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Samodra YL, Chuang YC. A growth curve model to estimate longitudinal effects of parental BMI on Indonesian children's growth patterns. J Dev Orig Health Dis 2024; 15:e20. [PMID: 39324178 DOI: 10.1017/s204017442400028x] [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: 09/27/2024]
Abstract
The global surge in childhood obesity is also evident in Indonesia. Parental body mass index (BMI) values were found to be one of the major determinants of the increasing prevalence of childhood obesity. It is uncertain if parental BMI during their offspring's childhood significantly affects their children's BMI trajectories into adulthood. We aimed to investigate the influence of parental BMI Z-scores on BMI trajectories of Indonesian school-aged children, with a focus on sex-specific effects. This study utilized data from the Indonesian Family Life Survey and tracked the same respondents over four time points, from wave 2 (1997-1998) to wave 5 (2014-2015). The sample of this study consisted of children aged 5-12 years in wave 2 for whom height and weight data were available. We utilized a two-level growth curve model to account for the hierarchical structure of the data, with time nested within individual children. Fathers' BMI Z-scores in wave 2 had a pronounced influence (β = 0.31) on female children's BMI Z-scores compared to the influence of mothers' BMI Z-scores (β = 0.17). Mothers' BMI Z-scores in wave 2 showed a stronger positive association with male children's BMI Z-scores (β = 0.22) than did the father's BMI Z-scores (β = 0.19). A significant interaction of fathers' BMI Z-scores and years of follow-up was found for male children. As male children's BMI Z-scores increased by year, this effect was stronger in those whose fathers' BMI Z-scores were at a higher level. In conclusion, we found that parental BMI values profoundly influenced their children's BMI trajectories.
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Affiliation(s)
| | - Ying-Chih Chuang
- School of Public Health, Taipei Medical University, New Taipei City, Taiwan
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2
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Gupta M, Phan TLT, Lê-Scherban F, Eckrich D, Bunnell HT, Beheshti R. Associations of Longitudinal BMI-Percentile Classification Patterns in Early Childhood with Neighborhood-Level Social Determinants of Health. Child Obes 2024. [PMID: 39187268 DOI: 10.1089/chi.2023.0157] [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] [Indexed: 08/28/2024]
Abstract
Background: Understanding social determinants of health (SDOH) that may be risk factors for childhood obesity is important to developing targeted interventions to prevent obesity. Prior studies have examined these risk factors, mostly examining obesity as a static outcome variable. Methods: We extracted electronic health record data from 2012 to 2019 for a children's health system that includes two hospitals and wide network of outpatient clinics spanning five East Coast states in the United States. Using data-driven and algorithmic clustering, we have identified distinct BMI-percentile classification groups in children from 0 to 7 years of age. We used two separate algorithmic clustering methods to confirm the robustness of the identified clusters. We used multinomial logistic regression to examine the associations between clusters and 27 neighborhood SDOHs and compared positive and negative SDOH characteristics separately. Results: From the cohort of 36,910 children, five BMI-percentile classification groups emerged: always having obesity (n = 429; 1.16%), overweight most of the time (n = 15,006; 40.65%), increasing BMI percentile (n = 9,060; 24.54%), decreasing BMI percentile (n = 5,058; 13.70%), and always normal weight (n = 7,357; 19.89%). Compared to children in the decreasing BMI percentile and always normal weight groups, children in the other three groups were more likely to live in neighborhoods with higher poverty, unemployment, crowded households, single-parent households, and lower preschool enrollment. Conclusions: Neighborhood-level SDOH factors have significant associations with children's BMI-percentile classification and changes in classification. This highlights the need to develop tailored obesity interventions for different groups to address the barriers faced by communities that can impact the weight and health of children living within them.
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Affiliation(s)
- Mehak Gupta
- Department of Computer Science, Southern Methodist University, Dallas, TX, USA
| | | | - Félice Lê-Scherban
- Epidemiology & Biostatistics, and Urban Health Collaborative Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | | | | | - Rahmatollah Beheshti
- Department of Computer & Info. Sciences, and Epidemiology, University of Delaware, Newark, DE, USA
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Gupta M, Phan TLT, Lê-Scherban F, Eckrich D, Bunnell HT, Beheshti R. Associations of longitudinal BMI percentile classification patterns in early childhood with neighborhood-level social determinants of health. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.06.08.23291145. [PMID: 37398451 PMCID: PMC10312866 DOI: 10.1101/2023.06.08.23291145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Background Understanding social determinants of health (SDOH) that may be risk factors for childhood obesity is important to developing targeted interventions to prevent obesity. Prior studies have examined these risk factors, mostly examining obesity as a static outcome variable. Methods We extracted EHR data from 2012-2019 for a children's health system that includes 2 hospitals and wide network of outpatient clinics spanning 5 East Coast states in the US. Using data-driven and algorithmic clustering, we have identified distinct BMI-percentile classification groups in children from 0 to 7 years of age. We used two separate algorithmic clustering methods to confirm the robustness of the identified clusters. We used multinomial logistic regression to examine the associations between clusters and 27 neighborhood SDOHs and compared positive and negative SDOH characteristics separately. Results From the cohort of 36,910 children, five BMI-percentile classification groups emerged: always having obesity (n=429; 1.16%), overweight most of the time (n=15,006; 40.65%), increasing BMI-percentile (n=9,060; 24.54%), decreasing BMI-percentile (n=5,058; 13.70%), and always normal weight (n=7,357; 19.89%). Compared to children in the decreasing BMI-percentile and always normal weight groups, children in the other three groups were more likely to live in neighborhoods with higher poverty, unemployment, crowded households, single-parent households, and lower preschool enrollment. Conclusions Neighborhood-level SDOH factors have significant associations with children's BMI-percentile classification and changes in classification. This highlights the need to develop tailored obesity interventions for different groups to address the barriers faced by communities that can impact the weight and health of children living within them. Impact Statement This study demonstrates the association between longitudinal BMI-percentile patterns and SDOH in early childhood. Five distinct clusters with different BMI-percentile trajectories are found and a strong association between these clusters and SDOH is observed. Our findings highlight the importance of targeted prevention and treatment interventions based on children's SDOH.
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Tan Y, Zhang D, Xiao P, Chen X, Zhang Y, Peng C, Peng A. Prenatal exposure to PM 2.5 and childhood body mass index growth trajectories from birth to 6 years old. Sci Rep 2024; 14:16936. [PMID: 39043939 PMCID: PMC11266715 DOI: 10.1038/s41598-024-68096-1] [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: 03/05/2024] [Accepted: 07/19/2024] [Indexed: 07/25/2024] Open
Abstract
This study aimed to determine the relationships between prenatal PM2.5 exposure and childhood growth trajectories during the first 6 years of life. A total of 47,625 pairs of mothers and children were recruited from a prospective birth cohort conducted between 2011 and 2013 in Wuhan, China, and followed for 6 years. We used the group-based trajectory models to classify the population into three trajectory groups: slow growth (n = 13,671, 28.7%), normal growth (n = 29,736, 62.4%), and rapid growth (n = 4218, 8.9%). Multinomial logistic regression models were used to determine the associations of prenatal PM2.5 exposure and childhood growth trajectories. Compared to normal growth trajectory, increased PM2.5 exposure in trimester 1, trimester 2 and the entire pregnancy showed significant associations with an increased risk of the slow growth trajectory but reduced the risk for the rapid growth trajectory, significant association of prenatal PM2.5 exposure with rapid growth trajectory was only observed in the trimester 3. Stratified analyses displayed relatively stronger associations among those mothers with maternal age over 35 years, pre-pregnancy BMI ≥ 25 kg/m2, and previous delivery experience. Prenatal exposure to PM2.5, particularly during the midpoint period of pregnancy, was more likely to have a slow growth trajectory and a lower risk of rapid growth trajectory. Maternal age, pre-pregnancy BMI, and previous delivery experience might modify these associations.
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Affiliation(s)
- Yafei Tan
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Xianggang Road, Jiangan District, Wuhan, 430016, Hubei, China
| | - Dan Zhang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Xianggang Road, Jiangan District, Wuhan, 430016, Hubei, China
| | - Pei Xiao
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Xianggang Road, Jiangan District, Wuhan, 430016, Hubei, China
| | - Xiaohui Chen
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Xianggang Road, Jiangan District, Wuhan, 430016, Hubei, China
| | - Yan Zhang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Xianggang Road, Jiangan District, Wuhan, 430016, Hubei, China
| | - Chang Peng
- School of Public Health, Chongqing Medical University, Yuzhong District, No. 1 Yixueyuan Road, Chongqing, 400016, China
| | - Anna Peng
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Xianggang Road, Jiangan District, Wuhan, 430016, Hubei, China.
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Mohamed M, Pallan MJ. Tracking changes in weight status in primary school children in Birmingham: an analysis of the National Child Measurement Programme - a retrospective cohort study. BMJ Paediatr Open 2024; 8:e002547. [PMID: 38991563 PMCID: PMC11331894 DOI: 10.1136/bmjpo-2024-002547] [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: 01/29/2024] [Accepted: 06/23/2024] [Indexed: 07/13/2024] Open
Abstract
One-in-four 4-5 years and more than one-in-three 10-11 years have excess weight in England. AIM To identify characteristics associated with (1) having overweight, obesity and severe obesity at 11 years and (2) rapid weight gain (defined as increasing weight status by one or more body mass index (BMI) categories) between the ages of 4-5 and 10-11 years. METHOD Using National Child Measurement Programme data, BMI at reception (4-5 years) and year 6 (10-11 years) were linked for 15 390 children. Weight categories were identified at both time points using BMI centile classifications.For each child, the number of BMI categories they crossed between reception and year 6 was identified. Logistic regression models were fitted to explore associations with sociodemographic characteristics of children with excess weight at age 10-11 years and with children experiencing rapid weight gain between reception and year 6. RESULTS Overall, 61.9% of children remained in their original weight category; 30% whose weight increased by ≥1 weight categories and 11.7% by ≥2 weight categories. Only 7.8% had decreased ≥1 weight categories and 0.9% had decreased ≥2 weight categories.Adjusting for other sociodemographic characteristics, girls were less likely than boys to increase ≥2 weight categories between reception and year 6 (OR 0.64; 95% CI 0.58 to 0.71; p<0.001). Compared to white children, Asian and mixed-ethnicity children had higher odds of rapid weight gain. Children with the highest deprivation were over 6 times more likely to increase ≥2 weight categories between reception and year 6 compared with children with the lowest deprivation (OR 6.1; 95% CI 1.92 to 19.10; p<0.01). CONCLUSION Male children, children of Asian and mixed ethnicity and children with high deprivation are at higher risk of rapid weight gain and should be targeted for intervention.
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Affiliation(s)
- Muna Mohamed
- Public Health, Birmingham City Council, Birmingham, UK
| | - Miranda J Pallan
- Professor of Child and Adolescent Public Health, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Zheng M, D'Souza NJ, Atkins L, Ghobadi S, Laws R, Szymlek-Gay EA, Grimes C, Baker P, He QQ, Campbell KJ. Breastfeeding and the Longitudinal Changes of Body Mass Index in Childhood and Adulthood: A Systematic Review. Adv Nutr 2024; 15:100152. [PMID: 37977327 PMCID: PMC10714232 DOI: 10.1016/j.advnut.2023.100152] [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: 08/29/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
Mounting evidence supports the beneficial role of breastfeeding in lowering obesity risk, but the enduring impact of breastfeeding on longitudinal changes in body mass index (BMI) (i.e., BMI trajectories) remains unclear. This systematic review summarized evidence on how breastfeeding influenced the longitudinal trajectories of BMI later in life. Literature searches were conducted in Medline, Embase, Web of Science, and ScienceDirect to identify studies that assessed how breastfeeding (versus other feeding types or duration) was associated with longitudinal trajectories of BMI or BMI z-score. Three randomized controlled trials (RCTs) and 24 longitudinal cohort studies were included. Two-thirds (18/27) of studies were rated as acceptable or high quality. Most cohort studies (9/11) showed that children who continued to breastfeed at 3 to 12 mo of age had a lower BMI trajectory or lower odds of following a high BMI trajectory than those who were formula-fed or mixed-fed. The BMI differences between breastfeeding and other feeding groups were evident from age 7 mo and remained up to 8 y, and the magnitude of between-group BMI differences increased with age. For breastfeeding duration, 12 out of 15 cohort studies found that longer breastfeeding duration was associated with lower BMI trajectories up to age 18 y. Moreover, beneficial associations were observed for both exclusive and any breastfeeding with BMI trajectory. In contrast, mixed findings were reported from 3 RCTs that compared BMI trajectories from birth to ages 12 to 24 mo between breastfeeding promotion versus control or breastfeeding versus formula-feeding groups. The current review provides further longitudinal evidence from cohort studies that breastfeeding versus formula/mixed feeding or longer breastfeeding duration was associated with lower BMI trajectories. Such associations initiated in early childhood became more apparent with age and were sustained into early adulthood. The existing evidence substantiates the importance of breastfeeding promotion and continuation to support obesity prevention.
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Affiliation(s)
- Miaobing Zheng
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
| | - Ninoshka J D'Souza
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Linda Atkins
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Saeed Ghobadi
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Rachel Laws
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Ewa A Szymlek-Gay
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Carley Grimes
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Philip Baker
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Qi-Qiang He
- School of Public Health, Wuhan University, Wuhan, Republic of China
| | - Karen J Campbell
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
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Payne E, Garden F, d'Udekem Y, Weintraub R, McCallum Z, Wightman H, Zentner D, Cordina R, Wilson TG, Ayer J. Prolonged Enteral Tube Feeding in Infants With a Functional Single Ventricle Is Associated With Adverse Outcomes After Fontan Completion. J Pediatr 2023:S0022-3476(23)00042-2. [PMID: 36708874 DOI: 10.1016/j.jpeds.2023.01.009] [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: 10/14/2022] [Revised: 01/13/2023] [Accepted: 01/22/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To define the baseline characteristics of long-term tube-fed single ventricle patients, investigate associations between long-term enteral tube feeding and growth, and determine associations with long-term outcomes after Fontan procedure. STUDY DESIGN We performed a retrospective cohort study of patients in the Australia and New Zealand Fontan Registry undergoing treatment at the Royal Children's Hospital, the Children's Hospital at Westmead, Royal Melbourne Hospital, and Royal Prince Alfred Hospital from 1981-2018. Patients were defined as tube-fed (TF) or non-tube-fed (NTF) based on enteral tube feeding at age 90 days. Feeding groups were compared regarding BMI trajectory, BMI at last follow-up, and long-term incidence of severe Fontan failure. RESULTS Of 390 patients (56(14%) TF, 334(86%) NTF), TF was associated with right ventricular dominance, hypoplastic left heart syndrome, Norwood procedure, increased procedures prior to Fontan, extracardiac conduit Fontan, Fontan fenestration, and atrioventricular valve repair/replacement. TF patients were less likely to be in the higher compared with lowest 0-6 month BMI trajectory (P<0.01,P=0.03), had lower 6month weight-for-age z-scores (P<0.01) and length-for-age z-scores (P=0.01). TF were less likely to be overweight/obese at pediatric follow-up (HR=0.31,95%CI:0.12-0.80;P=0.02) and more likely to be underweight at adult follow-up ((HR=16.51; 5%CI:2.70-101.10;P<0.01).TF compared with NTF was associated with increased risk of severe Fontan failure (HR=4.13;95%CI=1.65,10.31;P<0.01). CONCLUSIONS Prolonged infant enteral tube feeding is an independent marker of poor growth and adverse clinical outcomes extending long-term post-Fontan procedure.
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Affiliation(s)
- Emma Payne
- The University of Sydney, Sydney, AUSTRALIA; The University of Melbourne, Melbourne, AUSTRALIA
| | - Frances Garden
- The University of New South, Sydney, AUSTRALIA; The Ingham Institute of Applied Medical Research, Sydney, AUSTRALIA
| | | | - Robert Weintraub
- The University of Melbourne, Melbourne, AUSTRALIA; The Royal Children's Hospital, Melbourne, AUSTRALIA; The Murdoch Children's Research Institute, Melbourne, AUSTRALIA
| | - Zoe McCallum
- The Royal Children's Hospital, Melbourne, AUSTRALIA
| | | | - Dominica Zentner
- The University of Melbourne, Melbourne, AUSTRALIA; The Royal Melbourne Hospital, Melbourne, AUSTRALIA
| | - Rachael Cordina
- The University of Sydney, Sydney, AUSTRALIA; The Royal Prince Alfred Hospital, Sydney, AUSTRALIA
| | - Thomas G Wilson
- The University of Melbourne, Melbourne, AUSTRALIA; The Royal Children's Hospital, Melbourne, AUSTRALIA
| | - Julian Ayer
- The University of Sydney, Sydney, AUSTRALIA; The Heart Centre for Children, The Sydney Children's Hospital Network, Sydney, AUSTRALIA.
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Rousham EK, Goudet S, Markey O, Griffiths P, Boxer B, Carroll C, Petherick ES, Pradeilles R. Unhealthy Food and Beverage Consumption in Children and Risk of Overweight and Obesity: A Systematic Review and Meta-Analysis. Adv Nutr 2022; 13:1669-1696. [PMID: 35362512 PMCID: PMC9526862 DOI: 10.1093/advances/nmac032] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/25/2022] [Accepted: 03/25/2022] [Indexed: 01/28/2023] Open
Abstract
This WHO-commissioned review contributed to the update of complementary feeding recommendations, synthesizing evidence on effects of unhealthy food and beverage consumption in children on overweight and obesity. We searched PubMed (Medline), Cochrane CENTRAL, and Embase for articles, irrespective of language or geography. Inclusion criteria were: 1) randomized controlled trials (RCTs), non-RCTs, cohort studies, and pre/post studies with control; 2) participants aged ≤10.9 y at exposure; 3) studies reporting greater consumption of unhealthy foods/beverages compared with no or low consumption; 4) studies assessing anthropometric and/or body composition; and 5) publication date ≥1971. Unhealthy foods and beverages were defined using nutrient- and food-based approaches. Risk of bias was assessed using the ROBINS-I (risk of bias in nonrandomized studies of interventions version I) and RoB2 [Cochrane RoB (version 2)] tools for nonrandomized and randomized studies, respectively. Narrative synthesis was complemented by meta-analyses where appropriate. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation. Of 26,542 identified citations, 60 studies from 71 articles were included. Most studies were observational (59/60), and no included studies were from low-income countries. The evidence base was low quality, as assessed by ROBINS-I and RoB2 tools. Evidence synthesis was limited by the different interventions and comparators across studies. Evidence indicated that consumption of sugar-sweetened beverages (SSBs) and unhealthy foods in childhood may increase BMI/BMI z-score, percentage body fat, or odds of overweight/obesity (low certainty of evidence). Artificially sweetened beverages and 100% fruit juice consumption make little/no difference to BMI, percentage body fat, or overweight/obesity outcomes (low certainty of evidence). Meta-analyses of a subset of studies indicated a positive association between SSB intake and percentage body fat, but no association with change in BMI and BMI z-score. High-quality epidemiological studies that are designed to assess the effects of unhealthy food consumption during childhood on risk of overweight/obesity are needed to contribute to a more robust evidence base upon which to design policy recommendations. This protocol was registered at https://www.crd.york.ac.uk/PROSPERO as CRD42020218109.
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Affiliation(s)
- E K Rousham
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - S Goudet
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - O Markey
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - P Griffiths
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - B Boxer
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - C Carroll
- School of Health and Related Research, The University of Sheffield, Sheffield, United Kingdom
| | - E S Petherick
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, United Kingdom
| | - R Pradeilles
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
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Payne E, Garden F, d'Udekem Y, McCallum Z, Wightman H, Zannino D, Zentner D, Cordina R, Weintraub R, Wilson TG, Ayer J. Body Mass Index Trajectory and Outcome Post Fontan Procedure. J Am Heart Assoc 2022; 11:e025931. [PMID: 36073652 DOI: 10.1161/jaha.122.025931] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Patients with a single ventricle who experience early life growth failure suffer high morbidity and mortality in the perisurgical period. However, long-term implications of poor infant growth, as well as associations between body mass index (BMI) and outcome in adulthood, remain unclear. We aimed to model BMI trajectories of patients with a single ventricle undergoing a Fontan procedure to determine trajectory-based differences in baseline characteristics and long-term clinical outcomes. Methods and Results We performed a retrospective analysis of medical records from patients in the Australia and New Zealand Fontan Registry receiving treatment at the Royal Children's Hospital, The Children's Hospital at Westmead, Royal Melbourne Hospital, and Royal Prince Alfred Hospital from 1981 to 2018. BMI trajectories were modeled in 496 patients using latent class growth analysis from 0 to 6 months, 6 to 60 months, and 5 to 16 years. Trajectories were compared regarding long-term incidence of severe Fontan failure (defined as mortality, heart transplantation, Fontan takedown, or New York Heart Association class III/IV heart failure). Three trajectories were found for male and female subjects at each age group-lower, middle, higher. Subjects in the lower trajectory at 0 to 6 months were more likely to have an atriopulmonary Fontan and experienced increased mortality long term. No association was found between higher BMI trajectory, current BMI, and long-term outcome. Conclusions Poor growth in early life correlates with increased long-term severe Fontan failure. Delineation of distinct BMI trajectories can be used in larger and older cohorts to find optimal BMI targets for patient outcome.
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Affiliation(s)
- Emma Payne
- The University of Sydney Sydney Australia.,The University of Melbourne Melbourne Australia
| | - Frances Garden
- The University of New South Wales Sydney Australia.,The Ingham Institute of Applied Medical Research Sydney Australia
| | | | - Zoe McCallum
- The University of Melbourne Melbourne Australia.,The Royal Children's Hospital Melbourne Australia
| | | | - Diana Zannino
- Murdoch Children's Research Institute Melbourne Australia
| | - Dominica Zentner
- The University of Melbourne Melbourne Australia.,Royal Melbourne Hospital Melbourne Australia
| | - Rachael Cordina
- The University of Sydney Sydney Australia.,The Royal Prince Alfred Hospital Sydney Australia
| | - Robert Weintraub
- The University of Melbourne Melbourne Australia.,The Royal Children's Hospital Melbourne Australia.,Murdoch Children's Research Institute Melbourne Australia
| | - Thomas G Wilson
- The University of Melbourne Melbourne Australia.,The Royal Children's Hospital Melbourne Australia
| | - Julian Ayer
- The University of Sydney Sydney Australia.,The Heart Centre for Children The Sydney Children's Hospital Network Sydney Australia
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Khalsa AS, Li R, Rausch J, Klebanoff MA, Ingol TT, Boone KM, Keim SA. Early childhood growth trajectories in a Medicaid population. Pediatr Obes 2022; 17:e12918. [PMID: 35307980 PMCID: PMC9357091 DOI: 10.1111/ijpo.12918] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 02/07/2022] [Accepted: 02/28/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Evidence on the role of early growth trajectories and later obesity risk is primarily based on privately insured or universally insured samples. OBJECTIVES We aimed to characterize and determine factors associated with early growth trajectories and estimate associations with overweight/obesity risk in a Medicaid-insured and uninsured cohort. METHODS Infants seen at a large pediatric academic centre in 2010-2016 were included. Weight and length/height measurements were converted to age and sex-specific BMI z-scores (BMIz) based on the World Health Organization (WHO) Growth Standards. Group-based trajectories were modelled using BMIz created groups. Logistic and log-binomial regression models estimated associations between membership in trajectories and maternal/child factors and overweight or obesity at 36, 48, and 60 months, separately. Analyses were performed between 2019 and 2021. RESULTS The best-fitting model identified five BMIz trajectories among 30 189 children and 310 113 clinical encounters; two trajectories showed rapid rise in BMIz. Lower maternal education, pre-pregnancy maternal overweight/obese status, and maternal smoking were positively associated with both rapid-rising BMIz trajectories. Children in either of the two rapid-rising trajectories were 3.00 (95% CI: 2.85, 3.25), 2.97 (95% CI: 2.77, 3.18) and 2.76 (95% CI: 2.53, 3.01) times more likely to have overweight or obesity at 36, 48, and 60 months, respectively compared to children in the stable trajectory groups. CONCLUSIONS Among Medicaid insured and uninsured children, several maternal and child characteristics were associated with early rapid-rise in BMIz. Clinical monitoring of early rapidly rising BMI may be important to address modifiable risk factors for obesity in families from low-income households.
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Affiliation(s)
- Amrik Singh Khalsa
- Division of Primary Care Pediatrics, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205
- Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital 700 Children’s Drive, Columbus, OH 43205
- Department of Pediatrics, College of Medicine, The Ohio State University 370 W. 9th Ave. Columbus, OH 43210
| | - Rui Li
- Department of Hematology, James Cancer Hospital & Solove Research Institute, The Ohio State University Wexner Medical Center 460 W 10th Ave, Columbus, OH 43210
| | - Joseph Rausch
- Department of Pediatrics, College of Medicine, The Ohio State University 370 W. 9th Ave. Columbus, OH 43210
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205
| | - Mark A. Klebanoff
- Department of Pediatrics, College of Medicine, The Ohio State University 370 W. 9th Ave. Columbus, OH 43210
- Center for Perinatal Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205
- Division of Epidemiology, College of Public Health, The Ohio State University 370 W. 9 Ave. Columbus, OH 43210
| | - Taniqua T. Ingol
- Division of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599
| | - Kelly M. Boone
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205
| | - Sarah A. Keim
- Department of Pediatrics, College of Medicine, The Ohio State University 370 W. 9th Ave. Columbus, OH 43210
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205
- Division of Epidemiology, College of Public Health, The Ohio State University 370 W. 9 Ave. Columbus, OH 43210
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11
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Reyna ME, Petersen C, Dai DLY, Dai R, Becker AB, Azad MB, Miliku K, Lefebvre DL, Moraes TJ, Mandhane PJ, Boutin RCT, Finlay BB, Simons E, Kozyrskyj AL, Lou W, Turvey SE, Subbarao P. Longitudinal body mass index trajectories at preschool age: children with rapid growth have differential composition of the gut microbiota in the first year of life. Int J Obes (Lond) 2022; 46:1351-1358. [PMID: 35428865 PMCID: PMC9239911 DOI: 10.1038/s41366-022-01117-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND/OBJECTIVE The steep rise in childhood obesity has emerged as a worldwide public health problem. The first 4 years of life are a critical window where long-term developmental patterns of body mass index (BMI) are established and a critical period for microbiota maturation. Understanding how the early-life microbiota relate to preschool growth may be useful for identifying preventive interventions for childhood obesity. We aim to investigate whether longitudinal shifts within the bacterial community between 3 months and 1 year of life are associated with preschool BMI z-score trajectories. METHODS BMI trajectories from birth to 5 years of age were identified using group-based trajectory modeling in 3059 children. Their association with familial and environmental factors were analyzed. Infant gut microbiota at 3 months and 1 year was defined by 16S RNA sequencing and changes in diversity and composition within each BMIz trajectory were analyzed. RESULTS Four BMIz trajectories were identified: low stable, normative, high stable, and rapid growth. Infants in the rapid growth trajectory were less likely to have been breastfed, and gained less microbiota diversity in the first year of life. Relative abundance of Akkermansia increased with age in children with stable growth, but decreased in those with rapid growth, abundance of Ruminococcus and Clostridium at 1 year were elevated in children with rapid growth. Children who were breastfed at 6 months had increased levels of Sutterella, and decreased levels of Ruminococcus and Clostridium. CONCLUSION This study provides new insights into the relationship between the gut microbiota in infancy and patterns of growth in a cohort of preschool Canadian children. We highlight that rapid growth since birth is associated with bacteria shown in animal models to have a causative role in weight gain. Our findings support a novel avenue of research targeted on tangible interventions to reduce childhood obesity.
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Affiliation(s)
- Myrtha E Reyna
- Translational Medicine Program, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Charisse Petersen
- Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Darlene L Y Dai
- Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Ruixue Dai
- Translational Medicine Program, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Allan B Becker
- Section of Allergy and Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
- Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital, Winnipeg, MB, Canada
| | - Meghan B Azad
- Section of Allergy and Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
- Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital, Winnipeg, MB, Canada
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Kozeta Miliku
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Diana L Lefebvre
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Theo J Moraes
- Translational Medicine Program, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Rozlyn C T Boutin
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
| | - B Brett Finlay
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
- Michael Smith Laboratories, UBC, Vancouver, BC, Canada
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC, Canada
| | - Elinor Simons
- Section of Allergy and Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Anita L Kozyrskyj
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Stuart E Turvey
- Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Padmaja Subbarao
- Translational Medicine Program, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
- Department of Medicine, McMaster University, Hamilton, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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12
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Taneja S, Upadhyay RP, Chowdhury R, Kurpad AV, Bhardwaj H, Kumar T, Dwarkanath P, Bose B, Devi S, Kumar G, Kaur B, Bahl R, Bhandari N. Impact of supplementation with milk-cereal mix during 6-12 months of age on growth at 12 months: a 3-arm randomized controlled trial in Delhi, India. Am J Clin Nutr 2021; 115:83-93. [PMID: 34637505 PMCID: PMC8754995 DOI: 10.1093/ajcn/nqab304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/31/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A large proportion of infants in low- and middle-income countries are stunted. These infants are often fed complementary foods that are low-quality, primarily in terms of protein and micronutrients. OBJECTIVES We aimed to test 2 milk-cereal mixes supplemented with modest and high amounts of protein during 6-12 mo of age, compared with no supplementation, for their effect on length-for-age z score (LAZ) at 12 mo of age. METHODS Eligible infants (6 mo plus ≤29 d) were randomly assigned to either of the 2 interventions (modest- and high-protein) or a no supplement group. The milk-cereal mixes provided ∼125 kcal, 30%-45% energy from fats, and 80%-100% RDA of multiple micronutrients (MMN). The modest-protein group received 2.5 g protein [protein energy ratio (PER): 8%; 0.75 g from milk source] and the high-protein group received 5.6 g protein (PER: 18%, 1.68 g from milk source). One packet was given daily for 180 d. Counseling on continued breastfeeding and optimal infant-care practices was provided to all. RESULTS We enrolled 1548 infants (high-protein: n = 512; modest-protein: n = 519; and no supplement: n = 517). Compared with the no supplement group, there was an improvement in LAZ [adjusted mean difference (MD): 0.08; 95% CI: 0.01, 0.15], weight-for-age z score (MD: 0.12; 95% CI: 0.06, 0.19), weight-for-length z score (MD: 0.11; 95% CI: 0.02, 0.19), and midupper arm circumference z score (MD: 0.10; 95% CI: 0.02, 0.18) in the high-protein group at 12 mo of age. No significant differences for these anthropometric indicators were noted between the modest-protein and no supplement groups or between the high- and modest-protein groups. CONCLUSIONS Cereal mixes with higher amounts of milk-based protein and MMN may lead to improvement in linear growth and other anthropometric indexes in infants, compared with no supplementation.This trial was registered at ctri.nic.in as CTRI/2018/04/012932.
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Affiliation(s)
- Sunita Taneja
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Ravi P Upadhyay
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Ranadip Chowdhury
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Anura V Kurpad
- Department of Physiology, St John's Medical College, Bengaluru, India
| | - Himani Bhardwaj
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Tivendra Kumar
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | | | - Beena Bose
- Department of Physiology, St John's Medical College, Bengaluru, India
| | - Sarita Devi
- Department of Physiology, St John's Medical College, Bengaluru, India
| | - Gunjan Kumar
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Baljeet Kaur
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Rajiv Bahl
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
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13
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Zheng M, Campbell KJ, Baur L, Rissel C, Wen LM. Infant feeding and growth trajectories in early childhood: the application and comparison of two longitudinal modelling approaches. Int J Obes (Lond) 2021; 45:2230-2237. [PMID: 34230577 DOI: 10.1038/s41366-021-00892-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 05/11/2021] [Accepted: 06/24/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVES The role of infant feeding practices in longitudinal growth trajectories in children remains equivocal. This study utilised two longitudinal approaches to examine the associations of infant feeding mode (breastfeeding, mixed feeding, formula feeding), breastfeeding duration, and the timing of solid foods introduction with body mass index (BMI) z-score in early childhood. SUBJECTS/METHODS Secondary analyses of data from the Healthy Beginnings Trial were conducted. Infant feeding practices were reported by mothers at 6, 12, and 24 months of child age. Child weight and length were measured at birth, 12, 24, 42, and 60 months. Two longitudinal approaches: linear spline multilevel model (LSMM) and group-based trajectory modelling (GBTM) were used to describe BMI z-score trajectories and assess its associations with infant feeding practices. RESULTS The LSMM approach demonstrated that the breastfeeding group showed lower BMI z-scores from ages 12 to 60 months than the mixed feeding and formula feeding groups. Children who were breastfed for ≥ 6 versus < 6 months exhibited a lower BMI z-score trajectory from ages 12 to 60 months. Results from the GBTM approach revealed that the mixed feeding (OR: 1.83, 95%CI 1.04, 3.21) and the formula feeding group (OR: 2.00, 95%CI 0.67, 5.92) showed a tendency for higher odds of following the "High BMIz" trajectory than the breastfeeding group. Breastfeeding duration ≥6 versus < 6 months was linked with lower odds of following the "High BMIz" trajectory (OR 0.65, 95%CI 0.43, 0.98). Both approaches revealed no evidence of an association between the timing of solid foods introduction and BMI z-score trajectory. CONCLUSIONS The two longitudinal approaches revealed similar findings that infant feeding mode and breastfeeding duration, but not the timing of solid foods introduction, were associated with BMI z-score trajectory in early childhood. The findings provide robust longitudinal evidence to encourage and support extended breastfeeding for childhood obesity prevention.
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Affiliation(s)
- Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Louise Baur
- School of Public Health and Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Chris Rissel
- School of Public Health and Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Li Ming Wen
- School of Public Health and Sydney Medical School, The University of Sydney, Sydney, Australia.,Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, NSW, Sydney, Australia
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14
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Huvinen E, Tuomaala AK, Bergman PH, Meinilä J, Tammelin T, Kulmala J, Engberg E, Koivusalo SB. Ascending Growth is Associated with Offspring Adiposity in Pregnancies Complicated with Obesity or Gestational Diabetes. J Clin Endocrinol Metab 2021; 106:e1993-e2004. [PMID: 33524144 DOI: 10.1210/clinem/dgaa979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Early growth is associated with childhood adiposity, but the influence of lifestyle remains unknown. OBJECTIVE This work aimed to investigate the association of growth profiles from high-risk pregnancies with adiposity at age 5 years, taking into account lifestyle and several antenatal/postnatal exposures. METHODS This prospective cohort study. INCLUDED 609 children born during the Finnish Gestational Diabetes Prevention Study (RADIEL), recruiting women with body mass index (BMI) greater than or equal to 30 and/or prior gestational diabetes mellitus (GDM) (2008-2013). Altogether 332 children attended the 5-year follow-up (2014-2017). Main outcome measures included growth profiles based on ponderal index (PI = weight/height3), investigated using latent class mixed models. Adiposity was assessed with anthropometrics and body composition (InBody720). RESULTS We identified 3 growth profiles: ascending (n = 82), intermediate (n = 351), and descending (n = 149). Children with ascending growth had a higher body fat percentage, ISO-BMI, and waist circumference (P < .05) at age 5 years. Ascending (β 4.09; CI, 1.60-6.58) and intermediate (β 2.27; CI, 0.50-4.03) profiles were associated with higher fat percentage, even after adjustment for age, sex, gestational age, diet, physical activity, education, and prepregnancy BMI. Similar associations existed with ISO-BMI. After adjusting for age and education, ascending growth was associated with prepregnancy BMI (odds ratio [OR] 1.06; CI, 1.01-1.12), primiparity (OR 3.07; CI, 1.68-5.62), cesarean delivery (OR 2.23; CI, 1.18-4.21), and lifestyle intervention (OR 2.56; CI, 1.44-4.57). However, meeting the intervention goals and exclusive breastfeeding for 3 months or more were associated with lower odds of ascending growth. CONCLUSION Accelerated early growth was associated with higher adiposity in 5-year-old children from high-risk pregnancies, even when adjusted for lifestyle. Reducing cesarean deliveries and promoting breastfeeding may be beneficial for postnatal growth.
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Affiliation(s)
- Emilia Huvinen
- Teratology Information Service, Emergency Medicine, Department of Prehospital Emergency Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anna-Kaisa Tuomaala
- Department of Pediatrics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Paula H Bergman
- Biostatistics Consulting, Department of Public Health, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jelena Meinilä
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Tuija Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Janne Kulmala
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Elina Engberg
- Folkhälsan Research Center, Helsinki, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Saila B Koivusalo
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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15
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Wu AJ, Aris IM, Rifas-Shiman SL, Oken E, Taveras EM, Hivert MF. Longitudinal associations of fruit juice intake in infancy with DXA-measured abdominal adiposity in mid-childhood and early adolescence. Am J Clin Nutr 2021; 114:117-123. [PMID: 33829237 PMCID: PMC8246602 DOI: 10.1093/ajcn/nqab043] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 02/08/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Excessive abdominal adiposity is associated with health risks in children and adults. Higher consumption of fruit juice and other sources of fructose has been shown to promote weight gain and specifically visceral adiposity in adulthood. OBJECTIVES We aimed to examine the longitudinal associations of fruit juice intake in infancy with visceral adiposity in mid-childhood and early adolescence. METHODS We analyzed data from 783 participants in Project Viva, a US prebirth cohort. Our exposure was fruit juice intake at 1 y old. We measured visceral adipose tissue (VAT), subcutaneous abdominal adipose tissue (SAAT), and total abdominal adipose tissue (TAAT) in mid-childhood (mean age 7.8 ± 0.7 y) and early adolescence (13 ± 0.8 y) using DXA. We examined longitudinal associations of fruit juice intake at 1 y with VAT, SAAT, and TAAT area sex-specific standard deviation scores (SDSs) in mid-childhood and early adolescence using linear mixed models. We adjusted for child age at outcome, sex, race/ethnicity, age and BMI z-score at 1 y-questionnaire, maternal prepregnancy BMI, level of education, and prenatal sugar-sweetened beverage intake, paternal BMI, and median household income at birth. RESULTS After adjusting for child and parental covariates, each serving (120 mL) per day of fruit juice intake at 1 y was associated with persistently greater VAT area SDS (β = 0.08; 95% CI: 0.03, 0.13) at both timepoints in boys and girls. The association of fruit juice intake with VAT appeared stronger than that with SAAT (β = 0.05; 95% CI: 0.00, 0.09) and TAAT (β = 0.05; 95% CI: 0.01, 0.10). CONCLUSIONS Higher fruit juice intake in infancy was associated with greater abdominal adiposity, particularly VAT, in mid-childhood and early adolescence. Our findings support limiting fruit juice intake in infancy, which can have later impact on visceral adiposity in childhood and adolescence.Clinical Trial Registry number: NCT02820402 (https://clinicaltrials.gov/ct2/show/NCT02820402).
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Affiliation(s)
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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16
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Tan Y, Liao J, Zhang B, Mei H, Peng A, Zhao J, Zhang Y, Yang S, He M. Prenatal exposure to air pollutants and early childhood growth trajectories: A population-based prospective birth cohort study. ENVIRONMENTAL RESEARCH 2021; 194:110627. [PMID: 33345893 DOI: 10.1016/j.envres.2020.110627] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Air pollution exposure during pregnancy has been documented to be associated with impaired fetal growth and adverse birth outcomes, but the evidence regarding the effects of air pollution on early childhood growth is still limited. OBJECTIVE We aimed to explore the associations of exposure to air pollutants during pregnancy with childhood growth trajectories from birth to age of 6 years. METHODS A prospective cohort study based on the administrative registration system was conducted covering 62,540 births in Wuhan, China between January 1, 2011 and December 31, 2013 and followed for 6 years. Inverse distance weighted method was used to estimate the concentrations of air pollutants exposure for pregnant women. Group-based trajectory models (GBTM) were used to identify growth patterns of children: slow growth, normal growth, and rapid growth. Multinomial logistic regression models were used to examine the associations between prenatal exposure to air pollutants and childhood growth trajectories with adjustment for maternal age, educational status, pre-pregnancy BMI, residential areas, gestational diabetes, birth type, gender of infant, and breastfeeding duration. RESULTS The mean (SD) of prenatal exposure concentrations for PM10, SO2, NO2, CO, and O3 were 107.9 (30.4), 32.8(12.6), 55.8(13.1), 1081.2(293.1), and 81.6(31.0) μg/m3 respectively. Compared with normal growth trajectory, increased PM10 and CO exposure were significantly associated with higher risk of slow growth trajectory but lower risk of rapid growth trajectory. An increase in prenatal exposure to NO2 significantly increased both the risk of slow growth trajectory and rapid growth trajectory. Increased prenatal SO2 exposure was significantly associated with rapid growth trajectory and was not associated with low growth trajectory. With O3 exposure levels increased, risk to be rapid growth trajectory decreased. Prenatal air pollutants exposure had a greater impact on childhood growth of children who were girls, and those mothers lived in rural areas and were normal weight before pregnancy. CONCLUSIONS High levels of air pollutants exposure during pregnancy were associated with the risk of being in a trajectory with the deviation of BMI gain from birth to 6 years old. These findings suggest that efforts to identify children at risk of growth deviation in early childhood should pay attention to environmental exposure during pregnancy for their mothers.
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Affiliation(s)
- Yafei Tan
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Qiaokou District, Wuhan, 430030, Hubei, China; Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, No. 100 Hongkong Road, Jiangan District, Wuhan, 430016, Hubei, China
| | - Jiaqiang Liao
- West China School of Public Health, Sichuan University, No. 17 People's South Road, Wuhou District, Chengdu, 610041, China
| | - Bin Zhang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, No. 100 Hongkong Road, Jiangan District, Wuhan, 430016, Hubei, China
| | - Hong Mei
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, No. 100 Hongkong Road, Jiangan District, Wuhan, 430016, Hubei, China
| | - Anna Peng
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, No. 100 Hongkong Road, Jiangan District, Wuhan, 430016, Hubei, China
| | - Jinzhu Zhao
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jie Fang Avenue, Qiaokou District, Wuhan, 430030, China
| | - Yan Zhang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, No. 100 Hongkong Road, Jiangan District, Wuhan, 430016, Hubei, China
| | - Shaoping Yang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, No. 100 Hongkong Road, Jiangan District, Wuhan, 430016, Hubei, China.
| | - Meian He
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Qiaokou District, Wuhan, 430030, Hubei, China.
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17
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Ferré N, Luque V, Closa-Monasterolo R, Zaragoza-Jordana M, Gispert-Llauradó M, Grote V, Koletzko B, Escribano J. Association of Protein Intake during the Second Year of Life with Weight Gain-Related Outcomes in Childhood: A Systematic Review. Nutrients 2021; 13:583. [PMID: 33578699 PMCID: PMC7916342 DOI: 10.3390/nu13020583] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 12/19/2022] Open
Abstract
There is accumulating evidence that early protein intake is related with weight gain in childhood. However, the evidence is mostly limited to the first year of life, whereas the high-weight-gain-velocity period extends up to about 2 years of age. We aimed to investigate whether protein intake during the second year of life is associated with higher weight gain and obesity risk later in childhood. We conducted a systematic review with searches in both PubMed®/MEDLINE® and the Cochrane Central Register of Controlled Trials. Ten studies that assessed a total of 46,170 children were identified. We found moderate-quality evidence of an association of protein intake during the second year of life with fat mass at 2 years and at 7 years. Effects on other outcomes such as body mass index (BMI), obesity risk, or adiposity rebound onset were inconclusive due to both heterogeneity and low evidence. We conclude that higher protein intakes during the second year of life are likely to increase fatness in childhood, but there is limited evidence regarding the association with other outcomes such as body mass index or change in adiposity rebound onset. Further well-designed and adequately powered clinical trials are needed since this issue has considerable public health relevance.
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Affiliation(s)
- Natalia Ferré
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, 43201 Reus, Spain; (N.F.); (V.L.); (R.C.-M.)
- Institut d’Investigació Sanitaria Pere Virgili, 43001 Tarragona, Spain; (M.Z.-J.); (M.G.-L.)
| | - Verónica Luque
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, 43201 Reus, Spain; (N.F.); (V.L.); (R.C.-M.)
- Institut d’Investigació Sanitaria Pere Virgili, 43001 Tarragona, Spain; (M.Z.-J.); (M.G.-L.)
| | - Ricardo Closa-Monasterolo
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, 43201 Reus, Spain; (N.F.); (V.L.); (R.C.-M.)
- Institut d’Investigació Sanitaria Pere Virgili, 43001 Tarragona, Spain; (M.Z.-J.); (M.G.-L.)
- Pediatrics Unit, Hospital Universitari de Tarragona Joan XXIII, 43005 Tarragona, Spain
| | - Marta Zaragoza-Jordana
- Institut d’Investigació Sanitaria Pere Virgili, 43001 Tarragona, Spain; (M.Z.-J.); (M.G.-L.)
| | | | - Veit Grote
- Department Paediatrics, Dr. von Hauner Children’s Hospital, LMU University Hospital, Ludwig-Maximilians Universität München, 43201 Munich, Germany; (V.G.); (B.K.)
| | - Berthold Koletzko
- Department Paediatrics, Dr. von Hauner Children’s Hospital, LMU University Hospital, Ludwig-Maximilians Universität München, 43201 Munich, Germany; (V.G.); (B.K.)
| | - Joaquín Escribano
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, 43201 Reus, Spain; (N.F.); (V.L.); (R.C.-M.)
- Institut d’Investigació Sanitaria Pere Virgili, 43001 Tarragona, Spain; (M.Z.-J.); (M.G.-L.)
- Pediatrics Unit, Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain
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18
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Jasper EA, Cho H, Breheny PJ, Bao W, Dagle JM, Ryckman KK. Perinatal determinants of growth trajectories in children born preterm. PLoS One 2021; 16:e0245387. [PMID: 33507964 PMCID: PMC7842887 DOI: 10.1371/journal.pone.0245387] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/29/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A growing amount of evidence indicates in utero and early life growth has profound, long-term consequences for an individual's health throughout the life course; however, there is limited data in preterm infants, a vulnerable population at risk for growth abnormalities. OBJECTIVE To address the gap in knowledge concerning early growth and its determinants in preterm infants. METHODS A retrospective cohort study was performed using a population of preterm (< 37 weeks gestation) infants obtained from an electronic medical record database. Weight z-scores were acquired from discharge until roughly two years corrected age. Linear mixed effects modeling, with random slopes and intercepts, was employed to estimate growth trajectories. RESULTS Thirteen variables, including maternal race, hypertension during pregnancy, preeclampsia, first trimester body mass index, multiple status, gestational age, birth weight, birth length, head circumference, year of birth, length of birth hospitalization stay, total parenteral nutrition, and dextrose treatment, were significantly associated with growth rates of preterm infants in univariate analyses. A small percentage (1.32% - 2.07%) of the variation in the growth of preterm infants can be explained in a joint model of these perinatal factors. In extremely preterm infants, additional variation in growth trajectories can be explained by conditions whose risk differs by degree of prematurity. Specifically, infants with periventricular leukomalacia or retinopathy of prematurity experienced decelerated rates of growth compared to infants without such conditions. CONCLUSIONS Factors found to influence growth over time in children born at term also affect growth of preterm infants. The strength of association and the magnitude of the effect varied by gestational age, revealing that significant heterogeneity in growth and its determinants exists within the preterm population.
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Affiliation(s)
- Elizabeth A. Jasper
- Department of Epidemiology, University of Iowa, Iowa City, IA, United States of America
- * E-mail:
| | - Hyunkeun Cho
- Department of Biostatistics, University of Iowa, Iowa City, IA, United States of America
| | - Patrick J. Breheny
- Department of Biostatistics, University of Iowa, Iowa City, IA, United States of America
| | - Wei Bao
- Department of Epidemiology, University of Iowa, Iowa City, IA, United States of America
| | - John M. Dagle
- Department of Pediatrics, University of Iowa, Iowa City, IA, United States of America
| | - Kelli K. Ryckman
- Department of Epidemiology, University of Iowa, Iowa City, IA, United States of America
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19
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Community context, birth cohorts and childhood body mass index trajectories: Evidence from the China nutrition and health survey 1991-2011. Health Place 2020; 66:102455. [PMID: 33011489 DOI: 10.1016/j.healthplace.2020.102455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 09/05/2020] [Accepted: 09/14/2020] [Indexed: 02/06/2023]
Abstract
Childhood overweight and obesity have shown an increase in recent birth cohorts. China has undergone rapid socioeconomic transitions accompanied by lifestyle changes that have profoundly affected the physical growth of children. Less empirical research has considered the role of community context on the cohort effects of children's body mass index (BMI) z-score trajectories. We used the mixed effect models for repeated measurements with restricted cubic spline to predict the BMI z-score trajectories in children aged 1-17 years, influenced by different birth cohorts and community context using data from the China Health and Nutrition Survey from 1991 to 2011, and stratified by sex. Results indicated that the mean of BMI z-scores of children aged 1-17 years have increased in the 2000s cohort. Community context contributed to significant differences in BMI z-score increase with age from middle childhood, and this trend of community inequalities divergences in middle childhood in recent birth cohorts. Therefore, to promote equitable growth for all children in China, policy interventions focusing on the community context may have far-reaching effects on the health of children and adolescents.
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20
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Zheng M, Cameron AJ, Birken CS, Keown-Stoneman C, Laws R, Wen LM, Campbell KJ. Early Infant Feeding and BMI Trajectories in the First 5 Years of Life. Obesity (Silver Spring) 2020; 28:339-346. [PMID: 31970916 DOI: 10.1002/oby.22688] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 09/26/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study examined the relative impact of breastfeeding duration and timing of solids introduction on BMI z score (BMIz) trajectory in early childhood. METHODS This study conducted secondary analyses of data from the Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program (N = 542), a prospective cohort study with data collected at birth and 3, 9, 18, 42, and 60 months. Linear spline multilevel models were performed. RESULTS Differential growth rates were observed from birth to 3 months and from 9 to 18 months by breastfeeding duration (≥ 6 vs. < 6 months) and timing of solids introduction (before vs. after 6 months). Children who were breastfed for ≥ 6 versus < 6 months had lower BMIz at all ages from 3 to 60 months. The difference remained after adjusting for child and maternal factors, and the adjusted mean differences in BMIz at 3, 9, 18, 42, and 60 months were -0.34, -0.44, -0.13, -0.19, and -0.23, respectively. Children who received solids before versus after 6 months of age had higher BMIz at 18 and 42 months, but adjustment for child and maternal factors attenuated these differences. CONCLUSIONS Longer breastfeeding duration was associated with lower BMIz to 5 years of age, providing further support for infant feeding guidelines to prolong breastfeeding duration for healthy growth.
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Affiliation(s)
- Miaobing Zheng
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Adrian J Cameron
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Catherine S Birken
- Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Charles Keown-Stoneman
- Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Rachel Laws
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Li Ming Wen
- School of Public Health and Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Population Health Research and Evaluation Hub, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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21
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Zhu Z, Chang S, Cheng Y, Qi Q, Li S, Elhoumed M, Yan H, Dibley MJ, Fawzi WW, Zeng L, Sudfeld CR. Early life cognitive development trajectories and intelligence quotient in middle childhood and early adolescence in rural western China. Sci Rep 2019; 9:18315. [PMID: 31797987 PMCID: PMC6892923 DOI: 10.1038/s41598-019-54755-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 11/19/2019] [Indexed: 12/24/2022] Open
Abstract
The relationship of cognitive developmental trajectories during the dynamic first years with later life development outcomes remains unclear in low- and middle-income countries. 1388 Children born to women who participated in a randomized trial of antenatal micronutrient supplementation in rural China were prospectively followed. Cognitive development was assessed six times between 3 and 30 months of age using Bayley Scales of Infant Development, and then in mid-childhood (7-9 years) and early adolescence (10-12 years) using Wechsler Intelligence Scale for Children. We identified four distinct infant cognitive development trajectory subgroups using group-based trajectory modeling: (i) consistently above average, (ii) consistently average, (iii) started below average and then improved, and (iv) started below average and then declined. LBW infants (<2500 g) were 10.60 times (95% CI 3.57, 31.49) more likely to be in the trajectory group that started below average and then declined, while each grade increase in maternal education decreased the risk of being in this group by 73% (95% CI 54%, 84%). Infants who performed consistently above average had 8.02 (95% CI 1.46, 14.59) points higher IQ in adolescence versus the declining trajectory group. These findings suggest that interventions to improve early child development trajectories may produce long-term human capital benefits.
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Affiliation(s)
- Zhonghai Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, P.R. China
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Suying Chang
- United Nations Children's Fund, China Office, Beijing, 100600, P.R. China
| | - Yue Cheng
- Department of Nutrition and Food Safety Research, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, P.R. China
| | - Qi Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, P.R. China
| | - Shaoru Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, P.R. China
| | - Mohamed Elhoumed
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, P.R. China
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, P.R. China
- Nutrition and Food Safety Engineering Research Center of Shaanxi Province, Xi'an, 710061, Shaanxi, China
- Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, Xi'an, 710061, Shaanxi, China
| | - Michael J Dibley
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, P.R. China.
- Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, Xi'an, 710061, Shaanxi, China.
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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22
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Tang M. The impact of complementary feeding foods of animal origin on growth and the risk of overweight in infants. Anim Front 2019; 9:5-11. [PMID: 31667006 PMCID: PMC6798784 DOI: 10.1093/af/vfz037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Minghua Tang
- Section of Nutrition, Department of Pediatrics, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
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23
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Castenmiller J, de Henauw S, Hirsch-Ernst KI, Kearney J, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Naska A, Pelaez C, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Bresson JL, Fewtrell M, Kersting M, Przyrembel H, Dumas C, Titz A, Turck D. Appropriate age range for introduction of complementary feeding into an infant's diet. EFSA J 2019; 17:e05780. [PMID: 32626427 PMCID: PMC7009265 DOI: 10.2903/j.efsa.2019.5780] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Following a request from the European Commission, the Panel on Nutrition, Novel Foods and Food Allergens (NDA) revised its 2009 Opinion on the appropriate age for introduction of complementary feeding of infants. This age has been evaluated considering the effects on health outcomes, nutritional aspects and infant development, and depends on the individual's characteristics and development. As long as foods have an age-appropriate texture, are nutritionally appropriate and prepared following good hygiene practices, there is no convincing evidence that at any age investigated in the included studies (< 1 to < 6 months), the introduction of complementary foods (CFs) is associated with adverse health effects or benefits (except for infants at risk of iron depletion). For nutritional reasons, the majority of infants need CFs from around 6 months of age. Infants at risk of iron depletion (exclusively breastfed infants born to mothers with low iron status, or with early umbilical cord clamping (< 1 min after birth), or born preterm, or born small-for-gestational age or with high growth velocity) may benefit from earlier introduction of CFs that are a source of iron. The earliest developmental skills relevant for consuming pureed CFs can be observed between 3 and 4 months of age. Skills for consuming finger foods can be observed in some infants at 4 months, but more commonly at 5-7 months. The fact that an infant may be ready from a neurodevelopmental perspective to progress to a more diversified diet before 6 months of age does not imply that there is a need to introduce CFs. There is no reason to postpone the introduction of potentially allergenic foods (egg, cereals, fish and peanut) to a later age than that of other CFs as far as the risk of developing atopic diseases is concerned. Regarding the risk of coeliac disease, gluten can be introduced with other CFs.
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24
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Zulfiqar T, Burns RA, D’Este C, Strazdins L. BMI trajectories and risk factors among 2-11-year-old children by their immigrant status: evidence from the Longitudinal Study of Australian Children. BMJ Open 2019; 9:e026845. [PMID: 31289070 PMCID: PMC6615842 DOI: 10.1136/bmjopen-2018-026845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 05/14/2019] [Accepted: 05/31/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This study aimed to identify body mass index (BMI) trajectories and their predictors in Australian children by their maternal immigrant status. METHODS Data on 4142 children aged 2-3 years were drawn from the birth cohort of the Longitudinal Study of Australian Children. BMI was calculated according to the International Obesity Task Force cut-off points. Immigrant status was determined by the Australian Bureau of Statistics and the United Nations Development Programme, Human Development Index criteria. Latent class growth analysis estimated distinct BMI trajectories, and multinomial logistic regression analysis examined factors associated with these BMI trajectories. RESULTS Two BMI groups and six BMI trajectories were identified. The stable trajectories group included high-risk (10%, n=375), moderate-risk (5%, n=215) and low-risk (68%, n=2861) BMI trajectories. The changing trajectories group included delayed-risk (6%, n=234), gradual-risk (8%, n=314) and declining-risk (3%, n=143) BMI trajectories. We found some evidence that children of immigrants from low-and middle-income countries were more likely to have moderate-risk and high-risk BMI trajectories compared with low-risk BMI trajectory. However, these associations were insignificant in fully adjusted models. The explanatory risk factors for moderate-risk and high-risk BMI trajectory were birth weight, family socioeconomic position, and organised sports participation. Our results also suggest that 4-7 years of age may be important for the prevention of overweight/obesity in children. DISCUSSION A better understanding of the risk factors associated with distinct BMI trajectories in immigrant children will inform effective preventive strategies. Some of these risk factors such as non-participation in organised sports, and high screen time, may also impede the integration of immigrant children into the host culture. Obesity prevention strategies aimed at increasing physical activities in immigrant children could help deliver a social and health benefit by increasing social integration among children of immigrants and Australians.
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Affiliation(s)
- Tehzeeb Zulfiqar
- National Centre for Epidemiology & Population Health, Research School of Population Health - ANU, Canberra, Australian Capital Territory, Australia
| | - Richard A Burns
- Centre for Research on Ageing, Health & Wellbeing, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Catherine D’Este
- National Centre for Epidemiology & Population Health, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Lyndall Strazdins
- National Centre for Epidemiology & Population Health, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
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25
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Araújo CS, de Farias Costa PR, de Oliveira Queiroz VA, de Santana MLP, Miranda EP, Pitangueira JCD, de Assis AM. Age of introduction of complementary feeding and overweight in adolescence and adulthood: A systematic review. MATERNAL & CHILD NUTRITION 2019; 15:e12796. [PMID: 30768755 PMCID: PMC7198921 DOI: 10.1111/mcn.12796] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 01/23/2019] [Accepted: 01/29/2019] [Indexed: 11/27/2022]
Abstract
Recent studies on early infant feeding suggest that the type of diet and age of starting complementary foods may have a positive correlation with overweight in adolescence and adulthood. This study aimed to systematically review the evidence on the relationship between the age of introduction of complementary feeding and excess weight in adolescence and adulthood (PROSPERO: CRD42017067764). The preferred reporting items for systematic reviews and meta-analyses standards were used as a reference. Articles were researched on Medline via PubMed, Web of Science, Embase, Lilacs, Ovid, and Scopus, between June and December 2017. Descriptors were defined according to Medical Subject Heading. Of the 103 articles selected for complete reading, nine were included in the review. Of these, only three found an association between the age of introduction of complementary feeding and overweight. Despite these findings, the studies presented a high heterogeneity, mainly due to the difference in cut-off points for the age of introduction of complementary feeding and the classification of overweight. We concluded that the evidence was not consistent enough to confirm the existence of the association.
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Affiliation(s)
- Cybele Sodré Araújo
- Postgraduate Program in NutritionFederal University of Bahia (UFBA)SalvadorBrazil
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26
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Mattsson M, Maher GM, Boland F, Fitzgerald AP, Murray DM, Biesma R. Group-based trajectory modelling for BMI trajectories in childhood: A systematic review. Obes Rev 2019; 20:998-1015. [PMID: 30942535 DOI: 10.1111/obr.12842] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/19/2019] [Accepted: 01/20/2019] [Indexed: 12/24/2022]
Abstract
Childhood obesity is an important public health issue. We aimed to systematically review studies that used group-based trajectory modelling approaches to investigate body mass index (BMI) trajectories in early childhood, explore associated determinants, and the association with body composition outcomes. Five databases were searched systematically for studies using group-based trajectory modelling approaches to track BMI trajectories from birth. Fourteen studies using latent class growth analysis or growth mixture modelling to track BMI trajectories were identified. Three or four trajectories were identified in most studies. High maternal pre-pregnancy BMI was the most frequently identified risk factor for membership of a rapid gain trajectory. Significant associations between rapid weight gain and stable high trajectories and body measures at follow-up were identified by several studies. Relatively similar trajectories were identified across studies. Trajectories characterized by rapid weight gain were associated with several predictors, as well as body measures at follow-up, however not with great consistency. Similar associations with body measure outcomes were found for stable high and rapid gain trajectories, suggesting that long-term outcomes do not differ greatly between children with consistently high BMI and children with rapid increases in BMI. As the shape and timing of the trajectories differed between studies, it is difficult to draw conclusions.
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Affiliation(s)
- Molly Mattsson
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Gillian M Maher
- School of Public Health, University College Cork, Cork, Ireland
| | - Fiona Boland
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Deirdre M Murray
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Regien Biesma
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
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27
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Garden FL, Toelle BG, Mihrshahi S, Webb KL, Almqvist C, Tovey ER, Brew BK, Ayer JG, Skilton MR, Jones G, Ferreira MAR, Cowie CT, Weber-Chrysochoou C, Britton WJ, Celermajer DS, Leeder SR, Peat JK, Marks GB. Cohort profile: The Childhood Asthma Prevention Study (CAPS). Int J Epidemiol 2019; 47:1736-1736k. [PMID: 29800224 DOI: 10.1093/ije/dyy078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2018] [Indexed: 12/22/2022] Open
Affiliation(s)
- Frances L Garden
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.,Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Brett G Toelle
- Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia.,Sydney Local Health District, Sydney, NSW, Australia
| | - Seema Mihrshahi
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Karen L Webb
- Nutrition Policy Institute, University of California, Berkeley, CA, USA
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Euan R Tovey
- Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Bronwyn K Brew
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Julian G Ayer
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Heart Centre for Children, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Michael R Skilton
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, NSW, Australia
| | - Graham Jones
- School of Science and Health, Western Sydney University, Sydney, NSW, Australia
| | | | - Christine T Cowie
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.,Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
| | | | - Warwick J Britton
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Mycobacterial Research Program, Centenary Institute, Sydney, NSW, Australia
| | - David S Celermajer
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Stephen R Leeder
- Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, Australia
| | - Jennifer K Peat
- Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Guy B Marks
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.,Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
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28
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Robinson HA, Dam R, Hassan L, Jenkins D, Buchan I, Sperrin M. Post-2000 growth trajectories in children aged 4-11 years: A review and quantitative analysis. Prev Med Rep 2019; 14:100834. [PMID: 30976485 PMCID: PMC6439270 DOI: 10.1016/j.pmedr.2019.100834] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 02/15/2019] [Accepted: 02/16/2019] [Indexed: 02/08/2023] Open
Abstract
Children's body mass index (BMI) growth trajectories are associated with adult health outcomes, and vary by geography and epoch. Understanding these trajectories could help to identify high risk children and thus support improved health outcomes. In this review, we compare and quantitatively analyse BMI level and trajectory data published since 2010. We characterise recent growth in children aged 4-11 years, an age range most frequently targeted for BMI intervention, yet less studied than young childhood or infancy. Through searches in OVID, we identified 54 relevant texts which describe either post-2000 summary BMI values by age and gender in cohorts with sample sizes of over 1000 children, or the results of latent class analyses of BMI trajectories within the 4-11 year age range. Population level median growth curves were projected and visualised as weighted means. These BMI curves, based on data from 729,692 children, can be visually clustered into 'high' and 'low' charting groups with extreme outlying values. Within populations, latent class analyses converge on 3-4 individual child trajectories, two of which predispose adult overweight. These growth pathways diverge early in childhood, yet are not effectively distinguished via isolated BMI measurements taken between 4 and 11 years, meaning some high risk children may currently be poorly identified.
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29
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Barraclough JY, Garden FL, Toelle BG, Marks GB, Baur LA, Ayer JG, Celermajer DS. Weight Gain Trajectories from Birth to Adolescence and Cardiometabolic Status in Adolescence. J Pediatr 2019; 208:89-95.e4. [PMID: 30738659 DOI: 10.1016/j.jpeds.2018.12.034] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 12/09/2018] [Accepted: 12/12/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To assess the influence of the trajectory of weight gain from birth to adolescence on cardiovascular and metabolic risk. We studied childhood body mass index (BMI) trajectories from birth to age 14 years and cardiometabolic risk factors at age 14 years. STUDY DESIGN In total, 410 children with weight and height measurements were assessed from birth throughout childhood, from the Childhood Asthma Prevention Study, a prospective community-based cohort. BMI trajectory groups were determined by latent basis growth mixture models. Of these subjects, 190 had detailed cardiometabolic risk factors assessed at age 14 years. RESULTS Three BMI trajectory groups were identified; normal BMI, "early rising" excess BMI from 2 years, and "late rising" excess BMI from 5 years. Differences were found between normal and excess BMI in children at 14 years of age. In addition, children with an early rising BMI trajectory had statistically significantly higher central adiposity and a more atherogenic lipoprotein profile at age 14 years than children with a late rising BMI trajectory (P < .05). No differences between BMI trajectory groups in vascular structure or function was identified at age 14 years. CONCLUSIONS Earlier onset of an elevated BMI trajectory persisting from birth to age 14 years results in an unfavorable cardiometabolic risk profile at age 14 years, including central adiposity and more atherogenic lipoproteins, independent of achieved BMI.
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Affiliation(s)
- Jennifer Y Barraclough
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia; Heart Research Institute, Sydney, Australia.
| | - Frances L Garden
- Woolcock Institute of Medical Research, Glebe, New South Wales, Australia; South Western Sydney Clinical School, University of New South Wales, Sydney, Australia; Ingham Institute of Applied Medical Research, Sydney, Australia
| | - Brett G Toelle
- Woolcock Institute of Medical Research, Glebe, New South Wales, Australia; Sydney Local Health District, New South Wales, Australia
| | - Guy B Marks
- Woolcock Institute of Medical Research, Glebe, New South Wales, Australia; South Western Sydney Clinical School, University of New South Wales, Sydney, Australia; Ingham Institute of Applied Medical Research, Sydney, Australia
| | - Louise A Baur
- University of Sydney, Discipline of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, Westmead, New South Wales, Australia
| | - Julian G Ayer
- University of Sydney, Discipline of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, Westmead, New South Wales, Australia; The Heart Center for Children, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - David S Celermajer
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia; Heart Research Institute, Sydney, Australia
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30
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Plank LD, Obolonkin V, Smith M, Savila F, Jalili-Moghaddam S, Tautolo ES, Rush EC. Pacific Islands Families Study: Physical growth to age 14 and metabolic risk. Pediatr Obes 2019; 14:e12497. [PMID: 30653850 DOI: 10.1111/ijpo.12497] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 11/21/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND The relationships between the trajectories of weight gain from early childhood to adolescence and risk for metabolic disease are not well understood. OBJECTIVE The objective of the study is to examine the relationships between weight gain from 2 to 14 years and metabolic risk factors at age 14 years in Pacific Island children. METHODS z scores for weight were calculated at each of the ages 2.5, 4, 6, 9, 11, and 13.5 years in 1053 children. Growth trajectories were determined by estimating the linear trend of z scores with age for each child. In a subgroup of 204 children, biomarkers of metabolic risk were measured and related to linear trend intercepts and slopes. RESULTS More rapid growth (greater slope of z score trajectory) was associated with higher concentrations of insulin, leptin (boys), urate, and markers of liver function, insulin resistance and inflammation. Children with higher weights in early life (greater intercept) showed fewer associations with metabolic markers, but considered together, intercept and slope were independently associated with a range of metabolic risk factors. CONCLUSIONS Both rapid weight gain and a higher body weight in early childhood were associated with higher risk for metabolic disease. Monitoring growth trajectories may help target interventions to optimize nutrition, physical activity, and growth.
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Affiliation(s)
- Lindsay D Plank
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Vladimir Obolonkin
- Child Health Research Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Melody Smith
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - Fa'asisila Savila
- Centre for Pacific Health and Development Research, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Shabnam Jalili-Moghaddam
- Child Health Research Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.,Centre for Pacific Health and Development Research, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - El-Shadan Tautolo
- Centre for Pacific Health and Development Research, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Elaine C Rush
- Child Health Research Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.,Centre for Pacific Health and Development Research, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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31
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English LK, Obbagy JE, Wong YP, Butte NF, Dewey KG, Fox MK, Greer FR, Krebs NF, Scanlon KS, Stoody EE. Types and amounts of complementary foods and beverages consumed and growth, size, and body composition: a systematic review. Am J Clin Nutr 2019; 109:956S-977S. [PMID: 30982866 DOI: 10.1093/ajcn/nqy281] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Systematic reviews (SRs) were conducted by the Nutrition Evidence Systematic Review (NESR) team for the USDA's and the Department of Health and Human Services' Pregnancy and Birth to 24 Months Project. OBJECTIVES The aim was to describe the SRs examining the relationship between types and amounts of complementary foods and beverages (CFBs) and growth, size, and body-composition outcomes. METHODS The NESR team collaborated with subject matter experts to conduct this SR. The literature was searched and screened using predetermined criteria. For each included study, data were extracted and risk of bias was assessed. The evidence was qualitatively synthesized to develop a conclusion statement, and the strength of evidence was graded. RESULTS This SR includes 49 articles that examined type, amount, or both of CFBs consumed and growth, size, and body-composition outcomes. Moderate evidence suggests that consuming either different amounts of meat, meat instead of iron-fortified cereal, or types of CFBs with different fats or fatty acids does not favorably or unfavorably influence growth, size, or body composition. In relation to overweight/obesity, insufficient evidence is available with regard to the intake of meat or CFBs with different fats or fatty acids. Limited evidence suggests that type and amount of fortified infant cereal does not favorably or unfavorably influence growth, size, body composition, or overweight/obesity. Limited evidence suggests that sugar-sweetened beverage consumption during the complementary feeding period is associated with increased obesity risk in childhood but is not associated with other measures of growth, size, or body composition. Limited evidence showed a positive association between juice intake and infant weight-for-length and child body mass index z scores. Insufficient evidence is available on other CFBs or dietary patterns in relation to outcomes. CONCLUSIONS Although several conclusions were drawn, additional research is needed that includes randomized controlled trials, examines a wider range of CFBs, considers issues of reverse causality, and adjusts for potential confounders to address gaps and limitations in the evidence.
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Affiliation(s)
| | | | | | - Nancy F Butte
- USDA-Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Kathryn G Dewey
- Department of Nutrition, University of California, Davis, Davis, CA
| | | | - Frank R Greer
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Nancy F Krebs
- Department of Pediatrics, University of Colorado School of Medicine, CO
| | | | - Eve E Stoody
- USDA, Food and Nutrition Service, Alexandria, VA
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English LK, Obbagy JE, Wong YP, Butte NF, Dewey KG, Fox MK, Greer FR, Krebs NF, Scanlon KS, Stoody EE. Timing of introduction of complementary foods and beverages and growth, size, and body composition: a systematic review. Am J Clin Nutr 2019; 109:935S-955S. [PMID: 30982863 DOI: 10.1093/ajcn/nqy267] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The systematic review described in this article was conducted as part of the USDA and Department of Health and Human Services Pregnancy and Birth to 24 Months Project. OBJECTIVES The aim was to describe the relationship between timing of introduction of complementary foods and beverages (CFBs) and growth, size, and body-composition outcomes across the life span. METHODS The literature was searched and selected using predetermined criteria. Data were extracted and risk of bias assessed for each included study. Evidence was qualitatively synthesized, conclusion statements were developed, and the strength of the evidence was graded. RESULTS Eighty-one articles were included in this systematic review that addressed timing of CFB introduction relative to growth, size, and body-composition outcomes from infancy through adulthood. Moderate evidence suggests that introduction of CFBs between the ages of 4 and 5 mo compared with ∼6 mo is not associated with weight status, body composition, body circumferences, weight, or length among generally healthy, full-term infants. Limited evidence suggests that introduction of CFBs before age 4 mo may be associated with higher odds of overweight/obesity. Insufficient evidence exists regarding introduction at age ≥7 mo. CONCLUSIONS Although several conclusions were drawn in this systematic review, additional research is needed to address gaps and limitations in the evidence on timing of introduction of CFBs and growth, size, and body composition, such as randomized controlled trials that examine multiple outcomes and/or CFB introduction between the ages of 4 and 6 mo, and research that accounts for potential confounders such as feeding practices and baseline growth status and considers issues of reverse causality.
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Affiliation(s)
| | | | | | - Nancy F Butte
- Department of Pediatrics, USDA/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - Kathryn G Dewey
- Department of Nutrition, University of California, Davis, Davis, CA
| | | | - Frank R Greer
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Nancy F Krebs
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | | | - Eve E Stoody
- USDA, Food and Nutrition Service, Alexandria, VA
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Araújo J, Ramos E, Mishra GD, Severo M. The use of weight adjusted for height rather than body mass index to assess growth trajectory: Results from a population‐based cohort. Stat Med 2018; 38:855-865. [DOI: 10.1002/sim.8007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 09/25/2018] [Accepted: 09/27/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Joana Araújo
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto Porto Portugal
| | - Elisabete Ramos
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto Porto Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação MédicaFaculdade de Medicina da Universidade do Porto Porto Portugal
| | - Gita D. Mishra
- Centre for Longitudinal and Life Course Research, School of Public HealthUniversity of Queensland Brisbane Australia
| | - Milton Severo
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto Porto Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação MédicaFaculdade de Medicina da Universidade do Porto Porto Portugal
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Protein Intake during the First Two Years of Life and Its Association with Growth and Risk of Overweight. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081742. [PMID: 30110887 PMCID: PMC6121580 DOI: 10.3390/ijerph15081742] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/10/2018] [Accepted: 08/12/2018] [Indexed: 12/20/2022]
Abstract
Growth patterns early in life could exert a long-term impact on overweight and obesity development. Among all potential manipulative factors, infant diet is one of the most influential and could affect growth and subsequent health status during adolescence and adulthood. Dietary protein, as an important macronutrient in infants' diet, has been of special interest to researchers. Compared with human milk, infant formula tends to have a higher protein content and is associated with greater weight gain and later-in-life obesity risk. However, the effect of protein from other sources on infant growth trajectories during complementary feeding is not clear. Emerging research suggests that meat protein during early complementary feeding promotes linear growth while not increasing risk of overweight compared with dairy protein; and the gut microbiota might be a mediator between protein quality and growth trajectories. This review addresses the current knowledge of protein intake from birth to 24 months and its relationship with growth and risk of overweight.
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McGinty SM, Osganian SK, Feldman HA, Milliren CE, Field AE, Richmond TK. BMI Trajectories from Birth to Young Adulthood. Obesity (Silver Spring) 2018; 26:1043-1049. [PMID: 29675881 DOI: 10.1002/oby.22176] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 02/19/2018] [Accepted: 02/20/2018] [Indexed: 02/01/2023]
Abstract
OBJECTIVE This study aimed to compare BMI trajectories from childhood to early adulthood in those with overweight and/or obesity versus severe obesity. METHODS Longitudinal BMI values (2,542 measurements) were calculated from measured heights and weights for 103 children, adolescents, or young adults with overweight, obesity, or severe obesity. Segmented regression with splines was used to model BMI trajectories. RESULTS Sixty-nine participants were classified as ever having severe obesity versus 34 who never had severe obesity. Trajectories and slopes did not differ by sex or race/ethnicity. Compared with those who never had severe obesity, BMI was higher in the group with severe obesity at all ages, and BMI slope was higher for those with severe obesity at age 14 (P = 0.002), with peak slope occurring later (18 years vs. 16 years) and higher (4.5 ± 0.5 kg/m2 /y vs. 2.9 ± 0.5 kg/m2 /y; P < 0.02). In the group without severe obesity, BMI fell below zero by the mid-20s (-0.3 ± 0.6 kg/m2 /y); in those with severe obesity, BMI slope never reached zero (0.9 ± 0.5 kg/m2 /y). CONCLUSIONS Youth with severe obesity, compared with their peers without, started with higher BMIs, had more rapid rates of BMI increase beginning at age 14, as well as a higher peak and longer period of increase, and never achieved weight stabilization.
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Affiliation(s)
- Shannon M McGinty
- Harvard University Health Services, Harvard University, Cambridge, Massachusetts, USA
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Stavroula K Osganian
- Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Henry A Feldman
- Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Carly E Milliren
- Program for Patient Safety and Quality, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Alison E Field
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Tracy K Richmond
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
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36
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Heggeseth BC, Jewell NP. How Gaussian mixture models might miss detecting factors that impact growth patterns. Ann Appl Stat 2018. [DOI: 10.1214/17-aoas1066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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37
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Aris IM, Chen LW, Tint MT, Pang WW, Soh SE, Saw SM, Shek LPC, Tan KH, Gluckman PD, Chong YS, Yap F, Godfrey KM, Kramer MS, Lee YS. Body mass index trajectories in the first two years and subsequent childhood cardio-metabolic outcomes: a prospective multi-ethnic Asian cohort study. Sci Rep 2017; 7:8424. [PMID: 28827610 PMCID: PMC5567284 DOI: 10.1038/s41598-017-09046-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 07/20/2017] [Indexed: 12/31/2022] Open
Abstract
We investigated body mass index (BMI) trajectories in the first 2 years of life in 1170 children from an Asian mother-offspring cohort in Singapore, and examined their predictors and associations with childhood cardio-metabolic risk measures at 5 years. Latent class growth mixture modelling analyses were performed to identify distinct BMI z-score (BMIz) trajectories. Four trajectories were identified: 73.2%(n = 857) of the children showed a normal BMIz trajectory, 13.2%(n = 155) a stable low-BMIz trajectory, 8.6%(n = 100) a stable high-BMIz trajectory and 5.0%(n = 58) a rapid BMIz gain after 3 months trajectory. Predictors of the stable high-BMIz and rapid BMIz gain trajectories were pre-pregnancy BMI, gestational weight gain, Malay and Indian ethnicity, while predictors of stable low-BMIz trajectory were preterm delivery and Indian ethnicity. At 5 years, children with stable high-BMIz or rapid BMIz gain trajectories had increased waist-to-height ratios [B(95%CI) 0.02(0.01,0.03) and 0.03(0.02,0.04)], sum of skinfolds [0.42(0.19,0.65) and 0.70(0.36,1.03)SD units], fat-mass index [0.97(0.32,1.63)SD units] and risk of obesity [relative risk 3.22(1.73,6.05) and 2.56 (1.19,5.53)], but not higher blood pressure. BMIz trajectories were more predictive of adiposity at 5 years than was BMIz at 2 years. Our findings on BMIz trajectories in the first 2 years suggest important ethnic-specific differences and impacts on later metabolic outcomes.
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Affiliation(s)
- Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.
| | - Ling-Wei Chen
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mya Thway Tint
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wei Wei Pang
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shu E Soh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Lynette Pei-Chi Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kok-Hian Tan
- Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Fabian Yap
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Singapore, Singapore
| | - Michael S Kramer
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Canada
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
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Péneau S, Giudici KV, Gusto G, Goxe D, Lantieri O, Hercberg S, Rolland-Cachera MF. Growth Trajectories of Body Mass Index during Childhood: Associated Factors and Health Outcome at Adulthood. J Pediatr 2017; 186:64-71.e1. [PMID: 28283258 DOI: 10.1016/j.jpeds.2017.02.010] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 12/27/2016] [Accepted: 02/03/2017] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To identify body mass index (BMI) trajectories from birth to age 10 years and to assess their association with child and parental characteristics and with adult nutritional status and metabolic risk factors. STUDY DESIGN Retrospective cohort study with 1188 subjects aged 20-60 years. Childhood growth was assessed using measured weight and height data collected retrospectively from health booklets, which also provided information on gestational age, birth weight, and early nutrition. Height, weight, waist circumference, fasting blood glucose, lipids profile, and blood pressure were measured at adulthood. Participants self-reported parental silhouette based on a 9-figural scale. Group-based modeling was applied to identify BMI trajectories. Associations were assessed using ANOVA and multiple logistic regression. RESULTS Five growth trajectories following or crossing BMI percentiles emerged: stable-25th (15.3% of the sample), stable-50th (35.9%), stable-75th (28.0%), ascending-75th (19.2%), and ascending-obesity (1.6%). Overall, associated factors from early life were mother's corpulence (higher in the ascending-obesity group), gestational age (higher in the stable-50th, stable-75th, and in the ascending-obesity groups), and birth weight (higher in the ascending-obesity group) (all P < .05). Childhood trajectories were associated with adult BMI and waist circumference (higher in the stable-75th and in the ascending groups) (all P < .0001). CONCLUSIONS This study shows heterogeneity in patterns of growth trajectories. Specific trajectories were associated with greater BMI and waist circumference during adulthood. Monitoring growth trajectories may improve chronic disease prevention.
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Affiliation(s)
- Sandrine Péneau
- Paris 13 University, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Kelly Virecoulon Giudici
- Paris 13 University, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Gaëlle Gusto
- Inter-Regional Institute for Health (IRSA), La Riche, France
| | - Didier Goxe
- Inter-Regional Institute for Health (IRSA), La Riche, France
| | | | - Serge Hercberg
- Paris 13 University, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Bobigny, France; Nutritional Monitoring and Epidemiology Team (ESEN), Paris 13 University, Sorbonne Paris Cité, Bobigny, France; Nutritional Monitoring and Epidemiology Team (ESEN), Santé Publique France, Bobigny, France; Department of Public Health, Hôpital Avicenne, Bobigny, France
| | - Marie-Françoise Rolland-Cachera
- Paris 13 University, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
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Lynch BA, Rutten LJF, Ebbert JO, Kumar S, Yawn BP, Jacobson D, Sauver JS. Development of Distinct Body Mass Index Trajectories Among Children Before Age 5 Years: A Population-Based Study. J Prim Care Community Health 2017; 8:278-284. [PMID: 28434273 PMCID: PMC5653452 DOI: 10.1177/2150131917704326] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The prevalence of childhood obesity has increased over the past 3 decades. This study was designed to understand how childhood body mass index (BMI) influences later risk of obesity. We calculated BMIs for children residing in Olmsted County, Minnesota, between January 1, 2005 and December 31, 2012 using medical records data. We defined homogenous BMI trajectory clusters using a nonparametric hill-climbing algorithm. Overall, 16,538 (47%) children had >3 weight assessments at least 1 year apart and were included in the analyses. Within the 8-year follow-up period, children who were younger than 2 years and overweight had a 3- fold increase of obesity (adjusted hazard ratio [HR] = 3.24; 95% confidence interval [CI] = 2.69-3.89) and those aged 5 years and overweight had a 10-fold increased risk of obesity (adjusted HR = 9.97, 95% CI = 8.55-11.62). Three distinct BMI trajectories could be distinguished prior to 5 years of age. The risk of developing obesity in those who are overweight increased dramatically with increasing age. Interventions to prevent obesity need to occur prior to school age to prevent children from entering unhealthy BMI trajectories.
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40
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Paediatric obesity and cardiovascular risk factors - A life course approach. Porto Biomed J 2017; 2:102-110. [PMID: 32258598 DOI: 10.1016/j.pbj.2017.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 02/09/2017] [Indexed: 12/20/2022] Open
Abstract
Childhood obesity is increasingly prevalent worldwide, and Portugal presents one of the highest prevalence of obesity and overweight among the European countries. Since childhood obesity is a risk factor for obesity in adulthood, the high prevalence of overweight and obesity in paediatric age currently experienced is expected to lead to even higher prevalence of obesity in adulthood in future decades. It is well known that the prenatal period and infancy are critical or sensitive periods for obesity development, but a growing body of evidence also suggests a relevant role of childhood and adolescence. The exposure to some factors during these periods or specific time frames within these periods may confer additional risk for obesity development. Paediatric obesity is associated with cardiovascular risk factors both in the short or medium-term, but also in the long term, conferring additional risk for future adult health. However, it is not clear whether the relation between paediatric obesity and adult health is independent of adult adiposity. There is a moderate to high tracking of obesity from paediatric age into adulthood, which may partially explain the association with adult outcomes. Therefore, there has been increasing interest on life course frameworks to study the effect of the dynamics of adiposity across paediatric age on adult outcomes, namely on the cardiovascular disease risk. The use of this approach to study determinants and consequences of obesity raises methodological challenges to summarize the exposure to adiposity/obesity across the life span, being the identification of growth trajectories and the quantification of the duration of obesity among the most used methods. However, further investigation is still needed to explore the best methods to summarize exposure to adiposity and its variation across time.
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Kwon S, Janz KF, Letuchy EM, Burns TL, Levy SM. Association between body mass index percentile trajectories in infancy and adiposity in childhood and early adulthood. Obesity (Silver Spring) 2017; 25:166-171. [PMID: 27804242 PMCID: PMC5182145 DOI: 10.1002/oby.21673] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 08/11/2016] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To identify distinct body mass index (BMI) percentile trajectories during early childhood and examine adiposity levels in childhood and early adulthood according to the BMI percentile trajectories. METHODS Iowa Fluoride Study cohort parents (n = 1,093) reported their child's anthropometric data on average six times between ages 0 and 23 months. A subset of the cohort underwent DXA scans at approximately age 8 years (n = 495) and again at approximately age 19 years (n = 314). Group-based trajectory analysis was conducted to identify distinct BMI percentile trajectories from ages 0 to 23 months. Sex-specific age-adjusted linear regression analyses were conducted to compare fat mass index in childhood and early adulthood among subgroups that follow the distinct BMI percentile patterns. RESULTS Four BMI percentile patterns were identified: consistently low (group 1: 9.8%), increase in the second year (group 2: 33.7%), increase in the first year (group 3: 23.9%), and consistently high (group 4: 32.6%). Compared with group 2 females, groups 3 and 4 females had higher fat mass index in childhood and early adulthood (P < 0.05). However, no significant difference was found in males. CONCLUSIONS Females who experience a steep increase of BMI percentile in the first year of life, as opposed to a steep increase in the second year of life, may have higher body fat later in life, but this was not found in males.
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Affiliation(s)
- Soyang Kwon
- Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL
| | - Kathleen F. Janz
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA
- Department of Epidemiology, University of Iowa, Iowa City, IA
| | | | - Trudy L. Burns
- Department of Epidemiology, University of Iowa, Iowa City, IA
| | - Steven M. Levy
- Department of Epidemiology, University of Iowa, Iowa City, IA
- Department of Preventive and Community Dentistry, University of Iowa, Iowa City, IA
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Kelly Y, Patalay P, Montgomery S, Sacker A. BMI Development and Early Adolescent Psychosocial Well-Being: UK Millennium Cohort Study. Pediatrics 2016; 138:e20160967. [PMID: 27940679 PMCID: PMC5127062 DOI: 10.1542/peds.2016-0967] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The underlying influences on different patterns of BMI development are not well understood, and psychosocial outcomes linked to BMI development have been little investigated. Objectives were to identify BMI developmental trajectories across the first decade of life, examine early life predictors of trajectory membership, and investigate whether being on a particular BMI trajectory is associated with markers of psychosocial well-being. METHODS We used latent class analysis to derive BMI trajectories by using data collected at ages 3, 5, 7, and 11 years on 16 936 participants from the Millennium Cohort Study. Regression models were used to estimate predictors of BMI trajectory membership and their psychosocial correlates. RESULTS Four trajectories were identified: 83.8% had an average "stable" nonoverweight BMI, 0.6% were in a "decreasing" group, 13.1% had "moderate increasing" BMIs, and 2.5% had "high increasing" BMIs. Predictors of "moderate" and "high" increasing group membership were smoking in pregnancy (odds ratios [ORs] = 1.17 and 1.97, respectively), maternal BMI (ORs = 1.10 and 1.14), skipping breakfast (ORs = 1.66 and 1.76), nonregular bedtimes (ORs = 1.22 and 1.55). Children in the "moderate" and "high" increasing groups had worse scores for emotional symptoms, peer problems, happiness, body satisfaction, and self-esteem, and those in the "high increasing" group were more likely to have tried alcohol and cigarettes. CONCLUSIONS Several potentially modifiable early life factors including smoking in pregnancy, skipping breakfast, and bedtime routines were important predictors of BMI development in the overweight and obese range, and high BMI growth was linked to worse psychosocial well-being.
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Affiliation(s)
- Yvonne Kelly
- Department of Epidemiology and Public Health, University College London, London, United Kingdom;
| | - Praveetha Patalay
- Centre for Longitudinal Studies, University College London Institute of Education, London, United Kingdom; and
| | | | - Amanda Sacker
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Movin M, Garden FL, Protudjer JLP, Ullemar V, Svensdotter F, Andersson D, Kruse A, Cowell CT, Toelle BG, Marks GB, Almqvist C. Impact of childhood asthma on growth trajectories in early adolescence: Findings from the Childhood Asthma Prevention Study (CAPS). Respirology 2016; 22:460-465. [PMID: 27859946 DOI: 10.1111/resp.12928] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 08/18/2016] [Accepted: 08/18/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND OBJECTIVE Understanding the associations between childhood asthma and growth in early adolescence by accounting for the heterogeneity of growth during puberty has been largely unexplored. The objective was to identify sex-specific classes of growth trajectories during early adolescence, using a method which takes the heterogeneity of growth into account and to evaluate the association between childhood asthma and different classes of growth trajectories in adolescence. METHODS Our longitudinal study included participants with a family history of asthma born during 1997-1999 in Sydney, Australia. Hence, all participants were at high risk for asthma. Asthma status was ascertained at 8 years of age using data from questionnaires and lung function tests. Growth trajectories between 11 and 14 years of age were classified using a latent basis growth mixture model. Multinomial regression analyses were used to evaluate the association between asthma and the categorized classes of growth trajectories. RESULTS In total, 316 participants (51.6% boys), representing 51.3% of the entire cohort, were included. Sex-specific classes of growth trajectories were defined. Among boys, asthma was not associated with the classes of growth trajectories. Girls with asthma were more likely than girls without asthma to belong to a class with later growth (OR: 3.79, 95% CI: 1.33, 10.84). Excluding participants using inhaled corticosteroids or adjusting for confounders did not significantly change the results for either sex. CONCLUSION We identified sex-specific heterogeneous classes of growth using growth mixture modelling. Associations between childhood asthma and different classes of growth trajectories were found for girls only.
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Affiliation(s)
- Maria Movin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.,Woolcock Institute of Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Frances L Garden
- Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Jennifer L P Protudjer
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.,Centre for Allergy Research, Karolinska Institute, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Vilhelmina Ullemar
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Frida Svensdotter
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - David Andersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Andreas Kruse
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Chris T Cowell
- Woolcock Institute of Medical Research, The University of Sydney, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Brett G Toelle
- Woolcock Institute of Medical Research, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Local Health District, Sydney, New South Wales, Australia
| | - Guy B Marks
- Woolcock Institute of Medical Research, The University of Sydney, Sydney, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.,Centre for Allergy Research, Karolinska Institute, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Lung and Allergy Unit, Karolinska University Hospital, Stockholm, Sweden
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44
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Munthali RJ, Kagura J, Lombard Z, Norris SA. Childhood adiposity trajectories are associated with late adolescent blood pressure: birth to twenty cohort. BMC Public Health 2016; 16:665. [PMID: 27473865 PMCID: PMC4966706 DOI: 10.1186/s12889-016-3337-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 07/21/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Elevated blood pressure in childhood is a risk factor for adult hypertension which is a global health problem. Excess adiposity in childhood creates a predisposition to develop adult hypertension. Our aim was to explore distinct sex-specific adiposity trajectories from childhood to late adolescence and examined their association with blood pressure. METHODS Latent Class Growth Mixture Modeling (LCGMM) on longitudinal data was used to derive sex-specific and distinct body mass index (BMI: kg/m(2)) trajectories. We studied 1824 black children (boys = 877, girls = 947) from the Birth to Twenty (Bt20) cohort from Soweto, South Africa, and obtained BMI measures at ages 5 through 18 years. Participants with at least two age-point BMI measures, were included in the analysis. Analysis of variance (ANOVA), chi-square test, multivariate linear and standard logistic regressions were used to test study characteristics and different associations. RESULTS We identified three (3) and four (4) distinct BMI trajectories in boys and girls, respectively. The overall prevalence of elevated blood pressure (BP) was 34.9 % (39.4 % in boys and 30.38 % in girls). Boys and girls in the early onset obesity or overweight BMI trajectories were more likely to have higher BP values in late adolescence. Compared to those in the normal weight BMI trajectory, girls in early onset obesity trajectories had an increased risk of elevated BP with odds ratio (OR) of 2.18 (95 % confidence interval 1.31 to 4.20) and 1.95 (1.01 to 3.77). We also observed the weak association for boys in early onset overweight trajectory, (p-value = 0.18 and odds ratio of 2.39 (0.67 to 8.57)) CONCLUSIONS: Distinct weight trajectories are observed in black South African children from as early as 5 years. Early onset adiposity trajectories are associated with elevated BP in both boys and girls. It is important to consider individual patterns of early-life BMI development, so that intervention strategies can be targeted to at-risk individuals.
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Affiliation(s)
- Richard J. Munthali
- School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, The Mount, 9 Jubilee Road, Parktown, Johannesburg, 2193 South Africa
- Sydney Brenner Institute for Molecular Biosciences (SBIMB), University of the Witwatersrand, Johannesburg, South Africa
- MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Johannesburg, South Africa
- Division of Human Genetics, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand and National Health Laboratory Service, Johannesburg, South Africa
| | - Juliana Kagura
- MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Johannesburg, South Africa
| | - Zané Lombard
- School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, The Mount, 9 Jubilee Road, Parktown, Johannesburg, 2193 South Africa
- Division of Human Genetics, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand and National Health Laboratory Service, Johannesburg, South Africa
| | - Shane A. Norris
- MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Johannesburg, South Africa
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Moreno-Black G, Boles S, Johnson-Shelton D, Evers C. Exploring Categorical Body Mass Index Trajectories in Elementary School Children. THE JOURNAL OF SCHOOL HEALTH 2016; 86:495-506. [PMID: 27246674 PMCID: PMC5055398 DOI: 10.1111/josh.12402] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 11/07/2015] [Accepted: 11/10/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Studies of body mass index (BMI) change have focused on understanding growth trajectories from childhood to adolescence and adolescence to adulthood, but few have explored BMI trajectories solely in elementary (grades K-5) school children. This report complements these studies by exploring changes in obesity status using analytic methods developed to investigate categorical changes in life-course events. METHODS Sequences of a 4-state BMI variable (underweight, normal, overweight, and obese) were calculated using height and weight data collected annually (2008-2013) from 414 kindergarten and first-grade students participating in the Community and Schools Together (CAST) project. These sequences were explored using the TraMineR software package to investigate the distribution of sequences and states, calculate transition rates among states, and examine clustering of sequences. RESULTS Aggregated cluster solutions were identified consisting of either 4 clusters (normal, stepped, mixed, and obese) or 3 clusters (aggregation of obese cluster cases into stepped cluster) with membership in the former predicted by ethnicity and socioeconomic status (SES) and the latter by SES alone. Transition rate patterns among states varied markedly by cluster and state. CONCLUSION The finding of early emergence of stable obesity states, especially in Hispanic children confirms the need for early childhood interventions to influence BMI.
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Affiliation(s)
| | - Shawn Boles
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403.
| | | | - Cody Evers
- Portland State University, PO Box 751, Portland, OR 97207.
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Suchomlinov A, Tutkuviene J. Variability in growth tracking is associated with body mass index at 17 years of age. Acta Paediatr 2015; 104:e401-6. [PMID: 26033322 DOI: 10.1111/apa.13058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 01/31/2015] [Accepted: 05/26/2015] [Indexed: 10/23/2022]
Abstract
AIM Variability in individual growth tracking and its association with body mass index (BMI) in later life remains insufficiently explored. Our aim was to investigate growth tracking variabilities from birth up to the end of growth at 17 years of age and their relationship to BMI. METHODS Data were obtained from the personal health records of 1492 healthy children - 762 boys and 730 girls - who were born full term in 1990 in the city and surrounding villages of Vilnius in Lithuania. The analysis of growth tracking was performed using two methods: tracing the main percentiles and the changes in standard deviation scores for height and BMI. RESULTS Most of the boys and girls changed one growth track for height and BMI. However, girls from birth to two years of age and 11-17 years of age were the most likely to change two growth tracks for the growth indices. Children who were underweight at 17 years of age changed significantly more BMI tracks during the first two years of life (2.19 ± 1.21) than overweight and obese 17-year-olds (1.75 ± 1.14). CONCLUSION This study of 1492 healthy children at 17 years of age showed that great individual variability in the growth tracking of body mass index in early life was associated with being underweight at 17 years of age.
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Affiliation(s)
- Andrej Suchomlinov
- Department of Anatomy, Histology and Anthropology; Faculty of Medicine; Vilnius University; Vilnius Lithuania
| | - Janina Tutkuviene
- Department of Anatomy, Histology and Anthropology; Faculty of Medicine; Vilnius University; Vilnius Lithuania
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47
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Moreno-Black G, Stockard J. Two Worlds of Obesity: Ethnic Differences in Child Overweight/Obesity Prevalence and Trajectories. J Racial Ethn Health Disparities 2015; 3:331-9. [PMID: 27271074 DOI: 10.1007/s40615-015-0150-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 06/17/2015] [Accepted: 07/20/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Research on childhood obesity has examined the prevalence of overweight and obesity during childhood and developmental trajectories. This study focuses on the extent to which Hispanic and non-Hispanic white elementary students differ in prevalence of overweight and obesity by grade level, time, gender, and school setting. It also focuses on comparison of the trajectories in weight status for the Hispanic and non-Hispanic white students. METHODS BMI values were examined both using standard scores (z-scores) and as categorical variables. Cross-sectional data from 4 years were used to examine prevalence, and panel data across 2-year periods examined trajectories. Descriptive statistics and mixed models, controlling for school setting, were used. RESULTS Hispanic students began first grade with higher prevalence of obesity and overweight, and the differences were larger in higher grades and later years. The majority of students had stable weight status over the 2-year periods of the trajectory analysis, but Hispanic students began the panel with higher BMI-Z values and were more likely to increase and less likely to decrease BMI-Z. CONCLUSIONS The findings suggest that the degree of childhood overweight/obesity, especially among Hispanics, is substantial and will likely have profound impacts on adult obesity and other associated health issues in the future. Findings confirm the need for early childhood interventions to influence BMI.
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Affiliation(s)
| | - Jean Stockard
- Department of Planning, Public Policy and Management, University of Oregon, Eugene, Oregon, USA
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48
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Tu AW, Mâsse LC, Lear SA, Gotay CC, Richardson CG. Body mass index trajectories from ages 1 to 20: Results from two nationally representative canadian longitudinal cohorts. Obesity (Silver Spring) 2015; 23:1703-11. [PMID: 26179716 DOI: 10.1002/oby.21158] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 04/21/2015] [Accepted: 04/28/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVE In this study, unique body mass index (BMI) trajectories from ages 1 to 20 years were identified; each trajectory according to socio demographic and family characteristics was described. METHODS Participants came from two national population surveys (n = 7,253; n = 901) and were aged 1-6 years at baseline. Children were surveyed biennially over eight waves up to 14-20 years of age. BMI trajectories by sex and survey cohort were identified by group-based trajectory modeling. After crossvalidating trajectories between survey cohorts, the characteristics of trajectory membership were assessed by multinomial regression. RESULTS Four BMI trajectories were found: low, decreasing, medium, and high. The decreasing trajectory was characterized by an overweight or obese childhood followed by a normal-weight adolescence. The low, medium, and high trajectories were characterized by growth curves culminating, by age 20, to BMI 22.6, 29.3, and 34.9 kg/m(2) , respectively, for males and 20.6, 24.5, and 32.0 kg/m(2) , respectively, for females. Factors associated with the high trajectory included ethnicity and paternal education (female only), large for gestational age, rural area residence, and maternal smoking. CONCLUSIONS The identification and validation of four major trajectories reflect the heterogeneity in patterns of BMI development from 1 to 20 years.
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Affiliation(s)
- Andrew W Tu
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Louise C Mâsse
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Carolyn C Gotay
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chris G Richardson
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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Araújo J, Severo M, Barros H, Mishra GD, Guimarães JT, Ramos E. Developmental trajectories of adiposity from birth until early adulthood and association with cardiometabolic risk factors. Int J Obes (Lond) 2015; 39:1443-9. [PMID: 26155921 DOI: 10.1038/ijo.2015.128] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 06/22/2015] [Accepted: 07/02/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To identify developmental trajectories of adiposity from birth until early adulthood, and to investigate how they relate with cardiometabolic risk factors at 21 years of age. METHODS Participants' weight and height measurements were obtained using the EPITeen cohort protocol at 13, 17 and 21 years of age, and extracted from child health books as recorded during health routine evaluations since birth. Blood pressure, triglycerides, cholesterol and insulin resistance (HOMA-IR) were assessed at 21 years. Trajectories were defined using 719 participants contributing 11 459 measurements. The individual growth curves were modelled using mixed-effects fractional polynomial, and the trajectories were estimated using normal mixture modelling for model-based clustering. Differences in cardiometabolic risk factors at 21 years according to adiposity trajectories were estimated through analysis of covariance (ANCOVA), and adjusted means are presented. RESULTS Two trajectories-'Average body mass index (BMI) growth' (80.7%) and 'Higher BMI growth' (19.3%)-were identified. Compared with those in 'Average BMI growth', 'Higher BMI growth' participants were more frequently delivered by caesarean section, mothers were younger and had higher BMI, and parental education was lower; and at 21 years showed higher adjusted mean systolic (111.6 vs 108.3 mm Hg, P<0.001) and diastolic blood pressure (71.9 vs 68.4 mm Hg, P<0.001), and lower high-density lipoprotein cholesterol (53.3 vs 57.0 mg dl(-1), P=0.001). As there was a significant interaction between trajectories and sex, triglycerides and HOMA-IR were stratified by sex and we found significantly higher triglycerides, in males, and higher HOMA-IR in both sexes in 'Higher BMI growth' trajectory. All the differences were attenuated after adjustment for BMI at 21 years. CONCLUSIONS In this long-term follow-up, we were able to identify two adiposity trajectories, statistically related to the BMI and cardiometabolic profile in adulthood. Our results also suggest that the impact of the adiposity trajectory on cardiometabolic profile is mediated by current BMI.
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Affiliation(s)
- J Araújo
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal.,Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - M Severo
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal.,Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - H Barros
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal.,Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - G D Mishra
- Centre for Longitudinal and Life Course Research, School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - J T Guimarães
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal.,Department of Clinical Pathology, Centro Hospitalar de S. João, Porto, Portugal.,Department of Biochemistry, University of Porto Medical School, Porto, Portugal
| | - E Ramos
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal.,Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
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50
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Pryor LE, Brendgen M, Tremblay RE, Pingault JB, Liu X, Dubois L, Touchette E, Falissard B, Boivin M, Côté SM. Early Risk Factors of Overweight Developmental Trajectories during Middle Childhood. PLoS One 2015; 10:e0131231. [PMID: 26121682 PMCID: PMC4487897 DOI: 10.1371/journal.pone.0131231] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 05/31/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Research is needed to identify early life risk factors associated with different developmental paths leading to overweight by adolescence. OBJECTIVES To model heterogeneity in overweight development during middle childhood and identify factors associated with differing overweight trajectories. METHODS Data was drawn from the Quebec Longitudinal Study of Child Development (QLSCD; 1998-2010). Trained research assistants measured height and weight according to a standardized protocol and conducted yearly home interviews with the child's caregiver (mother in 98% of cases). Information on several putative early life risk factors for the development of overweight were obtained, including factors related to the child's perinatal, early behavioral family and social environment. Group-based trajectories of the probability of overweight (6-12 years) were identified with a semiparametric method (n=1678). Logistic regression analyses were used to identify early risk factors (5 months- 5 years) associated with each trajectory. RESULTS Three trajectories of overweight were identified: "early-onset overweight" (11.0 %), "late-onset overweight" (16.6%) and "never overweight" (72.5%). Multinomial analyses indicated that children in the early and late-onset group, compared to the never overweight group, had 3 common types of risk factors: parental overweight, preschool overweight history, and large size for gestational age. Maternal overprotection (OR= 1.12, CI: 1.01-1.25), short nighttime sleep duration (OR=1.66, CI: 1.07-2.57), and immigrant status (OR=2.01, CI: 1.05-3.84) were factors specific to the early-onset group. Finally, family food insufficiency (OR=1.81, CI: 1.00-3.28) was weakly associated with membership in the late-onset trajectory group. CONCLUSIONS The development of overweight in childhood follows two different trajectories, which have common and distinct risk factors that could be the target of early preventive interventions.
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Affiliation(s)
- Laura E. Pryor
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada
- Research Unit on Children’s Psychosocial Maladjustment, University of Montreal, Montreal, and University Laval, Quebec City, Canada
- Ste Justine Hospital Research Center, Montreal, Canada
| | - Mara Brendgen
- Research Unit on Children’s Psychosocial Maladjustment, University of Montreal, Montreal, and University Laval, Quebec City, Canada
- Ste Justine Hospital Research Center, Montreal, Canada
- Department of Psychology, University of Quebec in Montreal, Montreal, Canada
| | - Richard E. Tremblay
- Research Unit on Children’s Psychosocial Maladjustment, University of Montreal, Montreal, and University Laval, Quebec City, Canada
- Ste Justine Hospital Research Center, Montreal, Canada
- School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
- Institute of Genetic, Neurobiological, and Social Foundations of Child Development, Tomsk State University, Tomsk, Russian Federation
- International Laboratory for Child and Adolescent Mental Health Development, University of Montreal, Montreal, Canada, and French National Institute of Health and Medical Research (INSERM), Paris, France
| | - Jean-Baptiste Pingault
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada
- Ste Justine Hospital Research Center, Montreal, Canada
- International Laboratory for Child and Adolescent Mental Health Development, University of Montreal, Montreal, Canada, and French National Institute of Health and Medical Research (INSERM), Paris, France
| | - Xuecheng Liu
- Research Unit on Children’s Psychosocial Maladjustment, University of Montreal, Montreal, and University Laval, Quebec City, Canada
| | - Lise Dubois
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada
| | - Evelyne Touchette
- Research Unit on Children’s Psychosocial Maladjustment, University of Montreal, Montreal, and University Laval, Quebec City, Canada
- Department of Psychoeducation, University of Quebec in Trois Rivières, Trois Rivières, Quebec
| | - Bruno Falissard
- National Institute of Health and Medical Research (INSERM) U669, Paris, France
| | - Michel Boivin
- Research Unit on Children’s Psychosocial Maladjustment, University of Montreal, Montreal, and University Laval, Quebec City, Canada
- Institute of Genetic, Neurobiological, and Social Foundations of Child Development, Tomsk State University, Tomsk, Russian Federation
- School of Psychology, Laval University, Quebec City, Canada
| | - Sylvana M. Côté
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada
- Research Unit on Children’s Psychosocial Maladjustment, University of Montreal, Montreal, and University Laval, Quebec City, Canada
- Ste Justine Hospital Research Center, Montreal, Canada
- Institute of Genetic, Neurobiological, and Social Foundations of Child Development, Tomsk State University, Tomsk, Russian Federation
- International Laboratory for Child and Adolescent Mental Health Development, University of Montreal, Montreal, Canada, and French National Institute of Health and Medical Research (INSERM), Paris, France
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