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Leung AKC, Wong AHC, Hon KL. Childhood Obesity: An Updated Review. Curr Pediatr Rev 2024; 20:2-26. [PMID: 35927921 DOI: 10.2174/1573396318666220801093225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/05/2022] [Accepted: 05/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Childhood obesity is an important and serious public health problem worldwide. OBJECTIVE This article aims to familiarize physicians with the evaluation, management, and prevention of childhood. METHODS A PubMed search was conducted in May, 2021, in Clinical Queries using the key terms "obesity" OR "obese". The search included clinical trials, randomized controlled trials, case-control studies, cohort studies, meta-analyses, observational studies, clinical guidelines, case reports, case series, and reviews. The search was restricted to English literature and children. The information retrieved from the above search was used in the compilation of the present article. RESULTS Most obese children have exogenous obesity characterized by a growth rate for height above the 50th percentile, normal intelligence, normal genitalia, and lack of historical or physical evidence of an endocrine abnormality or a congenital syndrome. Obese children are at risk for dyslipidemia, hypertension, diabetes mellitus, non-alcoholic fatty liver disease, obstructive sleep apnea, psychosocial disturbances, impaired quality of life, and shorter life expectancy. The multitude of serious comorbidities necessitates effective treatment modalities. Dietary modification, therapeutic exercise, and behavioral modification are the fundamentals of treatment. Pharmacotherapy and/or bariatric surgery should be considered for obese individuals who do not respond to the above measures and suffer from a serious comorbid condition. CONCLUSION Childhood obesity, once established, is often refractory to treatment. Most treatment programs lead to a brief period of weight loss, followed by rapid re-accumulation of the lost weight after the termination of therapy. As such, preventive activity is the key to solving the problem of childhood obesity. Childhood obesity can be prevented by promoting a healthy diet, regular physical activity, and lifestyle modification. Parents should be encouraged to get involved in school and community programs that improve their children's nutritional status and physical activity.
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Affiliation(s)
- Alexander K C Leung
- Department of Pediatrics, The University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Alex H C Wong
- Department of Family Medicine, The University of Calgary, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong, China
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Muhsen K, Na’amnih W, Goldsmith R, Maya M, Zeidan N, Kassem E, Ornoy A. Associations of Feeding Practices in Early Life and Dietary Intake at School Age with Obesity in 10- to 12-Year-Old Arab Children. Nutrients 2021; 13:nu13062106. [PMID: 34205416 PMCID: PMC8234619 DOI: 10.3390/nu13062106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/13/2021] [Accepted: 06/17/2021] [Indexed: 11/16/2022] Open
Abstract
Understanding the role in pediatric obesity of early life feeding practices and dietary intake at school age is essential for early prevention. The study aimed to examine associations of early life feeding practices, environmental and health-related exposures, and dietary intake at school age as determinants of obesity in children aged 10–12 years. In an earlier study of 233 healthy infants in two Arab towns in northern Israel, neonatal history, feeding practices, and health information were obtained up to age 18 months. This follow-up study assessed dietary intake and anthropometric measurements at age 10–12 years using the 24 h recall method. Overall, 174 children participated in this study. Almost all (98%) the children were breastfed. The prevalence of obesity at school age was 42%. A multivariable model adjusted for energy intake and socioeconomic status showed positive associations of total fat intake and of weight-for-height z score, but not feeding practices in infancy, with obesity. Higher gestational age at birth was associated with lower odds of obesity at age 10–12 years. In conclusion, in a population with near universal breastfeeding, gestational age at birth, weight indicators but not feeding practices in infancy, and total fat intake at school age were associated with increased likelihood of obesity.
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Affiliation(s)
- Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (W.N.); (M.M.)
- Correspondence: ; Tel.: +972-3-6405945; Fax: +972-3-6409868
| | - Wasef Na’amnih
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (W.N.); (M.M.)
| | | | - Maayan Maya
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (W.N.); (M.M.)
| | - Nuha Zeidan
- Clalit Health Service, Diet and Nutrition Unit, P.O. Box 789, Arara 30026, Israel;
| | - Eias Kassem
- Department of Pediatrics, Hillel Yaffe Medical Center, Hadera 38100, Israel;
| | - Asher Ornoy
- Laboratory of Teratology, Department of Medical Neurobiology, The Hebrew University Hadassah Medical School, Jerusalem 9112002, Israel
- Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
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Vinke PC, Tigelaar C, Küpers LK, Corpeleijn E. The Role of Children's Dietary Pattern and Physical Activity in the Association Between Breastfeeding and BMI at Age 5: The GECKO Drenthe Cohort. Matern Child Health J 2020; 25:338-348. [PMID: 33258042 PMCID: PMC7870607 DOI: 10.1007/s10995-020-03063-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 12/26/2022]
Abstract
Objectives Breastfeeding is protective against childhood obesity, but the role of childhood lifestyle in this association is unclear. We investigated whether physical activity and dietary pattern at age 5 differed between breastfed and non-breastfed children, and how they relate to Body Mass Index (BMI) Z-scores. Methods 1477 children of the Dutch GECKO Drenthe birth cohort were included. At one month, children were categorized as breastfed (receiving breast milk exclusively or in combination with formula milk) or non-breastfed (receiving formula milk exclusively). At age 5, height and weight were objectively measured, physical activity was measured by ActiGraph GT3x and dietary patterns were assessed with a parent-reported food pattern questionnaire, assessing the consumption frequency of selected food items at seven occasions over the day. Results Non-breastfed children had higher BMI Z-scores (0.36 ± 0.90 vs. 0.20 ± 0.80 SD, p = 0.002), more frequently consumed sugar-sweetened beverages (25.0 ± 10.5 vs. 22.5 ± 9.71 times per week, p < 0.001), and consumed relatively less whole-wheat or brown bread (p = 0.007). Differences in sugar-sweetened beverage consumption were most pronounced during main meals. Total fruit consumption, sedentary time and moderate-to-vigorous physical activity levels did not differ between the groups. Multivariable adjusted linear regression analyses showed that the differences in BMI-z score between non-breastfed and breastfed children were not explained by the differences in sugar-sweetened beverages or type of bread consumed. Conclusions Infant breastfeeding itself is indicative of healthy dietary behaviors in early life, and is also more likely to be followed by a favorable dietary pattern at toddler age. However, the differences in dietary habits between breastfed and non-breastfed children did not explain the difference in BMI Z-score at the age of 5. Electronic supplementary material The online version of this article (10.1007/s10995-020-03063-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Petra Corianne Vinke
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, Groningen, 9700 RB, The Netherlands.
| | - Carolien Tigelaar
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, Groningen, 9700 RB, The Netherlands
| | - Leanne Karen Küpers
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, Groningen, 9700 RB, The Netherlands.,Division of Human Nutrition and Health, Wageningen University & Research, PO Box 8129, Wageningen, 6700 EV, The Netherlands
| | - Eva Corpeleijn
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, Groningen, 9700 RB, The Netherlands
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Gacem S, Al-Shahwan M, Hassan NGM, Djessas F, Jairoun A, Al-Hemyari S. A study to identify the most common reasons to wean among breastfeeding mothers in UAE. J Pharm Bioallied Sci 2020; 12:72-76. [PMID: 32801603 PMCID: PMC7398003 DOI: 10.4103/jpbs.jpbs_230_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 10/31/2019] [Indexed: 11/07/2022] Open
Abstract
Background: Despite the great benefits of breastfeeding for the mother and the child, many mothers face a lot of challenges and issues during lactation, which might lead to early weaning. Aim: The aim of this study was to assess the factors that can lead to early weaning and to identify the most common reasons to early weaning among breastfeeding mothers. Materials and Methods: This was a cross-sectional, questionnaire-based survey study. Eight hundred and fifty questionnaires were distributed to lactating mothers, but only 820 were returned making the response rate of 96.5%. Breastfeeding mothers in Ajman and Sharjah, United Arab Emirates (UAE) participated in the study. Statistical Analysis: The results were analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 20. IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. Descriptive statistics were used to summarize the data concerning the demographic characteristics. Categorical variables (such as nationality and educational level) were described by using frequency, percentages, bar chart, and pie chart. Results: The results revealed that 29% of respondents stopped breastfeeding for some reason. The main reasons stated by the participants were low milk supply (25.8%) and pain, congestion, and abscess (19.22%) followed by new pregnancy (17.5%), which were the most identified reasons for early discontinuation of breastfeeding. Conclusion: Our study indicated that the misconception of weaning because of a new pregnancy has declined in the UAE compared to a study conducted 3 years ago. A positive improvement was also observed in terms of weaning due to personal desire compared to previous years among mothers as they became more aware of the benefits of breastfeeding.
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Mosquera PS, Lourenço BH, Gimeno SGA, Malta MB, Castro MC, Cardoso MA. Factors affecting exclusive breastfeeding in the first month of life among Amazonian children. PLoS One 2019; 14:e0219801. [PMID: 31295320 PMCID: PMC6623463 DOI: 10.1371/journal.pone.0219801] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/01/2019] [Indexed: 12/22/2022] Open
Abstract
Early life feeding practices can directly affect the growth, development, and survival of a child. This study aimed to estimate the frequency of and factors associated with exclusive breastfeeding (EBF) in the first month of life among Amazonian infants. We used data of 1,523 mother-child pairs of the MINA-Brazil birth cohort study. Mothers were interviewed soon after delivery at baseline and by telephone at 30-45 days postpartum (n = 962, 63.2% of those eligible). Kaplan-Meier survival analysis and accelerated failure-time (AFT) models were used to estimate the probability of EBF and the factors associated with EBF duration in the first month. At 30 days of age, 36.7% of the studied population (95% confidence interval [CI] 33.6-39.8) were exclusively breastfed, with a median duration of 16 days. Considering all eligible children for follow-up, the probability of EBF in the first month was 43.7% (95% CI 40.4-46.8), and the median duration was 30 days. The duration of EBF (time-ratio, TR) was 28% longer among multiparous mothers (TR 1.28; 95% CI 1.11-1.48). The use of a pacifier and the occurrence of wheezing were associated with a reduced EBF duration by 33% (TR 0.67; 95% CI 0.58-0.77) and 19% (TR 0.80; 95% CI 0.70-0.93), respectively. These results highlight that EBF among children in the Brazilian Amazon is considerably below international recommendations, and indicate the immediate need to plan and implement actions to promote and support breastfeeding early in life.
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Affiliation(s)
- Paola Soledad Mosquera
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Bárbara H. Lourenço
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Suely G. A. Gimeno
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Maíra B. Malta
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Marcia C. Castro
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States of Ameirca
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Kwon MR, Cress E, Clark WA, Alamian A, Lu Y, Peterson JM. The adipokine C1q TNF related protein 3 (CTRP3) is elevated in the breast milk of obese mothers. PeerJ 2018. [PMID: 29527418 PMCID: PMC5842766 DOI: 10.7717/peerj.4472] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background C1q TNF related protein 3 (CTRP3) is a relatively novel hormonal factor primarily derived from adipose tissue and has anti-diabetic properties. To determine if CTRP3 could play a role in early childhood development, the purpose of this study was to establish the presence of CTRP3 in breast milk (BM) and to determine whether CTRP3 levels were correlated with pregravid obesity status of the mother. Methods Breast milk was collected from breast-feeding mothers who had a pregravid body mass index (BMI) classification of normal weight (BMI 18-25 kg/m2, n = 23) or obese (BMI > 30 kg/m2, n = 14). Immunoprecipitation followed by immunoblot analysis confirmed the presence of CTRP3 in BM. The concentration of CTRP3 in BM samples was determined by ELISA. Additional bioactive components were also measured by commercially available assays: ghrelin, insulin, leptin, adiponectin, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and glucose. Bioactive components in normal weight and obese mothers were compared using unpaired t-test (parametric) and Mann-Whitney U-test (non-parametric), as appropriate. Results The primary findings of this study are that the adipokine CTRP3 is present in BM and CTRP3 levels are increased with pregravid obesity. Additionally, this study independently confirmed previous work that BM from obese mothers has a higher concentration of insulin and leptin. Further, no differences were observed in BM between obese and normal weight mothers in ghrelin, adiponectin, IL-6, TNF-α, or glucose levels. Conclusion This study identified a novel factor in BM, CTRP3, and showed that BM CTRP3 levels higher in obese mothers. Because of the purported insulin sensitizing effect of CTRP3, it is possible that the elevated levels of CTRP3 in the BM of obese mothers may offset negative effects of elevated leptin and insulin levels in the BM of obese mothers. Future studies will need to be conducted to determine the relevance of CTRP3 in BM and to examine the presence of other adipose tissue-derived hormonal factors.
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Affiliation(s)
- Megan R Kwon
- Department of Allied Health Sciences, College of Clinical and Rehabilitative Health Sciences, East Tennessee State University, Johnson City, TN, USA
| | - Eileen Cress
- James H. Quillen VA Medical Center, Mountain Home, TN, USA
| | - W Andrew Clark
- Department of Allied Health Sciences, College of Clinical and Rehabilitative Health Sciences, East Tennessee State University, Johnson City, TN, USA
| | - Arsham Alamian
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Yongke Lu
- Department of Health Sciences, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Jonathan M Peterson
- Department of Health Sciences, College of Public Health, East Tennessee State University, Johnson City, TN, USA
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Koletzko B. Infant feeding and later obesity risk: what is the relationship? SCANDINAVIAN JOURNAL OF FOOD & NUTRITION 2016. [DOI: 10.1080/11026480600655394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Infektionsschutz und spezielle Hygienemaßnahmen in klinischen Disziplinen. KRANKENHAUS- UND PRAXISHYGIENE 2016. [PMCID: PMC7152143 DOI: 10.1016/b978-3-437-22312-9.00005-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Barriuso L, Miqueleiz E, Albaladejo R, Villanueva R, Santos JM, Regidor E. Socioeconomic position and childhood-adolescent weight status in rich countries: a systematic review, 1990-2013. BMC Pediatr 2015; 15:129. [PMID: 26391227 PMCID: PMC4578240 DOI: 10.1186/s12887-015-0443-3] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 09/04/2015] [Indexed: 01/09/2023] Open
Abstract
Background Childhood obesity is a major problem in rich countries due to its high prevalence and its harmful health consequences. An exploratory analysis conducted in the PubMed database highlighted that the number of papers published on the relationship between socioeconomic position (SEP) and childhood-adolescent weight status had risen substantially with respect to an earlier review which had covered the period 1990–2005. Methods To describe the findings on the relationship between SEP and childhood-adolescent weight status in papers published in rich countries from 1990 through 2013, studies were identified in the following databases: PubMed; Web of Knowledge (WOK); PsycINFO; Global Health; and Embase. We included observational studies from the 27 richest OECD countries, which covered study populations aged 0 to 21 years, and used parental education, income and/or occupation as family SEP indicators. A total of 158 papers met the inclusion criteria and reported 134 bivariable and 90 multivariable analyses. Results Examination of the results yielded by the bivariable analyses showed that 60.4 % of studies found an inverse relationship, 18.7 % of studies did not found relationship, and 20.9 % of studies found a relationship that varied depending on another variable, such as age, sex or ethnic group; the corresponding percentages in the multivariable analyses were 51.1, 20.0 and 27.8 %, respectively. Furthermore, 1.1 % found a positive relationship. Conclusion The relationship between SEP and childhood-adolescent weight status in rich countries is predominantly inverse and the positive relationship almost has disappeared. The SEP indicator that yields the highest proportion of inverse relationships is parents’ education. The proportion of inverse relationships is higher when the weight status is reported by parents instead using objective measurements. Electronic supplementary material The online version of this article (doi:10.1186/s12887-015-0443-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura Barriuso
- Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain.
| | - Estrella Miqueleiz
- Department of Sociology, Universidad Pública de Navarra, Campus de Arrosadía, s/n, 31006, Pamplona, Spain.
| | - Romana Albaladejo
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
| | - Rosa Villanueva
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
| | - Juana M Santos
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain. .,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - Enrique Regidor
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain. .,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Pudla KJ, Gonzaléz-Chica DA, de Vasconcelos FDAG. [Effect of breastfeeding on obesity of schoolchildren: influence of maternal education]. REVISTA PAULISTA DE PEDIATRIA 2015; 33:295-302. [PMID: 26100592 PMCID: PMC4620956 DOI: 10.1016/j.rpped.2015.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 01/15/2015] [Accepted: 01/23/2015] [Indexed: 10/31/2022]
Abstract
OBJECTIVE To evaluate the association between duration of breastfeeding (BF) and obesity in schoolchildren of Florianópolis (SC), and the role of possible effect modifiers. METHODS Cross-sectional study with a random sample of 2,826 schoolchildren (7-14 years). Weight and height were measured according to standardized procedures. Data concerning BF and sociodemographic variables were obtained from a questionnaire sent to parents/guardians. Children's nutritional status was evaluated by BMI-for-age z-score for gender (WHO reference curves). Adjusted analyses were performed through logistic regression, considering a possible interaction among variables. RESULTS Prevalence of obesity was 8.6% (95% CI: 7.6-9.7%) and 55.7% (95% CI: 53.8-57.6%) received breastmilk for ≥6 months. BF was not associated with obesity, even in the adjusted analysis. Stratified analysis according to maternal schooling showed that, in children aged 7-10 years and children whose mothers had 0-8 years of schooling, the chance of obesity was lower among those breastfeed for >1 month, especially among those who received breastmilk for 1-5 months (OR=0.22; 95% CI 0.08-0.62). Among children of women with higher educational level (>8 years), the chance of obesity was 44% lower in those who were breastfed for >12 months (p-value for interaction <0.01). This interaction was not found in older children (11-14 years). CONCLUSIONS Among children of women with lower schooling, BF for any period longer than 1 month is protective against obesity; however, for a higher maternal schooling, BF for less than 12 months increases the odds of obesity.
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Turčić Škledar M, Milošević M. Breastfeeding and Time of Complementary Food Introduction as Predictors of Obesity in Children. Cent Eur J Public Health 2015; 23:26-31. [DOI: 10.21101/cejph.a3956] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Yan J, Liu L, Zhu Y, Huang G, Wang PP. The association between breastfeeding and childhood obesity: a meta-analysis. BMC Public Health 2014; 14:1267. [PMID: 25495402 PMCID: PMC4301835 DOI: 10.1186/1471-2458-14-1267] [Citation(s) in RCA: 413] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 12/08/2014] [Indexed: 12/30/2022] Open
Abstract
Background The increase in childhood obesity is a serious public health concern. Several studies have indicated that breastfed children have a lower risk of childhood obesity than those who were not breastfed, while other studies have provided conflicting evidence. The objective of this meta-analysis was to investigate the association between breastfeeding and the risk of childhood obesity. Methods The PubMed, EMBASE and CINAHL Plus with Full Text databases were systematically searched from start date to 1st August 2014. Based on the meta-analysis, pooled adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated. I2 statistic was used to evaluate the between-study heterogeneity. Funnel plots and Fail-safe N were used to assess publication bias and reliability of results, and results from both Egger test and Begg test were reported. Results Twenty-five studies with a total of 226,508 participants were included in this meta-analysis. The studies’ publication dates ranged from 1997 to 2014, and they examined the population of 12 countries. Results showed that breastfeeding was associated with a significantly reduced risk of obesity in children (AOR = 0.78; 95% CI: 0.74, 0.81). Categorical analysis of 17 studies revealed a dose-response effect between breastfeeding duration and reduced risk of childhood obesity. Conclusion Results of our meta-analysis suggest that breastfeeding is a significant protective factor against obesity in children.
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Affiliation(s)
| | | | | | - Guowei Huang
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St, John's, Newfoundland and Labrador A1B 3 V6, Canada.
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Reynolds D, Hennessy E, Polek E. Is breastfeeding in infancy predictive of child mental well-being and protective against obesity at 9 years of age? Child Care Health Dev 2014; 40:882-90. [PMID: 24354743 DOI: 10.1111/cch.12126] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2013] [Indexed: 01/13/2023]
Abstract
BACKGROUND Preventing child mental health problems and child obesity have been recognized as public health priorities. The aim of the present study was to examine whether being breastfed (at all or exclusively) in infancy was a predictor of mental well-being and protective against risk of obesity at age 9. METHODS Cross-sectional data from a large, nationally representative cohort study in the Republic of Ireland was used (n = 8357). Data on breastfeeding were retrospectively recalled. Child mental well-being was assessed using a parent-completed Strengths and Difficulties Questionnaire (SDQ). Child's height and weight were measured using scientifically calibrated instruments. RESULTS Logistic regression analyses indicated that, after controlling for a wide range of potential confounding variables, being breastfed in infancy was associated with a 26% (P < 0.05) reduction in the risk of an abnormal SDQ score at 9 years. Being breastfed remained a significant predictor of child mental well-being when child obesity was controlled for, indicating that being breastfed, independent of child obesity, is a predictor of child mental well-being. The results of a second logistic regression indicated that, after controlling for a wide range of potential confounding variables, being breastfed for between 11 and 25 weeks was associated with a 36% (P < 0.05) reduction in the risk of obesity at 9 years, while being breastfed for 26 weeks or longer was associated with a 48% (P < 0.01) reduction in the risk of obesity at 9 years. CONCLUSIONS Breastfeeding in infancy may protect against both poor mental well-being and obesity in childhood.
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Affiliation(s)
- D Reynolds
- St Michael's House Willowfield Park, Dublin, Ireland
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de Albuquerque Maia L, Lisboa PC, de Oliveira E, da Silva Lima N, Lima ICB, Lopes RT, Ruffoni LDG, Nonaka KO, de Moura EG. Bone metabolism in obese rats programmed by early weaning. Metabolism 2014; 63:352-64. [PMID: 24355624 DOI: 10.1016/j.metabol.2013.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 11/11/2013] [Accepted: 11/12/2013] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Obesity and osteoporosis seem to have a common pathogenesis, especially because bone and adipose tissue have common origins. Since early weaning (EW) decreases adipogenesis and osteogenesis in neonate, further programming for obesity and hyperleptinemia, we hypothesized that these changes in adipogenesis could affect bone metabolism. MATERIALS/METHODS Lactating rats were separated into 3 groups: control - dams whose pups ate milk throughout lactation; mechanical EW (MEW) - dams were involved with a bandage interrupting suckling in the last 3days of lactation; pharmacological EW (PEW) - dams were bromocriptine-treated (0.5mg/twice a day via intraperitoneal injection) 3days before weaning. The adult offspring was subjected to dual-energy X-ray absorptiometry and bone tissue was also evaluated by computed tomography, microcomputed tomography and biomechanical tests, beyond serum analyses. RESULTS MEW and PEW presented higher total bone mineral density (BMD), total bone mineral content, spine BMD and bone area in postnatal day 150 (PN150). In PN180, both groups also presented increase of these parameters and higher femur BMD and fourth lumbar vertebra (LV4) BMD, femoral head radiodensity and LV4 vertebral body radiodensity, trabecular number, stiffness and break load; lower trabecular separation, maximal deformation and break deformation, and also hyperleptinemia and higher visceral fat mass and 25-hydroxivitamin D, whereas parathyroid hormone was unchanged. Serum C-terminal cross-linked telopeptide of type I collagen was lower for both groups. CONCLUSIONS Since both models program for obesity and increased bone mass, and leptin increases plasma vitamin D levels, probably leptin is the link between obesity and higher bone mass.
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Affiliation(s)
- Lígia de Albuquerque Maia
- Department of Physiological Sciences, State University of Rio de Janeiro, State University of Rio de Janeiro, Rio de Janeiro, RJ 20550-030, Brazil
| | - Patrícia Cristina Lisboa
- Department of Physiological Sciences, State University of Rio de Janeiro, State University of Rio de Janeiro, Rio de Janeiro, RJ 20550-030, Brazil
| | - Elaine de Oliveira
- Department of Physiological Sciences, State University of Rio de Janeiro, State University of Rio de Janeiro, Rio de Janeiro, RJ 20550-030, Brazil
| | - Natália da Silva Lima
- Department of Physiological Sciences, State University of Rio de Janeiro, State University of Rio de Janeiro, Rio de Janeiro, RJ 20550-030, Brazil
| | - Inaya Correa Barbosa Lima
- Nuclear Instrumentation Laboratory, COPPE-PEN, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21941-972, Brazil
| | - Ricardo Tadeu Lopes
- Nuclear Instrumentation Laboratory, COPPE-PEN, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21941-972, Brazil
| | | | - Keico Okino Nonaka
- Laboratory of Exercise Physiology, Federal University of São Carlos, São Carlos, São Paulo, SP 13565-905, Brazil
| | - Egberto Gaspar de Moura
- Department of Physiological Sciences, State University of Rio de Janeiro, State University of Rio de Janeiro, Rio de Janeiro, RJ 20550-030, Brazil.
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Beyerlein A, Kusian D, Ziegler AG, Schaffrath-Rosario A, von Kries R. Classification tree analyses reveal limited potential for early targeted prevention against childhood overweight. Obesity (Silver Spring) 2014; 22:512-7. [PMID: 24115762 DOI: 10.1002/oby.20628] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 09/10/2013] [Accepted: 09/13/2013] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Whether specific combinations of risk factors in very early life might allow identification of high-risk target groups for overweight prevention programs was examined. DESIGN AND METHODS Data of n = 8981 children from the German KiGGS study were analyzed. Using a classification tree approach, predictive risk factor combinations were assessed for overweight in 3-6, 7-10, and 11-17-year-old children. RESULTS In preschool children, the subgroup with the highest overweight risk were migrant children with at least one obese parent, with a prevalence of 36.6 (95% confidence interval or CI: 22.9, 50.4)%, compared to an overall prevalence of 10.0 (8.9, 11.2)%. The prevalence of overweight increased from 18.3 (16.8, 19.8)% to 57.9 (46.6, 69.3)% in 7-10-year-old children, if at least one parent was obese and the child had been born large-for-gestational-age. In 11-17-year-olds, the overweight risk increased from 20.1 (18.9, 21.3)% to 63.0 (46.4, 79.7)% in the highest risk group. However, high prevalence ratios were found only in small subgroups, containing <10% of all overweight cases in the respective age group. CONCLUSIONS Our results indicate only a limited potential for early targeted preventions against overweight in children and adolescents.
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Affiliation(s)
- Andreas Beyerlein
- Institute of Diabetes Research, Helmholtz Zentrum München, Munich, Germany; Forschergruppe Diabetes der Technischen Universität München, Munich, Germany
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18
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Prevention of childhood obesity risk from a pre-conceptual and pregnancy care perspective. J Perinat Neonatal Nurs 2014; 28:14-6. [PMID: 24476647 DOI: 10.1097/jpn.0000000000000005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Haschke F, Ziegler EE, Grathwohl D. Fast Growth of Infants of Overweight Mothers: Can It Be Slowed Down? ANNALS OF NUTRITION AND METABOLISM 2014; 64 Suppl 1:19-24. [DOI: 10.1159/000360505] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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20
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Nicotinic Cholinergic Signaling in Adipose Tissue and Pancreatic Islets Biology: Revisited Function and Therapeutic Perspectives. Arch Immunol Ther Exp (Warsz) 2013; 62:87-101. [DOI: 10.1007/s00005-013-0266-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 11/14/2013] [Indexed: 12/14/2022]
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21
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Scientific Opinion on nutrient requirements and dietary intakes of infants and young children in the European Union. EFSA J 2013. [DOI: 10.2903/j.efsa.2013.3408] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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22
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Rossiter MD, Evers SE. Infant Feeding Practices and: Children’s Weight Status. CAN J DIET PRACT RES 2013; 74:107-13. [PMID: 24018001 DOI: 10.3148/74.3.2013.107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Melissa D. Rossiter
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Susan E. Evers
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON
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23
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Zarrati M, Shidfar F, Moradof M, Nasiri Nejad F, Keyvani H, Rezaei Hemami M, Razmpoosh E. Relationship between Breast Feeding and Obesity in Children with Low Birth Weight. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:676-82. [PMID: 24578834 PMCID: PMC3918191 DOI: 10.5812/ircmj.11120] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 04/25/2013] [Accepted: 05/20/2013] [Indexed: 11/30/2022]
Abstract
Background Breast feeding appears to play a role in determining obesity and abdominal obesity during childhood, specifically in children with a history of low birth weight. Objective The purpose of this study is to investigate the relation of breast-feeding with either of abdominal obesity and obesity among Iranian school children. Materials and Methods A total of 1184 students (625 girls and 559 boys), aged 10 to 13 years old, were selected from 112 governmental elementary schools in Iran. Height, weight, waist circumference and blood pressure were measured using standard instruments and a pretested standardized questionnaire was performed for compiling information about family economics and educational level, first–degree family history of obesity, history of breast feeding, food pattern and birth weight, as well. Results 13.68% (n = 160) of students had a history of low birth weight, and 26.41% of them had abdominal obesity. Of all participants, 22.04% were overweight and 5.32% were obese which was more prevalent in girls than in boys (P = 0.03). First-degree family history of obesity (P = 0.001), excessive gestational weight gain (P = 0.001) and birth weight (P = 0.01) were significantly correlated with the prevalence of obesity and abdominal obesity during childhood. Moreover the prevalence of abdominal obesity in children with low birth weight was significantly correlated with breast feeding (P = 0.04); But this relation was not significantly about obesity in our participants (P = 0.9). Furthermore duration of breast feeding was significantly and inversely correlated with obesity and abdominal obesity in schoolchildren with low birth weight (P = 0.01). Conclusions The results suggest that Breast feeding and its long-term consequences were important factors for preventing metabolic syndrome criteria in childhood and later years of life span. With regard to the increasing prevalence of obesity in children, more research is urgently needed to clarify whether breast feeding have negative consequences for the risk of chronic disease in children, especially in children with low birth weight.
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Affiliation(s)
- Mitra Zarrati
- Department of Nutrition and Biochemistry, Faculty of Health, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Farzad Shidfar
- Department of Nutrition and Biochemistry, Faculty of Health, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Farzad Shidfar, Department of Nutrition and Biochemistry, Faculty of Health, Tehran University of Medical Sciences, Tehran, IR Iran, Tel: +98 2188779118, Fax: +98 2188779487, E-mail:
| | - Maryam Moradof
- Department of Exercise Physiology, Islamic Azad University, Tehran, IR Iran
| | - Farinaz Nasiri Nejad
- Department of Physiology, Medicine Faculty, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Hossein Keyvani
- Department of Virology, Medicine Faculty, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mohsen Rezaei Hemami
- Cardiovascular Research Center, Rajaee Hospital, Tehran University of Medical Sciences Tehran, IR Iran
| | - Elham Razmpoosh
- Department of Nutrition, Faculty of Health, Qazvin University of Medical Science, Qazvin, IR Iran
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Nagahara K, Dobashi K, Itabashi K. Feeding choice has a gender-associated effect on infant growth. Pediatr Int 2013; 55:481-7. [PMID: 23659739 DOI: 10.1111/ped.12123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 01/28/2013] [Accepted: 02/01/2013] [Indexed: 01/18/2023]
Abstract
BACKGROUND Appropriate nutrition during childhood is important for preventing future development of lifestyle-related diseases. The effect of feeding choice on infant growth in Japan is not known. METHODS Data from 204 healthy schoolchildren (age, 6-9 years) were obtained retrospectively from their parents by questionnaires. Breast-fed (BF) and formula-fed (FF) groups were defined as those fed only breast milk or formula milk at 4 months of age, respectively. There were 71 children (M/F, 31/40) in BF and 30 (M/F, 19/11) in FF. Anthropometric data at birth, and at 1, 4, 7, 10, 18, and 36 months of age in male and female infants were compared between the groups. RESULTS In male infants, height was significantly lower at 4 months, bodyweight was lower from 4 to 18 months, and body mass index (BMI) was lower from 10 to 36 months in BF than in FF. The standard deviation scores (SDS) for height, weight and BMI had a similar pattern. No significant differences were observed for these variables for female infants in BF compared with FF. Multiple regression analysis showed that birthweight, mother's pre-pregnancy weight, and infant feeding choice were significant factors associated with weight-SDS at 18 and 36 months. Feeding choice was the only factor associated with BMI-SDS at 18 months. CONCLUSIONS Infant feeding choice had a gender-associated effect on growth during infancy. When evaluating infant growth, not only birthweight and mother's pre-pregnancy weight, but also infant feeding choice and gender should be considered.
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Affiliation(s)
- Keiko Nagahara
- Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan
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25
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Żądzińska E, Rosset I. Pre-natal and perinatal factors affecting body mass index in pre-pubertal Polish children. Ann Hum Biol 2013; 40:477-84. [DOI: 10.3109/03014460.2013.806589] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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26
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Gong YH, Ji CY, Shan JP. Longitudinal study on infants' temperament and physical development in Beijing, China. Int J Nurs Pract 2013; 19:487-97. [PMID: 24093740 DOI: 10.1111/ijn.12104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The objective of this longitudinal study is to explore the relationship between temperament and physical development among infants in Beijing, China. A total of 1117 term, normal and singleton infants were followed regularly for 12 months. Body weight and horizontal length were measured at 42 days and monthly from the third to twelfth month of their lives. Infants' temperament was assessed using the revised Chinese infants' temperament scale when the infants were 6 months. There was a significant difference on temperament dimensions between infants' genders (P < 0.05). Infants' weight and length were significantly related to their parents' weight and height. Infants with positive temperaments (easy and intermediate) were heavier than those with negative temperaments (difficult and slow to warm up) (P < 0.05). The horizontal length of boys was related to their temperament categories (P < 0.05). Infants' weight and length were significantly related to their temperament category and parents' weight and height.
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Affiliation(s)
- Yu-hua Gong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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The effect of the season of birth and of selected maternal factors on linear enamel thickness in modern human deciduous incisors. Arch Oral Biol 2013; 58:951-63. [PMID: 23583018 DOI: 10.1016/j.archoralbio.2013.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 01/18/2013] [Accepted: 03/04/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Development of human tooth enamel is a part of a foetus's development; its correctness is the outcome of genetic and maternal factors shaping its prenatal environment. Many authors reported that individuals born in different seasons experience different early developmental conditions during pregnancy. In this study, we investigated the effects of season of birth and selected maternal factors on enamel thickness of deciduous incisors. DESIGN Dental sample comprises 60 deciduous incisors. The parents who handed over their children's teeth for research fill in questionnaires containing questions about the course of pregnancy. All teeth were sectioned in the labio-linqual plane using diamond blade (Buechler IsoMet 1000). The final specimens were observed by way of scanning electron microscopy at magnifications 80× and 320×. The thickness of total enamel (TE), prenatally (PE) and postnatally (PSE) formed enamel was measured. RESULTS Children born in summer and in spring (whose first and second foetal life fall on autumn and winter) have the thinnest enamel. Season of birth, number of children in family, diseases and spasmolytic medicines using by mother during pregnancy explained almost 13% of the variability of TE. Regression analysis proved a significant influence of the season of birth and selected maternal factors on the PE thickness - these factors explained over 17% of its variability. Neither of analysed variables had influenced PSE. CONCLUSIONS Our findings suggests that the thickness of enamel of deciduous incisors depends on the season of birth and some maternal factors. The differences were observed only in the prenatally formed enamel.
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Erenoglu N, Ayranci U, Son O. Eating habits and lifestyle in a group Turkish primary education children. Health (London) 2013. [DOI: 10.4236/health.2013.53067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Schellong K, Schulz S, Harder T, Plagemann A. Birth weight and long-term overweight risk: systematic review and a meta-analysis including 643,902 persons from 66 studies and 26 countries globally. PLoS One 2012; 7:e47776. [PMID: 23082214 PMCID: PMC3474767 DOI: 10.1371/journal.pone.0047776] [Citation(s) in RCA: 252] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 09/17/2012] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Overweight is among the major challenging health risk factors. It has been claimed that birth weight, being a critical indicator of prenatal developmental conditions, is related to long-term overweight risk. In order to check this important assumption of developmental and preventive medicine, we performed a systematic review and comprehensive meta-analysis. METHODS AND FINDINGS Relevant studies published up to January 2011 that investigated the relation between birth weight and later risk of overweight were identified through literature searches using MEDLINE and EMBASE. For meta-analysis, 66 studies from 26 countries and five continents were identified to be eligible, including 643,902 persons aged 1 to 75 years. We constructed random-effects and fixed-effects models, performed subgroup-analyses, influence-analyses, assessed heterogeneity and publication bias, performed meta-regression analysis as well as analysis of confounder adjusted data. Meta-regression revealed a linear positive relationship between birth weight and later overweight risk (p<0.001). Low birth weight (<2,500 g) was found to be followed by a decreased risk of overweight (odds ratio (OR) =0.67; 95% confidence interval (CI) 0.59-0.76). High birth weight (>4,000 g) was associated with increased risk of overweight (OR=1.66; 95% CI 1.55-1.77). Results did not change significantly by using normal birth weight (2,500-4,000 g) as reference category (OR=0.73, 95% CI 0.63-0.84, and OR=1.60, 95% CI 1.45-1.77, respectively). Subgroup- and influence-analyses revealed no indication for bias/confounding. Adjusted estimates indicate a doubling of long-term overweight risk in high as compared to normal birth weight subjects (OR=1.96, 95% CI 1.43-2.67). CONCLUSIONS Findings demonstrate that low birth weight is followed by a decreased long-term risk of overweight, while high birth weight predisposes for later overweight. Preventing in-utero overnutrition, e.g., by avoiding maternal overnutrition, overweight and/or diabetes during pregnancy, might therefore be a promising strategy of genuine overweight prevention, globally.
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Affiliation(s)
- Karen Schellong
- Clinic of Obstetrics, Division of ‘Experimental Obstetrics’, Charité – University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Sandra Schulz
- Clinic of Obstetrics, Division of ‘Experimental Obstetrics’, Charité – University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Thomas Harder
- Clinic of Obstetrics, Division of ‘Experimental Obstetrics’, Charité – University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Andreas Plagemann
- Clinic of Obstetrics, Division of ‘Experimental Obstetrics’, Charité – University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany
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Plagemann A, Harder T. Breast feeding and the risk of obesity and related metabolic diseases in the child. Metab Syndr Relat Disord 2012; 3:222-32. [PMID: 18370791 DOI: 10.1089/met.2005.3.222] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Breast feeding is the best way to nurture healthy newborns of healthy mothers. A number of studies have shown that breast feeding may protect against the later development of obesity and related metabolic diseases. Using data from our own meta-analysis as well as studies by other groups, in this review we systematically examine the current state of evidence regarding this topic. Breast feeding, in general, is shown to be associated later in a child's life with decreased risk of overweight, decreased blood cholesterol and blood pressure, and a reduced risk of developing type 2 diabetes. Additionally, we review data of our Kaulsdorf Cohort Study (KCS) showing, however, that these effects might be reversed when the mother is affected by a non-communicable disease such as diabetes mellitus, which alters the composition of breast milk. In particular, exposure to breast milk from diabetic mothers during the first days of life (first week; early neonatal period) seems to increase rather than decrease risk of overweight and, consecutively, impaired glucose tolerance in childhood. Taken together, current findings show clearly that breast feeding is effective in lowering the risk of developing key features of the metabolic syndrome in later life, and should therefore be promoted. With increasing prevalence of overweight and diabetes in women, however, more research is urgently needed to clarify whether breast feeding might even have negative consequences for risk of overweight and diabetogenic disturbances when the mother suffers from a metabolic disorder. From a more general perspective, breast feeding and its long-term consequences are an important paradigm for "perinatal programming" of health and disease.
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Affiliation(s)
- Andreas Plagemann
- Clinic of Obstetrics, Division of Experimental Obstetrics, Charité University Medicine Berlin, Berlin, Germany
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31
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Bogen DL, Hanusa BH, Whitaker RC. The Effect of Breast-Feeding with and without Formula Use on the Risk of Obesity at 4 Years of Age. ACTA ACUST UNITED AC 2012; 12:1527-35. [PMID: 15483218 DOI: 10.1038/oby.2004.190] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To determine the minimal duration of breast-feeding required to protect against later obesity, whether the concurrent use of formula lessened any protective effect of breast-feeding, and what maternal or child characteristics might modify the association between breast-feeding and child obesity. RESEARCH METHODS AND PROCEDURES This was a retrospective cohort study. Participants were 73,458 white and black low-income children followed from birth through 4 years of age. Obesity at age 4 years was defined as measured BMI >or= 95th percentile. Feeding exposure was based on breast-feeding duration and the age of formula initiation. Covariates were obtained from the children's birth certificates. RESULTS At age 4 years, the prevalence of obesity was 11.5%. Only 16% of children were breast-fed 8 weeks or longer. Breast-feeding was associated with a reduced risk of obesity only in white children whose mothers had not smoked in pregnancy. In this subgroup, the reduction in obesity risk (adjusted odds ratio, 95% confidence interval), compared with those never breast-fed, occurred only for children who were breast-fed at least 16 weeks without formula (0.71, 0.56 to 0.92) or at least 26 weeks with concurrent formula (0.70, 0.61 to 0.81). Among whites whose mothers smoked in pregnancy and among blacks, breast-feeding was not associated with a reduced risk of obesity at age 4 years. DISCUSSION In a population of low-income children, breast-feeding was associated with a reduced risk of obesity at age 4 years only among whites whose mothers did not smoke in pregnancy and only when breast-feeding continued for at least 16 weeks without formula or at least 26 weeks with formula.
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Affiliation(s)
- Debra L Bogen
- General Academic Pediatrics, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, DeSoto G-205, Pittsburgh, PA 15213, USA.
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Young BE, Johnson SL, Krebs NF. Biological determinants linking infant weight gain and child obesity: current knowledge and future directions. Adv Nutr 2012; 3:675-86. [PMID: 22983846 PMCID: PMC3648749 DOI: 10.3945/an.112.002238] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Childhood obesity rates have reached epidemic proportions. Excessive weight gain in infancy is associated with persistence of elevated weight status and later obesity. In this review, we make the case that weight gain in the first 6 mo is especially predictive of later obesity risk due to the metabolic programming that can occur early postpartum. The current state of knowledge regarding the biological determinants of excess infant weight gain is reviewed, with particular focus on infant feeding choice. Potential mechanisms by which different feeding approaches may program the metabolic profile of the infant, causing the link between early weight gain and later obesity are proposed. These mechanisms are likely highly complex and involve synergistic interactions between endocrine effects and factors that alter the inflammatory and oxidative stress status of the infant. Gaps in current knowledge are highlighted. These include a lack of data describing 1) what type of infant body fat distribution may impart risk and 2) how maternal metabolic dysfunction (obesity and/or diabetes) may affect milk composition and exert downstream effects on infant metabolism. Improved understanding and management of these early postnatal determinants of childhood obesity may have great impact on reducing its prevalence.
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Frequency of under- and overweight among children and adolescents during the economic transition in Poland. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2012; 63:216-32. [PMID: 22608527 DOI: 10.1016/j.jchb.2012.03.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 03/01/2012] [Indexed: 11/20/2022]
Abstract
The aim of this study is to examine the prevalence of underweight, overweight and obesity, using International Obesity Task Force (IOTF) criteria, in four cohorts of children and adolescents living in Poland in different economic eras: communist economy (1977/1978), crisis of the 1980s (1987/1988), political and economic transformation (1992/1994) and the free market economy (2002/2004). Analysis was conducted on a database including 10,934 records for children of the age 7-18 years. In Poland, in the last 26 years of economic and political transformations, the epidemic of obesity was not noticed but the growing incidence of children and adolescents with body mass deficit was observed (p<0.0001) (20.2% of girls in 2002/2004 vs. 11.0% in 1977/1978 and 12.1% of boys in 2002/2004 vs. 7.2% in 1977/1978). Lower parental education and a higher number of children in a family resulted in a higher prevalence of underweight (odds ratio [OR] fluctuated from 1.26 to 1.63). The social effects of the political transformation in Poland significantly affected families with low socio-economic status (SES), and especially more eco-sensitive boys. This result is opposite to the trends observed in Western countries and makes an important contribution to the current knowledge of the course of further changes in weight-to-height ratio at a global scale.
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McCrory C, Layte R. Breastfeeding and risk of overweight and obesity at nine-years of age. Soc Sci Med 2012; 75:323-30. [PMID: 22560796 DOI: 10.1016/j.socscimed.2012.02.048] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 11/21/2011] [Accepted: 02/27/2012] [Indexed: 10/28/2022]
Abstract
Whether breastfeeding is protective against the development of childhood overweight and obesity remains the subject of considerable debate. Although a number of meta-analyses and syntheses of the literature have concluded that the greater preponderance of evidence indicates that breastfeeding reduces the risk of obesity, these findings are by no means conclusive. The present study used data from the Growing Up in Ireland study to examine the relationship between retrospectively recalled breastfeeding data and contemporaneously measured weight status for 7798 children at nine-years of age controlling for a wide range of variables including; socio-demographic factors, the child's own lifestyle-related behaviours, and parental BMI. The results of the multivariable analysis indicated that being breastfed for between 13 and 25 weeks was associated with a 38 percent (p < 0.05) reduction in the risk of obesity at nine-years of age, while being breastfed for 26 weeks or more was associated with a 51 percent (p < 0.01) reduction in the risk of obesity at nine-years of age. Moreover, results pointed towards a dose-response patterning in the data for those breastfed in excess of 4 weeks. Possible mechanisms conveying this health benefit include slower patterns of growth among breastfed children, which it is believed, are largely attributable to differences in the composition of human breast milk compared with synthesised formula. The suggestion that the choice of infant feeding method has important implications for health and development is tantalising as it identifies a modifiable health behaviour that is amenable to intervention in primary health care settings and has the potential to improve the health of the population.
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Affiliation(s)
- Cathal McCrory
- The Economic and Social Research Institute, Whitaker Square, Sir John Rogerson's Quay, Dublin 2, Ireland.
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Abstract
Childhood obesity is a profoundly complex problem and serves as an example of a biospsychosocial issue. Scientific inquiry has provided incredible insight into the complex etiology of weight gain but must be viewed as an interaction between a human's propensity to conserve calories for survival in a world with an abundance of it. This article provides a brief overview divided between biological (nature) and psychosocial and behavioral (nurture) factors.
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Affiliation(s)
- Joseph A Skelton
- Department of Pediatrics, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
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De Kroon MLA, Renders CM, Buskermolen MPJ, Van Wouwe JP, van Buuren S, Hirasing RA. The Terneuzen Birth Cohort. Longer exclusive breastfeeding duration is associated with leaner body mass and a healthier diet in young adulthood. BMC Pediatr 2011; 11:33. [PMID: 21569265 PMCID: PMC3112108 DOI: 10.1186/1471-2431-11-33] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Accepted: 05/10/2011] [Indexed: 01/22/2023] Open
Abstract
Background Breastfeeding (BF) is protective against overweight and is associated with dietary behaviour. The aims of our study were to assess the relationship between exclusive BF duration and BMI, waist circumference (WC) and waist-hip ratio (WHR) at adulthood, and to study whether dietary behaviour could explain the relationship between BF duration and the proxies of fat mass. Methods In 2004-2005, 822 subjects from the Terneuzen Birth Cohort (n = 2,604), aged 18-28 years, filled in postal questionnaires including sociodemographic factors and aspects of dietary behaviour (dietary pattern, and consumption of fruit and vegetables, snacks, sweetened beverages and alcohol); 737 subjects also underwent anthropometric measurements of weight, height, and waist and hip circumference. The relationship between exclusive BF duration and dietary outcomes was investigated by logistic regression analysis. The relationships of BF duration with the anthropometric measures were investigated by linear regression analyses. All results were corrected for age, gender and possible confounders. Finally, regression analyses were performed to investigate if diet factors had a mediating effect on the relationship between BF duration and fat mass. Results A significant inverse dose-response relationship of BF duration was found for BMI (β-0.13, SE 0.06), WC (β-0.39, SE 0.18) and WHR (β-0.003, SE 0.001), after correction for age, gender and confounders. The odds ratio (OR) of exclusive BF duration in months for a breakfast frequency of at least 5 times a week was 1.16 (95%CI 1.06-1.27), and for snack consumption of less than twice a week was 1.15 (95%CI 1.06-1.25). Both ORs were corrected for age, gender and confounders. For other dietary outcomes, the results point in the same direction, i.e. a positive relationship with BF duration, but these were not statistically significant. A mediating effect of the diet factors on the association between BF and anthropometric outcomes was not shown. Conclusions Exclusive BF duration had a significant inverse dose-response relationship with BMI, WC and WHR at young adulthood. BF duration was positively related to a healthier diet at adulthood, but this did not explain the protective effect of BF against body fat. Our results underline the recommendation of the WHO to exclusively breastfeed for 6 months or longer.
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Affiliation(s)
- Marlou L A De Kroon
- Department of Public and Occupational Health, The EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
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Methodology for longitudinal assessment of nutrient intake and dietary habits in early childhood in a transnational multicenter study. J Pediatr Gastroenterol Nutr 2011; 52:96-102. [PMID: 21150649 DOI: 10.1097/mpg.0b013e3181f28d33] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES The aim of this study was to describe developed methods for repeated longitudinal assessment of feeding habits and nutrient intakes of children in a multicenter trial in different European countries and to assess feasibility. PATIENTS AND METHODS Nutrient intake and dietary habits of formula-fed and breast-fed infants were assessed in 5 European countries (Belgium, Germany, Italy, Poland, and Spain). Prospective age-adapted 3-day weighed food records were used from birth to 2 years of age (1, 2, 3, 4, 5, 6, 7, 8, 9, 12, 18, and 24 months). Standard operating procedures were developed to check each day's food record for quality. Dietitians were trained by using standardized food records. Data entry and nutrient analyses were performed with a dedicated software developed for this project. RESULTS Of 1368 study participants, at least one 3-day food record was available; of 25,367 1-day food records, data on quality could be evaluated. Overall, between 81% and 97% (depending on the country) of the food records had been completed with high accuracy. The implementation of solid foods and regular family foods decreased the recording quality significantly during the 2-year time course (P < 0.001). The standardized training shows coefficients of variation up to a maximum of about 41%, indicating differences in data entry. CONCLUSIONS The experiences gathered indicate that collecting dietary and behavioral data in a large number of infants from different cultures is a challenging but feasible task in which permanent supervision and training is vital. However, we conclude that the established methodology is suitable to obtain valuable results on current infant nutrition practice in Europe.
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Mangrio E, Lindström M, Rosvall M. Early life factors and being overweight at 4 years of age among children in Malmö, Sweden. BMC Public Health 2010; 10:764. [PMID: 21159203 PMCID: PMC3022848 DOI: 10.1186/1471-2458-10-764] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Accepted: 12/15/2010] [Indexed: 11/24/2022] Open
Abstract
Background Rising rates of obesity and overweight is an increasing public health problem all over the world. Recent research has shown the importance of early life factors in the development of child overweight. However, to the best of our knowledge there are no studies investigating the potential synergistic effect of early life factors and presence of parental overweight on the development of child overweight. Methods The study was population-based and cross-sectional. The study population consisted of children who visited the Child Health Care (CHC) centers in Malmö for their 4-year health check during 2003-2008 and whose parents answered a self-administered questionnaire (n = 9009 children). Results The results showed that having overweight/obese parents was strongly associated with the child being overweight or obese. Furthermore, there was an association between unfavorable early life factors (i.e., mother smoking during pregnancy, presence of secondhand tobacco smoke early in life, high birth weight) and the development of child overweight/obesity at four years of age, while breastfeeding seemed to have a protective role. For example, maternal smoking during pregnancy was associated with an odds ratio (OR) of 1.47 (95% CI: 1.22, 1.76) for overweight and 2.31 (95% CI: 1.68, 3.17) for obesity. The results further showed synergistic effects between parental overweight and exposure to unfavourable early life factors in the development of child overweight. Conclusions The present study shows the importance of early life factors in the development of child overweight and obesity, and thus puts focus on the importance of early targeted interventions.
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Affiliation(s)
- Elisabeth Mangrio
- Department of Clinical Sciences, Social Medicine and Health Politics, Lund University, Malmö, Sweden
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Associations between diet and (in)activity behaviours with overweight and obesity among 10–18-year-old Czech Republic adolescents. Public Health Nutr 2010; 13:1701-7. [DOI: 10.1017/s1368980010002259] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectivesTo assess the prevalence of normal weight, overweight and obesity among 10–18-year-old Czech Republic adolescents and to assess the association between energy balance-related behaviours and overweight/obesity.DesignCross-sectional data from ‘The 6th Nation-wide Anthropological Survey of Children and Adolescents 2001 Czech Republic’ have been used.SettingHeight and weight were objectively measured. Data on adolescents’ behaviours were assessed with self-reported questionnaires. Background variables were assessed by means of a parental questionnaire. Multi-level logistic regression analyses were conducted to assess behavioural risk factors of being overweight/obese.SubjectsData on 31 228 adolescents aged 10–18 years were included in the present study.ResultsThe highest prevalence of being overweight or obese was found among boys and younger adolescents. Boys were more physically active, watched more television (TV) and used the computer more often than did girls. Being on a diet and skipping meals were positively associated with being overweight/obese, independent of gender. In boys (10–14 years old), inverse associations with being overweight/obese were found when being more physically active. Monitoring weight showed inverse relations with being overweight/obese in 15–18-year-old girls. Watching TV more than 7 h a week was positively associated with being overweight/obese in 15–18-year-old girls, and was found to be negatively associated in boys of the same age group.ConclusionsThese behaviours should be targeted when preventing overweight and obesity among Czech Republic adolescents. Studies using better measures of energy balance-related behaviours are needed.
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Shields L, Mamun AA, O'Callaghan M, Williams GM, Najman JM. Breastfeeding and obesity at 21 years: a cohort study. J Clin Nurs 2010; 19:1612-7. [PMID: 20579201 DOI: 10.1111/j.1365-2702.2009.03015.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To determine the influence of breastfeeding on overweight and obesity, as determined by body mass index in early adulthood. BACKGROUND Obesity is a contemporary epidemic and linked to increased risk of later cardiovascular disease and type 2 diabetes. The success of long-term treatment is modest. Protective factors, such as potentially, and breastfeeding, are few and very important. There are uncertainties as to whether breastfeeding has a protective effect, especially in adults, or whether it is a reflection of other markers of obesity that are more linked to cardiovascular disease and diabetes risk. Some studies suggest that breastfeeding is protective in later life for cardiovascular disease and atherosclerosis. DESIGN Epidemiological analysis of longitudinal data set. METHODS We collected data about breastfeeding duration, body mass index of children at 21 years and confounding variables from an ongoing longitudinal study of a singleton birth cohort of 7223 children in Brisbane. We assessed the duration of breastfeeding at six months and prevalence of overweight and obesity at 21 years by body mass index. Adjustment for potential confounders was by multivariable multinomial logistic regression. RESULTS Data were available for 2553 young adults. In neither the unadjusted or adjusted analysis was longer duration of breastfeeding associated with reduction in obesity at 21 years. CONCLUSIONS Findings of this investigation are consistent with breastfeeding not independently affecting body mass index in young adults. RELEVANCE TO CLINICAL PRACTICE Breastfeeding has a range of important benefits for infants, mothers and families, although duration of breastfeeding may not play a substantial role in preventing adult onset obesity.
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Affiliation(s)
- Linda Shields
- Curtin Health Innovation Research Institute, Curtin University and Princess Margaret Children's Hospital, Perth, Western Australia.
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Rogero MM, Borges MC, Pires ISDO, Tirapegui J. O desmame precoce afeta o ganho de peso e a composição corporal em camundongos adultos? REV NUTR 2010. [DOI: 10.1590/s1415-52732010000100010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Avaliar o efeito do desmame precoce sobre o ganho de peso e a composição corporal de camundongos adultos jovens. MÉTODOS: Camundongos Swiss Webster, machos, foram desmamados precocemente (14º dia de vida) ou amamentados até o 21º dia de vida (grupo controle). Após o desmame, os animais foram alimentados com ração elaborada para roedores em crescimento até o 63º dia de vida, quando então foram sacrificados. RESULTADOS: O peso corporal dos animais do grupo desmamado de forma precoce foi significantemente maior no 28º, 35º e no 63º dias de vida em relação ao grupo controle (p<0,05). Porém, o consumo de ração não diferiu entre os grupos. A concentração sérica de proteínas totais, albumina e ferro, bem como a concentração hepática, muscular e cerebral de proteínas, ácido desoxirribonucléico e a relação proteína/ácido ribonucléico, não diferiram significantemente entre os grupos. O grupo desmamado precocemente apresentou maior quantidade absoluta de massa magra, lipídeos, proteínas e cinzas, em comparação ao grupo controle (p<0,05). A quantidade relativa de umidade, lipídeos, massa magra, proteínas e cinzas não diferiu entre os grupos. CONCLUSÃO: O desmame precoce, associado à ingestão de ração elaborada para roedores em crescimento, resultou em aumento do ganho de peso, porém não afetou a composição corporal de camundongos adultos.
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Balaban G, Motta MEFA, Silva GAP. Early weaning and other potential risk factors for overweight among preschool children. Clinics (Sao Paulo) 2010; 65:181-7. [PMID: 20186302 PMCID: PMC2827705 DOI: 10.1590/s1807-59322010000200010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Accepted: 11/26/2009] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To investigate whether early weaning constitutes a risk factor for overweight at preschool age and to identify other factors that affect this association. METHODS This was a case-control study of 366 children aged 2 to 6 years (176 boys and 190 girls) from three cities. The case group comprised overweight children, as defined by body mass index (BMI) for age greater than or equal to the 85(th) percentile. The main exposure analyzed was early weaning (exclusive or predominant breastfeeding for less than four months). RESULTS Early weaning was a significant risk factor for overweight in univariate analysis (OR = 1.69; 95% CI: 1.10-2.60; p = 0.02), but not in multivariate analysis (OR = 1.42; 95% CI: 0.86-2.34; p = 0.17). Maternal overweight, birth weight > or = 3,500 g and sedentarism were the main risk factors for overweight in multivariate analysis. DISCUSSION In our study, the protective effect of breastfeeding against overweight was only shown in univariate analysis; it did not persist after controlling for other variables. It is possible that breastfeeding has only a small protective role against overweight in comparison with other variables of greater importance. CONCLUSION Our results suggest that the potential protective effect of breastfeeding against overweight among preschool children is weaker than genetic and other environmental factors.
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Affiliation(s)
- Geni Balaban
- Federal University of Ceará and School of Medicine of Juazeiro do Norte - Ceará/PE, Brazil.
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Abstract
Obesity has reached epidemic proportions in the United States, with 35.1% of adults being classified as obese. Obesity affects every segment of the US population and continues to increase steadily, especially in children. Obesity increases the risk for many other chronic diseases, including diabetes mellitus, cardiovascular disease, and nonalcoholic fatty liver disease, and decreases overall quality of life. The current US generation may have a shorter life expectancy than their parents if the obesity epidemic is not controlled, and there is no indication that the prevalence of obesity is decreasing. Because of the complexity of obesity, it is likely to be one of the most difficult public health issues our society has faced.
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Affiliation(s)
- Victoria A Catenacci
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Colorado Denver, Denver, CO 80220, USA
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Novaes JFD, Lamounier JA, Franceschini SDCC, Priore SE. Fatores ambientais associados ao sobrepeso infantil. REV NUTR 2009. [DOI: 10.1590/s1415-52732009000500007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Avaliar os fatores ambientais intra-uterinos, perinatais e familiares associados ao sobrepeso infantil, ainda controversos na literatura. MÉTODOS: Estudo transversal realizado com 627 crianças, de 6 a 10 anos, matriculadas em escolas urbanas públicas e privadas do município de Viçosa (MG). O estado nutricional das crianças foi classificado pelo índice de massa corporal, segundo a preconização do Centers for Disease Control and Prevention. Foram aferidas as medidas de peso, estatura, pregas cutâneas tricipital e subescapular, circunferências da cintura e do quadril e pressão arterial das crianças, sendo os fatores ambientais obtidos por meio de questionário, segundo informações maternas. Classificou-se o estado nutricional das mães segundo a recomendação do World Health Organization. RESULTADOS: Do total de crianças, 87,9% eram eutróficas e 12,1% apresentavam sobrepeso. De acordo com a análise de regressão logística múltipla, os fatores associados ao sobrepeso infantil foram apresentar mãe obesa (OR: 6,92; p<0,001), ser filho unigênito (OR: 1,87; p=0,03), permacer tempo superior a 3 horas diárias em frente à televisão (OR: 1,91; p=0,04), não realizar educação física na escola (OR: 4,80; p=0,02) e ser do sexo masculino (OR: 2,60; p=0,001). CONCLUSÃO: Este estudo permite elucidar a identificação de fatores ambientais, potencialmente modificáveis, associados ao sobrepeso infantil no município de Viçosa. A determinação dos fatores ambientais é importante, uma vez que o aumento na prevalência do sobrepeso na infância não pode ser totalmente explicado pelos fatores genéticos.
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Smith J, Dunstone M, Elliott-Rudder M. Health professional knowledge of breastfeeding: are the health risks of infant formula feeding accurately conveyed by the titles and abstracts of journal articles? J Hum Lact 2009; 25:350-8. [PMID: 19369684 DOI: 10.1177/0890334409331506] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Effective promotion of breastfeeding is constrained if health professionals' knowledge on its importance is deficient. This study asks whether formula feeding is named as the risk factor in published research or whether it is considered the unspoken norm. A systematic analysis is conducted of the information content of titles and abstracts of 78 studies that report poorer health among formula-fed infants. This shows a surprising silence in the studies examined; formula is rarely named in publication titles or abstracts as an exposure increasing health risk. In 30% of cases, titles imply misleadingly that breastfeeding raises health risk. Only 11% of abstracts identify formula feeding as a health risk exposure. Initiatives to increase breastfeeding have described the importance of accurate language and well-informed health professional support. If widespread, this skew in communication of research findings may reduce health professionals' knowledge and support for breastfeeding.
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Affiliation(s)
- Julie Smith
- Australian Centre for Economic Research on Health, College of Medicine and Health Sciences, College of Medicine, Biology and Environment, Building 62, The Australian National University, ACT, Australia
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Garipagaoglu M, Budak N, Süt N, Akdikmen O, Oner N, Bundak R. Obesity risk factors in Turkish children. J Pediatr Nurs 2009; 24:332-7. [PMID: 19632511 DOI: 10.1016/j.pedn.2008.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2007] [Revised: 04/10/2008] [Accepted: 04/13/2008] [Indexed: 12/12/2022]
Abstract
On the basis of the knowledge that the prevalence of obesity in children has increased steadily in recent years, this study aimed to assess the association between obesity and certain risk factors in a group of 6- to 14-year-old children living in Istanbul. The study was carried out at the Istanbul University School of Medicine Hospital. Data were collected from 592 children aged between 6 and 14 years who were examined in general pediatrics clinics. Weight and height measurements were performed on the children and their parents. The children were classified as obese and nonobese in accordance with the body mass index reference values for Turkish children. Energy intake of children was estimated with a 3-day food consumption recording form. A structured questionnaire was used to collect the information from the parents on possible risk factors causing obesity. The physical activity state of the children was assessed. A logistic regression model was developed to examine the relationships between obesity and possible risk factors. Almost 32% (n = 184) and 69% (n = 408) of children were assessed as obese and nonobese, respectively. Although there was no difference in daily energy intakes of obese and nonobese children, 13.6% of obese and 40.9% of nonobese children were reported to do physical activity regularly. Obesity was strongly associated with parental obesity. Furthermore, energy intake; having regular physical activity; presence of obesity in the mother, the father, and the mother's family; and having a mother working out of home were also significantly associated with obesity. Creating awareness in mothers on the importance of a healthy nutrition and encouraging families to participate in physical activities are important points in the prevention of childhood obesity.
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Affiliation(s)
- Muazzez Garipagaoglu
- Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Abstract
Medical and scientific studies have proven that the body's metabolic programming can be influenced by diet and nutrition from early infancy. As a result, the incidence and outcome of several metabolic diseases such as obesity, hypertension and cardiovascular disorders have been found to be associated with birth weight, growth and feeding patterns, and the body composition in early childhood. Exclusive or partial breast feeding for at least 6 months is recommended by the World Health Organization, while the European Society of Pediatric Gastroenterology Hepatology and Nutrition Committee on Nutrition recommends the introduction of complementary foods at 4-6 months of age. The fat content of the diet should not be below 25% of the energy intake in order to maintain ideal growth while dietary proteins above 15% of the energy intake is related to future obesity. Long term benefits of breast feeding include a more ideal serum lipid profile and blood pressure, improved neuro-cognitive scores, and a decreased incidence for atopic dermatitis in children who have family members with atopic diseases. Several studies have also acknowledged the long term benefits for neuro-cognitive development from certain nutrients including long-chain polyunstaturated fatty acids and docosahexaenoic acid. Meat intake has proved to be beneficial to psychomotor development. It is suggested that early introduction for complementary foods before 4 months of age is a risk factor for atopic dermatitis; while no strong evidence showed delaying weaning foods can decrease the risk for allergic diseases.
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Affiliation(s)
- Tzee-Chung Wu
- Children's Medical Center, Taipei Veterans General Hospital, National Yang Ming University, School of Medicine, Taiwan.
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Koletzko B, von Kries R, Closa R, Monasterolo RC, Escribano J, Subías JE, Scaglioni S, Giovannini M, Beyer J, Demmelmair H, Anton B, Gruszfeld D, Dobrzanska A, Sengier A, Langhendries JP, Rolland Cachera MF, Grote V. Can infant feeding choices modulate later obesity risk? Am J Clin Nutr 2009; 89:1502S-1508S. [PMID: 19321574 DOI: 10.3945/ajcn.2009.27113d] [Citation(s) in RCA: 209] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Since the concept of lasting programming effects on disease risk in human adults by the action of hormones, metabolites, and neurotransmitters during sensitive periods of early development was proposed >3 decades ago, ample supporting evidence has evolved from epidemiologic and experimental studies and clinical trials. For example, numerous studies have reported programming effects of infant feeding choices on later obesity. Three meta-analyses of observational studies found that obesity risk at school age was reduced by 15-25% with early breastfeeding compared with formula feeding. We proposed that breastfeeding protects against later obesity by reducing the occurrence of high weight gain in infancy and that one causative factor is the lower protein content of human milk compared with most infant formula (the early protein hypothesis). We are testing this hypothesis in the European Childhood Obesity Project, a double-blind, randomized clinical trial that includes >1000 infants in 5 countries (Belgium, Germany, Italy, Poland, and Spain). We randomly assigned healthy infants who were born at term to receive for the first year infant formula and follow-on formula with higher or lower protein contents, respectively. The follow-up data obtained at age 2 y indicate that feeding formula with reduced protein content normalizes early growth relative to a breastfed reference group and the new World Health Organization growth standard, which may furnish a significant long-term protection against later obesity. We conclude that infant feeding practice has a high potential for long-term health effects, and the results obtained should stimulate the review of recommendations and policies for infant formula composition.
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Affiliation(s)
- Berthold Koletzko
- Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
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