elective and emergency CD examined separately against vaginal delivery as reference. MAIN OUTCOMES AND MEASURES Body mass index-for-age z scores at age 12 months calculated based on 2006 World Health Organization Child Growth Standards from infant weight and recumbent crown-heel length measurements taken between December 2010 and April 2012. High body mass index status at risk of overweight was defined as a z score of more than 1 SD and less than or equal to 2 SDs. Overweight was defined as a z score of more than 2 SDs. RESULTS Among 727 infants analyzed (51.2% [372] male), 30.5% (222) were born via CD, of which 33.3% (74) were elective. Prevalence of at risk of overweight and overweight at age 12 months was 12.2% (89) and 2.3% (17), respectively. Elective CD was significantly associated with at risk of overweight or overweight at age 12 months after adjusting for maternal ethnicity, age, education, parity, body mass index, antenatal smoking, hypertensive disorders of pregnancy, gestational diabetes, and sex-adjusted birth weight-for-gestational age (odds ratio, 2.05; 95% CI, 1.08-3.90; P = .03). The association persisted after further adjustment for intrapartum antibiotics and first 6 months infant feeding, 2 potential mediators of early childhood overweight and obesity (odds ratio, 2.02; 95% CI, 1.05-3.89; P = .04). No significant associations were found for emergency CD. Analysis with multiple imputation for missing covariates yielded similar results. CONCLUSIONS AND RELEVANCE Choice of delivery mode may influence risk of early childhood overweight. Clinicians are encouraged to discuss potential long-term implications of elective CD on child metabolic outcomes with patients who intend to have children.
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Affiliation(s)
- Meijin Cai
- Duke-NUS Medical School, Singapore, Singapore
| | - See Ling Loy
- Duke-NUS Medical School, Singapore, Singapore
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Peter D. Gluckman
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Yap-Seng Chong
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lynette Pei-Chi Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Yin Bun Cheung
- Center for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
- Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Ngee Lek
- Duke-NUS Medical School, Singapore, Singapore
- Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Yung Seng Lee
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Shiao-Yng Chan
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jerry Kok Yen Chan
- Duke-NUS Medical School, Singapore, Singapore
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Fabian Yap
- Duke-NUS Medical School, Singapore, Singapore
- Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Seng Bin Ang
- Duke-NUS Medical School, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Family Medicine Service, KK Women’s and Children’s Hospital, Singapore, Singapore
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Russell CG, Haszard JJ, Taylor RW, Heath ALM, Taylor B, Campbell KJ. Parental feeding practices associated with children's eating and weight: What are parents of toddlers and preschool children doing? Appetite 2018; 128:120-128. [DOI: 10.1016/j.appet.2018.05.145] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 02/15/2018] [Accepted: 05/25/2018] [Indexed: 02/01/2023]
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13
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Soskolne V, Cohen-Dar M, Obeid S, Cohen N, Rudolf MCJ. Risk and Protective Factors for Child Overweight/Obesity Among Low Socio-Economic Populations in Israel: A Cross Sectional Study. Front Endocrinol (Lausanne) 2018; 9:456. [PMID: 30186231 PMCID: PMC6113577 DOI: 10.3389/fendo.2018.00456] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/24/2018] [Indexed: 12/25/2022] Open
Abstract
Background and Aims: Scientific evidence regarding protective factors that contribute to healthy weight in childhood is limited and is particularly scarce in lower socio-economic populations in different ethnic groups. This study aimed to assess the prevalence of biological, behavioral and psychosocial factors for child overweight/obesity in Jewish and Arab population groups in Israel, and to compare their associations with child overweight/obesity in the two groups. Methods: Children aged 5-6 years were randomly selected from 20 Mother and Child Health clinics in towns and villages of lowest socio-economic ranking in Northern Israel. Children and mothers were invited for a special "One Stop Shop-Preparation for School" visit which included growth measurements. Questionnaires were distributed to mothers for self-report on biological, SES, psychological and lifestyle factors. Perinatal and early nutritional data were retrieved from clinic records. Multivariate analyses using logistic regression models predicting child overweight/obesity were conducted separately for Jewish (N = 371) and Arab (N = 575) children. Results: Overweight/obesity (BMI ≥85th centile) rates were higher in Jewish (25%) than Arab (19%) children. In both Jewish and Arab groups, respectively, maternal BMI (OR = 1.10 [95%CI = 1.04, 1.17]; OR = 1.08 [95%CI = 1.04, 1.13]), and child birthweight (OR = 1.33 [95%CI = 1.04, 1.71]; OR = 1.39 [95%CI = 1.11, 1.73]) were significant risk factors for overweight/obesity, and maternal self-efficacy regarding child's lifestyle was significantly protective (OR = 0.49 [95%CI = 0.28, 0.85]; OR = 0.54 [95%CI = 0.34, 0.85]). Additionally, four other maternal psychological and child behaviors were significantly associated with overweight/obesity in the Jewish group and two child lifestyle behavior factors in the Arab group. Moreover, significant interactions indicating moderation effects were found only in the Jewish group: maternal education and maternal age moderated the effect of maternal BMI on child overweight/obesity. No other moderation of risk factors was found. Discussion: In this study of children from low SES families, protective factors contributed to healthy child weight alongside risk factors for overweight/obesity. They differed between the population groups, and fewer variables explained overweight/obesity in Arab children. Although further expansion of these findings is required they point at the relevance of protective factors, maternal self-efficacy in particular, for understanding childhood obesity in specific ethnic contexts and for planning culturally adapted prevention programs in disadvantaged populations.
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Affiliation(s)
- Varda Soskolne
- Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
| | - Michal Cohen-Dar
- Northern Region Health Office, Ministry of Health, Nazareth Illit, Israel
| | - Samira Obeid
- Northern Region Health Office, Ministry of Health, Nazareth Illit, Israel
- Nursing Department, Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Nitsa Cohen
- Northern Region Health Office, Ministry of Health, Nazareth Illit, Israel
| | - Mary C. J. Rudolf
- Department of Population Health, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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Kracht CL, Sisson SB, Walker D, Kerr K, Stephens L, Anderson A, Seward J, Weedn AE, Cheney M, Copeland K, Salvatore AL, Jacob A, Key M, Dennison M, Tallbear C, Horm D. Early Care and Education Teacher’s Role in Obesity Prevention and Healthy Development of Young American Indian Children. J Transcult Nurs 2018; 30:75-85. [DOI: 10.1177/1043659618786363] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: The purpose of this study was to develop an understanding of how stakeholders, specifically early care and education (ECE) teachers, perceive their role in the development of young American Indian children, and envision working with health care providers and parents in order to enhance children’s health. Methodology: Twenty tribally affiliated ECE teachers from Oklahoma participated in interviews. Thematic analysis was conducted, and three main themes, each with two to three subthemes, emerged. Results: Teachers felt that nutrition and physical activity were important to children’s health. Teachers had little professional interaction with health care providers but desired more. Parental empowerment was conveyed as essential to actualize positive changes in their child’s behavior. Discussion: Teachers of tribally affiliated ECE centers are important stakeholders in promoting the health and well-being of young American Indian children. Additional efforts are needed to more effectively integrate teachers and nurses in order to create effective interventions. We propose a stakeholder partnership to guide the development of future interventions.
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Affiliation(s)
- Chelsea L. Kracht
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Susan B. Sisson
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Devon Walker
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Kelly Kerr
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Lancer Stephens
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Shared Clinical and Translational Resources, Oklahoma City, OK, USA
| | - Amber Anderson
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Julie Seward
- Southern Plains Tribal Health Board, Oklahoma City, OK, USA
| | - Ashley E. Weedn
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | | | - Kristen Copeland
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati, Cincinnati, OH, USA
| | | | | | - Michelle Key
- Chickasaw Nation Department of Community Services, Ada, OK, USA
| | | | - Chris Tallbear
- Southern Plains Tribal Health Board, Oklahoma City, OK, USA
| | - Diane Horm
- Early Childhood Education Institute, University of Oklahoma, Tulsa, OK, USA
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15
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Norman Å, Nyberg G, Elinder LS, Berlin A. Parental strategies for influencing the diet of their children – A qualitative study from disadvantaged areas. Appetite 2018. [DOI: 10.1016/j.appet.2018.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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16
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Litterbach EK, Russell CG, Taki S, Denney-Wilson E, Campbell KJ, Laws RA. Factors Influencing Engagement and Behavioral Determinants of Infant Feeding in an mHealth Program: Qualitative Evaluation of the Growing Healthy Program. JMIR Mhealth Uhealth 2017; 5:e196. [PMID: 29254908 PMCID: PMC5748479 DOI: 10.2196/mhealth.8515] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 09/19/2017] [Accepted: 10/10/2017] [Indexed: 01/01/2023] Open
Abstract
Background Infant feeding practices, including breastfeeding and optimal formula feeding practices, can play a role in the prevention of childhood obesity. The ubiquity of smartphone ownership among women of childbearing age provides important opportunities for the delivery of low-cost, broad reach parenting interventions delivered by mobile phone (mHealth or mobile health interventions). Little is known about how parents engage with mHealth programs targeting infant feeding and how such programs might influence infant feeding practices. Objective The objectives of this study were to explore participant views on (1) factors influencing engagement with the Growing healthy program, an mHealth program targeting healthy infant feeding practices from birth to 9 months of age, and (2) the ways in which the program influenced behavioral determinants of capability, opportunity, and motivation for breastfeeding and optimal formula feeding behaviors. Methods Semistructured, telephone interviews were conducted with a purposeful sample (n=24) of mothers participating in the Growing healthy program. Interviews explored participants’ views about engagement with the program and its features, and the ways the program influenced determinants of infant feeding behaviors related to breastfeeding and optimal formula feeding. The interview schedule was informed by the Capability, Opportunity, Motivation, and Behavior (COM-B) model. Results Participants reported that engagement fluctuated depending on need and the degree to which the program was perceived to fit with existing parenting beliefs and values. Participants identified that the credibility of the program source, the user friendly interface, and tailoring of content and push notifications to baby’s age and key transition points promoted engagement, whereas technical glitches were reported to reduce engagement. Participants discussed that the program increased confidence in feeding decisions. For breastfeeding mothers, this was achieved by helping them to overcome doubts about breast milk supply, whereas mothers using formula reported feeling more confident to feed to hunger and satiety cues rather than encouraging infants to finish the bottle. Participants discussed that the program provided around-the-clock, readily accessible, nonjudgmental information and support on infant feeding and helped to reinforce information received by health professionals or encouraged them to seek additional help if needed. Participants reflected that their plans for feeding were typically made before joining the program, limiting the potential for the program to influence this aspect of motivation. Rather, the program provided emotional reassurance to continue with current feeding plans. Conclusions Our findings suggest that engagement with the program was influenced by an interplay between the program features and needs of the user. Participants reported that the program enhanced confidence in feeding decisions by providing a 24/7 accessible, expert, nonjudgmental support for infant feeding that complemented health professional advice. It is likely that interventions need to commence during pregnancy to maximize the impact on breastfeeding intentions and plans.
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Affiliation(s)
- Eloise-Kate Litterbach
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.,Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia
| | - Catherine G Russell
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,Centre for Advanced Sensory Science, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, Australia
| | - Sarah Taki
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,Faculty of Health, University of Technology Sydney, Sydney, Australia.,Health Promotion Unit, Sydney Local Health District, Sydney, NSW, Australia
| | - Elizabeth Denney-Wilson
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,School of Nursing, University of Sydney, Sydney, Australia.,Sydney Local Health District, Sydney, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.,Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia
| | - Rachel A Laws
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.,Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia
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17
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Kozieł S, Chakraborty R, Bose K. Relationship between temperament and fatness in 11-year-old children and 17-year-old adolescents from Wrocław, Poland. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2017; 68:479-486. [PMID: 29175059 DOI: 10.1016/j.jchb.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 10/12/2017] [Indexed: 11/29/2022]
Abstract
Childhood obesity is increasing globally, and Poland is no exception. Studies indicate that relationship between obesity and psychological well-being is a complex issue and this needs further research. The objective of the present cross sectional study was to analyze the relationship between some temperament components and fatness among children in two developmental periods, approximately before and after adolescence. Participants included 122 children aged 11 years (57 boys and 65 girls), and 153 adolescents aged 17 years (64 boys and 89 girls) from 6 primary and 4 secondary schools in Wrocław, Poland. Height, weight, triceps-, subscapular and abdominal skinfold thicknesses were measured. Temperament was assessed by a questionnaire of Buss and Plomin (1984) in two versions: EAS-C for children completed by parents and EAS-D for youth and adults. Physical activity (PAL) was also assessed by a questionnaire. Mean, median and standard deviation (SD) were calculated and Student's t tests were performed to test for significance of differences between groups. Chi squared (χ2) statistic was used to test the significance of differences in frequencies. Analyses of covariance (ANCOVA) were performed to show the effect of the social - psychological factors on fatness. Controlling for socioeconomic status and physical activity level, activity, as a component of temperament had a significant effect on body fatness. The only component of temperament, which significantly influenced level of fatness in girls, was emotionality. These relationships differed according to sex and the two age groups concerned.
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Affiliation(s)
- S Kozieł
- Department of Anthropology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Science, Rudolf Weigiel 12, 53-114 Wroclaw, Poland.
| | - R Chakraborty
- Department of Anthropology, Dinabandhu Mahavidyalaya, Bongaon, West Bengal, India
| | - K Bose
- Department of Anthropology, Vidyasagar University, Midnapore, West Bengal, India
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18
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Chambers SA, Rowa-Dewar N, Radley A, Dobbie F. A systematic review of grandparents' influence on grandchildren's cancer risk factors. PLoS One 2017; 12:e0185420. [PMID: 29135979 PMCID: PMC5685489 DOI: 10.1371/journal.pone.0185420] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 09/12/2017] [Indexed: 01/13/2023] Open
Abstract
Many lifestyle patterns are established when children are young. Research has focused on the potential role of parents as a risk factor for non communicable disease in children, but there is limited investigation of the role of other caregivers, such as grandparents. The aim of this review was to identify and synthesise evidence for any influence grandparents' care practices may have on their grandchildren's long term cancer risk factors. A systematic review was carried out with searches across four databases (MEDLINE, Embase, Web of Science, PsycINFO) as well as searches of reference lists and citing articles, and Google Scholar. Search terms were based on six areas of risk that family care could potentially influence-weight, diet, physical activity, tobacco, alcohol and sun exposure. All study designs were included, as were studies that provided an indication of the interaction of grandparents with their grandchildren. Studies were excluded if grandparents were primary caregivers and if children had serious health conditions. Study quality was assessed using National Institute for Health and Care Excellence checklists. Grandparent impact was categorised as beneficial, adverse, mixed or as having no impact. Due to study heterogeneity a meta-analysis was not possible. Qualitative studies underwent a thematic synthesis of their results. Results from all included studies indicated that there was a sufficient evidence base for weight, diet, physical activity and tobacco studies to draw conclusions about grandparents' influence. One study examined alcohol and no studies examined sun exposure. Evidence indicated that, overall, grandparents had an adverse impact on their grandchildren's cancer risk factors. The theoretical work in the included studies was limited. Theoretically underpinned interventions designed to reduce these risk factors must consider grandparents' role, as well as parents', and be evaluated robustly to inform the evidence base further.
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Affiliation(s)
- Stephanie A. Chambers
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Neneh Rowa-Dewar
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Andrew Radley
- Directorate of Public Health, NHS Tayside, Dundee, United Kingdom
| | - Fiona Dobbie
- Faculty of Heath Sciences and Sport, University of Stirling, Stirling, United Kingdom
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19
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He's just content to sit: a qualitative study of mothers' perceptions of infant obesity and physical activity. BMC Public Health 2017. [PMID: 28629410 PMCID: PMC5477242 DOI: 10.1186/s12889-017-4503-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Rates of obesity among children ages zero to five are rapidly increasing. Greater efforts are needed to promote healthy behaviors of young children. Mothers are especially important targets for promoting health as mothers’ views play a vital role in helping their children foster healthy habits from an early age. Research has found parents’ views of infants’ weight may influence their feeding practices; however, limited research has explored mothers’ view of infants’ weight in relation to the promotion of physical activity. Therefore, the purpose of this study was to explore the perceptions of mothers of normal weight infants and overweight infants about their infant’s weight and physical activity. Methods Semi-structured interviews were conducted with mothers of normal weight (n = 18) and of overweight (n = 11) infants (6.5 ± 0.5 month) in a Midwestern city in the United States. A thematic analysis was used to analyze the data. Results A majority of mothers thought infants could be overweight. However, no mothers referenced their own infant as overweight. Mothers most commonly noted infants could be overweight only if they were formula fed and/or were overfed, not if they were breastfed. Mothers views were not negatively influenced by others who mentioned that their child was either “big” or “small” and only one mother had been told her infant was overweight. A majority of mothers thought an infant could be physically active. When discussing infant activity, mothers primarily referred to it in terms of general mobility and a few thought activity level was related to a personality characteristic. Mothers intended to promote physical activity in the future either through outdoor play or specific organized activities such as sports. Despite a majority of mothers stating they were currently physically active themselves, only a few talked about interacting with their infant to promote their infant’s physical activity. Conclusions Efforts are needed by healthcare professionals and other public health professionals to inform mothers about the dangers of increased weight during infancy as well as the importance of interacting with infants to promote physical activity. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4503-5) contains supplementary material, which is available to authorized users.
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20
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Morgen CS, Andersen PK, Mortensen LH, Howe LD, Rasmussen M, Due P, Sørensen TIA, Andersen AMN. Socioeconomic disparities in birth weight and body mass index during infancy through age 7 years: a study within the Danish National Birth Cohort. BMJ Open 2017; 7:e011781. [PMID: 28110282 PMCID: PMC5253532 DOI: 10.1136/bmjopen-2016-011781] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 11/07/2016] [Accepted: 12/15/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Socioeconomic inequalities in birth weight and in body mass index (BMI) later in childhood are in opposite directions, which raises questions about when during childhood the change in direction happens. We examined how maternal and paternal education and household income were associated with birthweight z-scores and with BMI z-scores at age 5 and 12 months and 7 years, and we examined the socioeconomic differences in the tracking of these z-scores across infancy and childhood. METHODS The associations were studied in a cohort of children in the Danish National Birth Cohort, single born between 1997 and 2003, for whom information on body size from at least 1 of 4 time points (n=85 062) was recorded. We examined the associations using linear mixed-effects modelling. RESULTS Children from families with a low maternal and paternal educational level changed their body size z-scores upwards between birth and age 7 years. At age 5 and 12 months, there were no educational gradient. A low maternal educational level was associated with lower birth weight for gestational age z-scores at birth for boys (-0.199; 95% CI -0.230 to -0.169) and girls (-0.198; 95% CI -0.229 to -0.167) and higher BMI z-scores at age 7 for boys (0.198; 95% CI 0.154 to 0.242) and girls (0.218; 95% CI 0.173 to 0.264). There was not a similarly clear pattern in the tracking between different household income groups. However, a low household income level was associated with higher z-scores of both birth weight and BMI at age 7 years, but with a much weaker gradient at 5 and 12 months. CONCLUSIONS The educational gradient shifts from positive with birth weight, to none during infancy to inverse with BMI at age 7 years. In contrast, the income gradient was positive at birth and at 7 years and much weaker during infancy.
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Affiliation(s)
- Camilla Schmidt Morgen
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Copenhagen, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Per Kragh Andersen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Laust Hvas Mortensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Laura D Howe
- MRC Integrative Epidemiology Unit, The University of Bristol, and School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | - Pernille Due
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Copenhagen, Denmark
- MRC Integrative Epidemiology Unit, The University of Bristol, and School of Social and Community Medicine, University of Bristol, Bristol, UK
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Marie Nybo Andersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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21
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Russell CG, Taki S, Azadi L, Campbell KJ, Laws R, Elliott R, Denney-Wilson E. A qualitative study of the infant feeding beliefs and behaviours of mothers with low educational attainment. BMC Pediatr 2016; 16:69. [PMID: 27209010 PMCID: PMC4875628 DOI: 10.1186/s12887-016-0601-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 05/10/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Infancy is an important period for the promotion of healthy eating, diet and weight. However little is known about how best to engage caregivers of infants in healthy eating programs. This is particularly true for caregivers, infants and children from socioeconomically disadvantaged backgrounds who experience greater rates of overweight and obesity yet are more challenging to reach in health programs. Behaviour change interventions targeting parent-infant feeding interactions are more likely to be effective if assumptions about what needs to change for the target behaviours to occur are identified. As such we explored the precursors of key obesity promoting infant feeding practices in mothers with low educational attainment. METHODS One-on-one semi-structured telephone interviews were developed around the Capability Opportunity Motivation Behaviour (COM-B) framework and applied to parental feeding practices associated with infant excess or healthy weight gain. The target behaviours and their competing alternatives were (a) initiating breastfeeding/formula feeding, (b) prolonging breastfeeding/replacing breast milk with formula, (c) best practice formula preparation/sub-optimal formula preparation, (d) delaying the introduction of solid foods until around six months of age/introducing solids earlier than four months of age, and (e) introducing healthy first foods/introducing unhealthy first foods, and (f) feeding to appetite/use of non-nutritive (i.e., feeding for reasons other than hunger) feeding. The participants' education level was used as the indicator of socioeconomic disadvantage. Two researchers independently undertook thematic analysis. RESULTS Participants were 29 mothers of infants aged 2-11 months. The COM-B elements of Social and Environmental Opportunity, Psychological Capability, and Reflective Motivation were the key elements identified as determinants of a mother's likelihood to adopt the healthy target behaviours although the relative importance of each of the COM-B factors varied with each of the target feeding behaviours. CONCLUSIONS Interventions targeting healthy infant feeding practices should be tailored to the unique factors that may influence mothers' various feeding practices, taking into account motivational and social influences.
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Affiliation(s)
| | - Sarah Taki
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Leva Azadi
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Rachel Laws
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Rosalind Elliott
- Faculty of Health, University of Technology Sydney, Sydney, Australia
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22
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Parkes A, Sweeting H, Young R, Wight D. Does parenting help to explain socioeconomic inequalities in children's body mass index trajectories? Longitudinal analysis using the Growing Up in Scotland study. J Epidemiol Community Health 2016; 70:868-73. [PMID: 27056682 PMCID: PMC5013155 DOI: 10.1136/jech-2015-206616] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 03/17/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND Pathways leading to socioeconomic inequalities in young children's body mass index (BMI) are not well understood. This study examined whether parenting related to the physical and social context of children's food consumption helped to explain associations between maternal educational level and child BMI trajectory. METHODS The study used data from 2957 families in a nationally representative birth cohort study surveyed from 2004 to 2011, with child BMI z-score measured 3 times (46, 70 and 94 months). Latent growth curve models examined associations between maternal education and BMI z-score trajectory, exploring mediating effects of parenting (positive mealtime interaction, informal meal setting and child bedroom TV) and unhealthy child diet. RESULTS After adjusting for maternal BMI, maternal education predicted increased inequality in child BMI z-score trajectory slope over the study period. The slope index of inequality coefficient for maternal education, that is, the change in z-score associated with the lowest relative to the highest maternal education level, was 0.17, p<0.001. Indirect effects of lower maternal education on steeper BMI trajectory via parenting and/or unhealthy diet represented 89% of the total effect. Pathways via parenting and then unhealthy diet accounted for 68% of significant indirect pathways, with the remainder via unhealthy diet only. Bedroom TV was the most important parenting pathway, followed by informal meal setting. CONCLUSIONS Pathways via parenting helped to explain the emergence of inequalities in young children's BMI related to maternal education. Interventions targeting parental provision of child bedroom TV and informal meal setting might reduce these inequalities.
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Affiliation(s)
- Alison Parkes
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Helen Sweeting
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Robert Young
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Daniel Wight
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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