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Megersa BS, Andersen GS, Abera M, Abdissa A, Zinab B, Ali R, Admassu B, Kedir E, Nitsch D, Filteau S, Girma T, Yilma D, Wells JC, Friis H, Wibaek R. Associations of early childhood body mass index trajectories with body composition and cardiometabolic markers at age 10 years: the Ethiopian infant anthropometry and body composition (iABC) birth cohort study. Am J Clin Nutr 2024; 119:1248-1258. [PMID: 38458400 DOI: 10.1016/j.ajcnut.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/17/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Variability in body mass index (BMI) (kg/m2) trajectories is associated with body composition and cardiometabolic markers in early childhood, but it is unknown how these associations track to later childhood. OBJECTIVES We aimed to assess associations of BMI trajectories from 0 to 5 y with body composition and cardiometabolic markers at 10 y. METHODS In the Ethiopian infant anthropometry and body composition (iABC) birth cohort, we previously identified 4 distinct BMI trajectories from 0 to 5 y: stable low BMI (19.2%), normal BMI (48.8%), rapid growth to high BMI (17.9%), and slow growth to high BMI (14.1%). At 10 y, we obtained data from 320 children on anthropometry, body composition, abdominal subcutaneous and visceral fat, and cardiometabolic markers. Associations of BMI trajectories and 10-y outcomes were analyzed using multiple linear regression. RESULTS Compared with children with the normal BMI trajectory, those with rapid growth to high BMI had 1.7 cm (95% CI: 0.1, 3.3) larger waist circumference and those with slow growth to high had 0.63 kg/m2 (95% CI: 0.09, 1.17) greater fat mass index and 0.19 cm (95% CI: 0.02, 0.37) greater abdominal subcutaneous fat, whereas those with stable low BMI had -0.28 kg/m2 (95% CI: -0.59, 0.03) lower fat-free mass at 10 y. Although the confidence bands were wide and included the null value, children with rapid growth to high BMI trajectory had 48.6% (95% CI: -1.4, 123.8) higher C-peptide concentration and those with slow growth to high BMI had 29.8% (95% CI: -0.8, 69.8) higher insulin and 30.3% (95% CI: -1.1, 71.6) higher homeostasis model assessment of insulin resistance, whereas those with rapid growth to high BMI had -0.23 mmol/L (95% CI: -0.47, 0.02) lower total cholesterol concentration. The trajectories were not associated with abdominal visceral fat, blood pressure, glucose, and other lipids at 10 y. CONCLUSIONS Children with rapid and slow growth to high BMI trajectories before 5 y tend to show higher measures of adiposity and higher concentrations of markers related to glucose metabolism at 10 y. CLINICAL TRIAL REGISTRY ISRCTN46718296 (https://www.isrctn.com/ISRCTN46718296).
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Affiliation(s)
- Bikila S Megersa
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.
| | | | - Mubarek Abera
- Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | | | - Beakal Zinab
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark; Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Rahma Ali
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark; Department of Population and Family Health, Jimma University, Jimma, Ethiopia
| | - Bitiya Admassu
- Department of Population and Family Health, Jimma University, Jimma, Ethiopia
| | - Elias Kedir
- Department of Radiology, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Dorothea Nitsch
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Suzanne Filteau
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tsinuel Girma
- Department of Pediatrics and Child Health, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Daniel Yilma
- Department of Internal Medicine, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Jonathan Ck Wells
- Childhood Nutrition Research Center, Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Rasmus Wibaek
- Clinical Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
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Lyons-Reid J, Derraik JGB, Kenealy T, Albert BB, Ramos Nieves JM, Monnard CR, Titcombe P, Nield H, Barton SJ, El-Heis S, Tham E, Godfrey KM, Chan SY, Cutfield WS. Impact of preconception and antenatal supplementation with myo-inositol, probiotics, and micronutrients on offspring BMI and weight gain over the first 2 years. BMC Med 2024; 22:39. [PMID: 38287349 PMCID: PMC10826220 DOI: 10.1186/s12916-024-03246-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 01/02/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Nutritional intervention preconception and throughout pregnancy has been proposed as an approach to promoting healthy postnatal weight gain in the offspring but few randomised trials have examined this. METHODS Measurements of weight and length were obtained at multiple time points from birth to 2 years among 576 offspring of women randomised to receive preconception and antenatally either a supplement containing myo-inositol, probiotics, and additional micronutrients (intervention) or a standard micronutrient supplement (control). We examined the influence on age- and sex-standardised BMI at 2 years (WHO standards, adjusting for study site, sex, maternal parity, smoking and pre-pregnancy BMI, and gestational age), together with the change in weight, length, BMI from birth, and weight gain trajectories using latent class growth analysis. RESULTS At 2 years, there was a trend towards lower mean BMI among intervention offspring (adjusted mean difference [aMD] - 0.14 SD [95% CI 0.30, 0.02], p = 0.09), and fewer had a BMI > 95th percentile (i.e. > 1.65 SD, 9.2% vs 18.0%, adjusted risk ratio [aRR] 0.51 [95% CI 0.31, 0.82], p = 0.006). Longitudinal data revealed that intervention offspring had a 24% reduced risk of experiencing rapid weight gain > 0.67 SD in the first year of life (21.9% vs 31.1%, aRR 0.76 [95% CI 0.58, 1.00], p = 0.047). The risk was likewise decreased for sustained weight gain > 1.34 SD in the first 2 years of life (7.7% vs 17.1%, aRR 0.55 [95% CI 0.34, 0.88], p = 0.014). From five weight gain trajectories identified, there were more intervention offspring in the "normal" weight gain trajectory characterised by stable weight SDS around 0 SD from birth to 2 years (38.8% vs 30.1%, RR 1.29 [95% CI 1.03, 1.62], p = 0.029). CONCLUSIONS Supplementation with myo-inositol, probiotics, and additional micronutrients preconception and in pregnancy reduced the incidence of rapid weight gain and obesity at 2 years among offspring. Previous reports suggest these effects will likely translate to health benefits, but longer-term follow-up is needed to evaluate this. TRIAL REGISTRATION ClinicalTrials.gov, NCT02509988 (Universal Trial Number U1111-1171-8056). Registered on 16 July 2015.
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Affiliation(s)
- Jaz Lyons-Reid
- Liggins Institute, The University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, The University of Auckland, Private Bag 92019, Auckland, New Zealand
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Timothy Kenealy
- Liggins Institute, The University of Auckland, Private Bag 92019, Auckland, New Zealand
- Department of Medicine and Department of General Practice and Primary Health Care, The University of Auckland, Auckland, New Zealand
| | - Benjamin B Albert
- Liggins Institute, The University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - J Manuel Ramos Nieves
- Nestlé Institute of Health Sciences, Nestlé Research, Société Des Produits Nestlé S.A, Lausanne, Switzerland
| | - Cathriona R Monnard
- Nestlé Institute of Health Sciences, Nestlé Research, Société Des Produits Nestlé S.A, Lausanne, Switzerland
| | - Phil Titcombe
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Heidi Nield
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Sheila J Barton
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Sarah El-Heis
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Elizabeth Tham
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Obstetrics & Gynaecology, National University of Singapore, Singapore, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Obstetrics & Gynaecology, National University of Singapore, Singapore, Singapore
| | - Wayne S Cutfield
- Liggins Institute, The University of Auckland, Private Bag 92019, Auckland, New Zealand.
- A Better Start - National Science Challenge, The University of Auckland, Auckland, New Zealand.
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Brockway MM, Daniel AI, Reyes SM, Granger M, McDermid JM, Chan D, Refvik R, Sidhu KK, Musse S, Patel PP, Monnin C, Lotoski L, Geddes D, Jehan F, Kolsteren P, Allen LH, Hampel D, Eriksen KG, Rodriguez N, Azad MB. Human Milk Macronutrients and Child Growth and Body Composition in the First Two Years: A Systematic Review. Adv Nutr 2024; 15:100149. [PMID: 37981047 PMCID: PMC10831902 DOI: 10.1016/j.advnut.2023.100149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 10/16/2023] [Accepted: 11/14/2023] [Indexed: 11/21/2023] Open
Abstract
Among exclusively breastfed infants, human milk (HM) provides complete nutrition in the first mo of life and remains an important energy source as long as breastfeeding continues. Consisting of digestible carbohydrates, proteins, and amino acids, as well as fats and fatty acids, macronutrients in human milk have been well studied; however, many aspects related to their relationship to growth in early life are still not well understood. We systematically searched Medline, EMBASE, the Cochrane Library, Scopus, and Web of Science to synthesize evidence published between 1980 and 2022 on HM components and anthropometry through 2 y of age among term-born healthy infants. From 9992 abstracts screened, 57 articles reporting observations from 5979 dyads were included and categorized based on their reporting of HM macronutrients and infant growth. There was substantial heterogeneity in anthropometric outcome measurement, milk collection timelines, and HM sampling strategies; thus, meta-analysis was not possible. In general, digestible carbohydrates were positively associated with infant weight outcomes. Protein was positively associated with infant length, but no associations were reported for infant weight. Finally, HM fat was not consistently associated with any infant growth metrics, though various associations were reported in single studies. Fatty acid intakes were generally positively associated with head circumference, except for docosahexaenoic acid. Our synthesis of the literature was limited by differences in milk collection strategies, heterogeneity in anthropometric outcomes and analytical methodologies, and by insufficient reporting of results. Moving forward, HM researchers should accurately record and account for breastfeeding exclusivity, use consistent sampling protocols that account for the temporal variation in HM macronutrients, and use reliable, sensitive, and accurate techniques for HM macronutrient analysis.
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Affiliation(s)
- Meredith Merilee Brockway
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Canada; Faculty of Nursing, University of Calgary, Canada
| | - Allison I Daniel
- Centre for Global Child Health, Hospital for Sick Children, Canada; Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Canada
| | - Sarah M Reyes
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Canada
| | - Matthew Granger
- Department of Food and Human Nutritional Sciences, University of Manitoba, Canada
| | | | - Deborah Chan
- Department of Pediatrics and Child Health, University of Manitoba, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Canada
| | - Rebecca Refvik
- Department of Food and Human Nutritional Sciences, University of Manitoba, Canada
| | - Karanbir K Sidhu
- Department of Food and Human Nutritional Sciences, University of Manitoba, Canada
| | - Suad Musse
- Department of Food and Human Nutritional Sciences, University of Manitoba, Canada
| | - Pooja P Patel
- Department of Public Health and Community Medicine, Tufts University School of Medicine, USA
| | - Caroline Monnin
- Neil John Maclean Health Sciences Library, University of Manitoba, Canada
| | - Larisa Lotoski
- Department of Pediatrics and Child Health, University of Manitoba, Canada
| | - Donna Geddes
- School of Molecular Sciences, The University of Western Australia, Australia
| | - Fyezah Jehan
- Department of Pediatrics, Aga Khan University, Pakistan
| | - Patrick Kolsteren
- Department of Food Safety and Food Quality, Ghent University, Belgium
| | - Lindsay H Allen
- Western Human Nutrition Research Center, Agriculture Research Service, United States Department of Agriculture, USA; Department of Nutrition, University of California, Davis, USA
| | - Daniela Hampel
- Western Human Nutrition Research Center, Agriculture Research Service, United States Department of Agriculture, USA; Department of Nutrition, University of California, Davis, USA
| | - Kamilla G Eriksen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | - Natalie Rodriguez
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Canada
| | - Meghan B Azad
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Canada.
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Brockway MM, Daniel AI, Reyes SM, Gauglitz JM, Granger M, McDermid JM, Chan D, Refvik R, Sidhu KK, Musse S, Patel PP, Monnin C, Lotoski L, Geddes DT, Jehan F, Kolsteren P, Bode L, Eriksen KG, Allen LH, Hampel D, Rodriguez N, Azad MB. Human Milk Bioactive Components and Child Growth and Body Composition in the First 2 Years: A Systematic Review. Adv Nutr 2024; 15:100127. [PMID: 37802214 PMCID: PMC10831900 DOI: 10.1016/j.advnut.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 09/11/2023] [Accepted: 09/26/2023] [Indexed: 10/08/2023] Open
Abstract
Human milk (HM) contains macronutrients, micronutrients, and a multitude of other bioactive factors, which can have a long-term impact on infant growth and development. We systematically searched MEDLINE, EMBASE, Cochrane Library, Scopus, and Web of Science to synthesize evidence published between 1980 and 2022 on HM components and anthropometry through 2 y of age among term-born infants. From 9992 abstracts screened, 141 articles were included and categorized based on their reporting of HM micronutrients, macronutrients, or bioactive components. Bioactives including hormones, HM oligosaccharides (HMOs), and immunomodulatory components are reported here, based on 75 articles from 69 unique studies reporting observations from 9980 dyads. Research designs, milk collection strategies, sampling times, geographic and socioeconomic settings, reporting practices, and outcomes varied considerably. Meta-analyses were not possible because data collection times and reporting were inconsistent among the studies included. Few measured infant HM intake, adjusted for confounders, precisely captured breastfeeding exclusivity, or adequately described HM collection protocols. Only 5 studies (6%) had high overall quality scores. Hormones were the most extensively examined bioactive with 46 articles (n = 6773 dyads), compared with 13 (n = 2640 dyads) for HMOs and 12 (n = 1422 dyads) for immunomodulatory components. Two studies conducted untargeted metabolomics. Leptin and adiponectin demonstrated inverse associations with infant growth, although several studies found no associations. No consistent associations were found between individual HMOs and infant growth outcomes. Among immunomodulatory components in HM, IL-6 demonstrated inverse relationships with infant growth. Current research on HM bioactives is largely inconclusive and is insufficient to address the complex composition of HM. Future research should ideally capture HM intake, use biologically relevant anthropometrics, and integrate components across categories, embracing a systems biology approach to better understand how HM components work independently and synergistically to influence infant growth.
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Affiliation(s)
- Meredith Merilee Brockway
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada; Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Allison I Daniel
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada; Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Sarah M Reyes
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | | | - Matthew Granger
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | - Deborah Chan
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, QC, Canada
| | - Rebecca Refvik
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Karanbir K Sidhu
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Suad Musse
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Pooja P Patel
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, Unites States
| | - Caroline Monnin
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, MB, Canada
| | - Larisa Lotoski
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - Fyezah Jehan
- Department of Pediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | - Patrick Kolsteren
- Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | - Lars Bode
- Department of Pediatrics, Mother-Milk-Infant Center of Research Excellence (MOMI CORE), University of California, San Diego (UC San Diego), San Diego, CA, United States
| | - Kamilla G Eriksen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Lindsay H Allen
- Department of Nutrition, University of California, Davis, CA, United States; Western Human Nutrition Research Center, Agriculture Research Service, United States Department of Agriculture, Washington, DC, Unites States
| | - Daniela Hampel
- Department of Nutrition, University of California, Davis, CA, United States; Western Human Nutrition Research Center, Agriculture Research Service, United States Department of Agriculture, Washington, DC, Unites States
| | - Natalie Rodriguez
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Meghan B Azad
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada; Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada.
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Lemdjo G, Kengne AP, Nouthe B, Lucas M, Carpentier A, Ngueta G. Humero-femoral index and diabetes risk in the US population- a case study. J Diabetes Metab Disord 2023; 22:1327-1335. [PMID: 37975100 PMCID: PMC10638166 DOI: 10.1007/s40200-023-01251-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/13/2023] [Indexed: 11/18/2023]
Abstract
Background The between-subject variability in diabetes risk persists in epidemiological studies, even after accounting for obesity. We investigated whether the humero-femoral index (HFI) was associated with prevalence of type 2 diabetes mellitus (T2DM) and assessed the incremental value of HFI as a marker of T2DM. Methods This population-based cross-sectional study used data from the National Health and Nutrition Examination Survey from 1999 to 2018. We assessed 42,088 adults aged ≥ 30 years. HFI was defined as the upper arm length/upper leg length ratio. The outcome included undiagnosed diabetes (based on 2-hour plasma glucose levels, fasting glucose and hemoglobin A1C) and history of diabetes (diagnosed diabetes or taking antidiabetic drugs). Results As compared with the bottom quartile, the prevalence ratio of T2DM was 1.28 (95% CI 1.19-1.38) in the second, 1.61 (95% CI 1.50-1.72) in the third, and 1.75 (95% CI 1.64-1.88) in the fourth quartile of HFI (P for trend < 0.0001). The positive association remained consistent within different patterns of BMI and WC in men but was rendered null in women. After adding HFI to the reference model (including WC only), the discrimination slopes increased by 60.0% in men and 51.1% in women. Conclusion Our findings suggest that HFI may be a key component in body structure contributing to the risk of T2DM. In men, the highest HFI was associated with elevated prevalence of T2DM, independent of BMI and WC. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01251-z.
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Affiliation(s)
- Gaelle Lemdjo
- Endocrinology Unit, Jordan Medical Service, Yaounde, Cameroon
| | - André Pascal Kengne
- Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Brice Nouthe
- Fraser Health Authority/Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Michel Lucas
- Department of Social and Preventive Medicine, Faculty of medicine, Laval University, Québec, Canada
| | - André Carpentier
- Division of Endocrinology, Department of Medicine, University of Sherbrooke, Sherbrooke, Canada
- Research Center of the CHU de Sherbrooke, University of Sherbrooke, Sherbrooke, Québec Canada
| | - Gérard Ngueta
- Research Center of the CHU de Sherbrooke, University of Sherbrooke, Sherbrooke, Québec Canada
- Department of Community Health Sciences, University of Sherbrooke, Sherbrooke, Québec Canada
- Centre de recherche du CHU de Sherbrooke, CRCHUS- Hôpital Fleurimont, Axe: Diabète, Obésité, Complications cardiovasculaires), Service d’endocrinologie, 12 eme Avenue Nord, Sherbrooke, 3001 Canada
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Ockene MW, Russo SC, Lee H, Monthé-Drèze C, Stanley TL, Ma IL, Toribio M, Shook LL, Grinspoon SK, Edlow AG, Fourman LT. Accelerated Longitudinal Weight Gain Among Infants With In Utero COVID-19 Exposure. J Clin Endocrinol Metab 2023; 108:2579-2588. [PMID: 36988326 PMCID: PMC10505544 DOI: 10.1210/clinem/dgad130] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Indexed: 03/30/2023]
Abstract
CONTEXT Since the initial outbreak of coronavirus disease 2019 (COVID-19), a novel population of children with in utero exposure to maternal infection has emerged whose health outcomes are largely unknown. OBJECTIVE To compare longitudinal growth trajectories among infants with vs without in utero COVID-19 exposure. METHODS We conducted a longitudinal cohort study leveraging a prospectively enrolled perinatal biorepository among 149 infants with in utero COVID-19 exposure and 127 unexposed controls. Weight, length, and body mass index (BMI) were abstracted from health records at 0, 2, 6, and 12 months and standardized using World Health Organization growth charts. Analyses were adjusted for maternal age, ethnicity, parity, insurance, and BMI as well as infant sex, birthdate, and breastfeeding. RESULTS Infants with in utero COVID-19 exposure vs controls exhibited differential trajectories of weight and BMI, but not length, z-score over the first year of life (study group × time interaction, P < .0001 for weight and BMI). Infants born to mothers with prenatal COVID-19 had lower BMI z-score at birth (effect size: -0.35, 95% CI -0.66 to -0.03) and greater gain in BMI z-score from birth to 12 months (effect size: 0.53, 95% CI 0.06 to 0.99). Birth weight z-score mediated a significant proportion of the relationship between COVID-19 exposure and postnatal growth (estimate ± SE, 32 ± 14%, P = .02). CONCLUSION Infants with in utero COVID-19 exposure exhibited lower birth weight and accelerated weight gain in the first year of life, which may be harbingers of downstream cardiometabolic pathology. Further studies are needed to delineate cardiometabolic sequelae among this emerging global population.
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Affiliation(s)
- Mollie W Ockene
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Samuel C Russo
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Hang Lee
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Carmen Monthé-Drèze
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Takara L Stanley
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Ingrid L Ma
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Mabel Toribio
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Lydia L Shook
- Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Steven K Grinspoon
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Andrea G Edlow
- Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Lindsay T Fourman
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
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Maidowski L, Kiess W, Baber R, Dathan-Stumpf A, Ceglarek U, Vogel M. Tracking of serum lipids in healthy children on a year-to-year basis. BMC Cardiovasc Disord 2023; 23:386. [PMID: 37532994 PMCID: PMC10398926 DOI: 10.1186/s12872-023-03391-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/11/2023] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVES To assess the stability of lipid profiles throughout childhood and evaluate their onset and dynamic. MATERIALS AND METHODS Lipid markers were longitudinally measured in more than 1300 healthy children from the LIFE Child study (Germany) and categorized into normal, at-risk, or adverse. Year-to-year intra-person persistence of the categories during follow-ups was examined and Pearson's correlation coefficient was calculated. RESULTS We found strong positive correlations for TC, LDL-C and ApoB (r > 0.75, p < 0.001) from the age of four years. Correlations were lowest during the first two years of life. Most children with normal levels also had normal levels the following year. Children with at-risk levels showed a tendency towards normal levels at the follow-up visit. Adverse levels of TC, LDL-C, ApoB (all ages), and HDL-C (from age 15) persisted in more than half of the affected children. Age-dependent patterns of stability were most pronounced and similar for TC, LDL-C, and ApoB. CONCLUSIONS Normal levels of serum lipids show high stability and adverse levels stabilized in early childhood for TC, LDL, and ApoB. At-risk and adverse levels of TC, LDL-C or ApoB may warrant further or repeated diagnostic measurements with regards to preventing CVD in the long run.
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Affiliation(s)
- Ludwig Maidowski
- University of Leipzig, LIFE Child Leipzig Research Center for Civilization Diseases, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany.
| | - Wieland Kiess
- University of Leipzig, LIFE Child Leipzig Research Center for Civilization Diseases, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany
- University of Leipzig, Hospital for Children and Adolescents, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Ronny Baber
- University of Leipzig, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Paul-List-Str. 13-15, 04013, Leipzig, Germany
- University of Leipzig, Leipzig Medical Biobank, Liebigstr. 27, 04103, Leipzig, Germany
| | - Anne Dathan-Stumpf
- University of Leipzig, Department of Women and Child Health, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Uta Ceglarek
- University of Leipzig, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Paul-List-Str. 13-15, 04013, Leipzig, Germany
| | - Mandy Vogel
- University of Leipzig, LIFE Child Leipzig Research Center for Civilization Diseases, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany
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8
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Huang W, Meir AY, Olapeju B, Wang G, Hong X, Venkataramani M, Cheng TL, Igusa T, Liang L, Wang X. Defining longitudinal trajectory of body mass index percentile and predicting childhood obesity: methodologies and findings in the Boston Birth Cohort. Precis Nutr 2023; 2:e00037. [PMID: 37745028 PMCID: PMC10513013 DOI: 10.1097/pn9.0000000000000037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/11/2023] [Accepted: 03/26/2023] [Indexed: 09/26/2023]
Abstract
Background Overweight or obesity (OWO) in school-age childhood tends to persist into adulthood. This study aims to address a critical need for early identification of children at high risk of developing OWO by defining and analyzing longitudinal trajectories of body mass index percentile (BMIPCT) during early developmental windows. Methods We included 3029 children from the Boston Birth Cohort (BBC) with repeated BMI measurements from birth to age 18 years. We applied locally weighted scatterplot smoothing with a time-limit scheme and predefined rules for imputation of missing data. We then used time-series K-means cluster analysis and latent class growth analysis to define longitudinal trajectories of BMIPCT from infancy up to age 18 years. Then, we investigated early life determinants of the BMI trajectories. Finally, we compared whether using early BMIPCT trajectories performs better than BMIPCT at a given age for predicting future risk of OWO. Results After imputation, the percentage of missing data ratio decreased from 36.0% to 10.1%. We identified four BMIPCT longitudinal trajectories: early onset OWO; late onset OWO; normal stable; and low stable. Maternal OWO, smoking, and preterm birth were identified as important determinants of the two OWO trajectories. Our predictive models showed that BMIPCT trajectories in early childhood (birth to age 1 or 2 years) were more predictive of childhood OWO (age 5-10 years) than a single BMIPCT at age 1 or 2 years. Conclusions Using longitudinal BMIPCT data from birth to age 18 years, this study identified distinct BMIPCT trajectories, examined early life determinants of these trajectories, and demonstrated their advantages in predicting childhood risk of OWO over BMIPCT at a single time point.
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Affiliation(s)
- Wanyu Huang
- Department of Civil and Systems Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, MD, USA
| | - Anat Yaskolka Meir
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bolanle Olapeju
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Guoying Wang
- Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Xiumei Hong
- Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Maya Venkataramani
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tina L. Cheng
- Cincinnati Children’s Hospital Medical Center and Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - Tak Igusa
- Department of Civil and Systems Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, MD, USA
| | - Liming Liang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Xiaobin Wang
- Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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9
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Tan L, Long LZ, Ma XC, Yang WW, Liao FF, Peng YX, Lu JM, Shen AL, An DQ, Qu H, Fu CG. Association of body mass index trajectory and hypertension risk: A systematic review of cohort studies and network meta-analysis of 89,094 participants. Front Cardiovasc Med 2023; 9:941341. [PMID: 36684600 PMCID: PMC9846820 DOI: 10.3389/fcvm.2022.941341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 12/02/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Body mass index (BMI) trajectories, such as non-linear time trends and nonlinear changes in BMI with age, can provide information on the underlying temporal health patterns. The relationship between BMI trajectories and the risk of hypertension remains controversial. Methods PubMed, Embase, Cochrane, Scopus, and Web of Science databases were searched from their inception to January 31, 2022. We categorized BMI trajectories as "Stable high," "table normal," "Stable low," "Fluctuated (sharp increase)," and "Fluctuated (elevated-decrease)." The main outcome was the relative risk for the prevalence of hypertension in the different BMI trajectories. Potential sources of heterogeneity were examined using meta-regression and subgroup analysis. A publication bias test and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach were also used. Results The 18 cohort studies included 89,094 participants. Compared with the "Stable normal" trajectory, "Stable high," "Fluctuated (sharp increase)," and "Fluctuated (elevated-decrease)" trajectories were associated with an increased relative risk of hypertension: [RR (95% CI)]: 1.80 (1.29 2.50), p < 0.001; 1.53 (1.27 1.83), p < 0.001; 1.30 (1.24 1.37), p = 0.001, respectively. The "Stable low" trajectory was associated with a reduced risk of hypertension [0.83 (0.79 0.83), p < 0.001]. The "Stable high" trajectory (surface under the cumulative ranking curve = 88.1%) had the highest probability of developing hypertension in the population. The certainty of the evidence for direct comparisons of the incidence of hypertension between various BMI trajectories was generally very low. Conclusion Our findings suggested that "Stable high," "Fluctuated (sharp increase)," and "Fluctuated (elevated-decrease)" trajectories were associated with an increased relative risk of hypertension, with the "Stable high" trajectory most likely associated with hypertension. Systematic review registration [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=308575], identifier [CRD42022308575].
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Affiliation(s)
- Ling Tan
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lin-zi Long
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiao-chang Ma
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Cardiovascular Clinical Medical Research Center of TCM, Beijing, China
| | - Wen-wen Yang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fei-fei Liao
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Yu-xuan Peng
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Jie-ming Lu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - A-ling Shen
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Dong-qing An
- Affiliated Hospital of Traditional Chinese Medicine, Xinjiang Medical University, Ürümqi, China
| | - Hua Qu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Cardiovascular Clinical Medical Research Center of TCM, Beijing, China,Hua Qu,
| | - Chang-geng Fu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Cardiovascular Clinical Medical Research Center of TCM, Beijing, China,*Correspondence: Chang-geng Fu,
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10
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Hu Z, Han L, Liu J, Fowke JH, Han JC, Kakhniashvili D, LeWinn KZ, Bush NR, Mason WA, Zhao Q. Prenatal metabolomic profiles mediate the effect of maternal obesity on early childhood growth trajectories and obesity risk: the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study. Am J Clin Nutr 2022; 116:1343-1353. [PMID: 36055779 PMCID: PMC9630879 DOI: 10.1093/ajcn/nqac244] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/26/2022] [Accepted: 08/30/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Maternal prepregnancy obesity is an important risk factor for offspring obesity, which may partially operate through prenatal programming mechanisms. OBJECTIVES The study aimed to systematically identify prenatal metabolomic profiles mediating the intergenerational transmission of obesity. METHODS We included 450 African-American mother-child pairs from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study pregnancy cohort. LC-MS was used to conduct metabolomic profiling on maternal plasma samples of the second trimester. The childhood growth outcomes of interest included BMI trajectories from birth to age 4 y (rising-high-, moderate-, and low-BMI trajectories) as well as overweight/obesity (OWO) risk at age 4 y. Mediation analysis was conducted to identify metabolite mediators linking maternal OWO and childhood growth outcomes. The potential causal effects of maternal OWO on metabolite mediators were examined using the Mendelian randomization (MR) method. RESULTS Among the 880 metabolites detected in the maternal plasma during pregnancy, 14 and 11 metabolites significantly mediated the effects of maternal prepregnancy OWO on childhood BMI trajectories and the OWO risk at age 4 y, respectively, and 5 mediated both outcomes. The MR analysis suggested 6 of the 20 prenatal metabolite mediators might be causally influenced by maternal prepregnancy OWO, most of which are from the pathways related to the metabolism of amino acids (hydroxyasparagine, glutamate, and homocitrulline), sterols (campesterol), and nucleotides (N2,N2-dimethylguanosine). CONCLUSIONS Our study provides further evidence that prenatal metabolomic profiles might mediate the effect of maternal OWO on early childhood growth trajectories and OWO risk in offspring. The metabolic pathways, including identified metabolite mediators, might provide novel intervention targets for preventing the intrauterine development of obesity in the offspring of mothers with obesity.
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Affiliation(s)
- Zunsong Hu
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Luhang Han
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jiawang Liu
- Medicinal Chemistry Core, Office of Research, University of Tennessee Health Science Center, Memphis, TN, USA; Department of Pharmaceutical Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jay H Fowke
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Joan C Han
- Departments of Pediatrics and Physiology, University of Tennessee Health Science Center, and Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA; Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, New York, NY, USA
| | - David Kakhniashvili
- Proteomics and Metabolomics Core, Office of Research, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - W Alex Mason
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Qi Zhao
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
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11
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Michael N, Gupta V, Fogel A, Huang J, Chen L, Sadananthan SA, Ong YY, Aris IM, Pang WW, Yuan WL, Loy SL, Thway Tint M, Tan KH, Chan JK, Chan SY, Shek LPC, Yap F, Godfrey K, Chong YS, Gluckman P, Velan SS, Forde CG, Lee YS, Eriksson JG, Karnani N. Longitudinal characterization of determinants associated with obesogenic growth patterns in early childhood. Int J Epidemiol 2022; 52:426-439. [PMID: 36087338 PMCID: PMC10114026 DOI: 10.1093/ije/dyac177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 08/29/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Longitudinal assessment of the determinants of obesogenic growth trajectories in childhood can suggest appropriate developmental windows for intervention. METHODS Latent class growth mixture modelling was used to identify body mass index (BMI) z-score trajectories from birth to age 6 years in 994 children from a prospective mother-offspring cohort (Chinese, Indian and Malay ethnicities) based in Singapore. We evaluated the early-life determinants of the trajectories as well as their associations with cardiometabolic risk markers at age 6 years. RESULTS Five BMI z-score trajectory patterns were identified, three within the healthy weight range, alongside early-acceleration and late-acceleration obesogenic trajectories. The early-acceleration pattern was characterized by elevated fetal abdominal circumference growth velocity, BMI acceleration immediately after birth and crossing of the obesity threshold by age 2 years. The late-acceleration pattern had normal fetal growth and BMI acceleration after infancy, and approached the obesity threshold by age 6 years. Abdominal fat, liver fat, insulin resistance and odds of pre-hypertension/hypertension were elevated in both groups. Indian ethnicity, high pre-pregnancy BMI, high polygenic risk scores for obesity and shorter breastfeeding duration were common risk factors for both groups. Malay ethnicity and low maternal educational attainment were uniquely associated with early BMI acceleration, whereas nulliparity and obesogenic eating behaviours in early childhood were uniquely associated with late BMI acceleration. CONCLUSION BMI acceleration starting immediately after birth or after infancy were both linked to early cardiometabolic alterations. The determinants of these trajectories may be useful for developing early risk stratification and intervention approaches to counteract metabolic adversities linked to childhood obesity.
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Affiliation(s)
- Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Varsha Gupta
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Anna Fogel
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Jonathan Huang
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Li Chen
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Yi Ying Ong
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, USA
| | - Wei Wei Pang
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wen Lun Yuan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Université de Paris, CRESS, Inserm, INRAE, Paris, France
| | - See Ling Loy
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Mya Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore.,Academic Medicine, Duke-National University of Singapore Graduate Medical School, Singapore
| | - Jerry Ky Chan
- Duke-NUS Medical School, Singapore.,Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lynette Pei-Chi Shek
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Fabian Yap
- Duke-NUS Medical School, Singapore.,Department of Pediatrics, KK Women's and Children's Hospital, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Keith Godfrey
- MRC Lifecourse Epidemiology Centre and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Institute of Bioengineering & Bioimaging, Agency for Science Technology and Research, Singapore
| | - Ciarán G Forde
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Neerja Karnani
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Bioinformatics Institute, Agency for Science Technology and Research, Singapore
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12
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Zou J, Wei Q, Ye P, Shi Y, Zhang Y, Shi H. Effects of Gestational Sleep Patterns and Their Changes on Maternal Glycemia and Offspring Physical Growth in Early Life. Nutrients 2022; 14:nu14163390. [PMID: 36014897 PMCID: PMC9416776 DOI: 10.3390/nu14163390] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
Maternal sleep patterns during pregnancy are drawing increased attention to examine its role in the regulation of maternal glycemia and physical growth of offspring within 24 months. Among 3329 eligible mother−child pairs included in the Shanghai Maternal−Child Pairs Cohort, sleep patterns of pregnant women were assessed by Pittsburgh Sleep Quality Index and objective measurement in early and late pregnancy. Offspring physical growth within 24 months was primarily indicated by the body mass index Z-score (BAZ), catch-up growth, and overweight/obesity. In total, 3329 and 382 pregnant women were included with subjectively assessed and objectively measured sleep pattern, respectively. The increased risk of GDM was associated with maternal night-time sleep duration ≥8.5 h in early pregnancy, or sleep quality change from poor to good during pregnancy (OR = 1.48; 95% CI, 1.06 to 2.07). In the GDM group, the effect of sleep duration in early pregnancy on overweight/obesity in offspring within 24 months showed a U-shaped curve, with a 1.73-fold and 1.43-fold increased risk of overweight/obesity of offspring in pregnant women with <7.5 or ≥8.5 h of sleep duration, respectively. A good gestational sleep pattern was required to reduce the risk of GDM and offspring overweight/obesity within 24 months.
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Affiliation(s)
- Jiaojiao Zou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, No. 130 Dong’an Road, Shanghai 200032, China
| | - Qian Wei
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, No. 130 Dong’an Road, Shanghai 200032, China
| | - Peiqi Ye
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, No. 130 Dong’an Road, Shanghai 200032, China
| | - Yuyang Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, No. 130 Dong’an Road, Shanghai 200032, China
| | - Yunhui Zhang
- Department of Environmental Health, School of Public Health, Fudan University, No. 130 Dong’an Road, Shanghai 200032, China
| | - Huijing Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, No. 130 Dong’an Road, Shanghai 200032, China
- Correspondence: ; Tel.: +86-21-54237022
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13
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Perez M, Winstone LK, Hernández JC, Curci SG, McNeish D, Luecken LJ. Association of BMI trajectories with cardiometabolic risk among low-income Mexican American children. Pediatr Res 2022;:1-6. [PMID: 35982141 DOI: 10.1038/s41390-022-02250-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/24/2022] [Accepted: 07/19/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND The aim of this study was to identify distinct trajectories of BMI growth from 2 to 7.5 years and examine their associations with markers of cardiometabolic risk at age 7.5 years among a sample of low-income Mexican American children. METHODS This longitudinal cohort study recruited 322 mother-child dyads to participate prenatally and at child age 2, 3, 4.5, 6, and 7.5 years. Child height/weight, waist circumference, and blood pressure were assessed at each time point. Blood was collected from child at 7.5 years. RESULTS Covarying for birthweight, three BMI trajectories were identified: Low-Stable BMI (73% of the sample), High-Stable BMI (5.6% of the sample), and Increasing BMI over time (21.4% of the sample). The High-Stable and Increasing BMI classes had higher waist circumference and systolic blood pressure and lower HDL-c than the Low-Stable BMI class (ps < 0.05). Among children with BMIs below the 85th percentile, 16% had three or more cardiometabolic risk indicators. CONCLUSIONS BMI classes were consistent with existing literature. For youth, standard medical practice is to examine cardiometabolic risk indicators when BMI is high; however, this practice would miss 16% of youth in our sample who exhibit cardiometabolic risk but do not screen in based on BMI. IMPACT Research indicates Mexican American youth are at risk for cardiometabolic dysregulation relative to other ethnic groups, yet there is a paucity of longitudinal research. An Increasing BMI and a High-Stable BMI class were associated with larger waist circumference, higher systolic blood pressure, and lower HDL cholesterol than the Low-Stable BMI class. BMI trajectories in childhood predict cardiometabolic risk indicators. As the sole screener for deciding when to test cardiometabolic indicators, BMI alone will miss some children exhibiting cardiometabolic dysregulation.
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14
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Veile A, Christopher L, Azcorra H, Dickinson F, Kramer K, Varela‐Silva I. Differences in nutritional status between rural and urban Yucatec Maya children: The importance of early life conditions. American Journal of Biological Anthropology 2022. [PMCID: PMC9314705 DOI: 10.1002/ajpa.24510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Early‐life conditions shape childhood growth and are affected by urbanization and the nutritional transition. To investigate how early‐life conditions (across the “first” and “second” 1000 days) are associated with rural and urban children's nutritional status, we analyzed anthropometric data from Maya children in Yucatan, Mexico. We collected weight, height and triceps skinfold measures, then computed body mass and fat mass indices (BMI/FMI), in a cross‐sectional sample of 6‐year‐olds (urban n = 72, rural n = 66). Demographic, socioeconomic and early‐life variables (birthweight/mode, rural/urban residence, household crowding) were collected by maternal interview. We statistically analyzed rural‐urban differences in demographic, socioeconomic, early‐life, and anthropometric variables, then created linear mixed models to evaluate associations between early‐life variables and child anthropometric outcomes. Two‐way interactions were tested between early‐life variables and child sex, and between early‐life variables and rural‐urban residence. Results showed that rural children were shorter‐statured, with lower overweight/obesity and cesarean delivery rates, compared to urban children. Household crowding was a negative predictor of anthropometric outcomes; the strongest effect was in boys and in urban children. Birthweight positively predicted anthropometric outcomes, especially weight/BMI. Birth mode was positively (not statistically) associated with any anthropometric outcome. Cesarean delivery was more common in boys than in girls, and predicted increased height in urban boys. In conclusion, urbanization and household crowding were the most powerful predictors of Maya 6‐year‐old anthropometry. The negative effects of crowding may disproportionately affect Maya boys versus girls and urban versus rural children. Early‐life conditions shape Maya children's nutritional status both in the “first” and “second” 1000 days.
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Affiliation(s)
- Amanda Veile
- Department of Anthropology Purdue University West Lafayette Indiana USA
| | | | - Hugo Azcorra
- Centro de Investigaciones Silvio Zavala Universidad Modelo Mérida Mexico
| | - Federico Dickinson
- Departamento de Ecología Humana Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional Mérida Mexico
| | - Karen Kramer
- Department of Anthropology University of Utah Salt Lake City Utah USA
| | - Inês Varela‐Silva
- Departamento de Ecología Humana Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional Mérida Mexico
- School of Sport, Exercise and Health Sciences Loughborough University Loughborough UK
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15
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Reyna ME, Petersen C, Dai DLY, Dai R, Becker AB, Azad MB, Miliku K, Lefebvre DL, Moraes TJ, Mandhane PJ, Boutin RCT, Finlay BB, Simons E, Kozyrskyj AL, Lou W, Turvey SE, Subbarao P. Longitudinal body mass index trajectories at preschool age: children with rapid growth have differential composition of the gut microbiota in the first year of life. Int J Obes (Lond). [PMID: 35428865 PMCID: PMC9239911 DOI: 10.1038/s41366-022-01117-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 12/20/2022]
Abstract
Background/Objective The steep rise in childhood obesity has emerged as a worldwide public health problem. The first 4 years of life are a critical window where long-term developmental patterns of body mass index (BMI) are established and a critical period for microbiota maturation. Understanding how the early-life microbiota relate to preschool growth may be useful for identifying preventive interventions for childhood obesity. We aim to investigate whether longitudinal shifts within the bacterial community between 3 months and 1 year of life are associated with preschool BMI z-score trajectories. Methods BMI trajectories from birth to 5 years of age were identified using group-based trajectory modeling in 3059 children. Their association with familial and environmental factors were analyzed. Infant gut microbiota at 3 months and 1 year was defined by 16S RNA sequencing and changes in diversity and composition within each BMIz trajectory were analyzed. Results Four BMIz trajectories were identified: low stable, normative, high stable, and rapid growth. Infants in the rapid growth trajectory were less likely to have been breastfed, and gained less microbiota diversity in the first year of life. Relative abundance of Akkermansia increased with age in children with stable growth, but decreased in those with rapid growth, abundance of Ruminococcus and Clostridium at 1 year were elevated in children with rapid growth. Children who were breastfed at 6 months had increased levels of Sutterella, and decreased levels of Ruminococcus and Clostridium. Conclusion This study provides new insights into the relationship between the gut microbiota in infancy and patterns of growth in a cohort of preschool Canadian children. We highlight that rapid growth since birth is associated with bacteria shown in animal models to have a causative role in weight gain. Our findings support a novel avenue of research targeted on tangible interventions to reduce childhood obesity.
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Chang R, Mei H, Zhang Y, Xu K, Yang S, Zhang J. Early childhood body mass index trajectory and overweight/obesity risk differed by maternal weight status. Eur J Clin Nutr 2022; 76:450-455. [PMID: 34535773 DOI: 10.1038/s41430-021-00975-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 06/11/2021] [Accepted: 06/23/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To evaluate the associations of maternal prepregnancy body mass index (pp-BMI) and gestational weight gain (GWG) with the childhood BMI z-score (BMI-z) trajectories from birth to 2 years old and the risk of overweight/obesity (OWO) at 2 years of age. SUBJECTS/METHODS Mother-child dyads (23,617) were involved in the analysis. They were followed up from early pregnancy to 2 years postpartum with their healthcare data recorded in the Wuhan Maternal and Child Health Management Information System (WMCHMIS). The OWO in children was defined as BMI-z > 1. Linear mixed models (LMM) and unconditional logistic regression were used to evaluate the independent and joint associations of pp-BMI and GWG with the BMI-z trajectory of children per their anthropometric measurements at 0, 1, 3, 6, 9, 12, 18, and 24 months old and the risk of OWO at 2 years of age. RESULTS Maternal overweight/obesity and excessive GWG independently and jointly increased the risks of their offspring falling into high BMI-z trajectories of birth to 2 years (p < 0.001). In addition, the children whose mothers were overweight/obese before pregnancy and gained excessive weight during pregnancy independently and jointly increased the OWO risk in children at age 2, with adjusted odds ratios (adjOR) of 1.36 (95% CI, 1.22-1.53), 1.28 (95% CI, 1.18-1.39), and 1.76 (95% CI: 1.52-2.03), respectively. CONCLUSIONS Maternal prepregnancy overweight/obesity and excessive GWG can independently and jointly increase the risks of their children falling into high BMI-z trajectories from birth to 2 years of age and becoming overweight/obese at age 2. Maternal overweight/obesity and excessive gestational weight should be the prime targets for early obese prevention efforts.
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Affiliation(s)
- Ruixia Chang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hong Mei
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuanyuan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ke Xu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shaoping Yang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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17
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Sum KK, Cai S, Law E, Cheon B, Tan G, Loo E, Lee YS, Yap F, Chan JKY, Daniel M, Chong YS, Meaney M, Eriksson J, Huang J. COVID-19-Related Life Experiences, Outdoor Play, and Long-term Adiposity Changes Among Preschool- and School-Aged Children in Singapore 1 Year After Lockdown. JAMA Pediatr 2022; 176:280-289. [PMID: 35072692 PMCID: PMC8787686 DOI: 10.1001/jamapediatrics.2021.5585] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Despite the potential for COVID-19 infection control-related events to have an effect on child well-being, comprehensive assessments of postlockdown changes and persistent outcomes are lacking. OBJECTIVE To survey the extent of COVID-19 lockdown-related lifestyle changes, their differences by child age and family socioeconomic status, and the potential association with child adiposity 1 year after lockdown. DESIGN, SETTING, AND PARTICIPANTS A self-administered, electronic survey was introduced to 2 ongoing child cohorts (the Singapore Preconception Study of Long-term Maternal and Child Outcomes [S-PRESTO] cohort of preschool children aged 1-4.5 years and the Growing Up in Singapore Towards Healthy Outcomes [GUSTO] cohort of primary school children aged 9-10.7 years) from July 8, 2020, to September 5, 2020, which was 1 to 3 months after the end of strict universal movement restrictions (duration of 73 days ending on June 19, 2020). All active participants from S-PRESTO and GUSTO, 2 population-based, longitudinal, parent-offspring cohorts in Singapore, were invited to participate and monitored through June 15, 2021. EXPOSURES Exposures included family income before and after the COVID-19 lockdown, changes in child outdoor play or exercise, and COVID-19-related life events; all data were self-reported by parents and school-aged children 1 to 3 months after the lockdown. MAIN OUTCOMES AND MEASURES Primary outcomes were self-reported COVID-19-related life events and changes in child online socialization, outdoor play or exercise, and intrafamily relationships. Study staff measured children's weight, height, and skinfold thickness before and up to 1 year after lockdown. Body mass indices (calculated as weight in kilograms divided by height in meters squared) and World Health Organization-standardized scores were computed. Differences before and after lockdown were compared using baseline-adjusted linear regression. RESULTS A total of 604 parents (53% of active cohort participants) and 356 school-aged children completed the survey and were similar to source cohorts. This represents 373 of 761 eligible children in the GUSTO cohort (mean [SD] age, 9.9 [0.4] years; 197 girls [52.8%]) and 231 of 370 eligible children in the S-PRESTO cohort (mean [SD] age, 2.6 [0.8] years; 121 boys [52.6%]). The COVID-19-related life changes were prevalent and varied (eg, 414 of 600 children [69.0%] reported changes in social activities). More than one-third of primary school-aged children (122 of 356 [34.3%]) and one-quarter of preschool-aged children (56 of 229 [24.5%]) eliminated any outdoor play after the lockdown. Lower family income before the lockdown was associated with increased odds of elimination of outdoor play (adjusted odds ratio per 1000 Singapore dollars [$730 US dollars] decrease, 1.09; 95% CI, 1.01-1.19). Complete elimination of outdoor activity (vs continued outdoor activity) was associated with an increase in body mass index of 0.48 (95% CI, 0.03-0.94) and a body mass index z score of 0.18 units (95% CI, 0-0.37) in school-aged children approximately 1 year after lockdown. CONCLUSIONS AND RELEVANCE Results of this cohort study suggest that 1 to 3 months after a brief, strict lockdown, a large proportion of parents and school-aged children reported elimination of outdoor play, which was more prevalent in lower-income families. Future research to better understand clinical implications and ways to mitigate lockdown outcomes is essential.
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Affiliation(s)
- Ka Kei Sum
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Shirong Cai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Evelyn Law
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore,Department of Paediatrics, Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Bobby Cheon
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore,School of Social Sciences, Nanyang Technological University, Singapore
| | | | - Evelyn Loo
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore,Department of Paediatrics, Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Yung Seng Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Fabian Yap
- KK Women’s and Children’s Hospital, Singapore
| | | | - Mary Daniel
- KK Women’s and Children’s Hospital, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore,Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Michael Meaney
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Johan Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore,Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Jonathan Huang
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
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Wang J, Wu Y, Du B, Li Z, Ye Y, Wang H, Niu Y, Chen Q, Zhang J, Chen S, Wu Y, Zhang X, Lu Y, Sun K. Growth patterns in early childhood and cardiovascular structure and function at 4 years old: A prospective cohort study. Nutr Metab Cardiovasc Dis 2021; 31:3492-3501. [PMID: 34625356 DOI: 10.1016/j.numecd.2021.08.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/31/2021] [Accepted: 08/06/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND AIMS Childhood overweight and obesity are lifetime risk factors for cardiovascular disease but the relationship between dynamic body mass index (BMI) change and cardiovascular structure and function in early childhood remains unclear. METHODS AND RESULTS This cohort study consisted 525 participants with 6 distinct representative growth patterns to examine the associations between BMI growth patterns and subsequent cardiovascular structure and function at age 4. BMIs were obtained at birth, 2 and 4 years old. Cardiovascular assessments were performed, including blood pressure (BP), cardiac geometric parameters, left ventricular (LV) function, speckle-tracking, integrated backscatter analysis and carotid intima-media thickness. Compared to the stable normal BMI pattern, children with the stable overweight (OW) pattern had significantly greater LV anatomic parameters in fully adjusted models. Children with the catch-up (CU) pattern revealed a uniform trend and had poorer strain. LV diameters and integrated backscatter signals were larger for those with BMI gain and lose pattern. Children with BMI lose pattern showed improved tendency involving LV mass index and BP. Both OW and CU patterns were associated with high systolic BP [odds ratio (95% CI): OW: 3.67 (1.08, 12.47); CU: 4.24 (1.75, 10.28)]. Compared to static BMI measurements at birth, 2 and 4 years old, dynamic BMI growth patterns were more predictive of cardiovascular structure and function at 4. CONCLUSIONS Children with overweight-related BMI growth patterns in early childhood experienced undesirable cardiovascular functional or structural changes as early as 4 years old, indicating that early intervention is needed and potentially beneficial.
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Affiliation(s)
- Jian Wang
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Yujian Wu
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Bowen Du
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Zhuoyan Li
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Yujiao Ye
- Children Heart Center, Sichuan Provincial Maternity and Child Health Care Hospital, 290 Shayan West Second Street, 610000 Chengdu, Sichuan Province, China
| | - Hualin Wang
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Yiwei Niu
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Qian Chen
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Sun Chen
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Yurong Wu
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Xi Zhang
- Clinical Research Unit, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China.
| | - Yanan Lu
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China.
| | - Kun Sun
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China.
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19
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Matsumoto N, Kubo T, Nakamura K, Mitsuhashi T, Takeuchi A, Tsukahara H, Yorifuji T. Trajectory of body mass index and height changes from childhood to adolescence: a nationwide birth cohort in Japan. Sci Rep 2021; 11:23004. [PMID: 34837002 PMCID: PMC8626480 DOI: 10.1038/s41598-021-02464-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 11/17/2021] [Indexed: 11/09/2022] Open
Abstract
To investigate the dynamics of body mass index (BMI) and height changes in childhood leading to obesity in adolescents. BMI Z-scores were calculated using the LMS (lambda-mu-sigma) method based on yearly height and weight information (age 1.5-15 years) from a nationwide Japanese birth cohort that started in 2001 (n = 26,711). We delineated the trajectories of BMI and height changes leading to obesity at age 15 years using mixed effect models. Children who became obese at the age of 15 years kept relatively high BMI z-scores through childhood for both genders, and had an increasing trend over time as opposed to the normal weight group, with an increasing slope during puberty. Early adiposity rebound was associated with overweight or obesity at the age of 15 years. Age at peak height velocity (APHV) occurred earlier in the obese/overweight group at age 15 years than in the normal weight group, and occurred later in the underweight group. Obese adolescents experienced early adiposity rebound timing and maintained a serial BMI z-score increase throughout childhood, with a greater slope at puberty. An earlier peak in height gain during puberty may have contributed to the observed patterns of BMI change.
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Affiliation(s)
- Naomi Matsumoto
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Toshihide Kubo
- Department of Pediatrics, National Hospital Organization, Okayama Medical Center, Okayama, Japan
| | - Kazue Nakamura
- Department of Pediatrics, National Hospital Organization, Okayama Medical Center, Okayama, Japan
| | - Toshiharu Mitsuhashi
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Akihito Takeuchi
- Department of Pediatrics, National Hospital Organization, Okayama Medical Center, Okayama, Japan
| | - Hirokazu Tsukahara
- Department of Pediatrics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Takashi Yorifuji
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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20
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Roberge JB, Harnois-Leblanc S, McNealis V, van Hulst A, Barnett TA, Kakinami L, Paradis G, Henderson M. Body Mass Index Z Score vs Weight-for-Length Z Score in Infancy and Cardiometabolic Outcomes at Age 8-10 Years. J Pediatr 2021; 238:208-214.e2. [PMID: 34302856 DOI: 10.1016/j.jpeds.2021.07.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/13/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To confirm that World Health Organization weight-for-length z scores (zWFL) and World Health Organization body mass index z scores (zBMI) in infancy are associated with adiposity and cardiometabolic measures at 8-10 years old and to compare the predictive ability of the 2 methods. STUDY DESIGN zWFL and zBMI at 6, 12, and 18 months of age were computed using data extracted from health booklets, among participants in the Québec Adipose and Lifestyle InvesTigation in Youth prospective cohort (n = 464). Outcome measures at 8-10 years included adiposity, lipid profile, blood pressure, and insulin dynamics. The relationships between zWFL, zBMI, and each outcome were estimated using multivariable linear regression models. Outcome prediction at 8-10 years was compared between the 2 methods using eta-squared and the Lin concordance correlation coefficient. RESULTS zWFL and zBMI were associated with all measures of adiposity at 8-10 years. Associations with other cardiometabolic measures were less consistent. For both zWFL and zBMI across infancy, eta-squared were highly similar and the Lin coefficients were markedly high (≥0.991) for all outcomes. CONCLUSIONS There was no evidence that zBMI and zWFL in infancy differed in their ability to predict adiposity and cardiometabolic measures in childhood. This lends support to the sole use of zBMI for growth monitoring and screening of overweight and obesity from birth to 18 years. TRIAL REGISTRATION ClinicalTrials.gov: NCT03356262.
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Affiliation(s)
- Jean-Baptiste Roberge
- CHU Sainte-Justine Research Centre, University of Montréal, Montréal, Canada; Department of Pediatrics, Faculty of Medicine, University of Montréal, Montréal, Canada
| | - Soren Harnois-Leblanc
- CHU Sainte-Justine Research Centre, University of Montréal, Montréal, Canada; School of Public Health, University of Montréal, Montréal, Canada
| | - Vanessa McNealis
- CHU Sainte-Justine Research Centre, University of Montréal, Montréal, Canada
| | | | - Tracie A Barnett
- CHU Sainte-Justine Research Centre, University of Montréal, Montréal, Canada; Department of Family Medicine, McGill University, Montréal, Canada
| | - Lisa Kakinami
- Department of Mathematics and Statistics, McGill University, Montréal, Canada; PERFORM Centre, Concordia University, Montréal, Canada
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics and Occupational Health, Montréal, Canada
| | - Mélanie Henderson
- CHU Sainte-Justine Research Centre, University of Montréal, Montréal, Canada; Department of Pediatrics, Faculty of Medicine, University of Montréal, Montréal, Canada; School of Public Health, University of Montréal, Montréal, Canada.
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21
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Norris T, Mansukoski L, Gilthorpe MS, Hamer M, Hardy R, Howe LD, Li L, Ong KK, Ploubidis GB, Viner RM, Johnson W. Early childhood weight gain: Latent patterns and body composition outcomes. Paediatr Perinat Epidemiol 2021; 35:557-568. [PMID: 33960515 DOI: 10.1111/ppe.12754] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/26/2020] [Accepted: 01/03/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Despite early childhood weight gain being a key indicator of obesity risk, we do not have a good understanding of the different patterns that exist. OBJECTIVES To identify and characterise distinct groups of children displaying similar early-life weight trajectories. METHODS A growth mixture model captured heterogeneity in weight trajectories between 0 and 60 months in 1390 children in the Avon Longitudinal Study of Parents and Children. Differences between the classes in characteristics and body size/composition at 9 years were investigated. RESULTS The best model had five classes. The "Normal" (45%) and "Normal after initial catch-down" (24%) classes were close to the 50th centile of a growth standard between 24 and 60 months. The "High-decreasing" (21%) and "Stable-high" (7%) classes peaked at the ~91st centile at 12-18 months, but while the former declined to the ~75th centile and comprised constitutionally big children, the latter did not. The "Rapidly increasing" (3%) class gained weight from below the 50th centile at 4 months to above the 91st centile at 60 months. By 9 years, their mean body mass index (BMI) placed them at the 98th centile. This class was characterised by the highest maternal BMI; highest parity; highest levels of gestational hypertension and diabetes; and the lowest socio-economic position. At 9 years, the "Rapidly increasing" class was estimated to have 68.2% (95% confidence interval [CI] 48.3, 88.1) more fat mass than the "Normal" class, but only 14.0% (95% CI 9.1, 18.9) more lean mass. CONCLUSIONS Criteria used in growth monitoring practice are unlikely to consistently distinguish between the different patterns of weight gain reported here.
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Affiliation(s)
- Tom Norris
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Liina Mansukoski
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Mark S Gilthorpe
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,Faculty of Medicine and Health, University of Leeds, Leeds, UK.,Alan Turing Institute, British Library, London, UK
| | - Mark Hamer
- Division of Surgery and Interventional Sciences, Faculty Medical Sciences, University College London, London, UK
| | - Rebecca Hardy
- CLOSER, Department of Social Science, University College London, London, UK
| | - Laura D Howe
- MRC Integrative Epidemiology Unit at the University of Bristol, Population Health Sciences, University of Bristol, Bristol, UK
| | - Leah Li
- Population, Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Ken K Ong
- MRC Epidemiology Unit and Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - George B Ploubidis
- Centre for Longitudinal Studies, Department of Social Science, University College London, London, UK
| | - Russell M Viner
- Population, Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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22
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Teng H, Hu J, Ge W, Dai Q, Liu J, Xiao C, Yin J, Zhu X. Body Mass Index Trajectories during 6-18 Years Old and the Risk of Hypertension in Young Adult: A Longitudinal Study in Chinese Population. Int J Hypertens 2021; 2021:6646868. [PMID: 34327015 DOI: 10.1155/2021/6646868] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/23/2021] [Indexed: 11/17/2022] Open
Abstract
Background Overweight/obesity in childhood is suggested to increase the risk of hypertension later in life. We aimed to assess whether and how body mass index (BMI) trajectories during 6–18 years of age are associated with hypertension in young adulthood (18–37 years) in the Chinese population. Methods Based on the China Health and Nutrition Survey (CHNS), a total of 1,872 participants who received ≥2 measurements of BMI during 6–18 years and had assessment of blood pressure (BP) in young adulthood were included. BMI trajectories were explored using latent class growth mixture models, and associations between identified trajectories with hypertension in young adulthood were examined by logistic regression analyses. Results Five heterogeneous BMI trajectories were identified: the low slow-increasing (20.03%), low moderate-increasing (56.14%), low rapid-increasing (17.04%), moderate-increasing (3.63%), and elevated-decreasing (3.15%) groups. Compared with the low slow-increasing group, another three increasing groups had gradually elevated risk of hypertension, yielding maximally adjusted odds ratio (95% confidence interval) (OR (95% CI)) of 2.48 (1.39–4.42), 3.24 (1.66–6.31), and 3.28 (1.19–9.08), respectively, whereas the elevated-decreasing group reversed overweight/obesity to normal weight in childhood, rendering its association with hypertension as not statistically significant (OR (95% CI) = 2.74 (0.98–7.65)). Conclusion Our study indicates that there are varied BMI trajectories from childhood to adulthood and that an elevated BMI trajectory during childhood is related with an increased risk of hypertension in young adulthood. In contrast, weight loss of children with high initial BMI may mitigate or reverse the risk. Our findings emphasize the importance of BMI continuous monitoring during early life.
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23
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Zhao Q, Hu Z, Kocak M, Liu J, Fowke JH, Han JC, Kakhniashvili D, Lewinn KZ, Bush NR, Mason WA, Tylavsky FA. Associations of prenatal metabolomics profiles with early childhood growth trajectories and obesity risk in African Americans: the CANDLE study. Int J Obes (Lond) 2021; 45:1439-1447. [PMID: 33824402 PMCID: PMC8496965 DOI: 10.1038/s41366-021-00808-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 02/17/2021] [Accepted: 03/22/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Prenatal metabolomics profiles, providing measures of in utero nutritional and environmental exposures, may improve the prediction of childhood outcomes. We aimed to identify prenatal plasma metabolites associated with early childhood body mass index (BMI) trajectories and overweight/obesity risk in offspring. METHODS This study included 450 African American mother-child pairs from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood Study. An untargeted metabolomics analysis was performed on the mothers' plasma samples collected during the second trimester. The children's BMI-z-score trajectories from birth to age 4 [rising-high- (9.8%), moderate- (68.2%), and low-BMI (22.0%)] and overweight/obesity status at age 4 were the main outcomes. The least absolute shrinkage and selection operator (LASSO) was used to select the prenatal metabolites associated with childhood outcomes. RESULTS The mothers were 24.5 years old on average at recruitment, 76.4% having education less than 12 years and 80.0% with Medicaid or Medicare. In LASSO, seven and five prenatal metabolites were associated with the BMI-z-score trajectories and overweight/obese at age 4, respectively. These metabolites are mainly from/relevant to the pathways of steroid biosynthesis, amino acid metabolism, vitamin B complex, and xenobiotics metabolism (e.g., caffeine and nicotine). The odds ratios (95% CI) associated with a one SD increase in the prenatal metabolite risk scores (MRSs) constructed from the LASSO-selected metabolites were 2.97 (1.95-4.54) and 2.03 (1.54-2.67) for children being in the rising-high-BMI trajectory group and overweight/obesity at age 4, respectively. The MRSs significantly improved the risk prediction for childhood outcomes beyond traditional prenatal risk factors. The increase (95% CI) in the area under the receiver operating characteristic curves were 0.10 (0.03-0.18) and 0.07 (0.02-0.12) for the rising-high-BMI trajectory (P = 0.005) and overweight/obesity at age 4 (P = 0.007), respectively. CONCLUSIONS Prenatal metabolomics profiles advanced prediction of early childhood growth trajectories and obesity risk in offspring.
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Affiliation(s)
- Qi Zhao
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
| | - Zunsong Hu
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Mehmet Kocak
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jiawang Liu
- Medicinal Chemistry Core, Office of Research, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Pharmaceutical Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jay H Fowke
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Joan C Han
- Departments of Pediatrics and Physiology, University of Tennessee Health Science Center, and Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA
| | - David Kakhniashvili
- Proteomics and Metabolomics Core, Office of Research, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Kaja Z Lewinn
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Nicole R Bush
- Departments of Pediatrics and Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - W Alex Mason
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Frances A Tylavsky
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
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Paksi W, Sirijunpen S, Nuntnarumit P, Pirojsakul K. Body Mass Index Trajectories and Duration of Obesity in Thai Children Diagnosed with Hypertension. Glob Pediatr Health 2021; 8:2333794X211012998. [PMID: 33997127 PMCID: PMC8111269 DOI: 10.1177/2333794x211012998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/02/2021] [Indexed: 11/15/2022] Open
Abstract
This study explored the relationship between BMI trajectories and the duration of obesity in Thai children diagnosed with hypertension. Demographic and blood pressure data from 536 children (270 boys, 50.3%) from a school in Bangkok, Thailand were collected. Hypertension was defined as blood pressure above the cutoff values specified in the 2017 American Academy of Pediatrics guidelines on 3 occasions. Records of BMI over the previous 3 years were reviewed. The prevalence of hypertension was 2.61% (14/536). Complete data on BMI trajectories were available in 421 non-hypertensive and 12 hypertensive children. The increase in BMI z-score over the previous 3 years was significantly greater in the hypertensive group than the non-hypertensive group, 1.45 (95% CI 0.42 to 1.88) versus 0.09 (95% CI: -0.35, 0.65), P = .008. In conclusion, children with a confirmed diagnosis of hypertension had a greater increase in BMI over the past 3 years than non-hypertensive children.
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Affiliation(s)
| | | | | | - Kwanchai Pirojsakul
- Mahidol University, Bangkok, Thailand
- Kwanchai Pirojsakul, Department of Pediatrics, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Bangkok 10400, Thailand.
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25
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Huvinen E, Tuomaala AK, Bergman PH, Meinilä J, Tammelin T, Kulmala J, Engberg E, Koivusalo SB. Ascending Growth is Associated with Offspring Adiposity in Pregnancies Complicated with Obesity or Gestational Diabetes. J Clin Endocrinol Metab 2021; 106:e1993-e2004. [PMID: 33524144 DOI: 10.1210/clinem/dgaa979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Early growth is associated with childhood adiposity, but the influence of lifestyle remains unknown. OBJECTIVE This work aimed to investigate the association of growth profiles from high-risk pregnancies with adiposity at age 5 years, taking into account lifestyle and several antenatal/postnatal exposures. METHODS This prospective cohort study. INCLUDED 609 children born during the Finnish Gestational Diabetes Prevention Study (RADIEL), recruiting women with body mass index (BMI) greater than or equal to 30 and/or prior gestational diabetes mellitus (GDM) (2008-2013). Altogether 332 children attended the 5-year follow-up (2014-2017). Main outcome measures included growth profiles based on ponderal index (PI = weight/height3), investigated using latent class mixed models. Adiposity was assessed with anthropometrics and body composition (InBody720). RESULTS We identified 3 growth profiles: ascending (n = 82), intermediate (n = 351), and descending (n = 149). Children with ascending growth had a higher body fat percentage, ISO-BMI, and waist circumference (P < .05) at age 5 years. Ascending (β 4.09; CI, 1.60-6.58) and intermediate (β 2.27; CI, 0.50-4.03) profiles were associated with higher fat percentage, even after adjustment for age, sex, gestational age, diet, physical activity, education, and prepregnancy BMI. Similar associations existed with ISO-BMI. After adjusting for age and education, ascending growth was associated with prepregnancy BMI (odds ratio [OR] 1.06; CI, 1.01-1.12), primiparity (OR 3.07; CI, 1.68-5.62), cesarean delivery (OR 2.23; CI, 1.18-4.21), and lifestyle intervention (OR 2.56; CI, 1.44-4.57). However, meeting the intervention goals and exclusive breastfeeding for 3 months or more were associated with lower odds of ascending growth. CONCLUSION Accelerated early growth was associated with higher adiposity in 5-year-old children from high-risk pregnancies, even when adjusted for lifestyle. Reducing cesarean deliveries and promoting breastfeeding may be beneficial for postnatal growth.
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Affiliation(s)
- Emilia Huvinen
- Teratology Information Service, Emergency Medicine, Department of Prehospital Emergency Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anna-Kaisa Tuomaala
- Department of Pediatrics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Paula H Bergman
- Biostatistics Consulting, Department of Public Health, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jelena Meinilä
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Tuija Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Janne Kulmala
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Elina Engberg
- Folkhälsan Research Center, Helsinki, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Saila B Koivusalo
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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26
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Jain V, Kumar B, Khatak S. Catch-up and Catch-down Growth in Term Healthy Indian Infants From Birth to Two Years: A Prospective Cohort Study. Indian Pediatr 2021. [DOI: 10.1007/s13312-021-2190-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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27
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Li X, Keown-Stoneman CDG, Lebovic G, Omand JA, Adeli K, Hamilton JK, Hanley AJ, Mamdani M, McCrindle BW, Sievenpiper JL, Tremblay MS, Maguire JL, Parkin PC, Birken CS. The association between body mass index trajectories and cardiometabolic risk in young children. Pediatr Obes 2020; 15:e12633. [PMID: 32181602 DOI: 10.1111/ijpo.12633] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/04/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Rapid growth is associated with increased cardiometabolic risk (CMR) in adolescence and adulthood. Little is known about whether the association between rapid growth and increased CMR originates in early childhood. OBJECTIVES To identify age and sex standardized body mass index (zBMI) trajectories and to examine the association between zBMI trajectories and CMR outcomes in children 0 to 60 months. STUDY DESIGN A longitudinal cohort study was conducted through The Applied Research Group for Kids (TARGet Kids!) in Toronto, Canada. Participants had repeated measures of weight and length or height performed from birth to 60 months of age. Latent class mixed modelling was used to identify the zBMI trajectories. Linear regressions were performed to determine the association between zBMI trajectories and the primary outcome, a CMR score, quantified as the sum of age- and sex- standardized waist circumference, systolic blood pressure, glucose, log-triglycerides and negative high-density lipoprotein cholesterol (HDL-C), divided by √5. Secondary outcomes were the individual components of the CMR formula as well as diastolic blood pressure and non-HDL-C. RESULTS Four BMI trajectories were identified among the 1166 children. After adjusting for all covariates, children in the rapidly accelerating trajectory had increased total CMR score (β = 1.38, 95% CI 0.77; 1.99, P < .001) and increased waist circumference score (β = 2.39, 95% CI 1.92; 2.86, P < .001) compared to the stable low group. CONCLUSIONS Rapid growth during early childhood is associated with increased CMR in preschool children, largely driven by larger waist circumference.
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Affiliation(s)
- Xuedi Li
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Charles D G Keown-Stoneman
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Gerald Lebovic
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jessica A Omand
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Khosrow Adeli
- Clinical Biochemistry, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Biochemistry and Laboratory Medicine & Pathology, University of Toronto, Toronto, Ontario, Canada
| | - Jill K Hamilton
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Anthony J Hanley
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Muhammad Mamdani
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Li Ka Shing Centre for Healthcare Analytics Research and Training, St. Michael's Hospital, Toronto, Ontario, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Brian W McCrindle
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Preventative Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Mark S Tremblay
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Jonathon L Maguire
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Patricia C Parkin
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Catherine S Birken
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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28
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Hu Z, Tylavsky FA, Kocak M, Fowke JH, Han JC, Davis RL, LeWinn KZ, Bush NR, Sathyanarayana S, Karr CJ, Zhao Q. Effects of Maternal Dietary Patterns during Pregnancy on Early Childhood Growth Trajectories and Obesity Risk: The CANDLE Study. Nutrients 2020; 12:E465. [PMID: 32069778 PMCID: PMC7071328 DOI: 10.3390/nu12020465] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/07/2020] [Accepted: 02/10/2020] [Indexed: 01/01/2023] Open
Abstract
We investigated the associations between maternal dietary patterns during pregnancy and early childhood growth trajectories and overweight/obesity risk in offspring. Maternal diet was assessed using a food frequency questionnaire during the second trimester, and dietary patterns were derived by reduced rank regression. The associations between maternal dietary pattern scores and body mass index (BMI) trajectories from birth to age four (rising-high, moderate, and low BMI trajectories) as well as overweight/obesity risk at age four were analyzed (n = 1257). Two maternal dietary patterns were identified. The fast food pattern included a higher intake of fried chicken and fish, fruit juices, mayonnaise, and sugar-sweetened beverages, while the processed food pattern included a higher intake of dairy, salad dressing, processed meat, and cold breakfast cereal. Women with greater adherence to the fast food pattern were more likely to have children in the rising-high BMI trajectory group [OR (95% CI) = 1.32 (1.07-1.62); p = 0.008] or having overweight/obesity at age four [OR (95% CI) = 1.31 (1.11-1.54); p = 0.001]. The processed food pattern was not associated with these outcomes. The maternal dietary pattern during pregnancy represented by fried foods and sugar-sweetened beverages may contribute to rapid early childhood growth and increased risk for obesity in offspring.
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Affiliation(s)
- Zunsong Hu
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (Z.H.); (F.A.T.); (M.K.); (J.H.F.)
| | - Frances A. Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (Z.H.); (F.A.T.); (M.K.); (J.H.F.)
| | - Mehmet Kocak
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (Z.H.); (F.A.T.); (M.K.); (J.H.F.)
| | - Jay H. Fowke
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (Z.H.); (F.A.T.); (M.K.); (J.H.F.)
| | - Joan C. Han
- Departments of Pediatrics and Physiology, University of Tennessee Health Science Center, and Children’s Foundation Research Institute, Le Bonheur Children’s Hospital, Memphis, TN 38103, USA;
| | - Robert L. Davis
- Center for Biomedical Informatics, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38103, USA;
| | - Kaja Z. LeWinn
- Department of Psychiatry, University of California San Francisco, San Francisco, CA 94118, USA;
| | - Nicole R. Bush
- Departments of Pediatrics and Psychiatry, University of California San Francisco, San Francisco, CA 94118, USA;
| | - Sheela Sathyanarayana
- Seattle Children’s Research Institute, Center for Child Health, Behavior, and Development, Seattle, WA 98121, USA;
- Department of Pediatrics, University of Washington, Seattle, WA 98121, USA;
| | - Catherine J. Karr
- Department of Pediatrics, University of Washington, Seattle, WA 98121, USA;
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA
- Department of Epidemiology, University of Washington, Seattle, WA 98195, USA
| | - Qi Zhao
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (Z.H.); (F.A.T.); (M.K.); (J.H.F.)
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29
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Wibaek R, Vistisen D, Girma T, Admassu B, Abera M, Abdissa A, Mudie K, Kæstel P, Jørgensen ME, Wells JCK, Michaelsen KF, Friis H, Andersen GS. Body mass index trajectories in early childhood in relation to cardiometabolic risk profile and body composition at 5 years of age. Am J Clin Nutr 2019; 110:1175-1185. [PMID: 31504088 DOI: 10.1093/ajcn/nqz170] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 07/03/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Both impaired and accelerated postnatal growth have been associated with adult risks of obesity and cardiometabolic diseases, like type 2 diabetes and cardiovascular disease. However, the timing of the onset of cardiometabolic changes and the specific growth trajectories linking early growth with later disease risks are not well understood. OBJECTIVES The aim of this study was to identify distinct trajectories of BMI growth from 0 to 5 y and examine their associations with body composition and markers of cardiometabolic risk at age 5 y. METHODS In a prospective birth cohort study of 453 healthy and term Ethiopian children with BMIs assessed a median of 9 times during follow-up, we identified subgroups of distinct BMI trajectories in early childhood using latent class trajectory modeling. Associations of the identified growth trajectories with cardiometabolic markers and body composition at 5 y were analyzed using multiple linear regression analyses in 4 adjustment models for each outcome. RESULTS We identified 4 heterogeneous BMI growth trajectories: stable low BMI (19.2%), normal BMI (48.8%), rapid catch-up to high BMI (17.9%), and slow catch-up to high BMI (14.1%). Compared with the normal BMI trajectory, children in the rapid catch-up to high BMI trajectory had higher triglycerides (TGs) (range of β-coefficients in Models 1-4: 19-21%), C-peptides (23-25%), fat masses (0.48-0.60 kg), and fat-free masses (0.50-0.77 kg) across the 4 adjustment models. Children in the stable low BMI trajectory had lower LDL cholesterol concentrations (0.14-0.17 mmol/L), HDL cholesterol concentrations (0.05-0.09 mmol/L), fat masses (0.60-0.64 kg), and fat-free masses (0.35-0.49 kg), but higher TGs (11-13%). CONCLUSIONS The development of obesity and cardiometabolic risks may be established already in early childhood; thus, our data provide a further basis for timely interventions targeted at young children from low-income countries with unfavorable growth patterns. The birth cohort was registered at ISRCTN as ISRCTN46718296.
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Affiliation(s)
- Rasmus Wibaek
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Dorte Vistisen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Tsinuel Girma
- Department of Pediatrics and Child Health, Jimma University, Jimma, Ethiopia.,Jimma University Clinical and Nutrition Research Partnership, Jimma University, Jimma, Ethiopia
| | - Bitiya Admassu
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,Jimma University Clinical and Nutrition Research Partnership, Jimma University, Jimma, Ethiopia.,Department of Population and Family Health, Jimma University, Jimma, Ethiopia
| | - Mubarek Abera
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,Jimma University Clinical and Nutrition Research Partnership, Jimma University, Jimma, Ethiopia.,Department of Psychiatry, Jimma University, Jimma, Ethiopia
| | - Alemseged Abdissa
- Jimma University Clinical and Nutrition Research Partnership, Jimma University, Jimma, Ethiopia.,Department of Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Kissi Mudie
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Pernille Kæstel
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Marit E Jørgensen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark.,National Institute of Public Health, Southern Denmark University, Copenhagen, Denmark
| | - Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Gregers S Andersen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
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30
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Affiliation(s)
- Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
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31
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Mattsson M, Maher GM, Boland F, Fitzgerald AP, Murray DM, Biesma R. Group-based trajectory modelling for BMI trajectories in childhood: A systematic review. Obes Rev 2019; 20:998-1015. [PMID: 30942535 DOI: 10.1111/obr.12842] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/19/2019] [Accepted: 01/20/2019] [Indexed: 12/24/2022]
Abstract
Childhood obesity is an important public health issue. We aimed to systematically review studies that used group-based trajectory modelling approaches to investigate body mass index (BMI) trajectories in early childhood, explore associated determinants, and the association with body composition outcomes. Five databases were searched systematically for studies using group-based trajectory modelling approaches to track BMI trajectories from birth. Fourteen studies using latent class growth analysis or growth mixture modelling to track BMI trajectories were identified. Three or four trajectories were identified in most studies. High maternal pre-pregnancy BMI was the most frequently identified risk factor for membership of a rapid gain trajectory. Significant associations between rapid weight gain and stable high trajectories and body measures at follow-up were identified by several studies. Relatively similar trajectories were identified across studies. Trajectories characterized by rapid weight gain were associated with several predictors, as well as body measures at follow-up, however not with great consistency. Similar associations with body measure outcomes were found for stable high and rapid gain trajectories, suggesting that long-term outcomes do not differ greatly between children with consistently high BMI and children with rapid increases in BMI. As the shape and timing of the trajectories differed between studies, it is difficult to draw conclusions.
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Affiliation(s)
- Molly Mattsson
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Gillian M Maher
- School of Public Health, University College Cork, Cork, Ireland
| | - Fiona Boland
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Deirdre M Murray
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Regien Biesma
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
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32
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Carsley S, Pope EI, Anderson LN, Tremblay MS, Tu K, Birken CS. Temporal trends in severe obesity prevalence in children and youth from primary care electronic medical records in Ontario: a repeated cross-sectional study. CMAJ Open 2019; 7:E351-E359. [PMID: 31110113 PMCID: PMC6527435 DOI: 10.9778/cmajo.20180174] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There are no current estimates of severe obesity in Canadian children. The objectives of this study were to determine the prevalence of severe obesity in children aged 18 years or less in Ontario and to determine temporal trends from 2004 to 2015. METHODS This was a repeated cross-sectional study using height/length and weight of children aged 18 years or less from the Electronic Medical Record Administrative data Linked Database (EMRALD), a database of primary care electronic medical records in Ontario. We calculated body mass index (for age and sex) z-scores (zBMI). Two years of data (2014 and 2015) were used to determine the period prevalence of severe obesity. We used multivariable linear regression generalized estimating equations to estimate the association of calendar year and mean zBMI. RESULTS In total, 55 233 children were included. The prevalence of severe obesity (zBMI > 3) increased with increasing age: it was 0.9% (95% confidence interval [CI] 0.7% to 1.0%) among children less than 5 years of age, 2.7% (95% CI 2.3% to 3.1%) among 5- to 9-year-olds, 2.9% (95% CI 2.4% to 3.3%) among 10- to 14-year-olds and 3.7% (95% CI 3.1% to 4.3%) among those aged 15-18. Boys aged 5-9 years had a significantly higher prevalence of severe obesity than their female counterparts (3.5% [95% CI 2.9% to 4.2%] v. 1.7% [95% CI 1.3% to 2.2%]). From 2004 to 2015, the mean zBMI decreased by 0.015 (95% CI -0.018 to -0.012) units per year, with the overall prevalence of severe obesity in all ages highest in 2005 (3%) and a decrease to 2% in 2015. INTERPRETATION The prevalence of severe obesity among children and adolescents in Ontario is consistent with that in other developed countries with the exception of the United States. There is evidence of plateauing of estimates and a small decrease in zBMI over time. Further understanding of the impact of prevention efforts on these estimates is an important next step.
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Affiliation(s)
- Sarah Carsley
- Department of Health Promotion, Chronic Disease and Injury Prevention (Carsley), Public Health Ontario; Faculty of Medicine (Pope), University of Toronto, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Anderson), McMaster University, Hamilton, Ont.; Healthy Active Living and Obesity Research (Tremblay), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; Department of Family and Community Medicine (Tu), University of Toronto; Toronto Western Hospital Family Health Team (Tu), University Health Network; Peter Gilgan Centre for Research and Learning, Child Health Evaluative Sciences (Birken), the Hospital for Sick Children; Pediatric Outcomes Research Team, Division of Paediatric Medicine, The Hospital for Sick Children; Department of Pediatric Medicine (Birken), University of Toronto, Toronto, Ont
| | - Eliza I Pope
- Department of Health Promotion, Chronic Disease and Injury Prevention (Carsley), Public Health Ontario; Faculty of Medicine (Pope), University of Toronto, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Anderson), McMaster University, Hamilton, Ont.; Healthy Active Living and Obesity Research (Tremblay), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; Department of Family and Community Medicine (Tu), University of Toronto; Toronto Western Hospital Family Health Team (Tu), University Health Network; Peter Gilgan Centre for Research and Learning, Child Health Evaluative Sciences (Birken), the Hospital for Sick Children; Pediatric Outcomes Research Team, Division of Paediatric Medicine, The Hospital for Sick Children; Department of Pediatric Medicine (Birken), University of Toronto, Toronto, Ont
| | - Laura N Anderson
- Department of Health Promotion, Chronic Disease and Injury Prevention (Carsley), Public Health Ontario; Faculty of Medicine (Pope), University of Toronto, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Anderson), McMaster University, Hamilton, Ont.; Healthy Active Living and Obesity Research (Tremblay), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; Department of Family and Community Medicine (Tu), University of Toronto; Toronto Western Hospital Family Health Team (Tu), University Health Network; Peter Gilgan Centre for Research and Learning, Child Health Evaluative Sciences (Birken), the Hospital for Sick Children; Pediatric Outcomes Research Team, Division of Paediatric Medicine, The Hospital for Sick Children; Department of Pediatric Medicine (Birken), University of Toronto, Toronto, Ont
| | - Mark S Tremblay
- Department of Health Promotion, Chronic Disease and Injury Prevention (Carsley), Public Health Ontario; Faculty of Medicine (Pope), University of Toronto, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Anderson), McMaster University, Hamilton, Ont.; Healthy Active Living and Obesity Research (Tremblay), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; Department of Family and Community Medicine (Tu), University of Toronto; Toronto Western Hospital Family Health Team (Tu), University Health Network; Peter Gilgan Centre for Research and Learning, Child Health Evaluative Sciences (Birken), the Hospital for Sick Children; Pediatric Outcomes Research Team, Division of Paediatric Medicine, The Hospital for Sick Children; Department of Pediatric Medicine (Birken), University of Toronto, Toronto, Ont
| | - Karen Tu
- Department of Health Promotion, Chronic Disease and Injury Prevention (Carsley), Public Health Ontario; Faculty of Medicine (Pope), University of Toronto, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Anderson), McMaster University, Hamilton, Ont.; Healthy Active Living and Obesity Research (Tremblay), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; Department of Family and Community Medicine (Tu), University of Toronto; Toronto Western Hospital Family Health Team (Tu), University Health Network; Peter Gilgan Centre for Research and Learning, Child Health Evaluative Sciences (Birken), the Hospital for Sick Children; Pediatric Outcomes Research Team, Division of Paediatric Medicine, The Hospital for Sick Children; Department of Pediatric Medicine (Birken), University of Toronto, Toronto, Ont
| | - Catherine S Birken
- Department of Health Promotion, Chronic Disease and Injury Prevention (Carsley), Public Health Ontario; Faculty of Medicine (Pope), University of Toronto, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Anderson), McMaster University, Hamilton, Ont.; Healthy Active Living and Obesity Research (Tremblay), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; Department of Family and Community Medicine (Tu), University of Toronto; Toronto Western Hospital Family Health Team (Tu), University Health Network; Peter Gilgan Centre for Research and Learning, Child Health Evaluative Sciences (Birken), the Hospital for Sick Children; Pediatric Outcomes Research Team, Division of Paediatric Medicine, The Hospital for Sick Children; Department of Pediatric Medicine (Birken), University of Toronto, Toronto, Ont.
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Hu Z, Tylavsky FA, Han JC, Kocak M, Fowke JH, Davis RL, Lewinn K, Bush NR, Zhao Q. Maternal metabolic factors during pregnancy predict early childhood growth trajectories and obesity risk: the CANDLE Study. Int J Obes (Lond) 2019; 43:1914-1922. [PMID: 30705389 PMCID: PMC6669102 DOI: 10.1038/s41366-019-0326-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/08/2018] [Accepted: 01/13/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND We investigated the individual and additive effects of three modifiable maternal metabolic factors, including pre-pregnancy overweight/obesity, gestational weight gain (GWG), and gestational diabetes mellitus (GDM), on early childhood growth trajectories and obesity risk. METHODS A total of 1425 mother-offspring dyads (953 black and 472 white) from a longitudinal birth cohort were included in this study. Latent class growth modeling was performed to identify the trajectories of body mass index (BMI) from birth to 4 years in children. Poisson regression models were used to examine the associations between the maternal metabolic risk factors and child BMI trajectories and obesity risk at 4 years. RESULTS We identified three discrete BMI trajectory groups, characterized as rising-high-BMI (12.6%), moderate-BMI (61.0%), or low-BMI (26.4%) growth. Both maternal pre-pregnancy obesity (adjusted relative risk [adjRR] = 1.96; 95% confidence interval [CI]: 1.36-2.83) and excessive GWG (adjRR = 1.71, 95% CI: 1.13-2.58) were significantly associated with the rising-high-BMI trajectory, as manifested by rapid weight gain during infancy and a stable but high BMI until 4 years. All three maternal metabolic indices were significantly associated with childhood obesity at age 4 years (adjRR for pre-pregnancy obesity = 2.24, 95% CI: 1.62-3.10; adjRR for excessive GWG = 1.46, 95% CI: 1.01-2.09; and adjRR for GDM = 2.14, 95% = 1.47-3.12). In addition, risk of rising-high BMI trajectory or obesity at age 4 years was stronger among mothers with more than one metabolic risk factor. We did not observe any difference in these associations by race. CONCLUSION Maternal pre-pregnancy obesity, excessive GWG, and GDM individually and jointly predict rapid growth and obesity at age 4 years in offspring, regardless of race. Interventions targeting maternal obesity and metabolism may prevent or slow the rate of development of childhood obesity.
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Affiliation(s)
- Zunsong Hu
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Joan C Han
- Departments of Pediatrics and Physiology, University of Tennessee Health Science Center, Memphis, TN, 38103, USA.,Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, 38103, USA
| | - Mehmet Kocak
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Jay H Fowke
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Robert L Davis
- Department of Pediatrics, Center for Biomedical Informatics, University of Tennessee Health Science Center, Memphis, TN, 38103, USA
| | - Kaja Lewinn
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, 94118, USA
| | - Nicole R Bush
- Departments of Pediatrics and Psychiatry, University of California San Francisco, San Francisco, CA, 94118, USA
| | - Qi Zhao
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, 38163, USA.
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Carsley S, Tu K, Parkin PC, Pullenayegum E, Birken CS. Overweight and obesity in preschool aged children and risk of mental health service utilization. Int J Obes (Lond) 2019; 43:1325-33. [PMID: 30546134 DOI: 10.1038/s41366-018-0280-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/16/2018] [Accepted: 11/04/2018] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To determine if overweight or obesity in preschool-age children is associated with mental health service utilization in later childhood. SUBJECTS Overall, 10,522 children 2 to <5 years, with no previous history of mental health service utilization, were identified from primary care electronic medical records (EMRs) across Ontario, Canada. METHODS This was a retrospective longitudinal cohort study. Height and weight data were extracted and body mass index z-scores (zBMI) were calculated using the World Health Organization Growth Standards. Mental health service utilization, between ages 5 and <19, was defined using administrative billing codes for mental health outpatient visits, emergency department visits, and hospitalizations. A multivariable Cox proportional hazards model was performed. RESULTS In total, 74.9% of children were healthy weight (zBMI between -2 and ≤1), 18.8% of children were at risk of overweight (zBMI between 1 and ≤2), 4.9% were overweight (zBMI > 2 and ≤3), and 1.5% had obesity (zBMI > 3). The median follow-up time was 2.2 years (IQR 1.0-4.2). The overall incidence rate of mental health service use was 44.5 events per 1000 person-years. The hazard ratio for girls with obesity was 2.73 (95% CI 1.62-4.60; p < 0.001) compared to girls with healthy weight. Compared to boys with healthy weight, boys 'at risk of overweight' and overweight were 1.22 (95% CI 1.03-1.44; p = 0.02) and 1.43 (95% CI 1.09-1.87; p = 0.01) times at higher risk of an incident mental health visit. CONCLUSION Our study shows an association between weight status in preschool school aged children and higher incidence of mental health service use in later childhood. This relationship was strongest in girls. Future research is needed to understand this relationship by mental health diagnosis, sex, and age.
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Aris IM, Rifas-Shiman SL, Li LJ, Yang S, Belfort MB, Thompson J, Hivert MF, Patel R, Martin RM, Kramer MS, Oken E. Association of Weight for Length vs Body Mass Index During the First 2 Years of Life With Cardiometabolic Risk in Early Adolescence. JAMA Netw Open 2018; 1:e182460. [PMID: 30646168 PMCID: PMC6324504 DOI: 10.1001/jamanetworkopen.2018.2460] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 07/11/2018] [Indexed: 12/17/2022] Open
Abstract
Importance The American Academy of Pediatrics currently recommends weight for length (WFL) for assessment of weight status in children younger than 2 years but body mass index (BMI) for children older than 2 years. However, the clinical implications of using WFL vs BMI in children younger than 2 years as an indicator of future health outcomes remains understudied. Objective To compare associations of overweight based on WFL vs BMI in children younger than 2 years with cardiometabolic outcomes during early adolescence. Design, Setting, and Participants This prospective study of birth cohorts in the United States (Project Viva) and Belarus (Promotion of Breastfeeding Intervention Trial [PROBIT]) performed from June 1, 1996, to November 31, 2002, included 13 666 children younger than 2 years. Main Exposures Overweight defined as Centers for Disease Control and Prevention (CDC) WFL in the 95th percentile or greater, World Health Organization (WHO) WFL in the 97.7th percentile or greater, or WHO BMI in the 97.7th percentile or greater at 6, 12, 18, or 24 months of age. Main Outcomes and Measures Primary outcomes were fat mass index, insulin resistance, metabolic risk score, and obesity during early adolescence. Secondary outcomes were height and BMI z scores, sum of skinfolds, waist circumference, and systolic blood pressure during early adolescence. Results The study included 919 children (mean [SD] age, 12.9 [0.9] years; 460 [50.1%] male; and 598 [65.1%] white) from Project Viva and 12 747 children (mean [SD] age, 11.5 [0.5] years; 6204 [48.7%] male; and 12 747 [100%] white) from PROBIT. During 6 to 24 months of age, in Project Viva, 206 children (22.4%) were overweight at any of the 4 times points according to the CDC WFL, 160 (17.4%) according to WHO WFL, and 161 (17.5%) according to WHO BMI cut points. In PROBIT, 3715 children (29.1%) were overweight at any of the 4 time points according to the CDC WFL, 3069 (24.1%) according to WHO WFL, and 3125 (24.5%) according to WHO BMI cut points. After maternal and child characteristics were adjusted for, being ever overweight (vs never overweight) during 6 to 24 months of age was associated with higher likelihood of adverse cardiometabolic risk markers during early adolescence, but associations did not differ substantially across WFL and BMI cut points in either cohort. For example, for fat mass index in Project Viva, β = 0.9 (95% CI, 0.5-1.4) for the CDC WFL, β = 1.1 (95% CI, 0.6-1.6) for WHO WFL, and β = 1.4 (95% CI, 0.9-1.9) for WHO BMI. For PROBIT, β = 0.5 (95% CI, 0.4-0.6) for the CDC WFL, β = 0.6 (95% CI, 0.5-0.7) for WHO WFL, and β = 0.6 (95% CI, 0.5-0.6) for WHO BMI. Neither growth metric in infancy was superior over the others based on F statistics (Project Viva: 17.1-17.8; PROBIT: 87.1-88.7). Findings were similar for insulin resistance, metabolic risk score, obesity, and secondary outcomes. Conclusions and Relevance Choice of WFL vs BMI to define overweight during the first 2 years of life may not greatly affect the association with cardiometabolic outcomes during early adolescence. The findings appear to have important implications for investigators seeking to use BMI as a growth metric for epidemiologic research and for practitioners monitoring the weight status of children younger than 2 years.
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Affiliation(s)
- Izzuddin M. Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Ling-Jun Li
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Division of Obstetrics and Gynecology, KK Women’s and Children’s Hospital, Singapore, Singapore
- Obstetrics and Gynecology Academic Clinical Programme, Duke–National University of Singapore Graduate Medical School, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Seungmi Yang
- Department of Pediatrics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine McGill University, Montreal, Quebec, Canada
| | - Mandy B. Belfort
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jennifer Thompson
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Diabetes Unit, Massachusetts General Hospital, Boston
| | - Rita Patel
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Richard M. Martin
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Michael S. Kramer
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Pediatrics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine McGill University, Montreal, Quebec, Canada
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Lindsay AC, Le Q, Greaney ML. Infant Feeding Beliefs, Attitudes, Knowledge and Practices of Chinese Immigrant Mothers: An Integrative Review of the Literature. Int J Environ Res Public Health 2017; 15:ijerph15010021. [PMID: 29295487 PMCID: PMC5800121 DOI: 10.3390/ijerph15010021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 12/18/2017] [Accepted: 12/20/2017] [Indexed: 12/15/2022]
Abstract
Chinese are a fast-growing immigrant population group in several parts of the world (e.g., Australia, Canada, Europe, Southeast Asia, United States). Research evidence suggests that compared to non-Hispanic whites, individuals of Asian-origin including Chinese are at higher risk of developing cardiovascular disease and type 2 diabetes at a lower body mass index (BMI). These risks may be possibly due to genetic differences in body composition and metabolic responses. Despite the increasing numbers of Chinese children growing up in immigrant families and the increasing prevalence of obesity among Chinese, little research has been focused on children of Chinese immigrant families. This integrative review synthesizes the evidence on infant feeding beliefs, attitudes, knowledge and practices of Chinese immigrant mothers; highlights limitations of available research; and offers suggestions for future research. Using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, we searched four electronic academic/research databases (CINAHL, Medline, PsycINFO, and PubMed) to identify peer-reviewed, full-text papers published in English between January 2000 and September 2017. Only studies with mothers 18+ years old of normally developing infants were included. Of the 797 citations identified, 15 full-text papers were retrieved and 11 studies (8 cross-sectional studies, 3 qualitative studies) met the inclusion criteria and were included in this review. Reviewed studies revealed high initiation rates of breastfeeding, but sharp declines in breastfeeding rates by six months of age. In addition, reviewed studies revealed that the concomitantly use of breast milk and formula, and the early introduction of solid foods were common. Finally, reviewed studies identified several familial and socio-cultural influences on infant feeding beliefs and practices that may increase risk of overweight and obesity during infancy and early childhood among Chinese children of immigrant families. Nonetheless, as only 11 studies were identified and because the majority of studies (n = 8) were conducted in Australia, additional research including longitudinal studies, and studies conducted in countries with large Chinese immigrant population are needed to further identify and understand influences on Chinese immigrant mothers' beliefs, attitudes, and practices related to infant feeding that may increase risk of child overweight and obesity. This information is needed to develop interventions tailored to the beliefs and needs of this fast-growing immigrant group and aimed at promoting healthy infant feeding practices to prevent childhood overweight and obesity.
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Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA.
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Qun Le
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA.
| | - Mary L Greaney
- Health Studies and Department of Kinesiology, University of Rhode Island, Kingston, RI 02881, USA.
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