Potential selection effects when estimating associations between the infancy peak or adiposity rebound and later body mass index in children

Timing based clustering of childhood BMI trajectories reveals differential maturational patterns; Study in the Northern Finland Birth Cohorts 1966 and 1986

BACKGROUND/OBJECTIVES

Children's biological age does not always correspond to their chronological age. In the case of BMI trajectories, this can appear as phase variation, which can be seen as shift, stretch, or shrinking between trajectories. With maturation thought of as a process moving towards the final state - adult BMI, we assessed whether children can be divided into latent groups reflecting similar maturational age of BMI. The groups were characterised by early factors and time-related features of the trajectories.

SUBJECTS/METHODS

We used data from two general population birth cohort studies, Northern Finland Birth Cohorts 1966 and 1986 (NFBC1966 and NFBC1986). Height (n = 6329) and weight (n = 6568) measurements were interpolated in 34 shared time points using B-splines, and BMI values were calculated between 3 months to 16 years. Pairwise phase distances of 2999 females and 3163 males were used as a similarity measure in k-medoids clustering.

RESULTS

We identified three clusters of trajectories in females and males (Type 1: females, n = 1566, males, n = 1669; Type 2: females, n = 1028, males, n = 973; Type 3: females, n = 405, males, n = 521). Similar distinct timing patterns were identified in males and females. The clusters did not differ by sex, or early growth determinants studied.

CONCLUSIONS

Trajectory cluster Type 1 reflected to the shape of what is typically illustrated as the childhood BMI trajectory in literature. However, the other two have not been identified previously. Type 2 pattern was more common in the NFBC1966 suggesting a generational shift in BMI maturational patterns.

Long-term impact of maternal pre-pregnancy BMI on the risk of overweight/obesity in preschool children: mediation by infant birth weight and BMI trajectory group from 0 to 2 years

BACKGROUND

Obesity is a complex multisystem disease that affects almost every organ system. Studying the early determinants of obesity and implementing targeted interventions have positive implications for promoting long-term health. Therefore, this study was to evaluate the impact of maternal pre-pregnancy overweight or obesity, weight gain rate (WGR) during the second and third trimesters, infant birth weight (IBW) and BMI trajectory group (BMI-TG) from 0 to 2 years on overweight or obesity in preschool children.

METHODS

A retrospective cohort analysis of data obtained from a hospital was performed using chain-mediated effects to analyze the direct and indirect effects of prepregnancy body mass index (ppBMI)on preschool children's body mass index (pcBMI), and mediated by three variables: WGR, IBW and BMI-TG.

RESULTS

We found that the effect of ppBMI and pcBMI was significantly mediated by IBW and BMI-TG. After adjusting for confounding factors, the total effect of ppBMI on pcBMI was estimated to be 0.1965 (bootstrap 95% CI: 0.1154-0.2783), the direct effect was 0.1562 (bootstrap 95% CI: 0.0750-0.2362), and the indirect effect was 0.0403 (bootstrap 95% CI: 0.0219 ~ 0.0651). The mediating effect accounted for 20.5% of the variance, indicating that 20.5% of the impact of ppBMI on pcBMI was mediated by two mediating factors: IBW and the BMI-TG.

CONCLUSIONS

Maternal overweight/obesity before pregnancy had a significant impact on overweight/obesity in preschool children and was mediated by two main factors: IBW and the BMI-TG.

Tracking the Prevalence of Obesity in Portuguese School-Aged Children: What Future to Expect?

BACKGROUND

Childhood obesity presents a significant public health concern globally, with implications for cardiovascular health and metabolic syndrome. In Portugal, approximately 31.6% of children are affected, highlighting the urgency for intervention strategies. This study aimed to assess the prevalence of overweight and obesity in Portuguese school-aged children, with a focus on sex and age differences.

METHODS

Anthropometric measurements were conducted on 1564 children aged 6-10 years, including weight, height, and skinfold thickness. Body Mass Index (BMI) and the percentage of body fat were calculated using established methods.

RESULTS

The results revealed significant differences in BMI (≤0.001) and body fat percentage (≤0.001) among different BMI categories, with a notable prevalence of overweight and obesity, particularly among boys. A total of 37% of the studied population is overweight or obese, among which 40.1% and 33.9% are boys and girls, respectively.

CONCLUSIONS

This study highlights statistically significant differences in BMI and body fat percentage for both sexes in different BMI categories. A large proportion of the population is overweight or obese, with a greater prevalence in boys. In short, childhood obesity has a negative impact on body composition and is associated with significant differences in anthropometric parameters, emphasizing the importance of preventative and intervention strategies to address this health problem.

Longitudinal association between the timing of adiposity peak and rebound and overweight at seven years of age

Background

The timing of adiposity peak (AP) or adiposity rebound (AR) is a determinant of overweight or obesity in adolescence and adulthood. However, limited studies have reported the association in young school-age children. We aimed to evaluate this association and explore the role of health behaviours in it.

Methods

Routinely collected, sequential, anthropometric data from the 1st to 80th months of age were used to estimate AP and AR timings in 2330 children born in Shanghai between 2010 and 2013. Multivariate regression analyses were applied to identify the associations between the AP or AR timings and the risk of developing overweight or obesity in first-grade school children. The roles of health behaviours, including dietary patterns, physical activity level, sleep and snacking habits, and screen time, were also evaluated.

Results

Children with a late AP or an early AR were at higher risk of overweight but not obesity or central obesity in their first grade. A high physical activity level was associated with a lower risk of having overweight in children with a late AP, and limited screen time was associated with a decreased risk of having overweight or obesity in children with an early AR. The absence of a late-night snacking habit in children with a non-early AR indicated a decreased risk of having overweight. However, this association was not observed among children with an early AR.

Conclusion

The timings of AP and AR are tied to overweight in middle childhood. Prevention strategies are suggested to move forward to control late AP and early AR.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12887-022-03190-9.

Child-Centred Health Dialogue for primary prevention of obesity in Child Health Services - a feasibility study

Aims: The aim of this study was to test a Child-Centred Health Dialogue model for primary prevention of obesity for 4-year-old children in Child Health Services, for its feasibility and the responsiveness of its outcomes. Methods: A feasibility study was set up with a non-randomised quasi-experimental cluster design comparing usual care with a structured multicomponent Child-Centred Health Dialogue consisting of two parts: (1) a universal part directed to all children and (2) a targeted part for families where the child is identified with overweight. Results: In total, 203 children participated in Child-Centred Health Dialogue while 582 children received usual care. Nurses trained in the model were able to execute both the universal health dialogue and the targeted part of the intervention. Tutorship enabled the nurses to reflect on and discuss their experiences, which strengthened their confidence and security. One year after the intervention fewer normal-weight 4-year-olds in the intervention group had developed overweight at the age of five compared with the control group, and none had developed obesity. The difference in overweight prevalence at follow-up did not reach statistical significance. Conclusions: This study demonstrates that a child-centred, multicomponent, interactive intervention for the promotion of healthy lifestyles and primary prevention of obesity for all 4-year-old children participating in Child Health Services is feasible on a small scale. As almost all caregivers make use of Child Health Services in Sweden, the findings should be confirmed in a randomised controlled trial before the intervention can be implemented on a larger scale.

Associations of grandparental diabetes mellitus with grandchild BMI status

Background

Maternal family history of diabetes was significantly and positively associated with birth weight in grandchildren, we aim to assess the effect of grandparental diabetes on the grandchild’ body mass index (BMI) at infancy peak (IP) and obesity status at age 2.

Methods

In our study, family diabetes mellitus (DM) information from Ma’anshan Birth Cohort Study (MABC) were gathered. For children, height and weight were retrieved from medical records. BMI at 6 observations (0, 3, 6, 9, 12, 18 months) was plotted for every child. Onset of IP was determined by visual inspection. BMI at age 2 was categorized according to WHO Child Growth Standards as normal, overweight or obesity. The association between maternal grandfather’ diabetes and the grandchild’ BMI at IP and BMI at age 2 were tested using linear regression models and logistic regression models, respectively.

Results

In our sample, about 6% of the maternal grandfather had DM, mean of infancy BMI peak was 18.37 kg/m², and 6.6% of the children were obesity at age 2. Maternal grandfather with DM could significantly increase the IP BMI values (β = 0.30, 95 CI = 0.02~0.57), and was associated with obesity status at age 2 (OR = 1.92, 95 CI = 1.08~3.39), but maternal grandmother and paternal grandparents were unrelated.

Conclusion

These results suggest that DM in maternal grandfather may be a risk factor for the grandchild high BMI at peak and obesity at age 2.

Associations of the infancy body mass index peak with anthropometry and cardiometabolic risk in Mexican adolescents

BACKGROUND

Early-life growth dynamics are associated with future health. Little is known regarding timing and magnitude of the infancy body mass index (BMI) peak with adiposity and metabolic biomarkers during adolescence.

AIM

To examine associations of the infancy BMI peak with anthropometry and cardiometabolic risk during peripuberty.

METHODS

Among 163 ELEMENT participants, this study estimated age and magnitude of the infancy BMI peak from eight anthropometric measurements from birth-36 months using Newton's Growth Models, an acceleration-based process model. Associations were examined of the infancy milestones with anthropometry and cardiometabolic risk at 8-14 years using linear regression models that accounted for maternal calcium supplementation and age; child's birthweight, sex, and age; and the other infancy milestone.

RESULTS

Median age at the infancy BMI peak was 9.6 months, and median peak BMI was 16.5 kg/m2. Later age and larger magnitude of the peak predicted higher BMI z-score, waist circumference, and skinfold thicknesses; i.e. each 1 month of age at peak and each 1 kg/m2 of peak BMI corresponded with 0.04 (0.01-0.07) and 0.33 (0.17-0.48) units of higher BMI z-score, respectively. Later age at peak was also a determinant of worse glycaemia and higher blood pressure.

CONCLUSION

Later age and larger magnitude of the infancy BMI peak are associated with higher adiposity at 8-14 years of age. Later age but not magnitude of the BMI peak are related to a worse cardiometabolic profile during peripuberty.