Parental smoking and childhood obesity: higher effect estimates for maternal smoking in pregnancy compared with paternal smoking--a meta-analysis

Association between secondhand smoke exposure and early eruption of deciduous teeth: a cross-sectional study

INTRODUCTION

Secondhand smoke (SHS) exposure is a risk factor for early childhood caries. Here we examined the association between SHS exposure and early tooth eruption (ETE) to clarify the additional etiology of an increased chance of contact between the tooth’s surface and acid produced by fermenting oral bacteria.

METHODS

Data of 388 child–mother pairs who attended health checkups at public health centers were assessed for children aged ≥18 months. SHS exposure was reported as maternal smoking during pregnancy and household smoking after birth. Associations between SHS exposure and ETE (≥3 canines in the oral cavity) were tested using multivariable analyses of the dose-response relationship. Subgroup and sensitivity analyses were performed for birth-weight subgroups and SHS exposure variables, respectively.

RESULTS

ETE prevalence was 65.5%, 68.1%, and 76.9% in the no, medium-dose (ceased partway and sometimes), and highest-dose (every day) exposure groups, respectively, during pregnancy, and 61.5%, 75.0%, and 75.5%, respectively, after birth. The association between the highest dose exposure during pregnancy and ETE was not significant (OR=1.42, 95% CI: 0.34–5.96, p=0.631), whereas that between highest dose exposure after birth and ETE was significant (OR=2.13, 95% CI: 1.06–4.31, p=0.034); this association was distinct in the subgroup of children with smaller birth weights (<3000 g) (OR=3.19, 95% CI: 1.08–9.44, p=0.036). The dose-response relationship was consistently significant for exposure after birth (p<0.05). The sensitivity analysis that employed no SHS exposure, as a reference, revealed that exposure after birth but no exposure during pregnancy was significantly associated with ETE (OR=2.29, 95% CI: 1.19–4.40, p=0.013). However, the association between exposure during pregnancy and ETE was consistently non-significant (p>0.05).

CONCLUSIONS

When controlling for variables of birth weight and exposure type, SHS exposure after birth was independently associated with the early eruption of deciduous canines. Further studies are warranted to examine the trajectory of SHS exposure after birth, ETE, and early childhood caries incidence.

ABBREVIATIONS

ETE: Early tooth eruption, SHS: Secondhand smoke

Maternal smoking and risk of obesity in school children: Investigating early life theory from the GRECO study

Based on the Early Life Theory, maternal smoking may be a factor affecting child weight status, adiposity level and blood pressure later in life. The purpose of this study was primarily to examine the risk of maternal smoking during pregnancy with overweight and obesity, central and total adiposity in school children. Secondarily, to assess the effect of maternal smoking, with children's blood pressure (BP). Data from the Greek Childhood Obesity cross sectional study (GRECO), conducted from October 2008 to May 2009, were used. A total of 2400 questionnaires gathered from children and their parents were analysed. Maternal and gestational data were gathered by a self-administered questionnaire. Women were categorized as non-smokers or smokers if they smoked ≥ 1 cigarettes/day during pregnancy. Children's body weight, height, waist circumference and BP were measured. Multiple logistic and linear regression analysis was conducted, adjusting for covariates. Four models were used in the process. The study found that children of maternal-smokers were more likely to be overweight or obese (OR: 1.6 to 1.82) and to have a larger waist circumference (OR: 1.73 to 1.85), compared to children of non-smokers in all models used. Total fat percentage was not significantly associated with maternal smoking when adjusted. Systolic and diastolic BP was not associated with maternal smoking. Results of this study strengthen the need for smoking cessation during pregnancy in order to possibly reduce the childhood obesity epidemic. Creating public health awareness of the potential risk of maternal-smoking on children's weight status later in life is warranted.

Ethical Considerations for Perinatal Toxicology Screening

Neonatal nurses frequently care for babies who have been exposed in utero to potentially harmful substances, both licit and illicit. The risks to the fetus from nicotine, marijuana, alcohol, and opiates are significant. Adverse effects from environmental factors may confound pharmacologic effects of substances. Nurses are called to shift the perception of substance use disorder from that of willful harm to the fetus to that of an opportunity to provide treatment assistance that can positively affect child health and development. Concerns for unethical practices in the toxicology screening of pregnant women and their babies by risk factors that are unproven or disproven are discussed, and three goals of toxicology screening based on the ethical principles of justice and beneficence are proposed. This article will help equip neonatal nurses to fulfill their professional responsibility to advocate for just screening and referral practices in their institutions and communities.

[What are the determinants of childhood obesity? : A literature review as part of the project "Nationwide Monitoring of Childhood Obesity Determinants"]

BACKGROUND

Obesity can impair health even in childhood and unfold negative health consequences through an individual's lifespan. In Germany, to date, a systematic and periodically updated synopsis of the multifaceted determinants of childhood obesity is lacking. In this paper, we present the results of a systematic literature review on childhood obesity determinants, which was conducted over the course of the implementation of nationwide monitoring.

METHODS

The review was carried out in three steps. Initially, a search for etiological models of childhood obesity was conducted. Based on these results, a systematic review of reviews on childhood obesity determinants was carried out. Finally, the results were verified by taking international guidelines on childhood obesity into account.

RESULTS

In total, 21 etiological models, 75 reviews and 7 guidelines were identified. Over 60 determinants were extracted from these publications and were summarized into the following categories: nutritional behavior, physical activity behavior, sleeping pattern, biological determinants and diseases, prenatal and early childhood determinants, psycho-social determinants, food environment, moveability/walkability, setting and social environment, health promotion and prevention, socioeconomic, demographic, and sociocultural determinants.

CONCLUSION

This review demonstrates the complex patterns of childhood obesity determinants in correspondence with a socio-ecological approach. The review will form the basis for the monitoring-system "Nationwide Monitoring of Childhood Obesity Determinants", which will be implemented at the Robert Koch Institute by the end of 2017.

Reducing tobacco smoking and smoke exposure to prevent preterm birth and its complications

Tobacco smoking and smoke exposure during pregnancy are associated with a range of adverse health outcomes, including preterm birth. Also, children born preterm have a higher risk of complications including bronchopulmonary dysplasia and asthma when their mothers smoked during pregnancy. Smoking cessation in early pregnancy can help reduce the adverse impact on offspring health. Counselling interventions are effective in promoting smoking cessation and reducing the incidence of preterm birth. Peer support and incentive-based approaches are likely to be of additional benefit, whereas the effectiveness of pharmacological interventions, including nicotine replacement therapy, has not definitely been established. Smoke-free legislation can help reduce smoke exposure as well as maternal smoking rates at a population level, and is associated with a reduction in preterm birth. Helping future mothers to stop smoking and protect their children from second hand smoke exposure must be a key priority for health care workers and policy makers alike.

The effect of prenatal smoking exposure on daily smoking among teenage offspring

AIMS

To study the predictive associations between maternal smoking and the impact of quitting smoking during pregnancy and offspring daily smoking at age 15-16 years.

DESIGN

The Northern Finland Birth Cohort 1986 (NFBC86) includes 99% of all births in the region and has an ongoing follow-up. Data were collected using questionnaires at 24th gestational week during pregnancy and after delivery, and at follow-up in 2001-02, when the offspring were aged 15-16 years.

SETTING

Northern Finland.

PARTICIPANTS

NFBC86 included 9432 live born children. Data regarding maternal smoking during pregnancy and offspring smoking at age 15-16 years were available for 4462 subjects (47.3% of the original sample).

MEASUREMENTS

The outcome was offspring's self-reported daily smoking. Maternal smoking during pregnancy was considered using a four-class variable: (1) no smoking, (2) mother had smoked, but had quit smoking before becoming pregnant, (3) mother quit smoking during the 1st trimester and (4) mother quit smoking after the 1st trimester or continued smoking throughout the pregnancy. Information regarding paternal smoking during pregnancy, maternal and paternal smoking and education level, family structure and dwelling at offspring's age 15-16 years were considered potential confounding variables.

FINDINGS

Continuing smoking after the 1st trimester increased the odds of daily smoking among offspring, independently of confounding factors [odds ratio (OR) = 1.8, 95% confidence interval (CI) = 1.3-2.5]. Continuing to smoke after the 1st trimester was associated with higher odds compared with quitting smoking during the 1st trimester. Also, parental smoking at offspring age 15-16 years increased the odds of offspring daily smoking, independently of prenatal smoking exposure.

CONCLUSIONS

Prenatal smoking exposure increases the risk for offspring adolescent daily smoking. Quitting smoking during the early stages of pregnancy may decrease the odds for offspring smoking.

Secondhand Smoke Exposure and Subclinical Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis

BACKGROUND

Few studies have evaluated the association between secondhand smoke (SHS) and subclinical cardiovascular disease among ethnically diverse populations. This study assesses the impact of SHS on inflammation and atherosclerosis (carotid intima-media thickness, coronary artery calcification, and peripheral arterial disease).

METHODS AND RESULTS

We examined 5032 nonsmoking adults aged 45 to 84 years without prior cardiovascular disease participating in the Multi-Ethnic Study of Atherosclerosis (MESA) from 2000 to 2002. SHS exposure was determined by self-report, and urinary cotinine was measured in a representative subset (n=2893). The multi-adjusted geometric mean ratios (95% CIs) for high-sensitivity C-reactive protein and interleukin-6 comparing 407 participants with SHS ≥12 h/wk versus 3035 unexposed participants were 1.13 (1.02-1.26) and 1.04 (0.98-1.11), respectively. The multi-adjusted geometric mean ratio for carotid intima-media thickness was 1.02 (0.97-1.07). Fibrinogen and coronary artery calcification were not associated with SHS. The prevalence of peripheral arterial disease (ankle-brachial index ≤0.9 or ≥1.4) was associated with detectable urinary cotinine (odds ratio, 2.10; 95% CI, 1.09-4.04) but not with self-reported SHS. Urinary cotinine was not associated with inflammation or carotid intima-media thickness.

CONCLUSIONS

Despite limited exposure assessment, this study supports the association of SHS exposure with inflammation and peripheral arterial disease.

Maternal smoking during pregnancy and rapid weight gain from birth to early infancy

Background

Although several studies have focused on the association between maternal smoking during pregnancy and rapid weight gain (RWG) during infancy, the dose-response relationship has not yet been confirmed, and very few studies have included Asian populations. Using a record-linkage method, we examined the association between maternal smoking during pregnancy and RWG in infants at around 4 months of age to clarify the dose-response relationship.

Methods

Two databases were used: maternal check-ups during pregnancy and early infancy check-ups (between April 1, 2013 and March 31, 2014 in Okinawa, Japan) were linked via IDs and provided to us after unlinkable anonymizing. For 10,433 subjects (5229 boys and 5204 girls), we calculated the change in infants' weight z-score by subtracting the z-score of their birth weight from their weight at early infancy check-ups. Smoking exposure was categorized into five groups. We used Poisson regression to examine the association of maternal smoking during pregnancy with RWG in early infancy.

Results

Overall, 1524 (14.6%) were ex-smoker and 511 (4.9%) were current smoker. Compared with the reference category of non-smokers, the adjusted risk ratio of RWG was 1.18 (95% confidence interval [CI], 1.06–1.32) for ex-smokers, 1.18 (95% CI, 0.93–1.50) for those who smoked 1–5 cigarettes per day, 1.57 (95% CI, 1.24–2.00) for those who smoked 6–10 cigarettes per day, and 2.13 (95% CI, 1.51–3.01) for those who smoked ≥11 cigarettes per day. There was a clear dose-response relationship.

Conclusion

Our study suggests that maternal smoking during pregnancy is associated in a dose-dependent manner with increased risk of RWG in early infancy.

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Maternal smoking in pregnancy is associated with Rapid Weight Gain in early infancy.

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The association of maternal smoking with rapid weight gain was dose-dependent.

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This study was based on a large population-based dataset in Japan.

Smoke-free legislation and child health

In this paper, we aim to present an overview of the scientific literature on the link between smoke-free legislation and early-life health outcomes. Exposure to second-hand smoke is responsible for an estimated 166 ,000 child deaths each year worldwide. To protect people from tobacco smoke, the World Health Organization recommends the implementation of comprehensive smoke-free legislation that prohibits smoking in all public indoor spaces, including workplaces, bars and restaurants. The implementation of such legislation has been found to reduce tobacco smoke exposure, encourage people to quit smoking and improve adult health outcomes. There is an increasing body of evidence that shows that children also experience health benefits after implementation of smoke-free legislation. In addition to protecting children from tobacco smoke in public, the link between smoke-free legislation and improved child health is likely to be mediated via a decline in smoking during pregnancy and reduced exposure in the home environment. Recent studies have found that the implementation of smoke-free legislation is associated with a substantial decrease in the number of perinatal deaths, preterm births and hospital attendance for respiratory tract infections and asthma in children, although such benefits are not found in each study. With over 80% of the world’s population currently unprotected by comprehensive smoke-free laws, protecting (unborn) children from the adverse impact of tobacco smoking and SHS exposure holds great potential to benefit public health and should therefore be a key priority for policymakers and health workers alike.

[Criteria catalogue to systematize conceptual approaches in universal prevention of childhood overweight : Methodological approach and first results]

BACKGROUND

Overweight and obesity are serious health risks for children and adolescents. Hence, various prevention projects have been initiated and implemented. Until now, a systematic overview of interventions in different settings has been lacking.

AIM(S)/RESEARCH QUESTION

The aim of the "Prevention of child overweight" project (SkAP-project) is to prepare a systematic overview of the conceptual approaches used in universal prevention of overweight among children and adolescents. First of all, a comprehensive criteria catalogue will be developed based on systematic searches. In the next step the criteria catalogue will be applied to identify and characterize conceptual approaches.

DATA AND METHODS

Criteria to describe conceptual approaches as well as determinants of childhood overweight were determined by systematic searches. The searches included relevant data bases and were further expanded by internet and hand search. Three settings (kindergarten, school and communities) and families are addressed by the systematic searches. Additional non-setting specific searches were conducted.

RESULTS

A comprehensive criteria catalogue was developed, which allows a detailed analysis of conceptual approaches. This catalogue covers further quality criteria as well as determinants of childhood overweight.

DISCUSSION

Currently, the criteria catalogue is being employed. Although the detailed analysis of conceptual approaches can be regarded as advantage of the criteria catalogue, there are also some limitations, such as the lack of necessary information provided in publications. Overall, the application will reveal an overview regarding universal prevention in childhood overweight, which is still lacking, and will support development in this field.

Thin mother, obese child? A review of early risk factors for obesity in offspring

PURPOSE OF REVIEW

The huge percentages of persons with obesity in many countries constitute a public health crisis. The severe consequences of obesity for physical health and emotional wellbeing already emerge in childhood. Therefore, the acknowledgment of early risk factors is essential to provide recommendations for prevention strategies. This review outlines the current state of research concerning early risk factors for obesity, that is, factors that even contribute to later obesity of the offspring during gestation. In this regard, this review specifically addresses the link between restricted eating behavior of the mother and obesity in her offspring. We systematically searched for articles in PsychINFO, PsychINDEX, MEDLINE, PubMed, MEDPILOT, and Web of Science, and we identified additional studies in bibliographies.

RECENT FINDINGS

Although some risk factors (e.g., short period of breastfeeding, gestational diabetes, and high maternal BMI) have a vast evidence base, others (e.g., restricted eating behavior and second-hand smoking) are insufficiently studied.

SUMMARY

Physical activity and diet programs in pregnancy can reduce not only the occurrence of gestational diabetes, but also the risk of inappropriate weight gain. As smoking during pregnancy and inappropriate eating behavior are associated with lower education, psychoeducation, for instance in sex education classes, could be easily conceivable.

A Novel Method to Describe Early Offspring Body Mass Index (BMI) Trajectories and to Study Its Determinants

Background

Accurately characterizing children’s body mass index (BMI) trajectories and studying their determinants is a statistical challenge. There is a need to identify early public health measures for obesity prevention. We describe a method that allows studies of the determinants of height, weight and BMI growth up to five years of age. We illustrated this method using maternal smoking during pregnancy as one of the early-life factors that is potentially involved in prenatal programming of obesity.

Methods

Individual height and weight trajectories were fitted using the Jenss-Bayley model on 28,381 and 30,515 measurements, respectively, from 1,666 children to deduce BMI trajectories. We assessed global associations between smoking and growth trajectories and cross-sectional associations at specific ages.

Results

Children exposed in late pregnancy had a 0.24 kg/m² (95% confidence interval: 0.07, 0.41) higher BMI at 5 years of age compared with non-exposed children. Although the BMIs of children exposed during late pregnancy became significantly higher compared with those of non-exposed children from 2 years onwards, the trajectories began to diverge during the first weeks of life.

Conclusion

Our method is relevant for studies on the relationships between individual-level exposures and the dynamics and shapes of BMI growth during childhood, including key features such as instantaneous growth velocities and the age or BMI value at the BMI infancy peak that benefit from the monotonic pattern of height and weight growth.

Leptin and Adiponectin Serum Levels from Infancy to School Age: Factors Influencing Tracking

BACKGROUND

Early adiponectin and leptin in children correlate with those measured at a later age. Prenatal and early life factors may influence the pattern of leptin and adiponectin longitudinal changes. We aimed to identify subgroups of children with distinct trajectories of leptin and adiponectin over the first eight years of life, and to explore determinants predisposing an individual to be included in a specific trajectory class.

METHODS

The analysis was based on data obtained from the EU Childhood Obesity Project (CHOP) cohort. The current study involved 459 children with adiponectin and leptin measured at 6 months, 5½ and 8 years of age.

RESULTS

Three groups of leptin trajectories were identified: low-decreasing, medium-stable, and high-increasing, and two trajectory groups for adiponectin: lower and higher. The risk to be classified in the high-increasing group was higher than in the low-decreasing group for female gender (OR 10.67; 95% CI 4.94-23.05; p < 0.001); formula feeding (OR 3.34; 95% CI 1.11-10.09; p < 0.05); maternal overweight (OR 4.43; 95% CI 2.20-8.94; p < 0.001); and smoking in pregnancy (OR 4.14; 95% CI 2.07-8.29; p < 0.001). No predictors for being in the higher vs. lower adiponectin group were discovered.

CONCLUSIONS

Mothers' smoking during pregnancy, maternal overweight, and formula feeding distinguished different courses of leptin trajectories; but the effect may be associated with changes in adiposity.

Epidemiology of Obesity and Diabetes and Their Cardiovascular Complications

Obesity and diabetes mellitus have reached epidemic proportions in the past few years. During 2011 to 2012, more than one-third of the US population was obese. Although recent trend data indicate that the epidemic has leveled off, prevalence of abdominal obesity continues to rise, especially among adults. As seen for obesity, the past few decades have seen a doubling of the diabetes mellitus incidence with an increasing number of type 2 diabetes mellitus cases being diagnosed in children. Significant racial and ethnic disparities exist in the prevalence and trends of obesity and diabetes mellitus. In general, in both adults and children, non-Hispanic blacks and Mexican Americans seem to be at a high risk than their non-Hispanic white counterparts. Secular changes in agricultural policies, diet, food environment, physical activity, and sleep have all contributed to the upward trends in the diabesity epidemic. Despite marginal improvements in physical activity and the US diet, the food environment has changed drastically to an obesogenic one with increased portion sizes and limited access to healthy food choices especially for disadvantaged populations. Interventions that improve the food environment are critical as both obesity and diabetes mellitus raise the risk of cardiovascular disease by ≈2-fold. Among those with type 2 diabetes mellitus, significant sex differences occur in the risk of cardiovascular disease such that diabetes mellitus completely eliminates or attenuates the advantages of being female. Given the substantial burden of obesity and diabetes mellitus, future research efforts should adopt a translational approach to find sustainable and holistic solutions in preventing these costly diseases.

The human placental proteome is affected by maternal smoking

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The effects of maternal smoking on the term placental proteome was studied.

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Maternal smoking significantly affected 18% of protein spots.

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Maternal smoking affects systems controlling the development and function of placenta.

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The observed placental changes may contribute to the lowered birth weights.

Detrimental effects of maternal smoking on the term placental proteome and steroid-metabolizing activities, and maternal hormone levels, were studied by using seven non-smoker and seven smoker placentae. Smoking significantly affected 18% of protein spots. The functional networks affected were i) cell morphology, cellular assembly and organization, cellular compromise (15 hits) and ii) DNA replication, recombination, and repair, energy production, nucleic acid metabolism (6 hits). Smoking significantly up-regulated such proteins as, SERPINA1, EFHD1 and KRT8; and down-regulated SERPINB2, FGA and HBB. Although maternal plasma steroids were not significantly altered, the catalytic activity of CYP1A1 was increased whereas CYP19A1 activity was reduced by smoking. Furthermore, transcript expression of CYP1A1 and CYP4B1 were induced while HSD17B2, NFKB and TGFB1 were repressed by smoking. The observed smoking induced wide-spread changes on placental proteome and transcript levels may contribute to the lowered birth weights of the new-born child and placenta.

Select Prenatal Environmental Exposures and Subsequent Alterations of Gene-Specific and Repetitive Element DNA Methylation in Fetal Tissues

Strong evidence implicates maternal environmental exposures in contributing to adverse outcomes during pregnancy and later in life through the developmental origins of health and disease hypothesis. Recent research suggests these effects are mediated through the improper regulation of DNA methylation in offspring tissues, specifically placental tissue, which plays a critical role in fetal development. This article reviews the relevant literature relating DNA methylation in multiple tissues at or near delivery to several prenatal environmental toxicants and stressors, including cigarette smoke, endocrine disruptors, heavy metals, as well as maternal diet. These human studies expand upon previously reported outcomes in animal model interventions and include effects on both imprinted and non-imprinted genes. We have also noted some of the strengths and limitations in the approaches used, and consider the appropriate interpretation of these findings in terms of their effect size and their relationship to differential gene expression and potential health outcomes. The studies suggest an important role of DNA methylation in mediating the effects of the intrauterine environment on children's health and a need for additional research to better clarify the role of this epigenetic mechanism as well as others.

Parental smoking during pregnancy and the risk of gestational diabetes in the daughter

BACKGROUND

Fetal exposure to parental smoking may have long-term impact on the development of disease in adulthood. We examined the association of parental smoking during pregnancy with risk of gestational diabetes mellitus (GDM) in the daughter.

METHODS

We included 15,665 singleton pregnancies from 10,152 women in the Nurses' Health Study II cohort whose mothers participated in the Nurses' Mothers' Cohort Study. Data on maternal and paternal smoking during pregnancy and associated covariates were recalled by the mothers. GDM diagnosis was self-reported by the daughters and was validated by medical record review in a previous study. We used log-binomial models with generalized estimating equations to estimate relative risks (RRs) and 95% confidence intervals (CIs).

RESULTS

We observed a positive association between maternal heavy smoking during pregnancy and risk of GDM in the daughter. The multivariable-adjusted RRs (95% CIs) of GDM among women whose mothers did not smoke during pregnancy, continued smoking 1-14, 15-24, and ≥ 25 cigarettes/day were 1.00 (reference), 1.05 (0.81-1.35), 1.27 (0.95-1.70) and 1.98 (1.18-3.30), respectively (P for trend = 0.01). Further adjustment for the women's perinatal variables, adult-life characteristics and body mass index during various periods of life modestly attenuated the association. No association was observed between paternal smoking during the pregnancy period and risk of GDM in the daughter.

CONCLUSIONS

Maternal heavy smoking (≥ 25 cigarettes/day) during pregnancy was associated with higher risk of gestational diabetes in the daughter. Further studies are warranted to confirm our findings and to elucidate the underlying mechanisms.

Association of early and late maternal smoking during pregnancy with offspring body mass index at 4 to 5 years of age

The objective was to investigate the association between early and late maternal smoking during pregnancy on offspring body mass index (BMI). We undertook a retrospective cohort study using linked records from the Women’s and Children’s Health Network in South Australia. Among a cohort of women delivering a singleton, live-born infants between January 2000 and December 2005 (n=7658), 5961 reported not smoking during pregnancy, 297 reported quitting smoking during the first trimester of pregnancy, and 1400 reported continued smoking throughout pregnancy. Trained nurses measured the height and weight of the children at preschool visits in a state-wide surveillance programme. The main outcome measure was age- and sex-specific BMI z-score. At 4 to 5 years, mean (s.d.) BMI z-score was 0.40 (1.05), 0.60 (1.07) and 0.65 (1.18) in children of mothers who reported never smoking, quitting smoking and continued smoking during pregnancy, respectively. Compared with the group of non-smokers, both quitting smoking and continued smoking were associated with an increase in child BMI z-score of 0.15 (95% confidence interval: 0.01–0.29) and 0.21 (0.13–0.29), respectively. A significant dose–response relationship was also observed between the number of cigarettes smoked per day on average during the second half of pregnancy and the increase in offspring BMI z-score (P<0.001). In conclusion, any maternal smoking in pregnancy, even if mothers quit, is associated with an increase in offspring BMI at 4 to 5 years of age.

Impact of Caregiver Type for 3-Year-Old Children on Subsequent Between-Meal Eating Habits and Being Overweight From Childhood to Adulthood: A 20-Year Follow-up of the Ibaraki Children's Cohort (IBACHIL) Study

Background

Because of the increasing number of mothers who continue to work after childbirth, participation in childcare has diversified. However, the impact of the main caregiver on children’s habits has not been determined. We sought to examine the effect of caregiver differences on childhood habituation of between-meal eating and body mass index (BMI).

Methods

The Ibaraki Children’s Cohort Study involved 4592 Japanese children whose parents answered health questionnaires at age 3. Follow-up questionnaires were distributed to parents when children were 6 and 12 years old and to study subjects directly when they were 22 years old. We compared prevalence of between-meal eating and overweight as well as mean BMI at ages 6, 12, and 22 years, by their main daytime caregiver at age 3.

Results

Compared to children cared for by mothers, those cared for by grandparents had a higher prevalence of between-meal eating before dinner for boys and girls at ages 6 and 12 years. At age 22 years, boys cared for by grandparents had a higher prevalence of overweight than those cared for by mothers (18.5% versus 11.2%, P = 0.037), but no such difference was noted in girls. However, both boys and girls cared for by grandparents had higher mean BMI over time than those cared for by mothers (coefficient = 0.47 kg/m² for boys and coefficient = 0.35 kg/m² for girls).

Conclusions

Being cared for by grandparents at age 3 was associated with subsequent between-meal eating habits, being overweight, and increased mean BMI from childhood to adulthood.