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Kracht CL, Neshteruk CD, Moding KJ, Rolke LJ, Wagner BE, Kielb E, Ferrante MJ, Robinson C, Keinsley J, Colella J, Speirs KE, Luecking CT. Community-based diet and obesity-related policy, system, and environmental interventions for obesity prevention during the first 1000 days: A scoping review. Obes Rev 2024; 25:e13815. [PMID: 39159998 DOI: 10.1111/obr.13815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/19/2024] [Accepted: 07/25/2024] [Indexed: 08/21/2024]
Abstract
Community-based policy, systems, and environmental interventions have the potential to reduce modifiable risk factors for obesity early in life. The purpose of this scoping review was to characterize the breadth, generalizability, and methodological quality of community-based diet and obesity-related policy, system, and environmental interventions during the first 1000 days of life, from pregnancy to 24 months of age. Eight databases were searched, and 83 studies (122 references) were included. Data were extracted for breadth (intervention characteristics), generalizability (reach, effectiveness, adoption, implementation, and maintenance), and study quality (Downs and Black Checklist). Systems and environmental approaches were common (> 80%), relative to policy approaches (39%). The majority (60-69%) occurred in the prenatal period and early infancy (0-3 months), assessed breastfeeding or child growth/obesity (53% for both), and included people with lower income (80%) or racial and/or ethnic minority groups (63%). Many interventions reported positive outcomes (i.e., in the expected direction) for child diet, breastfeeding, and feeding practices (> 62%). Few reported intervention maintenance or spanned the full 1000 days. Most studies were classified as good (32%) or fair (56%) methodological quality. The interventions mainly addressed pregnancy and early infancy. Rigorous and representative investigation is needed to improve intervention reach, sustainability, and application in toddlerhood.
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Affiliation(s)
- Chelsea L Kracht
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- University of Kansas Medical Center, Kansas City, KS, USA
| | - Cody D Neshteruk
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Duke University School of Medicine, Durham, NC, USA
| | - Kameron J Moding
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN, USA
| | - Laura J Rolke
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Duke University School of Medicine, Durham, NC, USA
| | - Brooke E Wagner
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Duke University School of Medicine, Durham, NC, USA
| | - Elizabeth Kielb
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN, USA
| | - Mackenzie J Ferrante
- Department of Nutritional Sciences, School of Environmental and Biological Sciences, Rutgers University, New Brunswick, NJ, USA
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Cayla Robinson
- Department of Dietetics and Human Nutrition, Martin-Gatton College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA
| | - Jason Keinsley
- Department of Dietetics and Human Nutrition, Martin-Gatton College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA
| | - Jordan Colella
- Department of Dietetics and Human Nutrition, Martin-Gatton College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA
| | - Katherine E Speirs
- Human Development and Family Science, John and Doris Norton School of Human Ecology, University of Arizona, Tucson, AZ, USA
| | - Courtney T Luecking
- Department of Dietetics and Human Nutrition, Martin-Gatton College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA
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Helle C, Hillesund ER, Øverby NC. Exploring Public Health Nurses' Thoughts, Needs and Expectations for the Development and Usability of an Online Parenting Resource on Early Nutrition Delivered through Primary Care: A Qualitative Study. Nutrients 2024; 16:2861. [PMID: 39275177 PMCID: PMC11397169 DOI: 10.3390/nu16172861] [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] [Received: 07/04/2024] [Revised: 08/08/2024] [Accepted: 08/22/2024] [Indexed: 09/16/2024] Open
Abstract
Public health nurses (PHNs) constitute an important source of nutritional knowledge for parents during the child's first 1000 days of life, but parents also seek advice from various online sources. Access to timely digital interventions may facilitate healthful eating habits later in life. In the Nutrition Now project, we wanted to combine previously evaluated digital interventions on early nutrition and implement the integrated intervention at municipality level. We prospectively explored PHNs' thoughts, needs and expectations regarding the development and usability of such a digital resource. Semi-structured interviews were conducted with six PHNs, and data was subjected to thematic analysis. Four main themes were identified: (1) an online resource on nutrition may be a useful tool; (2) the content should attract interest and be broad in scope; (3) it must be easy to apply and adapted to different users; and (4) participating in a development process should seem meaningful. Our findings highlight the need for easily accessible, quality-assured online information to underpin the guidance provided by PHNs. The study further sheds light on prerequisites considered by PHNs to be crucial for parents to engage in a digital resource, as well as their perspectives on how it best may be communicated and used.
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Affiliation(s)
- Christine Helle
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, 4604 Kristiansand, Norway
| | - Elisabet Rudjord Hillesund
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, 4604 Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, 4604 Kristiansand, Norway
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Ramirez A, Fox K, Melo Herrera Y, Gans KM, Risica PM, McCurdy K, Jennings E, Tovar A. Goals, Barriers, and Facilitators of Caregivers Who Participated in an In-Home Intervention to Improve Food Parenting Practices and Child Diet Quality. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:521-531. [PMID: 38691079 PMCID: PMC11305948 DOI: 10.1016/j.jneb.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/28/2024] [Accepted: 04/01/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE To explore the goals, barriers, and facilitators set by caregivers of preschool-aged children to improve food parenting practices and household food environments. DESIGN Secondary qualitative analysis of collaborative goal sheets completed during in-home and telephone visits as part of a home-based pilot intervention. PARTICIPANTS Thirty-three Hispanic/Latinx caregivers, predominantly of low income. PHENOMENON OF INTEREST Patterns in goal content and anticipated barriers and facilitators. ANALYSIS Thematic analysis of goal sheets with a mixed inductive-deductive approach. RESULTS Almost half of the goals were to support a healthy environment (40.7%) by increasing the availability of healthy foods through food shopping and meal planning. Other goals were to increase structure (33.7%) by establishing food-related routines and decreasing distractions. Goals related to autonomy support (25.4%) included involving their children (eg, cooking together). Caregivers' perceived barriers encompass individual (eg, stress, lack of time), interpersonal (eg, other family members' eating behaviors), and environmental-level (eg, food availability) factors. Caregivers only identified facilitators at the individual and interpersonal levels (eg, motivation). CONCLUSIONS AND IMPLICATIONS Understanding goals, barriers, and facilitators can be used to tailor key messages to improve food parenting practices and children's diets. Future interventions can target broader environmental barriers while increasing awareness of individual, interpersonal, and environmental-level facilitators.
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Affiliation(s)
- Andrea Ramirez
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI.
| | - Katelyn Fox
- Weight Control and Diabetes Research Center, The Miriam Hospital & Alpert Medical School of Brown University, Providence, RI
| | | | - Kim M Gans
- Human Development and Family Sciences, University of Connecticut, Storrs, CT
| | | | - Karen McCurdy
- Department of Human Development and Family Science, University of Rhode Island, Kingston, RI
| | - Ernestine Jennings
- Department of Psychiatry and Human Behavior, The Miriam Hospital & Alpert Medical School of Brown University, Providence, RI
| | - Alison Tovar
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI
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Melnik BC, Weiskirchen R, Stremmel W, John SM, Schmitz G. Risk of Fat Mass- and Obesity-Associated Gene-Dependent Obesogenic Programming by Formula Feeding Compared to Breastfeeding. Nutrients 2024; 16:2451. [PMID: 39125332 PMCID: PMC11314333 DOI: 10.3390/nu16152451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/21/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024] Open
Abstract
It is the purpose of this review to compare differences in postnatal epigenetic programming at the level of DNA and RNA methylation and later obesity risk between infants receiving artificial formula feeding (FF) in contrast to natural breastfeeding (BF). FF bears the risk of aberrant epigenetic programming at the level of DNA methylation and enhances the expression of the RNA demethylase fat mass- and obesity-associated gene (FTO), pointing to further deviations in the RNA methylome. Based on a literature search through Web of Science, Google Scholar, and PubMed databases concerning the dietary and epigenetic factors influencing FTO gene and FTO protein expression and FTO activity, FTO's impact on postnatal adipogenic programming was investigated. Accumulated translational evidence underscores that total protein intake as well as tryptophan, kynurenine, branched-chain amino acids, milk exosomal miRNAs, NADP, and NADPH are crucial regulators modifying FTO gene expression and FTO activity. Increased FTO-mTORC1-S6K1 signaling may epigenetically suppress the WNT/β-catenin pathway, enhancing adipocyte precursor cell proliferation and adipogenesis. Formula-induced FTO-dependent alterations of the N6-methyladenosine (m6A) RNA methylome may represent novel unfavorable molecular events in the postnatal development of adipogenesis and obesity, necessitating further investigations. BF provides physiological epigenetic DNA and RNA regulation, a compelling reason to rely on BF.
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Affiliation(s)
- Bodo C. Melnik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, D-49076 Osnabrück, Germany
| | - Ralf Weiskirchen
- Institute of Molecular Pathobiochemistry, Experimental Gene Therapy and Clinical Chemistry (IFMPEGKC), RWTH University Hospital Aachen, D-52074 Aachen, Germany;
| | - Wolfgang Stremmel
- Praxis for Internal Medicine, Beethovenstrasse 2, D-76530 Baden-Baden, Germany;
| | - Swen Malte John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, D-49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, D-49076 Osnabrück, Germany;
| | - Gerd Schmitz
- Institute for Clinical Chemistry and Laboratory Medicine, University Hospital of Regensburg, D-93053 Regensburg, Germany;
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Varela EG, Shelnutt KP, Miller DM, Zeldman J, Mobley AR. Policy, Systems, and Environmental Strategies to Support Healthy Eating Behaviors in Early Childhood: A Scoping Review of Existing Evaluation Tools. J Acad Nutr Diet 2024:S2212-2672(24)00720-2. [PMID: 39033923 DOI: 10.1016/j.jand.2024.07.160] [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: 05/26/2023] [Revised: 06/24/2024] [Accepted: 07/16/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Policy, systems, and environmental (PSE) change strategies aimed at supporting healthy eating behaviors work to enhance optimal nutrition by making healthy foods more available and accessible in the community. PSE change strategies can complement and strengthen knowledge, skills, and behaviors obtained through individual-level nutrition education. OBJECTIVE This scoping review aimed to identify existing literature evaluating early childhood (ie, children younger than age 5 years) PSE change strategies supporting healthy eating behaviors and to describe the evaluation tools used to assess the identified PSE change strategies. METHODS Three databases (PubMed, Cumulated Index in Nursing and Allied Health Literature, and Web of Science) were used to systematically search for articles published between 2013 and 2023 written in English and conducted in the United States that evaluated PSE change strategies supporting healthy eating behaviors in young children (ie, children younger than age 5 years). Two study members conducted the review, discussing and reconciling discrepancies until a consensus was reached for interobserver reliability. RESULTS Findings from this review identified 48 studies evaluating early childhood PSE change strategies supporting healthy eating behaviors, with 36 studies using 25 PSE-focused evaluation tools to evaluate these strategies. Most tools (80%) assessed PSE change strategies supporting access and availability of healthy food and beverage options in early childhood education settings. Studies did not evaluate child-level outcomes (ie, attitudes, preferences, and behaviors) to showcase improvement of early childhood nutrition. Only 60% of the tools reported evidence of validity or reliability. CONCLUSIONS Most of the studies identified in this scoping review were aimed to evaluate healthy eating PSE change strategies focused on improving access to and availability of healthy foods and beverages in early childhood education settings. Future research is needed to develop and validate PSE-focused evaluation tools assessing child-level healthy eating practices and behaviors.
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Affiliation(s)
- Elder Garcia Varela
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Karla P Shelnutt
- Department of Family, Youth & Community Sciences, University of Florida, Gainesville, Florida
| | - David M Miller
- Collaborative Assessment and Program Evaluation Services, School of Human Development and Organizational Studies in Education, College of Education, University of Florida, Gainesville, Florida
| | - Jamie Zeldman
- Department of Health Education and Behavior, University of Florida, Gainesville, Florida
| | - Amy R Mobley
- Department of Health Education and Behavior, University of Florida, Gainesville, Florida.
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Sivakumar S, Lama D, Rabhi N. Childhood obesity from the genes to the epigenome. Front Endocrinol (Lausanne) 2024; 15:1393250. [PMID: 39045266 PMCID: PMC11263020 DOI: 10.3389/fendo.2024.1393250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/25/2024] [Indexed: 07/25/2024] Open
Abstract
The prevalence of obesity and its associated comorbidities has surged dramatically in recent decades. Especially concerning is the increased rate of childhood obesity, resulting in diseases traditionally associated only with adulthood. While obesity fundamentally arises from energy imbalance, emerging evidence over the past decade has revealed the involvement of additional factors. Epidemiological and murine studies have provided extensive evidence linking parental obesity to increased offspring weight and subsequent cardiometabolic complications in adulthood. Offspring exposed to an obese environment during conception, pregnancy, and/or lactation often exhibit increased body weight and long-term metabolic health issues, suggesting a transgenerational inheritance of disease susceptibility through epigenetic mechanisms rather than solely classic genetic mutations. In this review, we explore the current understanding of the mechanisms mediating transgenerational and intergenerational transmission of obesity. We delve into recent findings regarding both paternal and maternal obesity, shedding light on the underlying mechanisms and potential sex differences in offspring outcomes. A deeper understanding of the mechanisms behind obesity inheritance holds promise for enhancing clinical management strategies in offspring and breaking the cycle of increased metabolic risk across generations.
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Affiliation(s)
| | | | - Nabil Rabhi
- Department of Biochemistry and Cell Biology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
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Du S, Zhou N, Zheng W, Zhu X, Ling R, Zhou W, Li X. Prepuberty is a window period for curcumin to prevent obesity in postnatal overfed rats. Pediatr Res 2024; 96:104-114. [PMID: 38548969 DOI: 10.1038/s41390-024-03154-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/03/2024] [Accepted: 03/06/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Overnutrition in early life increases the risk of obesity and metabolic diseases. We investigated the effects and the window period of a curcumin (CUR) diet on postnatal overfed rats. METHODS Male rats aged 3 days were randomly divided into normal litters (NL, 10 pups/litter) and small litters (SL, 3 pups/litter). After weaning (Week 3, W3), NL rats were fed a normal diet (NL) and SL rats were fed a normal diet (SL) or 2% CUR diet from weaning (W3) (SL-CURW13), beginning of puberty (W6) (SL-CURW16), or end of puberty (W8) (SL-CURW18) for 10 weeks. RESULTS Body weight, glucose intolerance and hyperlipidemia in the SL rats were higher than in the NL rats, especially after puberty. After the CUR intervention, SL-CURW13 and SL-CURW16 rats showed lower body weight gain, adipose tissue weight and mRNA level of C/EBPα in SAT, along with higher mRNA levels of β-catenin. There was no difference between SL and SL-CURW18 rats. Glucose tolerance, serum lipids and hepatic lipids recovered to normal in the SL-CURW13 rats, but only partially in the SL-CURW16 and SL-CURW18 rats. CONCLUSION Prepuberty is a window period for CUR intervention to improve programmed outcomes in postnatal overfed rats. IMPACT Overnutrition during the first 1000 days of life has persistent negative effects on metabolism. Strategies should be taken to prevent overnutrition in early life to reduce the risk of obesity and metabolic disease in later life. A small-litter rat model was utilized to simulate early-life overnutrition in humans. We investigated the different effects and critical period for curcumin intervention on postnatal overfed rats. Dietary curcumin intervention before puberty could effectively transform nutritional programming to reduce obesity and metabolic disorders caused by early-life overnutrition, and an earlier intervention might predict a better outcome.
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Affiliation(s)
- Susu Du
- Department of Child Health Care, Children's Hospital of Nanjing Medical University, Nanjing, 210008, Jiangsu, China
| | - Nan Zhou
- Department of Child Health Care, Children's Hospital of Nanjing Medical University, Nanjing, 210008, Jiangsu, China
| | - Wen Zheng
- Department of Child Health Care, Children's Hospital of Nanjing Medical University, Nanjing, 210008, Jiangsu, China
| | - Xiaolei Zhu
- Department of Child Health Care, Children's Hospital of Nanjing Medical University, Nanjing, 210008, Jiangsu, China
| | - Ru Ling
- Department of Child Health Care, Children's Hospital of Nanjing Medical University, Nanjing, 210008, Jiangsu, China
| | - Wei Zhou
- Department of Child Health Care, Children's Hospital of Nanjing Medical University, Nanjing, 210008, Jiangsu, China
| | - Xiaonan Li
- Department of Child Health Care, Children's Hospital of Nanjing Medical University, Nanjing, 210008, Jiangsu, China.
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Ortega-Ramírez AD, Murillo-Zamora E, Trujillo-Hernández B, Delgado-Enciso I, Sánchez-Ramírez CA. Birth weight, slowness in eating and feeding practices as independent determinants of rapid weight gain. Acta Paediatr 2024. [PMID: 38922980 DOI: 10.1111/apa.17330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 06/07/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
AIM Our aim was to identify independent determinants of rapid weight gain in infants at 3-4, 6, and 12 months of age. METHODS A cohort study was conducted on Mexican term infants in public and private settings between March 2021 and May 2023. Rapid weight gain was defined as a ≥0.67 SD change in weight-for-age-Z-score from birth to 3-4, 6, and 12 months of age. Maternal and infant characteristics were described, and infant feeding practices, appetitive traits, weight, and length were analysed at 3-4, 6, and 12 months of age. Rapid weight gain predictors were determined using generalised linear regression models. RESULTS In total, 168 infants were recruited (55% boys). Small-for-gestational-age status increased rapid weight gain risk 1.5 times, whereas large-for-gestational-age status represented a 20%-30% decrease. Slowness in eating decreased the risk by 10%. Protective factors were older maternal age and higher educational level, whereas formula feeding, early complementary feeding, greater food enjoyment, and satiety responsiveness increased the risk. CONCLUSIONS Small for gestational age, slowness in eating, and feeding practices can be rapid weight gain predictors across the first year of life.
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Affiliation(s)
| | - Efrén Murillo-Zamora
- Faculty of Medicine, University of Colima, Colima, Mexico
- Clinical Epidiemiology Research Unit, Mexican Institute of Social Security, Villa de Álvarez, Colima, Mexico
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Limauro R, Cioffi L, Bianco V, Caruso V, Casani A, Del Gaizo D, Esposito A, Farris E, Gallo P, Giuliano M, Iannone A, Izzo A, La Vecchia MT, Raineri L, Sabetti P, Sassi R, Servodidio C, Sorice N, Cioffi V, Antignani A, Valerio G. Nutritional counselling and risk factors for obesity: an observational study in toddlers. Ital J Pediatr 2024; 50:115. [PMID: 38872179 PMCID: PMC11170809 DOI: 10.1186/s13052-024-01668-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 04/28/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Nutrition exerts a fundamental role in the prevention of obesity (OB). The aim of this study was to assess the extent to which well recognized risk factors for early OB can be associated to overweight (OW) or OB under a standardized nutritional approach and surveillance in toddlers. METHODS The eligible population was represented by 676 toddlers aged 24-36 months, assigned to 18 primary care pediatricians trained on nutritional issues who shared a standardized nutritional approach. Six-hundred-twenty-nine children (333 boys), mean age 27.8 ± 4.2 months were effectively included in this observational study. Parents received nutritional advice with particular emphasis to proteins and sugar composition supported by leaflets and reinforced at each visit. Body mass index was assessed at the age of 24-36 months. The following individual and family risk factors were considered: gestational age, birth weight, eutocic/caesarean delivery, milk feeding history, household smoking or antibiotics exposure, parents' weight, height and educational level. Prevalence of OW/OB was compared to a group of 742 toddlers (373 boys) under usual care. RESULTS Under a standardized nutritional counselling, 28.1% toddlers were classified as OW/OB compared to 36.9% toddlers under usual care (p = 0.005). In unadjusted models, parental OW/OB was significantly associated to OW/OB in toddlers (p < 0.01), while high birth weight did not reach statistical significance (p = 0.07). In adjusted models, including all the explanatory variables studied, only paternal OW/OB vs. normal weight was significantly associated to OW/OB in toddlers (OR 2.035, 95% confidence interval 1.206-3.436). No protective effect of exclusive breast feeding during the first 6 months of age was demonstrated. CONCLUSIONS Toddlers under a standardized nutrition counselling focused to limit protein and simple sugars, showed lower prevalence of OW/OB compared to usual care. Healthy promotion activities should take into account the influence of paternal BMI on the offspring adiposity.
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Affiliation(s)
- Raffaele Limauro
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Luigi Cioffi
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Vincenzo Bianco
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Vincenzo Caruso
- Benevento Section, Italian Federation of Pediatricians, Benevento, 82010, Italy
| | - Antonella Casani
- Benevento Section, Italian Federation of Pediatricians, Benevento, 82010, Italy
| | | | - Aldo Esposito
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Evelina Farris
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Patrizia Gallo
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Maria Giuliano
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Agnese Iannone
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Annamaria Izzo
- Benevento Section, Italian Federation of Pediatricians, Benevento, 82010, Italy
| | | | - Luca Raineri
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Patrizia Sabetti
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Roberto Sassi
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | | | - Nunziatina Sorice
- Benevento Section, Italian Federation of Pediatricians, Benevento, 82010, Italy
| | - Valentina Cioffi
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples, 80131, Italy
| | | | - Giuliana Valerio
- Department of Medical, Movement and Wellbeing Sciences, University of Naples Parthenope, Naples, 80133, Italy.
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10
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Scully M, Jinnette R, Le L, Martin J, Schmidtke A. Compliance of Australian commercial foods for young children (<36 months) with an international nutrient and promotion profile model. Aust N Z J Public Health 2024; 48:100158. [PMID: 38886145 DOI: 10.1016/j.anzjph.2024.100158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 04/18/2024] [Accepted: 04/30/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVE To assess how Australian infant and toddler foods compare to a nutrient and promotion profile model (NPPM) developed by the World Health Organization to support the appropriate promotion of commercial food products for children aged 6-36 months. METHODS A cross-sectional audit of infant and toddler foods found at three major Australian supermarkets was conducted in September/October 2022. Using nutrition and promotional data extracted from the packaging, products were classified according to NPPM categories and assessed against relevant compositional, front-of-pack labelling and promotional requirements. RESULTS Of 330 eligible products identified, just 28% met all NPPM compositional requirements. Toddler foods were less compliant than infant foods overall (18% vs. 31%; p=0.021), and for specific nutrients such as sodium (75% vs. 89%; p=0.003). No products met all NPPM front-of-pack labelling/promotional requirements. Only two-thirds and two-fifths of products were compliant with product name and ingredient list requirements, respectively. CONCLUSION Australian infant and toddler foods do not fully comply with the NPPM requirements. While toddler foods performed comparatively worse in terms of their nutritional adequacy, there is considerable scope to improve the nutrient profile of both infant and toddler foods. IMPLICATIONS FOR PUBLIC HEALTH To better support young children's health and development, the introduction of mandatory nutrition standards for Australian toddler foods, and the improvement of nutrition standards for Australian infant foods, in line with the NPPM, is needed. To be most effective, these should be combined with regulations for the labelling and promotion of these foods in line with the NPPM.
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Affiliation(s)
- Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Rachael Jinnette
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Linh Le
- Prevention Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Jane Martin
- Food for Health Alliance, Melbourne, Victoria, Australia
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Loperfido F, Vincenti A, Basilico S, Conti MV, Orsini F, Franchi C, Sossan C, Magarini A, Zuccotti G, Calcaterra V, Cena H. Rethinking food policy framework to tackle childhood obesity in the Italian context. Nutr Rev 2024:nuae059. [PMID: 38781308 DOI: 10.1093/nutrit/nuae059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Pediatric obesity has been described by the World Health Organization as 1 of the most serious public health challenges of the 21st century. Projections of increasing burdens of pediatric obesity and its related diseases on society highlight the need for urgent and substantial action. Many scientific and public debates about the prevention of childhood obesity are centered around simple dichotomies presenting a single-level solution. In contrast, efficient prevention programs should overcome these overly simplistic dichotomies and proceed in the early years of life within the family environment and the whole society, throughout one's lifetime. Food policies have the potential to counteract pediatric obesity by creating healthy food environments. However, the current food policies approach lacks monitoring indicators to assess short- and long-term impact, and is not well integrated into regional, national, and cross-cutting initiatives. Therefore, redesigning and rethinking food policy strategies and goals is an important opportunity to address childhood obesity, safeguard the planet, and contribute to economic and social prosperity.
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Affiliation(s)
- Federica Loperfido
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, 27100, Italy
| | - Alessandra Vincenti
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, 27100, Italy
| | - Sara Basilico
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, 27100, Italy
| | - Maria Vittoria Conti
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, 27100, Italy
| | - Francesca Orsini
- Laboratory of Pharmacoepidemiology and Human Nutrition, Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, 20156, Italy
| | - Carlotta Franchi
- Laboratory of Pharmacoepidemiology and Human Nutrition, Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, 20156, Italy
- Italian Institute for Planetary Health, Milano, 20156, Italy
| | - Cristina Sossan
- Area Food Policy, Direzione Educazione, Comune di Milano, Milan, 20139, Italy
| | - Andrea Magarini
- Area Food Policy, Direzione Educazione, Comune di Milano, Milan, 20139, Italy
| | - Gianvincenzo Zuccotti
- Department of Biomedical and Clinical Science, University of Milan, Milan, 20157, Italy
| | | | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, 27100, Italy
- Clinical Nutrition Unit, Department of General Medicine, ICS Maugeri IRCCS, Pavia, 27100, Italy
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12
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Chibuye M, Mende DR, Spijker R, Simuyandi M, Luchen CC, Bosomprah S, Chilengi R, Schultsz C, Harris VC. Systematic review of associations between gut microbiome composition and stunting in under-five children. NPJ Biofilms Microbiomes 2024; 10:46. [PMID: 38782939 PMCID: PMC11116508 DOI: 10.1038/s41522-024-00517-5] [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] [Received: 11/16/2023] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
Childhood stunting is associated with impaired cognitive development and increased risk of infections, morbidity, and mortality. The composition of the enteric microbiota may contribute to the pathogenesis of stunting. We systematically reviewed and synthesized data from studies using high-throughput genomic sequencing methods to characterize the gut microbiome in stunted versus non-stunted children under 5 years in LMICs. We included 14 studies from Asia, Africa, and South America. Most studies did not report any significant differences in the alpha diversity, while a significantly higher beta diversity was observed in stunted children in four out of seven studies that reported beta diversity. At the phylum level, inconsistent associations with stunting were observed for Bacillota, Pseudomonadota, and Bacteroidota phyla. No single genus was associated with stunted children across all 14 studies, and some associations were incongruent by specific genera. Nonetheless, stunting was associated with an abundance of pathobionts that could drive inflammation, such as Escherichia/Shigella and Campylobacter, and a reduction of butyrate producers, including Faecalibacterium, Megasphera, Blautia, and increased Ruminoccoccus. An abundance of taxa thought to originate in the oropharynx was also reported in duodenal and fecal samples of stunted children, while metabolic pathways, including purine and pyrimidine biosynthesis, vitamin B biosynthesis, and carbohydrate and amino acid degradation pathways, predicted linear growth. Current studies show that stunted children can have distinct microbial patterns compared to non-stunted children, which could contribute to the pathogenesis of stunting.
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Affiliation(s)
- Mwelwa Chibuye
- Department of Global Health, Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Research Division, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- Amsterdam Institute of Infection and Immunity, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Daniel R Mende
- Amsterdam Institute of Infection and Immunity, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Department of Medical Microbiology and Infection Control, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Rene Spijker
- Department of Global Health, Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Michelo Simuyandi
- Research Division, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Chaluma C Luchen
- Department of Global Health, Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Research Division, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Samuel Bosomprah
- Research Division, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- Department of Biostatistics, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Roma Chilengi
- Research Division, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- The Zambia National Public Health Institute (ZNPHI), Lusaka, Zambia
| | - Constance Schultsz
- Department of Global Health, Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Institute of Infection and Immunity, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Department of Medical Microbiology and Infection Control, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Vanessa C Harris
- Department of Global Health, Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
- Amsterdam Institute of Infection and Immunity, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
- Division of Infectious Diseases, Department of Internal Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
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13
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Dixon HG, Awoke MA, Scully M, McCann J, Martin J, Morley B, Rhodes A, McAleese A, Schmidtke A. Effects of marketing claims on toddler food products on parents' product preferences, perceptions and purchasing intentions: an online experiment. Int J Behav Nutr Phys Act 2024; 21:60. [PMID: 38773586 PMCID: PMC11110258 DOI: 10.1186/s12966-024-01603-9] [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] [Received: 11/21/2023] [Accepted: 04/28/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND The retail market for toddler-specific packaged foods is growing. Many of these products are ultra-processed and high in nutrients of concern for health, yet marketed in ways that may make them appear wholesome. This study aims to assess parents' responses to claims on unhealthy, ultra-processed toddler food products and test whether removing such claims promotes more accurate product perceptions and healthier product preferences. METHODS Parents of toddlers aged 12 to < 36 months (N = 838) were recruited for an online experiment testing four on-pack claim conditions: control (no claim); 'contains "good" ingredient'; 'free from "bad" ingredient'; and unregulated 'child-related' claim. Participants were randomly assigned to one condition, then viewed images of toddler food products that varied in nutrition content and the claims displayed. Participants completed tasks assessing product preferences (unhealthy product displaying claim vs. a healthier option with no claim, across four food categories (banana bars, strawberry snacks, blueberry yogurt snacks and veggie snacks)), purchase intentions and product perceptions. Poisson regression (count variable) and linear regression (continuous outcomes) analyses were employed to test for mean differences by marketing claim conditions. RESULTS For the overall sample, brief exposure to 'free from "bad" ingredient' claims increased participant's intentions to purchase unhealthy food products for their toddlers, but there was no clear evidence that 'contains "good" ingredient' claims and 'child-related' claims significantly impacted parent's preferences, purchase intentions and perceptions of toddler foods. However, certain claims influenced particular parent subgroups. Notably, parents with three or more children chose more unhealthy products when these products displayed 'contains "good" ingredient' or 'free from "bad" ingredient' claims; the latter claims also promoted stronger purchase intentions and enhanced product perceptions among this subgroup. CONCLUSIONS Findings indicate that 'free from "bad" ingredient' claims on unhealthy toddler foods are of most concern, as they boost the appeal of these products to parents. 'Contains "good" ingredient' claims and 'child-related' claims showed limited effects in this study. Considering available evidence, we recommend claims should not be permitted on child-oriented foods, as they may promote inaccurate product perceptions and unhealthy product choices by parents, that can detract from their children's diets and health.
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Affiliation(s)
- Helen Gwenda Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 200 Victoria Pde., East Melbourne, VIC, 3002, Australia.
- School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia.
| | - Mamaru Ayenew Awoke
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 200 Victoria Pde., East Melbourne, VIC, 3002, Australia
| | - Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 200 Victoria Pde., East Melbourne, VIC, 3002, Australia
| | - Jennifer McCann
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
| | - Jane Martin
- Food for Health Alliance, Melbourne, VIC, Australia
| | - Belinda Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 200 Victoria Pde., East Melbourne, VIC, 3002, Australia
| | - Anthea Rhodes
- The Royal Children's Hospital Melbourne, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Alison McAleese
- Prevention Division, Cancer Council Victoria, Melbourne, VIC, Australia
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14
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Han HJ, Woo J, Wi WY, Cho KD, Koo M, Hong SJ, Jung YM, Kim HY, Ahn KH, Hong SC, Kim HJ, Oh MJ, Cho GJ. The impact of the COVID-19 pandemic on infant obesity: A nationwide retrospective cohort study. J Infect Public Health 2024; 17:795-799. [PMID: 38520760 DOI: 10.1016/j.jiph.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/19/2024] [Accepted: 03/10/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Lifestyle changes, such as those related to the COVID-19 pandemic, including alterations in physical activity and dietary habits, are known to affect pregnancy outcomes. In particular, suboptimal intrauterine conditions during pregnancy are known to influence not only fetal growth but also growth during infancy. However, research on the impact of the environmental changes caused by the COVID-19 pandemic on the growth of infants and children during their early years is lacking. To address this issue, this study evaluated the effect of the COVID-19 pandemic on obesity in infants. METHODS This retrospective cohort study used the data collected from the Korea National Health Insurance (KNHI) claims database. The data of 1985,678 women who delivered infants between 2015 and 2021 were collected. Women who delivered during the pandemic and those who delivered during the pre-pandemic period were matched in a 1:1 frequency-matched pair procedure for factors such as age, hypertension, diabetes mellitus, preeclampsia, gestational diabetes mellitus, mode of delivery, gestational age at delivery, offspring sex, and birth weight. Finally, 197,580 women were enrolled. The weight and head circumference of infants (4-6 months of age) of the COVID-19 pandemic group were compared with those of the pre-pandemic group. RESULTS The COVID-19 pandemic group infants exhibited significantly higher weight and prevalence of obesity at 4-6 months of age compared to infants in the pre-pandemic group. After adjustment for covariates, pandemic group infants had a higher risk of obesity (odds ratio: 1.54, 95% confidence interval: 1.51-1.57) compared to the pre-pandemic group infants. CONCLUSION The COVID-19 pandemic has had a notable impact on the weight of infants aged 4-6 months. This suggests that pandemic conditions may influence the growth of newborns, underscoring the importance of monitoring and assessing trends in the growth of infants born during such crises.
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Affiliation(s)
- Hye Jin Han
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Joohyun Woo
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Won Young Wi
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Kyu-Dong Cho
- Big Data Department, National Health Insurance Service, Gangwon-do, Republic of Korea
| | - Minji Koo
- Big Data Department, National Health Insurance Service, Gangwon-do, Republic of Korea
| | - Su Jung Hong
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Young Mi Jung
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Ho Yeon Kim
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Ki Hoon Ahn
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Soon-Cheol Hong
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Hai-Joong Kim
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Min-Jeong Oh
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Republic of Korea.
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15
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Aristova A, Spence AC, Irwin C, Elford A, Graham L, Love P. Nutrition environments in early childhood education: do they align with best practice? Public Health Nutr 2024; 27:e124. [PMID: 38680073 DOI: 10.1017/s136898002400096x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
OBJECTIVE To assess the comprehensiveness (scope of nutrition guidance) and strength (clarity of written language) of centre-based nutrition policies (CBNP) within early childhood education (ECE) centres. To also consider the applicability of an existing CBNP assessment tool and policy alignment with best practice food provision and feeding practices. DESIGN Cross-sectional online study to assess written ECE CNBP using the Wellness Child Care Assessment Tool. SETTING Licenced ECE centres in the state of Victoria, Australia. PARTICIPANTS ECE centres (operating at least 8 h per d, 48 weeks per annum), stratified by location (rural and metropolitan), centre management type (profit and not-for-profit) and socio-economic area (low, middle, high). RESULTS Included individual CBNP (n 118), predominantly from metropolitan centres (56 %) and low-medium socio-economic areas (78 %). Policies had low overall Wellness Child Care Assessment Tool scores, particularly strength scores which were low across all four domains (i.e. nutrition education, nutrition standards, health promotion and communication/evaluation). The nutrition standards domain had the lowest strength score. The communication/evaluation domain had the lowest comprehensiveness score. Content analysis indicated low scores may relate to the Wellness Child Care Assessment Tool applicability for the Australian context due to differences in best practice guidance. CONCLUSION Despite the presence of written nutrition policies in ECE centres, many showed weak language and lacked comprehensiveness and strength. This may relate to poor implementation of best practice food provision or feeding practices. Low scores, however, may partly stem from using an assessment tool that is not country-specific. The redevelopment of country-specific tools to assess ECE CNBP may be warranted.
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Affiliation(s)
- Anna Aristova
- School of Exercise and Nutrition Sciences, Deakin University, Waurn Ponds, VIC3216, Australia
| | - Alison C Spence
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Christopher Irwin
- School of Health Sciences and Social Work (SHS), Nutrition and Dietetics, Griffith University, Southport, QLD, Australia
| | - Audrey Elford
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Laura Graham
- School of Exercise and Nutrition Sciences, Deakin University, Waurn Ponds, VIC3216, Australia
| | - Penelope Love
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
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16
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Tartaglia J, Jancey J, Scott JA, Dhaliwal SS, Begley A. Effectiveness of a food literacy and positive feeding practices program for parents of 0 to 5 years olds in Western Australia. Health Promot J Austr 2024; 35:263-275. [PMID: 37160723 DOI: 10.1002/hpja.742] [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] [Received: 10/11/2022] [Revised: 03/20/2023] [Accepted: 04/26/2023] [Indexed: 05/11/2023] Open
Abstract
ISSUE ADDRESSED Lifelong eating behaviours are established in childhood. Improving parents' food literacy skills is essential, as parents play a fundamental role in establishing their children's healthy eating behaviours and preferences for nutritious food. This paper describes the development and evaluation of an innovative program that combines food literacy with positive parent feeding practices, targeting parents in disadvantaged areas of Western Australia. METHODS The Food Sensations® for Parents five-week program was delivered to participants from community-based parenting organisations during 2020 and 2021. Formative research and a pre-post evaluation design were adopted. RESULTS Pre- and post-evaluation data were collected from 224 participants (96% female). There was a statistically significant improvement in the mean score for 13 food literacy behaviours, 10 positive parenting feeding practices and a mean increase in parents' daily vegetable intake of 1/3 serve. Participants reported significantly greater net improvements in food literacy behaviours than feeding practices, the largest being the Use a nutrition information panel to make food choices (33.1%). Multivariate logistic regression analyses found English as a first language, being older than 35, and from a higher Socio-Economic Index for Areas resulted in a higher likelihood of positive changes in behaviours and practices. CONCLUSIONS The findings indicate that the program is effective in improving the frequency of use of food literacy behaviours, positive parenting feeding practices and increasing vegetable consumption. SO WHAT?: Analysing improvements in food literacy behaviours and feeding practices provides clarity on what change can be expected with a five-week parent program.
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Affiliation(s)
| | - Jonine Jancey
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Jane Anne Scott
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Satvinder S Dhaliwal
- Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Gelugor, Penang, Malaysia
- Singapore University of Social Sciences, Singapore, Singapore
| | - Andrea Begley
- School of Population Health, Curtin University, Perth, Western Australia, Australia
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17
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Kristiansen AL, Myhre JB, Paulsen MM, Totland TH, Lande B, Andersen LF. Secular trends in infant feeding practices during the first year of life in Norway: findings from 1998 to 2019 - the Spedkost surveys. Br J Nutr 2024; 131:851-859. [PMID: 37822223 PMCID: PMC10864993 DOI: 10.1017/s0007114523002246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/22/2023] [Accepted: 10/04/2023] [Indexed: 10/13/2023]
Abstract
The aims of the present study were to assess secular trends in breast-feeding and to explore associations between age at introduction of solid foods and breast-feeding duration. Data from three national dietary surveys in Norway were used, including infants born in 1998 (Spedkost 1, n 1537), 2006 (Spedkost 2, n 1490) and 2018 (Spedkost 3, n 1831). In all surveys, around 80 % of the infants were breastfed at 6 months of age. At 12 months of age, breast-feeding rate was 41 % in Spedkost 1, increasing to 48 % in Spedkost 2 and 51 % in Spedkost 3. Compared with earlier introduction, introduction of solid foods at ≥ 5 months of age was associated with a lower risk of breast-feeding cessation during the first year of life in the two most recent Spedkost surveys. In Spedkost 2, the adjusted hazard ratio for breast-feeding cessation during the first year of life for those introduced to solid foods at ≥ 5 months of age was 0·43 (95 % CI (0·31, 0·60)), P < 0·001, while the corresponding number in Spedkost 3 was 0·44 (95 % CI (0·29, 0·67)), P < 0·001. In conclusion, breast-feeding at infant age 12 months increased over time. Introduction of solid foods at ≥ 5 months of age was positively associated with breast-feeding duration in the two most recent Spedkost surveys. As breast-feeding contributes to numerous health benefits for infant and mother, and possibly improved dietary sustainability in infancy, findings point to the importance of continued protection, support and promotion of breast-feeding.
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Affiliation(s)
- Anne Lene Kristiansen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Sports, Physical Education and Outdoor Studies, Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Bakkenteigen, Norway
| | - Jannicke Borch Myhre
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Mari Mohn Paulsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Food Safety, Norwegian Institute of Public Health, Oslo, Norway
| | - Torunn Holm Totland
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Britt Lande
- Division for Prevention and Public Health, Norwegian Directorate of Health, Oslo, Norway
| | - Lene Frost Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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18
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Capra ME, Decarolis NM, Monopoli D, Laudisio SR, Giudice A, Stanyevic B, Esposito S, Biasucci G. Complementary Feeding: Tradition, Innovation and Pitfalls. Nutrients 2024; 16:737. [PMID: 38474864 DOI: 10.3390/nu16050737] [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: 02/03/2024] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
According to WHO, "complementary feeding (CF) is the process starting when breast milk alone or infant formula alone is no longer sufficient to meet the nutritional requirements of infants, and therefore, other foods and liquids are needed, along with breast human milk or a breastmilk substitute". CF is one of the most important "critical and sensitive periods" in human life: indeed, timing and approaches to solid foods introduction in an infant's nutrition are of utmost importance as potential epigenetic factors from infancy to adulthood. CF is also deeply influenced by each country and single-family traditions, culture, and beliefs. The aim of our narrative review is to analyze traditional CF practices, including innovative and alternative ones that emerged in the last decades, such as baby-led weaning or plant-based weaning, and to evaluate their effects on the risk of developing non-communicable diseases. Moreover, we will discuss pitfalls and misunderstandings that pediatricians frequently have to face when dealing with complementary feeding. Health care professionals must not have prejudices against parents' wishes or traditions about CF; rather, they should support and educate them in case of any alternative CF choice, always pursuing the infant's adequate growth, neuro- and taste development, and the achievement of correct eating behavior as the primary goal.
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Affiliation(s)
- Maria Elena Capra
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Italian Society of Pediatric Nutrition (SINUPE), 20126 Milan, Italy
| | - Nicola Mattia Decarolis
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Delia Monopoli
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Serena Rosa Laudisio
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Antonella Giudice
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Brigida Stanyevic
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Giacomo Biasucci
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Italian Society of Pediatric Nutrition (SINUPE), 20126 Milan, Italy
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
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19
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Flores TR, de Andrade Leão OA, Nunes BP, Mielke GI, Dos Santos Costa C, Buffarini R, Domingues MR, da Silveira MF, Hallal PC, Bertoldi AD. Prepregnancy maternal BMI and trajectories of BMI-for-age in children up to four years of age: findings from the 2015 Pelotas (Brazil) birth cohort. Int J Obes (Lond) 2024; 48:353-359. [PMID: 38092956 DOI: 10.1038/s41366-023-01422-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 11/10/2023] [Accepted: 11/22/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND The aims of the study were to: (a) describe BMI-for-age trajectories in children up to four years of age; (b) evaluate the association between prepregnancy maternal BMI and the BMI-for-age trajectories. METHODS Data from 3218 (75.3% of the original cohort) children from the Pelotas 2015 Birth Cohort were analyzed. Prepregnancy BMI (kg/m2) was measured on the perinatal interview. Z-scores of BMI-for-age were calculated for children at three months, 1, 2 and 4 years. Trajectories were identified using a semi-parametric group-based modeling approach. Multinomial logistic regression was used to test the association between prepregnancy BMI (weight excess: BMI ≥ 25 kg/m2) and BMI-for-age trajectories. RESULTS Four trajectories of the BMI-for-age, in z-score, were identified and represent children in the "increasing", "adequate", "stabilized" and "risk for weight excess" group. A total of 196 children (7.1%) belonged to the group that was at risk of weight excess. Adjusted analyses showed that children whose mothers presented prepregnancy weight excess had 2.36 (95%CI 1.71; 3.24) times more risk of belonging to group "risk for weight excess" when compared to those children whose mothers presented underweight/normal weight before pregnancy. CONCLUSION The risk of weight excess in children up to 4 years of age were greater in mothers who presented prepregnancy weight excess.
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Affiliation(s)
- Thaynã R Flores
- Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
| | | | - Bruno P Nunes
- Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Program in Nursing, Federal University of Pelotas, Pelotas, Brazil
| | - Gregore Iven Mielke
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | | | - Romina Buffarini
- Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | | | - Pedro C Hallal
- Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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20
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Vandoni M, Marin L, Cavallo C, Gatti A, Grazi R, Albanese I, Taranto S, Silvestri D, Di Carlo E, Patanè P, Carnevale Pellino V, Zuccotti G, Calcaterra V. Poor Motor Competence Affects Functional Capacities and Healthcare in Children and Adolescents with Obesity. Sports (Basel) 2024; 12:44. [PMID: 38393264 PMCID: PMC10891969 DOI: 10.3390/sports12020044] [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: 12/18/2023] [Revised: 01/19/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND From a young age, children learn different motor skills known as fundamental motor skills. The acquisition of these skills is crucial for the future development of context-tailored actions that could improve adherence to physical activity (PA) practice. Motor competence and function deficits have been associated with pediatric obesity. We reviewed the literature data regarding motor competence in pediatrics and impaired motor performance in children and adolescents with obesity. METHODS We assessed the abstracts of the available literature (n = 110) and reviewed the full texts of potentially relevant articles (n = 65) that were analyzed to provide a critical discussion. RESULTS Children and adolescents with obesity show impaired motor performance, executive functions, postural control, and motor coordination. Children's age represents a crucial point in the development of motor skills. Early interventions are crucial to preventing declines in motor proficiency and impacting children's PA and overall fitness levels. CONCLUSIONS To involve children, the PA protocol must be fun and tailored in consideration of several aspects, such as clinical picture, level of physical fitness, and motor skills. A supervised adapted exercise program is useful to personalized PA programs from an early pediatric age.
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Affiliation(s)
- Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
| | - Luca Marin
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta;
| | - Caterina Cavallo
- Department of Sport and Exercise Science, LUNEX International University of Health, Exercise and Sports, 50, Avenue du Parc des Sports, 4671 Differdange, Luxembourg;
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
| | - Roberta Grazi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
| | - Ilaria Albanese
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
- Industrial Engineering Department, University of Tor Vergata, 00133 Rome, Italy
| | - Silvia Taranto
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
| | - Dario Silvestri
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta;
| | - Eleonora Di Carlo
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
| | - Pamela Patanè
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
- Industrial Engineering Department, University of Tor Vergata, 00133 Rome, Italy
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
- Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy
| | - Valeria Calcaterra
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
- Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
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Mekonen EG, Zegeye AF, Workneh BS, Techane MA, Tamir TT, Terefe B. Unhealthy food consumption and its determinants among children aged 6 to 23 months in sub-Saharan Africa: a multilevel analysis of the demographic and health survey. BMC Pediatr 2024; 24:40. [PMID: 38218821 PMCID: PMC10787455 DOI: 10.1186/s12887-023-04514-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 12/27/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Unhealthy food consumption that begins early in life is associated with a higher risk of nutrient inadequacy and related chronic diseases later in life. Healthy eating and consumption of important nutrients help to maintain a healthy body weight and reduce the risk of developing chronic conditions. Research from sub-Saharan Africa regarding consumption of unhealthy foods remains limited, with no studies quantifying the pooled prevalence among young children. Therefore, this study is intended to assess the pooled prevalence and determinants of unhealthy food consumption among children aged 6 to 23 months. METHODS Data from the most recent demographic and health surveys of five countries in sub-Saharan Africa conducted between 2015 and 2022 were used. A total weighted sample of 16,226 children aged 6 to 23 months was included in the study. Data extracted from DHS data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with the dependent variable. Intra-class correlation coefficient, likelihood ratio test, median odds ratio, and deviance (-2LLR) values were used for model comparison and fitness. Finally, variables with a p-value < 0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant. RESULTS The pooled prevalence of unhealthy food consumption among children aged 6 to 23 months was 13.41% (95% CI: 12.89-13.94%). Higher consumption of unhealthy foods was reported among mothers with low education [adjusted odds ratio (AOR) = 0.37; 95% confidence interval (CI) (0.30, 0.46)], unmarried women [AOR = 1.19; 95% CI (1.05, 1.34)], who had no media exposure [AOR = 0.64; 95% CI (0.56, 0.72)], delivered at home [AOR = 0.74; 95% CI (0.62, 0.87)], who hadn't had a PNC checkup [AOR = 0.66; 95% CI (0.60, 0.73)], wealthier households [AOR = 1.20; 95% CI (1.05, 1.37)], older children (aged ≥ 9 months) [AOR = 3.88; 95% CI (3.25, 4.63)], and low community level media exposure [AOR = 1.18; 95% CI (1.04, 1.34)]. CONCLUSION Nearly one out of seven children aged 6 to 23 months consumed unhealthy foods. Maternal educational level, marital status of the mother, exposure to media, wealth index, place of delivery, PNC checkup, and the current age of the child were factors significantly associated with unhealthy food consumption. Therefore, improving women's education, disseminating nutrition-related information through the media, providing more attention to poor and unmarried women, and strengthening health facility delivery and postnatal care services are recommended.
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Affiliation(s)
- Enyew Getaneh Mekonen
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Alebachew Ferede Zegeye
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belayneh Shetie Workneh
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Masresha Asmare Techane
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Tarik Tamir
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Vassilopoulou E, Feketea G, Pagkalos I, Rallis D, Milani GP, Agostoni C, Douladiris N, Lakoumentas J, Stefanaki E, Efthymiou Z, Tsabouri S. Complementary Feeding Practices: Recommendations of Pediatricians for Infants with and without Allergy Risk. Nutrients 2024; 16:239. [PMID: 38257132 PMCID: PMC10819658 DOI: 10.3390/nu16020239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/30/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
AIM To investigate the routine guidance provided by pediatricians concerning the timing of complementary feeding (CF) for both healthy infants and those at a heightened risk of allergies. METHODS A total of 233 pediatricians participated in an anonymous online survey that included questions about demographics and recommendations for CF. Specifically, they provided guidance on the types of foods, preparation methods, supplements, time intervals for introducing new foods to infants at low and high allergy risk, and delayed food introductions for high-risk cases. RESULTS The respondents advised introducing certain foods at specific ages: fruits, starchy non-gluten grains, vegetables, olive oil, and meat were appropriate at 6 months; gluten-rich grains at 7 months; yogurt, hard-boiled eggs, and legumes at 8 months; fish at 8.5 months; and nuts at 9 months. Pediatricians, especially those with less than 15 years of practice, often introduced egg, seafood, gluten-rich grains, legumes, and nuts earlier for high-risk infants. Parenthood and male gender were associated with the earlier introduction of eggs and grains. CONCLUSIONS Greek pediatricians follow a structured food introduction schedule for CF in infants. Interestingly, they tend to delay the introduction of common food allergens and recommend longer intervals between introducing new foods, particularly for high-risk infants. Key Notes: Despite recent evidence-based indications on healthy complementary feeding strategies for infants, discrepancies persist among pediatricians regarding food choices and the order and timing of food introduction, both for healthy infants and those at risk of allergy. Guidance on complementary feeding by pediatricians is influenced by their individual characteristics. Pediatricians tend to delay the introduction of common food allergens and recommend longer intervals between introducing new foods, particularly for high-risk infants.
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Affiliation(s)
- Emilia Vassilopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (E.V.); (I.P.); (J.L.); (Z.E.)
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.P.M.); (C.A.)
| | - Gavriela Feketea
- Department of Pediatrics, “Karamandaneio” Children’s Hospital of Patra, 26331 Patras, Greece
- Department of Pharmacology, “luliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Ioannis Pagkalos
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (E.V.); (I.P.); (J.L.); (Z.E.)
| | - Dimitrios Rallis
- School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (D.R.); (S.T.)
| | - Gregorio Paolo Milani
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.P.M.); (C.A.)
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20157 Milan, Italy
| | - Carlo Agostoni
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.P.M.); (C.A.)
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20157 Milan, Italy
| | - Nikolaos Douladiris
- Allergy Unit, 2nd Pediatric Clinic, University of Athens, 11527 Athens, Greece;
| | - John Lakoumentas
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (E.V.); (I.P.); (J.L.); (Z.E.)
| | - Evangelia Stefanaki
- Department of Pediatrics, General Hospital of Heraklion, Venizeleio and Pananio, 71409 Heraklion, Greece;
| | - Zenon Efthymiou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (E.V.); (I.P.); (J.L.); (Z.E.)
| | - Sophia Tsabouri
- School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (D.R.); (S.T.)
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Moholdt T, Stanford KI. Exercised breastmilk: a kick-start to prevent childhood obesity? Trends Endocrinol Metab 2024; 35:23-30. [PMID: 37735048 PMCID: PMC11005327 DOI: 10.1016/j.tem.2023.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/23/2023]
Abstract
Exercise has systemic health benefits through effects on multiple tissues, with intertissue communication. Recent studies indicate that exercise may improve breastmilk composition and thereby reduce the intergenerational transmission of obesity. Even if breastmilk is considered optimal infant nutrition, there is evidence for variations in its composition between mothers who are normal weight, those with obesity, and those who are physically active. Nutrition early in life is important for later-life susceptibility to obesity and other metabolic diseases, and maternal exercise may provide protection against the development of metabolic disease. Here we summarize recent research on the influence of maternal obesity on breastmilk composition and discuss the potential role of exercise-induced adaptations to breastmilk as a kick-start to prevent childhood obesity.
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Affiliation(s)
- Trine Moholdt
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Gynaecology and Obstetrics, St. Olav's Hospital, Trondheim, Norway.
| | - Kristin I Stanford
- Dorothy M. Davis Heart and Lung Research Institute, Department of Physiology and Cell Biology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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24
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Holmen M, Giskeødegård GF, Moholdt T. High-intensity exercise increases breast milk adiponectin concentrations: a randomised cross-over study. Front Nutr 2023; 10:1275508. [PMID: 38164413 PMCID: PMC10757973 DOI: 10.3389/fnut.2023.1275508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Adiponectin plays a role in glucose and fat metabolism and is present in human breast milk. It has been postulated that higher breast milk adiponectin concentrations may prevent rapid weight gain in infancy. Prior research indicates that circulating adiponectin increases acutely after endurance exercise, but no prior research has investigated the effect of exercise on breast milk adiponectin concentrations. The purpose of this randomised, cross-over study was to determine the acute effects of endurance exercise on adiponectin concentrations in human breast milk. Methods Participants who were exclusively breastfeeding a 6-12 week-old term infant (N = 20) completed three conditions in the laboratory: (1) Moderate-intensity continuous training (MICT), (2) High-intensity interval training (HIIT), and (3) No activity (REST). At each condition, we collected breast milk at 07:00 h (before exercise/rest), 11:00 h (immediately after exercise/rest), 12:00 h (1 h after exercise/rest), and 15:00 h (4 h after exercise/rest) and determined adiponectin concentrations using enzyme-linked immunosorbent assay. We compared changes in adiponectin concentrations after MICT and HIIT, adjusted for the morning concentration on each test day, with those after REST, using paired t-tests. Results Adiponectin concentrations increased 1 h after HIIT, from 4.6 (± 2.2) μg/L in the 07:00 h sample to 5.6 (± 2.6) μg/L. This change was 0.9 μg/L (95% confidence interval 0.3 to 1.5) greater than the change between these two timepoints in the REST condition (p = 0.025). There were no other statistically significant changes in adiponectin concentrations. Conclusion HIIT may increase adiponectin concentrations in breast milk acutely after exercise. Further studies should determine the impact of exercise-induced elevations in breast milk adiponectin concentrations on growth and metabolism in infancy.
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Affiliation(s)
- Mads Holmen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Guro F. Giskeødegård
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Trine Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Women’s Clinic, St.Olavs Hospital, Trondheim, Norway
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25
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Svensson K, Gennings C, Hagenäs L, Wolk A, Håkansson N, Wikström S, Bornehag CG. Maternal nutrition during mid-pregnancy and children's body composition at 7 years of age in the SELMA study. Br J Nutr 2023; 130:1982-1992. [PMID: 37232113 PMCID: PMC10632724 DOI: 10.1017/s0007114523000983] [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] [Received: 11/22/2022] [Revised: 03/24/2023] [Accepted: 04/12/2023] [Indexed: 05/27/2023]
Abstract
Optimal nutrition during pregnancy is vital for both maternal and child health. Our objective was to explore if prenatal diet is associated with children's height and body fat. Nutrient intake was assessed through a FFQ from 808 pregnant women and summarised to a nutrition index, 'My Nutrition Index' (MNI). The association with children's height and body fat (bioimpedance) was assessed with linear regression models. Secondary analysis was performed with BMI, trunk fat and skinfolds. Overall, higher MNI score was associated with greater height (β = 0·47; (95 % CI 0·00, 0·94), among both sexes. Among boys, higher MNI was associated with 0·15 higher BMI z-scores, 0·12 body fat z-scores, 0·11 trunk fat z-scores, and larger triceps, and triceps + subscapular skinfolds (β = 0·05 and β = 0·06; on the log2 scale) (P-value < 0·05). Among girls, the opposite associations were found with 0·12 lower trunk fat z-scores, and smaller subscapular and suprailiac skinfolds (β = -0·07 and β = -0·10; on the log2 scale) (P-value < 0·05). For skinfold measures, this would represent a ± 1·0 millimetres difference. Unexpectedly, a prenatal diet in line with recommended nutrient intake was associated with higher measures of body fat for boys and opposite to girls at a pre-pubertal stage of development.
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Affiliation(s)
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Lars Hagenäs
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niclas Håkansson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sverre Wikström
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
- Centre for Clinical Research and Education, County Council of Värmland, Värmland County, Sweden
| | - Carl-Gustaf Bornehag
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
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26
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Bertin B, Foligne B, Ley D, Lesage J, Beghin L, Morcel J, Gottrand F, Hermann E. An Overview of the Influence of Breastfeeding on the Development of Inflammatory Bowel Disease. Nutrients 2023; 15:5103. [PMID: 38140362 PMCID: PMC10745409 DOI: 10.3390/nu15245103] [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] [Received: 11/22/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
The first 1000 days of life is a critical period that contributes significantly to the programming of an individual's future health. Among the many changes that occur during this period early in life, there is growing evidence that the establishment of healthy gut microbiota plays an important role in the prevention of both short- and long-term health problems. Numerous publications suggest that the quality of the gut microbiota colonisation depends on several dietary factors, including breastfeeding. In this respect, a relationship between breastfeeding and the risk of inflammatory bowel disease (IBD) has been suggested. IBDs are chronic intestinal diseases, and perinatal factors may be partly responsible for their onset. We review the existence of links between breastfeeding and IBD based on experimental and clinical studies. Overall, despite encouraging experimental data in rodents, the association between breastfeeding and the development of IBD remains controversial in humans, partly due to the considerable heterogeneity between clinical studies. The duration of exclusive breastfeeding is probably decisive for its lasting effect on IBD. Thus, specific improvements in our knowledge could support dietary interventions targeting the gut microbiome, such as the early use of prebiotics, probiotics or postbiotics, in order to prevent the disease.
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Affiliation(s)
- Benjamin Bertin
- Univ. Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, F-59000 Lille, France; (B.B.); (B.F.); (D.L.); (J.L.); (L.B.); (J.M.); (F.G.)
| | - Benoit Foligne
- Univ. Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, F-59000 Lille, France; (B.B.); (B.F.); (D.L.); (J.L.); (L.B.); (J.M.); (F.G.)
| | - Delphine Ley
- Univ. Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, F-59000 Lille, France; (B.B.); (B.F.); (D.L.); (J.L.); (L.B.); (J.M.); (F.G.)
| | - Jean Lesage
- Univ. Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, F-59000 Lille, France; (B.B.); (B.F.); (D.L.); (J.L.); (L.B.); (J.M.); (F.G.)
| | - Laurent Beghin
- Univ. Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, F-59000 Lille, France; (B.B.); (B.F.); (D.L.); (J.L.); (L.B.); (J.M.); (F.G.)
- Univ. Lille, Inserm, CHU Lille, CIC-1403 Inserm-CHU, F-59000 Lille, France
| | - Jules Morcel
- Univ. Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, F-59000 Lille, France; (B.B.); (B.F.); (D.L.); (J.L.); (L.B.); (J.M.); (F.G.)
- Univ. Lille, Inserm, CHU Lille, CIC-1403 Inserm-CHU, F-59000 Lille, France
| | - Frédéric Gottrand
- Univ. Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, F-59000 Lille, France; (B.B.); (B.F.); (D.L.); (J.L.); (L.B.); (J.M.); (F.G.)
- Univ. Lille, Inserm, CHU Lille, CIC-1403 Inserm-CHU, F-59000 Lille, France
| | - Emmanuel Hermann
- Univ. Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, F-59000 Lille, France; (B.B.); (B.F.); (D.L.); (J.L.); (L.B.); (J.M.); (F.G.)
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27
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Wright EC, van Oort B, Bjøntegaard MM, Carlsen MH, Andersen LF. Environmental and nutritional assessment of young children's diets in Norway: comparing the current diet with national dietary guidelines and the EAT-Lancet reference diet. Eur J Nutr 2023; 62:3383-3396. [PMID: 37653070 PMCID: PMC10611869 DOI: 10.1007/s00394-023-03243-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023]
Abstract
PURPOSE Introducing healthy and sustainable diets early in life can promote lifelong healthy dietary patterns with a low environmental impact. Therefore, we aimed to estimate the environmental and nutritional consequences of a dietary change for 2-year-old children in Norway towards healthier dietary patterns. METHODS Environmental impacts of the current habitual diet among 2-year-olds (n = 1413) were estimated for six impact categories and compared with scenario diets based on the Norwegian food-based dietary guidelines (FBDG) and the EAT-Lancet Commission reference diet. Last, we evaluated the nutritional adequacy of the diets against the Norwegian nutrition recommendations for children aged 2-5 years. The current diet was assessed by an FFQ. RESULTS Environmental impacts of the current habitual diet were up to two times higher than those of the scenario diets. Compared with the current diet, impacts from the FBDG scenario diet were reduced by 35% for water use and 18% for terrestrial acidification, whereas impacts from the EAT-Lancet scenario diet were reduced by 51% for water use, 57% for terrestrial acidification, 36% for global warming potential and 27% for freshwater eutrophication. Milk and dairy products were the main contributors to environmental impacts in both the current diet and the FBDG scenario diet. The scenario diets were nutritionally adequate and improved the dietary quality among Norwegian 2-year-olds. CONCLUSION Compared to current diets among young children, more plant-based dietary patterns in line with national FBDG or the EAT-Lancet Commission reference diet can improve the nutritional adequacy of diets and simultaneously reduce environmental impacts.
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Affiliation(s)
| | - Bob van Oort
- CICERO Center for International Climate Research, Oslo, Norway
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28
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Schratz LM, Larkin O, Dos Santos N, Martin C. Caregiver Influences on Eating Behaviors in Children: An Opportunity for Preventing Obesity. Curr Atheroscler Rep 2023; 25:1035-1045. [PMID: 38032429 DOI: 10.1007/s11883-023-01171-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE OF REVIEW This review seeks to define caregiver practices that impact childhood eating behaviors and identify ways to utilize these relationships to prevent childhood obesity. RECENT FINDINGS Childhood obesity, which correlates with adult obesity and increased cardiovascular risk, is increasing in prevalence and severity. Caregivers play a significant role in shaping a child's eating behaviors and their predisposition to obesity. Maternal influences during pregnancy and infancy impact a child's future food preferences. Caregiver feeding styles (authoritarian, authoritative, indulgent, and uninvolved) are associated with distinct effects on children's eating behaviors and self-regulation. Authoritative feeding styles promote child autonomy while setting boundaries in the feeding environment. Early caregiver education and coaching regarding nutrition and feeding practices is beneficial to establishing healthy eating behaviors for children. Various caregivers, including parents, grandparents, siblings, teachers, and others, influence a child's eating habits at different stages of development. These caregivers can both positively and negatively impact a child's diet. Comprehensive interventions involving these various caregivers to promote healthy eating practices in children is ideal. Such interventions should be sensitive to cultural and environmental factors. Childhood obesity is a complex issue with long-term health effects. Early intervention using comprehensive approaches including all caregivers, community support, and public policies to address the social determinants of health will be beneficial. Future research should focus on valid outcome measures and equitable interventions that encompass all aspects of a child's life.
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Affiliation(s)
- Lorraine M Schratz
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA.
| | - Olivia Larkin
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA
| | - Nilse Dos Santos
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA
| | - Christine Martin
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA
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29
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Li S, Nor NM, Kaliappan SR. Long-term effects of child nutritional status on the accumulation of health human capital. SSM Popul Health 2023; 24:101533. [PMID: 37916186 PMCID: PMC10616551 DOI: 10.1016/j.ssmph.2023.101533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/09/2023] [Accepted: 10/09/2023] [Indexed: 11/03/2023] Open
Abstract
Research on the impact of childhood nutrition on adult health and human capital has been extensively studied in developed countries, but research in China on this topic is limited. Nowadays, for children's nutritional status, while significant progress has been made in addressing childhood undernutrition in China, regional disparities persist, conversely, the prevalence of childhood overweight continues to rise. For adults' health human capital, the burden of chronic non-communicable diseases among Chinese residents is gradually increasing, over 50% of Chinese residents are overweight or obese, with obesity being one of the risk factors for other chronic diseases. Therefore, this study uses national representative data from 1991 to 2015 China Health and Nutrition Survey (CHNS), matched with individual information from their childhood, to examine the relationship between childhood nutrition and adult health human capital. Based on the two-way fixed effects models and logit models, the study finds that childhood nutrition status measured by height-for-age z score (HAZ) significantly and continuously has been influencing adult health human capital measured by height, BMI, self-rated health (SRH), whether have been sick in last four weeks (SH). BMI-for-age z score (BMIZ) significantly and continuously influence adult health human capital measured by BMI, blood pressure, and perceived stress (PS). Among that, this study places special emphasis on the long-lasting effects of late childhood and adolescence (ages exceeding 6) on the progressive height accumulation and sustained presence of elevated blood pressure. In conclusion, reducing childhood overweight and promoting linear growth and development throughout the whole childhood can reduce the future burden of disease on the nation.
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Affiliation(s)
- Sa Li
- School of Business and Economics, Universiti Putra Malaysia, 43400, UPM, Serdang, Selangor, Malaysia
| | - Norashidah Mohamed Nor
- School of Business and Economics, Universiti Putra Malaysia, 43400, UPM, Serdang, Selangor, Malaysia
| | - Shivee Ranjanee Kaliappan
- School of Business and Economics, Universiti Putra Malaysia, 43400, UPM, Serdang, Selangor, Malaysia
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Wall CJ, Pearce J. Energy and nutrient content of school lunches provided for children attending school-based nurseries: a cross-sectional study. Public Health Nutr 2023; 26:2641-2651. [PMID: 37921199 PMCID: PMC10755416 DOI: 10.1017/s1368980023002331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/18/2023] [Accepted: 10/20/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE To nutritionally analyse lunches provided for 3-4-year-old children attending school nurseries. Energy and nutrient content are compared with nutrient frameworks underpinning voluntary guidelines for early years settings (EYS) and mandatory standards for infant schools (4-7-year-olds). DESIGN A cross-sectional study, recording all main meals, vegetarian meals, jacket potato options, sandwich options and all desserts and accompaniments provided over 5 consecutive days in each school. Two portions of each meal were collected each day and weighed. Recipe and portion weight data were entered into nutrient analysis software. SETTING School nurseries where lunch was provided by the school. SUBJECTS Nine schools, providing a total of 161 meals. RESULTS Lunches contained more energy (1881 kJ/450 kcal), fat (15·5 g), free sugars (10·5 g) and Na (424 mg) than suggested by the nutrient framework for EYS. Carbohydrate (60·6 g), protein (16·8 g), fibre (6·7 g), Fe (2·4 mg), Zn (2·0 mg), Ca (202 mg), vitamin A (304 µg) and vitamin C (19 mg) also exceeded minimum recommendations. Compared with a revised nutrient framework for infant schools, energy was within range, whilst saturated fat, free sugars and Na were above maximum recommendations for this age group, and Zn was below. Sandwich meals were lower in vitamin C (P < 0·001-P = 0·05) and Fe (P = 0·012-P = 0·017) and higher in Na (P < 0·001-P = 0·003) and Ca (P < 0·001-P = 0·05). CONCLUSION Lunches provided for children attending school nurseries are more in line with the framework for 4-7-year-olds. Free sugars, saturated fat and Na are areas of concern consistent with previous studies. Protein is three times more than recommended. Large portions of cakes and biscuits contribute to excess energy provision.
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Affiliation(s)
- Claire J Wall
- Food & Nutrition Subject Group, Sheffield Business School, Sheffield Hallam University, Howard Street, Sheffield, S1 1WB, UK
| | - Jo Pearce
- Food & Nutrition Subject Group, Sheffield Business School, Sheffield Hallam University, Howard Street, Sheffield, S1 1WB, UK
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Hall K, Geary N, Warnock AL, Dooyema C. Supporting Healthy Weight in Statewide Quality Rating and Improvement Systems: A Review of 2020 Standards and Comparison to 2015 Standards. Child Obes 2023; 19:541-551. [PMID: 36472466 PMCID: PMC10235206 DOI: 10.1089/chi.2022.0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Quality Rating and Improvement Systems (QRISs) are used to assess, improve, and communicate quality in early care and education (ECE) programs. One strategy for supporting healthy growth in early childhood is embedding nutrition, physical activity, infant feeding, and screen time content into state QRIS standards, using the Caring for Our Children high-impact obesity prevention standards (HIOPS) and the CDC Spectrum of Opportunities framework (CDC Spectrum). We assessed the number of obesity prevention standards in QRISs in 2020 and compared results to an analysis published in 2015. Methods: We collected state QRIS standards for ECE centers from March to April 2020. Two analysts coded documents for standards related to 47 HIOPS and 6 Spectrum areas. Results: Thirty-nine states and the District of Columbia had statewide QRISs in early 2020. Of these, 21 QRISs (53%) embedded 1 or more HIOPS, and 26 (65%) embedded 1 or more Spectrum components. On average, 6.9% of HIOPS were embedded in QRIS standards in 2020, an increase from 4.6% in 2015. Nine QRISs included more HIOPS in 2020 than in 2015. Five QRISs added 10% or more of the 47 HIOPS between 2015 and 2020. Physical activity and screen time standards continued to be most often included; infant feeding standards were least included. Conclusion: Obesity prevention components were embedded in three-quarters of state QRISs, and more were embedded in 2020 than in 2015, suggesting that QRISs can be levers for supporting healthy weight in ECE settings.
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Affiliation(s)
- Kelly Hall
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education (ORISE) Research Participation Program, Oak Ridge, TN, USA
| | - Nora Geary
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
- McKing Consulting Corporation, Atlanta, GA, USA
| | - Amy Lowry Warnock
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carrie Dooyema
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Oliver Olid A, de la O V, Bueso OE, Moreno-Villares JM, Martínez-González MÁ, Martín-Calvo N. Longer Breastfeeding Duration is Associated With Lower Consumption of Ultraprocessed Foods in a Sample of Spanish Preschoolers: The SENDO Project. J Acad Nutr Diet 2023; 123:1555-1567. [PMID: 37276962 DOI: 10.1016/j.jand.2023.05.028] [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: 04/17/2022] [Revised: 05/18/2023] [Accepted: 05/31/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Breastfeeding has been linked to a higher consumption of fruit and vegetables at ages 4 to 5 years. More recently, it has been suggested that it may also be associated with lower ultraprocessed food (UPF) consumption in childhood. OBJECTIVE The aim of this study was to assess whether breastfeeding duration was associated with consumption of UPF in a sample of Mediterranean preschoolers. DESIGN This study involved a cross-sectional analysis of baseline information of children in the Child Follow-Up for Optimal Development cohort. Children were enrolled at ages 4 to 5 years and information was gathered through an online questionnaire completed by parents. Dietary information was collected with a previously validated semi-quantitative food frequency questionnaire and foods were classified based on the degree of processing according to the NOVA classification. PARTICIPANTS/SETTING This study used baseline information for 806 participants enrolled in the Child Follow-Up for Optimal Development cohort between January 2015 and June 2021 in Spain. MAIN OUTCOMES MEASURES Main study outcome measures were difference in grams per day and in the percentage of total energy intake from UPF consumption related to breastfeeding duration, and odds ratio that UPF represents a high percentage of total energy intake. STATISTICAL ANALYSES Crude and multivariable adjusted estimates were calculated with generalized estimating equations to account for intracluster correlation between siblings. RESULTS The prevalence of breastfeeding in the sample was 84%. After adjusting for potential confounders, children who were breastfed for some time reported significantly lower consumption of UPF than children who were not breastfed at all. The mean differences were -19.2 g (95% CI -44.2 to 10.8) for children who were breastfed for <6 months, -42.5 g (95% CI -77.2 to -7.80) for those who were breastfed for 6 to 12 months, and -43.6 g (95% CI -79.8 to -7.48) for those who were breastfed for 12 months or more (P value for trend = 0.01). After adjusting for potential confounders, compared with children who were not breastfed, those who were breastfed for ≥12 months had consistently lower odds of UPF representing more than 25%, 30%, 35%, and 40% of total energy intake. CONCLUSIONS Breastfeeding is associated with lower consumption of UPF in Spanish preschoolers.
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Affiliation(s)
- Asier Oliver Olid
- Department of Pediatrics, Hospital Universitario de Navarra, Pamplona, Spain
| | - Víctor de la O
- IMDEA Research Institute on Food & Health Sciences. Precision Nutrition and Cardiometabolic Health, Madrid, Spain
| | | | | | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain; CIBER Pathophysiology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Nerea Martín-Calvo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain; CIBER Pathophysiology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain.
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Calcaterra V, Cena H, Sottotetti F, Rossi V, Loperfido F, Zuccotti G. Breast and Formula Milk and Early Puberty Onset. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1686. [PMID: 37892349 PMCID: PMC10605833 DOI: 10.3390/children10101686] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/12/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023]
Abstract
Nutrients have an enormous impact on many hormonal systems and aspects of health, and nutrition status is a crucial regulator of growth and pubertal development in children and adolescents. In this narrative review, we explore the connection between these feeding methods and the timing of puberty to provide a clearer understanding of how infant nutrition might contribute to the early development of puberty. Puberty is a key stage in the transition from childhood to adulthood and the timing of puberty represents a significant biological milestone of growth. Breast milk seems to have a pivotal role in puberty onset, mainly due to its dynamism, which shape indirectly the gut microbiota in early life, besides direct exposure of the baby to the milk microbiota through gut-breast axis. Concerning breast and formula milk and their effects on the onset of puberty, a protective role of the former occurs. As for the potential harmful effects of soy-based formulas and the isoflavones that they contain, the studies reported demonstrate conflicting opinions, underlining the need for further research on this topic. A healthy and well-nourished diet from the earliest stages of life has significant preventive potential for overall well-being, reducing the risk of many health problems later in life.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy;
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (G.Z.)
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (F.S.); (F.L.)
- Clinical Nutrition Unit, General Medicine, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
| | - Francesca Sottotetti
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (F.S.); (F.L.)
| | - Virginia Rossi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (G.Z.)
| | - Federica Loperfido
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (F.S.); (F.L.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (G.Z.)
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milano, Italy
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Moholdt T, Ashby ER, Tømmerdal KH, Lemoine MCC, Holm RL, Sætrom P, Iversen AC, Ravi A, Simpson MR, Giskeødegård GF. Randomised controlled trial of exercise training during lactation on breast milk composition in breastfeeding people with overweight/obesity: a study protocol for the MILKSHAKE trial. BMJ Open Sport Exerc Med 2023; 9:e001751. [PMID: 37829712 PMCID: PMC10565229 DOI: 10.1136/bmjsem-2023-001751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/14/2023] Open
Abstract
Breast milk from people with overweight/obesity may differ in composition compared with that from normal-weight people. Exercise training can modify breast milk composition in rodent models, with a beneficial impact demonstrated on the offspring's metabolism, but whether these findings translate to humans is unclear. This trial aims to determine the effect of an exercise intervention on breast milk composition and whether an exercise-induced modification of breast milk impacts the infants' growth and body composition. Effect of Exercise Training on Breastmilk Composition is a randomised, controlled trial with two parallel groups, one exercise group and one control group, with a 1:1 allocation. We will include a minimum of 62 exclusively breastfeeding participants, 6 weeks postpartum. The exercise intervention lasts 8 weeks and comprises 25 supervised endurance exercise sessions with moderate or high intensity. The primary outcome measure is the change in the relative concentration of the human milk oligosaccharide 3'sialyllactose in breast milk from baseline at 6 weeks postpartum to the end of the intervention period. Secondary outcomes include breast milk concentrations of other metabolites, cytokines, hormones and microRNA, maternal health outcomes, infant growth, infant gut microbiome and infant circulating microRNA. Maternal and infant outcomes will be measured before, during and after the intervention period, with a follow-up of the infants until they are 24 months old. Trial registration number NCT05488964.
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Affiliation(s)
- Trine Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Gynaecology and Obstetrics, St. Olav's Hospital, Trondheim, Norway
| | - Emily Rose Ashby
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Karina Hammer Tømmerdal
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Rebecca Lyng Holm
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Pål Sætrom
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ann-Charlotte Iversen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anuradha Ravi
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Melanie Rae Simpson
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Guro F Giskeødegård
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
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Guan A, Batra A, Seligman H, Hamad R. Understanding the Predictors of Low Take-Up of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): A Nationwide Longitudinal Study. Matern Child Health J 2023; 27:1795-1810. [PMID: 37286848 PMCID: PMC10247269 DOI: 10.1007/s10995-023-03728-y] [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] [Accepted: 05/21/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is among the largest U.S. social safety net programs. Although strong evidence exists regarding the benefits of WIC, take-up (i.e., participation among eligible individuals) has steadily declined in the past decade. This study addresses gaps in our knowledge regarding predictors of WIC take-up during this time. METHODS Data were drawn from the 1998-2017 waves of the National Health Interview Study (NHIS), a serial cross-sectional study of the U.S. POPULATION The analytic sample included 23,645 children and 10,297 women eligible for WIC based on self-reported demographic characteristics. To investigate predictors of WIC take-up, we regressed self-reported WIC receipt on a range of individual-level predictors (e.g., age, nativity, income) and state- level predictors (e.g., unemployment rate, governor's political affiliation) using multivariable logistic regression. In secondary analyses, results were additionally stratified by race/ethnicity, time period, and age (for children). RESULTS For both women and children, older maternal age and higher educational attainment were associated with decreased take-up of WIC. Associations differed by race/ethnicity, time period, and state characteristics including caseload of other social programs (e.g., Medicaid). DISCUSSION Our study identifies groups that are less likely to take up WIC benefits for which they are eligible, thereby contributing important evidence to inform programs and policies to increase WIC participation among groups with lower take-up. As WIC evolves past the COVID-19 pandemic, special attention will be needed to ensure that resources to encourage and support the participation of racially and economically marginalized individuals are equitably distributed.
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Affiliation(s)
- Alice Guan
- Department of Epidemiology & Biostatistics, University of California San Francisco (UCSF), San Francisco, CA, USA.
- Department of Epidemiology and Biostatistics, University of California, 550 16th Street, 2nd Floor, San Francisco, CA, 94143, USA.
| | - Akansha Batra
- Department of Epidemiology & Biostatistics, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Hilary Seligman
- Department of Epidemiology & Biostatistics, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Medicine, UCSF, San Francisco, CA, USA
- Center for Vulnerable Populations, UCSF, San Francisco, CA, USA
- Philip R. Lee Institute for Health Policy Studies, UCSF, San Francisco, CA, USA
| | - Rita Hamad
- Center for Vulnerable Populations, UCSF, San Francisco, CA, USA
- Department of Family & Community Medicine, UCSF, San Francisco, CA, USA
- Philip R. Lee Institute for Health Policy Studies, UCSF, San Francisco, CA, USA
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Pearce J, Wall CJ. School lunch portion sizes provided for children attending early years settings within primary schools: A cross-sectional study. J Hum Nutr Diet 2023; 36:1887-1900. [PMID: 37278164 DOI: 10.1111/jhn.13183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/28/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND In England, many children attend an early years' setting (EYS) that is part of a primary school. Where a school lunch is available, this is often the same for both EYS and school children. This study explored how school lunch portion sizes served for 3-4-year-old EYS children compared with portion size guidance for EYS and schools, given that recommendations are different for EYS and school-aged children. METHODS Twelve schools were recruited in four local authorities, each of which provided a school lunch to children attending EYS (aged 3-4 years) and reception classes (aged 4-5 years) from the same menu. Two portions of each menu item were weighed, each day, for five consecutive days. Mean, median, standard deviation and correlation coefficient were calculated for each food item. RESULTS Most caterers reported serving the same-sized portions to both 3-4-year-olds and 5-7-year-olds. Food items falling outside of the typical range for EYS were more commonly above the range (10 food items) than below it (6 food items). Notably, portions of cakes and biscuits were larger than recommended. Portion weights falling outside of the recommended range for 4-10-year-olds were usually too small (12 of 14 items). Some foods provided by the schools in the study did not have typical portion sizes for EYS as they were not 'good choices of foods to serve'. CONCLUSIONS These results suggest caterers may not be following guidelines appropriate for all the children they are catering for.
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Affiliation(s)
- Jo Pearce
- Food and Nutrition Subject Group, Sheffield Business School, Sheffield Hallam University, Sheffield
| | - Claire J Wall
- Food and Nutrition Subject Group, Sheffield Business School, Sheffield Hallam University, Sheffield
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Pimenta IT, Griep RH, de Matos SMA, de Fatima Haueisen Sander Diniz M, Moreno AB, de Jesus Mendes da Fonseca M. Body shape trajectories are associated with birth weight, body mass index and sociodemographic conditions in participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): a multiple correspondence analysis. BMC Public Health 2023; 23:1857. [PMID: 37749586 PMCID: PMC10518926 DOI: 10.1186/s12889-023-16779-1] [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] [Received: 04/25/2023] [Accepted: 09/18/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Evaluating lifelong weight trajectories is challenging due to the high costs of studies that follow individuals from childhood to adulthood. The use of silhouette scales has been a new approach to assess the body shape trajectory across life as a proxy for body weight trajectory. Depending on body shape trajectories, individuals may be more prone to develop diseases in adulthood. Therefore, identifying factors related to them is essential for public health. This study aimed to evaluate body shape trajectories across the lifespan and to verify associations between them, birth weight, body mass index, and sociodemographic conditions in a Brazilian cohort. METHODS This is a cross-sectional analysis conducted with 14,014 participants of first follow-up data collection of Longitudinal Study of Adult Health (ELSA-Brasil). ELSA-Brasil is a multicentric prospective cohort study initiated in 2008 with civil servants of six public institutions in the Northeast, South and Southeast regions of Brazil. We applied a clustering method to longitudinal data to identify body shape trajectories from 5 to 40 years of age and assessed the associations between these trajectories and birth weight, body mass index and sociodemographic conditions (race, education, maternal education and monthly per capita family income) using multiple correspondence analysis. RESULTS We found five body shape trajectories for women and three for men. Low birth weight was associated with a slight to moderate increase in shape. High birth weight was associated with maintaining large body size in both sexes and markedly increased body shape in women. Higher sociodemographic status and white race were associated with marked increases in body shape in men and maintenance of medium body shape in women. CONCLUSIONS The study shows that variables related to worse lifetime weight status (evaluated by anthropometry), such as presence of obesity, are also associated with worse body shape trajectories, as assessed with silhouette scales. Our results suggest that body shape trajectories are a good indicator of body weight trajectories and may be used when cohort studies are not possible.
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Affiliation(s)
| | - Rosane Harter Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | - Arlinda B Moreno
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Dharod JM, McElhenny KS, DeJesus JM. Formula Feeding Is Associated with Rapid Weight Gain between 6 and 12 Months of Age: Highlighting the Importance of Developing Specific Recommendations to Prevent Overfeeding. Nutrients 2023; 15:4004. [PMID: 37764785 PMCID: PMC10536371 DOI: 10.3390/nu15184004] [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] [Received: 08/08/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
We examined differences in mean daily calorie intake and rapid weight gain risk among 6- to 12-month-old infants by milk feeding status: breastmilk only, breastmilk and formula (combined), or formula only. Another objective was to determine what frequency and amount of formula fed were associated with overfeeding among infants. Mother-infant dyads (n = 240) were recruited from a pediatric clinic mainly serving Medicaid recipients. At 6, 9, and 12 months of infants' age, 24 h feeding recalls were conducted using the multiple-pass method. Infant weight measurements were accessed from clinic records to estimate rapid weight gain between 6 and 12 months. Among the participants, 82% received WIC. More than half of the participants were either African American or Latino by race/ethnicity. Calorie intake among formula-only fed infants was higher than in the other two milk feeding groups. One-fourth of the infants were experiencing rapid weight gain, and the risk was 3-fold higher among formula-only fed infants. Exceeding daily calorie requirements or overfeeding was associated with both formula amount and the frequency of feeding (p < 0.01). Specific guidelines and education on formula feeding practices are critical to prevent accelerated growth among infants. Gaining further understanding on parenting style and formula feeding practices is also warranted.
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Affiliation(s)
- Jigna M. Dharod
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC 27412, USA;
| | - Kristen S. McElhenny
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC 27412, USA;
| | - Jasmine M. DeJesus
- Department of Psychology, College of Arts and Sciences, University of North Carolina at Greensboro, Greensboro, NC 27412, USA;
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Ji N, Johnson M, Eckel SP, Gauderman WJ, Chavez TA, Berhane K, Faham D, Lurmann F, Pavlovic NR, Grubbs BH, Lerner D, Habre R, Farzan SF, Bastain TM, Breton CV. Prenatal ambient air pollution exposure and child weight trajectories from the 3rd trimester of pregnancy to 2 years of age: a cohort study. BMC Med 2023; 21:341. [PMID: 37674158 PMCID: PMC10483706 DOI: 10.1186/s12916-023-03050-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Prenatal air pollution exposure may increase risk for childhood obesity. However, few studies have evaluated in utero growth measures and infant weight trajectories. This study will evaluate the associations of prenatal exposure to ambient air pollutants with weight trajectories from the 3rd trimester through age 2 years. METHODS We studied 490 pregnant women who were recruited from the Maternal and Development Risks from Environmental and Social Stressors (MADRES) cohort, which comprises a low-income, primarily Hispanic population in Los Angeles, California. Nitrogen dioxide (NO2), particulate matter < 10 µm (PM10), particulate matter < 2.5 µm (PM2.5), and ozone (O3) concentrations during pregnancy were estimated from regulatory air monitoring stations. Fetal weight was estimated from maternal ultrasound records. Infant/child weight measurements were extracted from medical records or measured during follow-up visits. Piecewise spline models were used to assess the effect of air pollutants on weight, overall growth, and growth during each period. RESULTS The mean (SD) prenatal exposure concentrations for NO2, PM2.5, PM10, and O3 were 16.4 (2.9) ppb, 12.0 (1.1) μg/m3, 28.5 (4.7) μg/m3, and 26.2 (2.9) ppb, respectively. Comparing an increase in prenatal average air pollutants from the 10th to the 90th percentile, the growth rate from the 3rd trimester to age 3 months was significantly increased (1.55% [95%CI 1.20%, 1.99%] for PM2.5 and 1.64% [95%CI 1.27%, 2.13%] for NO2), the growth rate from age 6 months to age 2 years was significantly decreased (0.90% [95%CI 0.82%, 1.00%] for NO2), and the attained weight at age 2 years was significantly lower (- 7.50% [95% CI - 13.57%, - 1.02%] for PM10 and - 7.00% [95% CI - 11.86%, - 1.88%] for NO2). CONCLUSIONS Prenatal ambient air pollution was associated with variable changes in growth rate and attained weight from the 3rd trimester to age 2 years. These results suggest continued public health benefits of reducing ambient air pollution levels, particularly in marginalized populations.
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Affiliation(s)
- Nan Ji
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | | | - Sandrah P Eckel
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - William J Gauderman
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - Thomas A Chavez
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - Kiros Berhane
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Dema Faham
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - Fred Lurmann
- Sonoma Technology Inc., Petaluma, CA, 94954, USA
| | | | - Brendan H Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | | | - Rima Habre
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - Shohreh F Farzan
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - Theresa M Bastain
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - Carrie V Breton
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA.
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40
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Miyake K, Horiuchi S, Shinohara R, Kushima M, Otawa S, Yui H, Akiyama Y, Ooka T, Kojima R, Yokomichi H, Mochizuki K, Yamagata Z. Maternal dietary fiber intake during pregnancy and child development: the Japan Environment and Children's Study. Front Nutr 2023; 10:1203669. [PMID: 37575329 PMCID: PMC10415901 DOI: 10.3389/fnut.2023.1203669] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/20/2023] [Indexed: 08/15/2023] Open
Abstract
Background Animal studies have shown that maternal low-fiber diets during pregnancy may impair brain development and function in offspring, but this has not been validated by epidemiological studies. The aim of this study was to investigate the link between maternal dietary fiber intake during pregnancy and neurodevelopmental delay in offspring using a large birth cohort. Methods A total of 76,207 mother-infant pairs were analyzed using data from the Japan Environment and Children's Study, a nationwide prospective cohort study. Maternal dietary fiber intake was estimated using the food frequency questionnaire in mid-pregnancy. Maternal dietary fiber intake was adjusted for energy and classified into quintiles. Developmental delay was assessed in five domains using the Japanese version of the Ages and Stages Questionnaire, Third Edition at the age of 3 years. The logistic regression analysis was performed to estimate the odds ratio (OR) and 95% confidence interval (CI) for the link between dietary fiber intake during pregnancy and developmental delay at the age of 3 years. Results The lowest intake group of total dietary fiber had a higher risk of delayed communication [adjusted OR (aOR), 1.51; 95% CI, 1.32-1.74], fine motor (aOR, 1.45; 95% CI, 1.32-1.61), problem-solving (aOR, 1.46; 95% CI, 1.32-1.61), and personal-social skills (aOR, 1.30; 95% CI, 1.12-1.50) than did the highest intake group. An analysis that excluded the effects of insufficient folic acid intake during pregnancy also showed a similar trend. Conclusion This study showed that maternal dietary fiber deficiency during pregnancy might influence an increased risk of neurodevelopmental delay in offspring.
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Affiliation(s)
- Kunio Miyake
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Sayaka Horiuchi
- Center for Birth Cohort Studies, University of Yamanashi, Chuo, Japan
| | - Ryoji Shinohara
- Center for Birth Cohort Studies, University of Yamanashi, Chuo, Japan
| | - Megumi Kushima
- Center for Birth Cohort Studies, University of Yamanashi, Chuo, Japan
| | - Sanae Otawa
- Center for Birth Cohort Studies, University of Yamanashi, Chuo, Japan
| | - Hideki Yui
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Yuka Akiyama
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Tadao Ooka
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Reiji Kojima
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Hiroshi Yokomichi
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Kazuki Mochizuki
- Department of Local Produce and Food Sciences, Faculty of Life and Environmental Sciences, University of Yamanashi, Kofu, Japan
| | - Zentaro Yamagata
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
- Center for Birth Cohort Studies, University of Yamanashi, Chuo, Japan
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Olga L, Vervoort J, van Diepen JA, Gross G, Petry CJ, Prentice PM, Chichlowski M, van Tol EAF, Hughes IA, Dunger DB, Ong KK. Associations between breast milk intake volume, macronutrient intake and infant growth in a longitudinal birth cohort: the Cambridge Baby Growth and Breastfeeding Study (CBGS-BF). Br J Nutr 2023; 130:56-64. [PMID: 36259139 PMCID: PMC10244014 DOI: 10.1017/s0007114522003178] [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] [Received: 03/15/2022] [Revised: 09/14/2022] [Accepted: 09/27/2022] [Indexed: 02/16/2023]
Abstract
Growth patterns of breastfed infants show substantial inter-individual differences, partly influenced by breast milk (BM) nutritional composition. However, BM nutritional composition does not accurately indicate BM nutrient intakes. This study aimed to examine the associations between both BM intake volumes and macronutrient intakes with infant growth. Mother-infant dyads (n 94) were recruited into the Cambridge Baby Growth and Breastfeeding Study (CBGS-BF) from a single maternity hospital at birth; all infants received exclusive breast-feeding (EBF) for at least 6 weeks. Infant weight, length and skinfolds thicknesses (adiposity) were repeatedly measured from birth to 12 months. Post-feed BM samples were collected at 6 weeks to measure TAG (fat), lactose (carbohydrate) (both by 1H-NMR) and protein concentrations (Dumas method). BM intake volume was estimated from seventy infants between 4 and 6 weeks using dose-to-the-mother deuterium oxide (2H2O) turnover. In the full cohort and among sixty infants who received EBF for 3+ months, higher BM intake at 6 weeks was associated with initial faster growth between 0 and 6 weeks (β + se 3·58 + 0·47 for weight and 4·53 + 0·6 for adiposity gains, both P < 0·0001) but subsequent slower growth between 3 and 12 months (β + se - 2·27 + 0·7 for weight and -2·65 + 0·69 for adiposity gains, both P < 0·005). BM carbohydrate and protein intakes at 4-6 weeks were positively associated with early (0-6 weeks) but tended to be negatively related with later (3-12 months) adiposity gains, while BM fat intake showed no association, suggesting that carbohydrate and protein intakes may have more functional relevance to later infant growth and adiposity.
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Affiliation(s)
- Laurentya Olga
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - Jacques Vervoort
- Department of Agrotechnology and Food Sciences, Wageningen University, Wageningen, the Netherlands
| | - Janna A. van Diepen
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Nijmegen, the Netherlands; Evansville, IN, USA
| | - Gabriele Gross
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Nijmegen, the Netherlands; Evansville, IN, USA
| | - Clive J. Petry
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | | | - Maciej Chichlowski
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Nijmegen, the Netherlands; Evansville, IN, USA
| | - Eric A. F. van Tol
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Nijmegen, the Netherlands; Evansville, IN, USA
| | - Ieuan A. Hughes
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - David B. Dunger
- Department of Paediatrics, University of Cambridge, Cambridge, UK
- Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Ken K. Ong
- Department of Paediatrics, University of Cambridge, Cambridge, UK
- Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- MRC Epidemiology Unit, Wellcome Trust-MRC Institute of Metabolic Science, NIHR Cambridge Comprehensive Biomedical Research Centre, Cambridge Biomedical Campus, University of Cambridge, Cambridge, CB2 0QQ, UK
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42
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Sauer P. Obesity in Early Life: Its Causes, Prevention and Risks in Later Life. Nutrients 2023; 15:2999. [PMID: 37447324 DOI: 10.3390/nu15132999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Being overweight or obese at the end of the first year of life is associated with an increased risk of obesity in later life and an increased risk of developing other diseases, like type 1 diabetes mellitus, cardiovascular disorders and psycho-social problems [...].
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Affiliation(s)
- Pieter Sauer
- Department of Pediatrics, Beatrix Children's Hospital, University Medical Center, Hanzeplein 1, 9700RB Groningen, The Netherlands
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43
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Gsoellpointner M, Eibensteiner F, Thanhaeuser M, Ristl R, Jilma B, Berger A, Haiden N. Effects of early introduction of solid foods on nutrient intake in preterm infants during their 1st year of life: a secondary outcome analysis of a prospective, randomized intervention study. Front Nutr 2023; 10:1124544. [PMID: 37275631 PMCID: PMC10232899 DOI: 10.3389/fnut.2023.1124544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/21/2023] [Indexed: 06/07/2023] Open
Abstract
Very low birth weight (VLBW) infants have higher nutritional needs even after hospital discharge. However, data concerning current nutrient intakes at different time points after the introduction of solid foods and whether dietary reference values are being met are scarce. To adress this issue, this secondary analysis of a prospective, two-arm interventional study in 177 VLBW infants 21 investigates dietary intake comparing early and late (early: 10-12 weeks corrected for gestational age, late: 16-18 weeks corrected for gestational age) introduction of standardized complementary food during the first year of life. Nutritional intake was assessed using self-reported monthly 3-day dietary records from 3 until 12 months, corrected for gestational age. The time point of the introduction of solid foods did not influence nutrient intake, but the early introduction of solids tended toward a higher proportional intake of protein and carbohydrates and a lower intake of fat as a percentage of total energy) during the 1st year of life, corrected for gestational age. The results of this study indicate that this standardized feeding concept was sufficient for zinc, calcium, and phosphorus intake. However, dietary iron and vitamin D intakes did not meet the recommendations. Thus, prolonged iron supplementation should be considered beyond the introduction of meat and vitamin D supplementation at least until 12 months, corrected for gestational age. Trial registration number ClinicalTrials.gov: NCT01809548.
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Affiliation(s)
| | - Fabian Eibensteiner
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Margarita Thanhaeuser
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Robin Ristl
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Bernd Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Angelika Berger
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Nadja Haiden
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
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44
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Wasniewska M, Pepe G, Aversa T, Bellone S, de Sanctis L, Di Bonito P, Faienza MF, Improda N, Licenziati MR, Maffeis C, Maguolo A, Patti G, Predieri B, Salerno M, Stagi S, Street ME, Valerio G, Corica D, Calcaterra V. Skeptical Look at the Clinical Implication of Metabolic Syndrome in Childhood Obesity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040735. [PMID: 37189984 DOI: 10.3390/children10040735] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/25/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023]
Abstract
Metabolic syndrome (MetS) is defined by a cluster of several cardio-metabolic risk factors, specifically visceral obesity, hypertension, dyslipidemia, and impaired glucose metabolism, which together increase risks of developing future cardiovascular disease (CVD) and type 2 diabetes mellitus (T2D). This article is a narrative review of the literature and a summary of the main observations, conclusions, and perspectives raised in the literature and the study projects of the Working Group of Childhood Obesity (WGChO) of the Italian Society of Paediatric Endocrinology and Diabetology (ISPED) on MetS in childhood obesity. Although there is an agreement on the distinctive features of MetS, no international diagnostic criteria in a pediatric population exist. Moreover, to date, the prevalence of MetS in childhood is not certain and thus the true value of diagnosis of MetS in youth as well as its clinical implications, is unclear. The aim of this narrative review is to summarize the pathogenesis and current role of MetS in children and adolescents with particular reference to applicability in clinical practice in childhood obesity.
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Affiliation(s)
- Malgorzata Wasniewska
- Division of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy
| | - Giorgia Pepe
- Division of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy
| | - Tommaso Aversa
- Division of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy
| | - Simonetta Bellone
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | - Luisa de Sanctis
- Department of Public Health and Pediatric Sciences, University of Torino, 10126 Turin, Italy
| | - Procolo Di Bonito
- Department of Internal Medicine, "Santa Maria delle Grazie" Hospital, 80078 Pozzuoli, Italy
| | - Maria Felicia Faienza
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Nicola Improda
- Neuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Santobono-Pausilipon Children's Hospital, 80122 Napoli, Italy
| | - Maria Rosaria Licenziati
- Neuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Santobono-Pausilipon Children's Hospital, 80122 Napoli, Italy
| | - Claudio Maffeis
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy
| | - Alice Maguolo
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy
| | - Giuseppina Patti
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, University of Genova, 16128 Genova, Italy
| | - Barbara Predieri
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit, University of Modena and Reggio Emilia, Largo del Pozzo, 71, 41124 Modena, Italy
| | - Mariacarolina Salerno
- Pediatric Endocrinology Unit, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Stefano Stagi
- Health Sciences Department, University of Florence and Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Maria Elisabeth Street
- Unit of Paediatrics, Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, 43126 Parma, Italy
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, University of Napoli "Parthenope", 80133 Napoli, Italy
| | - Domenico Corica
- Division of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy
| | - Valeria Calcaterra
- Department of Pediatrics, "Vittore Buzzi" Children's Hospital, 20157 Milano, Italy
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Carr T, Thompson AL, Benjamin-Neelon SE, Wasser HM, Ward DS. Confirmatory factor analysis of the infant feeding styles questionnaire in infant and toddler child care teachers. Appetite 2023; 183:106449. [PMID: 36621724 PMCID: PMC10041657 DOI: 10.1016/j.appet.2023.106449] [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] [Received: 11/04/2022] [Revised: 12/19/2022] [Accepted: 01/03/2023] [Indexed: 01/07/2023]
Abstract
Early childhood is a critical time of development. Caregiver feeding style, including of child care providers, has been implicated in influencing children's food preferences and obesity. A better understanding of the determinants of child care providers' feeding styles is important as children increasingly receive daily care and nutrition in child care centers. Valid instruments to measure provider feeding styles specifically for infants are needed. This study's objective was to validate, for use with child care providers, the Infant Feeding Styles Questionnaire (IFSQ), an instrument originally designed for parents of infants and toddlers. Study data came from the Baby Nutrition and Physical Activity Self-Assessment for Child Care (Baby NAP SACC) study, a cluster randomized trial, designed to evaluate the efficacy of a six-month-long obesity prevention intervention in child care centers. The IFSQ was administered at baseline and follow-up to infant and toddler teacher participants (n = 244). Scores for baseline IFSQ teacher responses (n = 219) were calculated for the 13 sub-constructs across the five feeding styles. We tested reliability with Cronbach's alpha coefficients and performed confirmatory factor analysis to examine factor loadings and goodness of fit characteristics, modifying constructs to achieve best fit. Reliability coefficients ranged from 0.42 to 0.82 for all sub-constructs. Goodness of fit indices for the final model ranged from: root mean square error of approximation (RMSEA) 0.000-0.082; comparative fit index (CFI) 0.943-1.000; Tucker-Lewis index (TLI) 0.906-1.000; and standardized root mean squared error (SRMR) 0.006-0.130. In a sample of racially diverse infant and toddler child care teachers, final models of the laissez-faire, pressuring, and responsive constructs and the restrictive-diet quality sub-construct performed well. Overall model fit was poor for the indulgence construct, but good for solely its corresponding belief items.
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Affiliation(s)
- Tara Carr
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Amanda L Thompson
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Department of Anthropology, University of North Carolina, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Heather M Wasser
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Dianne S Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
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46
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De Simoni E, Rizzetto G, Molinelli E, Capodaglio I, Offidani A, Simonetti O. The Role of Diet in Children with Psoriasis: Emerging Evidence and Current Issues. Nutrients 2023; 15:nu15071705. [PMID: 37049545 PMCID: PMC10097110 DOI: 10.3390/nu15071705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/17/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Psoriasis is an immune-mediated inflammatory systemic disease with skin tropism and chronic relapsing course; it is associated with an increased cardiovascular risk and with many metabolic comorbidities, emerging during childhood in 22–33% of cases. Diet influences the presentation and the clinical course of inflammatory diseases, including psoriasis; in particular, it was shown that a Mediterranean, gluten-free, or low-calorie diet may positively affect disease control in adult patients with psoriasis and adequate pharmacological therapy. These three dietary regimens may play a role also in children with psoriasis. It has been demonstrated that pediatric psoriasis is associated with psychological stress, celiac disease, and obesity, which may be positively influenced by these dietary regimens, respectively. Therefore, the expertise of multiple health figures (gastroenterologists, nutritionists, pediatricians, dermatologists) is required to plan a tailor-made dietary strategy, ensuring good growth, through an adequate intake of essential micro- and macronutrients and, at the same time, impacting the pro-inflammatory biochemical profile and on the associated cardiovascular risk of psoriasis disease.
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Affiliation(s)
- Edoardo De Simoni
- Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Giulio Rizzetto
- Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
- Correspondence:
| | - Elisa Molinelli
- Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Irene Capodaglio
- Hospital Cardiology and UTIC, Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - Annamaria Offidani
- Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Oriana Simonetti
- Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
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Gelman R, Whelan J, Spiteri S, Duric D, Oakhill W, Cassar S, Love P. Adoption, implementation, and sustainability of early childhood feeding, nutrition and active play interventions in real-world settings: a systematic review. Int J Behav Nutr Phys Act 2023; 20:32. [PMID: 36941649 PMCID: PMC10029282 DOI: 10.1186/s12966-023-01433-1] [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: 08/01/2022] [Accepted: 03/05/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Instilling healthy dietary habits and active play in early childhood is an important public health focus. Interventions supporting the establishment of nutrition and active play behaviours in the first years of life have shown positive outcomes and long-term cost-effectiveness, however, most are research trials, with limited evidence regarding real-world application. Implementation science theories, models and frameworks (TMFs) can guide the process of research translation from trial to real-world intervention. The application of TMFs within nutrition and active play intervention studies in early childhood (< 5 years) is currently unknown. This systematic review identified the use of TMFs and barriers/ enablers associated with intervention adoption, implementation, and sustainability in early childhood nutrition and active play interventions implemented under real-world conditions. METHODS Six databases were searched for peer-reviewed publications between 2000-2021. Studies were included if primary outcomes reported improvement in diet, physical activity or sedentary behaviours amongst children aged < 5 years and interventions were delivered under real-world conditions within a community and/or healthcare setting. Two reviewers extracted and evaluated studies, cross checked by a third and verified by all authors. Quality assessment of included studies was completed by two authors using the Mixed Methods Appraisal Tool (MMAT). RESULTS Eleven studies comprising eleven unique interventions were included. Studies represented low, middle and high-income countries, and were conducted across a range of settings. Five TMFs were identified representing four of Nilsen's implementation model categories, predominantly 'evaluation models'. Ninety-nine barriers/facilitators were extracted across the three intervention phases-Implementation (n = 33 barriers; 33 facilitators), Sustainability (n = 19 barriers; n = 9 facilitators), Adoption (n = 2 barriers; n = 3 facilitators). Identified barriers/facilitators were mapped to the five domains of the Durlak and DuPre framework, with 'funding', 'compatibility' and 'integration of new programming' common across the three intervention phases. CONCLUSIONS Findings demonstrate that there is no systematic application of TMFs in the planning, implementation and/or evaluation of early childhood nutrition and active play interventions in real-world settings, and selective and sporadic application of TMFs occurs across the intervention lifespan. This apparent limited uptake of TMFs is a missed opportunity to enhance real-world implementation success. TRIAL REGISTRATION PROSPERO (CRD42021243841).
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Affiliation(s)
- Rivka Gelman
- School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, 3220, Australia.
| | - Jillian Whelan
- School of Medicine, Institute of Health Transformation, Deakin University, Geelong, VIC, 3220, Australia
| | - Sheree Spiteri
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, 3220, Australia
| | - Danijela Duric
- School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, 3220, Australia
| | - Winnie Oakhill
- School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, 3220, Australia
| | - Samuel Cassar
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, 3052, Australia
| | - Penelope Love
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, 3220, Australia
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Early Life Programming of Vascular Aging and Cardiometabolic Events: The McDonald Lecture 2022. Artery Res 2023. [DOI: 10.1007/s44200-023-00031-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Abstract
AbstractThe early life programming of adult health and disease (Developmental Origins of Adult Health and Disease; DOHaD) concept has attracted increased attention during recent years. In this review evidence is presented for epidemiological associations between early life factors (birth weight, prematurity) and cardiometabolic traits and risk of disease in adult life. Even if not all studies concur, the evidence in general is supporting such links. This could be due to either nature or nurture. There is evidence to state that genetic markers influencing birth weight could also be of importance for offspring hypertension or risk of coronary heart disease, this supporting the nature argument. On the other hand, several studies, both historical and experimental, have found that the change of maternal dietary intake or famine in pregnancy may cause permanent changes in offspring body composition as well as in hemodynamic regulation. Taken together, this also supports the strategy of preventive maternal and child health care, starting already during the preconception period, for lowering the risk of adult cardiometabolic disease in the affected offspring. Further studies are needed to better understand the mediating mechanisms, for example concerning arterial function, hemodynamic regulation, renal function, and neuroendocrine influences, related to the development of early vascular aging (EVA) and cardiovascular disease manifestations.
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Monteiro LM, Barbosa CF, Lichtenecker DCK, Argeri R, Gomes GN. Sex modifies the renal consequences of high fructose consumption introduced after weaning. Front Physiol 2023; 14:1090090. [PMID: 37008005 PMCID: PMC10050681 DOI: 10.3389/fphys.2023.1090090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/03/2023] [Indexed: 03/17/2023] Open
Abstract
After lactation, many children consume fructose-rich processed foods. However, overconsumption of these foods can predispose individuals to non-communicable chronic diseases, which can have different repercussions depending on the sex. Thus, we evaluated the effects of fructose overload introduced after weaning on the renal function of young rats of both sexes.Methods: After weaning, male and female offspring of Wistar rats were assigned to drink water (the male/water and female/water groups) or 20% D-fructose solution (male/fructose and female/fructose groups). Food and water or fructose solution was offered ad libitum. Rats were evaluated at 4 months. Parameters analyzed: blood pressure, body weight, triglyceride levels, glomerular filtration rate, sodium, potassium, calcium, and magnesium excretion, macrophage infiltration, and eNOS and 8OHdG expression in renal tissue. CEUA-UNIFESP: 2757270117.Results: Fructose intake affected the blood pressure, body weight, and plasma triglyceride in all rats. Glomerular filtration rate was significantly reduced in males that received fructose when compared to that of the control group. Sodium and potassium excretion decreased in all fructose-treated rats; however, the excreted load of these ions was significantly higher in females than in males. In the female control group, calcium excretion was higher than that of the male control group. Fructose overload increased magnesium excretion in females, and also increased macrophage infiltration and reduced eNOS expression in both males and females.Conclusion: Fructose overload introduced after weaning caused metabolic and renal changes in rats. Renal function was more affected in males; however, several significant alterations were also observed in the female-fructose group.
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Affiliation(s)
- Letícia Maria Monteiro
- Department of Physiology, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
- Postgraduate Program in Translational Medicine, Department of Medicine, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Celine Farias Barbosa
- Department of Physiology, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | | | - Rogério Argeri
- Department of Physiology, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
- Postgraduate Program in Translational Medicine, Department of Medicine, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Guiomar Nascimento Gomes
- Department of Physiology, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
- *Correspondence: Guiomar Nascimento Gomes,
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50
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Oliver Olid A, Moreno-Galarraga L, Moreno-Villares JM, Bibiloni MDM, Martínez-González MÁ, de la O V, Fernandez-Montero A, Martín-Calvo N. Breastfeeding Is Associated with Higher Adherence to the Mediterranean Diet in a Spanish Population of Preschoolers: The SENDO Project. Nutrients 2023; 15:nu15051278. [PMID: 36904277 PMCID: PMC10005753 DOI: 10.3390/nu15051278] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 02/26/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVE To assess whether breastfeeding during the first months of life is associated with adherence to the Mediterranean dietary (MedDiet) pattern in preschool children. DESIGN The Seguimiento del Niño para un Desarrollo Óptimo (SENDO) project is an ongoing pediatric cohort with open recruitment, started in 2015 in Spain. Participants, recruited when they are 4 to 5 years old at their primary local health center or school, are followed annually through online questionnaires. For this study, 941 SENDO participants with full data on study variables were included. Breastfeeding history was collected retrospectively at baseline. Adherence to the Mediterranean diet was assessed with the KIDMED index (range -3 to 12). RESULTS After accounting for multiple sociodemographic and lifestyle confounders, including parental attitudes and knowledge about dietary recommendations for children, breastfeeding was independently associated with a higher adherence to the MedDiet. Compared with children who were never breastfed, children breastfed for ≥6 months had a one-point increase on their mean KIDMED score (Mean difference +0.93, 95%confidence interval [CI]. 0.52-1.34, p for trend <0.001). The odds ratio of high adherence to the MedDiet (KIDMED index ≥8) was 2.94 (95%CI 1.50-5.36) in children who were breastfed for at least 6 months, as compared to their peers who were never breastfeed. Children who were breastfed for less than 6 months exhibited intermediate levels of adherence (p for trend <0.01). CONCLUSION Breastfeeding for 6 months or longer is associated with a higher adherence to the Mediterranean diet during the preschool years.
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Affiliation(s)
- Asier Oliver Olid
- Department of Pediatrics, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Laura Moreno-Galarraga
- Department of Pediatrics, Hospital Universitario de Navarra, 31008 Pamplona, Spain
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain
- Correspondence: (L.M.-G.); (A.F.-M.); Tel.: +34-848429888 (L.M.-G.)
| | | | - Maria del Mar Bibiloni
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, 07122 Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Miguel Ángel Martínez-González
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain
- Department of Preventive Medicine and Public Health, Facultad de Medicina, Universidad de Navarra, 31008 Pamplona, Spain
- Pathophysiology of Obesity and Nutrition, Centro de Investigación Biomédica en Red, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Víctor de la O
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain
- Department of Preventive Medicine and Public Health, Facultad de Medicina, Universidad de Navarra, 31008 Pamplona, Spain
| | - Alejandro Fernandez-Montero
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain
- Department of Occupational Medicine, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- Correspondence: (L.M.-G.); (A.F.-M.); Tel.: +34-848429888 (L.M.-G.)
| | - Nerea Martín-Calvo
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain
- Department of Preventive Medicine and Public Health, Facultad de Medicina, Universidad de Navarra, 31008 Pamplona, Spain
- Pathophysiology of Obesity and Nutrition, Centro de Investigación Biomédica en Red, Instituto de Salud Carlos III, 28029 Madrid, Spain
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