Relationship between body mass index at age 3 years and body composition at age 11 years among Japanese children: the Shizuoka population-based study

Associations between sugar-sweetened beverages before and during pregnancy and offspring overweight/obesity in Japanese women: the TMM BirThree Cohort Study

OBJECTIVE

The association between high sugar-sweetened beverages (SSB) intake during pregnancy and offspring overweight/obesity has been reported only from Western countries. The objective of this study was to examine the association between SSB intake before and during pregnancy and offspring overweight/obesity among Japanese women.

DESIGN

Japanese prospective birth cohort study.

SETTING

We analysed mother-offspring pairs who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study from 2013 to 2017. SSB intake during pregnancy was evaluated using the FFQ and classified into three groups: none (0 g/d), medium (<195 g/d) and high (>195 g/d). Overweight or obesity at 1 year of age in offspring was defined as having a BMI Z-score greater than 2 sd, calculated based on the BMI reference data for Japanese children. Multiple logistic regression analyses were performed to examine the associations between SSB intake before and during pregnancy and offspring overweight/obesity, after adjusting for covariates.

PARTICIPANTS

Japanese mother-offspring pairs (n 7114).

RESULTS

The overweight/obesity rate of the offspring was 8·8 %. Pregnant women with a high intake of SSB in early to mid-pregnancy had a higher risk of overweight/obesity in their offspring compared with those who did not; the OR was 1·52 (95 % CI (1·09, 2·12)).

CONCLUSIONS

High SSB intake in early to mid-pregnancy was associated with an increased risk of offspring overweight/obesity at 1 year of age.

Body weight at 1.5- and 3-year health checks and body fat at 14 years of age: a population-based retrospective cohort study using dual-energy X-ray absorptiometry

BACKGROUND

In Japan, height and weight measurements, taken for all children at birth and 1.5- and 3-year health checks, are recorded in the Mother and Child Health (MCH) Handbook, as required by the law. The present population-based retrospective cohort study aimed to evaluate the diagnostic performance of height and weight records in the Handbook for predicting excessive adiposity in adolescents.

METHODS

The source population consisted of 8th grade students (800 students aged 14 years) registered at two public junior high schools. Of these, we excluded students who were born at a gestational age < 37 weeks or > 42 weeks. The present analyses included 435 participants who provided complete information. Body mass index (BMI) was calculated using height and weight records. Body fat mass at 14 years of age was measured by dual-energy X-ray absorptiometry (DXA). Diagnostic performance of BMI calculated from the MCH Handbook records to discriminate between the presence and absence of excessive adiposity at 14 years of age was evaluated using receiver operating characteristic (ROC) curve analysis. The area under the ROC curve (AUC) was used to quantify the diagnostic accuracy of BMI.

RESULTS

With regard to the prediction of excessive fat at 14 years of age, AUCs and 95% confidence intervals for BMI at 1.5 and 3 years of age were greater than 0.5. Meanwhile, the AUC of BMI at birth was not significantly greater than 0.5.

CONCLUSION

The present study findings indicate that BMI values calculated using MCH Handbook data have potential ability to distinguish between the presence and absence of excessive fat at 14 years of age.

Differences in bone mineral density between normal-weight children and children with overweight and obesity: a systematic review and meta-analysis

OBJECTIVE

This study examines the differences in bone mineral density between normal-weight children and children with overweight or obesity.

METHODS

A systematic review and meta-analysis of observational studies (published up to 22 June 2016) on the differences in bone mineral density between normal-weight children and overweight and obese children was performed. Results were pooled when possible and mean differences (MDs) were calculated between normal-weight and overweight and normal-weight and obese children for bone content and density measures at different body sites.

RESULTS

Twenty-seven studies, with a total of 5,958 children, were included. There was moderate and high quality of evidence that overweight (MD 213 g; 95% confidence interval [CI] 166, 261) and obese children (MD 329 g; 95%CI [229, 430]) have a significantly higher whole body bone mineral content than normal-weight children. Similar results were found for whole body bone mineral density. Sensitivity analysis showed that the association was stronger in girls.

CONCLUSIONS

Overweight and obese children have a significantly higher bone mineral density compared with normal-weight children. Because there was only one study included with a longitudinal design, the long-term impact of childhood overweight and obesity on bone health at adulthood is not clear.

Differences in the anthropometry of Asian children and its role in metabolic health in later life: A narrative review

BACKGROUND

The increasing incidence of childhood obesity in Asia could be a reflection of early life programming in which environmental/nutritional challenges during pregnancy and first two years of life (the so-called first 1000 days) influence later health.

OBJECTIVE OF NARRATIVE REVIEW

To assess differences/similarities of anthropometric measures in early life and their influences on metabolic health risk in later life among children in Asia.

METHODS

Literature search for publication in English using selected key words from Medline (PubMed), Scopus, Science Direct and Google Scholar published from 1994 to October 2014. Some comparisons with Caucasian setting were made when relevant.

RESULTS

From 152 publications selected for this narrative review, differences in foetal growth and birth weight were deducted between Asian and Caucasian children. Infants in India and Hong Kong had increased fat mass at birth and early infancy as compared to those from other parts of the world. Pre- and during pregnancy conditions influenced birth weight; feeding practices and gender influenced post-natal growth and body composition development. High and low birth weights followed by rapid postnatal growth were linked to increased risks of obesity, insulin resistance and high blood pressure in later life.

CONCLUSION

Foetal and postnatal growth trajectories are different between countries within and outside Asia. Extremes in birth weight followed by rapid postnatal growth were linked to increased risks of metabolic health of children in this region. As there is limited evidence in Asia, it is important to conduct thorough investigations by using longitudinal studies on early life programming.

The Mother and Child Health Handbook in Japan as a Health Promotion Tool: An Overview of Its History, Contents, Use, Benefits, and Global Influence

Background. The Mother and Child Health Handbook (MCHH), a tool used by almost all parents in Japan, serves as a record book shared by parents and health providers to monitor maternal health care throughout the perinatal period, track the child's health and growth, and provide educational information. Methods. A review of the existing literature was performed by narrative review using electronic databases with the search term "Maternal and Child Health Handbook" from January 1980 to February 2016. Results. Twenty-eight papers were obtained: 3 review articles, 17 original articles, 2 brief reports, 2 letters, 1 research note, and 3 proceedings. After the MCHH was initiated in 1947, Japan's infant mortality rate decreased to 2.6 per 1000 live births in 2007, and it is still decreasing. Information recorded in the MCHH at antenatal examinations can be used to evaluate a child's risk of obesity, cardiovascular disease, endocrine disease, mental illness, and infectious disease. Utah's Department of Health implemented a program called "Baby Your Baby" in 1987 based on the Japanese MCHH; this included a similar booklet with family records and educational information. Thus, the MCHH is a unique tool in Japan that has influenced other countries to adopt similar programs. Conclusion. We will confirm the importance of the MCHH's role in promoting health and open dialogue.

Longitudinal association between preschool fussy eating and body composition at 6 years of age: The Generation R Study

Background

Children’s fussy eating behavior has been related to both underweight and overweight in cross-sectional studies, but the direction of these associations and the relation with more detailed measures of body composition remains unclear. We aimed to examine whether fussy eating at age 4 years is longitudinally related to body mass index (BMI), fat mass index (FMI) and fat-free mass index (FFMI) at 6 years of age.

Methods

This study was embedded in Generation R, a population-based, prospective cohort. Data were available for 4191 children. The Children’s Eating Behaviour Questionnaire (CEBQ), administered at age 4 years, was used to derive a fussy eating profile. This profile is characterized by high scores on food avoidant scales and low scores on food approach scales. At age 6 years, height and weight were measured at our research center. Body fat and fat-free mass were measured using Dual-energy-X-ray absorptiometry. We used age- and sex-specific standard deviation scores (SDS) for all outcomes.

Results

After adjustment for confounders, the fussy eating profile was related to lower BMI-SDS (B = −0.37, 95 % CI: −0.47;−0.26), lower FMI-SDS (B = −0.22, 95 % CI: −0.33;−0.12) and lower FFMI-SDS (B = −0.41, 95 % CI: −0.54;−0.29). When adjusting for baseline BMI at 4 years, the fussy eating profile predicted a 0.11 lower BMI-SDS at age 6 (95 % CI: −0.19;−0.04). This change in BMI was mainly due to a decrease in FFMI (B = −0.19, 95 % CI: −0.29;−0.09). Fussy eaters also had a higher risk of becoming underweight than non-fussy eaters (OR = 2.28, 95 % CI: 1.34;3.87).

Conclusions

Our findings suggest that young fussy eaters are at risk of having a lower fat free mass and of becoming underweight over a 2-year period. This implies that fussy eaters may benefit from careful monitoring to prevent an adverse growth development.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-015-0313-2) contains supplementary material, which is available to authorized users.

Development of waist circumference percentiles for Japanese children and an examination of their screening utility for childhood metabolic syndrome: a population-based cross-sectional study

BACKGROUND

In Japan, waist circumference (WC) percentiles to screen for childhood metabolic syndrome (MetS) are unavailable. The objectives of this study were to develop WC and WC-to-height ratio (WC/Ht) percentile curves by age and sex for Japanese children, and to test their utility in screening for MetS in children with obesity who are otherwise healthy.

METHODS

The WC and WC/Ht percentiles were developed using the LMS method of summarizing growth standards, which monitors changing skewness (L), medians (M), and coefficients of variation (S) in childhood distributions. A representative dataset was used, which consisted of 3,634 boys and 3,536 girls aged 4.5-12.75 years in Shizuoka prefecture, Japan, between 2010 and 2012. Children who were obese (355 boys and 230 girls) aged 6-12 years from Osaka prefecture, Japan, were screened for childhood MetS using the new percentiles and the International Diabetes Federation's (IDF's) definition of MetS.

RESULTS

The number of participants with certain metabolic abnormalities (high systolic and diastolic blood pressure, and a high level of triglycerides) was significantly higher in boys aged 10-12 years, with a WC ≥ 90th percentile, than among those with a WC < 90th percentile. None of the participants with a WC < 90th percentile exhibited two or more metabolic abnormalities, regardless of their age or sex. Among the participants aged 10-12 years, 11.4 % of boys and 4.4 % of girls with a WC ≥ 90th percentile were diagnosed with MetS.

CONCLUSIONS

The new percentiles may have a certain level of potential to screen Japanese children for childhood MetS in accordance with the IDF definition.

Association of rapid weight gain during early childhood with cardiovascular risk factors in Japanese adolescents

Background

Because of the lack of relevant data, we investigated the association between rapid weight gain (RWG) during early childhood and cardiovascular risk factors in Japanese adolescents.

Methods

The source population comprised 2285 adolescents aged 13 to 14 years enrolled in any public school in Fukuroi City, Japan during 2008, 2009, or 2010. Since there are no private schools in this city, almost all adolescents who lived in the city went to 1 of these schools. We obtained data on blood pressure (BP), serum lipids, and anthropometry during adolescence, as well as anthropometry at birth, age 1.5 years, and age 3 years, from the Maternal and Child Health Handbook for 1624 children. RWG was defined as a change in body-weight standard deviation score greater than 0.67 from age 0 to 1.5 years or from age 1.5 to 3 years.

Results

After adjusting for confounding factors, adolescents who had RWG from 0 to age 1.5 years or from age 1.5 to 3 years were more likely to be overweight. Adolescents who had RWG during both periods were more likely to be overweight (odds ratio [OR], 6.37; 95% CI, 3.06–13.24), have unfavorable lipid concentrations (OR, 2.03; 95% CI, 1.15–3.58), and have high BP (OR: 2.36, 95% CI: 1.34–4.13). The associations with unfavorable lipid concentrations and high BP disappeared after further adjusting for current body mass index.

Conclusions

RWG during early childhood predicts unfavorable lipid concentrations and high BP in Japanese adolescents, and this relationship is mediated by body mass index in later life.