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AlTarrah D, Lanigan J, Feehan J, Al Dhaheri AS, Shah SM, Cheikh Ismail L, Singhal A. Infant feeding practices and risk of preschool obesity in AlAin, UAE: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002803. [PMID: 38330043 PMCID: PMC10852324 DOI: 10.1371/journal.pgph.0002803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/20/2024] [Indexed: 02/10/2024]
Abstract
Early childhood obesity is serious public health problem, and poses a risk of obesity in later life. The study aimed to investigate whether infant feeding affects risk of overweight and obesity in preschool children in the United Arab Emirates (UAE). A cross-sectional study was carried out. Data was collected in a kindergarten in Al Ain, UAE. One hundred and fifty parents and preschool children aged 2 to 6 years participated in the study. Univariate and multivariate linear regression were used to investigate associations. A longer duration of breastfeeding and later introduction of complementary foods were associated with a lower BMI z-score in preschool children. Each month of any breastfeeding was associated with a lower BMI z-score in the unadjusted model (β = -0.03; 95% CI -0.05, -0.01; p = 0.01), and each month increase in the age of introducing complementary foods was associated with a lower BMI z-score in the unadjusted model (β = -0.43; 95% CI: -0.60 to-0.027; p<0.001). These associations remained after adjustment for potential confounding factors (age, sex, maternal BMI, maternal education level, mother's age, social class, father's BMI) for duration of breastfeedinig (β = -0.02; 95% CI: -0.05 to 0.00; p<0.001) and age of complementary feeding (β = -0.39; 95% CI: -0.57 to-0.21; p<0.001). Poor infant feeding practices (shorter duration of breastfeedinig and early introduction of complementary foods) were found to be associated with higher BMI in preschool children. Promoting appropriate proper infant feeding practices in line with recommendations could be one strategy to help prevent childhood obesity in the UAE.
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Affiliation(s)
- Dana AlTarrah
- Department of Social and Behavioral Sciences, Faculty of Public Health, Kuwait University, Kuwait City, Kuwait
| | - Julie Lanigan
- Joint institution UCL Great Ormond Street Hospital, Institute of Child Health, University College London, London, United Kingdom
| | - Jack Feehan
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Ayesha S. Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Syed M. Shah
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Women’s and Reproductive Health, University of Oxford, Nuffield, Oxford, United Kingdom
| | - Atul Singhal
- Joint institution UCL Great Ormond Street Hospital, Institute of Child Health, University College London, London, United Kingdom
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Padhani ZA, Das JK, Siddiqui FA, Salam RA, Lassi ZS, Khan DSA, Abbasi AMA, Keats EC, Soofi S, Black RE, Bhutta ZA. Optimal timing of introduction of complementary feeding: a systematic review and meta-analysis. Nutr Rev 2023; 81:1501-1524. [PMID: 37016953 DOI: 10.1093/nutrit/nuad019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
CONTEXT The timing of introducing complementary feeding (CF) is crucial because premature or delayed CF can be associated with adverse health outcomes in childhood and adulthood. OBJECTIVE This systematic review aims to evaluate the impact of the timing of CF introduction on health, nutrition, and developmental outcomes among normal-term infants. DATA SOURCES Electronic databases and trial registries were searched, along with the reference lists of the included studies and relevant systematic reviews. DATA EXTRACTION Two investigators independently extracted data from the included studies on a standardized data-extraction form. DATA ANALYSIS Data were meta-analyzed separately for randomized controlled trials (RCTs) and observational studies on the basis of early introduction of CF (< 3 months, < 4 months, < 6 months of age) or late introduction of CF (> 6 months, > 8 months of age). Evidence was summarized according to GRADE criteria. In total, 268 documents were included in the review, of which 7 were RCTs (from 24 articles) and 217 were observational studies (from 244 articles). Evidence from RCTs did not suggest an impact of early introduction, while low-certainty evidence from observational studies suggested that early introduction of CF (< 6 months) might increase body mass index (BMI) z score and overweight/obesity. Early introduction at < 3 months might increase BMI and odds of lower respiratory tract infection (LRTI), and early introduction at < 4 months might increase height, LRTI, and systolic and diastolic blood pressure (BP). For late introduction of CF, there was a lack of evidence from RCTs, but low-certainty evidence from observational studies suggests that late introduction of CF (> 6 months) might decrease height, BMI, and systolic and diastolic BP and might increase odds of intestinal helminth infection, while late introduction of CF (> 8 months) might increase height-for-age z score. CONCLUSION Insufficient evidence does suggest increased adiposity with early introduction of CF. Hence, the current recommendation of introduction of CF should stand, though more robust studies, especially from low- and middle-income settings, are needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42020218517.
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Affiliation(s)
- Zahra A Padhani
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Jai K Das
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
| | - Faareha A Siddiqui
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
| | - Rehana A Salam
- Centre of Research Excellence, Melanoma Institute Australia, University of Sydney, Sydney, New South Wales, Australia
| | - Zohra S Lassi
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | | | - Ammaar M A Abbasi
- Division of Women and Child Health, Aga Khan University, Karachi, Sindh, Pakistan
| | - Emily C Keats
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sajid Soofi
- Division of Women and Child Health, Aga Khan University, Karachi, Sindh, Pakistan
| | - Robert E Black
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Zulfiqar A Bhutta
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
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Kamal FD, Dagar M, Reza T, Karim Mandokhail A, Bakht D, Shahzad MW, Silloca-Cabana EO, Mohsin SN, Chilla SP, Bokhari SFH. Beyond Diet and Exercise: The Impact of Gut Microbiota on Control of Obesity. Cureus 2023; 15:e49339. [PMID: 38143595 PMCID: PMC10748854 DOI: 10.7759/cureus.49339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
Obesity, a widespread health concern characterized by the excessive accumulation of body fat, is a complex condition influenced by genetics, environment, and social determinants. Recent research has increasingly focused on the role of gut microbiota in obesity, highlighting its pivotal involvement in various metabolic processes. The gut microbiota, a diverse community of microorganisms residing in the gastrointestinal tract, interacts with the host in a myriad of ways, impacting energy metabolism, appetite regulation, inflammation, and the gut-brain axis. Dietary choices significantly shape the gut microbiota, with diets high in fat and carbohydrates promoting the growth of harmful bacteria while reducing beneficial microbes. Lifestyle factors, like physical activity and smoking, also influence gut microbiota composition. Antibiotics and medications can disrupt microbial diversity, potentially contributing to obesity. Early-life experiences, including maternal obesity during pregnancy, play a vital role in the developmental origins of obesity. Therapeutic interventions targeting the gut microbiota, including prebiotics, probiotics, fecal microbiota transplantation, bacterial consortium therapy, and precision nutrition, offer promising avenues for reshaping the gut microbiota and positively influencing weight regulation and metabolic health. Clinical applications of microbiota-based therapies are on the horizon, with potential implications for personalized treatments and condition-based interventions. Emerging technologies, such as next-generation sequencing and advanced bioinformatics, empower researchers to identify specific target species for microbiota-based therapeutics, opening new possibilities in healthcare. Despite the promising outlook, microbiota-based therapies face challenges related to microbial selection, safety, and regulatory issues. However, with ongoing research and advances in the field, these challenges can be addressed to unlock the full potential of microbiota-based interventions.
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Affiliation(s)
| | - Mehak Dagar
- Internal Medicine, Himalayan Institute of Medical Sciences, New Delhi, IND
| | - Taufiqa Reza
- Medicine, Avalon University School of Medicine, Youngstown, USA
| | | | - Danyal Bakht
- Medicine and Surgery, Mayo Hospital, Lahore, PAK
| | | | | | - Syed Naveed Mohsin
- Orthopedics, St. James's Hospital, Dublin, IRL
- General Surgery, Cavan General Hospital, Cavan, IRL
| | - Srikar P Chilla
- Medicine, CARE Hospitals, Hyderabad, IND
- Health Sciences, University of East London, London, GBR
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Bedani CR, Dualib PM, Carvalho CCR, Oliveira JM, Mattar R, Dib SA, de Almeida-Pititto B. Father's weight could contribute to large babies in overweight and obese mothers with and without gestational diabetes. Arch Pediatr 2023; 30:192-194. [PMID: 36907730 DOI: 10.1016/j.arcped.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 09/01/2022] [Accepted: 01/15/2023] [Indexed: 03/12/2023]
Abstract
We evaluated whether there was an association between fathers' nutritional status and children's birth weight (BW) considering weight-matched mothers with and without gestational diabetes mellitus (GDM). In total, 86 trios of women, infants, and fathers were evaluated. BW was not different between the groups of obese and non-obese parents, frequency of maternal obesity, or GDM. The percentage of infants who were large for gestational age (LGA) was 25% in the obese group and 14% in the non-obese group (p = 0.44). There was a borderline significance for higher body mass index (p = 0.09) of the father in the LGA group compared with the adequate for gestational age group. These results corroborate the hypothesis that the father's weight can also be relevant for the occurrence of LGA.
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Affiliation(s)
- Caio Rodrigues Bedani
- Universidade Federal de São Paulo, Graduate Program in Medicine, Rua Botucatu, n° 740, Vila Clementino, São Paulo-SP, CEP 04023-062, Brazil
| | - Patricia M Dualib
- Postgraduate Program in Endocrinology and Metabolism, Universidade Federal de Sao Paulo, Rua Estado de Israel, n° 639, Vila Clementino, São Paulo-SP, CEP 04022-001, Brazil; Department of Medicine, Division of Endocrinology, Universidade Federal de Sao Paulo, Rua Sena Madureira, n° 1500, Vila Clementino, São Paulo-SP, CEP 04021-001, Brazil
| | - Camila C R Carvalho
- Postgraduate Program in Endocrinology and Metabolism, Universidade Federal de Sao Paulo, Rua Estado de Israel, n° 639, Vila Clementino, São Paulo-SP, CEP 04022-001, Brazil
| | - Julia M Oliveira
- Postgraduate Program in Endocrinology and Metabolism, Universidade Federal de Sao Paulo, Rua Estado de Israel, n° 639, Vila Clementino, São Paulo-SP, CEP 04022-001, Brazil.
| | - Rosiane Mattar
- Department of Obstetrics, Universidade Federal de Sao Paulo, Rua Napoleão de Barros, n° 875, Vila Clementino, São Paulo-SP, CEP 04024-002, Brazil
| | - Sergio A Dib
- Postgraduate Program in Endocrinology and Metabolism, Universidade Federal de Sao Paulo, Rua Estado de Israel, n° 639, Vila Clementino, São Paulo-SP, CEP 04022-001, Brazil; Department of Medicine, Division of Endocrinology, Universidade Federal de Sao Paulo, Rua Sena Madureira, n° 1500, Vila Clementino, São Paulo-SP, CEP 04021-001, Brazil
| | - Bianca de Almeida-Pititto
- Postgraduate Program in Endocrinology and Metabolism, Universidade Federal de Sao Paulo, Rua Estado de Israel, n° 639, Vila Clementino, São Paulo-SP, CEP 04022-001, Brazil; Department of Preventive Medicine, Universidade Federal de Sao Paulo, Rua Botucatu, n° 740, Vila Clementino, São Paulo-SP, CEP 04023-062, Brazil
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ÖZGEN ÖZKAYA Ş, ÖZKAYA V, GARİPAĞAOĞLU M. Obesity risk factors in Turkish preschool children: a cross-sectional study. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1176281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Amaç: Bu çalışma, Türk okul öncesi çocuklarında obezite ile ilgili potansiyel risk faktörlerini -gebelik öncesi ve sonrası, çocuk, ebeveyn ve çevresel faktörler- belirlemeyi amaçlamaktadır.
Gereç ve Yöntem: Özel ve devlete bağlı 25 anaokulunda 3-5 yaş grubu 538 çocuk ve anneleri ile yüz yüze görüşme yöntemi kullanılarak kesitsel bir çalışma gerçekleştirilmiştir. Gebelik, bebeklik ve okul öncesi döneme ait demografik, antropometrik, beslenme, uyku ve fiziksel aktivite bilgileri sorgulanmıştır. İki günlük besin tüketim kayıtları ve antropometrik ölçümleri alınmıştır.
Bulgular: Okul öncesi çocuklarda hafif şişmanlık ve obezite sıklığı %27 olarak saptanmıştır. Yirmi sekiz potansiyel risk faktöründen gebelik öncesi obezitesi [1,108 (1,042-1,179)], gebelik sonu obezitesi (OR:4,350, CI:2,053-9,217), gebelikte >200mg/gün kafein alımı (OR:1,588, CI:1,031- 2,446), obezitesi olan babaya sahip olma (OR:1,089 CI:1,027-1,155), devlet okulu yerine özel okula gitme (OR:2,093, CI:1,298-3,376), hızlı yeme (OR:3,355, CI:1,175-9,583), kısa öğle yemeği süresi (OR:0,966, CI:0,934-0,998), günlük uyku süresinin 2 saat ekran süresi (OR:1,560, CI:1,012-2,405) okul öncesi çocukluk obezitesi ile ilişkili bulunmuştur.
Sonuç: Ebeveyn obezitesi, gebelikte kafein alımı, yeme hızı, günlük uyku ve ekran süresi Türk okul öncesi çocuklarında obezite risk faktörleri olarak belirlendi. Erken çocukluk döneminde anne ve çocuğa ait risk faktörlerinin belirlenmesi, yaşam tarzının ve obezojenik çevrenin düzenlenmesi, obeziteden koruyucu olabilir.
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Affiliation(s)
| | - Volkan ÖZKAYA
- ISTANBUL MEDIPOL UNIVERSITY, FACULTY OF HEALTH SCIENCES
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6
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Pérez-Muñoz C, Carretero-Bravo J, Ortega-Martín E, Ramos-Fiol B, Ferriz-Mas B, Díaz-Rodríguez M. Interventions in the first 1000 days to prevent childhood obesity: a systematic review and quantitative content analysis. BMC Public Health 2022; 22:2367. [PMID: 36527103 PMCID: PMC9758903 DOI: 10.1186/s12889-022-14701-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Childhood obesity poses a global health challenge. In recent years, there has been an increase in interventions that begin in pregnancy, putting the concept of early programming and early risk factors into practice. The present study aims to update the findings regarding interventions in the first 1000 days of life. METHODS A systematic review based on the PRISMA guidelines was carried out in PubMed, WoS, Scopus and CINAHL to obtain the articles to be analysed. We included those studies published between 2016 and 2021. Human interventions that started within the first 1000 days of life and acted on at least one programming factor were included. Once selected, coding and quantitative content analysis was carried out to obtain a profile of the interventions during the first 1000 days. RESULTS From all screened articles, 51 unique interventions, which met the selection criteria, were included. The majority of interventions (81%) took place in high-income areas. Almost all (86%) were targeted at the general population. The majority (54%) started in the second trimester of pregnancy. A clear majority (61%) ended at the time of birth. 44% of the interventions included all pregnant women. Only 48% of these interventions were focused on improving the nutritional status of the offspring in the short term. Most interventions collected the baby's weight at birth (68%). CONCLUSIONS It can be concluded that current interventions are not covering as many aspects as they should. Future research should be conducted more frequently in developing countries and target disadvantaged groups. These interventions should include all pregnant women, regardless of their nutritional status, aiming to cover as many programming factors as possible and extending through the first 1000 days of life, with body mass index or skinfolds as measures of effectiveness during this period.
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Affiliation(s)
- Celia Pérez-Muñoz
- grid.7759.c0000000103580096Facultad de Enfermería Y Fisioterapia, University of Cádiz, Ana de Viya 52, 11009 Cádiz, Spain
| | - Jesús Carretero-Bravo
- grid.7759.c0000000103580096Facultad de Enfermería Y Fisioterapia, University of Cádiz, Ana de Viya 52, 11009 Cádiz, Spain
| | - Esther Ortega-Martín
- grid.7759.c0000000103580096Facultad de Enfermería Y Fisioterapia, University of Cádiz, Ana de Viya 52, 11009 Cádiz, Spain
| | - Begoña Ramos-Fiol
- grid.7759.c0000000103580096Facultad de Enfermería Y Fisioterapia, University of Cádiz, Ana de Viya 52, 11009 Cádiz, Spain
| | | | - Mercedes Díaz-Rodríguez
- grid.7759.c0000000103580096Facultad de Enfermería Y Fisioterapia, University of Cádiz, Ana de Viya 52, 11009 Cádiz, Spain
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Comparison of the key modifiable factors in the first 1000 days predicting subsequent overweight and obesity in pre-school children in Tehran: a case-control study. Br J Nutr 2022; 128:955-963. [PMID: 34588008 DOI: 10.1017/s0007114521003937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The identification of paediatric obesity predictors in the early stages of life is warranted, as it can influence the development of effective strategies to prevent metabolic disorders. In this case-control study, we assessed nine risk factors for paediatric obesity, namely a birth weight > 4000 g, an exclusive breast-feeding period < 4 months, the introduction of solid food at < 4 months, maternal overweight or obesity before pregnancy, maternal smoking during pregnancy, the presence of gestational diabetes, paternal overweight and obesity and paternal smoking. In order to identify the most relevant predictors of paediatric obesity, we employed a multiple logistic regression model with R2 Cox Snell by adjusting confounders. In the randomly selected 509 preschool children from Tehran, children exposed to gestational diabetes had the maximum predicted probability of obesity (4·36 (1·94, 9·80) %) among the analysed risk factors %. The introduction of solid food at < 4 months of age increased the risk of obesity by 2·98 (1·77, 4·97 %). The OR of childhood obesity was associated with maternal overweight and obesity (2·72(1·60-4·60) %), maternal smoking (2·21 (1·18, 4·11) %) and excessive gestational weight gain (1·89 (1·23, 2·91) %). Paternal smoking and high birth weight increased the risk of paediatrics obesity > 1·8 times (1·15-2·94) and > 1·5 times (1·015-2·43), respectively. There was no association between the paternal BMI, the exclusive breast-feeding time and the risk of paediatric obesity. Among early risk factors, probably gestational diabetes can be considered as the most important predictor for the risk of paediatric obesity.
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Carrillo-Balam G, Doi L, Marryat L, Williams AJ, Bradshaw P, Frank J. Validity of Scottish predictors of child obesity (age 12) for risk screening in mid-childhood: a secondary analysis of prospective cohort study data-with sensitivity analyses for settings without various routinely collected predictor variables. Int J Obes (Lond) 2022; 46:1624-1632. [PMID: 35662271 PMCID: PMC9395267 DOI: 10.1038/s41366-022-01157-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/07/2022] [Accepted: 05/24/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To analyse the Growing Up in Scotland cohort for predictors of obesity at age 12, present at school entry (age 5-6). METHODS The initial model included literature-based risk factors likely to be routinely collected in high-income countries (HICs), as well as "Adverse/Protective Childhood Experiences (ACEs/PCEs)". Missing data were handled by Multiple Chained Equations. Variable-reduction was performed using multivariable logistic regression with backwards and forwards stepwise elimination, followed by internal validation by bootstrapping. Optimal sensitivity/specificity cut-offs for the most parsimonious and accurate models in two situations (optimum available data, and routinely available data in Scotland) were examined for their referral burden, and Positive and Negative Predictive Values. RESULTS Data for 2787 children with full outcome data (obesity prevalence 18.3% at age 12) were used to develop the models. The final "Optimum Data" model included six predictors of obesity: maternal body mass index, indoor smoking, equivalized income quintile, child's sex, child's BMI at age 5-6, and ACEs. After internal validation, the area under the receiver operating characteristic curve was 0.855 (95% CI 0.852-0.859). A cut-off based on Youden's J statistic for the Optimum Data model yielded a specificity of 77.6% and sensitivity of 76.3%. 37.0% of screened children were "Total Screen Positives" (and thus would constitute the "referral burden".) A "Scottish Data" model, without equivalized income quintile and ACEs as a predictor, and instead using Scottish Index of Multiple Deprivation quintile and "age at introduction of solid foods," was slightly less sensitive (76.2%) but slightly more specific (79.2%), leading to a smaller referral burden (30.8%). CONCLUSION Universally collected, machine readable and linkable data at age 5-6 predict reasonably well children who will be obese by age 12. However, the Scottish treatment system is unable to cope with the resultant referral burden and other criteria for screening would have to be met.
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Affiliation(s)
| | - Lawrence Doi
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Louise Marryat
- School of Health Sciences, University of Dundee, Dundee, UK
| | | | | | - John Frank
- Usher Institute, University of Edinburgh, Edinburgh, UK.
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Lin D, Chen DD, Huang J, Li Y, Wen XS, Shi HJ. Longitudinal association between the timing of adiposity peak and rebound and overweight at seven years of age. BMC Pediatr 2022; 22:215. [PMID: 35439975 PMCID: PMC9016949 DOI: 10.1186/s12887-022-03190-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background The timing of adiposity peak (AP) or adiposity rebound (AR) is a determinant of overweight or obesity in adolescence and adulthood. However, limited studies have reported the association in young school-age children. We aimed to evaluate this association and explore the role of health behaviours in it. Methods Routinely collected, sequential, anthropometric data from the 1st to 80th months of age were used to estimate AP and AR timings in 2330 children born in Shanghai between 2010 and 2013. Multivariate regression analyses were applied to identify the associations between the AP or AR timings and the risk of developing overweight or obesity in first-grade school children. The roles of health behaviours, including dietary patterns, physical activity level, sleep and snacking habits, and screen time, were also evaluated. Results Children with a late AP or an early AR were at higher risk of overweight but not obesity or central obesity in their first grade. A high physical activity level was associated with a lower risk of having overweight in children with a late AP, and limited screen time was associated with a decreased risk of having overweight or obesity in children with an early AR. The absence of a late-night snacking habit in children with a non-early AR indicated a decreased risk of having overweight. However, this association was not observed among children with an early AR. Conclusion The timings of AP and AR are tied to overweight in middle childhood. Prevention strategies are suggested to move forward to control late AP and early AR. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03190-9.
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Affiliation(s)
- Dan Lin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
| | - Di-di Chen
- Minhang District Centre of Disease Control and Prevention, Shanghai, China.,Minhang Branch, School of Public Health, Fudan University, Shanghai, China
| | - Jun Huang
- Minhang Maternal and Child Health Centre, Shanghai, China
| | - Yun Li
- Minhang Maternal and Child Health Centre, Shanghai, China
| | - Xiao-Sa Wen
- Minhang District Centre of Disease Control and Prevention, Shanghai, China.,Minhang Branch, School of Public Health, Fudan University, Shanghai, China
| | - Hui-Jing Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China.
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Hildebrand JS, Ferguson PL, Sciscione AC, Grobman WA, Newman RB, Tita AT, Wapner RJ, Nageotte MP, Palomares K, Skupski DW, Cooper DM, Zhang C, Neelon B, Vena JE, Hunt KJ. Breastfeeding Associations with Childhood Obesity and Body Composition: Findings from a Racially Diverse Maternal-Child Cohort. Child Obes 2022; 18:178-187. [PMID: 34669515 PMCID: PMC8982114 DOI: 10.1089/chi.2021.0138] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Studies suggest breastfeeding lowers obesity risk in childhood, but generalizability of existing evidence is limited. We examined associations of breastfeeding with childhood overweight, obesity, and percentage body fat, in a racially diverse maternal-child cohort. Methods: This cross-sectional study included 823 children, ages 4-8 years, enrolled in the Environmental Exposures and Child Health Outcomes (ECHO) cohort, a subset of the National Institute of Child Health and Human Development Fetal Growth Studies cohort. Logistic regression was used to estimate odds ratios and 95% confidence intervals (CIs) for overweight [BMI (kg/m2) 85th to <95th percentile] and obesity (BMI ≥95th percentile) in relation to breastfeeding including duration of exclusive and total breastfeeding. Linear regression was used to evaluate association between breastfeeding and percentage body fat measured by bioelectrical impedance analysis. Results: Fifty-two percent of children were male, 32% non-Hispanic Black, 29% Hispanic, 27% non-Hispanic White, and 13% Asian; 16% were overweight and 13% obese. Six months of exclusive breastfeeding, compared with no breastfeeding, was associated with 60% lower odds of obesity (95% CI 0.18-0.91) adjusting for age, gender, race, socioeconomic status, maternal BMI, and child's activity. Percentage body fat was inversely associated with breastfeeding duration. For none, <6, and ≥6 months of exclusive breastfeeding, adjusted mean percentage body fat was 16.8, 14.5, and 13.4, respectively. Results did not differ by gender, race/ethnicity, or maternal BMI status. Conclusions: Exclusive breastfeeding for the first 6 months of life is inversely and significantly associated with obesity and percentage body fat at ages 4-8 years. These findings support current breastfeeding guidelines.
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Affiliation(s)
- Janet S. Hildebrand
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.,Target RWE Health Evidence Solutions, Durham, NC, USA
| | - Pamela L. Ferguson
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Anthony C. Sciscione
- Department of Obstetrics & Gynecology, Christiana Care Health System, Newark, DE, USA
| | - William A. Grobman
- Department of Obstetrics & Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Roger B. Newman
- Department of Obstetrics & Gynecology, Medical University of South Carolina, Charleston, SC, USA
| | - Alan T. Tita
- Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ronald J. Wapner
- Department of Obstetrics & Gynecology, Columbia University Medical Center, New York, NY, USA
| | - Michael P. Nageotte
- Department of Obstetrics & Gynecology, Long Beach Memorial Medical Center, Long Beach, CA, USA
| | - Kristy Palomares
- Department of Obstetrics & Gynecology, Saint Peter's University Hospital, New Brunswick, NJ, USA
| | - Daniel W. Skupski
- Department of Obstetrics & Gynecology, New York Presbyterian Queens Hospital, Queens, NY, USA
| | - Daniel M. Cooper
- Department of Pediatrics, University of California at Irvine School of Medicine, Irvine, CA, USA,Department of Pediatrics, Fountain Valley Regional Hospital and Medical Center, Fountain Valley, CA, USA
| | - Cuilin Zhang
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Brian Neelon
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - John E. Vena
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kelly J. Hunt
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.,Address correspondence to: Kelly J. Hunt, PhD, Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite 303, Charleston, SC 29425, USA
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11
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Prenatal Education Intervention for Increasing Knowledge and Changing Attitude Toward Offspring Obesity Risk Factors. J Perinat Educ 2022; 31:94-103. [PMID: 35386491 PMCID: PMC8970135 DOI: 10.1891/jpe-2021-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This pre- and post-test quasi-experimental design study pilot tested an educational intervention designed to increase knowledge of and change attitudes toward prenatal factors that increase risk of childhood offspring obesity in 36 pregnant women. Educational intervention content included monitoring blood glucose, gestational weight gain in pregnancy, healthy lifestyle choices, and breastfeeding. Education intervention delivery method included: Verbal, written, and video. Participants’ knowledge improved after the intervention for most topics (p = .03–.000). Their attitude score also differed before and after intervention (p = .002). Video delivery mode was the most useful, attractive, and most helpful method. This study showed an education intervention could potentially increase pregnant women’s knowledge and attitudes toward offspring obesity risk factors.
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12
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Haby K, Gyllensten H, Hanas R, Berg M, Premberg Å. A Lifestyle Intervention During Pregnancy and Its Effects on Child Weight 2.5 Years Later. Matern Child Health J 2022; 26:1881-1890. [PMID: 35253077 PMCID: PMC9374787 DOI: 10.1007/s10995-022-03395-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2022] [Indexed: 11/27/2022]
Abstract
Aim The aim of this study was to evaluate if overweight and obesity in the offspring is reduced by a low-intensity antenatal primary care intervention with focus on diet and physical activity for pregnant women with obesity, comparing children to mothers receiving the intervention with children to mothers who did not. Methods This study is a follow-up of children 2.5 years of age after their mothers’ participation in a non-randomised controlled intervention intending to limit gestational weight gain. All study participants received standard antenatal care. The intervention group received lifestyle support via motivational talks with midwife and support from dietician. Data on child weight were collected by medical records, letter and phone. Results There was no significant difference between the groups 2.5 years after intervention (International Obesity Task Force ISO-BMI 25 (child BMI corresponding to adult BMI of 25): 20% vs. 21%; ISO-BMI 30: 4.6% vs. 1.3%). The mother’s BMI at the beginning of pregnancy significantly influenced child BMI at 2.5 years (r = 0.13, p = 0.014, r2 = 0.017). For each unit of increase in maternal BMI at enrollment, the probability of child ISO-BMI ≥ 25 increased by 7.5% (p = 0.021) and of ≥ 30, by 12.9% (p = 0.017). Conclusion The frequency of overweight and obesity of the children at 2.5 years of age was significantly correlated to the mother’s BMI, but not correlated to the mothers’ participation in the antenatal lifestyle intervention. Thus, it seems important to address obesity and lifestyle issues before and between pregnancies. Trial registration The study has been registered at ClinicalTrials.gov, Identifier: NCT03147079. Supplementary Information The online version contains supplementary material available at 10.1007/s10995-022-03395-5.
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Affiliation(s)
- Karin Haby
- Antenatal Health Care, Primary Health Care, Research and Development Unit, Regionhälsan, Gothenburg, Sweden.
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Primary Health Care and Research and Development Unit, Regionhälsan, Gothenburg, Region Västra Götaland, Sweden.
| | - Hanna Gyllensten
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ragnar Hanas
- Department of Paediatrics, NU Hospital Group, Uddevalla, Sweden
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Åsa Premberg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Primary Health Care and Research and Development Unit, Regionhälsan, Gothenburg, Region Västra Götaland, Sweden
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13
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Gawlik A, Salonen A, Jian C, Yanover C, Antosz A, Shmoish M, Wasniewska M, Bereket A, Wudy SA, Hartmann MF, Thivel D, Matusik P, Weghuber D, Hochberg Z. Personalized approach to childhood obesity: Lessons from gut microbiota and omics studies. Narrative review and insights from the 29th European childhood obesity congress. Pediatr Obes 2021; 16:e12835. [PMID: 34296826 DOI: 10.1111/ijpo.12835] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 06/20/2021] [Accepted: 07/05/2021] [Indexed: 12/19/2022]
Abstract
The traditional approach to childhood obesity prevention and treatment should fit most patients, but misdiagnosis and treatment failure could be observed in some cases that lie away from average as part of individual variation or misclassification. Here, we reflect on the contributions that high-throughput technologies such as next-generation sequencing, mass spectrometry-based metabolomics and microbiome analysis make towards a personalized medicine approach to childhood obesity. We hypothesize that diagnosing a child as someone with obesity captures only part of the phenotype; and that metabolomics, genomics, transcriptomics and analyses of the gut microbiome, could add precision to the term "obese," providing novel corresponding biomarkers. Identifying a cluster -omic signature in a given child can thus facilitate the development of personalized prognostic, diagnostic, and therapeutic approaches. It can also be applied to the monitoring of symptoms/signs evolution, treatment choices and efficacy, predisposition to drug-related side effects and potential relapse. This article is a narrative review of the literature and summary of the main observations, conclusions and perspectives raised during the annual meeting of the European Childhood Obesity Group. Authors discuss some recent advances and future perspectives on utilizing a systems approach to understanding and managing childhood obesity in the context of the existing omics data.
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Affiliation(s)
- Aneta Gawlik
- Department of Paediatrics and Paediatric Endocrinology, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland
| | - Anne Salonen
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Ching Jian
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Chen Yanover
- Healthcare Informatics, IBM Research-Haifa, Haifa, Israel
| | - Aleksandra Antosz
- Department of Paediatrics and Paediatric Endocrinology, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland
| | - Michael Shmoish
- Bioinformatics Knowledge Unit, The Lokey Centre, Technion - Israel Institute of Technology, Haifa, Israel
| | - Malgorzata Wasniewska
- Department of Human Pathology in Adulthood and Childhood, University of Messina, Messina, Italy
| | - Abdullah Bereket
- School of Medicine, Department of Paediatric Endocrinology, Marmara University, Istanbul, Turkey
| | - Stefan A Wudy
- Steroid Research & Mass Spectrometry Unit, Laboratory for Translational Hormone Analytics, Division of Paediatric Endocrinology & Diabetology, Center of Child and Adolescent Medicine, Justus-Liebig-University, Giessen, Germany
| | - Michaela F Hartmann
- Steroid Research & Mass Spectrometry Unit, Laboratory for Translational Hormone Analytics, Division of Paediatric Endocrinology & Diabetology, Center of Child and Adolescent Medicine, Justus-Liebig-University, Giessen, Germany
| | - David Thivel
- University Clermont Auvergne, UFR Medicine, Clermont-Ferrand, France
| | - Pawel Matusik
- Department of Paediatrics and Paediatric Endocrinology, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland
| | - Daniel Weghuber
- Department of Paediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Ze'ev Hochberg
- Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
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14
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Gyllensten H, Haby K, Berg M, Premberg Å. Cost effectiveness of a controlled lifestyle intervention for pregnant women with obesity. BMC Pregnancy Childbirth 2021; 21:639. [PMID: 34548038 PMCID: PMC8456662 DOI: 10.1186/s12884-021-04098-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 08/29/2021] [Indexed: 11/30/2022] Open
Abstract
Background The Mighty Mums antenatal lifestyle intervention is a person-centered behavioral intervention focusing on nutrition and physical activity for pregnant women with obesity (body mass index [BMI] ≥30). The aim of this study was to evaluate the costs and clinical outcomes of adding the Mighty Mums intervention to standard antenatal care. Methods Participants in the intervention group (n = 434) received motivational talks with their midwife and a selection of physical and/or nutritional activities in addition to antenatal care. Control participants (n = 867) from adjacent geographic areas received standard antenatal care. Costs for staff, unit costs for specific activities, and registered costs for specialized antenatal care were analyzed for associations with gestational weight gain and self-reported health. Results are reported for the intention-to-treat (ITT) population and a per protocol (PP) population identified by participation in the intervention. Analyses included bootstrapped linear regressions adjusted for background characteristics that differed significantly between groups. Results The average costs were SEK 9727 higher (95% confidence interval [CI]: 6677 to 12,777) among participants in the intervention group than in the control ITT population and SEK 8655 (95% CI 4586 to 12,724) higher than in the PP population. The cost increase per 1 kg reduction in gestational weight gain was SEK 12,369 in the ITT population and SEK 7209 for the PP population. Conclusion Participation in the Mighty Mums intervention was associated with higher costs, but also reduced gestational weight gain. The cost per kilogram reduction in gestational weight gain was low, particularly in the PP population. A future decision to implement this behavioral intervention in standard care should take into account society’s willingness to pay per unit reduction in gestational weight gain. Trial registration The study is registered at ClinicalTrials.gov, Identifier: NCT03147079. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04098-5.
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Affiliation(s)
- Hanna Gyllensten
- Institute of Health and Care Sciences, University of Gothenburg, Box 457, SE-405 30, Göteborg, Sweden. .,Centre for Person-Centred Care - GPCC, University of Gothenburg, Gothenburg, Sweden. .,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Karin Haby
- Institute of Health and Care Sciences, University of Gothenburg, Box 457, SE-405 30, Göteborg, Sweden.,Region Västra Götaland, Research and Development Primary Health Care, Gothenburg, Sweden
| | - Marie Berg
- Institute of Health and Care Sciences, University of Gothenburg, Box 457, SE-405 30, Göteborg, Sweden.,Centre for Person-Centred Care - GPCC, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Obstetrics, Gothenburg, Sweden
| | - Åsa Premberg
- Institute of Health and Care Sciences, University of Gothenburg, Box 457, SE-405 30, Göteborg, Sweden.,Region Västra Götaland, Research and Development Primary Health Care, Gothenburg, Sweden
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15
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Birth weight, life course factors and excess weight among schoolchildren in Niterói, Rio de Janeiro, Brazil in 2010. J Pediatr (Rio J) 2021; 97:531-539. [PMID: 33290734 PMCID: PMC9432005 DOI: 10.1016/j.jped.2020.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/11/2020] [Accepted: 10/08/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To investigate the association between birth weight and excess weight among students aged 6-14 years, adjusted for life course confounding factors. METHODS Cross-sectional study with 6-14-year-old schoolchildren in 2010; 795 school children from two public schools. In addition, a sub-sample was selected using a case-cohort study approach. Sociodemographic, breastfeeding, food introduction, previous weight gain, family history, current clinical and behavioral variables as well as maternal variables related to pregnancy, were collected. Multivariable weighted logistic regression was used to evaluate the association between birth weight and overweight. All prevalent cases of overweight (n = 160) were selected to compose the case group and a random sub-sample of all students participating in the study (n = 276 students, of whom 88 were cases) were the control group. RESULTS An unadjusted 6% increase in the excess weight prevalence ratio (p-value = 0.004) was found for each 100 g increase in birth weight. With adjustment for age, sex and behavioral variables (models 1 and 2), the association of birth weight with excess weight was positive and statistically significant, but it was no longer significant in the final model (model 3) when clinical variables were considered. CONCLUSIONS Although some of the secondary associations were statistically significant, we could not identify a significant association between birthweight and excess weight in adolescents.
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16
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Díaz-Rodríguez M, Pérez-Muñoz C, Carretero-Bravo J, Ruíz-Ruíz C, Serrano-Santamaría M, Ferriz-Mas BC. Early Risk Factors for Obesity in the First 1000 Days-Relationship with Body Fat and BMI at 2 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8179. [PMID: 34360471 PMCID: PMC8346117 DOI: 10.3390/ijerph18158179] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 12/23/2022]
Abstract
(1) Background: Obesity is defined as an excessive accumulation of body fat. Several early developmental factors have been identified which are associated with an increased risk of childhood obesity and increased adiposity in childhood. The primary objective of the present study is to analyse the effect of various early risk factors on Body Mass Index (BMI) and body fat percentage at 2 years of age. (2) Methods: A prospective cohort study design was used, with the sample consisting of 109 mother-child pairs from whom data were collected between early pregnancy and 2 years old. Adiposity was determined based on skinfold measurements using the Brooks and Siri formulae. Mean comparison tests (Student's t-test and ANOVAs) and multiple linear regression models were used to analyse the relationship between early programming factors and dependent variables. (3) Results: Maternal excess weight during early pregnancy (β = 0.203, p = 0.026), gestational smoking (β = 0.192, p = 0.036), and accelerated weight gain in the first 2 years (β = - 0.269, p = 0.004) were significantly associated with high body fat percentage. Pre-pregnancy BMI and accelerated weight gain in the first 2 years were associated with high BMI z-score (β = 0.174, p = 0.047 and β = 0.417, p = 0.000 respectively). The cumulative effect of these variables resulted in high values compared to the baseline zero-factor group, with significant differences in BMI z-score (F = 8.640, p = 0.000) and body fat percentage (F = 5.402, p = 0.002) when three factors were present. (4) Conclusions: The presence of several early risk factors related to obesity in infancy was significantly associated with higher BMI z-score and body fat percentage at 2 years of age. The presence of more than one of these variables was also associated with higher adiposity at 2 years of age. Early prevention strategies should address as many of these factors as possible.
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Affiliation(s)
- Mercedes Díaz-Rodríguez
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (M.D.-R.); (C.P.-M.); (J.C.-B.)
| | - Celia Pérez-Muñoz
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (M.D.-R.); (C.P.-M.); (J.C.-B.)
| | - Jesús Carretero-Bravo
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (M.D.-R.); (C.P.-M.); (J.C.-B.)
| | - Catalina Ruíz-Ruíz
- Clinic Management Unit (CMU), Andalusian Health System, 11510 Cádiz, Spain; (C.R.-R.); (M.S.-S.)
| | | | - Bernardo C. Ferriz-Mas
- Clinic Management Unit (CMU), Andalusian Health System, 11510 Cádiz, Spain; (C.R.-R.); (M.S.-S.)
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17
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Malihi Z, Portch R, Hashemi L, Schlichting D, Wake M, Morton S, Fa'alili-Fidow J, Mensah F, Olds T, Atatoa Carr P, Kingi TK, Grant CC, Denny S. Modifiable Early Childhood Risk Factors for Obesity at Age Four Years. Child Obes 2021; 17:196-208. [PMID: 33595354 DOI: 10.1089/chi.2020.0174] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Childhood obesity is associated with an increased risk of adult obesity and related chronic disease. Our aim was to identify modifiable exposures that are independently associated with obesity in the preschool age group. Methods: A prospective cohort study of 5734 children in New Zealand with anthropometric measurements was completed at age 4.5 years. The modifiable exposures of interest, measured at age 9 months and 2 years, were: food security during infancy; and, at age 2 years, screen time; sleep duration; and takeaway food and soft drink intake. The risk of obesity independently associated with each exposure was determined using Binomial and Poisson regression and described using adjusted risk ratios (RRs) and 95% confidence intervals (CIs), after controlling for confounding variables including gender, ethnicity, birth weight, and mother's age. The probability of obesity given cumulative exposures to the four risk factors and the population attributable fraction (PAF) were estimated. Results: Lower food security during infancy (<mean study sample score; RR = 1.32; 95% CI : 1.06-1.64) and, at age 2 years, more screen time (>1 hour/day; RR = 1.22; 95% CI : 1.01-1.48), shorter sleep duration (≤11.5 hours/day; RR = 1.30; 95% CI : 1.05-1.61), and weekly to daily consumption of takeaway/soft drink (RR = 1.25, 95% CI : 1.00-1.57) were independently associated with an increased risk of obesity at age 4.5 years. The cumulative PAF for childhood obesity was 42.9%, under an ideal scenario where all risk factors were eliminated. Conclusion: Exposure to modifiable factors by age 2 years is associated with obesity at age 4.5 years. Interventions to prevent childhood obesity need to be effective during infancy.
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Affiliation(s)
- Zarintaj Malihi
- Department of Paediatrics, Child, and Youth Health, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Richard Portch
- Department of Paediatrics, Child, and Youth Health, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Ladan Hashemi
- Department of Paediatrics, Child, and Youth Health, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Deborah Schlichting
- Department of Paediatrics, Child, and Youth Health, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Melissa Wake
- Prevention and Innovation Group, Population Health Theme, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Susan Morton
- Growing Up in New Zealand, School of Population Health, University of Auckland, Auckland, New Zealand.,Centre for Longitudinal Research-He Ara ki Mua, University of Auckland, Auckland, New Zealand
| | - Jacinta Fa'alili-Fidow
- Growing Up in New Zealand, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Fiona Mensah
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Tim Olds
- Alliance for Research in Exercise, Nutrition, and Activity (ARENA), University of South Australia, Adelaide, Australia
| | - Polly Atatoa Carr
- Department of Paediatrics, Waikato District Health Board and National Institute of Demographic and Economic Analysis, University of Waikato, Hamilton, New Zealand
| | - Te Kani Kingi
- Research and Innovation, Te Whare Wananga o Awanuiarangi, Whakatane, New Zealand
| | - Cameron C Grant
- Department of Paediatrics, Child, and Youth Health, School of Medicine, University of Auckland, Auckland, New Zealand.,Centre for Longitudinal Research-He Ara ki Mua, University of Auckland, Auckland, New Zealand.,General Paediatrics, Starship Children's Hospital, Auckland, New Zealand
| | - Simon Denny
- Mater Young Adult Health Centre, Level 5 Potter Link, South Brisbane, Queensland, Australia
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18
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Postnatal Catch-Up Growth Programs Telomere Dynamics and Glucose Intolerance in Low Birth Weight Mice. Int J Mol Sci 2021; 22:ijms22073657. [PMID: 33915805 PMCID: PMC8037520 DOI: 10.3390/ijms22073657] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 01/06/2023] Open
Abstract
Low birth weight and rapid postnatal weight gain are independent predictors of obesity and diabetes in adult life, yet the molecular events involved in this process remain unknown. In inbred and outbred mice, this study examines natural intrauterine growth restriction (IUGR) in relation to body weight, telomere length (TL), glucose tolerance, and growth factor gene (Igf1, Igf2, Insr, Igf1r, and Igf2r) mRNA expression levels in the brain, liver, and muscle at 2- and 10 days of age and then at 3- and 9 months of age. At birth, ~15% of the animals showed IUGR, but by 3 and 9 months, half of these animals had regained the same weight as controls without IUGR (recuperated group). At 10 days, there was no difference in TL between animals undergoing IUGR and controls. However, by 3 and 9 months of age, the recuperated animals had shorter TL than the control and IUGR-non recuperated animals and also showed glucose intolerance. Further, compared to controls, Igf1 and Igf2 growth factor mRNA expression was lower in Day 2-IUGR mice, while Igf2r and Insr mRNA expression was higher in D10-IUGR animals. Moreover, at 3 months of age, only in the recuperated group were brain and liver Igf1, Igf2, Insr, and Igf2r expression levels higher than in the control and IUGR-non-recuperated groups. These data indicate that catch-up growth but not IUGR per se affects TL and glucose tolerance, and suggest a role in this latter process of insulin/insulin-like growth signaling pathway gene expression during early development.
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19
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Smart SJ, Nikaj AN, Yu L, Li H, Yan F, Zhang J. Association between maternal smoking during pregnancy and offspring overweight in U.S.-born children. Pediatr Obes 2021; 16:e12717. [PMID: 32924334 DOI: 10.1111/ijpo.12717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 07/15/2020] [Accepted: 07/22/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND The criticism of the literature on smoking during pregnancy and offspring overweight was the confounding from postnatal factors. Interaction between gestational age and prenatal maternal smoking has not yet assessed. METHODS We used the Third National Health and Nutrition Examination Survey (1988-1994), linked with natality files of US-born singletons aged 2 to 6 years. A body mass index in the 85th percentile or higher were considered overweight, including obesity. Gestational age was dichotomized as preterm (<37 weeks, n = 240) or full-term (n = 2125). Smoking status during pregnancy was ascertained by a questionnaire-based interview during National Health and Nutrition Examination Survey. RESULTS The prevalence of offspring overweight and obesity combined was 17.3% (SE = 1.3%). And 24.0% (1.3%) of mothers smoked while pregnant. A significant interaction was observed between maternal smoking and gestational age. In preterm children, a higher prevalence of overweight (34.3% [6.7%]) was found among the offspring of smoking mothers compared to non-smoking mothers (15.8% [3.6%]). After adjustment for socio-demographics, prenatal and postnatal factors, in preterm born offspring, the odds ratio of being born to smoking mothers was 2.46 (95% confidence intervals: 1.13-5.37) among children with overweight/obesity compared to children with healthy weight born to non-smoking mothers. In full-term children, the OR of being born to smoking mothers was 0.72 (0.50-1.03) among offspring with overweight/obesity relative to offspring with healthy weight born to non-smoking mothers. CONCLUSIONS Maternal smoking during pregnancy was strongly associated with offspring overweight and obesity in preterm births after control for postnatal factors. Preterm children of smoking mothers should be prioritized for obesity prevention.
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Affiliation(s)
- Shirley J Smart
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Aurela N Nikaj
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Lili Yu
- Department of Biostatistics, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Hongxia Li
- Shanghai East Hospital, Tongji University, School of Medicine, Shanghai, China.,Department of Social Medicine, School of Public Health, Fudan University, Shanghai, China
| | - Fei Yan
- Department of Social Medicine, School of Public Health, Fudan University, Shanghai, China
| | - Jian Zhang
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
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20
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Eating Behaviors in Relation to Child Weight Status and Maternal Education. CHILDREN-BASEL 2021; 8:children8010032. [PMID: 33430408 PMCID: PMC7826797 DOI: 10.3390/children8010032] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 12/30/2020] [Accepted: 01/05/2021] [Indexed: 12/18/2022]
Abstract
Background: The eating behavior of children is important to maintain a healthy weight. This current study explored the differences in children’s eating behaviors and their relation to weight status and maternal education level, using the child eating behavior questionnaire (CEBQ). Methods: The study recruited 169 participants aged between six and ten years. Multinomial logistic regression was conducted to examine the association between the CEBQ factors and children’s body weight status. The association between the CEBQ scores and maternal educational levels was examined using a one-way analysis of variance (ANOVA). Results: The multinomial logistic regression findings indicate that children in the obese group exhibited a significant increase in food responsiveness, enjoyment of food, emotional overeating, and a decrease in satiety responsiveness compared to normal weight children. The one-way ANOVA showed a significant difference in subscales under the food approach (food responsiveness, desire to drink, emotional overeating) and food avoidance (satiety responsiveness) based upon the child’s weight status. The three subscales under the food approach category were significantly dependent upon the maternal education but did not have a significant association with food avoidance. Conclusions: The results suggest that the increase in food responsiveness and emotional overeating in obese children is influenced by maternal education.
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Robinson N, McKay JA, Pearce MS, Albani V, Wright CM, Adamson AJ, Brown H. The Biological and Social Determinants of Childhood Obesity: Comparison of 2 Cohorts 50 Years Apart. J Pediatr 2021; 228:138-146.e5. [PMID: 32949578 DOI: 10.1016/j.jpeds.2020.09.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/08/2020] [Accepted: 09/11/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine whether the same relationships between early-life risk factors and socioeconomic status (SES) with childhood body mass index (BMI) are observed in a modern cohort (2000) compared with a historic cohort (1947). STUDY DESIGN The relationships between early-life factors and SES with childhood BMI were examined in 2 prospective birth cohorts from the same region, born 50 years apart: 711 children in the 1947 Newcastle Thousand Families Study (NTFS) and 475 from the 2000 Gateshead Millennium Study (GMS). The associations between birth weight, breastfeeding, rapid infancy growth (0-12 months), early-life adversity (0-12 months), and parental SES (birth and childhood) with childhood BMI z-scores and whether overweight/obese (BMI >91st percentile using UK 1990 reference) aged 9 years were examined using linear regression, path analyses, and logistic regression. RESULTS In the NTFS, the most advantaged children were taller than the least (+0.91 height z-score, P = .001), whereas in GMS they had lower odds of overweight/obese than the least (0.35 [95% CI 0.14-0.86]). Rapid infancy growth was associated with increased BMI z-scores in both cohorts, and with increased likelihood of overweight/obese in GMS. CONCLUSIONS This study suggests that children exposed to socioeconomic disadvantage or who have rapid infancy growth in modern environments are now at lower risk of growth restriction but greater risk of overweight.
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Affiliation(s)
- Natassia Robinson
- Population Health Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
| | - Jill A McKay
- Faculty of Health and Life Sciences, Department of Applied Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Mark S Pearce
- Population Health Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Viviana Albani
- Population Health Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Charlotte M Wright
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Ashley J Adamson
- Population Health Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Heather Brown
- Population Health Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
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22
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Flores-Barrantes P, Iguacel I, Iglesia-Altaba I, Moreno LA, Rodríguez G. Rapid Weight Gain, Infant Feeding Practices, and Subsequent Body Mass Index Trajectories: The CALINA Study. Nutrients 2020; 12:nu12103178. [PMID: 33080922 PMCID: PMC7603162 DOI: 10.3390/nu12103178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/10/2020] [Accepted: 10/13/2020] [Indexed: 01/16/2023] Open
Abstract
We aimed to study growth patterns according to rapid weight gain (RWG) and infant feeding practices during the first 120 days and whether infant feeding practices mediated the association between RWG in the first semester of life and subsequent body mass index (BMI) z-score in children from age 1 to 6. (1) Methods: 862 children from the Growth and Feeding during Lactation and Early Childhood in Children of Aragon study (CALINA in Spanish) were examined. Repeated-measures ANOVA analyses were conducted to assess growth trajectories according to RWG and type of feeding practice. The product of coefficients mediation method was used to assess the potential contribution of infant feeding practices to the association between RWG and BMI z-score. Mediation models were conducted using IBM SPSS-PROCESS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp. (2) Results: BMI and weight z-score trajectories were significantly higher in the RWG group and the formula-fed group. No significant differences were found regarding height. Infant feeding practices did not mediate the association between RWG and BMI z-score but were associated with BMI at 6 years. (3) Conclusions: Infant feeding practices and RWG determine different growth trajectories of BMI and weight during childhood. Although infant feeding practices did not mediate the association between early RWG and BMI later in life, formula feeding is independently related to higher BMI growth patterns later in childhood.
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Affiliation(s)
- Paloma Flores-Barrantes
- GENUD (Growth, Exercise, NUtrition, and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Spain Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Zaragoza, Spain; (I.I.); (I.I.-A.); (L.A.M.); (G.R.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-876-553-756
| | - Isabel Iguacel
- GENUD (Growth, Exercise, NUtrition, and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Spain Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Zaragoza, Spain; (I.I.); (I.I.-A.); (L.A.M.); (G.R.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28029 Madrid, Spain
| | - Iris Iglesia-Altaba
- GENUD (Growth, Exercise, NUtrition, and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Spain Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Zaragoza, Spain; (I.I.); (I.I.-A.); (L.A.M.); (G.R.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Red de Salud Materno Infantil y del Desarrollo (SAMID), RETICS ISCIII, 28029 Madrid, Spain
| | - Luis A. Moreno
- GENUD (Growth, Exercise, NUtrition, and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Spain Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Zaragoza, Spain; (I.I.); (I.I.-A.); (L.A.M.); (G.R.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28029 Madrid, Spain
| | - Gerardo Rodríguez
- GENUD (Growth, Exercise, NUtrition, and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Spain Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Zaragoza, Spain; (I.I.); (I.I.-A.); (L.A.M.); (G.R.)
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Red de Salud Materno Infantil y del Desarrollo (SAMID), RETICS ISCIII, 28029 Madrid, Spain
- Departamento de Pediatría, Radiología y Medicina Física, Universidad de Zaragoza, 12, 50009 Zaragoza, Spain
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23
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Iguacel I, Gasch-Gallén Á, Ayala-Marín AM, De Miguel-Etayo P, Moreno LA. Social vulnerabilities as risk factor of childhood obesity development and their role in prevention programs. Int J Obes (Lond) 2020; 45:1-11. [PMID: 33033393 DOI: 10.1038/s41366-020-00697-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/08/2020] [Accepted: 09/26/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Large socioeconomic, gender, and ethnic inequalities exist in terms of childhood obesity worldwide. Children from low socioeconomic status families are more likely to have overweight/obesity and related cardiometabolic problems and future cancer risk. A wider concept are social vulnerabilities defined as social or economic characteristics or experiences negatively affecting children through behavioral, biological factors, or mental health. Social vulnerabilities include also therefore low subjective perceptions of social position. OBJECTIVE This study aims to identify social vulnerabilities and to summarize their impact as obesity development risk factor. Preventive programs implemented targeting these vulnerable groups and their effectiveness are also discussed. METHODS Literature review based on the experience of the authors social vulnerabilities identified as risk factors for childhood obesity were children whose parents lack of a social network, low support from formal and informal sources, parental unemployment, belonging to a minority group or having migrant background, adverse childhood experiences including household dysfunction, violence and childhood maltreatment and other traumatic experiences, gender inequalities and being part of nontraditional families. RESULTS The impact of social vulnerabilities on childhood obesity is independent of SES; however, SES exacerbates or buffer the effect social vulnerabilities have on different lifestyles and stress. Behavioral, biological, and mental health mechanisms may explain the association between social vulnerabilities and childhood obesity. CONCLUSIONS Behaviors such as dietary intake, physical activity, sedentary behaviors, and sleep are negatively affected by the stress and low levels of mental health derived from social vulnerabilities. It seems that high energy intakes rather than low physical activity levels might be the main driving force behind the obesity epidemic in vulnerable groups. Most of the prevention programs identified did not take into account social vulnerabilities and inequalities making them ineffective in most vulnerable groups. Interventions conducted in children from socially vulnerable group suggest modest but promising effects.
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Affiliation(s)
- Isabel Iguacel
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences; University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain. .,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain. .,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain. .,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
| | - Ángel Gasch-Gallén
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences; University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Alelí M Ayala-Marín
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences; University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Pilar De Miguel-Etayo
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences; University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences; University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
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24
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Sitarik AR, Havstad SL, Johnson CC, Jones K, Levin AM, Lynch SV, Ownby DR, Rundle AG, Straughen JK, Wegienka G, Woodcroft KJ, Yong GJM, Cassidy-Bushrow AE. Association between cesarean delivery types and obesity in preadolescence. Int J Obes (Lond) 2020; 44:2023-2034. [PMID: 32873910 PMCID: PMC7530127 DOI: 10.1038/s41366-020-00663-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 08/10/2020] [Accepted: 08/19/2020] [Indexed: 01/04/2023]
Abstract
Background/Objectives: The association between mode of delivery and childhood obesity remains inconclusive. Because few studies have separated C-section types (planned or unplanned C-section), our objective was to assess how these subtypes relate to pre-adolescent obesity. Subjects/Methods: The study consisted of 570 maternal-child pairs drawn from the WHEALS birth cohort based in Detroit, Michigan. Children were followed-up at 10 years of age where a variety of anthropometric measurements were collected. Obesity was defined based on BMI percentile (≥95th percentile), as well as through gaussian finite mixture modeling on the anthropometric measurements. Risk ratios (RRs) and 95% confidence intervals (CIs) for obesity comparing planned and unplanned C-sections to vaginal deliveries were computed, which utilized inverse probability weights to account for loss to follow-up and multiple imputation for covariate missingness. Mediation models were fit to examine the mediation role of breastfeeding. Results: After adjusting for marital status, maternal race, prenatal tobacco smoke exposure, maternal age, maternal BMI, any hypertensive disorders during pregnancy, gestational diabetes, prenatal antibiotic use, child sex, parity, and birthweight z-score, children born via planned C-section had 1.77 times higher risk of obesity (≥95th percentile), relative to those delivered vaginally ((95% CI)=(1.16,2.72); p=0.009). No association was found comparing unplanned C-section to vaginal delivery (RR (95% CI)=0.75 (0.45, 1.23); p=0.25). Results were similar but slightly stronger when obesity was defined by anthropometric class (RR (95% CI)=2.78 (1.47, 5.26); p=0.002). Breastfeeding did not mediate the association between mode of delivery and obesity. Conclusions: These findings indicate that children delivered via planned C-section—but not unplanned C-section—have a higher risk of pre-adolescent obesity, suggesting that partial labor or membrane rupture (typically experienced during unplanned C-section delivery) may offer protection. Additional research is needed to understand the biological mechanisms behind this effect, including whether microbiological differences fully or partially account for the association.
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Affiliation(s)
- Alexandra R Sitarik
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA.
| | - Suzanne L Havstad
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Christine C Johnson
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Kyra Jones
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Albert M Levin
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Susan V Lynch
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, CA, USA
| | - Dennis R Ownby
- Division of Allergy & Immunology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jennifer K Straughen
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | | | - Germaine J M Yong
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, CA, USA
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25
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Lakhanpaul M, Benton L, Lloyd-Houldey O, Manikam L, Rosenthal DM, Allaham S, Heys M. Nurture Early for Optimal Nutrition (NEON) programme: qualitative study of drivers of infant feeding and care practices in a British-Bangladeshi population. BMJ Open 2020; 10:e035347. [PMID: 32565459 PMCID: PMC7307527 DOI: 10.1136/bmjopen-2019-035347] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To explore optimal infant feeding and care practices and their drivers within the British-Bangladeshi population of East London, UK, as an exemplar to inform development of a tailored, coadapted participatory community intervention. DESIGN Qualitative community-based participatory research. SETTING Community and children's centres and National Health Service settings within Tower Hamlets, London, UK. PARTICIPANTS 141 participants completed the community study including: British-Bangladeshi mothers, fathers, grandmothers and grandfathers of infants and young children aged 6-23 months, key informants and lay community members from the British-Bangladeshi population of Tower Hamlets, and health professionals working in Tower Hamlets. RESULTS 141 participants from all settings and generations identified several infant feeding and care practices and wider socioecological factors that could be targeted to optimise nutritional outcomes. Our modifiable infant feeding and care practices were highlighted: untimely introduction of semi and solid foods, overfeeding, prolonged parent-led feeding and feeding to 'fill the belly'. Wider socioecological determinants were highlighted, categorised here as: (1) society and culture (e.g. equating 'chubby baby' to healthy baby), (2) physical and local environment (e.g. fast food outlets, advertising) and (3) information and awareness (e.g. communication with healthcare professionals around cultural norms). CONCLUSIONS Parenting interventions should be codeveloped with communities and tailored to recognise and take account of social and cultural norms and influence from different generations that inform infant feeding and care practices and may be of particular importance for infants from ethnically diverse communities. In addition, UK infant feeding environment requires better regulation of marketing of foods for infants and young children if it is to optimise nutrition in the early years.
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Affiliation(s)
- Monica Lakhanpaul
- Population, Policy and Practice, University College London Institute of Child Health, London, UK
- Whittington Health NHS Trust, London, UK
| | - Lorna Benton
- Population, Policy and Practice, University College London Institute of Child Health, London, UK
| | - Oliver Lloyd-Houldey
- Population, Policy and Practice, University College London Institute of Child Health, London, UK
| | - Logan Manikam
- Department of Epidemiology and Public Health, University College London Institute of Epidemiology and Health Care, London, UK
- Aceso Global Health Consultants Ltd, London, UK
| | - Diana Margot Rosenthal
- Population, Policy and Practice, University College London Institute of Child Health, London, UK
| | - Shereen Allaham
- Department of Epidemiology and Public Health, University College London Institute of Epidemiology and Health Care, London, UK
- Aceso Global Health Consultants Ltd, London, UK
| | - Michelle Heys
- Population, Policy and Practice, University College London Institute of Child Health, London, UK
- Specialist Children's and Young People's Services, East London NHS Foundation Trust, London, Newham, UK
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26
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Yoshida S, Kimura T, Noda M, Takeuchi M, Kawakami K. Association of maternal prepregnancy weight and early childhood weight with obesity in adolescence: A population-based longitudinal cohort study in Japan. Pediatr Obes 2020; 15:e12597. [PMID: 31912637 PMCID: PMC7079020 DOI: 10.1111/ijpo.12597] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/31/2019] [Accepted: 10/21/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND The impact of birth weight and obesity in early childhood on obesity in adolescence remains unclear. OBJECTIVES To examine the association of overweight/obesity at age 15 years with birth weight, overweight/obesity in early childhood and overweight/obesity in mothers. METHODS This population-based retrospective cohort study used early childhood and school age health check-up data of 1581 children in Japan, followed-up until age 15 years. Generalized estimation equation analyses were used to investigate the association of overweight/obesity at age 15 years with low/high birth weight, overweight/obesity in 3 years of age and overweight/obesity in mothers. The cutoff points for all variables were defined by international criteria. RESULTS Of 1581 mother-child pairs, 130 (8.2%) children had low birth weight, while 93 (5.9%) and 167 (10.6%) were overweight/obese at age 3 and 15 years, respectively. Overweight/obesity at age 3 years and overweight/obesity in mothers were associated with overweight/obesity at age 15 years (adjusted odds ratio [aOR], 4.26; 95% confidence interval [CI]: 2.51-7.25 and (aOR, 2.46; 95% CI: 1.41-4.30). No association between low birth weight and overweight/obesity at age 15 years was observed. CONCLUSIONS Overweight/obesity in mothers and overweight/obesity at 3 years of age, but not birth weight, were associated with overweight/obesity at age 15 years.
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Affiliation(s)
- Satomi Yoshida
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public HealthKyoto UniversityKyotoJapan
| | - Takeshi Kimura
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public HealthKyoto UniversityKyotoJapan
| | - Masahiro Noda
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public HealthKyoto UniversityKyotoJapan
| | - Masato Takeuchi
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public HealthKyoto UniversityKyotoJapan
| | - Koji Kawakami
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public HealthKyoto UniversityKyotoJapan
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27
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Ekambareshwar M, Taki S, Mihrshahi S, Baur LA, Rissel C, Wen LM. Participant Experiences of an Infant Obesity Prevention Program Delivered via Telephone Calls or Text Messages. Healthcare (Basel) 2020; 8:E60. [PMID: 32188139 PMCID: PMC7151095 DOI: 10.3390/healthcare8010060] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/11/2020] [Accepted: 03/13/2020] [Indexed: 01/01/2023] Open
Abstract
A 3-arm randomised controlled trial implemented in 2017, recruited participants from four Local Health Districts (LHDs) in New South Wales (NSW) to test an early obesity prevention program delivered via telephone calls (telephone) or text messages (SMS). This sub-study explored participants' experience and satisfaction with the program. A multimethod design was used. Quantitative satisfaction questions were completed by participants when their child was six-months old. A purposive sample of participants with varying satisfaction levels was invited for in-depth qualitative interviews. Data were analysed using Excel (quantitative) and inductive thematic analysis (qualitative). Of the 1155 participants recruited: 947 (293 telephone; 338 SMS; 316 control) completed the six-month survey; 34 (14 telephone; 13 SMS; 7 control) were interviewed. Participants' overall program satisfaction was 100% (telephone) and 85% (SMS). Participants' qualitative responses demonstrated appreciation of: personalised stage-based information; opportunity to communicate with health professionals (telephone); linked Healthy Beginnings booklets and SMS mostly as nudges (SMS). There is a clear need for stage-based information, and supplemented modes of delivery i.e., text messages along with telephone calls; with text messages solely seen as nudges or reminders. However, individual preferences vary according to information needs at any given time, time constraints on new mothers and hence, multiple modes of information provision are recommended in order to reach a wider population and for better engagement. Choice and flexibility in mode of delivery has the potential to provide equitable access to information, empowering women with infants to practice recommended health behaviours for infant obesity prevention.
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Affiliation(s)
- Mahalakshmi Ekambareshwar
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia
- NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood, The University of Sydney, Camperdown 2006, Australia
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Camperdown 2006, Australia
| | - Sarah Taki
- NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood, The University of Sydney, Camperdown 2006, Australia
- Health Promotion Unit, Sydney Local Health District, Camperdown 2050, Australia
| | - Seema Mihrshahi
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia
- NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood, The University of Sydney, Camperdown 2006, Australia
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Camperdown 2006, Australia
| | - Louise A. Baur
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia
- NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood, The University of Sydney, Camperdown 2006, Australia
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Camperdown 2006, Australia
- Sydney Medical School, The University of Sydney, Camperdown 2006, Australia
| | - Chris Rissel
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia
- NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood, The University of Sydney, Camperdown 2006, Australia
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Camperdown 2006, Australia
- New South Wales Office of Preventive Health, Ministry of Health, Liverpool 2170, Australia
| | - Li Ming Wen
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia
- NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood, The University of Sydney, Camperdown 2006, Australia
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Camperdown 2006, Australia
- Health Promotion Unit, Sydney Local Health District, Camperdown 2050, Australia
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Ra JS, Yun HJ. Risk Factors in Early Life for Preschool Children in Korea that are Associated with Being Overweight or Obese. Osong Public Health Res Perspect 2020; 11:15-26. [PMID: 32149038 PMCID: PMC7045879 DOI: 10.24171/j.phrp.2020.11.1.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/29/2020] [Accepted: 02/03/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The present study addressed the risk factors in early life for Korean preschool children that are associated with being overweight or obese. METHODS A descriptive cross-sectional design was used to conduct this study, which included 507 mothers with preschool children aged 3-5 years, who attended daycare centers. Data were acquired via a self-administered questionnaire completed by the mothers. Of the 650 questionnaires that were distributed, 507 (78%) were completed and sent back. Multivariate logistic regression analyses were used to identify risk factors in early life, which may contribute to being overweight or obese in preschool children. RESULTS Fifty-eight (11.4%) preschool children were overweight and 41 (8.1%) were obese. Multivariate logistic regression analysis with adjustment for covariates, revealed a significant association with the introduction of solid foods before 4 months of age [adjusted odds ratio (aOR) = 9.49, p = 0.029] and a nonresponsive feeding style (aOR = 2.80, p = 0.043) with being overweight or obese in preschool children. CONCLUSION The findings of this study highlighted the need for parenting education programs on feeding practices to increase their understanding of hunger and satiety cues in infants, and appropriate timing for the introduction of solid foods.
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Affiliation(s)
- Jin Suk Ra
- College of Nursing, Chungnam National University, Daejeon, Korea
| | - Hyun Jung Yun
- Department of Nursing, Cheongju University, Cheongju, Korea
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Sejersen TS, Vinding RK, Stokholm J, Chawes B, Bønnelykke K, Krakauer M, Bisgaard H. Antibiotic exposure in infancy and development of BMI and body composition in childhood. EClinicalMedicine 2019; 17:100209. [PMID: 31891142 PMCID: PMC6933179 DOI: 10.1016/j.eclinm.2019.10.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/22/2019] [Accepted: 10/30/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND It has been hypothesized that antibiotic usage in early life could contribute to development of overweight in childhood. Studies have seen association between antibiotic usage and overweight in childhood. We aimed to investigate the relationship between antibiotic exposure in infancy and development of body mass index (BMI) and body composition. METHODS A prospective mother-child cohort study of 738 pregnant women and their 700 children, Copenhagen Prospective Studies on Asthma in Childhood2010 (COPSAC2010). Information on antibiotic exposure was collected by interviews. Height/length and weight measures were collected at age 1, 2, 3, 4, 5 and 6 years and body composition was determined by a dual-energy X-ray absorptiometry (DXA) scan at age 3.5 and 6 years. FINDINGS 306 (46%) of the 661 children were exposed to antibiotics before 1 year of age. There were no differences in BMI z-score development at age 1-6 years between children exposed to antibiotics compared to unexposed: z-score difference, -0.06 (95%CI: -0.17;0.06), p = 0.33, and no sex-differences (p-interaction = 0.48). Children exposed vs. not exposed to antibiotics had comparable fat percentage at 6 years of age: log(mean difference), 0.60% (95%CI: -0.212 to 1.41), p = 0.15. INTERPRETATION Children exposed to antibiotics had similar BMI, BMI z-score and body composition between 1 and 6 years of life compared to unexposed children. Our study does not support the hypothesis that antibiotic exposure in infancy leads to development of obesity in the first 6 years of life. FUNDING The Lundbeck Foundation, The Ministry of Health, Danish Council for Strategic Research and The Capital Region Research Foundation.
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Affiliation(s)
- Tobias Steen Sejersen
- Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, 2820 Gentofte, Denmark
- Department of Pediatrics, Naestved Hospital, Denmark
| | - Rebecca Kofod Vinding
- Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, 2820 Gentofte, Denmark
- Department of Pediatrics, Naestved Hospital, Denmark
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, 2820 Gentofte, Denmark
- Department of Pediatrics, Naestved Hospital, Denmark
| | - Bo Chawes
- Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, 2820 Gentofte, Denmark
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, 2820 Gentofte, Denmark
| | - Martin Krakauer
- Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, University Hospital of Copenhagen, Denmark
| | - Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, 2820 Gentofte, Denmark
- Corresponding author.
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Sanyaolu A, Okorie C, Qi X, Locke J, Rehman S. Childhood and Adolescent Obesity in the United States: A Public Health Concern. Glob Pediatr Health 2019; 6:2333794X19891305. [PMID: 31832491 PMCID: PMC6887808 DOI: 10.1177/2333794x19891305] [Citation(s) in RCA: 149] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 10/12/2019] [Accepted: 11/06/2019] [Indexed: 12/18/2022] Open
Abstract
Childhood and adolescent obesity have reached epidemic levels in the United States. Currently, about 17% of US children are presenting with obesity. Obesity can affect all aspects of the children including their psychological as well as cardiovascular health; also, their overall physical health is affected. The association between obesity and other conditions makes it a public health concern for children and adolescents. Due to the increase in the prevalence of obesity among children, a variety of research studies have been conducted to discover what associations and risk factors increase the probability that a child will present with obesity. While a complete picture of all the risk factors associated with obesity remains elusive, the combination of diet, exercise, physiological factors, and psychological factors is important in the control and prevention of childhood obesity; thus, all researchers agree that prevention is the key strategy for controlling the current problem. Primary prevention methods are aimed at educating the child and family, as well as encouraging appropriate diet and exercise from a young age through adulthood, while secondary prevention is targeted at lessening the effect of childhood obesity to prevent the child from continuing the unhealthy habits and obesity into adulthood. A combination of both primary and secondary prevention is necessary to achieve the best results. This review article highlights the health implications including physiological and psychological factors comorbidities, as well as the epidemiology, risk factors, prevention, and control of childhood and adolescent obesity in the United States.
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Affiliation(s)
| | | | - Xiaohua Qi
- Saint James School of Medicine, Anguilla, British West Indies
| | - Jennifer Locke
- Saint James School of Medicine, Anguilla, British West Indies
| | - Saif Rehman
- Saint James School of Medicine, Anguilla, British West Indies
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31
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Iguacel I, Chung A, Gearon E, Moreno LA, Peeters A, Backholer K. Influence of early-life risk factors on socioeconomic inequalities in weight gain. J Public Health (Oxf) 2019; 40:e447-e455. [PMID: 29608712 DOI: 10.1093/pubmed/fdy056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 03/05/2018] [Indexed: 11/14/2022] Open
Abstract
Background Previous research has examined the role of early-life risk factors on childhood weight gain.The extent to which these factors drive socioeconomic differences in weight is unclear. We aimed to quantify the influence of early-life risk factors on the development of socioeconomic inequalities in children's body mass index (BMI) z-score at 10-11 years. Methods Overall, 2186 children from the Longitudinal Study of Australian Children were examined. Socioeconomic position (SEP) was measured as a continuous composite of parent's education, occupation and income. The Product of Coefficients mediation method was used to quantify the contribution of maternal smoking during pregnancy, gestational diabetes, prematurity, caesarean section, birthweight, not being breastfed, early introduction of solid food, maternal BMI and paternal BMI to the relationship between SEP and BMI z-score. Results Each increasing decile of SEP (higher SEP) was associated with a 0.05 unit lower (95% CI: -0.06, -0.03) BMI z-score at 10-11 years. In total, 83.5% of these differences in BMI z-score could be explained by socioeconomic differences in maternal smoking during pregnancy (26.9%), maternal BMI (39.6%) and paternal BMI (17.0%). Conclusions Interventions to reduce socioeconomic inequalities in excess weight gain during childhood should support the attainment of a healthy parental weight and prevent smoking during pregnancy.
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Affiliation(s)
- Isabel Iguacel
- Deakin University, Geelong, Global Obesity Centre (GLOBE), World Health Organization Collaborating Centre for Obesity Prevention, Centre for Population Health Research School of Health & Social Development, Burwood, Australia.,Growth, Exercise, NUtrition and Development (GENUD) Research Group, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón) and Centro de Investigación Biomédica en Red de Fisiopatología de la Nutrición y la Obesidad (CIBEROBN), Zaragoza, Spain
| | - Alexandra Chung
- Deakin University, Geelong, Global Obesity Centre (GLOBE), World Health Organization Collaborating Centre for Obesity Prevention, Centre for Population Health Research School of Health & Social Development, Burwood, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Emma Gearon
- Deakin University, Geelong, Global Obesity Centre (GLOBE), World Health Organization Collaborating Centre for Obesity Prevention, Centre for Population Health Research School of Health & Social Development, Burwood, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Luis A Moreno
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón) and Centro de Investigación Biomédica en Red de Fisiopatología de la Nutrición y la Obesidad (CIBEROBN), Zaragoza, Spain
| | - Anna Peeters
- Deakin University, Geelong, Global Obesity Centre (GLOBE), World Health Organization Collaborating Centre for Obesity Prevention, Centre for Population Health Research School of Health & Social Development, Burwood, Australia
| | - Kathryn Backholer
- Deakin University, Geelong, Global Obesity Centre (GLOBE), World Health Organization Collaborating Centre for Obesity Prevention, Centre for Population Health Research School of Health & Social Development, Burwood, Australia
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Gallagher K, Ralph J, Petros T, Qualls C, Leeman L, Rogers RG. Postpartum Weight Retention in Primiparous Women and Weight Outcomes in Their Offspring. J Midwifery Womens Health 2019; 64:427-434. [PMID: 31298482 DOI: 10.1111/jmwh.12986] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 03/19/2019] [Accepted: 03/28/2019] [Indexed: 11/27/2022]
Abstract
INTRODUCTION To explore the effect of prepregnancy body mass index (BMI) and gestational weight gain on postpartum weight retention in nulliparous women and weight-for-length percentiles of offspring to 2 years following birth. METHODS A retrospective secondary analysis of a large, prospective longitudinal study of women conducted during pregnancy and after their first birth was completed to examine outcomes associated with postpartum weight retention. A chart review of the offspring of these women was completed to explore the relationship between maternal prepregnancy BMI and gestational weight gain on offspring weight-for-length percentiles. RESULTS Data from 652 woman-infant dyads were available for analysis. Average postpartum weight retention was 4.0 kg at one year for all groups. At 6 weeks postpartum, women who were obese prior to pregnancy retained significantly less weight than did women who were normal weight prior to pregnancy (P < .05). Women who were normal weight or overweight at the onset of pregnancy and had gestational weight gain within Institute of Medicine recommendations retained significantly less weight at 6 weeks, 6 months, and 1 year postpartum (P < .01) when compared with women in those same weight groups who had a gestational weight gain in excess of the recommended guideline. Women who entered pregnancy obese and who had a gestational weight gain within the recommended weight range during pregnancy retained significantly less weight compared with women who were obese and who gained in excess of the guideline at 6 weeks postpartum only (P < .05). No statistically significant differences were seen in offspring weight-for-length percentiles at any time point based on maternal prepregnancy BMI or weight gain within guidelines. DISCUSSION Many women retained weight up to one year postpartum. In this study, we saw no statistically significant differences between the prepregnant BMI groups or between gestational weight gain within guidelines or in excess of guidelines on offspring weight-for-length percentiles.
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Affiliation(s)
- Kelly Gallagher
- Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, New Mexico
| | - Jody Ralph
- Faculty of Nursing, University of Windsor, Windsor, Ontario, Canada
| | - Thomas Petros
- Department of Psychology, University of North Dakota, Grand Forks, North Dakota
| | - Clifford Qualls
- Clinical and Translation Science Center, University of New Mexico, Albuquerque, New Mexico
| | - Lawrence Leeman
- Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, New Mexico.,Department of Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico
| | - Rebecca G Rogers
- Department of Women's Health, The University of Texas at Austin Dell Medical School, Austin, Texas
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Almquist‐Tangen G, Bergman S, Dahlgren J, Lindholm A, Roswall J, Alm B. Consuming milk cereal drinks at one year of age was associated with a twofold risk of being overweight at the age of five. Acta Paediatr 2019; 108:1115-1121. [PMID: 30511422 DOI: 10.1111/apa.14666] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 11/01/2018] [Accepted: 11/15/2018] [Indexed: 12/22/2022]
Abstract
AIM We previously reported that consuming milk cereal drinks at six months of age was associated with a high body mass index (BMI) at 12 and 18 months. This study examined the association between daily consumption at 12 months of age and BMI at the age of five. METHODS We followed up 1870/2666 (70%) children recruited at birth in 2007-2008 for the Swedish longitudinal population-based Halland Health and Growth Study a mean of 5.09 ± 0.28 years. Feeding practices were obtained from parental questionnaires, and anthropometric data were collected by child health nurses. RESULTS At five years, 11.6% were overweight and 2.3% were obese. Milk cereal drinks were consumed by about 85% and 10% at one and five years of age, respectively. Consumption at 12 months was associated with almost double the risk of being overweight at five years of age (adjusted odds ratio 1.94, 95% confidence interval 1.08-3.50). Other risk factors were a family history of obesity, low paternal educational level and paternal smoking. CONCLUSION Consuming milk cereal drinks daily at 12 months was associated with a twofold risk of being overweight at five years. These findings may affect the counselling guidelines used at child healthcare centres.
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Affiliation(s)
- Gerd Almquist‐Tangen
- Child Health Care Unit Halmstad Sweden
- Department of Paediatrics Institute of Clinical Sciences at the Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Stefan Bergman
- Academy of Health and Welfare Halmstad University Halmstad Sweden
| | - Jovanna Dahlgren
- Department of Paediatrics Institute of Clinical Sciences at the Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Annelie Lindholm
- Academy of Health and Welfare Halmstad University Halmstad Sweden
| | - Josefine Roswall
- Department of Paediatrics Institute of Clinical Sciences at the Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Bernt Alm
- Department of Paediatrics Institute of Clinical Sciences at the Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
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Lee I, Bang KS, Moon H, Kim J. Risk Factors for Obesity Among Children Aged 24 to 80 months in Korea: A Decision Tree Analysis. J Pediatr Nurs 2019; 46:e15-e23. [PMID: 30773305 DOI: 10.1016/j.pedn.2019.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/04/2019] [Accepted: 02/04/2019] [Indexed: 01/17/2023]
Abstract
PURPOSE The purpose of this study was to examine the multiple intergenerational risk factors of obesity among children aged 24 to 80 months using national cohort data. DESIGN AND METHODS This is a retrospective longitudinal cohort study using the Korean National Health Insurance (KNHI) database, and the number of study participants was 1,001,775 families. Social-Economic Status (SES), parental and child-related factors were examined. Descriptive statistics and Chi-squared Automatic Interaction Detection (CHAID) for a decision tree analysis were conducted. RESULTS The prevalence of obesity was 6.57%, and that of overweight was 11.31% among the entire study population. The 17 groups with a prevalence of childhood obesity higher than the mean prevalence rate were classified as high-risk groups for childhood obesity; there were 6 groups with a prevalence of childhood obesity twice as high as the mean prevalence rate from this study. The best predictors were as follows: mothers being obese prior to conception, fathers being obese, non- medical aid beneficiaries, and mothers with hypertension during gestation. CONCLUSIONS The best predictors of children obesity were parental obesity history and SES. Other parental predictors of outcomes were gestational hypertension and diabetes, older pregnancy, drinking during gestation, and depression after delivery. Child-related outcome predictors were noncompliance with exclusive breastfeeding, a sugar-sweetened beverage intake ≥200 ml per day, and irregular breakfast consumption. PRACTICE IMPLICATIONS These findings could help community health nurses assess high-risk groups for early childhood obesity and develop or provide effective interventions in the early stages of life.
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Affiliation(s)
- Insook Lee
- The Research of Institute of Nursing Science, College of Nursing, Seoul National University, Seoul, South Korea.
| | - Kyung-Sook Bang
- The Research of Institute of Nursing Science, College of Nursing, Seoul National University, Seoul, South Korea.
| | - Hyojeong Moon
- College of Nursing, Seoul National University, Seoul, South Korea.
| | - Jieun Kim
- College of Nursing, Chung Cheong University, Heungdeok-Gu, Cheongju-Si, Chungcheongbuk-Do, South Korea.
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Goncalves WSF, Byrne R, Viana MT, Trost SG. Parental influences on screen time and weight status among preschool children from Brazil: a cross-sectional study. Int J Behav Nutr Phys Act 2019; 16:27. [PMID: 30866958 PMCID: PMC6416855 DOI: 10.1186/s12966-019-0788-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 03/05/2019] [Indexed: 11/15/2022] Open
Abstract
Background Little is known about the influence of parental attributes and parental screen time behaviours on pre-schooler’s screen time and weight status in low-to-middle income countries. The purpose of this study was to examine the relationships between parental screen time, parental self-efficacy to limit screen time, child screen time and child BMI in preschool-aged children in Brazil. Methods Three hundred eighteen parent-child dyads from Caruaru, Brazil completed a survey measuring sociodemographic data, weekday and weekend screen time, and parental self-efficacy for limiting screen time. Height and weight were measured and used to derive BMI and BMI percentile. Observed variable path analysis was used to evaluate the relationships between the parental and child variables. Results Analyses were conducted for screen time on weekdays and weekend days. Parental screen time was positively associated with child screen time, either directly (weekdays = β = 0.27, p < 0.001, weekends = β = 0.24, p < 0.001) or indirectly through reduced self-efficacy to limit child screen time (weekdays = β = − 0.15, p = 0.004, weekends = β = − 0.16, p = 0.004). After controlling for household income, parental occupation, and parental BMI, greater child screen time on weekends, not weekdays, was associated with higher child BMI percentile (β = 0.15, p = 0.006). Conclusions Parental screen time and self-efficacy to limit screen time are important influences on child screen time and weight status in pre-schoolers from Brazil. Reducing parental screen time and increasing parental confidence to limit screen time may be effective strategy to prevent overweight in Brazilian pre-schoolers.
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Affiliation(s)
- Widjane Sheila Ferreira Goncalves
- Centre for Children's Health Research, Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Level 6, 62 Graham St, South Brisbane, QLD, 4101, Australia.,Federal University of Pernambuco, Recife, PE, Brazil
| | - Rebecca Byrne
- Centre for Children's Health Research, Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Level 6, 62 Graham St, South Brisbane, QLD, 4101, Australia
| | | | - Stewart G Trost
- Centre for Children's Health Research, Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Level 6, 62 Graham St, South Brisbane, QLD, 4101, Australia.
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Veile A, Valeggia C, Kramer KL. Cesarean birth and the growth of Yucatec Maya and Toba/Qom children. Am J Hum Biol 2019; 31:e23228. [PMID: 30815932 DOI: 10.1002/ajhb.23228] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 01/30/2019] [Accepted: 02/03/2019] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Cesarean delivery is often epidemiologically associated with childhood obesity. However, little attention is paid to post-birth modulatory environments, and most studies are conducted in settings where obesity arises for a number of reasons in addition to birth mode. We therefore assess population differences in the relationship between birth mode and childhood growth using data from rural and peri-urban Latin American indigenous populations, and test predictions developed using life history theory. METHODS Child height and weight were measured monthly in 80 Yucatec Maya and 58 Toba/Qom children aged 1-48 months (2007-2014, 3812 observations). Random-effects linear mixed models were used to compare children's growth by population, sex, and birth mode, accounting for potential confounders. RESULTS Cesarean delivery rates were 47% (Toba/Qom) and 20% (Yucatec Maya). Childhood obesity and overweight rates were low in both populations. Cesarean-delivered children had significantly greater weight gain (but similar height grain) compared to vaginally-delivered children. By age 4, cesarean delivered Yucatec Maya girls and boys, and Toba/Qom boys (not girls), had significantly higher weight-for-age compared to vaginally-delivered children from their own sex and population. CONCLUSIONS This provides one of the first attempts to document differences in children's growth patterns according to mode of birth in modernizing indigenous populations. Cesarean delivery is associated with young children's growth patterns, even in the absence of many obesity-inducing factors. There are also population, age, and sex differences in the relationship between birth mode and childhood weight trajectories that warrant future investigation.
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Affiliation(s)
- Amanda Veile
- Department of Anthropology, Purdue University, West Lafayette, Indiana
| | - Claudia Valeggia
- Department of Anthropology, Yale University, New Haven, Connecticut
| | - Karen L Kramer
- Department of Anthropology, University of Utah, Salt Lake City, Utah
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English LK, Obbagy JE, Wong YP, Butte NF, Dewey KG, Fox MK, Greer FR, Krebs NF, Scanlon KS, Stoody EE. Timing of introduction of complementary foods and beverages and growth, size, and body composition: a systematic review. Am J Clin Nutr 2019; 109:935S-955S. [PMID: 30982863 DOI: 10.1093/ajcn/nqy267] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The systematic review described in this article was conducted as part of the USDA and Department of Health and Human Services Pregnancy and Birth to 24 Months Project. OBJECTIVES The aim was to describe the relationship between timing of introduction of complementary foods and beverages (CFBs) and growth, size, and body-composition outcomes across the life span. METHODS The literature was searched and selected using predetermined criteria. Data were extracted and risk of bias assessed for each included study. Evidence was qualitatively synthesized, conclusion statements were developed, and the strength of the evidence was graded. RESULTS Eighty-one articles were included in this systematic review that addressed timing of CFB introduction relative to growth, size, and body-composition outcomes from infancy through adulthood. Moderate evidence suggests that introduction of CFBs between the ages of 4 and 5 mo compared with ∼6 mo is not associated with weight status, body composition, body circumferences, weight, or length among generally healthy, full-term infants. Limited evidence suggests that introduction of CFBs before age 4 mo may be associated with higher odds of overweight/obesity. Insufficient evidence exists regarding introduction at age ≥7 mo. CONCLUSIONS Although several conclusions were drawn in this systematic review, additional research is needed to address gaps and limitations in the evidence on timing of introduction of CFBs and growth, size, and body composition, such as randomized controlled trials that examine multiple outcomes and/or CFB introduction between the ages of 4 and 6 mo, and research that accounts for potential confounders such as feeding practices and baseline growth status and considers issues of reverse causality.
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Affiliation(s)
| | | | | | - Nancy F Butte
- Department of Pediatrics, USDA/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - Kathryn G Dewey
- Department of Nutrition, University of California, Davis, Davis, CA
| | | | - Frank R Greer
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Nancy F Krebs
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | | | - Eve E Stoody
- USDA, Food and Nutrition Service, Alexandria, VA
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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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Iguacel I, Escartín L, Fernández-Alvira JM, Iglesia I, Labayen I, Moreno LA, Samper MP, Rodríguez G. Early life risk factors and their cumulative effects as predictors of overweight in Spanish children. Int J Public Health 2018; 63:501-512. [DOI: 10.1007/s00038-018-1090-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 03/05/2018] [Accepted: 03/07/2018] [Indexed: 12/19/2022] Open
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40
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Mustila T, Raitanen J, Keskinen P, Luoto R. A pragmatic controlled trial to prevent childhood obesity within a risk group at maternity and child health-care clinics: results up to six years of age (the VACOPP study). BMC Pediatr 2018; 18:89. [PMID: 29486763 PMCID: PMC5828437 DOI: 10.1186/s12887-018-1065-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 02/15/2018] [Indexed: 02/02/2023] Open
Abstract
Background Obesity in childhood appears often during the toddler years. The prenatal environment influences obesity risk. Maternal gestational diabetes, the child’s diet, and physical activity in the first few years have an important role in subsequent weight gain. A study was conducted to evaluate effectiveness of a primary health-care lifestyle counselling intervention in prevention of childhood obesity up to 6 years of age. Methods The study was a controlled pragmatic trial to prevent childhood obesity and was implemented at maternity and child health-care clinics. The participants (n = 185) were mothers at risk of gestational diabetes mellitus with their offspring born between 2008 and 2010. The prenatal intervention, started at the end of the first trimester of pregnancy, consisted of counselling on diet and physical activity by municipal health-care staff. The intervention continued at yearly appointments with a public health-nurse at child health-care clinics. The paper reports the offspring weight gain results for 2–6 years of age. Weight gain up to 6 years of age was assessed as BMI standard deviation scores (SDS) via a mixed-effect linear regression model. The proportion of children at 6 years with overweight/obesity was assessed as weight-for-height percentage and ISO-BMI. Priority was not given to power calculations, because of the study’s pragmatic nature. Results One hundred forty seven children’s (control n = 76/85% and intervention n = 71/56%) weight and height scores were available for analysis at 6 years of age. There was no significant difference in weight gain or overweight/obesity proportions between the groups at 6 years of age, but the proportion of children with obesity in both groups was high (assessed as ISO-BMI 9.9% and 11.8%) relative to prevalence in this age group in Finland. Conclusion As the authors previously reported, the intervention-group mothers had lower prevalence of gestational diabetes mellitus, but a decrease in obesity incidence before school age among their offspring was not found. The authors believe that an effective intervention should start before conception, continuing during pregnancy and the postpartum period through the developmentally unique child’s first years. Trial registration ClinicalTrials.gov NCT00970710. Registered 1 September 2009. Retrospectively registered.
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Affiliation(s)
- Taina Mustila
- Seinäjoki Central Hospital, Hanneksenrinne 7, 60220, Seinäjoki, Finland.
| | - Jani Raitanen
- UKK Institute for Health Promotion, Tampere, Finland.,Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Päivi Keskinen
- Pediatric Research Centre, 33014 University of Tampere, Tampere, Finland.,Tampere University Hospital, 33521, Tampere, Finland
| | - Riitta Luoto
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
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Rauschert S, Mori TA, Beilin LJ, Jacoby P, Uhl O, Koletzko B, Oddy WH, Hellmuth C. Early Life Factors, Obesity Risk, and the Metabolome of Young Adults. Obesity (Silver Spring) 2017; 25:1549-1555. [PMID: 28758369 DOI: 10.1002/oby.21915] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 05/30/2017] [Accepted: 06/01/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Noncommunicable diseases such as obesity have become a serious global public health epidemic. This study aimed to examine whether there was an association between early life factors (with a special focus on breastfeeding) BMI, waist circumference, and the metabolome in offspring at 20 years. METHODS Data from the Western Australian Pregnancy Cohort (Raine) Study were analyzed using 1,024 plasma samples from the 20-year follow-up. A liquid chromatography, tandem mass spectrometry metabolomics approach was used to measure metabolites. Multiple linear regression models were performed and adjusted for relevant confounders. Inverse probability weighting was used to adjust the 20-year data for differences in socioeconomic variables between participants and nonparticipants since the commencement of the study. RESULTS An inverse association between breastfeeding and BMI or waist circumference at 20 years was lost after adjusting for parental prepregnancy BMI and maternal smoking during pregnancy. There was no significant effect of breastfeeding on metabolite concentrations at 20 years. CONCLUSIONS Although other studies have shown associations between breastfeeding, obesity, and metabolite concentrations at younger ages, this was not evident in our study in young adults. We found no association of metabolites previously associated with waist circumference at 20 years and breastfeeding in early life.
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Affiliation(s)
- Sebastian Rauschert
- Ludwig Maximilians Universität München, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Trevor A Mori
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Lawrence J Beilin
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Peter Jacoby
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Olaf Uhl
- Ludwig Maximilians Universität München, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - Berthold Koletzko
- Ludwig Maximilians Universität München, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - Wendy H Oddy
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Christian Hellmuth
- Ludwig Maximilians Universität München, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
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42
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Tarro L, Aceves-Martins M, Papell-Garcia I, Arola L, Giralt M, Llauradó E, Solà R. A Youth-Led, Social Marketing Intervention Run by Adolescents to Encourage Healthy Lifestyles among Younger School Peers (EYTO-Kids Project): A Protocol for Pilot Cluster Randomized Controlled Trial (Spain). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080923. [PMID: 32962313 PMCID: PMC5580625 DOI: 10.3390/ijerph14080923] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/14/2017] [Accepted: 08/15/2017] [Indexed: 12/24/2022]
Abstract
Introduction: The EYTO-kids (European Youth Tackling Obesity in Adolescents and Children) study aims to increase fruit and/or vegetable consumption and physical activity, decrease sedentary lifestyles, and reduce the intake of sugary drinks and fast food using an innovative methodology based on social marketing and youth involvement. Methods: This study is a pilot school-based cluster randomized controlled 10-month intervention spanning two academic years (2015–2016 and 2016–2017), with eight primary schools and three high schools randomized into and designated the control group and eight primary schools and four high schools designated the intervention group in Reus, Spain. At least 301 younger school peers per group should be included. At the intervention high schools, the adolescent creators (ACs) receive an initial 16-h training session. In total, 26–32 high school ACs (12–14 years) from the four high schools will design and implement four health-promotion activities (1 h/each) for their younger (8–10 years), primary school peers. The control group will not receive any intervention. The outcomes (fruit, vegetable, fast food and sugary drink consumption; physical activity; and sedentary behaviors) of the control and intervention groups will be measured pre- and post-intervention. Conclusion: This study describes a protocol for pilot, peer-led, social marketing and youth-involved intervention, where adolescents design and implement activities for their younger peers to promote healthy lifestyles.
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Affiliation(s)
- Lucia Tarro
- Health Education and Promotion, Functional Nutrition, Oxidation and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43204 Reus, Spain; (L.T.); (M.A.-M.); (M.G.); (R.S.)
- Eurecat Reus: Technological Centre of Nutrition and Health (CTNS) -TECNIO-URV-CEICS, Av. Universitat 1, 43204 Reus, Spain; (I.P.-G.); (L.A.)
| | - Magaly Aceves-Martins
- Health Education and Promotion, Functional Nutrition, Oxidation and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43204 Reus, Spain; (L.T.); (M.A.-M.); (M.G.); (R.S.)
| | - Ignasi Papell-Garcia
- Eurecat Reus: Technological Centre of Nutrition and Health (CTNS) -TECNIO-URV-CEICS, Av. Universitat 1, 43204 Reus, Spain; (I.P.-G.); (L.A.)
| | - Lluís Arola
- Eurecat Reus: Technological Centre of Nutrition and Health (CTNS) -TECNIO-URV-CEICS, Av. Universitat 1, 43204 Reus, Spain; (I.P.-G.); (L.A.)
- Departament de Bioquímica i Biotecnologia, Nutrigenomics Research Group, Universitat Rovira i Virgili, C/Marcel·lí Domingo 1, 43007 Tarragona, Spain
| | - Montse Giralt
- Health Education and Promotion, Functional Nutrition, Oxidation and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43204 Reus, Spain; (L.T.); (M.A.-M.); (M.G.); (R.S.)
- Unit of Pharmacology, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43204 Reus, Spain
| | - Elisabet Llauradó
- Health Education and Promotion, Functional Nutrition, Oxidation and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43204 Reus, Spain; (L.T.); (M.A.-M.); (M.G.); (R.S.)
- Correspondence: ; Tel.: +34-977-758-920; Fax: +34-977-759-322
| | - Rosa Solà
- Health Education and Promotion, Functional Nutrition, Oxidation and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43204 Reus, Spain; (L.T.); (M.A.-M.); (M.G.); (R.S.)
- CIBERDEM, Hospital Universitari Sant Joan, IISPV, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43204 Reus, Spain
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Association of maternal gestational weight gain with their offspring's anthropometric outcomes at late infancy and 6 years old: mediating roles of birth weight and breastfeeding duration. Int J Obes (Lond) 2017; 42:8-14. [PMID: 28775373 DOI: 10.1038/ijo.2017.183] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 07/08/2017] [Accepted: 07/23/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Longitudinal studies examining the potential mediating roles of birth weight and breastfeeding duration on the pathways between maternal gestational weight gain (GWG) and offspring anthropometric outcomes are lacking. METHODS We analyzed data from the mother-child pairs in the Infant Feeding Practices Study II (IFPS II) in late infancy (n=1548) and at the Year 6 Follow-up (n=1514) Study. Child anthropometrics included age- and sex-specific Z-scores for weight for age (WAZ), height /length for age, weight for height/length and body mass index (BMIZ). Structural equation models were used to estimate the total, direct and indirect effects of GWG on child anthropometrics through birth weight and breastfeeding duration. RESULTS The total effect of GWG on offspring anthropometric outcomes was significant for WAZ (β=0.107, 95% confidence interval (CI): 0.052, 0.161) at late infancy and for WAZ (β=0.122, 95% CI: 0.066, 0.177) and BMIZ (β=0.120, 95% CI: 0.063, 0.178) at 6 years old. The direct effects of GWG on offspring's WAZ and BMIZ were observed only at 6 years old. The indirect effects of GWG through birth weight were significant on most of the offspring's anthropometric measures. Compared to breastfeeding duration, birth weight was a stronger mediator on the pathways between GWG and all proposed anthropometric measures both in late infancy and in early childhood. Longer duration of breastfeeding was inversely associated with all offspring anthropometric outcomes at late infancy but not with those outcomes at 6 years old. CONCLUSIONS Our findings suggest a stronger indirect rather than direct effect of GWG on children's anthropometric outcomes mainly through birth weight, independent of maternal sociodemographic and reproductive factors. Longer duration of breastfeeding might suppress the positive relationship between GWG, birth weight and anthropometric outcomes in late infancy but not among 6 years old.
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Chi DL, Luu M, Chu F. A scoping review of epidemiologic risk factors for pediatric obesity: Implications for future childhood obesity and dental caries prevention research. J Public Health Dent 2017; 77 Suppl 1:S8-S31. [PMID: 28600842 DOI: 10.1111/jphd.12221] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 04/06/2017] [Indexed: 01/31/2023]
Abstract
RESEARCH QUESTIONS What are the non-modifiable (socioeconomic, genetic) and modifiable factors (physical activity, dietary behaviors) related to childhood (under age 12) obesity? How can this knowledge be applied to oral health professionals' efforts to prevent or manage dental caries in children? OBJECTIVES Studies have identified risk factors for childhood obesity. The purpose of this scoping review was to develop a conceptual model to identify non-modifiable and modifiable risk factors for childhood obesity and to illustrate how these findings are relevant in developing interventions aimed at preventing obesity and dental caries in children. METHODS The authors searched PubMed and Embase and limited the study to English-language publications. A total of 2,572 studies were identified. After de-duplication, 2,479 studies remained and were downloaded into a citation-management tool. Two authors screened the titles and abstracts for relevance. Two hundred and sixty studies remained and were retrieved for a full-text review, and 80 studies were excluded, resulting in 180 studies included in the scoping review. An inductive content analytic methods was used to organize all statistically significant obesity risk factors into seven domains, which were classified as non-modifiable or modifiable; then a conceptual model of common risk factors associated with childhood obesity and dental caries was developed. RESULTS Non-modifiable obesity risk factors include biological and developmental (e.g., genes, developmental conditions, puberty), sociodemographic and household (e.g., race/ethnicity, socioeconomic status, parent education, unemployment), cultural (e.g., degree of acculturation), and community (e.g., neighborhood composition). Modifiable risk factors included behavioral (e.g., diet, physical activity, weight), psychosocial (e.g., maternal stress, family functioning, parenting practices, child temperament), and medical (e.g., parent smoking, maternal health, child health). CONCLUSIONS Identifying common risk factors has important implications for future oral health research aimed at preventing childhood obesity and dental caries. Epidemiologic knowledge gleaned from the literature can be used to develop rigorous interventions and programs aimed at preventing these highly prevalent diseases and improving health outcomes for children.
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Affiliation(s)
- Donald L Chi
- Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - Monique Luu
- Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - Frances Chu
- Oral Health Sciences, University of Washington, Seattle, WA, USA
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Vinding RK, Sejersen TS, Chawes BL, Bønnelykke K, Buhl T, Bisgaard H, Stokholm J. Cesarean Delivery and Body Mass Index at 6 Months and Into Childhood. Pediatrics 2017; 139:peds.2016-4066. [PMID: 28814549 DOI: 10.1542/peds.2016-4066] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/10/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The prevalence of cesarean delivery (CD) is rising worldwide, and so is childhood obesity. Studies have shown associations between these factors. We examined the development of BMI from birth through childhood to determine whether CDs were associated with differences in growth and obesity. METHODS Term children from the birth cohorts Copenhagen Prospective Studies on Asthma in Childhood2000 (COPSAC2000) and COPSAC2010 were included. Height, length, and weight measurements were collected prospectively until 5 years in COPSAC2010 and until 13 years in COPSAC2000. Dual-energy x-ray absorptiometry (DXA) scans were performed at 3.5 and 7 years. Information on relevant covariates were verified during clinical visits. Analyses were adjusted for covariates associating with CD. RESULTS In COPSAC2010, 20% (N = 138/673) of the children were delivered by CD; 49% were girls. In COPSAC2000, 19% (N = 76/393) were delivered by CD; 51% were girls. Children delivered by CD had a higher mean BMI at 6 months compared with those delivered vaginally: COPSAC2010 β-coefficient, .41 (95% confidence interval [CI], .12 to .69), P = .01; COPSAC2000 β-coefficient, .16 (95% CI, -.11 to .68), P = .16; and meta-analysis β-coefficient, .37 (95% CI, .14 to .60), P = .002. There were no differences in BMI trajectory between the 2 groups by 5 and 13 years, nor cross-sectional BMI at 5 and 13 years, nor in fat percentages from DXA scans. CONCLUSIONS Children delivered by CD had a higher BMI at 6 months of age, but this difference did not track into later childhood. Our study does not support the hypothesis that CD leads to later overweight.
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Affiliation(s)
- Rebecca Kofod Vinding
- Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen and Danish Pediatric Asthma Center, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Pediatrics, Naestved Hospital, Naestved, Denmark; and
| | - Tobias Steen Sejersen
- Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen and Danish Pediatric Asthma Center, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Pediatrics, Naestved Hospital, Naestved, Denmark; and
| | - Bo L Chawes
- Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen and Danish Pediatric Asthma Center, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen and Danish Pediatric Asthma Center, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Thora Buhl
- Department of Clinical Physiology and Nuclear Medicine, Herlev-Gentofte, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen and Danish Pediatric Asthma Center, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark;
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen and Danish Pediatric Asthma Center, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Pediatrics, Naestved Hospital, Naestved, Denmark; and
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Abstract
BACKGROUND The present study examined the effects of breastfeeding and its duration on the development of childhood obesity from 24 months through grade 6. METHODS U.S. longitudinal data collected from 1234 children were analyzed using logistic regression models and generalized estimating equation (GEE). Child height and weight were measured six times at ages of 24 months, 36 months, 54 months, grade 1, grade 3, and grade 6. RESULTS During the early 1990s, prevalence of breastfeeding was low in the United States, 60% and 48% at 1 and 6 months, respectively. Nonsmoking, white, married mothers with both parents in the household, and with income above the poverty line, were more likely to breastfeed at 1 month of age of their babies. Obesity rate of the children increased with age from 24 months to grade 6. Logistic regression showed that breastfeeding at month 1 was associated with 53% (odds ratio [OR]: 0.47, 95% confidence interval [CI]: 0.30-0.73) and 47% (OR: 0.53, 95% CI: 0.36-0.78) decreased risks for childhood obesity at grades 1 and 6, respectively. GEE analysis showed that breastfeeding at 1 month reduced risk for childhood obesity by 36% (95% CI: 0.47-0.88) from ages 24 months through grade 6. Regarding breastfeeding duration, more than 6 months (vs. never) was associated with a decreased risk for childhood obesity by 42% (OR: 0.58, 95% CI: 0.36-0.94). CONCLUSIONS Breastfeeding at 1 month and more than 6 months reduced the risk of childhood obesity. Rate of breastfeeding was low in the United States in the 1990s, which may have had long-term implications on children.
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Affiliation(s)
- Liang Wang
- 1 Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University , Johnson City, TN
| | - Candice Collins
- 1 Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University , Johnson City, TN
| | - Melanie Ratliff
- 1 Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University , Johnson City, TN
| | - Bin Xie
- 2 School of Community and Global Health, Claremont Graduate University , Claremont, CA
| | - Youfa Wang
- 3 Fisher Institute of Health and Well-Being, Systems-Oriented Global Childhood Obesity Intervention Program, Department of Nutrition and Health Sciences, College of Health, Ball State University , Muncie, IN
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Nappo A, González-Gil EM, Ahrens W, Bammann K, Michels N, Moreno LA, Kourides Y, Iacoviello L, Mårild S, Fraterman A, Molnàr D, Veidebaum T, Siani A, Russo P. Analysis of the association of leptin and adiponectin concentrations with metabolic syndrome in children: Results from the IDEFICS study. Nutr Metab Cardiovasc Dis 2017; 27:543-551. [PMID: 28511904 DOI: 10.1016/j.numecd.2017.04.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 03/20/2017] [Accepted: 04/08/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS Adipokines may play a role in the pathogenesis of the metabolic syndrome (MetS) in children. We aimed to evaluate the association of leptin, adiponectin, and its ratio (L/A ratio) with the metabolic syndrome (MetS) in a subsample of the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) cohort. METHODS AND RESULTS Leptin, adiponectin and MetS parameters were measured in a subsample of 1253 children (3-9.9 years) participating to the IDEFICS study, grouped as: Non-OW (underweight/normal weight) and OW/Ob (overweight/obese). MetS was defined using the sex- and age-specific cut-offs based on the distribution of MetS components in the IDEFICS cohort. The prevalence of the MetS among OW/Ob was 24.8% and 27.1% in boys and girls respectively, whereas ≤2% among Non-OW. OW/Ob had significantly higher leptin and L/A ratio as compared to Non-OW. Significantly higher leptin was found in OW/Ob with MetS as compared with OW/Ob without MetS. Significantly lower adiponectin was observed only in OW/Ob girls as compared to Non-OW. A 1SD increase in leptin and L/A ratio z-scores or a 1SD decrease in adiponectin z-score were significantly associated with higher risk of MetS. After adjustment for BMI or body fat mass (BFM) the association remained significant only for leptin. CONCLUSION We showed that in European children, higher leptin concentration is associated with MetS, even after adjusting for BMI or BFM, confirming an early role of leptin in MetS, while the association of adiponectin with MetS seems be mediated by body fat in this age range.
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Affiliation(s)
- A Nappo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - E M González-Gil
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - W Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Institute of Statistics, Faculty of Mathematics and Computer Science, Bremen University, Bremen, Germany
| | - K Bammann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - N Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Y Kourides
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - L Iacoviello
- Department of Epidemiology and Prevention, Unit of Molecular and Nutritional Epidemiology, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - S Mårild
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Fraterman
- Laboratoriumsmedizin Dortmund, Eberhard & Partner Dortmund, Germany
| | - D Molnàr
- Department of Paediatrics, Medical Faculty, University of Pécs, Pécs, Hungary
| | - T Veidebaum
- National Institute for Health Development, Tallinn, Estonia
| | - A Siani
- Institute of Food Sciences, National Research Council, Avellino, Italy.
| | - P Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
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Potential selection effects when estimating associations between the infancy peak or adiposity rebound and later body mass index in children. Int J Obes (Lond) 2016; 41:518-526. [PMID: 27899810 DOI: 10.1038/ijo.2016.218] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 09/24/2016] [Accepted: 11/13/2016] [Indexed: 12/23/2022]
Abstract
INTRODUCTION This study aims to evaluate a potential selection effect caused by exclusion of children with non-identifiable infancy peak (IP) and adiposity rebound (AR) when estimating associations between age and body mass index (BMI) at IP and AR and later weight status. SUBJECTS AND METHODS In 4744 children with at least 4 repeated measurements of height and weight in the age interval from 0 to 8 years (37 998 measurements) participating in the IDEFICS (Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants)/I.Family cohort study, fractional polynomial multilevel models were used to derive individual BMI trajectories. Based on these trajectories, age and BMI at IP and AR, BMI values and growth velocities at selected ages as well as the area under the BMI curve were estimated. The BMI growth measures were standardized and related to later BMI z-scores (mean age at outcome assessment: 9.2 years). RESULTS Age and BMI at IP and AR were not identifiable in 5.4% and 7.8% of the children, respectively. These groups of children showed a significantly higher BMI growth during infancy and childhood. In the remaining sample, BMI at IP correlated almost perfectly (r⩾0.99) with BMI at ages 0.5, 1 and 1.5 years, whereas BMI at AR correlated perfectly with BMI at ages 4-6 years (r⩾0.98). In the total study group, BMI values in infancy and childhood were positively associated with later BMI z-scores where associations increased with age. Associations between BMI velocities and later BMI z-scores were largest at ages 5 and 6 years. Results differed for children with non-identifiable IP and AR, demonstrating a selection effect. CONCLUSIONS IP and AR may not be estimable in children with higher-than-average BMI growth. Excluding these children from analyses may result in a selection bias that distorts effect estimates. BMI values at ages 1 and 5 years might be more appropriate to use as predictors for later weight status instead.
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Veile A, Kramer KL. Childhood body mass is positively associated with cesarean birth in Yucatec Maya subsistence farmers. Am J Hum Biol 2016; 29. [PMID: 27699897 DOI: 10.1002/ajhb.22920] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 08/07/2016] [Accepted: 08/20/2016] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The epidemiologic link between cesarean birth and childhood obesity is unresolved, partly because most studies come from industrialized settings where many post-birth factors affect the risk for obesity. We take advantage of an unusual ethnographic situation where hospital and cesarean birth modes have recently been introduced among Yucatec Maya subsistence farmers, but young children have had minimal exposure to the nutritional transition. While we expect to find very low rates of childhood obesity, we predict that cesarean-born children will be larger and heavier than vaginally born children. METHODS Weight and height were collected monthly on 108 children aged 0-5 (3576 observations total). Birth mode and birthweight were collected by maternal interview. Data were analyzed using linear mixed models that compare child growth [Maya population-specific Z-scores for weight-for-age and body mass index-for-age (WAZ and BMIZ)] in cesarean and vaginally born children aged 0-5 years. RESULTS The cesarean rate was 20%, no children were obese, and 5% were overweight. Cesarean birth was a significant predictor of child WAZ and BMIZ after accounting for maternal effects, child birthweight, and sex. Children who were born by cesarean to mothers with high BMI had the highest WAZ of all children by 5 years of age, and the highest BMIZ of all children at all ages. CONCLUSION Cesarean-born Maya children had higher BMI than vaginally born children, even in the absence of many known confounding factors that contribute to childhood obesity. Child growth was most sensitive to birth mode when mothers had high BMI.
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Affiliation(s)
- Amanda Veile
- Department of Anthropology, Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, 47907-2050
| | - Karen L Kramer
- Department of Anthropology, University of Utah, Salt Lake City, Utah, 84112
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Zhang T, Cai L, Ma L, Jing J, Chen Y, Ma J. The prevalence of obesity and influence of early life and behavioral factors on obesity in Chinese children in Guangzhou. BMC Public Health 2016; 16:954. [PMID: 27613102 PMCID: PMC5016860 DOI: 10.1186/s12889-016-3599-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 08/25/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Childhood obesity has become a public health concern in many countries. In Southern China, the prevalence of childhood obesity increased from 6.2 to 7.5 % between 2007 and 2011. This study aimed to report the current prevalence of overweight and obesity, analyzed the early life and behavioral determinants of obesity, and investigated the weight-loss practices among Chinese children in Guangzhou. METHODS Three thousand seven hundred sixty-six primary school students aged 7-12 years were recruited in Guangzhou, China in 2013. Questionnaires were used to assess (1) early life factors: birth weight, delivery mode, gestational age and feeding patterns; (2) behavioral factors: dietary intake, eating speed, sedentary time, physical activities and sleep duration; and (3) weight-loss practices: improving diet, increasing exercise, taking weight-loss drugs and undergoing a diet. The criteria of Working Group of Obesity in China were applied to classify overweight and obesity based on measured weight and height. Multivariable logistic regression analyses were performed to examine the determinants of overweight/obesity and adoption of weight-loss practices. RESULTS The prevalence of childhood overweight and obesity were 11.2 and 10.0 %, respectively. High birth weight (≥4.0 kg versus 2.5 ~ 4.0 kg, odd ratio [OR]: 2.34; 95 % confidence interval [CI]: 1.53-3.58), sugar-sweetened beverages (SSBs) intake (OR: 1.39; 95 % CI: 1.05-1.85), vegetable intake (OR: 1.12; 95 % CI: 1.01-1.24), and doing homework (OR: 1.24; 95 % CI: 1.08-1.43) were positively associated with obesity. Eating speed faster than peers was positively associated with obesity and yielded the highest OR (versus "as fast as peers", OR: 3.18; 95 % CI: 2.28-4.44). Approximately 57, 81 and 87 % of normal-weight, overweight and obese children, respectively, reported weight-loss practices. Self-perception of weight status presented as the strongest determinant for weight-loss practices. CONCLUSIONS The prevalence of overweight and obesity were high in Chinese children in Guangzhou, and both were higher than previous level in 2011. Further research should address the unhealthy dietary (e.g. SSBs intake, fast eating speed) and sedentary behaviors (e.g. doing homework) of these children. Moreover, an accurate perception of body weight can help promote the adoption of weight-loss practices in overweight and obese children.
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Affiliation(s)
- Ting Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Lu Ma
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China.
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China.
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
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