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Dow C, Galera C, Charles MA, Heude B. Maternal pre-pregnancy BMI and offspring hyperactivity-inattention trajectories from 3 to 8 years in the EDEN birth cohort study. Eur Child Adolesc Psychiatry 2023; 32:2057-2065. [PMID: 35851811 DOI: 10.1007/s00787-022-02047-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 07/06/2022] [Indexed: 12/15/2022]
Abstract
Evidence suggests obesity during pregnancy is associated with offspring attention-deficit hyperactivity disorder. However, studies have been limited to evaluating the association at a single age with inadequate data on important maternal lifestyle confounders and unmeasured familial confounding. The objective of this study was to examine the association between maternal pre-pregnancy body mass index (BMI) and child hyperactivity-inattention symptoms (HIS) at 3, 5 and 8 years. Data came from the EDEN mother-child cohort. Maternal pre-pregnancy BMI status (kg/m2) was calculated using pre-pregnancy weight and height (self-reported by mothers or measured by midwives). HIS were assessed by parental-report on the Strengths and Difficulties Questionnaire at 3, 5 and 8 years of age and used to derive developmental trajectories of HIS (n = 1428). Multivariate models were adjusted for confounders including socioeconomic status, maternal lifestyle behaviours (exercise, diet, smoking, alcohol), childcare and a stimulating home environment. Paternal BMI was used as a negative control. Compared to a normal pre-pregnancy BMI, pre-pregnancy maternal obesity was positively associated with increased odds of a high HIS trajectory between 3 and 8 years old in both unadjusted and adjusted logistic regression (adjusted odds ratio [aOR] 1.87 [95% CI 1.12, 3.12]). Pre-pregnancy overweight was not significantly associated after adjustment for confounders (aOR 1.32 [0.87, 2.01]). Maternal pre-pregnancy obesity, but not overweight, was associated with increased likelihood of a high HIS trajectory in children from 3 to 8 years old. This association persisted despite controlling for many important maternal lifestyle factors and paternal BMI. Further research is warranted to identify possible mediators involved.
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Affiliation(s)
- Courtney Dow
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), ORCHAD Team, Paris, France.
| | - Cédric Galera
- Univ. Bordeaux, Inserm, Bordeaux Population Health Center, UMR 1219, 33000, Bordeaux, France
- Centre Hospitalier Perrens, Bordeaux, France
| | - Marie-Aline Charles
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), ORCHAD Team, Paris, France
| | - Barbara Heude
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), ORCHAD Team, Paris, France
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Ha DH, Nguyen HV, Bell LK, Devenish-Coleman G, Golley RK, Thomson WM, Manton DJ, Leary SD, Scott JA, Spencer J, Do LG. Trajectories of child free sugars intake and dental caries - a population-based birth cohort study. J Dent 2023:104559. [PMID: 37230240 DOI: 10.1016/j.jdent.2023.104559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/16/2023] [Accepted: 05/22/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVES To investigate the association between trajectories of free sugars intake during the first five years of life and dental caries experience at five years. METHODS Data from the SMILE population-based prospective birth cohort study, collected at one, two and five years old, were used. A 3-days dietary diary and food frequency questionnaire were used to estimate free sugars intake (FSI) in grams. The primary outcomes were dental caries prevalence and experience (dmfs). The Group-Based Trajectory Modelling method was used to characterize three FSI trajectories ('Low and increasing'; 'Moderate and increasing'; and 'High and increasing'), which were the main exposures. Multivariable regression models were generated to compute adjusted prevalence ratios (APR) and rate ratios (ARR) for the exposure, controlling for socioeconomic factors. RESULTS The prevalence of caries was 23.3%, with a mean dmfs of 1.4, and a median of 3.0 among those who had caries. There were clear gradients of caries prevalence and experience by the FSI trajectories. The 'High and increasing' had an APR of 2.13 (95%CI 1.23-3.70) and ARR of 2.77 (95%CI 1.45-5.32) against the 'Low and increasing'. The 'Moderate and increasing' group had intermediate estimates. A quarter of the caries cases could have been prevented if the whole study sample had been in the 'Low and increasing' FSI trajectory. CONCLUSION A sustained, high trajectory of FSI from a young age was positively associated with child dental caries. Measures to minimise consumption of free sugars must commence early in life. CLINICAL SIGNIFICANCE The study has provided high level evidence to inform clinicians' decisions in promoting a healthy dietary pattern for young children.
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Affiliation(s)
- Diep H Ha
- School of Dentistry, Faculty of Health and Behavioural Sciences, The University of Queensland, Australia.
| | - Huy V Nguyen
- Health Innovation and Transformation Centre, Federation University, Australia
| | - Lucinda K Bell
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Australia
| | | | - Rebecca K Golley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Australia
| | - W Murray Thomson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Australia
| | | | - Sam D Leary
- Centrum voor Tandheelkunde en Mondzorgkunde, UMCG, University of Groningen, the Netherlands
| | - Jane A Scott
- Nutrition and Dietetics, School of Population Health, Curtin University, Australia
| | - John Spencer
- Bristol Biomedical Research Centre Nutrition Theme, Bristol Dental School, University of Bristol, United Kingdom
| | - Loc G Do
- School of Dentistry, Faculty of Health and Behavioural Sciences, The University of Queensland, Australia; Nutrition and Dietetics, School of Population Health., Curtin University, Australia; Australian Research Centre for Population Oral Health, University of Adelaide, Australia
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Robinson SL, Ghassabian A, Sundaram R, Trinh MH, Lin TC, Bell EM, Yeung E. Parental Weight Status and Offspring Behavioral Problems and Psychiatric Symptoms. J Pediatr 2020; 220:227-236.e1. [PMID: 32067780 PMCID: PMC7186145 DOI: 10.1016/j.jpeds.2020.01.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/10/2019] [Accepted: 01/09/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To assess relations of prepregnancy maternal and paternal obesity with offspring behavioral problems and psychiatric symptoms at 7-8 years in the Upstate KIDS study, a prospective cohort study. STUDY DESIGN Maternal body mass index (BMI) was calculated from prepregnancy height and weight provided in vital records or self-report at 4 months postpartum. Mothers reported paternal height and weight. At 7-8 years, mothers indicated if their children had been diagnosed with ADHD or anxiety (n = 1915). Additionally, children's behavior was measured with the Strengths and Difficulties Questionnaire at 7 years of age (n = 1386) and the Vanderbilt ADHD Diagnostic Parent Rating Scale at 8 years of age (n = 1484). Based on Strengths and Difficulties Questionnaire scores, we identified children with borderline behavioral problems. Adjusted risk ratios (aRR) and 95% CIs were estimated with robust multivariable Poisson regression. RESULTS Compared with children of mothers with a BMI of <25, children whose mothers had BMI 25-30, 30-35, and ≥35 kg/m2 had higher risks of reported ADHD (aRR, 1.14, 95% CI, 0.78-1.69; aRR, 1.96, 95% CI, 1.29-2.98; and aRR, 1.82, 95% CI,1.21-2.74, respectively). Risks of hyperactivity problems identified by the Strengths and Difficulties Questionnaire and a positive screen for inattentive or hyperactive/impulsive behavior with the Vanderbilt ADHD Diagnostic Parent Rating Scale were also higher with increasing maternal prepregnancy BMI. Paternal BMI was not associated with child outcomes. CONCLUSIONS Our findings suggest that maternal, rather than paternal, obesity is associated with maternal report of child ADHD diagnosis and inattentive or hyperactivity problems. Further research is needed to understand how maternal obesity might influence these behavioral changes during or after pregnancy.
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Affiliation(s)
- Sonia L Robinson
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Akhgar Ghassabian
- Departments of Pediatrics, Environmental Medicine, and Population Health, New York University School of Medicine, New York, NY
| | - Rajeshwari Sundaram
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Mai-Han Trinh
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | | | - Erin M Bell
- Departments of Environmental Health Sciences, and Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, NY
| | - Edwina Yeung
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
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Ha DH, Do LG, Spencer AJ, Thomson WM, Golley RK, Rugg-Gunn AJ, Levy SM, Scott JA. Factors Influencing Early Feeding of Foods and Drinks Containing Free Sugars-A Birth Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101270. [PMID: 29065527 PMCID: PMC5664771 DOI: 10.3390/ijerph14101270] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 10/15/2017] [Accepted: 10/18/2017] [Indexed: 12/22/2022]
Abstract
Early feeding of free sugars to young children can increase the preference for sweetness and the risk of consuming a cariogenic diet high in free sugars later in life. This study aimed to investigate early life factors influencing early introduction of foods/drinks containing free sugars. Data from an ongoing population-based birth cohort study in Australia were used. Mothers of newborn children completed questionnaires at birth and subsequently at ages 3, 6, 12, and 24 months. The outcome was reported feeding (Yes/No) at age 6–9 months of common foods/drinks sources of free sugars (hereafter referred as foods/drinks with free sugars). Household income quartiles, mother’s sugar-sweetened beverage (SSB) consumption, and other maternal factors were exposure variables. Analysis was conducted progressively from bivariate to multivariable log-binomial regression with robust standard error estimation to calculate prevalence ratios (PR) of being fed foods/drinks with free sugars at an early age (by 6–9 months). Models for both complete cases and with multiple imputations (MI) for missing data were generated. Of 1479 mother/child dyads, 21% of children had been fed foods/drinks with free sugars. There was a strong income gradient and a significant positive association with maternal SSB consumption. In the complete-case model, income Q1 and Q2 had PRs of 1.9 (1.2–3.1) and 1.8 (1.2–2.6) against Q4, respectively. The PR for mothers ingesting SSB everyday was 1.6 (1.2–2.3). The PR for children who had been breastfed to at least three months was 0.6 (0.5–0.8). Similar findings were observed in the MI model. Household income at birth and maternal behaviours were significant determinants of early feeding of foods/drinks with free sugars.
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Affiliation(s)
- Diep H Ha
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide 5005, Australia.
| | - Loc G Do
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide 5005, Australia.
| | - Andrew John Spencer
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide 5005, Australia.
| | | | - Rebecca K Golley
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide 5005, Australia.
| | - Andrew J Rugg-Gunn
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK.
| | - Steven M Levy
- College of Dentistry, University of Iowa, Iowa, IA 52242, USA.
| | - Jane A Scott
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
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Yeung EH, Sundaram R, Ghassabian A, Xie Y, Buck Louis G. Parental Obesity and Early Childhood Development. Pediatrics 2017; 139:peds.2016-1459. [PMID: 28044047 PMCID: PMC5260147 DOI: 10.1542/peds.2016-1459] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/03/2016] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Previous studies identified associations between maternal obesity and childhood neurodevelopment, but few examined paternal obesity despite potentially distinct genetic/epigenetic effects related to developmental programming. METHODS Upstate KIDS (2008-2010) recruited mothers from New York State (excluding New York City) at ∼4 months postpartum. Parents completed the Ages and Stages Questionnaire (ASQ) when their children were 4, 8, 12, 18, 24, 30, and 36 months of age corrected for gestation. The ASQ is validated to screen for delays in 5 developmental domains (ie, fine motor, gross motor, communication, personal-social functioning, and problem-solving ability). Analyses included 3759 singletons and 1062 nonrelated twins with ≥1 ASQs returned. Adjusted odds ratios (aORs) and 95% confidence intervals were estimated by using generalized linear mixed models accounting for maternal covariates (ie, age, race, education, insurance, marital status, parity, and pregnancy smoking). RESULTS Compared with normal/underweight mothers (BMI <25), children of obese mothers (26% with BMI ≥30) had increased odds of failing the fine motor domain (aOR 1.67; confidence interval 1.12-2.47). The association remained after additional adjustment for paternal BMI (1.67; 1.11-2.52). Paternal obesity (29%) was associated with increased risk of failing the personal-social domain (1.75; 1.13-2.71), albeit attenuated after adjustment for maternal obesity (aOR 1.71; 1.08-2.70). Children whose parents both had BMI ≥35 were likely to additionally fail the problem-solving domain (2.93; 1.09-7.85). CONCLUSIONS Findings suggest that maternal and paternal obesity are each associated with specific delays in early childhood development, emphasizing the importance of family information when screening child development.
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Affiliation(s)
| | | | | | | | - Germaine Buck Louis
- Office of the Director, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland
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Impact of parental obesity on neonatal markers of inflammation and immune response. Int J Obes (Lond) 2016; 41:30-37. [PMID: 27780976 PMCID: PMC5209273 DOI: 10.1038/ijo.2016.187] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 08/25/2016] [Accepted: 09/25/2016] [Indexed: 12/11/2022]
Abstract
Background/Objectives Maternal obesity may influence neonatal and childhood morbidities through increased inflammation and/or altered immune response. Less is known about paternal obesity. We hypothesized that excessive parental weight contributes to elevated inflammation and altered immunoglobulin (Ig) profiles in neonates. Subjects/Methods In the Upstate KIDS Study maternal pre-pregnancy body mass index (BMI) was obtained from vital records and paternal BMI from maternal report. Biomarkers were measured from newborn dried blood spots (DBS) among neonates whose parents provided consent. Inflammatory scores were calculated by assigning one point for each of 5 pro-inflammatory biomarkers above the median and one point for an anti-inflammatory cytokine below the median. Linear regression models and generalized estimating equations were used to estimate mean differences (β) and 95% confidence intervals (CI) in the inflammatory score and Ig levels by parental overweight/obesity status compared to normal weight. Results Among 2974 pregnancies, 51% were complicated by excessive maternal weight (BMI>25), 73% by excessive paternal weight, and 28% by excessive gestational weight gain. Maternal BMI categories of overweight (BMI 25.0-29.9) and obese class II/III (BMI≥35) were associated with increased neonatal inflammation scores (β=0.12, 95% CI: 0.02, 0.21; p=0.02, and β=0.13, CI: −0.002, 0.26; p=0.05, respectively) but no increase was observed in the obese class I group (BMI 30-34.9). Mothers with class I and class II/III obesity had newborns with increased IgM levels (β=0.11, CI: 0.04, 0.17; p=0.001 and β=0.12, CI: 0.05, 0.19); p<0.001, respectively). Paternal groups of overweight, obese class I and obese class II/III had decreased neonatal IgM levels (β=−0.08, CI: −0.13,-0.03, p=0.001; β=−0.07, CI: −0.13, −0.01, p=0.029 and β=−0.11, CI:−0.19,-0.04, p=0.003, respectively). Conclusions Excessive maternal weight was generally associated with increased inflammation and IgM supporting previous observations of maternal obesity and immune dysregulation in offspring. The role of paternal obesity requires further study.
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Patel N, Pasupathy D, Poston L. Determining the consequences of maternal obesity for offspring health. Exp Physiol 2015; 100:1421-8. [PMID: 26464224 DOI: 10.1113/ep085132] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/05/2015] [Indexed: 12/20/2022]
Abstract
NEW FINDINGS What is the topic of this review? Observational studies have highlighted the association of increasing maternal body mass index with offspring adiposity and the subsequent risk of cardiometabolic disorders in adulthood. The in utero environment has become a target for intervention in order to reduce the burden of obesity, despite the mechanistic pathways of this association remaining unclear. What advances does it highlight? This short review provides a critical appraisal of the recent literature, including biological pathways and strategies to address causal relationships. The global obesity epidemic has been causally linked to changes in diet and lifestyle. Observational data and animal studies have now highlighted associations between in utero environmental exposures and increased susceptibility to obesity and related cardiometabolic disorders in later life. Maternal body mass index has been reported to show an independent association with offspring adiposity from an early age and to play an important role in the predisposition to obesity and metabolic disease in later life. Thus, the in utero environment has been the focus of recent targeted interventions to improve public health. In this review, we summarize recent progress in this field, including the use of animal models to investigate mechanistic links between maternal obesity and offspring metabolic risk. We then assess the level of evidence and challenges in establishing causal inferences from present birth cohorts.
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Affiliation(s)
- Nashita Patel
- Division of Women's Health, Women's Health Academic Centre, Faculty of Life Sciences and Medicine, King's College London, St Thomas' Hospital, London, UK
| | - Dharmintra Pasupathy
- Division of Women's Health, Women's Health Academic Centre, Faculty of Life Sciences and Medicine, King's College London, St Thomas' Hospital, London, UK
| | - Lucilla Poston
- Division of Women's Health, Women's Health Academic Centre, Faculty of Life Sciences and Medicine, King's College London, St Thomas' Hospital, London, UK
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Chang CH, Chuang LM. Fetal exposure to parental smoking and the risk of type 2 diabetes: Are lifestyle-related factors more important? J Diabetes Investig 2015; 7:472-5. [PMID: 27180661 PMCID: PMC4931196 DOI: 10.1111/jdi.12428] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 09/03/2015] [Accepted: 09/08/2015] [Indexed: 11/27/2022] Open
Abstract
Current evidence suggests that although fetal exposure to smoking might increase the risk of type 2 diabetes in later life, lifestyle factors either during pregnancy or in adulthood may play a more important role. A ‘family‐based association study’ design might be helpful to detangle the relation among intrauterine exposure, lifestyle factors, and risk of diabetes in later life.
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Affiliation(s)
- Chia-Hsuin Chang
- Department of Internal Medicine, National Taiwan University Hospital and Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Lee-Ming Chuang
- Department of Internal Medicine, National Taiwan University Hospital and Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
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Robinson SM, Crozier SR, Harvey NC, Barton BD, Law CM, Godfrey KM, Cooper C, Inskip HM. Modifiable early-life risk factors for childhood adiposity and overweight: an analysis of their combined impact and potential for prevention. Am J Clin Nutr 2015; 101:368-75. [PMID: 25646335 PMCID: PMC4307207 DOI: 10.3945/ajcn.114.094268] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Early life may be a "critical period" when appetite and regulation of energy balance are programmed, with lifelong consequences for obesity risk. Insight into the potential impact of modifying early-life risk factors on later obesity can be gained by evaluating their combined effects. OBJECTIVE The objective was to examine the relation between the number of early-life risk factors and obesity outcomes among children in a prospective birth cohort (Southampton Women's Survey). DESIGN Five risk factors were defined: maternal obesity [prepregnant body mass index (BMI; in kg/m(2)) >30], excess gestational weight gain (Institute of Medicine, 2009), smoking during pregnancy, low maternal vitamin D status (<64 nmol/L), and short duration of breastfeeding (none or <1 mo). Obesity outcomes examined when the children were aged 4 and 6 y were BMI, dual-energy X-ray absorptiometry-assessed fat mass, overweight, or obesity (International Obesity Task Force). Data were available for 991 mother-child pairs, with children born between 1998 and 2003. RESULTS Of the children, 148 (15%) had no early-life risk factors, 330 (33%) had 1, 296 (30%) had 2, 160 (16%) had 3, and 57 (6%) had 4 or 5. At both 4 and 6 y, there were positive graded associations between number of early-life risk factors and each obesity outcome (all P < 0.001). After taking account of confounders, the relative risk of being overweight or obese for children who had 4 or 5 risk factors was 3.99 (95% CI: 1.83, 8.67) at 4 y and 4.65 (95% CI: 2.29, 9.43) at 6 y compared with children who had none (both P < 0.001). CONCLUSIONS Having a greater number of early-life risk factors was associated with large differences in adiposity and risk of overweight and obesity in later childhood. These findings suggest that early intervention to change these modifiable risk factors could make a significant contribution to the prevention of childhood obesity.
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Affiliation(s)
- Siân M Robinson
- From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML)
| | - Sarah R Crozier
- From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML)
| | - Nicholas C Harvey
- From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML)
| | - Benjamin D Barton
- From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML)
| | - Catherine M Law
- From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML)
| | - Keith M Godfrey
- From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML)
| | - Cyrus Cooper
- From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML)
| | - Hazel M Inskip
- From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML)
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Howe LD, Firestone R, Tilling K, Lawlor DA. Trajectories and Transitions in Childhood and Adolescent Obesity. A LIFE COURSE PERSPECTIVE ON HEALTH TRAJECTORIES AND TRANSITIONS 2015. [DOI: 10.1007/978-3-319-20484-0_2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Associations between infant feeding and the size, tempo and velocity of infant weight gain: SITAR analysis of the Gemini twin birth cohort. Int J Obes (Lond) 2014; 38:980-7. [PMID: 24722545 PMCID: PMC4088337 DOI: 10.1038/ijo.2014.61] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 03/27/2014] [Accepted: 04/06/2014] [Indexed: 12/30/2022]
Abstract
Objective: Infant growth trajectories, in terms of size, tempo and velocity, may programme lifelong obesity risk. Timing of breastfeeding cessation and weaning are both implicated in rapid infant growth; we examined the association of both simultaneously with a range of growth parameters. Design: Longitudinal population-based twin birth cohort. Subjects: The Gemini cohort provided data on 4680 UK infants with a median of 10 (interquartile range=8–15) weight measurements between birth and a median of 6.5 months. Age at breastfeeding cessation and weaning were reported by parents at mean age 8.2 months (s.d.=2.2, range=4–20). Growth trajectories were modelled using SuperImposition by Translation And Rotation (SITAR) to generate three descriptors of individual growth relative to the average trajectory: size (grams), tempo (weeks, indicating the timing of the peak growth rate) and velocity (% difference from average, reflecting mean growth rate). Complex-samples general linear models adjusting for family clustering and confounders examined associations between infant feeding and SITAR parameters. Results: Longer breastfeeding (>4 months vs never) was independently associated with lower growth velocity by 6.8% (s.e.=1.3%) and delayed growth tempo by 1.0 (s.e.=0.2 weeks), but not with smaller size. Later weaning (⩾6 months vs <4 months) was independently associated with lower growth velocity by 4.9% (s.e.=1.1%) and smaller size by 102 g (s.e.=25 g). Conclusions: Infants breastfed for longer grew slower for longer after birth (later peak growth rate) but were no different in size, while infants weaned later grew slower overall and were smaller but the timing of peak growth did not differ. Slower trajectories with a delayed peak in growth may have beneficial implications for programming later obesity risk. Replication in cohorts with longer follow-up, alternative confounding structures or randomised controlled trials are required to confirm the long-term effects and directionality, and to rule out residual confounding.
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