Association of common maternal infections with birth outcomes: a multinational cohort study

PURPOSE

It is unclear whether common maternal infections during pregnancy are risk factors for adverse birth outcomes. We assessed the association between self-reported infections during pregnancy with preterm birth and small-for-gestational-age (SGA) in an international cohort consortium.

METHODS

Data on 120,507 pregnant women were obtained from six population-based birth cohorts in Australia, Denmark, Israel, Norway, the UK and the USA. Self-reported common infections during pregnancy included influenza-like illness, common cold, any respiratory tract infection, vaginal thrush, vaginal infections, cystitis, urinary tract infection, and the symptoms fever and diarrhoea. Birth outcomes included preterm birth, low birth weight and SGA. Associations between maternal infections and birth outcomes were first assessed using Poisson regression in each cohort and then pooled using random-effect meta-analysis. Risk ratios (RR) and 95% confidence intervals (CI) were calculated, adjusted for potential confounders.

RESULTS

Vaginal infections (pooled RR, 1.10; 95% CI, 1.02-1.20) and urinary tract infections (pooled RR, 1.17; 95% CI, 1.09-1.26) during pregnancy were associated with higher risk of preterm birth. Similar associations with low birth weight were also observed for these two infections. Fever during pregnancy was associated with higher risk of SGA (pooled RR, 1.07; 95% CI, 1.02-1.12). No other significant associations were observed between maternal infections/symptoms and birth outcomes.

CONCLUSION

Vaginal infections and urinary infections during pregnancy were associated with a small increased risk of preterm birth and low birth weight, whereas fever was associated with SGA. These findings require confirmation in future studies with laboratory-confirmed infection diagnosis.

Exploring associations between the Big Five personality traits and cognitive ability with COVID-19 vaccination hesitancy and uptake among mothers and offspring in a UK prospective cohort study

BACKGROUND

Vaccines reduce the severity of symptoms, and risk of hospitalisation and death from infectious diseases. Yet, vaccination hesitancy persists. Research identifying psychological risk factors for vaccination hesitancy is limited and reports conflicting results. This study sought to address these inconsistencies and explore the role of personality and cognitive ability in COVID-19 vaccination hesitancy and uptake in a prospective cohort study.

METHODS

Data came from young adults (Generation-1; G1) and their mothers (Generation-0; G0) in the Avon Longitudinal Study of Parents and Children (ALSPAC). Multinomial logistic regressions, adjusting for several sociodemographic confounders, were used to explore whether personality and cognitive ability were associated with COVID-19 vaccination hesitancy and uptake. 4,960 G1 and 4,853 G0 mothers were included in the study population.

FINDINGS

Among G1, 38.4% exhibited vaccination hesitancy, yet 91.9% of the cohort received the vaccine. In adjusted models, higher levels of openness, agreeableness, conscientiousness, and cognitive ability were associated with an increased probability of wanting the vaccine. Similarly, higher levels of agreeableness, openness and cognitive ability were associated with an increased probability of vaccination uptake. However, the evidence of associations with vaccine uptake were generally weaker than with vaccination hesitancy. 56.7% of the offspring who did not want the vaccine either received the vaccine or intended to, whilst 43.3% still had no intention.Among G0 mothers, 25.6% were vaccination hesitant, yet 99.0% of the cohort received the vaccine. 3.1% said they did not want the vaccine; approximately 80% of these either received the vaccine or intended to. We found inconclusive evidence for an association between cognitive ability and vaccination hesitancy among G0 mothers.

INTERPRETATION

This study identified psychological factors associated with vaccination hesitancy and uptake. If these associations are causal, these findings may help design more effective vaccination hesitancy interventions.

Daily Duration of Eating for Children and Adolescents: A Systematic Review and Meta-Analysis

Time-limited eating is a dietary intervention whereby eating is limited to a specific window of time during the day. The usual eating windows of adults, and how these can be manipulated for dietary interventions, is well documented. However, there is a paucity of data on eating windows of young people, the manipulation of which may be a useful intervention for reducing obesity. This paper reviewed the existing literature on the eating windows of children and adolescents, aged 5-18 years, plus clock times of first and last intakes and variations by subgroup. Two databases (Medline and Embase) were searched for eligible papers published between February 2013 and February 2023, with forward searching of the citation network of included studies on Web of Science. Articles were screened, and data extracted, in duplicate by two independent reviewers. Ten studies were included, with both observational and experimental designs. Narrative synthesis showed large variations in eating windows with average values ranging from 9.7 h to 16.4 h. Meta-analysis, of five studies, showed a pooled mean daily eating window of 11.3 h (95% CI 11.0, 11.7). Large variations in eating windows exist across different study populations; however, the pooled data suggest that it may be possible to design time-limited eating interventions in paediatric populations aimed at reducing eating windows. Further high-quality research, investigating eating windows and subsequent associations with health outcomes, is needed.

Paternal health in the first 12-13 years of the ALSPAC study

The Avon Longitudinal Study of Parents and Children (ALSPAC) collected information from the enrolled pregnancy onwards to identify features of the environment in which the study child was brought up. Among data collected were features concerning the health of the mothers' partners - generally the study father. This was an important feature since the father's physical and mental health can have a long-term effect on the family. In this Data Note we describe the data available on the father's health from pregnancy until 12 years after the offspring was born. Not only is this a valuable addition to the environmental information available for studies of the child's development and the mental health of the mother over time, but it will provide a useful description of the father himself during adulthood.

Associations of childhood diet quality scores with arterial stiffness and carotid artery intima-media thickness in adolescence/early adulthood: findings from the ALSPAC cohort

This study examined the relationship between childhood diet quality and arterial stiffness and thickness during adolescence/early adulthood. Participants were from the Avon Longitudinal Study of Parents and Children (ALSPAC) with dietary data at ages 7, 10 and 13 years and pulse wave velocity (PWV) and carotid intima-media thickness (cIMT) at ages 17 and/or 24 years. Diet quality (DQ) was assessed using five scores: a children's Mediterranean-style diet (C-rMED) Z-score, a children's Dietary Inflammatory Z-score (C-DIS), a DASH diet Z-score, a children's Eatwell Guide (C-EWG) Z-score reflecting UK dietary guidelines and a data-driven obesogenic Z-score. Adjusted regression models examined the associations between DQ scores at 7-13 years and PWV and cIMT at 17 and 24 years. In adjusted models, a high v. low Obesogenic Z-score at 7 and 10 years was associated with higher PWV at 17: β 0.07 (95 % CI 0.01, 0.13) and β 0.10 (95 % CI 0.04, 0.16), respectively. A high v. low C-rMED Z-score at 7 years was associated with lower PWV at 17 (β -0.07; 95 % CI -0.14, -0.01). A high (more anti-inflammatory) vs low C-DIS Z-score at 10 years was associated with a lower PWV at 17 years: β -0.06 (95 % CI -0.12, -0.01). No other associations were observed. In conclusion, an Obesogenic dietary pattern in childhood (7-10 years) was related to increased arterial stiffness, while Mediterranean-style and anti-inflammatory diets were related to decreased arterial stiffness in adolescence. This highlights the importance of establishing healthy dietary habits early in life to protect against vascular damage.

Measures of puberty in the Avon Longitudinal Study of Parents and Children (ALSPAC) offspring cohort

Background

When studying the development of children through the preteen years into adolescence, it is often important to link features of their physical and mental health to the stage of puberty at the time. This is complex since individuals vary substantially in the ages at which they reach different pubertal milestones.

Methods

The Avon Longitudinal Study of Parents and Children (ALSPAC) is an ongoing longitudinal cohort study based in southwest England that recruited over 14000 women in pregnancy, with expected dates of delivery between April 1991 and December 1992. From 1999, information on puberty was collected using a number of different methods : (a) A series of annual questionnaires were administered when the index children were aged between eight and 17 years; these were mainly concerned with the physical changes associated with puberty; (b) identification of the age at peak height growth using the SITAR methodology; and (c) retrospective information from the girls on their age at onset of menstruation (menarche).

Results

The advantages and disadvantages of each method are discussed.

Conclusions

The data are available for analysis by interested researchers.

Associations between religious/spiritual beliefs and behaviours and dietary patterns: analysis of the parental generation in a prospective cohort study (ALSPAC) in Southwest England

OBJECTIVE

Religious/spiritual beliefs and behaviours (RSBB) have been associated with health outcomes, with diet a potential mediator of this relationship. We therefore explored whether RSBB were associated with differences in diet.

DESIGN

Dietary patterns and nutrient intakes were derived from food frequency questionnaire completed by pregnant women in 1991-1992 (mean age = 28·3 years, range = 15-46) and by the mothers and partners 4 years post-partum (mothers mean age = 32·3, range = 19-49; partners mean age = 34·5, range = 18-74). RSBB exposures measured in pregnancy included religious belief, affiliation and attendance. We first explored whether RSBBs were associated with dietary patterns in confounder-adjusted linear regression models. If associations were found, we examined whether RSBB were associated with nutrient intake (linear regression) and following nutrient intake guidelines (logistic regression).

SETTING

Prospective birth cohort study in Southwest England (Avon Longitudinal Study of Parents and Children; ALSPAC).

PARTICIPANTS

13 689 enrolled mothers and their associated partners.

RESULTS

In pregnant women, RSBB were associated with higher 'traditional' (i.e. 'meat and two veg') and lower 'vegetarian' dietary pattern scores. Religious attendance and non-Christian religious affiliation were associated with higher 'health-conscious' dietary pattern scores. Religious attendance was associated with increased micronutrient intake and following recommended micronutrient intake guidelines, with weaker effects for religious belief and affiliation. Comparable patterns were observed for mothers and partners 4 years post-partum, although associations between RSBB and nutrient intakes were weaker for partners.

CONCLUSIONS

RSBBs are associated with broad dietary patterns and nutrient intake in this cohort. If these reflect causal relationships, diet may potentially mediate the pathway between RSBB and health.

Prospective association between adherence to UK dietary guidelines in school-age children and cardiometabolic risk markers in adolescence/early adulthood in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort

Research into how alignment to UK dietary guidelines during childhood affects cardiometabolic health is limited. The association between adherence to UK dietary guidelines during childhood and overall cardiometabolic risk (CMR) in adolescence/early adulthood was explored using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). ALSPAC children with diet diaries completed at 7, 10 and 13 years of age, and data on CMR markers at 17 years (n 1940) and 24 years (n 1957) were included. A children's Eatwell Guide (C-EWG) score was created by comparing dietary intakes at each age to UK dietary guidelines for nine foods/nutrients. Cardiometabolic health at 17 and 24 years was assessed using a composite CMR score. Multivariable linear regression models examined associations between C-EWG scores at 7, 10 and 13 years and the CMR score at 17 and 24 years, adjusting for confounders. C-EWG scores were generally low. However, a higher score (adherence to more dietary guidelines) at 7 years old was associated with a lower CMR score at 17 and 24 years: β -0·13 (95 % CI -0·25, -0·01) and β -0·25 (95 % CI -0·38, -0·13) for a 1-point increase in C-EWG score, respectively. A higher C-EWG score at 10 years was also associated with a lower CMR z-score at 24 years. No clear associations were evident at other ages. Greater adherence to UK dietary guidelines during mid-childhood was associated with a better overall cardiometabolic profile, suggesting that encouraging children to eat in this way has long-term benefits to health.

Causal effects of later-eating rhythm on adiposity in children through the comparison of two cohorts in the UK and China: a cross-cohort study

BACKGROUND

Later-eating rhythm (LER) refers to a later timing, greater energy intake, and higher meal frequency in the evening. The role of childhood LER in obesity development is emerging, but most evidence is cross-sectional. Cross-context comparison allows the improvement of causal inference in observational studies by comparing cohorts with different confounding structures. This method is applied to assess the causal effects of LER on adiposity, by exploring the likelihood of residual confounding due to socioeconomic status.

METHODS

In this cross-cohort analysis, we used ongoing birth cohort data from the UK Avon Longitudinal Study of Parents and Children (ALSPAC) established in 1991, and the nationally representative China Health and Nutrition Survey (CHNS) collected in 1989-2011. Children with available data at age 7 years were eligible. We applied indices of inequality for assessing confounding structure by regressing LER/adiposity on the standardised score of socioeconomic status (SES) in each cohort. We used multivariable linear and binary logistic regressions to model cross-sectional and prospective associations between LER at 7 years of age and body-mass index (BMI) at ages 7 and 9 years in both cohorts. Analyses were adjusted by age, sex, ethnicity, residency, and socioeconomic status. We used a p value for the Cochrane Q-test obtained from meta-analysis to test for heterogeneity between cohorts.

FINDINGS

We analysed data from 4019 children (2170 [54·0%] female; 1849 [46.0%] male) in ALSPAC and 1749 (788 [45·1%] female; 961 [54.9%] male) in CHNS. The associations between SES and LER or adiposity differed between ALSPAC and CHNS (SES and energy intake for evening main meal: b=1·81 [95% CI 0·81 to 2·81] vs -3·02 [-4·76 to -1·27]; SES and frequency of evening snacks: odds ratio [OR]=0·51 [95% CI 0·41-0·63] vs 5·71 [3·54-9·22]; SES and BMI: b=-0·42 [-0·65 to -0·18] vs 1·29 [0·75 to 1·84]). Positive associations between frequency of evening snacks and BMI were seen in both cross-sectional and longitudinal analyses in both cohorts (mean change of BMI with 1 day increase of consuming evening snacks b=0·09 [0·02 to 0·15]; 0·13 [0·03 to 0·22] kg/m2 per day in ALSPAC, and b=0·11 [-0·07 to 0·28]; 0·30 [0·07 to 0·52] kg/m2 per day in CHNS). No associations were found for energy intake. p values for heterogeneity ranged from 0·107 to 0·932.

INTERPRETATION

Both cohorts showed consistent results despite varied dietary cultures and SES patterning of LER or adiposity. Energy intake in the evening or night was not associated with adiposity, whereas evening snacking was. More recent, high-quality cohorts are warranted to enhance the strength of the conclusions.

FUNDING

None.

Childhood life events of women enrolled in the Avon Longitudinal Study of Parents & Children (ALSPAC)

At the time of planning ALSPAC there was accumulating evidence that abuse and other childhood traumas were related to psychiatric problems later in life. In addition, the age at which such trauma occurred was likely to be important in influencing its long-term impact. Detailed data was therefore collected from enrolled women on traumatic events occurring during their own childhoods, along with their age at the time. The questionnaire entitled 'About Yourself' was sent out to expectant women who had enrolled in the study, which included a page in the form of a grid (an events diary) with one row per year of childhood and columns for recording where she was living at the time, who was looking after her, and any traumatic events that occurred. These free-text responses were then coded, and any events were assigned a score indicating the level of trauma the event was likely to have caused on a scale of 1 (highly traumatic) to 6 (least traumatic). This paper describes the variety of text data collected and how it was coded. The ALSPAC study has a great deal of follow-up data collected on the original respondents, as well as on their parents and grandparents, partners, offspring and their grandchildren, providing huge potential for analyses on the antecedents and outcomes of adverse childhood events across multiple generations.

Quality of relationships in mothers and their partners in the Avon Longitudinal Study of Parents and Children

Quality of relationship between partners is associated with a wide range of physical and psychological outcomes like anxiety and depression. There are relatively few longitudinal studies with detailed and repeated measures for quality of relationship, particularly in both partners. The Avon Longitudinal Study of Parents and Children (ALSPAC) is a large birth cohort study in the UK with five post-partum repeated measures of quality of relationship between mothers and their partners assessed using the Intimate Bond Measure (IBM). The Measure includes two subscales named "Care" and "Control". These were measured at 2.75, 6, 9, 12, and 18 years post-partum (baseline N for mothers: 8675; baseline N for partners: 5499). The aims of this data note are to provide a comprehensive overview on the existing IBM data in ALSPAC and to describe both its strengths and limitations for future users. The internal consistency of the subscales were high (Cronbach's alpha 0.95 and 0.88 for the Care and Control subscales) in both mothers and their partners at the baseline. In the Care subscale, all 12 items were highly correlated with the overall score (r>0.62) at the baseline, but in the Control subscale there were three items that had relatively low correlations with the total subscale (r<0.46). This should be taken into account in future research. The longitudinal nature of this data on both mothers and partners will enable detailed explorations of the causes and consequences of differences in quality of relationship.

Trajectories of dietary patterns from pregnancy to 12 years post-pregnancy and associated maternal characteristics: evidence from the Avon Longitudinal Study of Parents and Children

PURPOSE

Dietary patterns (DPs) during pregnancy have been well researched. However, little is known about maternal diet after pregnancy. The aim of the study was to explore maternal DPs longitudinally, examine trajectories over 12 years after pregnancy and identify associated factors.

METHODS

Of 14,541 pregnant women enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) complete dietary information was available for 5336 women. Principal components analysis (PCA) was used to derive DPs. DP scores at each time point were used to create DP trajectories using group-based trajectory modelling (GBTM). Multinomial logistic regression assessed the association with maternal factors.

RESULTS

A total of six distinct DPs were identified over time with different numbers of DPs at each time point. The "healthy" and "processed" DPs persisted over the 12-year post-pregnancy. Three trajectories of "healthy" and "processed" DPs were identified from GBTM. Half the women were on the moderately healthy DP trajectory with 37% on the lower trajectory and 9% on the higher healthy DP trajectory. 59% of women were on the lower processed DP trajectory with 38% on the moderate trajectory and 3.3% on the higher processed DP trajectory. Low educational attainment, low social class and smoking in pregnancy were independently associated with being on a less favourable DP trajectory over the 12 years.

CONCLUSION

Health professionals should provide support on smoking cessation along with healthy eating advice during ante-natal counselling. Continued support on eating healthily after pregnancy would be beneficial for mothers and families.

Prospective association between an obesogenic dietary pattern in early adolescence and metabolomics derived and traditional cardiometabolic risk scores in adolescents and young adults from the ALSPAC cohort

BACKGROUND

Dietary intake during early life may be a modifying factor for cardiometabolic risk (CMR). Metabolomic profiling may enable more precise identification of CMR in adolescence than traditional CMR scores. We aim to assess and compare the prospective associations between an obesogenic dietary pattern (DP) score at age 13 years with a novel vs. traditional CMR score in adolescence and young adulthood in the Avon Longitudinal Study of Parents and Children (ALSPAC).

METHODS

Study participants were ALSPAC children with diet diary data at age 13. The obesogenic DP z-score, characterized by high energy-density, high % of energy from total fat and free sugars, and low fibre density, was previously derived using reduced rank regression. CMR scores were calculated by combining novel metabolites or traditional risk factors (fat mass index, insulin resistance, mean arterial blood pressure, triacylglycerol, HDL and LDL cholesterol) at age 15 (n = 1808), 17 (n = 1629), and 24 years (n = 1760). Multivariable linear regression models estimated associations of DP z-score with log-transformed CMR z-scores.

RESULTS

Compared to the lowest tertile, the highest DP z-score tertile at age 13 was associated with an increase in the metabolomics CMR z-score at age 15 (β = 0.20, 95% CI 0.09, 0.32, p trend < 0.001) and at age 17 (β = 0.22, 95% CI 0.10, 0.34, p trend < 0.001), and with the traditional CMR z-score at age 15 (β = 0.15, 95% CI 0.05, 0.24, p trend 0.020). There was no evidence of an association at age 17 for the traditional CMR z-score (β = 0.07, 95% CI -0.03, 0.16, p trend 0.137) or for both scores at age 24.

CONCLUSIONS

An obesogenic DP was associated with greater CMR in adolescents. Stronger associations were observed with a novel metabolite CMR score compared to traditional risk factors. There may be benefits from modifying diet during adolescence for CMR health, which should be prioritized for further research in trials.

The Avon Longitudinal Study of Parents and Children (ALSPAC): a 2022 update on the enrolled sample of mothers and the associated baseline data

The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prospective birth cohort, based in and around Bristol, UK, established to explore genetic and environmental factors impacting health and development. 14,541 pregnancies were initially recruited from 20,248 eligible pregnancies. As the G1 (Generation-1) offspring turned 7 years of age, children from eligible pregnancies who had not been enrolled into the study were invited to take part. The enrolment status of these additional G1 offspring (n=913) has been well-documented. Here we provide an updated description of the ALSPAC G0 (Generation-0) mothers study cohort (which includes newly enrolled mothers), their associated pregnancies and the mz data file that defines this cohort. At the time of writing there are 14,833 unique mothers enrolled in ALSPAC, with 15,447 associated pregnancies enrolled. The update to the mz file also includes new variables to assist researchers when using mothers' data whilst accounting for non-independence between data related to multiple pregnancies (i.e., women with more than one pregnancy in the study).

The Avon Longitudinal Study of Parents and Children (ALSPAC): a 2022 update on the enrolled sample of mothers and the associated baseline data

The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prospective birth cohort, based in and around Bristol, UK, established to explore genetic and environmental factors impacting health and development. 14,541 pregnancies were initially recruited from 20,248 eligible pregnancies. As the G1 (Generation-1) offspring turned 7 years of age, children from eligible pregnancies who had not been enrolled into the study were invited to take part. The enrolment status of these additional G1 offspring (n=913) has been well-documented. Here we provide an updated description of the ALSPAC G0 (Generation-0) mothers study cohort (which includes newly enrolled mothers), their associated pregnancies and the mz data file that defines this cohort. At the time of writing there are 14,833 unique mothers enrolled in ALSPAC, with 15,447 associated pregnancies enrolled. The update to the mz file also includes new variables to assist researchers when using mothers' data whilst accounting for non-independence between data related to multiple pregnancies (i.e., women with more than one pregnancy in the study).

Gender differences in the distribution of children's physical activity: evidence from nine countries

BACKGROUND

Physical activity in childhood is thought to influences health and development. Previous studies have found that boys are typically more active than girls, yet the focus has largely been on differences in average levels or proportions above a threshold rather than the full distribution of activity across all intensities. We thus examined differences in the distribution of physical activity between girls and boys in a multi-national sample of children.

METHODS

We used the harmonised International Children Accelerometry Database (ICAD), including waist-worn accelerometry data from 15,461 individuals (Boys: 48.3%) from 9 countries. Employing Generalised Additive Models of Location, Shape, and Scale (GAMLSS) we investigated gender differences in the distribution of individuals, including comparisons of variability (SD) and average physical activity levels (mean and median) and skewness. We conducted this analysis for each activity intensity (Sedentary, Light, and Moderate-to-Vigorous (MVPA)) and a summary measure (counts per minute (CPM)).

RESULTS

Sizable gender differences in the distribution of activity were found for moderate to vigorous activity and counts per minute, with boys having higher average levels (38% higher mean volumes of MVPA, 20% higher CPM), yet substantially more between-person variability (30% higher standard deviation (SD) for MVPA, 17% higher SD for CPM); boys' distributions were less positively skewed than girls. Conversely, there was little to no difference between girls and boys in the distribution of sedentary or light-intensity activity.

CONCLUSIONS

Inequality in activity between girls and boys was driven by MVPA. The higher mean volumes of MVPA in boys occurred alongside greater variability. This suggests a need to consider the underlying distribution of activity in future research; for example, interventions which target gender inequality in MVPA may inadvertently lead to increased inequality within girls.

Demographic and socioeconomic predictors of religious/spiritual beliefs and behaviours in a prospective cohort study (ALSPAC) in Southwest England: Results from the parental generation

Background: We explored associations between possible demographic and socioeconomic causes of religious/spiritual beliefs and behaviours (RSBB) in the parental generation of the Avon Longitudinal Study of Parents and Children (ALSPAC). Methods : We used a prospective birth cohort study (ALSPAC) in Southwest England with 14,157 enrolled mothers and 14,154 associated partners. Three RSBB outcome measures collected during pregnancy were examined: religious belief (belief in God/a divine power; yes/not sure/no), religious affiliation (Christian/none/other) and religious attendance (frequency of attendance at a place of worship). Multiple demographic and socioeconomic exposures were assessed (23 in mothers and 22 in partners). We explored age-adjusted associations between each exposure and outcome using multinomial regression, in addition to exposure-age interactions. Results: Many demographic and socioeconomic factors were associated with RSBB, including age, ethnicity, marital status, education, income and deprivation. Overall, higher socioeconomic position was associated with increased levels of RSBB, particularly regarding religious attendance. For instance, compared to mothers with the lowest level of educational attainment, a degree-level education was associated with a six-fold increase in the relative risk ratio of religious attendance at least once a week, relative to not attending at all (RRR=5.90; 95% CI=[4.44; 7.86]). The magnitude of these associations often varied by outcome, e.g., income was associated with religious attendance, but only weakly with religious affiliation. Although results were demographically and socially patterned, overall effect sizes were relatively small, with a largest pseudo- R 2 value of 2.4%. Patterns of association were similar for mothers and partners. Conclusion: The observed positive association between socioeconomic position and RSBB is contrary to much previous theoretical and empirical work. Potential reasons for these differences are discussed, including cross-cultural variation in religiosity and state support, and differences between RSBB measures. This descriptive paper can also help inform future studies using these data regarding the consideration of appropriate confounders.

Demographic and socioeconomic predictors of religious/spiritual beliefs and behaviours in a prospective cohort study (ALSPAC) in Southwest England: Results from the parental generation

Background: We explored associations between possible demographic and socioeconomic causes of religious/spiritual beliefs and behaviours (RSBB) in the parental generation of the Avon Longitudinal Study of Parents and Children (ALSPAC). Methods : We used a prospective birth cohort study (ALSPAC) in Southwest England with 14,157 enrolled mothers and 14,154 associated partners. Three RSBB outcome measures collected during pregnancy were examined: religious belief (belief in God/a divine power; yes/not sure/no), religious affiliation (Christian/none/other) and religious attendance (frequency of attendance at a place of worship). Multiple demographic and socioeconomic exposures were assessed (23 in mothers and 22 in partners). We explored age-adjusted associations between each exposure and outcome using multinomial regression, in addition to exposure-age interactions. Results: Many demographic and socioeconomic factors were associated with RSBB, including age, ethnicity, marital status, education, income and deprivation. Overall, higher socioeconomic position was associated with increased levels of RSBB, particularly regarding religious attendance. For instance, compared to mothers with the lowest level of educational attainment, a degree-level education was associated with a six-fold increase in the relative risk ratio of religious attendance at least once a week, relative to not attending at all (RRR=5.90; 95% CI=[4.44; 7.86]). The magnitude of these associations often varied by outcome, e.g., income was associated with religious attendance, but only weakly with religious affiliation. Although results were demographically and socially patterned, overall effect sizes were relatively small, with a largest pseudo- R 2 value of 2.4%. Patterns of association were similar for mothers and partners. Conclusion: The observed positive association between socioeconomic position and RSBB is contrary to much previous theoretical and empirical work. Potential reasons for these differences are discussed, including cross-cultural variation in religiosity and state support, and differences between RSBB measures. This descriptive paper can also help inform future studies using these data regarding the consideration of appropriate confounders.

Adherence to UK dietary guidelines in school-aged children from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort

Compliance to UK dietary recommendations was assessed in school-aged children from a population-based cohort: the Avon Longitudinal Study of Parents and Children (ALSPAC). A Children's Eatwell Guide (C-EWG) score was developed to assess socio-demographic predictors of meeting dietary recommendations. ALSPAC children with plausible diet diary data at 7 years (n 5373), 10 years (n 4450) and 13 years (n 2223) were included in the study. Their dietary intakes (recorded between 1998 and 2006) were compared with dietary guidelines for total and saturated fats, free sugars, salt, fibre, protein, carbohydrates, fruit and vegetables, non-oily and oily fish and red/processed meat. The C-EWG score (0-9 points) indicated the number of recommendations met at each age. Cross-sectional associations between socio-demographic characteristics and C-EWG scores were assessed using multivariable regression. The lowest adherence to guidelines at 7 years was for sugar (0·1 % meeting recommendations), followed by fibre (7·7 %), oily fish (9·5 %), saturated fat (9·7 %) and fruit and vegetables (15·2 %). Highest adherence was for limiting red/processed meat (67·3 %) and meeting carbohydrate recommendations (77·3 %). At 7 years, 12·1 % of participants failed to meet any of the nine recommendations, 26·9 % met one and 28·2 % met two. Similar patterns were seen at 10 and 13 years. A lower social class and maternal educational attainment and higher maternal BMI were associated with meeting fewer recommendations. Most school-aged children in this cohort did not meet UK dietary recommendations, particularly children from lower socio-economic backgrounds. Additional public health initiatives are needed to improve the quality of UK children's diets, particularly targeting lower socio-economic groups.

Are childhood oral health behaviours and experiences associated with dental anxiety in adolescence?

BACKGROUND

Dental anxiety is associated with untreated dental caries. Understanding which childhood behaviours or experiences have the strongest association with later dental anxiety may help focus preventive strategies, subsequently limiting the burden of dental caries and anxiety.

AIM

The aim of this study was to explore whether behaviours and experiences during childhood were associated with adolescent dental anxiety.

DESIGN

Data were obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC). Multivariable logistic regression was used to explore associations between adolescent dental anxiety and childhood behaviours and experiences. 1791 participants answered questions about oral health behaviours and experiences at 8 years of age and dental anxiety questions aged 17 years.

RESULTS

Children with experience of invasive dental treatment were more likely to have dental anxiety at 17 years of age than those who had not experienced dental treatment (OR 1.63; 95% CI: 1.12, 2.37; p = .011). Irregular dental attenders in childhood had over three times the odds of dental anxiety by adolescence, compared with regular attenders (OR 3.67 95% CI: 1.52, 8.88; p = .004).

CONCLUSIONS

Adolescent dental anxiety is associated with invasive treatment and irregular dental attendance in childhood. A history of irregular attendance or invasive treatment may serve as a useful predictor when considering dental anxiety in young adult patients. Early preventive care supports good attendance and oral health. These actions may have secondary effects of reducing future dental anxiety.

The beneficial role of personality in preserving well-being during the pandemic: A longitudinal population study

BACKGROUND

The COVID-19 pandemic resulted in increased rates of mental health problems. We examined the possible role of the personality characteristic, Locus of Control (LOC), in moderating pandemic-induced stress.

METHODS

The UK-based Avon Longitudinal Study of Parents & Children (ALSPAC), 7021 adults (mean ages: women 57.6 (SD = 4.48); partners 60.5 (SD = 5.36)) responded to a 2020 questionnaire which included a generalised measure of LOC. Between March 2020-January 2021, questionnaires focussed on the pandemic were administered, which included measures of mental health. Over 60 % of respondents completed questionnaires at three timepoints of interest.

RESULTS

In those with an internal LOC higher rates of positive well-being and reduced likelihood of anxiety and depression were shown compared to those who were external, e.g. after adjustment for socioeconomic/demographic factors mean differences in well-being score for internal compared with external women was +2.01 (95%CI +1.02,+2.10) p = 0.0001; for their partners +2.52 (95%CI +1.22,+3.82) p = 0.0002. External women were more likely than internals to have depression (adjusted OR 3.41 [95%CI 1.77,6.57] p < 0.0005.

LIMITATIONS

Attrition is a problem in this 30-year-old longitudinal cohort. Those still participating are more likely to have higher education and SES levels, be female and have an internal LOC. This population suffers from a lack of ethnic diversity.

CONCLUSIONS

Having an internal LOC positively moderated the effects of pandemic-induced stress on the frequency of anxiety and depression in middle-age. Programmes geared to raise internality and coping strategies may have long-term benefits on well-being in stressful situations, especially for women and frontline health professionals.

The myth and reality of familial resemblance in dietary intake: a systematic review and meta-analysis on the resemblance of dietary intake among parent and offspring

Background

There is a strong societal belief that parents are role models for their child's dietary behaviours in early life that may persist throughout the life course. Evidence has shown inconclusive dietary resemblance in parent-child (PC) pairs. This systematic review and meta-analysis aimed to examine dietary resemblance between parent and children.

Methods

We systematically searched for studies on PC dietary resemblance, via six electronic databases (PubMed, Ovid MEDLINE, Embase, APA PsycNet, CINAHL, and Web of Science) and other grey sources of literature between 1980 and 2020. We performed quality effect meta-analysis model on transformed correlation coefficients (z) to examine the resemblance in dietary intakes including nutrient intakes, food group intakes and whole diet. Finally, the Fisher's transformed coefficient (z) was used for meta-regression analysis to identify potential moderators. Heterogeneity and inconsistency were examined using the Q and I² statistic. The study is registered on PROSPERO, CRD42019150741.

Findings

A total of 61 studies met the inclusion criteria for systematic review, 45 were included in the meta-analysis. Pooled analyses showed weak to moderate PC dietary intake associations for energy: (r: 0.19; 95% CI: 0.16, 0.22), fat (% energy): (r: 0.23; 95% CI: 0.16, 0.29), protein (% energy): (r: 0.24; 95% CI: 0.20, 0.27), carbohydrate (% energy): (r: 0.24; 95% CI: 0.19, 0.29), fruits and vegetable (g/d): (r: 0.28; 95% CI: 0.25, 0.32), confectionary food (g/d): (r: 0.20; 95% CI: 0.17, 0.23), and whole diet (r: 0.35; 95% CI: 0.28, 0.42). Dietary intakes associations by study characteristics, including population, study year, dietary assessment method, person reporting dietary intake, quality of the study, and study design were highly variable, but associations were similar between PC pairs.

Interpretation

The resemblance among parent-child pairs was weak to moderate for most aspects of dietary intakes. These findings challenge the social myth that parental dietary intake behaviour shapes their child's dietary intake.

Funding

None.

Regular smoking of male ancestors in adolescence and fat mass in young adult grandchildren and great-grandchildren

Background: Previous studies using the Avon Longitudinal Study of Parents and Children (ALSPAC) have shown that if men commenced smoking prior to the onset of puberty their sons, their granddaughters and great-granddaughters were more likely to have excess fat (but not lean) mass during childhood, adolescence and early adulthood. In this study we assess associations between ancestral smoking during adolescence (ages 11-16 years) with fat and lean mass of subsequent generations at two ages. Methods: We analysed data on exposures of grandparents and great-grandparents collected by ALSPAC. The outcomes were the fat masses of their grandchildren and great-grandchildren measured at ages 17 and 24. Measures of lean mass were used as controls. Adjustment was made for 8-10 demographic factors using multiple regression. Results: We found associations between adolescent smoking of the paternal grandfathers and the adjusted fat mass of their grandchildren, but no associations with the grandchildren's lean mass. Grandchildren at age 17 had an average excess fat mass of +1.65 [95% CI +0.04, +3.26] Kg, and at age 24 an average excess of +1.55 [95% CI -0.27, +3.38] Kg. Adolescent smoking by the maternal grandfather showed similar, but weaker, associations: at 17 an average excess fat mass of +1.02 Kg [95% CI -0.20, +2.25] Kg, and at 24 an average excess of +1.28 [95% CI -0.11, +2.66] Kg. There were no pronounced differences between the sexes of the children. For the great-grandparents there were few convincing results, although numbers were small. Conclusions: We have shown associations between grandfathers' smoking in adolescence and increased fat (but not lean) mass in their children. Confirmation of these associations is required, either in a further data set or by demonstrating the presence of supportive biomarkers.

Dietary patterns, lung function and asthma in childhood: a longitudinal study

BACKGROUND

Longitudinal epidemiological data are scarce examining the relationship between dietary patterns and respiratory outcomes in childhood. We investigated whether three distinct dietary patterns in mid-childhood were associated with lung function and incident asthma in adolescence.

METHODS

In the Avon Longitudinal Study of Parents and Children, 'processed', 'traditional', and 'health-conscious' dietary patterns were identified using principal components analysis from food frequency questionnaires at 7 years of age. Post-bronchodilator forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and forced expiratory flow at 25-75% of FVC (FEF25-75) were measured at 15.5 years and were transformed to z-scores based on the Global Lung Function Initiative curves. Incident asthma was defined by new cases of doctor-diagnosed asthma at age 11 or 14 years.

RESULTS

In multivariable-adjusted models, the 'health-conscious' pattern was positively associated with FEV1 (regression coefficient comparing top versus bottom quartile of pattern score 0.16, 95% CI 0.01 to 0.31, P for trend 0.04) and FVC (0.18, 95% CI 0.04 to 0.33, P for trend 0.02), while the 'processed' pattern was negatively associated with FVC (- 0.17, 95% CI - 0.33 to - 0.01, P for trend 0.03). Associations between the 'health-conscious' and 'processed' patterns and lung function were modified by SCGB1A1 and GPX4 gene polymorphisms. We found no evidence of an association between the 'traditional' pattern and lung function, nor between any pattern and FEF25-75 or incident asthma.

CONCLUSIONS

A 'health-conscious' diet in mid-childhood was associated with higher subsequent lung function, while a diet high in processed food was associated with lower lung function.

Social, emotional and behavioural difficulties associated with persistent speech disorder in children: A prospective population study

Purpose

Social, emotional and behavioural difficulties (SEBD) in childhood are associated with negative consequences across the life course. Children with developmental language disorder have been identified as being at risk of developing SEBD but it is unclear whether a similar risk exists for children with speech sound disorder, a condition which impacts on children's ability to make themselves understood and has been shown to be associated with poor educational outcomes.

Methods

Participants were children who attended the 8-year-old clinic in the Avon Longitudinal Study of Parents and Children (N = 7390). Children with speech sound disorder that had persisted beyond the period of typical speech acquisition (persistent speech disorder [PSD]) at age 8 were identified from recordings and transcriptions of speech samples (N = 263). Parent-, teacher- and child-reported questionnaires and interviews including the Strengths and Difficulties Questionnaire, Short Moods and Feelings Questionnaire and measures for antisocial and risk-taking behaviour were used to provide outcome scores for SEBD at 10-14 years in a series of regression analyses.

Results

Following adjustment for biological sex, socio-economic status and Intelligence Quotient, children with PSD at age 8 were more likely to show peer problems at age 10-11 years compared with their peers, as reported by teachers and parents. Teachers were more likely to report problems with emotionality. Children with PSD were no more likely to report symptoms of depression than their peers. No associations were observed between PSD, risk of antisocial behaviour, trying alcohol at age 10 or smoking cigarettes at age 14.

Conclusions

Children with PSD may be at risk in terms of their peer relationships. This could impact on their wellbeing and, while not observed at this age, may lead to depressive symptoms in older childhood and adolescence. There is also the potential that these symptoms may impact on educational outcomes.

Quality of relationships in mothers and their partners in the Avon Longitudinal Study of Parents and Children

Quality of relationship between partners is associated with a wide range of physical and psychological outcomes like anxiety and depression. There are relatively few longitudinal studies with detailed and repeated measures for quality of relationship, particularly in both partners. The Avon Longitudinal Study of Parents and Children (ALSPAC) is a large birth cohort study in the UK with five post-partum repeated measures of quality of relationship between mothers and their partners assessed using the Intimate Bond Measure (IBM). The Measure includes two subscales named “Care” and “Control”. These were measured at 2.75, 6, 9, 12, and 18 years post-partum (baseline N for mothers: 8675; baseline N for partners: 5499). The aims of this data note are to provide a comprehensive overview on the existing IBM data in ALSPAC and to describe both its strengths and limitations for future users. The internal consistency of the subscales were high (Cronbach's alpha 0.95 and 0.88 for the Care and Control subscales) in both mothers and their partners at the baseline. In the Care subscale, all 12 items were highly correlated with the overall score (r>0.62) at the baseline, but in the Control subscale there were three items that had relatively low correlations with the total subscale (r<0.46). This should be taken into account in future research. The longitudinal nature of this data on both mothers and partners will enable detailed explorations of the causes and consequences of differences in quality of relationship.

Possible transgenerational associations between grandparents’ childhood exposures and religious belief in their granddaughters: a longitudinal cohort study

Background: Research in non-genetic inheritance indicates that grandparents’ smoking habits and their childhood experiences of trauma can influence the physical and psychological attributes of their grandchildren. This was particularly apparent for outcomes such as autism and obesity where the population prevalence changed over time. Other factors which have changed temporally include religious and spiritual beliefs (RSBs) which have been declining in Western populations. Methods: We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to explore whether grandparental exposures were associated with the religious and/or spiritual beliefs of their grandchildren as measured with a positive response to the question “Do you believe in God or some divine power?” . In line with other inter/trans-generational human studies we hypothesised that: (H1) grandparents’ childhood exposures to cigarette smoking (whether in utero or by active smoking) and/or exposure to traumatic events during childhood will be associated with their grandchild’s RSB; (H2) associations will differ between maternal and paternal lines of inheritance; (H3) relationships will vary with age at grandparental exposure, and (H4) associations will differ between grandsons and granddaughters. Results: We found significant associations between the grandchild’s RSB and both the grandparents’ smoking and their childhood trauma histories (H1 supported). These associations were mainly found down the maternal line (H2 possibly supported) and results varied with age of exposure of the grandparents; being strongest for in utero exposure of cigarette smoke and for pre-puberty exposure of traumatic events (H3 supported), and that granddaughters were more affected than grandsons (H4 supported). Conclusions: We hope that these results will motivate collection of similar data to further evaluate these questions in other populations, including a possible role for biological mechanisms.

The Avon Longitudinal Study of Parents and children ALSPAC G0 Partners: A cohort profile

ALSPAC is an ongoing population-based, observational study designed to investigate how genetic/environmental characteristics might influence the health/development of children and their parents. It has evolved to facilitate the measurement of many outcomes in the parental cohort. Pregnant women resident in Bristol, UK with expected dates of delivery between April 1991-December 1992 were eligible. 14,541 pregnancies were originally enrolled. Partners of the pregnant women were initially invited to take part by the women with formal enrolment of individuals since 2010. Data has been collected from 12,113 partners, with 3,807 formally enrolled. Data collected to date: 21 questionnaires, clinical follow up in 2012 (mean age: 53 years) and a family-based clinical follow-up currently ongoing (mean age: 63 years). Questionnaires asked about a wide range of environmental measures, physical/mental health and other phenotypic details including six questionnaires throughout the COVID-19 pandemic. Clinical measures include anthropometrics, blood pressure, body composition, cardiovascular health and a fasting blood sample. DNA has been extracted with genome-wide data available on >3,000 partners and exomes on ~1500 trios. The data contributes to one of the most deeply phenotyped birth cohorts in the world, providing trios of data and multi-generational information, and is fully accessible through a managed access process.

Antibody levels following vaccination against SARS-CoV-2: associations with post-vaccination infection and risk factors in two UK longitudinal studies

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody levels can be used to assess humoral immune responses following SARS-CoV-2 infection or vaccination, and may predict risk of future infection. Higher levels of SARS-CoV-2 anti-Spike antibodies are known to be associated with increased protection against future SARS-CoV-2 infection. However, variation in antibody levels and risk factors for lower antibody levels following each round of SARS-CoV-2 vaccination have not been explored across a wide range of socio-demographic, SARS-CoV-2 infection and vaccination, and health factors within population-based cohorts.

Methods

Samples were collected from 9361 individuals from TwinsUK and ALSPAC UK population-based longitudinal studies and tested for SARS-CoV-2 antibodies. Cross-sectional sampling was undertaken jointly in April-May 2021 (TwinsUK, N=4256; ALSPAC, N=4622), and in TwinsUK only in November 2021-January 2022 (N=3575). Variation in antibody levels after first, second, and third SARS-CoV-2 vaccination with health, socio-demographic, SARS-CoV-2 infection, and SARS-CoV-2 vaccination variables were analysed. Using multivariable logistic regression models, we tested associations between antibody levels following vaccination and: (1) SARS-CoV-2 infection following vaccination(s); (2) health, socio-demographic, SARS-CoV-2 infection, and SARS-CoV-2 vaccination variables.

Results

Within TwinsUK, single-vaccinated individuals with the lowest 20% of anti-Spike antibody levels at initial testing had threefold greater odds of SARS-CoV-2 infection over the next 6-9 months (OR = 2.9, 95% CI: 1.4, 6.0), compared to the top 20%. In TwinsUK and ALSPAC, individuals identified as at increased risk of COVID-19 complication through the UK 'Shielded Patient List' had consistently greater odds (two- to fourfold) of having antibody levels in the lowest 10%. Third vaccination increased absolute antibody levels for almost all individuals, and reduced relative disparities compared with earlier vaccinations.

Conclusions

These findings quantify the association between antibody level and risk of subsequent infection, and support a policy of triple vaccination for the generation of protective antibodies.

Funding

Antibody testing was funded by UK Health Security Agency. The National Core Studies program is funded by COVID-19 Longitudinal Health and Wellbeing - National Core Study (LHW-NCS) HMT/UKRI/MRC ([MC_PC_20030] and [MC_PC_20059]). Related funding was also provided by the NIHR 606 (CONVALESCENCE grant [COV-LT-0009]). TwinsUK is funded by the Wellcome Trust, Medical Research Council, Versus Arthritis, European Union Horizon 2020, Chronic Disease Research Foundation (CDRF), Zoe Ltd and the National Institute for Health Research (NIHR) Clinical Research Network (CRN) and Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust in partnership with King's College London. The UK Medical Research Council and Wellcome (Grant ref: [217065/Z/19/Z]) and the University of Bristol provide core support for ALSPAC.

Voluntary risk mitigation behaviour can reduce impact of SARS-CoV-2: a real-time modelling study of the January 2022 Omicron wave in England

BACKGROUND

Predicting the likely size of future SARS-CoV-2 waves is necessary for public health planning. In England, voluntary "plan B" mitigation measures were introduced in December 2021 including increased home working and face coverings in shops but stopped short of restrictions on social contacts. The impact of voluntary risk mitigation behaviours on future SARS-CoV-2 burden is unknown.

METHODS

We developed a rapid online survey of risk mitigation behaviours ahead of the winter 2021 festive period and deployed in two longitudinal cohort studies in the UK (Avon Longitudinal Study of Parents and Children (ALSPAC) and TwinsUK/COVID Symptom Study (CSS) Biobank) in December 2021. Using an individual-based, probabilistic model of COVID-19 transmission between social contacts with SARS-CoV-2 Omicron variant parameters and realistic vaccine coverage in England, we predicted the potential impact of the SARS-CoV-2 Omicron wave in England in terms of the effective reproduction number and cumulative infections, hospital admissions and deaths. Using survey results, we estimated in real-time the impact of voluntary risk mitigation behaviours on the Omicron wave in England, if implemented for the entire epidemic wave.

RESULTS

Over 95% of survey respondents (NALSPAC = 2686 and NTwins = 6155) reported some risk mitigation behaviours, with vaccination and using home testing kits reported most frequently. Less than half of those respondents reported that their behaviour was due to "plan B". We estimate that without risk mitigation behaviours, the Omicron variant is consistent with an effective reproduction number between 2.5 and 3.5. Due to the reduced vaccine effectiveness against infection with the Omicron variant, our modelled estimates suggest that between 55% and 60% of the English population could be infected during the current wave, translating into between 12,000 and 46,000 cumulative deaths, depending on assumptions about severity and vaccine effectiveness. The actual number of deaths was 15,208 (26 November 2021-1 March 2022). We estimate that voluntary risk reduction measures could reduce the effective reproduction number to between 1.8 and 2.2 and reduce the cumulative number of deaths by up to 24%.

CONCLUSIONS

Predicting future infection burden is affected by uncertainty in disease severity and vaccine effectiveness estimates. In addition to biological uncertainty, we show that voluntary measures substantially reduce the projected impact of the SARS-CoV-2 Omicron variant but that voluntary measures alone would be unlikely to completely control transmission.

A Hybrid Architecture (CO-CONNECT) to Facilitate Rapid Discovery and Access to Data Across the United Kingdom in Response to the COVID-19 Pandemic: Development Study

BACKGROUND

COVID-19 data have been generated across the United Kingdom as a by-product of clinical care and public health provision, as well as numerous bespoke and repurposed research endeavors. Analysis of these data has underpinned the United Kingdom's response to the pandemic, and informed public health policies and clinical guidelines. However, these data are held by different organizations, and this fragmented landscape has presented challenges for public health agencies and researchers as they struggle to find relevant data to access and interrogate the data they need to inform the pandemic response at pace.

OBJECTIVE

We aimed to transform UK COVID-19 diagnostic data sets to be findable, accessible, interoperable, and reusable (FAIR).

METHODS

A federated infrastructure model (COVID - Curated and Open Analysis and Research Platform [CO-CONNECT]) was rapidly built to enable the automated and reproducible mapping of health data partners' pseudonymized data to the Observational Medical Outcomes Partnership Common Data Model without the need for any data to leave the data controllers' secure environments, and to support federated cohort discovery queries and meta-analysis.

RESULTS

A total of 56 data sets from 19 organizations are being connected to the federated network. The data include research cohorts and COVID-19 data collected through routine health care provision linked to longitudinal health care records and demographics. The infrastructure is live, supporting aggregate-level querying of data across the United Kingdom.

CONCLUSIONS

CO-CONNECT was developed by a multidisciplinary team. It enables rapid COVID-19 data discovery and instantaneous meta-analysis across data sources, and it is researching streamlined data extraction for use in a Trusted Research Environment for research and public health analysis. CO-CONNECT has the potential to make UK health data more interconnected and better able to answer national-level research questions while maintaining patient confidentiality and local governance procedures.

The external housing environment of participants in the Avon Longitudinal Study of Parents and Children (ALSPAC): a resource for studies of influences on health

Background: Early life environmental health exposures related to housing can have a significant impact on an individual's physical and mental health and physical development. Housing exposures can fall into two main areas - a representation of social circumstances and physical conditions. Methods: During pregnancy and post-delivery, self-completion questionnaires concerning the housing environment were administered to the ALSPAC (Avon Longitudinal Study of Parents & Children) study mothers and their partners until the study offspring were aged 18. Data collected included types of housing, housing tenure, numbers of rooms in the home, whether shared or sole use of kitchen and indoor flushing toilet, household moves, Council Tax band, difficulties in affording rent/mortgage and becoming homeless. Here we also describe the historic development of housing in the Bristol and surrounding Avon areas. Results: Data collected included the tenure (e.g., owned/rented) of the home, its size (indexed by the number of rooms), the presence of over-crowding (measured by the number of residents per room), presence of amenities, and frequency of household moves. This information was collected on over 13,000 women during pregnancy >8000 at age 10 and >4000 at 18 years. Council Tax bands were asked at 10 and 18 years. Conclusions: This is the first of two Data Notes on the housing type and housing circumstances of the families enrolled in ALSPAC. The second Data Note will detail their internal housing conditions. The data provides an excellent resource for researchers when considering the influences of housing on physical and mental health and development.

Demographic and socioeconomic predictors of religious/spiritual beliefs and behaviours in a prospective cohort study (ALSPAC) in Southwest England: Results from the offspring generation

Background: We explored associations between possible demographic and socioeconomic causes of religious/spiritual beliefs and behaviours (RSBB) in the offspring generation of the Avon Longitudinal Study of Parents and Children (ALSPAC). Methods: We examined approximately 4,450 offspring aged 28 years with RSBB data from a prospective birth cohort study (ALSPAC) in Southwest England. Three RSBB outcome measures were assessed: religious belief (belief in God/a divine power; yes/not sure/no), religious affiliation (Christian/none/other) and religious attendance (frequency of attendance at a place of worship). We explored age- and sex-adjusted associations between 35 demographic and socioeconomic exposures and each of the three RSBB outcomes using multinomial regression. Exposure-sex interactions were also examined. Results: Some sociodemographic factors were associated with RSBB in this cohort; for instance, being female and from an ethnicity other than White were associated with increased religiosity across all domains. For many other exposures, however, associations were frequently null or inconsistent, often depending on the specific exposure and outcome combination. As an example, higher educational attainment was associated with higher rates of religious attendance, but not with religious belief or affiliation; in contrast, higher income was associated with lower levels of religiosity. No consistent interactions between sex and the exposures on RSBB were found. Effect sizes were also rather weak, with most pseudo-R2 values below 0.5% and a maximum of 1.2%. Conclusions: The results highlight that several demographic and socioeconomic factors are associated with RSBB in this cohort. However, the number of these associations, and their magnitude, is smaller than comparable results from the parental generation of these offspring, suggesting that patterns of sociodemographic factors associated with RSBB differ between these generations. In addition to describing these associations, this paper will help inform future studies using these data, particularly regarding the choice of potential sociodemographic confounders.

Parental spiritual and religious beliefs and behaviour data collected from the Avon Longitudinal Study of Parents and Children, 2020

There are few studies that chart the ways in which the religious beliefs and practices of parents and their offspring vary over time. Even fewer can relate this to aspects of their physical and mental health or distinguish the different facets of the environment that may have influenced the development or loss of religious/spiritual belief and behaviours over time. This paper describes the recent data collection in the Avon Longitudinal Study of Parents and Children (ALSPAC) on the beliefs and behaviours of the study parents some 27-28 years after the first measures were collected. Questions that were previously administered to the mother and her partner on religion, spirituality, behaviours, and beliefs (RSBB) were repeated for the fourth time, together with enhanced data on RSBB. The new data are described and compared with previous responses. The most notable difference between the 9 year and the 2020 sweep was the increase of professed non-believers in both the mothers (17.5% vs 29.8%) and partners (31.9% vs. 45.3%). As expected, on each occasion study partners were less likely to acknowledge RSBB compared to the study mothers. In the latest sweep, respondents were less likely to be unsure if they believed and more likely to not believe. Responses to "Do you believe in God or a divine power?" in mothers ranged from 49.9% stating 'yes' antenatally to 43.5% doing so in 2020; 14.9% vs 29.8% for 'no' and 35.2% to 26.6% for 'not sure'. For partners, the corresponding figures are: 'yes' 37.0% vs. 30.0%; 'no' 28.6% vs. 45.3% and 'not sure' 34.5% vs. 24.6%. We plan to undertake detailed analyses of the antecedents and consequences of RBSS. All data are available for use by interested researchers.

Inflammation proteomics datasets in the ALSPAC cohort

Proteomics is the identification, detection and quantification of proteins within a biological sample. The complete set of proteins expressed by an organism is known as the proteome. The availability of new high-throughput proteomic technologies, such as Olink Proteomic Proximity Extension Assay (PEA) technology has enabled detailed investigation of the circulating proteome in large-scale epidemiological studies. In particular, the Olink® Target 96 inflammatory panel allows the measurement of 92 circulating inflammatory proteins. The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prospective population-based cohort study which recruited pregnant women in 1991-1992 and has followed these women, their partners, and their offspring ever since. In this data note, we describe the proteomic data available in ALSPAC. Ninety-two proteins were analysed in 9000 blood plasma samples using the Olink® Target 96 inflammatory panel. Samples were derived from 2968 fasted mothers (mean age 47.5; Focus on Mothers 1 (FOM1)), 3005 non-fasted offspring at age 9 (Focus@9) and 3027 fasted offspring at age 24 (Focus@24). Post sample filtering, 1834 offspring have data at both timepoints and 1119 of those have data from their mother available. We performed quality control analyses using a standardised data processing workflow (metaboprep) to produce a filtered dataset of 8983 samples for researchers to use in future analyses. Initial validation analyses indicate that IL-6 measured using the Olink® Target 96 inflammatory panel is highly correlated with IL-6 previously measured by clinical chemistry (Pearson’s correlation = 0.77) and we are able to reproduce the reported positive correlation between body mass index (BMI) and IL-6. The pre-processing and validation analyses indicate a rich proteomic dataset to further characterise the role of inflammation in health and disease.

Maternal reports of morbidity during the index ALSPAC pregnancy

Within the ALSPAC (Avon Longitudinal Study of Parents and Children) resource, information concerning the health of the mother during pregnancy is available from three sources: (i) computerised data collected by midwives after the birth of the baby, known as the STORK database; (ii) data abstracted by ALSPAC staff from detailed medical obstetric records, and (iii) reports by mothers during pregnancy, and shortly after the birth using structured questionnaires completed at home. In this Data Note we focus on source (iii), and detail the information obtained from these mothers concerning their health, signs and symptoms together with medications and supplements taken during pregnancy. We also describe how the data can be accessed.

Socioeconomic position and adverse childhood experiences as risk factors for health-related behaviour change and employment adversity during the COVID-19 pandemic: insights from a prospective cohort study in the UK

Background

Non-pharmaceutical interventions to reduce the spread of COVID-19 may have disproportionately affected already disadvantaged populations.

Methods

We analysed data from 2710 young adult participants of the Avon Longitudinal Study of Parents and Children. We assessed the associations of socioeconomic position (SEP) and Adverse Childhood Experiences (ACEs, e.g. abuse, neglect, measures of family dysfunction) with changes to health-related behaviours (meals, snacks, exercise, sleep, alcohol and smoking/vaping), and to financial and employment status during the first UK lockdown between March–June 2020.

Results

Experiencing 4+ ACEs was associated with reporting decreased sleep quantity during lockdown (OR 1.53, 95% CI: 1.07–2.18) and increased smoking and/or vaping (OR 1.85, 95% CI: 0.99–3.43); no other associations were seen between ACEs or SEP and health-related behaviour changes. Adverse financial and employment changes were more likely for people with low SEP and for people who had experienced multiple ACEs; e.g. a history of 4+ ACEs was associated with being furloughed or on other leave during lockdown (OR 1.92, 95% CI: 1.35–2.74).

Conclusions

In this sample of young adults, there was little evidence that lockdown worsened inequalities in health-related behaviours. However, adverse financial and employment consequences of lockdown were more likely to be experienced by people who have already experienced socioeconomic deprivation or childhood adversity, thereby widening social inequalities and demonstrating the need for support into adulthood for those with a history of ACEs.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14184-8.

The housing environment of participants in the Avon Longitudinal Study of Parents and Children (ALSPAC): a resource for studies of influences on health

Background: Early life environmental health exposures related to housing can have a significant impact on an individual’s physical and mental health and physical development. Housing exposures can fall into two main areas – a representation of social circumstances and physical conditions.   Methods: During pregnancy and post-delivery, self-completion questionnaires concerning the housing environment were administered until the study offspring were aged 18 to the ALSPAC (Avon Longitudinal Study of Parents & Children) study mothers and their partners. Data collected included types of housing, housing tenure, numbers of rooms in the home, whether shared or sole use of kitchen and indoor flushing toilet, household moves, Council Tax band, difficulties in affording rent/mortgage and becoming homeless. Here we also describe the historic development of housing in the Bristol and surrounding Avon areas.   Results: Data collected included the tenure (e.g., owned/rented) of the home, its size (indexed by the number of rooms), the presence of over-crowding (measured by the number of residents per room), presence of amenities, and frequency of household moves. This information was collected on over 13,000 women during pregnancy >8000 at age 10 and >4000 at 18 years. Council Tax bands were asked at 10 and 18 years.   Conclusions: This is the first of two Data Notes on the housing type and housing circumstances of the families enrolled in ALSPAC. A second Data Note will detail their internal housing conditions. The data provides an excellent resource for researchers when considering the influences of housing on physical and mental health and development.

Parental spiritual and religious beliefs and behaviour data collected from the Avon Longitudinal Study of Parents and Children, 2020

There are few studies that chart the ways in which the religious beliefs and practices of parents and their offspring vary over time. Even fewer can relate this to aspects of their physical and mental health or distinguish the different facets of the environment that may have influenced the development or loss of religious/spiritual belief and behaviours over time. This paper describes the recent data collection in the Avon Longitudinal Study of Parents and Children (ALSPAC) on the beliefs and behaviours of the study parents some 27-28 years after the first measures were collected. Questions that were previously administered to the mother and her partner on religion, spirituality, behaviours, and beliefs (RSBB) were repeated for the fourth time, together with enhanced data on RSBB. The new data are described and compared with previous responses. The most notable difference between the 9 year and the 2020 sweep was the increase of professed non-believers in both the mothers (17.5% vs 29.8%) and partners (31.9% vs. 45.3%). As expected, on each occasion study partners were less likely to acknowledge RSBB compared to the study mothers. In the latest sweep, respondents were less likely to be unsure if they believed and more likely to not believe. Responses to "Do you believe in God or a divine power?" in mothers ranged from 49.9% stating 'yes' antenatally to 43.5% doing so in 2020; 14.9% vs 29.8% for 'no' and 35.2% to 26.6% for 'not sure'. For partners, the corresponding figures are: 'yes' 37.0% vs. 30.0%; 'no' 28.6% vs. 45.3% and 'not sure' 34.5% vs. 24.6%. We plan to undertake detailed analyses of the antecedents and consequences of RBSS. All data are available for use by interested researchers.

Possible transgenerational associations between grandparents’ childhood exposures and religious belief in their granddaughters: a longitudinal cohort study

Background: Research in non-genetic inheritance indicates that grandparents’ smoking habits and their childhood experiences of trauma can influence the physical and psychological attributes of their grandchildren. This was particularly apparent for outcomes such as autism and obesity where the population prevalence changed over time. Other factors which have changed temporally include religious and spiritual beliefs (RSBs) which have been declining in Western populations. Methods: We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to explore whether grandparental exposures were associated with the religious and/or spiritual beliefs of their grandchildren. In line with other inter/trans-generational human studies we predicted that: (P1) grandparents’ childhood exposures to cigarette smoking (whether in utero or by active smoking) and/or exposure to traumatic events during childhood will be associated with their grandchild’s RSB; (P2) associations will differ between maternal and paternal lines of inheritance; (P3) relationships will vary with age at grandparental exposure, and (P4) associations will differ between grandsons and granddaughters. Results: We found significant associations between the grandchild’s RSB and both the grandparents’ smoking and their childhood trauma histories (P1 supported). These associations were mainly found down the maternal line (P2 possibly supported) and results varied with age of exposure of the grandparents; being strongest for in utero exposure of cigarette smoke and for pre-puberty exposure of traumatic events (P3 supported), and that granddaughters were more affected than grandsons (P4 supported). Conclusions: We hope that these results will motivate collection of similar data to further evaluate these questions in other populations, including a possible role for biological mechanisms.

Religious/spiritual beliefs and behaviours and study participation in a prospective cohort study (ALSPAC) in Southwest England

Background Longitudinal studies are key to understanding risk factors for health, well-being, and disease, yet associations may be biased if study invitation and participation are non-random. Religious/spiritual beliefs and behaviours (RSBB) are increasingly recognised as having potentially important relationships with health. However, it is unclear whether RSBB is associated with study participation. We examine whether RSBB is associated with participation in the longitudinal birth cohort ALSPAC (Avon Longitudinal Study of Parents and Children). Methods Three RSBB factors were used: religious belief (belief in God/a divine power; yes/not sure/no), religious affiliation (Christian/none/other), and religious attendance (frequency of attendance at a place of worship). Participation was measured in three ways: i) total number of questionnaires/clinics completed; ii) completion of the most recent questionnaire (in 2020); and iii) length of participation. Analyses were repeated for the ALSPAC mothers, their partners, and the study children, and were adjusted for relevant socio-demographic confounders. Results Religious attendance was positively associated with participation in all adjusted models in all three cohorts. For example, study mothers who attended a place of worship at least once a month on average completed two more questionnaires (out of a possible 50), had 50% greater odds of having completed the most recent questionnaire, and had 25% reduced risk of drop-out, relative to those who did not attend a place of worship. In the adjusted analyses, religious belief and attendance were not associated with participation. However, the majority of unadjusted models showed associations between RSBB and participation. Conclusion After adjusting for confounders, religious attendance –  not religious belief or affiliation – was associated with participation in ALSPAC. These results indicate that use of RSBB variables (and religious attendance in particular) may result in selection bias and spurious associations; these potential biases should be explored and discussed in future studies using these data.

Bias from questionnaire invitation and response in COVID-19 research: an example using ALSPAC

Background: Longitudinal studies are crucial for identifying potential risk factors for infection with, and consequences of, COVID-19, but relationships can be biased if they are associated with invitation and response to data collection. We describe factors relating to questionnaire invitation and response in COVID-19 questionnaire data collection in a multigenerational birth cohort (the Avon Longitudinal Study of Parents and Children, ALSPAC). Methods: We analysed online questionnaires completed between the beginning of the pandemic and easing of the first UK lockdown by participants with valid email addresses who had not actively disengaged from the study. We assessed associations of pre-pandemic sociodemographic, behavioural, anthropometric and health-related factors with: i) being sent a questionnaire; ii) returning a questionnaire; and iii) item response (for specific questions). Analyses were conducted in three cohorts: the index children born in the early 1990s (now young adults; 41 variables assessed), their mothers (35 variables) and the mothers' partners (27 variables). Results: Of 14,849 young adults, 41% were sent a questionnaire, of whom 57% returned one. Item response was >95%. In this cohort, 78% of factors were associated with being sent a questionnaire, 56% with returning one, and, as an example of item response, 20% with keyworker status response. For instance, children from mothers educated to degree-level had greater odds of being sent a questionnaire (OR=5.59; 95% CI=4.87-6.41), returning one (OR=1.60; 95% CI=1.31-1.95), and responding to items (e.g., keyworker status OR=1.65; 95% CI=0.88-3.04), relative to children from mothers with fewer qualifications. Invitation and response rates and associations were similar in all cohorts. Conclusions: These results highlight the importance of considering potential biases due to non-response when using longitudinal studies in COVID-19 research and interpreting results. We recommend researchers report response rates and factors associated with invitation and response in all COVID-19 observational research studies, which can inform sensitivity analyses.

Regular smoking of male ancestors in adolescence and fat mass in young adult grandchildren and great-grandchildren

Background: Previous studies using the Avon Longitudinal Study of Parents and Children (ALSPAC) have shown that if men commenced smoking prior to the onset of puberty their sons, their granddaughters and great-granddaughters were more likely to have excess fat (but not lean) mass during childhood, adolescence and early adulthood. In this study we assess associations between ancestral smoking during adolescence (ages 11-16 years) with fat and lean mass of subsequent generations at two ages. Methods: We analysed data on exposures of grandparents and great-grandparents collected by ALSPAC. The outcomes were the fat masses of their grandchildren and great-grandchildren measured at ages 17 and 24. Measures of lean mass were used as controls. Adjustment was made for 8-10 demographic factors using multiple regression. Results: We found associations between adolescent smoking of the paternal grandfathers and the adjusted fat mass of their grandchildren, but no associations with the grandchildren's lean mass. Grandchildren at age 17 had an average excess fat mass of +1.65 [95% CI +0.04, +3.26] Kg, and at age 24 an average excess of +1.55 [95% CI -0.27, +3.38] Kg. Adolescent smoking by the maternal grandfather showed similar, but weaker, associations: at 17 an average excess fat mass of +1.02 Kg [95% CI -0.20, +2.25] Kg, and at 24 an average excess of +1.28 [95% CI -0.11, +2.66] Kg. There were no pronounced differences between the sexes of the children. For the great-grandparents there were few convincing results, although numbers were small. Conclusions: We have shown associations between grandfathers' smoking in adolescence and increased fat (but not lean) mass in their children. Confirmation of these associations is required, either in a further data set or by demonstrating the presence of supportive biomarkers.

Long COVID burden and risk factors in 10 UK longitudinal studies and electronic health records

The frequency of, and risk factors for, long COVID are unclear among community-based individuals with a history of COVID-19. To elucidate the burden and possible causes of long COVID in the community, we coordinated analyses of survey data from 6907 individuals with self-reported COVID-19 from 10 UK longitudinal study (LS) samples and 1.1 million individuals with COVID-19 diagnostic codes in electronic healthcare records (EHR) collected by spring 2021. Proportions of presumed COVID-19 cases in LS reporting any symptoms for 12+ weeks ranged from 7.8% and 17% (with 1.2 to 4.8% reporting debilitating symptoms). Increasing age, female sex, white ethnicity, poor pre-pandemic general and mental health, overweight/obesity, and asthma were associated with prolonged symptoms in both LS and EHR data, but findings for other factors, such as cardio-metabolic parameters, were inconclusive.

Maternal reports of morbidity during the index ALSPAC pregnancy

Within the ALSPAC (Avon Longitudinal Study of Parents and Children) resource, information concerning the health of the mother during pregnancy is available from three sources: (i) computerised data collected by midwives after the delivery of the baby, known as the STORK database; (ii) data abstracted by ALSPAC staff from detailed medical obstetric records, and (iii) reports by mothers during pregnancy, and shortly after delivery using structured questionnaires completed at home. In this Data Note we focus on source (iii), and detail the information obtained from these mothers concerning their health, signs and symptoms together with medications and supplements taken during pregnancy. We also describe how the data can be accessed.

Cross-sectional and longitudinal associations of active travel, organised sport and physical education with accelerometer-assessed moderate-to-vigorous physical activity in young people: the International Children's Accelerometry Database

BACKGROUND

Physical activity (PA) declines during childhood. Important sources of PA are active travel, organised sport and physical education (PE), but it is unclear how these domain-specific PA sources contribute to (changes in) daily moderate-to-vigorous PA (MVPA) in young people. This study aimed to examine (1) the cross-sectional association between domain-specific physical activity (i.e., active travel, organised sport and PE) and daily minutes in accelerometer-assessed MVPA; and (2) the longitudinal association between domain-specific physical activity at baseline and change in daily minutes in MVPA.

METHODS

Participants (baseline age 11.3 ± .1.2 years) were drawn from three studies in the International Children's Accelerometry Database. The contribution of self-reported standardised active travel, organised sport and PE to accelerometer-measured daily minutes in MVPA was examined using linear regression. In cross-sectional analyses, MVPA was regressed on each PA domain in separate models, adjusted for study, age, sex, maternal education, season, and monitor wear time. In longitudinal analyses, change in MVPA was regressed on each of the baseline PA domains, additionally adjusting for changes in season and wear time, follow-up duration, and baseline MVPA. R-squared was used to compare variance explained by each PA domain.

RESULTS

In the cross-sectional analyses (n = 3871), organised sport (standardised β = 3.81, 95% confidence interval [95%CI] = 3.06, 4.56) and active travel (β = 3.46, 95%CI = 2.73, 4.19) contributed more to daily MVPA than PE (β = 0.82, 95%CI = -0.02, 1.66). Compared to the base model which included only covariates (R2 = 21.5%), organised sport (absolute change: + 1.9%) and active travel (+ 1.7%) models explained more of the variance than the PE model (± < 0.1%). Associations followed a similar pattern in the longitudinal analyses (n = 2302), but none of the PA domains predicted change in MVPA (organised sport: standardised β = 0.85, 95%CI = -0.03, 1.72; active travel: β = 0.68, 95%CI = -0.14, 1.50; PE: β = 0.02, 95%CI = -0.87, 0.91).

CONCLUSIONS

A multi-sectoral approach covering a wide range of PA domains should be promoted to minimise the age-related decline in MVPA during childhood.

Cross-sectional and prospective associations of sleep duration and bedtimes with adiposity and obesity risk in 15 810 youth from 11 international cohorts

OBJECTIVES

To investigate associations of bedtimes and sleep durations with adiposity levels in children and adolescents.

METHODS

Individual data were pooled for 12 247 children (5819 with follow-up adiposity at 2.3 ± 1.4 years post-baseline) and 3563 adolescents from 11 international studies. Associations between questionnaire-based sleep durations, bedtimes and four groups of combined bedtimes and sleep lengths (later-shorter [reference]/earlier-shorter/later-longer/earlier-longer) with measured adiposity (body mass index [BMI] and waist circumference z-scores) and weight status, were investigated.

RESULTS

In children, longer sleep durations were consistently associated with lower adiposity markers, and earlier bedtimes were related to lower BMI z-score. Compared to sleeping <10 h, longer baseline sleep duration favourably predicted Δwaist z-score in girls (≥10 and <11 h (β-coefficient (95% confidence interval [CI])): -0.06 (-0.12 to -0.01)) and boys (≥11 h: -0.10 [-0.18 to -0.01]). Combined groups that were defined by longer sleep (later-longer and earlier-longer sleep patterns) were associated with lower adiposity, and later-longer sleep favourably predicted Δwaist z-score in girls (-0.09 [-0.15 to -0.02]). In adolescents, longer sleep durations and earlier bedtimes were associated with lower BMI z-score in the whole sample, and also with lower waist z-score in boys. Combined groups that were characterized by earlier bedtimes were associated with the same outcomes. For example, earlier-shorter (-0.22 (-0.43 to -0.01) and earlier-longer (-0.16 (-0.25 to -0.06) sleep were both associated with lower BMI z-score.

CONCLUSIONS

If the associations are causal, longer sleep duration and earlier bedtimes should be targeted for obesity prevention, emphasizing longer sleep for children and earlier bedtimes for adolescents.

Paternal grandmother's smoking in pregnancy is associated with extreme aversion to bitter taste in their grandchildren

Although there are many examples in the experimental literature of an environmental exposure in one generation impacting the phenotypes of subsequent generations, there are few studies that can assess whether such associations occur in humans. The Avon Longitudinal Study of Parents and Children (ALSPAC) has, however, been able to determine whether there are associations between grandparental exposures and their grandchildren's development. Several of our studies, including sensitivity to loud noise, have shown associations between a grandmother smoking in pregnancy and the phenotype of the grandchild. These results were mostly specific to the sex of the grandchild and to whether the prenatal (i.e. during pregnancy) smoking occurred in the maternal or paternal grandmother. Here, we have used ancestral data on prenatal smoking among the grandmothers of the ALSPAC index children to examine possible effects on the grandchild's ability to detect the bitter taste of PROP (6 n-propylthiouracil), distinguishing between the 10% deemed 'extreme tasters', and the rest of the population (total N = 4656 children). We showed that grandchildren whose paternal (but not maternal) grandmothers had smoked in pregnancy were more likely than those of non-smoking grandmothers to be extreme tasters [odds ratio (OR) 1.28; 95% confidence interval (CI) 1.03, 1.59] and that this was more likely in granddaughters (OR 1.42; 95% CI 1.03, 1.95) than grandsons (OR 1.18; 95% CI 0.88, 1.60). This pattern of association between paternal foetal exposure and the granddaughter's development has been found with several other outcomes, suggesting that investigations should be undertaken to investigate possible mechanisms.

The Avon Longitudinal Study of Parents and Children - A resource for COVID-19 research: Antibody testing results, April - June 2021

The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prospective population-based cohort which recruited pregnant women in 1990-1992 and has followed these women, their partners (Generation 0; G0) and their offspring (Generation 1; G1) ever since. The study reacted rapidly and repeatedly to the coronavirus disease 2019 (COVID-19) pandemic, deploying multiple online questionnaires and a previous home-based antibody test in October 2020. A second antibody test, in collaboration with ten other longitudinal population studies, was completed by 4,622 ALSPAC participants between April and June 2021. Of 4,241 participants with a valid spike protein antibody test result (8.2% were void), indicating antibody response to either COVID-19 vaccination or natural infection, 3,172 were positive (74.8%). Generational differences were substantial, with 2,463/2,555 G0 participants classified positive (96.4%) compared to 709/1,686 G1 participants (42.1%). Of 4,199 participants with a valid nucleocapsid antibody test result (9.2% were void), suggesting potential and recent natural infection, 493 were positive (11.7%); 248/2,526 G0 participants (9.8%) and 245/1,673 G1 participants (14.6%) tested positive, respectively. We also compare results for this round of testing to that undertaken in October 2020. Future work will combine these test results with additional sources of data to identify participants' COVID-19 infection and vaccination status. These ALSPAC COVID-19 serology data are being complemented with linkage to health records and Public Health England pillar testing results as they become available, in addition to four previous questionnaire waves and a prior antibody test. Data have been released as an update to the previous COVID-19 datasets. These comprise: 1) a standard dataset containing all participant responses to all four previous questionnaires with key sociodemographic factors; and 2) individual participant-specific release files enabling bespoke research across all areas supported by the study. This data note describes the second ALSPAC antibody test and the data obtained from it.

The inflammatory potential of the diet in childhood is associated with cardiometabolic risk in adolescence/young adulthood in the ALSPAC birth cohort

PURPOSE

This study examined the association between a Dietary Inflammatory Score adapted for children (cDIS) and Cardiometabolic Risk (CMR) score in adolescence/early adulthood in the Avon Longitudinal Study of Parents and Children (ALSPAC).

METHODS

The cDIS was calculated at 7, 10 and 13 years using diet diary data. Anthropometric and biochemical data at 17 (N = 1937) and 24 (N = 1957) years were used to calculate CMR scores at each age [mean sex-specific z-scores from triacylglycerol, HDL-cholesterol, LDL-cholesterol, mean arterial blood pressure (MAP), homeostatic model assessment of insulin resistance (HOMA-IR) and fat-mass index (FMI)]. Multivariable linear regression models examined associations between cDIS at 7, 10 and 13 years and a continuous CMR z-score and individual CMR markers at 17 and 24 years.

RESULTS

In fully adjusted models, a higher cDIS (more pro-inflammatory diet) at 7 years was associated with an increase in CMR z-score at 17 years (β 0.19; 95% CI 0.03-0.35 for third versus first cDIS tertile) and at 24 years (β 0.28; 95% CI 0.11,0.44 for third versus first cDIS tertile). There was a weak association between a higher cDIS at 10 years and an increase in CMR z-score at 17 years (β 0.16; 95% CI - 0.003, 0.32 for third versus first cDIS tertile). No other clear associations were evident. FMI, MAP and HOMA-IR were the main CMR factors contributing to these associations.

CONCLUSION

A more pro-inflammatory diet during childhood was associated with a worse cardiometabolic profile in late adolescence/early adulthood. A childhood diet abundant in nutrients with anti-inflammatory properties could help reduce development of CMR factors.