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Hou J, Hou J, Die X, Sun J, Zhang M, Liu W, Wang Y. Impact of overweight/obesity on clinical outcomes after reduction for intussusception in children. Pediatr Surg Int 2021; 37:887-895. [PMID: 33825955 DOI: 10.1007/s00383-021-04888-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Childhood obesity is a worsening epidemic. Little is known about the impact of overweight and obesity (OV-OB) on clinical outcomes after reduction for intussusception in children. The aim of this study was to compare clinical outcomes after primarily air enema reduction for intussusception in grouped OV-OB (body mass index-for-age percentile ≥ 85) pediatric patients compared with no OV-OB patients. METHODS A retrospective study of 564 children who had undergone intussusception reduction via pneumatic reduction (PR) from April 2018 to January 2020 was conducted with assessments of demographic data, clinical symptoms, pre-reduction examination, and reduction results. One-to-one propensity score matching (PSM) was performed to compare clinical outcomes between patients with and without OV-OB, and the risk factors affecting recurrence and surgical reduction were analyzed in the PSM population. RESULTS Of the 564 patients, 132 cases (23.4%) were OV-OB (overweight: 95 cases; obesity: 37 cases). In the propensity-matched analysis, the OV-OB group showed a significant increase in surgical reduction (10.2% versus 0.9%, P = 0.005) and recurrence (47.2% versus 10.2%, P < 0.001), excretion time of carbon powder after PR (median: 11.2 h versus 8.4 h, P < 0.001), higher maximum pressure of PR (median: 10.2 kPa versus 7.8 kPa, P < 0.001), and number of PR attempts (mean: 2.0 versus 1.4, P < 0.001). There were no significant differences in the reasons for surgery (PR failure or bowel perforation), time to recurrence (early or late), and the times of recurrences ≥ 2. After applying the multivariate logistic regression analysis, we found that OV-OB and white blood cell count ≥ 20 × 109/L were risk factors for both surgical reduction and the recurrence of intussusception. CONCLUSION This study suggested that childhood OV-OB was associated with the failure of PR and recurrence of intussusception after reduction, which should be paid more attention in clinical practice.
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Affiliation(s)
- Jinping Hou
- Department of Neonatal Gastrointestinal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China
| | - Jinfeng Hou
- Department of Neonatal Gastrointestinal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China
| | - Xiaohong Die
- Department of Neonatal Gastrointestinal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China
| | - Jing Sun
- Department of Neonatal Gastrointestinal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China
| | - Min Zhang
- Department of Neonatal Gastrointestinal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China
| | - Wei Liu
- Department of Neonatal Gastrointestinal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China
| | - Yi Wang
- Department of Neonatal Gastrointestinal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China.
- Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China.
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Schlottmann H, Broome M, Herbst R, Burkhardt MC, Mescher A. Nurse-Led Telephone Follow-Up to Improve Parent Promotion of Healthy Behaviors in Young Children With Motivational Interviewing Techniques. J Pediatr Health Care 2019; 33:545-554. [PMID: 30926151 DOI: 10.1016/j.pedhc.2019.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 02/03/2019] [Accepted: 02/06/2019] [Indexed: 01/23/2023]
Abstract
INTRODUCTION The American Academy of Pediatrics (AAP) recommends primary care-based health promotion for obesity prevention at all visits, focusing on nutrition and activity. METHODS In this quality improvement project, a primary care innovation was developed to support parents in promoting healthy habits in their children ages 2 to 5 years old. Nurse-led telephone support using motivational interviewing was implemented during two follow-up phone calls aimed at helping parent-child dyads reach self-created activity or nutrition goals. RESULTS Parent-rated confidence and motivation related to meeting these goals showed significant increases. During the second call, 80% self-reported goal completion and high satisfaction with the visits. Registered nurses reported a significant increase in their self-efficacy of communication with parents. DISCUSSION This project showed the feasibility of using nurse telephone visits in an urban low-income primary care setting to improve parental recognition and understanding of healthy habits that align with American Academy of Pediatrics recommendations for obesity prevention.
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Jackson DB, Vaughn MG. Maternal medical risks during pregnancy and childhood externalizing behavior. Soc Sci Med 2018; 207:19-24. [DOI: 10.1016/j.socscimed.2018.04.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 02/06/2018] [Accepted: 04/21/2018] [Indexed: 11/26/2022]
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Jackson DB, Lynch KR, Helton JJ, Vaughn MG. Food Insecurity and Violence in the Home: Investigating Exposure to Violence and Victimization Among Preschool-Aged Children. HEALTH EDUCATION & BEHAVIOR 2018. [PMID: 29532691 DOI: 10.1177/1090198118760683] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children experiencing or witnessing violence in the home are at risk of a number of cognitive, social, and behavioral challenges as they age. A handful of recent studies have suggested that food insecurity may be one factor associated with violence against children in the home. The present study uses data from the Early Childhood Longitudinal Study-Birth Cohort to explore the link between household food insecurity during the first three waves of data collection (i.e., the first few years of life) and witnessing or being the victim of violence in the home among very young children (~ age 4). The results suggest that the predicted probability of early childhood exposure to violence and/or victimization in the home is nearly 6 times greater in persistently food-insecure households (i.e., households that are food insecure across all three waves) relative to food secure households. Limitations and avenues for future research are noted.
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Affiliation(s)
- Dylan B Jackson
- 1 The University of Texas at San Antonio, San Antonio, TX, USA
| | - Kellie R Lynch
- 1 The University of Texas at San Antonio, San Antonio, TX, USA
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Jackson DB. The Interplay Between Early Father Involvement and Neonatal Medical Risk in the Prediction of Infant Neurodevelopment. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2017; 18:106-115. [PMID: 27873045 DOI: 10.1007/s11121-016-0734-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The current study examines the association between early father involvement and infant neurodevelopment, and whether neonatal medical risk moderates this association. Data from approximately 6000 fathers and their children were obtained from the Early Childhood Longitudinal Study: Birth Cohort (ECLS-B). Hierarchical regression was employed to analyze the data. The findings reveal that the association between early father involvement and infant neurodevelopment is contingent on both the timing of involvement (i.e., prenatal/perinatal or infancy) and offspring medical status at birth. The neurodevelopment of medically at-risk neonates was enhanced when fathers were involved during the gestational period and at the time of their birth. This relationship was not detected, however, in the case of infants who did not experience medical risks as neonates. Neonatal medical risk appears to be an important moderating factor in the link between father involvement during pregnancy and childbirth and infant neurodevelopment. Practitioners should continue to make efforts to involve fathers during gestation and childbirth. The findings of the present study suggest that doing so may protect against neurodevelopmental delays in neonates with medical risks.
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Abstract
OBJECTIVE To investigate the association between maternal employment and childhood overweight in low- and middle-income countries (LMIC). Design/Setting We utilized cross-sectional data from forty-five Demographic and Health Surveys from 2010 to 2016 (n 268 763). Mothers were categorized as formally employed, informally employed or non-employed. We used country-specific logistic regression models to investigate the association between maternal employment and childhood overweight (BMI Z-score>2) and assessed heterogeneity in the association by maternal education with the inclusion of an interaction term. We used meta-analysis to pool the associations across countries. Sensitivity analyses included modelling BMI Z-score and normal weight (weight-for-age Z-score≥-2 to <2) as outcomes. SUBJECTS Participants included children 0-5 years old and their mothers (aged 18-49 years). RESULTS In most countries, neither formal nor informal employment was associated with childhood overweight. However, children of employed mothers, compared with children of non-employed mothers, had higher BMI Z-score and higher odds of normal weight. In countries where the association varied by education, children of formally employed women with high education, compared with children of non-employed women with high education, had higher odds of overweight (pooled OR=1·2; 95 % CI 1·0, 1·4). CONCLUSIONS We find no clear association between employment and child overweight. However, maternal employment is associated with a modestly higher BMI Z-score and normal weight, suggesting that employment is currently associated with beneficial effects on children's weight status in most LMIC.
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Jackson DB, Vaughn MG. Parental History of Disruptive Life Events and Household Food Insecurity. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:554-560.e1. [PMID: 28689609 DOI: 10.1016/j.jneb.2017.04.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate whether a history of disruptive life events (ie, school suspension or expulsion, job termination, hospitalization for mental health, and/or criminal justice involvement) among parents is positively associated with household food insecurity. DESIGN Structured interviews and self-report surveys. SETTING Households across all 50 states in the US. PARTICIPANTS Subsample of 6,270 households that participated in the Early Childhood Longitudinal Study-Birth Cohort with valid maternal and paternal data. MAIN OUTCOME MEASURES Food insecurity was measured when children were aged 9 months (wave 1), 2 years (wave 2), and 4 years (wave 3). Parental history of disruptive life events was measured at wave 1. ANALYSIS Logistic regression was used to carry out the analyses. RESULTS Each examined disruptive life event was associated with a significant increase in the odds of persistent household food insecurity (P < .05). The probability of persistent household food insecurity was >6 times as large in households with 1 or both parents reporting the occurrence of each of the disruptive life events, relative to households with none of these parental risk factors. CONCLUSIONS AND IMPLICATIONS Practitioners may want to consider parental history of various disruptive life events in their assessment of familial risk of household food insecurity. Future policy efforts might include a cost-benefit estimate analysis of intervening earlier in the food insecurity-disruptive life events nexus to advocate for savings to the taxpayer for prevention services. Moreover, future research could evaluate these practice and policy-driven efforts using quasi-experimental designs.
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Affiliation(s)
- Dylan B Jackson
- Department of Criminal Justice, University of Texas at San Antonio, San Antonio, TX.
| | - Michael G Vaughn
- College for Public Health and Social Justice, Saint Louis University, St Louis, MO
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Abstract
Obesity has become increasingly prevalent, and the number of obese patients in need of liver transplant is expected to continue to increase. In addition, liver disease due to nonalcoholic fatty liver disease is expected to become the leading cause of liver transplantation in the near future. However, obesity remains a relative contraindication in liver transplant. New strategies in managing this patient population are clearly needed. To this end, the authors review the current literature on the efficacy of bariatric surgery in the setting of liver transplantation in obese patients.
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Affiliation(s)
- Duminda Suraweera
- Department of Medicine, Olive-View Medical Center, 14445 Olive View Drive, 2B-182, Sylmar, CA 91342, USA
| | - Erik Dutson
- Department of Surgery, University of California at Los Angeles, 200 Medical Plaza, Suite 214, Los Angeles, CA 90095, USA
| | - Sammy Saab
- Department of Surgery, University of California at Los Angeles, 200 Medical Plaza, Suite 214, Los Angeles, CA 90095, USA; Department of Medicine, University of California at Los Angeles, 200 Medical Plaza, Suite 214, Los Angeles, CA 90095, USA.
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Jackson DB, Newsome J, Beaver KM. Does early paternal involvement predict offspring developmental diagnoses? Early Hum Dev 2016; 103:9-16. [PMID: 27434724 DOI: 10.1016/j.earlhumdev.2016.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 06/27/2016] [Accepted: 07/01/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND A long line of research has illustrated that fathers play an important role in the development of their children. Few studies, however, have examined the impact of paternal involvement at the earliest stages of life on developmental diagnoses in childhood. AIMS The present study extends this line of research by exploring the possibility that paternal involvement prenatally, postnatally, and at the time of birth may influence offspring risk for various diagnoses in childhood. STUDY DESIGN A quasi-experimental, propensity score matching design was used to create treatment and control groups to assess the relationship between paternal involvement at each stage of development and developmental diagnoses. SUBJECTS Approximately 6000 children, and a subsample of fathers, who participated in the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B). OUTCOME MEASURES Activity, attention and learning, speech or language, and other diagnoses in early childhood, and overall number of diagnoses at 4years of age. RESULTS We find no consistent evidence that low paternal involvement prenatally or postnatally increases the risk of various developmental diagnoses by age 4. However, children whose fathers were absent at the time of their birth were at significantly greater risk of incurring various developmental diagnoses, as well as a significantly greater number of developmental diagnoses. CONCLUSIONS The findings expand our understanding of exactly how early paternal influence begins and the specific dimensions of early father behaviors that are related to the risk of various developmental diagnoses. Ultimately, these results have important implications concerning father involvement during the earliest stages of the life course.
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Affiliation(s)
| | - Jamie Newsome
- The University of Texas at San Antonio, United States
| | - Kevin M Beaver
- Florida State University, United States; King Abdulaziz University, Saudi Arabia
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Yeaton WH, Shah MK, Moss BG. Evaluating Coincident Relationships Between Obesity Incidence and Normal Weight Incidence From Birth Through Kindergarten for US Children. Am J Health Promot 2016; 32:177-187. [PMID: 27879295 DOI: 10.1177/0890117116676545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE We examine the concurrent relationship between obesity incidence and normal weight status incidence and prevalence in children between 9 months and kindergarten. DESIGN Multistage, probability sample from the Early Childhood Longitudinal Study-Birth cohort. SETTING United States. PARTICIPANTS Representative sample of US preschool children (n = 9950) followed from birth through kindergarten. MEASURES From direct, anthropometric measures, we reported prevalence and incidence rates across 4 follow-up periods. ANALYSIS In addition to prevalence and incidence rates, we reported risk ratios based on multiple definitions and estimated predicted probabilities of obesity and normal weight status using clinically meaningful body mass index (BMI)-for-age percentiles. RESULTS Obesity prevalence (13%-20%) was much smaller than normal weight status prevalence (66%-70%). Lower socioeconomic status, Hispanic, and non-Hispanic black children had greater risk of obesity. During 9 months to kindergarten, obesity incidence decreased two-thirds (15.6%), while normal weight status incidence decreased almost one-half (44.6%). Coincidently, normal weight status incidence (ranged from 23% to 45%) was consistently and substantially higher than obesity incidence (ranged from 5% to 15%). During 4 years to kindergarten, the obesity risk for overweight children was 13 times higher than that for normal weight status children. CONCLUSION Overall rates of obese and normal weight incidence were substantial at 9 months, trended lower, but remained high through kindergarten. At 4 years to kindergarten, children with relatively high initial BMI were very likely to become obese but far less likely to achieve normal weight status.
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Affiliation(s)
- William H Yeaton
- 1 Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Megha K Shah
- 2 Department of Family and Preventive Medicine, Emory University, Atlanta, GA, USA
| | - Brian G Moss
- 3 School of Social Work, Wayne State University, Detroit, MI, USA
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Lawrence E, Mollborn S, Riosmena F. Early Childhood Disadvantage for Sons of Mexican Immigrants: Body Mass Index Across Ages 2-5. Am J Health Promot 2016; 30:545-53. [PMID: 26305614 PMCID: PMC4767705 DOI: 10.4278/ajhp.140725-quan-366] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 02/06/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE To distinguish the origins of higher weight status and determine when and why intra- and interracial/ethnic disparities emerge. DESIGN The study used a longitudinal analysis of the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B). SETTING The study was conducted in the United States. SUBJECTS Participants were children of non-Hispanic white mothers and children of U.S.- and foreign-born mothers of Mexican origin from a nationally representative sample of children born in the year 2001 (N ≈ 3700). MEASURES The Centers for Disease Control and Prevention growth charts determined sex- and age-specific weight status. Covariates were obtained from birth certificate records and parent interviews. ANALYSIS Frequencies, growth curve trajectories, and ordinary least squares regression examined body mass index (BMI) and obesity across survey waves. RESULTS Compared to their peers with non-Hispanic white mothers, children of Mexican-heritage mothers have higher average BMI and greater rates of obesity. The BMI of boys with Mexican-born mothers is higher relative to whites and children of U.S.-born Mexican mothers across early childhood, increasing sharply at about age 4.5 years. This divergence is driven by increases in the BMI of boys, as girls do not show the same growth. A number of measures, including descriptors of children's nutritional intake, lifestyle factors, and acculturation, do not explain the increased obesity rates among sons of Mexican mothers. CONCLUSION Despite favorable perinatal health and weight, Mexican-American sons of foreign-born mothers show disadvantages in BMI that emerge close to the start of kindergarten.
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Affiliation(s)
- Elizabeth Lawrence
- Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder, Boulder, Colorado
| | - Stefanie Mollborn
- Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder, Boulder, Colorado
| | - Fernando Riosmena
- Institute of Behavioral Science and Department of Geography, University of Colorado Boulder, Boulder, Colorado
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Roy SM, Spivack JG, Faith MS, Chesi A, Mitchell JA, Kelly A, Grant SFA, McCormack SE, Zemel BS. Infant BMI or Weight-for-Length and Obesity Risk in Early Childhood. Pediatrics 2016; 137:peds.2015-3492. [PMID: 27244803 PMCID: PMC4845873 DOI: 10.1542/peds.2015-3492] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2016] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Weight-for-length (WFL) is currently used to assess adiposity under 2 years. We assessed WFL- versus BMI-based estimates of adiposity in healthy infants in determining risk for early obesity. METHODS Anthropometrics were extracted from electronic medical records for well-child visits for 73 949 full-term infants from a large pediatric network. World Health Organization WFL and BMI z scores (WFL-z and BMI-z, respectively) were calculated up to age 24 months. Correlation analyses assessed the agreement between WFL-z and BMI-z and within-subject tracking over time. Logistic regression determined odds of obesity at 2 years on the basis of adiposity classification at 2 months. RESULTS Agreement between WFL-z and BMI-z increased from birth to 6 months and remained high thereafter. BMI-z at 2 months was more consistent with measurements at older ages than WFL-z at 2 months. Infants with high BMI (≥85th percentile) and reference WFL (5th-85th percentiles) at 2 months had greater odds of obesity at 2 years than those with high WFL (≥85th percentile) and reference BMI (5th-85th percentiles; odds ratio, 5.49 vs 1.40; P < .001). At 2 months, BMI had a higher positive predictive value than WFL for obesity at 2 years using cut-points of either the 85th percentile (31% vs 23%) or 97.7th percentile (47% vs 29%). CONCLUSIONS High BMI in early infancy is more strongly associated with early childhood obesity than high WFL. Forty-seven percent of infants with BMI ≥97.7th percentile at 2 months (versus 29% of infants with WFL ≥97.7th percentile at 2 months) were obese at 2 years. Epidemiologic studies focused on assessing childhood obesity risk should consider using BMI in early infancy.
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Affiliation(s)
| | - Jordan G Spivack
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | - Myles S Faith
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | | | - Jonathan A Mitchell
- Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Andrea Kelly
- Divisions of Endocrinology and Diabetes, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | - Struan F A Grant
- Divisions of Endocrinology and Diabetes, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and Human Genetics, and
| | - Shana E McCormack
- Divisions of Endocrinology and Diabetes, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | - Babette S Zemel
- Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania;
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Guerrero AD, Chung PJ. Racial and Ethnic Disparities in Dietary Intake among California Children. J Acad Nutr Diet 2016; 116:439-448. [PMID: 26433453 PMCID: PMC4769954 DOI: 10.1016/j.jand.2015.08.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 08/19/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The prevalence of childhood obesity among racial and ethnic minority groups is high. Multiple factors affect the development of childhood obesity, including dietary practices. OBJECTIVE To examine the racial and ethnic differences in reported dietary practices among the largest minority groups of California children. METHODS Data from the 2007 and 2009 California Health Interview Survey were analyzed using multivariate regression with survey weights to examine how race, ethnicity, sociodemographic characteristics, and child factors were associated with specific dietary practices. RESULTS The sample included 15,902 children aged 2 to 11 years. In multivariate regressions, substantial differences in fruit juice, fruit, vegetable, sugar-sweetened beverages, sweets, and fast-food consumption were found among the major racial and ethnic groups of children. Asians regardless of interview language were more likely than whites to have low vegetable intake consumption (Asians English interview odds ratio [OR] 1.20, 95% CI 1.01 to 1.43; Asians non-English-interview OR 2.09, 95% CI 1.23 to 3.57) and low fruit consumption (Asians English interview OR 1.69, 95% CI 1.41 to 2.03; Asians non-English interview OR 3.04, 95% CI 2.00 to 4.6). Latinos regardless of interview language were also more likely than whites to have high fruit juice (Latinos English interview OR 1.54, 95% CI 1.28 to 1.84 and Latinos non-English interview OR 1.29, 95% CI 1.02 to 1.62) and fast-food consumption (Latinos English interview OR 1.74, 95% CI 1.46 to 2.08 and Latinos non-English interview OR 1.48, 95% CI 1.16 to 1.91); but Latinos were less likely than whites to consume sweets (Latinos English interview OR 0.81, 95% CI 0.66 to 0.99 and Latinos non-English interview OR 0.56, 95% CI 1.16 to 1.91). CONCLUSIONS Significant racial and ethnic differences exist in the dietary practices of California children. Increased fruit and vegetable consumption appears to be associated with parent education but not income. Our findings suggest that anticipatory guidance and dietary counseling might benefit from tailoring to specific ethnic groups to potentially address disparities in overweight and obesity.
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Abstract
To prevent the intergenerational transfer of obesity and end the current epidemic, interventions are needed across the early life stages, from preconception to prenatal to infancy through the age of 2 years. The foundation for obesity is laid in early life by actions and interactions passed from parent to child that have long-lasting biologic and behavioral consequences. The purpose of this paper is to examine the best evidence about (a) factors in parents and offspring that promote obesity during the early life stages, (b) the social determinants and dimensions of obesity in early life, (c) promising and effective interventions for preventing obesity in early life, and (d) opportunities for future research into strategies to disrupt the intergenerational cycle of obesity that begins early in life. The pathway for halting the intergenerational obesity epidemic requires the discovery and development of evidence-based interventions that can act across multiple dimensions of influence on early life.
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Affiliation(s)
- Debra Haire-Joshu
- Public Health and Medicine, Brown School, Washington University in St. Louis, St. Louis, Missouri 63130;
| | - Rachel Tabak
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri 63130;
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AZEVEDO KATHRYNJ, ROBINSON THOMASN. Anthropology in the design of preventive behavioral health programs for children and families living in disadvantaged neighborhoods. ANNALS OF ANTHROPOLOGICAL PRACTICE 2015. [DOI: 10.1111/napa.12078] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- KATHRYN J. AZEVEDO
- Menlo Park Division, National Center for PTSD; Veterans Affairs Palo Alto Health Care System
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Racial and Ethnic Disparities in Early Childhood Obesity: Growth Trajectories in Body Mass Index. J Racial Ethn Health Disparities 2015; 3:129-37. [PMID: 26896112 DOI: 10.1007/s40615-015-0122-y] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 04/15/2015] [Accepted: 04/24/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aims of this study are to describe growth trajectories in the body mass index (BMI) among the major racial and ethnic groups of US children and to identify predictors of children's BMI trajectories. METHODS The Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) was used to identify predictors of BMI growth trajectories, including child characteristics, maternal attributes, home practices related to diet and social behaviors, and family sociodemographic factors. Growth models, spanning 48 to 72 months of age, were estimated with hierarchical linear modeling via STATA/Xtmixed methods. RESULTS Approximately one-third of 4-year-old females and males were overweight and/or obese. African-American and Latino children displayed higher predicted mean BMI scores and differing mean BMI trajectories, compared with White children, adjusting for time-independent and time-dependent predictors. Several factors were significantly associated with lower mean BMI trajectories, including very low birth weight, higher maternal education level, residing in a two-parent household, and breastfeeding during infancy. Greater consumption of soda and fast food was associated with higher mean BMI growth. Soda consumption was a particularly strong predictor of mean BMI growth trajectory for young Black children. Neither the child's inactivity linked to television viewing nor fruit nor vegetable consumption was predictive of BMI growth for any racial/ethnic group. CONCLUSION Significant racial and ethnic differences are discernible in BMI trajectories among young children. Raising parents' and health practitioners' awareness of how fast food and sweetened-beverage consumption contributes to early obesity and growth in BMI-especially for Blacks and Latinos-could improve the health status of young children.
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Hernandez RG, Marcell AV, Garcia J, Amankwah EK, Cheng TL. Predictors of favorable growth patterns during the obesity epidemic among US school children. Clin Pediatr (Phila) 2015; 54:458-68. [PMID: 25686842 PMCID: PMC4834888 DOI: 10.1177/0009922815570579] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To report the prevalence of favorable growth patterns, including healthy weight maintenance (HWM) and return to healthy weight (RHW) among US school-age children. METHODS A longitudinal analysis of childhood growth patterns from the Early Childhood Longitudinal Study-Kindergarten Cohort was completed (n = 9416). The primary outcome included describing the prevalence of HWM/RHW patterns using consecutive child growth data from kindergarten to fifth grades. Multivariate logistic regression was used to explore predictors of HWM/RHW. Incidence of RHW is calculated by grade level. RESULTS Seventy percent (n = 6617) of children enter kindergarten at a healthy weight and approximately 70% maintained a healthy weight through fifth grade. Among overweight/obese kindergartners, only 17.1% outgrew their weight risk (RHW) by fifth grade. CONCLUSIONS Fewer than 1 in 5 at-risk children outgrow their weight risk during school-age yet a majority of healthy weight children can maintain healthy weight during a critical growth period. Future work should explore additional socioecologic factors associated with favorable growth.
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Affiliation(s)
- Raquel G. Hernandez
- Johns Hopkins University School of Medicine, Baltimore MD,All Children’s Hospital Johns Hopkins Medicine, St. Petersburg Florida
| | | | - Janelle Garcia
- All Children’s Hospital Johns Hopkins Medicine, St. Petersburg Florida
| | | | - Tina L. Cheng
- Johns Hopkins University School of Medicine, Baltimore MD
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18
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Early childhood healthy and obese weight status: potentially protective benefits of breastfeeding and delaying solid foods. Matern Child Health J 2015; 18:1224-32. [PMID: 24057991 DOI: 10.1007/s10995-013-1357-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of this study was to assess the relationship between breastfeeding and postponing introduction to solid food (SF) on children's obesity and healthy weight status (WS), at 2 and 4 years. Drawing upon a nationally representative sample of children from the Early Childhood Longitudinal Study-Birth Cohort, we estimated the magnitude of the relationship between children's WS and early feeding practices. Contingency tables and multinomial logistic regression were used to analyze obese and healthy WS for breastfed and never breastfed children and examine three timing categories for SF introduction. With both percentages and odds, breastfeeding and delaying introduction to SF until 4 months were associated with lower obesity rates and higher, healthy WS rates (typically 5-10%). Analyses of feeding practice combinations revealed that when children were not breastfed, obesity odds decreased when SF introduction was postponed until 4 months. Obesity odds were further reduced when SF delay was combined with breastfeeding. Consistent increases in healthy WS were also observed. Benefits were stable across both follow-up periods. Breastfeeding and delaying complementary foods yielded consistently and substantially lower likelihood of obesity and greater probability of healthy WS. Health policies targeting early feeding practices represent promising interventions to decrease preschool obesity and promote healthy WS.
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Bjerregaard LG, Rasmussen KM, Michaelsen KF, Skytthe A, Mortensen EL, Baker JL, Sørensen TIA. Effects of body size and change in body size from infancy through childhood on body mass index in adulthood. Int J Obes (Lond) 2014; 38:1305-11. [PMID: 24942870 DOI: 10.1038/ijo.2014.108] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 05/19/2014] [Accepted: 06/10/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Weight and weight gain throughout infancy are related to later obesity, but whether the strength of the associations varies during the infancy period is uncertain. AIMS Our aims were to identify the period of infancy when change in body weight has the strongest association with adult body mass index (BMI) and also the extent to which these associations during infancy are mediated through childhood BMI. METHODS The Copenhagen Perinatal Cohort, in which participants were followed from birth through 42 years of age, provided information on weight at 12 months and BMI at 42 years for 1633 individuals. Information on weight at birth, 2 weeks, 1, 2, 3, 4 and 6 months was retrieved from health visitors' records and information on BMI at ages 7 and 13 years from school health records. The associations of infant weight and weight gain standard deviation scores (SDS) with adult BMI-SDS were analyzed using multiple linear regression and path analysis. RESULTS Higher-weight-SDS at all ages from birth to an age 12 months were associated with higher-BMI-SDS at 42 years (regression coefficients 0.08-0.12). Infant weight gain-SDS was associated with greater BMI-SDS at 42 years only between birth and 3 months (0.09, 95% confidence intervals (CI) 0.04, 0.15) driven by an association between 2 and 3 months (0.12, 95% CI: 0.04, 0.20). The latter was partly mediated through later BMI in the path analysis. Infant weight gain-SDS between 3 and 12 months was not associated with greater BMI-SDS at 42 years. CONCLUSIONS Faster weight gain during only the first 3 months of infancy was associated with increased adult BMI, although not in a consistent monthly pattern. Adult BMI is more sensitive to high weight gain during early infancy than late infancy, but not specifically to the first month of life.
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Affiliation(s)
- L G Bjerregaard
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - K M Rasmussen
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - K F Michaelsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - A Skytthe
- Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - E L Mortensen
- 1] Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark [2] Institute of Public Health and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - J L Baker
- 1] Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark [2] Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - T I A Sørensen
- 1] Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark [2] Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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20
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Rendall MS, Weden MM, Lau C, Brownell P, Nazarov Z, Fernandes M. Evaluation of bias in estimates of early childhood obesity from parent-reported heights and weights. Am J Public Health 2014; 104:1255-62. [PMID: 24832432 DOI: 10.2105/ajph.2014.302001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We evaluated bias in estimated obesity prevalence owing to error in parental reporting. We also evaluated bias mitigation through application of Centers for Disease Control and Prevention's biologically implausible value (BIV) cutoffs. METHODS We simulated obesity prevalence of children aged 2 to 5 years in 2 panel surveys after counterfactually substituting parameters estimated from 1999-2008 National Health and Nutrition Examination Survey data for prevalence of extreme height and weight and for proportions obese in extreme height or weight categories. RESULTS Heights reported below the first and fifth height-for-age percentiles explained between one half and two thirds, respectively, of total bias in obesity prevalence. Bias was reduced by one tenth when excluding cases with height-for-age and weight-for-age BIVs and by one fifth when excluding cases with body mass-index-for-age BIVs. Applying BIVs, however, resulted in incorrect exclusion of nonnegligible proportions of obese children. CONCLUSIONS Correcting the reporting of children's heights in the first percentile alone may reduce overestimation of early childhood obesity prevalence in surveys with parental reporting by one half to two thirds. Excluding BIVs has limited effectiveness in mitigating this bias.
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Affiliation(s)
- Michael S Rendall
- Michael S. Rendall is with the Department of Sociology, University of Maryland, College Park. Margaret M. Weden, Christopher Lau, and Peter Brownell are with RAND, Santa Monica, CA. Zafar Nazarov is with the Department of Economics, Purdue University, Fort Wayne, IN. Meenakshi Fernandes is with the World Food Programme, Rome, Italy
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21
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Reifsnider E, McCormick DP, Cullen KW, Szalacha L, Moramarco MW, Diaz A, Reyna L. A randomized controlled trial to prevent childhood obesity through early childhood feeding and parenting guidance: rationale and design of study. BMC Public Health 2013; 13:880. [PMID: 24063435 PMCID: PMC3852597 DOI: 10.1186/1471-2458-13-880] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 09/03/2013] [Indexed: 12/22/2022] Open
Abstract
Background Early and rapid growth in Infants is strongly associated with early development and persistence of obesity in young children. Substantial research has linked child obesity/overweight to increased risks for serious health outcomes, which include adverse physical, psychological, behavioral, or social consequences. Methods/design The goal of this study is to compare the effectiveness of structured Community Health Worker (CHW)- provided home visits, using an intervention created through community-based participatory research, to standard care received through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) office visits in preventing the development of overweight (weight/length ≥85th percentile) and obesity (weight/length ≥95th percentile) in infants during their first 3 years of life. One hundred forty pregnant women in their third trimester (30–36 weeks) will be recruited and randomly assigned to the intervention or control group. Discussion This study will provide prospective data on the effects of an intervention to prevent childhood obesity in children at high risk for obesity due to ethnicity, income, and maternal body mass index (BMI). It will have wide-ranging applicability and the potential for rapid dissemination through the WIC program, and will demonstrate the effectiveness of a community approach though employing CHWs in preventing obesity during the first 3 years of life. This easy-to-implement obesity prevention intervention can be adapted for many locales and diverse communities and can provide evidence for policy change to influence health throughout life. Trial registration Clinical Trials Number: NCT01905072
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Affiliation(s)
- Elizabeth Reifsnider
- College of Nursing and Health Innovation, Arizona State University, 500 N, 3rd Street, Phoenix, AZ 85004, USA.
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22
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Abstract
During the past two decades, the incidence of childhood obesity has increased at alarming rates throughout the world. Obesity is associated with a variety of physiological changes that may impair a patient's response to surgery. With the rising rates of childhood obesity, pediatric surgeons must appreciate differences in the management and outcomes of these patients. Difficult physical examination, elevated inflammatory blood markers, and negative influence of obesity on the detection rate of the appendix on ultrasound have been reported causing diagnostic challenging of appendicitis in obese children. Moreover, obesity is associated with longer hospital stay and higher morbidity and minimal invasive techniques' superior outcomes over open technique in children undergoing appendectomy.
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Affiliation(s)
- Balazs Kutasy
- National Children's Research Center, Our Lady's Children's Hospital, Dublin, Ireland.
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23
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Chang Y, Gable S. Predicting weight status stability and change from fifth grade to eighth grade: the significant role of adolescents' social-emotional well-being. J Adolesc Health 2013; 52:448-55. [PMID: 23298991 DOI: 10.1016/j.jadohealth.2012.09.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 09/15/2012] [Accepted: 09/18/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE The primary objective of this study was to predict weight status stability and change across the transition to adolescence using parent reports of child and household routines and teacher and child self-reports of social-emotional development. METHODS Data were from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K), a nationally representative sample of children who entered kindergarten during 1998-1999 and were followed through eighth grade. At fifth grade, parents reported on child and household routines and the study child and his/her primary classroom teacher reported on the child's social-emotional functioning. At fifth and eighth grade, children were directly weighed and measured at school. Nine mutually-exclusive weight trajectory groups were created to capture stability or change in weight status from fifth to eighth grade: (1) stable obese (ObeSta); (2) obese to overweight (ObePos1); (3) obese to healthy (ObePos2); (4) stable overweight (OverSta); (5) overweight to healthy (OverPos); (6) overweight to obese (OverNeg); (7) stable healthy (HelSta); (8) healthy to overweight (HelNeg1); and (9) healthy to obese (HelNeg2). RESULTS Except for breakfast consumption at home, school-provided lunches, nighttime sleep duration, household and child routines did not predict stability or change in weight status. Instead, weight status trajectory across the transition to adolescence was significantly predicted by measures of social-emotional functioning at fifth grade. CONCLUSIONS Assessing children's social-emotional well-being in addition to their lifestyle routines during the transition to adolescence is a noteworthy direction for adolescent obesity prevention and intervention.
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Affiliation(s)
- Yiting Chang
- University of Vermont, Burlington, VT 05405, USA.
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24
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Andersen LG, Holst C, Michaelsen KF, Baker JL, Sørensen TIA. Weight and weight gain during early infancy predict childhood obesity: a case-cohort study. Int J Obes (Lond) 2012; 36:1306-11. [PMID: 22907690 DOI: 10.1038/ijo.2012.134] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Infant weight and weight gain are positively associated with later obesity, but whether there is a particular critical time during infancy remains uncertain. OBJECTIVE The aim was to investigate when and how weight and weight gain during infancy become associated with childhood obesity. METHODS In a cohort representing 28 340 children born from 1959-67 and measured in Copenhagen schools, 962 obese children (2007 World Health Organization criteria), were compared with a 5% randomly selected sub-cohort of 1417 children. Information on weight at birth, 2 weeks, 1, 2, 3, 4, 6 and 9 months was retrieved from health visitors' records. Odds ratios and 95% confidence intervals (CI) for childhood obesity by tertiles of weight at each age and by change in tertiles of weight between two consecutive measurements were estimated using multivariate logistic regression with adjustment for indicators of socioeconomic status, preterm birth, and breastfeeding. RESULTS Compared with children in the middle weight-tertile, children with a weight in the upper tertile had a 1.36-fold (CI, 1.10-1.69) to 1.72-fold (CI, 1.36-2.18) higher risk of childhood obesity from birth through 9 months, whereas children in the lower weight-tertile had almost half the risk of obesity from 2 through 9 months. The risk of childhood obesity associated with change in weight-tertile in each interval was stable at ∼1.5-fold per weight-tertile increase throughout infancy. CONCLUSIONS Infant weight and weight gain are associated with obesity in childhood already during the first months of life. Determinants of weight gain shortly after birth may be a suitable target for prevention of obesity.
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Affiliation(s)
- L G Andersen
- Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark.
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25
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Chapman DJ, Pérez-Escamilla R. Breastfeeding among minority women: moving from risk factors to interventions. Adv Nutr 2012; 3:95-104. [PMID: 22332107 PMCID: PMC3262621 DOI: 10.3945/an.111.001016] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The gap between current breastfeeding practices and the Healthy People 2020 breastfeeding goals is widest for black women compared with all other ethnic groups. Also of concern, Hispanic and black women have the highest rates of formula supplementation of breast-fed infants before 2 d of life. These disparities must be addressed through the scale-up of effective interventions. The objective of this critical review is to identify and evaluate U.S.-based randomized trials evaluating breastfeeding interventions targeting minorities and highlight promising public health approaches for minimizing breastfeeding disparities. Through PubMed searches, we identified 22 relevant publications evaluating 18 interventions targeting minorities (peer counseling [n = 4], professional support [n = 4], a breastfeeding team [peer + professional support, n = 3], breastfeeding-specific clinic appointments [n = 2], group prenatal education [n = 3], and enhanced breastfeeding programs [n = 2]). Peer counseling interventions (alone or in combination with a health professional), breastfeeding-specific clinic appointments, group prenatal education, and hospital/Special Supplemental Nutrition Program for Women, Infants, and Children enhancements were all found to greatly improve breastfeeding initiation, duration, or exclusivity. Postpartum professional support delivered by nurses was found to be the least effective intervention type. Beyond improving breastfeeding outcomes, 6 interventions resulted in reductions in infant morbidity or health care use. Future research should include further evaluations of successful interventions, with an emphasis on determining the optimal timeframe for the provision of support, the effect of educating women's family members, and the impact on infant health care use and cost-effectiveness.
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Abstract
To effectively intervene with the overweight and obese youth, it is imperative that primary care providers and behavioral interventionists work in concert to help families implement healthy behaviors across socioenvironmental domains. In this article, the authors review current office-based counseling practices and provide evidence-based recommendations for addressing weight status and strategies for encouraging behavior change with children and families, primarily by increasing social support. By providing such collaborative targeted efforts, consistent health messages and support are delivered across children's everyday contexts, thereby helping the youth to achieve successful implementation of eating and activity behaviors and sustainable weight loss outcomes.
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Affiliation(s)
- Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8134, St. Louis, Missouri 63110, Phone: 314-286-2079, Fax: 314-286-2091
| | - Andrea E. Kass
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8134, St. Louis, Missouri 63110, Phone: 314-286-2113, Fax: 314-286-2091
| | - Rachel P. Kolko
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8134, St. Louis, Missouri 63110, Phone: 314-286-0253, Fax: 314-286-2091
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27
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Abstract
Socioeconomic stress associated with financial and psychosocial stress is widespread in society. A comprehensive body of research indicates that low socioeconomic status and social stress is associated with a broad spectrum of health risks. This paper reviews epidemiological evidence demonstrating the association between chronic social stress and development of obesity and symptoms leading to metabolic syndrome. The cumulative effects of socioeconomic stress on health and well being are evident throughout the lifespan, affecting children, adolescents, and adults. While the links between stress and metabolic disease are documented, the mechanisms remain less well understood. Animal models are well established and have provided opportunities to systematically investigate contributing mechanisms that may be targeted to develop treatment and prevention strategies against metabolic disorders arising from exposure to chronic social stress.
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Affiliation(s)
- Kellie L K Tamashiro
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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28
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Harbaugh BL, Kolbo JR, Molaison EF, Hudson GM, Zhang L, Wells D. Obesity and Overweight Prevalence among a Mississippi Low-Income Preschool Population: A Five-Year Comparison. ISRN NURSING 2011; 2011:270464. [PMID: 22007319 PMCID: PMC3175382 DOI: 10.5402/2011/270464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Accepted: 07/21/2011] [Indexed: 01/09/2023]
Abstract
Purpose. This study determined 2010 rates of overweight/obesity in a representative sample of low-income preschoolers in Mississippi, USA and compared rates between 2005 (N = 1250) and 2010 (N = 1765). Significance. Obesity is a significant global health issue because of its well-established negative health consequences. Child obesity is a concern due to risk of early-onset obesity-related illnesses and the longevity of lifetime exposure to those illnesses. Methods. Identical measures were used in 2005 and 2010 with complex-stratified sampling designs. Results. Chi-square tests revealed that overall obesity/overweight rates between 2005 (20.6%/17.9%) and 2010 (20.8%/17.0%) had not changed significantly for the samples as a whole, nor by gender or race. Age group comparisons indicated a significant decline in obesity rates of 3 year olds (20.3% in 2005, reduced to 13.1% in 2010, P = 0.035). These findings mimic the trend toward stabilization of obesity rates noted in national low-income preschool populations.
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Affiliation(s)
- Bonnie L. Harbaugh
- School of Nursing, College of Health, University of Southern Mississippi, 118 College Drive, Box 5095, Hattiesburg, MS 39406-0001, USA
| | - Jerome R. Kolbo
- School of Social Work, College of Health, University of Southern Mississippi, 118 College Drive, Box 5114, Hattiesburg, MS 39406-0001, USA
| | - Elaine F. Molaison
- Department of Nutrition and Food Systems, College of Health, University of Southern Mississippi, 118 College Drive, Box 5172, Hattiesburg, MS 39406-0001, USA
| | - Geoffrey M. Hudson
- School of Human Performance and Recreation, College of Health, University of Southern Mississippi, 118 College Drive, Box 5142, Hattiesburg, MS 39406-0001, USA
| | - Lei Zhang
- Office of Health Data and Research, Mississippi State Department of Health, 570 E. Woodrow Wilson, Jackson, MS 39215-1700, USA
| | - Danyell Wells
- School of Social Work, College of Health, University of Southern Mississippi, 118 College Drive, Box 5114, Hattiesburg, MS 39406-0001, USA
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