The Relationship of Eating Rate and Degree of Chewing to Body Weight Status among Preschool Children in Japan: A Nationwide Cross-Sectional Study

Adherence to a healthy lifestyle behavior composite score and cardiometabolic risk factors in Spanish children from the CORALS cohort

To assess the associations between the adherence to a composite score comprised of 6 healthy lifestyle behaviors and its individual components with several cardiometabolic risk factors in Spanish preschool children. Cross-sectional analyses were conducted in 938 participants included in the CORALS cohort aged 3-6 years. Six recognized healthy lifestyle behaviors (breastfeeding, sleep duration, physical activity, screentime, adherence to the Mediterranean diet, and eating speed) were assessed in a composite score. Multiple linear and logistic regression models were fitted to assess the associations with cardiometabolic risk factors (weight status, waist circumference, fat mass index, blood pressure, fasting plasma glucose, and lipid profile). In the adjusted multiple linear and logistic regression models, compared with the reference category of adherence to the healthy lifestyle behavior composite score, those participants in the category of the highest adherence showed significant decreased prevalence risk of overweight or obesity [OR (95% CI), 0.4 (0.2, 0.6)] as well as significant lower waist circumference, fat mass index (FMI), systolic blood pressure and fasting plasma glucose concentration [β (95% CI), - 1.4 cm (- 2.5, - 0.4); - 0.3 kg/m2 (- 0.5, - 0.1); and - 3.0 mmHg (- 5.2, - 0.9); - 1.9 mg/dL (- 3.5, - 0.4), respectively]. Slow eating speed was individually associated with most of the cardiometabolic risk factors.   Conclusions: Higher adherence to the healthy lifestyle behavior composite score was associated with lower waist circumference, FMI, other cardiometabolic risk factors, and risk of overweight or obesity in Spanish preschool children. Further studies are required to confirm these associations. What is Known: • Lifestyle is a well-recognized etiologic factor of obesity and its comorbidities. • Certain healthy behaviors such as adhering to a healthy diet, increasing physical activity, and decreasing screentime are strategies for prevention and treatment of childhood obesity. What is New: • Higher adherence to the healthy lifestyle behavior composite score to 6 healthy behaviors (breastfeeding, sleep duration, physical activity, screentime, eating speed, and adherence to the Mediterranean diet) was associated with decreased adiposity, including prevalence risk of overweight or obesity, and cardiometabolic risk in preschool children. • Slow eating and greater adherence to the Mediterranean diet were mainly associated to lower fasting plasma and serum triglycerides concentration, respectively.

Chewing and its influence on swallowing, gastrointestinal and nutrition-related factors: a systematic review

The study aimed to evaluate the hypothesis that chewing is a mechanical and physiological contributor to swallowing, physiologic/pathologic processes of the gastrointestinal tract (GIT), and nutrition-related factors. A search strategy was applied to three different databases to investigate if chewing function in adults affects the swallowing, physiologic/pathologic processes of the GIT, and nutrition-related factors compared to controls with no exposure. The included studies were evaluated for methodological quality and risk of bias and certainty of evidence. The results showed 71 eligible studies. Overall, the results showed that 46 studies supported the hypothesis while 25 refuted it. However, the GRADE analysis showed low to very low certainty of the evidence to support the hypothesis that chewing is an important contributor in the swallowing process, and physiologic/pathologic processes in the GIT. The GRADE analysis also showed a moderate to very low certainty of the evidence to suggest that chewing function contributes to nutrition-related parameters. The overall results of the current study showed that a majority (64.7%) of the studies (46 out of 71) supported the hypothesis. However, robust studies with proper design, adequate sample size, and well-defined outcome parameters are needed to establish conclusive evidence.

Factors associated with eating rate: a systematic review and narrative synthesis informed by socio-ecological model

Accumulating evidence shows associations between rapid eating and overweight. Modifying eating rate might be a potential weight management strategy without imposing additional dietary restrictions. A comprehensive understanding of factors associated with eating speed will help with designing effective interventions. The aim of this review was to synthesise the current state of knowledge on the factors associated with eating rate. The socio-ecological model (SEM) was utilised to scaffold the identified factors. A comprehensive literature search of eleven databases was conducted to identify factors associated with eating rate. The 104 studies that met the inclusion criteria were heterogeneous in design and methods of eating rate measurement. We identified thirty-nine factors that were independently linked to eating speed and mapped them onto the individual, social and environmental levels of the SEM. The majority of the reported factors pertained to the individual characteristics (n = 20) including demographics, cognitive/psychological factors and habitual food oral processing behaviours. Social factors (n = 11) included eating companions, social and cultural norms, and family structure. Environmental factors (n = 8) included food texture and presentation, methods of consumption or background sounds. Measures of body weight, food form and characteristics, food oral processing behaviours and gender, age and ethnicity were the most researched and consistent factors associated with eating rate. A number of other novel and underresearched factors emerged, but these require replication and further research. We highlight directions for further research in this space and potential evidence-based candidates for interventions targeting eating rate.

Effect of Obesity on Masticatory Muscle Activity and Rhythmic Jaw Movements Evoked by Electrical Stimulation of Different Cortical Masticatory Areas

This study investigates rhythmic jaw movement (RJM) patterns and masticatory muscle activities during electrical stimulation in two cortical masticatory areas in obese male Zucker rats (OZRs), compared to their counterparts-lean male Zucker rats (LZRs) (seven each). At the age of 10 weeks, electromyographic (EMG) activity of the right anterior digastric muscle (RAD) and masseter muscles, and RJMs were recorded during repetitive intracortical micro-stimulation in the left anterior and posterior parts of the cortical masticatory area (A-area and P-area, respectively). Only P-area-elicited RJMs, which showed a more lateral shift and slower jaw-opening pattern than A-area-elicited RJMs, were affected by obesity. During P-area stimulation, the jaw-opening duration was significantly shorter (p < 0.01) in OZRs (24.3 ms) than LZRs (27.9 ms), the jaw-opening speed was significantly faster (p < 0.05) in OZRs (67.5 mm/s) than LZRs (50.8 mm/s), and the RAD EMG duration was significantly shorter (p < 0.01) in OZRs (5.2 ms) than LZR (6.9 ms). The two groups had no significant difference in the EMG peak-to-peak amplitude and EMG frequency parameters. This study shows that obesity affects the coordinated movement of masticatory components during cortical stimulation. While other factors may be involved, functional change in digastric muscle is partly involved in the mechanism.

Mastication in overweight and obese children: A comparative cross-sectional study

OBJECTIVE

The objective of this study was to analyze masticatory characteristics in children from 7 to 10 years, and to compare these characteristics among normal weight, overweight and obese children.

METHODS

This is a cross-sectional study, conducted in northeast Brazil, with a sample of 160 children, aged 7 to 10 years. The authors evaluated: nutritional and dental status; food intake; masticatory parameters and orofacial myofunctional characteristics. The children were divided according to nutritional status into normal weight (n = 101), overweight (n = 33) and obesity (n = 26) groups.

RESULTS

The results showed that Obese children had a larger bite size (g) (median = 6.0, Q1-Q3 = 4.0-9.0, p = 0.049) and performed fewer masticatory sequences (median = 3.0, Q1-Q3 = 2.0-3.2, p = 0.024) than children with normal weight (median = 5.0, Q1-Q3 = 4.0-7.0; median = 4.0, Q1-Q3 = 3.0-5.0). Furthermore, obese children finished feeding in a shorter time (s) (median = 62.5, Q1-Q3 = 50.5-70.0, p = 0.039) than normal weight children (median = 66.0, Q1-Q3 = 56.5-78.0) and overweight children (median = 66.0, Q1-Q3 = 58.0-81.5).

CONCLUSIONS

The present results suggest that obese children present changes in mastication, evidenced by larger bite-size, performing fewer masticatory sequences and rapid mastication, which may contribute to increased food consumption and the development of excess weight.

Associations Between Eating Speed, Diet Quality, Adiposity, and Cardiometabolic Risk Factors

OBJECTIVE

To assess the associations between eating speed, adiposity, cardiometabolic risk factors, and diet quality in a cohort of Spanish preschool-children.

STUDY DESIGN

A cross-sectional study in 1371 preschool age children (49% girls; mean age, 4.8 ± 1.0 years) from the Childhood Obesity Risk Assessment Longitudinal Study (CORALS) cohort was conducted. After exclusions, 956 participants were included in the analyses. The eating speed was estimated by summing the total minutes used in each of the 3 main meals and then categorized into slow, moderate, or fast. Multiple linear and logistic regression models were fitted to assess the β-coefficient, or OR and 95% CI, between eating speed and body mass index, waist circumference, fat mass index (FMI), blood pressure, fasting plasma glucose, and lipid profile.

RESULTS

Compared with participants in the slow-eating category, those in the fast-eating category had a higher prevalence risk of overweight/obesity (OR, 2.9; 95% CI, 1.8-4.4; P < .01); larger waist circumference (β, 2.6 cm; 95% CI, 1.5-3.8 cm); and greater FMI (β, 0.3 kg/m²; 95% CI, 0.1-0.5 kg/m²), systolic blood pressure (β, 2.8 mmHg; 95% CI, 0.6-4.9 mmHg), and fasting plasma glucose levels (β, 2.7 mg/dL, 95% CI, 1.2-4.2 mg/dL) but lower adherence to the Mediterranean diet (β, -0.5 points; 95% CI, -0.9 to -0.1 points).

CONCLUSIONS

Eating fast is associated with higher adiposity, certain cardiometabolic risk factors, and lower adherence to a Mediterranean diet. Further long-term and interventional studies are warranted to confirm these associations.

Health-Related Lifestyles in Relation to Body Mass Index Among Young and Middle-Aged Women in Japan

BACKGROUND

Being underweight, overweight, or obese can lead to adverse health effects. Hence, it is important to understand the specific factors that change the burden of underweight and overweight to target appropriate disease control strategies. This study was designed to examine the prevalence and factors associated with underweight and overweight among young and middle-aged women in Japan.

MATERIALS AND METHODS

A cross-sectional study was conducted among women aged 20-59 years who participated in health checkups at a regional health care center in 2018 and 2019 (N = 1722). The assessments included anthropometric, blood pressure measurements, and a standardized self-administered questionnaire. Multivariable logistic regression analysis assessed lifestyle factors associated with body mass index for underweight <18.5 kg/m²) and overweight/obesity (25.0 kg/m² and above).

RESULTS

The prevalence of underweight and overweight/obesity were 12.3%, and 22.5%, respectively. No lifestyle factors were found to be significantly associated with being underweight. Having dinner within 2 hours before bed was positively associated with being overweight/obese [adjusted odds ratio (AOR): 1.448, 95% confidence interval (CI): 1.014-2.068]. Women who gained 10 kg since their 20s were more likely to fall into overweight/obesity category (AOR: 9.674, 95% CI: 1.014-2.068). Women who were using a lipid-lowering medication (AOR: 3.150, CI: 1.892-5.246) were associated with three times higher risk of being overweight/obese. Hypertension and dyslipidemia were significantly associated with overweight/obesity (AOR: 3.094, 95% CI: 2.201-4.351 and AOR: 2.498, 95% CI: 1.831-3.409, respectively).

CONCLUSION

One in five middle-aged women was overweight or obese, whereas one in eight was underweight. In relation to the prevention of overweight/obesity, specific health promotion messages regarding eating timing should be developed.

Associations with oral health indices for obesity risk among Japanese men and women: results from the baseline data of a cohort study

Background

Oral health is composed of various oral health indices (OHIs), such as oral self-care habits, oral hygiene, oral function, and mastication ability. Oral self-care habits have frequently been examined for obesity risk. This study aimed to comprehensively clarify the association between OHIs and obesity risk.

Methods

We collected data for 15 questions on the four OHIs and measured the body mass index of 3494 men and 2552 women aged 35–79 years. Obesity was defined as a body mass index ≥25 kg/m². The four OHIs were scored by the corresponding questions (good as “reference”), and the summed score was defined as “comprehensive OHI”, that is, the fifth OHI. Each lowest tertile score was used as “reference”. Using multiple logistic regression analysis, odds ratios (ORs), 95% confidence intervals (CIs), and p-values for trends were estimated.

Results

In the men and women, the ORs were 1.37 (1.11–1.67, < 0.01) and 2.48 (1.80–3.42, < 0.01) for oral self-care habits, and 1.78 (1.42–2.24, < 0.01) and 3.06 (2.12–4.43, < 0.01) for tooth brushing frequency, respectively. Moreover, in men, a significant trend was found for “harder rinsing out your mouth”, related to “oral function”. In women, the ORs were 1.74 (1.28–2.36, < 0.01) and 1.43 (1.00–2.06, < 0.01) for “comprehensive OHI” and “longer meal time” related to “mastication ability”, respectively.

Conclusions

Our findings showed that obesity risk was associated with poor of oral health, which were comprehensively composed of various OHIs, among middle-aged and older Japanese men and women.

Effects of Developmental Failure of Swallowing Threshold on Obesity and Eating Behaviors in Children Aged 5-15 Years

Background: The aim of the present study was to identify factors related to developmental failure of swallowing threshold in children aged 5−15 years. Methods: A total of 83 children aged 5−15 years were included in this study. A self-administered lifestyle questionnaire was completed, along with hand grip strength and oral function tests. Swallowing threshold was determined based on the concentration of dissolved glucose obtained from gummy jellies when the participants signaled that they wanted to swallow the chewed gummy jellies. Developmental failure of swallowing threshold was defined as glucose concentrations in the lowest 20th percentile. After univariate analysis, multivariate binary logistic regression analysis was used to identify factors associated with developmental failure of swallowing threshold. Results: Hand grip strength was significantly correlated with masticatory performance (r = 0.611, p < 0.01). Logistic regression analysis revealed factors related to developmental failure of swallowing threshold, i.e., overweight/obesity (Odds ratio) (OR) = 5.343, p = 0.031, 95% CI = 1.168−24.437) and eating between meals at least once a day (OR = 4.934, p = 0.049, 95% CI = 1.004−24.244). Conclusions: Developmental failure of swallowing threshold was closely associated with childhood obesity in 5- to 15-year-old children.

The effect of bolus size on masticatory parameters at swallowing threshold in children using a hard, solid, artificial test food

The effect of different bolus sizes on food breakdown has been studied in adults, but not in children. The objective of this study was to study median particle size (MPS) and other parameters of masticatory function at swallowing threshold (ST) in 8–10‐year‐old‐children with two different bolus sizes. A randomized crossover trial was undertaken in 89 eight to ten‐year‐old children. The study was performed with informed consent and ethical approval. The artificial test food used was made of a condensation silicone (Optosil Comfort) following a standardized protocol. Two bolus sizes (three or four quarters of a 20‐mm diameter, 5‐mm thick tablet) were randomized to avoid an order effect and tested in different sessions. Variables were: MPS (X₅₀) at ST, number of cycles until ST, sequence and cycle duration as well as cycles/g. Comparisons were performed with paired t and Wilcoxon tests, regressions and correlations were run. Cutoff for statistical significance was .05. Statistically significant differences were found for all variables; X₅₀ (2.5 ± 0.8 vs. 2.8 ± 0.7 mm, p < .001), cycles until ST (38 vs. 40, p = .022), sequence (25 vs. 27 s, p = .003), and cycle duration (650 vs. 683 ms, p = .015) and cycles/g (27 vs. 21 cycles/g, p < .001), three or four quarters, respectively. In conclusion, in children, as in adults, chewing on a bigger bolus size leads to a larger MPS (X₅₀) at ST. When chewing on a larger bolus the number of cycles increases, but not enough to swallow the same particle size since the number of cycles/g is less with a bigger bolus size.

Determination of Chewing Count from Video Recordings Using Discrete Wavelet Decomposition and Low Pass Filtration

Several studies have shown the importance of proper chewing and the effect of chewing speed on the human health in terms of caloric intake and even cognitive functions. This study aims at designing algorithms for determining the chew count from video recordings of subjects consuming food items. A novel algorithm based on image and signal processing techniques has been developed to continuously capture the area of interest from the video clips, determine facial landmarks, generate the chewing signal, and process the signal with two methods: low pass filter, and discrete wavelet decomposition. Peak detection was used to determine the chew count from the output of the processed chewing signal. The system was tested using recordings from 100 subjects at three different chewing speeds (i.e., slow, normal, and fast) without any constraints on gender, skin color, facial hair, or ambience. The low pass filter algorithm achieved the best mean absolute percentage error of 6.48%, 7.76%, and 8.38% for the slow, normal, and fast chewing speeds, respectively. The performance was also evaluated using the Bland-Altman plot, which showed that most of the points lie within the lines of agreement. However, the algorithm needs improvement for faster chewing, but it surpasses the performance of the relevant literature. This research provides a reliable and accurate method for determining the chew count. The proposed methods facilitate the study of the chewing behavior in natural settings without any cumbersome hardware that may affect the results. This work can facilitate research into chewing behavior while using smart devices.

A prospective comparative study of the MNA-SF and GNRI nutritional screening tools in predicting infectious complications among elderly patients over 70 years undergoing posterior lumbar arthrodesis

Malnutrition is a risk factor for postoperative infectious complications of elderly patients undergoing posterior lumbar arthrodesis. At present, there is no gold standard for nutrition screening tools. We analyzed the value of predicting infectious complications among elderly patients over 70 years undergoing posterior lumbar arthrodesis by comparing the MNA-SF and GNRI. Demographic data, anthropometric measurements, serum albumin, surgical data and the occurrence of infectious complications and LOS were collected. Mini Nutritional Assessment short form (MNA-SF), Geriatric Nutritional Risk Index (GNRI) were performed within 24 h before surgery. Multivariable logistic regression analyses were used to identify predictors of infectious complications. The discriminatory performances of GNRI and MNA-SF scores for the occurrence of infectious complications were determined by receiver operating characteristic curves (ROC) analyses and the area under the curve (AUC). The study included 252 patients with a median age of 76.82 ± 6.41 years (range 70-84 years), and 142 patients (56.3%) were female. There were no significant differences in infectious complications (p = 0.236) and LOS (p = 0.580) among different GNRI categories. 27.3% malnourished patients evaluated by the MNA-SF suffered from infectious complications and 10.1% patients at risk of malnourished had infectious complications. Those patients had statistically significant higher prevalence of infectious complications (p = 0.002) and longer LOS (p = 0.023) than well-nourished patients. Multivariable analysis revealed that preoperative malnutrition and at risk of malnourished by the MNA-SF was significantly associated with infections. The area under the curve (AUC) of MNA-SF was 0.754, which was significantly high than AUC of GNRI (0.623) (Delong's test, p = 0.033). This study demonstrated that MNA-SF is a simple and effective tool for predicting the risk of infectious complications in elderly patients undergoing posterior lumbar arthrodesis.

Eating Speed, Eating Frequency, and Their Relationships with Diet Quality, Adiposity, and Metabolic Syndrome, or Its Components

Excess body weight is a major global health concern, particularly due to its associated increased health risks. Several strategies have been proposed to prevent overweight and obesity onset. In the past decade, it has been suggested that eating speed/rate and eating frequency might be related to obesity. The main aim of this narrative review was to summarize existing evidence regarding the impact of eating speed/rate and eating frequency on adiposity, metabolic syndrome (MetS), or diet quality (DQ). For this purpose, a literature search of observational and interventional trials was conducted between June and September 2020 in PubMed and Web of Sciences databases, without any data filters and no limitations for publication date. Results suggest that children and adults with a faster eating speed/rate may be associated with a higher risk of developing adiposity, MetS or its components. Furthermore, a higher eating frequency could be associated with diet quality improvement, lower adiposity, and lower risk of developing MetS or its components. Further interventional trials are warranted to clarify the mechanism by which these eating behaviors might have a potential impact on health.

The association of skipping breakfast with cancer-related and all-cause mortality in a national cohort of United States adults

PURPOSE

Many lifestyle and dietary factors have been recognized as risk factors for cancer morbidity and mortality. However, investigations of the association of the frequency of breakfast consumption and cancer are limited. This study aimed to examine the association of skipping breakfast with all-cause and cancer-related mortality in a national cohort of United States men and women.

METHODS

Data were from 7,007 adults aged ≥ 40 years who participated in the third National Health and Nutrition Examination Survey (1988-1994) and had follow-up information on mortality up until 31 December 2015. Cox proportional hazards regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI).

RESULTS

The mean age of participants was 55.4 years, with 54.4% and 79% being women and non-Hispanic whites, respectively. Approximately, 16% of participants rarely consumed breakfast, 23.0% consumed breakfast some days, and 61% consumed breakfast every day. During a median follow-up of 22.2 years, 3,573 deaths occurred with 795 being related to cancer. In models adjusting for sociodemographic factors, smoking, physical activity, body mass index, hypertension, diabetes, cholesterol levels, total energy intake and diet quality, persons who rarely consumed breakfast had a higher risk of cancer-related mortality (HR = 1.52; CI:1.06-2.18) and all-cause (HR = 1.69; CI: 1.42-2.02) compared to those who took breakfast every day.

CONCLUSION

In this nationally representative sample, skipping breakfast was associated with elevated risks for all-cause and cancer-related mortality. This study provides evidence for the benefits of regular breakfast consumption in reducing the risk of all-cause and cancer mortality.

Reliability of a novel wearable device to measure chewing frequency

Purpose In recent years, the chewing frequency, i.e., the number of chewing cycles, has decreased owing to changes in dietary habits. Although these changes may be related to complete body health, there is no evidence-based tool to measure the dietary habits. We developed a small ear-hung wearable device for monitoring mastication behavior. The device, worn on the ear pinna, allows the counting of the number of chewing cycles, and data are collected on a smartphone via Bluetooth. In this study, the reliability of the novel device was verified.Methods A total of 22 healthy volunteers participated in the study. During measurement, the subjects wore the novel wearable device on their right ear pinna and were asked to chew gum, gummy jellies, and rice balls. The number of chewing cycles was counted by the device. A mandibular kinesiograph (MKG) was also recorded, and the chewing activity was recorded as a video. The accuracy, precision, and recall of the ear-hung device were calculated by comparing the data obtained from the MKG and the video recording. Additionally, the factors affecting reliability were examined.Results The accuracy, precision, and recall of the novel device were 101.6 ± 13.6%, 85.3 ± 11.0%, and 84.5 ± 9.5%, respectively. Although the accuracy was not affected by any factor, precision and recall of the novel device for women were significantly worse than that for men, and were greatest when the subjects were chewing gum.Conclusions Our findings suggest that the newly developed ear-hung wearable device for counting the number of chewing cycles was sufficiently reliable.

Time trend of axial length and associated factors in 4- and 5-year-old children in Shanghai from 2013 to 2019

Purpose

To evaluate the time trend of axial length (AL) and associated factors in 4- and 5-year-old children in Shanghai from 2013 to 2019.

Methods

This was a 7-year observational study of 985 four-year-old and 1059 five-year-old children in Shanghai. AL, horizontal and vertical corneal curvature, spherical equivalent (SE), and body height and weight were measured. Furthermore, a questionnaire was collected, including time outdoors and bad eyesight habits.

Results

In 4-year-old children, no significant difference was found in AL (P = 0.526), but significant differences were observed in SE (P = 0.001), horizontal corneal curvature (P = 0.006), vertical corneal curvature (P = 0.004), height (P < 0.001), and weight (P = 0.022) from 2013 to 2019. In 5-year-old children, no significant differences were found in AL (P = 0.304), SE (P = 0.200), or weight (P = 0.292), but significant differences were observed in horizontal corneal curvature (P = 0.040), vertical corneal curvature (P = 0.015), and height (P < 0.001) from 2013 to 2019. Multivariate analyses revealed that AL was mainly significantly associated with boys and time outdoors in the 4- and 5-year-old children.

Conclusions

The AL of 4- and 5-year-old children remained relatively stable in Shanghai from 2013 to 2019. Longitudinal studies are needed to confirm the relationship between AL elongation and environmental risk factors.

Maternal pre-pregnancy underweight is associated with underweight and low bone mass in school-aged children

INTRODUCTION

A number of studies have reported that pre-pregnancy overweight status is associated with offspring obesity, yet only a few studies have examined pre-pregnancy underweight status as it associates with offspring health. The aim of the present study was to assess the effect of pre-pregnancy underweight status in a mother on health outcomes in her offspring. To this end, the primary outcome examined in the present study was underweight status in the offspring, with a secondary outcome of offspring low bone mass.

MATERIALS AND METHODS

The present retrospective cohort study, conducted from 2008 to 2011, targeted a source population of all students registered as fifth-graders at three public elementary schools in Hamamatsu and Fukuroi cities. Maternal height and weight before and after pregnancy and offspring weight and height at birth were obtained from the Maternal and Child Health Handbook. Offspring weight and height at age 10 years were measured using standard procedures. Offspring total body less head (TBLH) bone mineral content (BMC) was determined with a dual-energy X-ray absorptiometry scanner.

RESULTS

Pre-pregnancy underweight status was found to be associated with an increased risk of an underweight status in female offspring (OR = 2.88, 95% CI 1.06-7.81). Offspring TBLH BMC in the underweight mother group was significantly lower than that in the non-underweight mother group.

CONCLUSIONS

We determined that pre-pregnancy underweight status was more likely to lead to an underweight status and low TBLH BMC in school-aged offspring.