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Li S, Cao C, Watson D, Yang L, Kharbanda EO. Maternal smoking during pregnancy links to childhood blood pressure through birth weight and body mass index: NHANES 1999-2018. J Hum Hypertens 2024; 38:134-139. [PMID: 37773293 DOI: 10.1038/s41371-023-00865-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/22/2023] [Accepted: 06/21/2023] [Indexed: 10/01/2023]
Abstract
Maternal smoking during pregnancy (MSDP) is associated with lower birth weight, childhood obesity, and elevated blood pressure (BP) in offspring. We aimed to examine whether birth weight and body mass index (BMI) mediate the effect of MSDP on BP in children. The study included 14,713 children aged 8 to 15 years from the National Health and Nutrition Examination Surveys from 1999 to 2018. General third-variable models were used to examine the mediating effects of birth weight and BMI on the association of MSDP with BP. A total of 1928 (13.1%) children were exposed to MSDP. MSDP was associated with reduced birth weight (p < 0.001), increased BMI (p < 0.001), and elevated systolic BP (p = 0.005). MSDP was not associated with systolic BP after adjustment for birth weight and BMI z-score (p = 0.875), with 95.0% of the effect of MSDP on BP mediated by birth weight (39.1%) and BMI (55.9%). In conclusion, lower birth weight and increased obesity measures mediate the adverse effects of MSDP on BP in children. These findings provide novel mechanistic insight into the adverse effect of MSDP on BP in children and have implications for preventing hypertension in later life.
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Affiliation(s)
- Shengxu Li
- Children's Minnesota Research Institute, Children's Minnesota, Minneapolis, MN, USA.
| | - Chao Cao
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Dave Watson
- Children's Minnesota Research Institute, Children's Minnesota, Minneapolis, MN, USA
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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2
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Wu Y, Hao X, Zhu K, Zheng C, Guan F, Zeng P, Wang T. Long-term adverse influence of smoking during pregnancy on height and body size of offspring at ten years old in the UK Biobank cohort. SSM Popul Health 2023; 24:101506. [PMID: 37692834 PMCID: PMC10492214 DOI: 10.1016/j.ssmph.2023.101506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023] Open
Abstract
Background To explore the long-term relationship between maternal smoking during pregnancy and early childhood growth in the UK Biobank cohort. Methods To estimate the effect of maternal smoking during pregnancy on offspring height and body size at ten years old, we performed binary logistic analyses and reported odds ratios (OR) as well as 95% confidence intervals (95%CIs). We also implemented the cross-contextual comparison study to examine whether such influence could be repeatedly observed among three different ethnicities in the UK Biobank cohort (n = 22,140 for White, n = 7094 for South Asian, and n = 5000 for Black). In particular, we conducted the sibling cohort study in White sibling cohort (n = 9953 for height and n = 7239 for body size) to control for unmeasured familial confounders. Results We discovered that children whose mothers smoked during pregnancy had greater risk of being shorter or plumper at age ten in the full UK Biobank White cohort, with 15.3% (95% CIs: 13.0%∼17.7%) higher risk for height and 32.4% (95%CIs: 29.5%∼35.4%) larger risk for body size. Similar associations were identified in the South Asian and Black ethnicities. These associations were robust and remained significant in the White sibling cohort (12.6% [95%CIs: 5.0%∼20.3%] for height and 36.1% [95%CIs: 26.3%∼45.9%] for body size) after controlling for family factors. Conclusion This study robustly confirms that maternal smoking during pregnancy can promote height deficit and obesity for offspring at ten years old. Our findings strongly encourage mothers to quit smoking during pregnancy for improving growth and development of offspring.
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Affiliation(s)
- Yuxuan Wu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Xingjie Hao
- Department of Biostatistics and Epidemiology, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Kexuan Zhu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Chu Zheng
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Fengjun Guan
- Department of Pediatrics, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Ping Zeng
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Key Laboratory of Environment and Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Engineering Research Innovation Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Ting Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
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Ng JWY, Felix JF, Olson DM. A novel approach to risk exposure and epigenetics-the use of multidimensional context to gain insights into the early origins of cardiometabolic and neurocognitive health. BMC Med 2023; 21:466. [PMID: 38012757 PMCID: PMC10683259 DOI: 10.1186/s12916-023-03168-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Each mother-child dyad represents a unique combination of genetic and environmental factors. This constellation of variables impacts the expression of countless genes. Numerous studies have uncovered changes in DNA methylation (DNAm), a form of epigenetic regulation, in offspring related to maternal risk factors. How these changes work together to link maternal-child risks to childhood cardiometabolic and neurocognitive traits remains unknown. This question is a key research priority as such traits predispose to future non-communicable diseases (NCDs). We propose viewing risk and the genome through a multidimensional lens to identify common DNAm patterns shared among diverse risk profiles. METHODS We identified multifactorial Maternal Risk Profiles (MRPs) generated from population-based data (n = 15,454, Avon Longitudinal Study of Parents and Children (ALSPAC)). Using cord blood HumanMethylation450 BeadChip data, we identified genome-wide patterns of DNAm that co-vary with these MRPs. We tested the prospective relation of these DNAm patterns (n = 914) to future outcomes using decision tree analysis. We then tested the reproducibility of these patterns in (1) DNAm data at age 7 and 17 years within the same cohort (n = 973 and 974, respectively) and (2) cord DNAm in an independent cohort, the Generation R Study (n = 686). RESULTS We identified twenty MRP-related DNAm patterns at birth in ALSPAC. Four were prospectively related to cardiometabolic and/or neurocognitive childhood outcomes. These patterns were replicated in DNAm data from blood collected at later ages. Three of these patterns were externally validated in cord DNAm data in Generation R. Compared to previous literature, DNAm patterns exhibited novel spatial distribution across the genome that intersects with chromatin functional and tissue-specific signatures. CONCLUSIONS To our knowledge, we are the first to leverage multifactorial population-wide data to detect patterns of variability in DNAm. This context-based approach decreases biases stemming from overreliance on specific samples or variables. We discovered molecular patterns demonstrating prospective and replicable relations to complex traits. Moreover, results suggest that patterns harbour a genome-wide organisation specific to chromatin regulation and target tissues. These preliminary findings warrant further investigation to better reflect the reality of human context in molecular studies of NCDs.
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Affiliation(s)
- Jane W Y Ng
- Department of Pediatrics, Cummings School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, AB, T3B 6A8, Canada
| | - Janine F Felix
- The Generation F Study Group, Erasmus MC University Medical Center Rotterdam, Postbus, 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - David M Olson
- Departments of Obstetrics and Gynecology, Physiology, and Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 220 HMRC, Edmonton, AB, T6G2S2, Canada.
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Maternal smoking in pregnancy and blood pressure during childhood and adolescence: a meta-analysis. Eur J Pediatr 2023; 182:2119-2132. [PMID: 36823476 PMCID: PMC10175379 DOI: 10.1007/s00431-023-04836-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/12/2023] [Accepted: 01/20/2023] [Indexed: 02/25/2023]
Abstract
UNLABELLED Arterial hypertension during childhood or adolescence is rising, and smoking during pregnancy may constitute a modifiable risk factor. This study aims to evaluate the effect of maternal smoking during pregnancy on diastolic (DBP) and systolic blood pressure (SBP) in childhood and adolescence. A bibliographic search was conducted in PubMed, Embase, and CENTRAL databases in March 2022. Meta-analysis was performed with the difference in mean-adjusted SBP/DBP of children and adolescents aged 3-17 years, according to maternal smoking/non-smoking in pregnancy. A random effects model was applied; a leave-one-out analysis and meta-analysis by subgroups were performed. A modified Newcastle-Ottawa scale was used to assess the quality of the studies. Evidence levels were rated using the GRADE system. Fifteen studies were included in the meta-analysis; all of them evaluated the mean-adjusted SBP difference in children or adolescents (N = 73,448), and 6 also that of DBP (N = 31,459). Results showed that maternal smoking during pregnancy significantly increased SBP (β = 0.31 mmHg 95% CI 0.14-0.49). A greater increase in mean-adjusted SBP was observed in those studies that completed the recruitment before 1990, were conducted in non-European countries, used standard mercury or manual sphygmomanometry, adjusted for birth weight, and were in the lowest quality subgroup. No significant association was found for DBP. The GRADE level of evidence was low for SBP and very low for DBP. CONCLUSION Smoking in pregnancy might increase SBP in childhood and adolescence. Due to the low level of evidence, solid inferences cannot be drawn about the clinical relevance of these findings. WHAT IS KNOWN • AHT is the leading cause of premature death among adults worldwide. • Deleterious effects derived from SHS exposure on children's health have been documented since early 1970. To date, there are contradictory results about the effects of prenatal SHS exposure on children's BP. WHAT IS NEW • Smoking in pregnancy may increase SBP during childhood and adolescence. • Maternal smoking during pregnancy could have greater influence on their offspring's SBP than on DBP.
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Robertson OC, Marceau K, Moding KJ, Knopik VS. Developmental pathways linking obesity risk and early puberty: The thrifty phenotype and fetal overnutrition hypotheses. DEVELOPMENTAL REVIEW 2022. [DOI: 10.1016/j.dr.2022.101048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cheema S, Abraham A, El-Nahas KG, Abou-Amona R, Al-Hamaq AO, Maisonneuve P, Chaabna K, Lowenfels AB, Mamtani R. Assessment of Overweight, Obesity, Central Obesity, and Type 2 Diabetes among Adolescents in Qatar: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14601. [PMID: 36361482 PMCID: PMC9653877 DOI: 10.3390/ijerph192114601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
Qatar has a high obesity and type 2 diabetes mellitus (T2DM) burden. This study aimed to (1) determine the prevalence of overweight, obesity, and T2DM in 13-17-year-old adolescents and (2) evaluate associations with adolescents' lifestyle and breastfeeding history, parental weight, and familial T2DM history. A cross-sectional study (double-stage cluster sampling) was conducted in 2018-2020 using a self-administered parental and adolescent questionnaire. In the results, 23.4% of the adolescents (107/459) were overweight; 19.9% (91/459) were obese; and 37.6% (171/459) had evidence of central obesity. Random blood sugar (RBS) was suggestive of prediabetes (≥140 mg/dL) for 23 (5.0%) adolescents and T2DM (≥200 mg/dL) for none. In multivariable analysis, obesity was significantly associated with no breastfeeding (OR = 3.17, 95% CI: 1.09-9.26) compared to breastfed adolescents for ≥6 months, with first-degree family history of T2DM (OR = 2.27; 95% CI: 1.22-4.27), with maternal obesity (OR = 2.40; 95% CI: 1.01-5.70), and with acanthosis nigricans in adolescents (OR = 19.8; 95% CI: 8.38-46.9). Central obesity was significantly associated with maternal obesity (OR = 2.21; 95% CI: 1.14-4.27) and with acanthosis nigricans (OR = 3.67; 95% CI: 1.88-7.18). Acanthosis nigricans (OR = 4.06; 95% CI: 1.41-11.7) was the only factor associated with elevated RBS. Addressing future disease burden among adults in Qatar will require extensive health and well-being programs, focused on healthy lifestyles and behaviors such as nutritious diets, physical activity, stress management, and self-care.
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Affiliation(s)
- Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha P.O. Box 24144, Qatar
| | - Amit Abraham
- Institute for Population Health, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha P.O. Box 24144, Qatar
| | | | | | | | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Karima Chaabna
- Institute for Population Health, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha P.O. Box 24144, Qatar
| | - Albert B. Lowenfels
- Department of Surgery and Department of Family Medicine, New York Medical College, Valhalla, New York, NY 10595, USA
| | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha P.O. Box 24144, Qatar
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Baran J, Weres A, Baran R, Czenczek-Lewandowska E, Leszczak J, Wyszyńska J. Preterm Birth and the Type of Birth and Their Impact on the Incidence of Overweight and Obesity in Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912042. [PMID: 36231343 PMCID: PMC9566099 DOI: 10.3390/ijerph191912042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 05/02/2023]
Abstract
The purpose of the study was to evaluate the influence of the type of birth and preterm birth on the risk of overweight and obesity in the children studied. The study involved 749 children of pre-school and school age, between 4 and 15 years of age. Information about the type of delivery and the potential preterm birth came from the child's health book and the mother's pregnancy card. The authors assessed the body height and body weight of each child. The analysis showed that on average every six children were born before due date (before the end of 37 weeks of gestation) and slightly more than 40% of the children were born by cesarean section (CS). A statistical analysis was performed, including descriptive statistics and Spearman's correlation, and to evaluate the differences in the analyzed groups, nonparametric tests and chi-square independence tests were used: the Mann-Whitney test, and the Kruskal-Wallis test due to the lack of a normalized distribution. The incidence of overweight and obesity was higher in 7-11-year-old boys born with CS vs. vaginal birth (VD) (p = 0.026). There were no statistically significant differences between BMI centile value and preterm birth. Cesarean section birth significantly increases the percentage of boys with overweight and obesity in early school age and may be associated with higher percentile values of children with BMI in this age group.
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Affiliation(s)
- Joanna Baran
- Institute of Health Sciences, Medical College, University of Rzeszów, 35-310 Rzeszów, Poland
- Natural and Medical Center for Innovative Research, 35-310 Rzeszów, Poland
- Correspondence:
| | - Aneta Weres
- Institute of Health Sciences, Medical College, University of Rzeszów, 35-310 Rzeszów, Poland
| | - Rafał Baran
- Institute of Health Sciences, Medical College, University of Rzeszów, 35-310 Rzeszów, Poland
- SOLUTION-Statistical Analysis, 35-120 Rzeszów, Poland
| | - Ewelina Czenczek-Lewandowska
- Institute of Health Sciences, Medical College, University of Rzeszów, 35-310 Rzeszów, Poland
- Natural and Medical Center for Innovative Research, 35-310 Rzeszów, Poland
| | - Justyna Leszczak
- Institute of Health Sciences, Medical College, University of Rzeszów, 35-310 Rzeszów, Poland
- Natural and Medical Center for Innovative Research, 35-310 Rzeszów, Poland
| | - Justyna Wyszyńska
- Institute of Health Sciences, Medical College, University of Rzeszów, 35-310 Rzeszów, Poland
- Natural and Medical Center for Innovative Research, 35-310 Rzeszów, Poland
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Abstract
The use of tobacco during pregnancy is the leading preventable cause of pregnancy complications and adverse birth outcomes. In high-income countries, around one in 10 pregnant women smokes tobacco, while smokeless tobacco is the primary form of tobacco used in many low- and middle-income countries. Although the risk of tobacco-related harms can be reduced substantially if mothers cease smoking in the first trimester of pregnancy, the proportion of women who successfully quit smoking during pregnancy remains modest. Psychosocial interventions are first-line treatment, with some high-quality evidence showing that counselling is effective in promoting smoking cessation among pregnant women. There is insufficient evidence regarding the efficacy and safety of smoking cessation pharmacotherapies when used during pregnancy, although in some countries nicotine replacement therapy is recommended for pregnant women who have been unable to quit without pharmacological assistance. E-cigarettes are increasingly being used as a smoking cessation aid in the general population of smokers, but more research is needed to determine if e-cigarettes are a safe and effective treatment option for pregnant women.
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Affiliation(s)
- Alys Havard
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
- Centre for Big Data Research in Health, UNSW Sydney, Sydney, Australia
| | - Jonathan James Chandran
- CICADA Adolescent Drug and Alcohol Service, Department of Adolescent Medicine, Sydney Children's Hospital, Sydney, Australia
| | - Ju Lee Oei
- Department of Newborn Care, the Royal Hospital for Women, Randwick, Australia
- School of Women's and Children's Health, UNSW Sydney, Sydney, Australia
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Eitmann S, Mátrai P, Németh D, Hegyi P, Lukács A, Bérczi B, Czumbel LM, Kiss I, Gyöngyi Z, Varga G, Balaskó M, Pétervári E. Maternal overnutrition elevates offspring's blood pressure-A systematic review and meta-analysis. Paediatr Perinat Epidemiol 2022; 36:276-287. [PMID: 35041216 PMCID: PMC9305555 DOI: 10.1111/ppe.12859] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 12/13/2021] [Accepted: 12/19/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Maternal overnutrition during pregnancy predisposes the offspring to cardiometabolic diseases. OBJECTIVES This systematic review and meta-analysis aimed to investigate the association between maternal overnutrition and offspring's blood pressure (BP) and the effect of offspring's obesity on this association. DATA SOURCES PubMed, EMBASE, Clinicaltrials.gov, CENTRAL. STUDY SELECTION AND DATA EXTRACTION Human studies published in English before October 2021 were identified that presented quantitative estimates of association between maternal overnutrition just before or during pregnancy and the offspring's BP. SYNTHESIS Random-effect model with the DerSimonian and Laird weighting method was used to analyse regression coefficients or mean differences. RESULTS After selection, 17 observational studies (140,517 mother-offspring pairs) were included. Prepregnancy body mass index (ppBMI) showed positive correlation with BP in offspring (regression coefficient for systolic: 0.38 mmHg per kg/m2 , 95% confidence interval (CI) 0.17, 0.58; diastolic: 0.10 mmHg per kg/m2 , 95% CI 0.05, 0.14). These indicate 1.9 mmHg increase in systolic and 0.5 mmHg increase in diastolic BP of offspring with every 5 kg/m2 gain in maternal ppBMI. Results on coefficients adjusted for offspring's BMI also showed association (systolic: 0.08 mmHg per kg/m2 , 95% CI 0.04, 0.11; diastolic: 0.03 mmHg per kg/m2 , 95% CI 0.01, 0.04). Independent from ppBMI, gestational weight gain (GWG) showed positive correlation with systolic BP (systolic BP: 0.05 mmHg per kg, 95% CI 0.01, 0.09), but not after adjustment for offspring's BMI. Mean systolic BP was higher in children of mothers with excessive GWG than in those of mothers with optimal GWG (difference: 0.65 mmHg, 95% CI 0.25, 1.05). CONCLUSIONS Independent from offspring's BMI, higher prepregnancy BMI may increase the risk for hypertension in offspring. The positive association between GWG and offspring's systolic BP is indirect via offspring's obesity. Reduction in maternal obesity and treatment of obesity in children of obese mothers are needed to prevent hypertension.
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Affiliation(s)
- Szimonetta Eitmann
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
| | - Péter Mátrai
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
| | - Dávid Németh
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
| | - Péter Hegyi
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary,Szentágothai Research CentreMedical SchoolUniversity of PécsPécsHungary,Centre for Translational MedicineSemmelweis UniversityBudapestHungary,Division of Pancreatic Diseases, Heart and Vascular CenterSemmelweis UniversityBudapestHungary
| | - Anita Lukács
- Department of Physiology, Anatomy and NeuroscienceFaculty of Science and InformaticsUniversity of SzegedSzegedHungary
| | - Bálint Bérczi
- Department of Public Health MedicineMedical SchoolUniversity of PécsPécsHungary
| | - László Márk Czumbel
- Department of Oral BiologyFaculty of DentistrySemmelweis UniversityBudapestHungary
| | - István Kiss
- Department of Public Health MedicineMedical SchoolUniversity of PécsPécsHungary
| | - Zoltán Gyöngyi
- Department of Public Health MedicineMedical SchoolUniversity of PécsPécsHungary
| | - Gábor Varga
- Department of Oral BiologyFaculty of DentistrySemmelweis UniversityBudapestHungary
| | - Márta Balaskó
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
| | - Erika Pétervári
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
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Jaakkola JM, Rovio SP, Pahkala K, Viikari J, Rönnemaa T, Jula A, Niinikoski H, Mykkänen J, Juonala M, Hutri-Kähönen N, Kähönen M, Lehtimäki T, Raitakari OT. Childhood exposure to parental smoking and life-course overweight and central obesity. Ann Med 2021; 53:208-216. [PMID: 33305629 PMCID: PMC7901689 DOI: 10.1080/07853890.2020.1853215] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 11/14/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To evaluate the association between childhood parental smoking exposure and the risk of overweight/obesity from childhood to adulthood. METHODS This study leverages the data from two longitudinal population based cohort studies, the Cardiovascular Risk in Young Finns Study between years 1980-2011/2012 (YFS; N = 2,303; baseline age 3-18 years) and the Special Turku Coronary Risk Factor Intervention Project between years 1989-2009/2010 (STRIP; N = 632; baseline age 7 months). Weight, height and waist circumference were measured from childhood to adulthood. Overweight/obesity was defined as body mass index ≥25 kg/m2 in adults and using the Cole criteria in children. Central obesity was defined as waist circumference > 100/90 cm in men/women and as a waist-to-height ratio > 0.50 in children. Statistical analyses were adjusted for age, sex, socioeconomic status, smoking, birth weight, parental ages, diet and physical activity. RESULTS Childhood parental smoking exposure was associated with increased risk for life-course overweight/obesity (YFS: RR1.13, 95%CI 1.02-1.24; STRIP: RR1.57, 95%CI 1.10-2.26) and central obesity (YFS: RR1.18, 95%CI 1.01-1.38; STRIP: RR1.45, 95%CI 0.98-2.15). CONCLUSIONS Childhood exposure to parental smoking is associated with increased risk of overweight/obesity over the life-course. KEY MESSAGES Exposure to parental smoking in childhood was associated with increased risk of overweight/obesity, central obesity and adiposity measured by skinfold thickness from childhood to adulthood.
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Affiliation(s)
- Johanna M. Jaakkola
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Suvi P. Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical activity, University of Turku, Turku, Finland
| | - Jorma Viikari
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Tapani Rönnemaa
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Antti Jula
- Department of Chronic Disease Prevention, Institute for Health and Welfare, Turku, Finland
| | - Harri Niinikoski
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - Juha Mykkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Markus Juonala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University Hospital, and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Olli T. Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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Creese HM, Hope S, Christie D, Goddings AL, Viner R. Is earlier obesity associated with poorer executive functioning later in childhood? Findings from the Millennium Cohort Study. Pediatr Obes 2021; 16:e12785. [PMID: 33728769 DOI: 10.1111/ijpo.12785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 02/08/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Children affected with overweight or obesity have been associated with having lower educational achievement compared to peers who are non-overweight/obese. One of the drivers of this association could be a link between obesity and poorer executive function. Evidence is limited to small, cross-sectional studies which lack adjustment for important common causes. OBJECTIVE We investigate the association between weight status and executive function longitudinally in mid-childhood, accounting for potential common causes. METHODS Linear regression analyses were conducted to examine associations between weight status between 5 and 7 years and executive functioning at 11 years in members of the Millennium Cohort Study (n = 7739), accounting for a wide range of potential common causes. Age- and sex-specific International Obesity Taskforce cut-points for body mass index (BMI) were used. Executive function, including decision-making, impulsivity and spatial working memory, was assessed using the Cambridge Neuropsychological Test Automated Battery. RESULTS There were no unadjusted associations between weight status and decision-making or impulsivity. After adjustment for all potential common causes, there was a lack of consistent evidence to support an association between persistent obesity (including overweight) between 5 and 7 years and spatial working memory task at 11 years. CONCLUSIONS We found little evidence that poorer spatial working memory contributes to the association of children with obesity having lower educational achievement.
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Affiliation(s)
- Hanna-Marie Creese
- Population, Policy and Practice Programme, UCL Institute of Child Health, London, UK.,Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Steven Hope
- Population, Policy and Practice Programme, UCL Institute of Child Health, London, UK
| | - Deborah Christie
- Child and Adolescent Psychology Service, UCL Hospitals, NHS Foundation Trust, London, UK
| | - Anne-Lise Goddings
- Population, Policy and Practice Programme, UCL Institute of Child Health, London, UK
| | - Russell Viner
- Population, Policy and Practice Programme, UCL Institute of Child Health, London, UK
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12
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Jaspers Faijer-Westerink H, Stavnsbo M, Hutten BA, Chinapaw M, Vrijkotte TGM. Ideal cardiovascular health at age 5-6 years and cardiometabolic outcomes in preadolescence. Int J Behav Nutr Phys Act 2021; 18:33. [PMID: 33676545 PMCID: PMC7936465 DOI: 10.1186/s12966-021-01090-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The American Heart Association (AHA) developed a definition of ideal cardiovascular health (ICH) based on the presence of both ideal health behaviours (diet, physical activity, weight status and smoking) and ideal health factors (glucose, total cholesterol and blood pressure levels). However, research of ICH in the paediatric population is scarce. We aimed to study ICH at age 5-6 years by extending the original ICH score with the health behaviours: sleep duration, screen time and prenatal smoke exposure, and to evaluate its association with cardiometabolic outcomes at age 11-12. METHODS A total of 1666 children aged 5-6 years were selected from the database of the ABCD-study, a prospective cohort study on the health and development of children born in Amsterdam, the Netherlands. Of these, 846 (50.8%) were boys and 1460 (87.6%) had a healthy weight. Data on self-reported health behaviours and health factors were used to calculate the ICH scores (original and extended) by adding the frequency of scoring 'healthy' on each indicator, based on international cut-offs. The children were followed up for 6 years and cardiometabolic outcomes (carotid intima-media thickness (CIMT), blood pressure, glucose and lipids) were measured. Associations between ICH (both original and extended) and cardiometabolic outcomes were examined using multivariable regression models. RESULTS At age 5-6 years, 11% scored poor (score 1-5), 56% intermediate (score 6-7) and 33% good (score 8-9) on extended ICH. Healthy diet and normal total cholesterol concentrations were the least prevalent. Neither the original nor the extended ICH scores were associated with CIMT at age 11-12. A higher score on the extended ICH was associated with lower total cholesterol (p for trend < 0.001), lower systolic (p for trend = 0.012) and diastolic blood pressure (p for trend = 0.011), and lower body mass index (BMI) (p < 0.001) at age 11-12. The original ICH score was associated with lower total cholesterol (p < 0.001) and BMI (p < 0.001) only. CONCLUSION Our findings suggest that extending the ICH score in young children with additional health behaviours improves prediction of some cardiometabolic outcomes, but not CIMT in preadolescence, compared to the original ICH score. We would recommend other researchers to incorporate objective measures of health behaviours and longer follow-up to find out whether associations persist into adulthood.
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Affiliation(s)
- Hester Jaspers Faijer-Westerink
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, Meibergdreef 9, room J2-209, 1100 DE, Amsterdam, The Netherlands
| | - Mette Stavnsbo
- Department of Sports Science and Physical Education, University of Agder, PO BOX 422, 4604, Kristiansand, Norway
| | - Barbara A Hutten
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Cardiovascular Sciences Research Institute, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, Meibergdreef 9, room J1B-209-1, 1100 DE, Amsterdam, The Netherlands
| | - Mai Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, PO Box 7057, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Tanja G M Vrijkotte
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, Meibergdreef 9, room J2-209, 1100 DE, Amsterdam, The Netherlands.
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13
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S Machado IB, Tofanelli MR, Saldanha da Silva AA, Simões E Silva AC. Factors Associated with Primary Hypertension in Pediatric Patients: An Up-to-Date. Curr Pediatr Rev 2021; 17:15-37. [PMID: 33430749 DOI: 10.2174/1573396317999210111200222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Arterial hypertension in children is considered a common alteration nowadays, mainly because obesity is a growing worldwide problem closely related to increased blood pressure. Childhood hypertension can be classified as primary or secondary, depending on the etiology. Primary or essential hypertension still has its pathophysiology not fully elucidated, and there is no consensus in the literature on most underlying mechanisms. In this review, genetic and environmental factors, including sodium and potassium intake, socioeconomic status, ethnicity, family structure, obesity, sedentary lifestyle, prematurity and low birth weight, prenatal and postnatal exposures are highlighted. OBJECTIVE The present study aimed to perform an update on primary hypertension in childhood, providing clinicians and researchers an overview of the current state of the literature regarding the influence of genetic and environmental factors. METHODS This integrative review searched for articles on genetic and environmental factors related to primary hypertension in pediatric patients. The databases evaluated were PubMed and Scopus. RESULTS The studies have provided insights regarding many genetic and environmental factors, in addition to their association with the pathophysiology of primary hypertension in childhood. Findings corroborated the idea that primary hypertension is a multifactorial disease. Further studies in the pediatric population are needed to elucidate the underlying mechanisms. CONCLUSION The study of primary hypertension in pediatrics has utmost importance for the adoption of preventive measures and the development of more efficient treatments, therefore reducing childhood morbidity and the incidence of cardiovascular diseases and other health consequences later in life.
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Affiliation(s)
- Isabella Barreto S Machado
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Matheus Rampinelli Tofanelli
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ariadna A Saldanha da Silva
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ana Cristina Simões E Silva
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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60 Minutes Per Day in Moderate to Vigorous Physical Activity as a Natural Health Protector in Young Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238918. [PMID: 33266258 PMCID: PMC7729608 DOI: 10.3390/ijerph17238918] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 11/23/2020] [Accepted: 11/27/2020] [Indexed: 12/11/2022]
Abstract
The aim of this study was to check whether following the recommendations of the World Health Organization (WHO) concerning physical activity protects children and adolescents against the occurrence of overweight and obesity. A total of 1002 children were included in the analysis. The average age of the studied children was 9.36 years ± 3.52 years. Measurement of height and body mass was performed for every child, followed by physical activity assessment over seven days. In each group analyzed, the overweight and obese children had a shorter time in moderate to vigorous physical activity (MVPA) than the children with normal body mass. Among the children spending < 60 min per day in MVPA, the risk of occurrence of overweight and obesity was greater than among children with physical activity > 60 min per day. It was also shown that the greatest risk of occurrence of body mass disorder was a situation in which the mother’s gestational weight gain (GWG) is over 18 kg and the child does not spend a minimum of 60 min/day in MVPA. Not meeting the recommendation is connected with an increased chance of the occurrence of overweight and obesity. The level of physical activity influences the incidence of overweight and obesity. The children with overweight and obesity spent less time per day in MVPA. An increased body mass in mothers during pregnancy associated with a child’s low level of physical activity increases the risk of the occurrence of overweight and obesity.
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Baran J, Weres A, Czenczek-Lewandowska E, Leszczak J, Kalandyk-Osinko K, Łuszczki E, Sobek G, Mazur A. Excessive Gestational Weight Gain: Long-Term Consequences for the Child. J Clin Med 2020; 9:jcm9123795. [PMID: 33255248 PMCID: PMC7761026 DOI: 10.3390/jcm9123795] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/11/2020] [Accepted: 11/21/2020] [Indexed: 02/07/2023] Open
Abstract
Background: The aim of the study was to analyse the impact of mothers’ gestational weight gain (GWG) and age at birth on the long-term risk of overweight and obesity in preschool and school-aged children. Methods: The study involved 749 mothers and children at ages between four and 15 years old. Each child was assessed for height and body weight, and then, the body mass category was determined based on the body mass index (BMI) percentile according to the sex and age of the subjects. Information on the perinatal risk factors for overweight and obesity came from the child’s health card or mother’s maternity card. They contained information about the mother’s age at the time of childbirth and the mother’s gestational weight gain during pregnancy. Results: In the group of 7–11-year-olds, the maternal weight gain during pregnancy was higher in obese children than in children with normal weight (18.8 kg vs. 14.3 kg; p = 0.002). This relationship was shown analogously in the group of 7–11-years-olds boys (20.6 kg vs. 15.1 kg; p = 0.005). Positive correlations were also shown between mother’s gestational weight gain and the BMI percentage of the whole group (p = 0.004). In the case of the mother’s age, no statistically significant relationship was found with the child’s weight category. Conclusions: Mothers’ weight gain during pregnancy is a factor that promotes overweightness and obesity in the child. Maternal age at birth does not appear to lead to any propensity toward overweightness and obesity in the later life of a child.
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Affiliation(s)
- Joanna Baran
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
- Correspondence:
| | - Aneta Weres
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
| | - Ewelina Czenczek-Lewandowska
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
| | - Justyna Leszczak
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
| | - Katarzyna Kalandyk-Osinko
- Institute of Medical Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (K.K.-O.); (A.M.)
| | - Edyta Łuszczki
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
| | - Grzegorz Sobek
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
| | - Artur Mazur
- Institute of Medical Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (K.K.-O.); (A.M.)
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16
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Xie T, Falahi F, Schmidt‐Ott T, Vrijkotte TGM, Corpeleijn E, Snieder H. Early Determinants of Childhood Blood Pressure at the Age of 6 Years: The GECKO Drenthe and ABCD Study Birth Cohorts. J Am Heart Assoc 2020; 9:e018089. [PMID: 33167754 PMCID: PMC7763711 DOI: 10.1161/jaha.120.018089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background There is still uncertainty about the nature and relative impact of early determinants on childhood blood pressure. This study explored determinants of blood pressure at the age of 6 years in 2 Dutch birth cohorts. Methods and Results Results of hierarchical multiple linear regression analyses in GECKO (Groningen Expert Center for Kids With Obesity) Drenthe study (n=1613) were replicated in ABCD (Amsterdam Born Children and Their Development) study (n=2052). All analyses were adjusted for child's age, sex, height, and body mass index (BMI), and maternal education and subsequently performed in the combined sample. No associations were found between maternal smoking during pregnancy and childhood blood pressure. In the total sample, maternal prepregnancy BMI was positively associated with systolic blood pressure (SBP) (β [95% CI], 0.09 [0.02–0.16] mm Hg) and diastolic blood pressure (β [95% CI], 0.11 [0.04–0.17] mm Hg). Children of women with hypertension had higher SBP (β [95% CI], 0.98 [0.17–1.79] mm Hg). Birth weight standardized for gestational age was inversely associated with SBP (β [95% CI], −6.93 [−9.25 to −4.61] mm Hg) and diastolic blood pressure (β [95% CI], −3.65 [−5.70 to −1.61] mm Hg). Longer gestational age was associated with lower SBP (β [95% CI] per week, −0.25 [−0.42 to −0.08] mm Hg). Breastfeeding for 1 to 3 months was associated with lower SBP (β [95% CI], −0.96 [−1.82 to −0.09] mm Hg) compared with no or <1 month of breastfeeding. Early BMI gain from the age of 2 to 6 years was positively associated with SBP (β [95% CI], 0.41 [0.08–0.74] mm Hg) and diastolic blood pressure (β [95% CI], 0.37 [0.07–0.66] mm Hg), but no effect modification by birth weight was found. Conclusions Higher maternal prepregnancy BMI, maternal hypertension, a relatively lower birth weight for gestational age, shorter gestational age, limited duration of breastfeeding, and more rapid early BMI gain contribute to higher childhood blood pressure at the age of 6 years.
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Affiliation(s)
- Tian Xie
- Department of EpidemiologyUniversity of GroningenUniversity Medical Center GroningenGroningenthe Netherlands
| | - Fahimeh Falahi
- Department of EpidemiologyUniversity of GroningenUniversity Medical Center GroningenGroningenthe Netherlands
| | - Tabea Schmidt‐Ott
- Department of EpidemiologyUniversity of GroningenUniversity Medical Center GroningenGroningenthe Netherlands
| | - Tanja G. M. Vrijkotte
- Department of Public HealthAmsterdam Public Health Research InstituteAmsterdam University Medical CenterUniversity of AmsterdamAmsterdamthe Netherlands
| | - Eva Corpeleijn
- Department of EpidemiologyUniversity of GroningenUniversity Medical Center GroningenGroningenthe Netherlands
| | - Harold Snieder
- Department of EpidemiologyUniversity of GroningenUniversity Medical Center GroningenGroningenthe Netherlands
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17
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Iguacel I, Gasch-Gallén Á, Ayala-Marín AM, De Miguel-Etayo P, Moreno LA. Social vulnerabilities as risk factor of childhood obesity development and their role in prevention programs. Int J Obes (Lond) 2020; 45:1-11. [PMID: 33033393 DOI: 10.1038/s41366-020-00697-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/08/2020] [Accepted: 09/26/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Large socioeconomic, gender, and ethnic inequalities exist in terms of childhood obesity worldwide. Children from low socioeconomic status families are more likely to have overweight/obesity and related cardiometabolic problems and future cancer risk. A wider concept are social vulnerabilities defined as social or economic characteristics or experiences negatively affecting children through behavioral, biological factors, or mental health. Social vulnerabilities include also therefore low subjective perceptions of social position. OBJECTIVE This study aims to identify social vulnerabilities and to summarize their impact as obesity development risk factor. Preventive programs implemented targeting these vulnerable groups and their effectiveness are also discussed. METHODS Literature review based on the experience of the authors social vulnerabilities identified as risk factors for childhood obesity were children whose parents lack of a social network, low support from formal and informal sources, parental unemployment, belonging to a minority group or having migrant background, adverse childhood experiences including household dysfunction, violence and childhood maltreatment and other traumatic experiences, gender inequalities and being part of nontraditional families. RESULTS The impact of social vulnerabilities on childhood obesity is independent of SES; however, SES exacerbates or buffer the effect social vulnerabilities have on different lifestyles and stress. Behavioral, biological, and mental health mechanisms may explain the association between social vulnerabilities and childhood obesity. CONCLUSIONS Behaviors such as dietary intake, physical activity, sedentary behaviors, and sleep are negatively affected by the stress and low levels of mental health derived from social vulnerabilities. It seems that high energy intakes rather than low physical activity levels might be the main driving force behind the obesity epidemic in vulnerable groups. Most of the prevention programs identified did not take into account social vulnerabilities and inequalities making them ineffective in most vulnerable groups. Interventions conducted in children from socially vulnerable group suggest modest but promising effects.
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Affiliation(s)
- Isabel Iguacel
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences; University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain. .,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain. .,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain. .,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
| | - Ángel Gasch-Gallén
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences; University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Alelí M Ayala-Marín
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences; University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Pilar De Miguel-Etayo
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences; University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences; University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
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18
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Zhao B, Johnston FH, O'Sullivan T, Williamson GJ, Melody S, Dalton M, Venn A, Negishi K. Early life exposure to coal mine fire and tobacco smoke affect subclinical vascular function. Arch Dis Child 2020; 105:539-544. [PMID: 31862698 DOI: 10.1136/archdischild-2019-317528] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 11/21/2019] [Accepted: 12/01/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To evaluate whether vascular health in young children was associated with exposure to a 6-week episode of coal mine fire smoke or environmental tobacco smoke (ETS) in a retrospective cohort study. METHODS Three years after a coal mine fire in Victoria, Australia, we investigated the vascular health of children either in utero (n=75) or aged <2 years (postnatal exposure, n=96) at the time of the fire. The outcomes were the carotid intima-media thickness (IMT) and pulse wave velocity (PWV). The mean and peak daily particulate matter <2.5 µm in diameter (PM2.5) exposures were estimated based on their daily locations throughout the fire period. Multivariable linear regression models were used to test for associations between the fire-related PM2.5 and outcomes adjusted for relevant covariates including ETS. RESULTS In the postnatal-exposure group, each 10 µg/m³ increase in mean PM2.5 level was independently positively associated with PWV (β=0.116, p=0.028). When these two groups were combined, there was an association between mean PM2.5 and increased PWV in those children who had ETS exposure (β=0.148, p=0.033) or whose mothers smoked (β=0.151, p=0.011), but not in those not exposed to ETS or maternal smoking. CONCLUSIONS Three years after a coal mine fire, infants aged up to 2 years at the time of exposure have increases in vascular stiffness. Although no adverse effects were observed in the in uterus exposure group, further follow-up study is needed to elucidate the long-term effects of coal mine fire smoke exposure.
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Affiliation(s)
- Bing Zhao
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Tierney O'Sullivan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Grant J Williamson
- School of Natural Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Shannon Melody
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Marita Dalton
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Kazuaki Negishi
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia .,Faculty of Medicine and Health, Nepean Clinical School, Charles Perkins Centre Nepean, University of Sydney, Penrith, New South Wales, Australia
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19
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Cardiovascular risk factors in offspring exposed to gestational diabetes mellitus in utero: systematic review and meta-analysis. J Dev Orig Health Dis 2020; 11:599-616. [PMID: 31902382 DOI: 10.1017/s2040174419000850] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Gestational diabetes mellitus (GDM) is a pregnancy complication that affects one in seven pregnancies. Emerging evidence demonstrates that children born of pregnancies complicated by GDM may be at increased risk of cardiovascular disease (CVD) in adulthood. Therefore, the aim of this study was to determine cardiovascular risk factors in offspring exposed to GDM in utero. PubMed, CINAHL, SCOPUS, and EMBASE databases were searched. Information was extracted on established CVD risk factors including blood pressure, lipids, blood glucose, fasting insulin, body mass index (BMI), and endothelial/microvascular function. The review protocol is registered in PROSPERO (CRD42018094983). Prospective and retrospective studies comparing offspring exposed to GDM compared to controls (non-GDM pregnancies) were considered. We included studies that defined GDM based on the International Association of Diabetes and Pregnancy Study Groups (IADPSG) definition, or prior definitions. The PRISMA guidelines were followed in conducting this systematic review. Methodological quality was assessed using the Newcastle-Ottawa Quality Assessment Scale. Study selection, data extraction, and quality assessment were done by two independent reviewers. The data were pooled using a random-effects model. Of 59 eligible studies, 24 were included in the meta-analysis. Offspring exposed to GDM had higher systolic blood pressure (mean difference (MD): 1.75 mmHg, 95% CI 0.57-2.94; eight studies, 7264 participants), BMI z-score (MD 0.11, 95% CI 0.02-0.20; nine studies, 8759 participants), and glucose (standard MD 0.43, 95% CI 0.08-0.77; 11 studies, 6423 participants) than control participants. In conclusion, offspring exposed to GDM have elevated systolic blood pressure, BMI, and glucose. Those exposed to GDM in utero may benefit from early childhood blood pressure measurements.
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20
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Cabral M, Fonseca MJ, González-Beiras C, Santos AC, Correia-Costa L, Barros H. Maternal Smoking: A Life Course Blood Pressure Determinant? Nicotine Tob Res 2019; 20:674-680. [PMID: 28575495 DOI: 10.1093/ntr/ntx117] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/30/2017] [Indexed: 01/03/2023]
Abstract
Introduction Exposure to maternal smoking early in life may affect blood pressure (BP) control mechanisms. We examined the association between maternal smoking (before conception, during pregnancy, and 4 years after delivery) and BP in preschool children. Methods We evaluated 4295 of Generation XXI children, recruited at birth in 2005-2006 and reevaluated at the age of 4. At birth, information was collected by face-to-face interview and additionally abstracted from clinical records. At 4-year follow-up, interviews were performed and children's BP measured. Linear regression models were fitted to estimate the association between maternal smoking and children's BP. Results Children of smoking mothers presented significantly higher BP levels. After adjustment for maternal education, gestational hypertensive disorders, and child's body mass index, children exposed during pregnancy to maternal smoking presented a higher systolic BP (SBP) z-score (β = 0.08, 95% confidence interval [CI] 0.04 to 0.14). In crude models, maternal smoking was associated with higher SBP z-score at every assessed period. However, after adjustment, an attenuation of the association estimates occurred (β = 0.08, 95% CI 0.03 to 0.13 before conception; β = 0.07, 95%CI 0.02 to 0.12; β = 0.04, 95%CI -0.02 to 0.10; and β = 0.06, 95%CI 0.00 to 0.13 for the first, second, and third pregnancy trimesters, respectively; and β = 0.07, 95%CI 0.02 to 0.12 for current maternal smoking). No significant association was observed for diastolic BP z-score levels. Conclusion Maternal smoking before, during, and after pregnancy was independently associated with systolic BP z-score in preschool children. This study provides additional evidence to the public health relevance of maternal smoking cessation programs if early cardiovascular health of children is envisaged. Implications Using observational longitudinal data from the birth cohort Generation XXI, this study showed that exposure to maternal smoking-before pregnancy, during pregnancy, and 4 years after delivery-was associated with a systolic BP-raising effect in children at the age of 4. The findings of this study add an important insight into the need to support maternal smoke-free environments in order to provide long-term cardiovascular benefit, starting as early as possible in life.
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Affiliation(s)
- Maria Cabral
- EPIUnit, Institute of Public Health, University of Porto, Portugal
| | - Maria J Fonseca
- EPIUnit, Institute of Public Health, University of Porto, Portugal
| | | | - Ana C Santos
- EPIUnit, Institute of Public Health, University of Porto, Portugal
| | | | - Henrique Barros
- EPIUnit, Institute of Public Health, University of Porto, Portugal
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21
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Larqué E, Labayen I, Flodmark CE, Lissau I, Czernin S, Moreno LA, Pietrobelli A, Widhalm K. From conception to infancy - early risk factors for childhood obesity. Nat Rev Endocrinol 2019; 15:456-478. [PMID: 31270440 DOI: 10.1038/s41574-019-0219-1] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/10/2019] [Indexed: 12/25/2022]
Abstract
Maternal lifestyle during pregnancy, as well as early nutrition and the environment infants are raised in, are considered relevant factors for the prevention of childhood obesity. Several models are available for the prediction of childhood overweight and obesity, yet most have not been externally validated. Moreover, the factors considered in the models differ among studies as the outcomes manifest after birth and depend on maturation processes that vary between individuals. The current Review examines and interprets data on the early determinants of childhood obesity to provide relevant strategies for daily clinical work. We evaluate a selection of prenatal and postnatal factors associated with child adiposity. Actions to be considered for preventing childhood obesity include the promotion of healthy maternal nutrition and weight status at reproductive age and during pregnancy, as well as careful monitoring of infant growth to detect early excessive weight gain. Paediatricians and other health-care professionals should provide scientifically validated, individual nutritional advice to families to counteract excessive adiposity in children. Based on systematic reviews, original papers and scientific reports, we provide information to help with setting up public health strategies to prevent overweight and obesity in childhood.
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Affiliation(s)
- Elvira Larqué
- Department of Physiology, University of Murcia, Murcia, Spain
| | - Idoia Labayen
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD) and Department of Health Sciences, Public University of Navarra, Pamplona, Spain
| | - Carl-Erik Flodmark
- Childhood Obesity Unit, Department of Pediatrics, Skane University Hospital, Malmo, Sweden
- Department of Clinical Sciences, Faculty of Medicine, University of Lund, Lund, Sweden
| | - Inge Lissau
- Childhood Obesity Unit, Department of Pediatrics, Skane University Hospital, Malmo, Sweden
- Department of Clinical Sciences, Faculty of Medicine, University of Lund, Lund, Sweden
- Clinical Research Centre, University Hospital Copenhagen, Hvidovre, Denmark
| | - Sarah Czernin
- Deptartment of Pediatrics, Division of Nutrition and Metabolism and Austrian Academic institute for Clinical Nutrition, Vienna, Austria
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development Research Group, Universidad de Zaragoza, Zaragoza, Spain.
- Instituto Agroalimentario de Aragón (IA2) and Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
| | - Angelo Pietrobelli
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Kurt Widhalm
- Deptartment of Pediatrics, Division of Nutrition and Metabolism and Austrian Academic institute for Clinical Nutrition, Vienna, Austria
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22
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Magalhães EIDS, Sousa BAD, Lima NP, Horta BL. Maternal smoking during pregnancy and offspring body mass index and overweight: a systematic review and meta-analysis. CAD SAUDE PUBLICA 2019; 35:e00176118. [DOI: 10.1590/0102-311x00176118] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 08/02/2019] [Indexed: 08/30/2023] Open
Abstract
Abstract: The present study aimed to conduct a systematic review and meta-analysis to evaluate the evidence on the association of maternal smoking during pregnancy with offspring body composition in childhood, adolescence and adulthood. MEDLINE, Web of Science and LILACS databases were searched. Reference lists were also screened. We included original studies, conducted in humans, that assessed the association of maternal smoking during pregnancy with offspring body mass index (BMI) and overweight in childhood, adolescence and adulthood, published through May 1st, 2018. A meta-analysis was used to estimate pooled effect sizes. The systematic review included 64 studies, of which 37 evaluated the association of maternal smoking during pregnancy with overweight, 13 with BMI, and 14 evaluated both outcomes. Of these 64 studies, 95 measures of effect were extracted and included in the meta-analysis. We verified that the quality of evidence across studies regarding maternal smoking in pregnancy and overweight and BMI of offspring to be moderate and low, respectively. Most studies (44 studies) were classified as moderate risk bias. Heterogeneity among studies included was high and, in the random-effects pooled analysis, maternal smoking during pregnancy increased the odds of offspring overweight (OR: 1.43, 95%CI: 1.35; 1.52) and mean difference of BMI (β: 0.31, 95%CI: 0.23; 0.39). In conclusion, offspring of mothers who smoked during pregnancy have higher odds of overweight and mean difference of BMI, and these associations persisted into adulthood.
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23
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Craig SJC, Blankenberg D, Parodi ACL, Paul IM, Birch LL, Savage JS, Marini ME, Stokes JL, Nekrutenko A, Reimherr M, Chiaromonte F, Makova KD. Child Weight Gain Trajectories Linked To Oral Microbiota Composition. Sci Rep 2018; 8:14030. [PMID: 30232389 PMCID: PMC6145887 DOI: 10.1038/s41598-018-31866-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 08/27/2018] [Indexed: 12/16/2022] Open
Abstract
Gut and oral microbiota perturbations have been observed in obese adults and adolescents; less is known about their influence on weight gain in young children. Here we analyzed the gut and oral microbiota of 226 two-year-olds with 16S rRNA gene sequencing. Weight and length were measured at seven time points and used to identify children with rapid infant weight gain (a strong risk factor for childhood obesity), and to derive growth curves with innovative Functional Data Analysis (FDA) techniques. We showed that growth curves were associated negatively with diversity, and positively with the Firmicutes-to-Bacteroidetes ratio, of the oral microbiota. We also demonstrated an association between the gut microbiota and child growth, even after controlling for the effect of diet on the microbiota. Lastly, we identified several bacterial genera that were associated with child growth patterns. These results suggest that by the age of two, the oral microbiota of children with rapid infant weight gain may have already begun to establish patterns often seen in obese adults. They also suggest that the gut microbiota at age two, while strongly influenced by diet, does not harbor obesity signatures many researchers identified in later life stages.
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Affiliation(s)
- Sarah J C Craig
- Center for Medical Genomics, Penn State University, University Park, PA, 16802, USA.,Department of Biology, Penn State University, University Park, PA, 16802, USA
| | - Daniel Blankenberg
- Department of Biochemistry and Molecular Biology, Penn State University, University Park, PA, 16802, USA.,Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Alice Carla Luisa Parodi
- Department of Mathematics, Politecnico di Milano, Piazza Leonardo da Vinci, 32, Milano, 20133, Italy
| | - Ian M Paul
- Center for Medical Genomics, Penn State University, University Park, PA, 16802, USA.,Department of Pediatrics, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA
| | - Leann L Birch
- Department of Foods and Nutrition, 176 Dawson Hall, University of Georgia, Athens, GA, 30602, USA
| | - Jennifer S Savage
- Center for Childhood Obesity Research, Penn State University, University Park, PA, 16802, USA.,Department of Nutritional Sciences, Penn State University, University Park, PA, 16802, USA
| | - Michele E Marini
- Center for Childhood Obesity Research, Penn State University, University Park, PA, 16802, USA
| | - Jennifer L Stokes
- Department of Pediatrics, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA
| | - Anton Nekrutenko
- Department of Biochemistry and Molecular Biology, Penn State University, University Park, PA, 16802, USA
| | - Matthew Reimherr
- Center for Medical Genomics, Penn State University, University Park, PA, 16802, USA. .,Department of Statistics, Penn State University, University Park, PA, 16802, USA.
| | - Francesca Chiaromonte
- Center for Medical Genomics, Penn State University, University Park, PA, 16802, USA. .,Department of Statistics, Penn State University, University Park, PA, 16802, USA. .,EMbeDS, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà, 33, Pisa, 56127, Italy.
| | - Kateryna D Makova
- Center for Medical Genomics, Penn State University, University Park, PA, 16802, USA. .,Department of Biology, Penn State University, University Park, PA, 16802, USA.
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24
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Hyde NK, Brennan-Olsen SL, Wark JD, Hosking SM, Holloway-Kew KL, Pasco JA. Vitamin D during pregnancy and offspring body composition: a prospective cohort study. Pediatr Obes 2018; 13:514-521. [PMID: 29701327 DOI: 10.1111/ijpo.12286] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 01/09/2018] [Accepted: 01/13/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND Evidence regarding the association between gestational vitamin D status and offspring body composition during childhood is inconsistent. Therefore, we aimed to determine the association between maternal vitamin D and offspring lean and fat mass in the Vitamin D in Pregnancy birth cohort. METHODS Subjects were mother-child pairs recruited from the Australian-based Vitamin D in Pregnancy cohort study. Mothers were recruited before 16 weeks' gestation and provided a blood sample at both recruitment and at 28-32 weeks' gestation. Serum vitamin D [25(OH)D] was measured by radioimmunoassay (Tyne and Wear, UK). Offspring lean and fat mass were quantified by using dual-energy X-ray absorptiometry (GE Lunar Prodigy, Madison, WI, USA) at 11 years of age. RESULTS Median maternal 25(OH)D levels were 55.9 (42.2-73.3) and 56.1 (43.6-73.9) at recruitment and 28-32 weeks' gestation, respectively. Maternal smoking was identified as an effect modifier in the association between maternal vitamin D status at recruitment and offspring body composition. In smokers, but not non-smokers, serum 25(OH)D status at recruitment was negatively associated with offspring fat mass percentage and positively associated with lean mass (both p < 0.05). There was no association with 25(OH)D status at 28-32 weeks' gestation. CONCLUSIONS Maternal vitamin D status in early pregnancy, in smokers, is associated with offspring body composition. These important findings warrant confirmation in larger studies and trials.
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Affiliation(s)
- N K Hyde
- Deakin University, Geelong, Victoria, Australia
| | - S L Brennan-Olsen
- Deakin University, Geelong, Victoria, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), C/-The University of Melbourne and Western Health, St Albans, Victoria, Australia.,Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia
| | - J D Wark
- University of Melbourne Department of Medicine (Royal Melbourne Hospital), Parkville, Victoria, Australia.,Bone and Mineral Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - S M Hosking
- Deakin University, Geelong, Victoria, Australia
| | | | - J A Pasco
- Deakin University, Geelong, Victoria, Australia.,Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Victoria, Australia
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25
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Isong IA, Rao SR, Bind MA, Avendaño M, Kawachi I, Richmond TK. Racial and Ethnic Disparities in Early Childhood Obesity. Pediatrics 2018; 141:peds.2017-0865. [PMID: 29269386 PMCID: PMC5744272 DOI: 10.1542/peds.2017-0865] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2017] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES The prevalence of childhood obesity is significantly higher among racial and/or ethnic minority children in the United States. It is unclear to what extent well-established obesity risk factors in infancy and preschool explain these disparities. Our objective was to decompose racial and/or ethnic disparities in children's weight status according to contributing socioeconomic and behavioral risk factors. METHODS We used nationally representative data from ∼10 700 children in the Early Childhood Longitudinal Study Birth Cohort who were followed from age 9 months through kindergarten entry. We assessed the contribution of socioeconomic factors and maternal, infancy, and early childhood obesity risk factors to racial and/or ethnic disparities in children's BMI z scores by using Blinder-Oaxaca decomposition analyses. RESULTS The prevalence of risk factors varied significantly by race and/or ethnicity. African American children had the highest prevalence of risk factors, whereas Asian children had the lowest prevalence. The major contributor to the BMI z score gap was the rate of infant weight gain during the first 9 months of life, which was a strong predictor of BMI z score at kindergarten entry. The rate of infant weight gain accounted for between 14.9% and 70.5% of explained disparities between white children and their racial and/or ethnic minority peers. Gaps in socioeconomic status were another important contributor that explained disparities, especially those between white and Hispanic children. Early childhood risk factors, such as fruit and vegetable consumption and television viewing, played less important roles in explaining racial and/or ethnic differences in children's BMI z scores. CONCLUSIONS Differences in rapid infant weight gain contribute substantially to racial and/or ethnic disparities in obesity during early childhood. Interventions implemented early in life to target this risk factor could help curb widening racial and/or ethnic disparities in early childhood obesity.
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Affiliation(s)
- Inyang A. Isong
- Boston Children’s Hospital, Boston, Massachusetts;,Department of Social and Behavioral Sciences, Harvard T.H Chan School of Public Health and
| | - Sowmya R. Rao
- Department of Surgery, Boston University, Boston, Massachusetts; and
| | - Marie-Abèle Bind
- Department of Statistics, Faculty of Arts and Sciences, Harvard University, Cambridge, Massachusetts
| | - Mauricio Avendaño
- Department of Social and Behavioral Sciences, Harvard T.H Chan School of Public Health and,Department of Social Science, Health and Medicine, King’s College London, London, United Kingdom
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H Chan School of Public Health and
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26
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Magriplis E, Farajian P, Panagiotakos DB, Risvas G, Zampelas A. Maternal smoking and risk of obesity in school children: Investigating early life theory from the GRECO study. Prev Med Rep 2017; 8:177-182. [PMID: 29071203 PMCID: PMC5650646 DOI: 10.1016/j.pmedr.2017.10.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 09/18/2017] [Accepted: 10/02/2017] [Indexed: 11/26/2022] Open
Abstract
Based on the Early Life Theory, maternal smoking may be a factor affecting child weight status, adiposity level and blood pressure later in life. The purpose of this study was primarily to examine the risk of maternal smoking during pregnancy with overweight and obesity, central and total adiposity in school children. Secondarily, to assess the effect of maternal smoking, with children's blood pressure (BP). Data from the Greek Childhood Obesity cross sectional study (GRECO), conducted from October 2008 to May 2009, were used. A total of 2400 questionnaires gathered from children and their parents were analysed. Maternal and gestational data were gathered by a self-administered questionnaire. Women were categorized as non-smokers or smokers if they smoked ≥ 1 cigarettes/day during pregnancy. Children's body weight, height, waist circumference and BP were measured. Multiple logistic and linear regression analysis was conducted, adjusting for covariates. Four models were used in the process. The study found that children of maternal-smokers were more likely to be overweight or obese (OR: 1.6 to 1.82) and to have a larger waist circumference (OR: 1.73 to 1.85), compared to children of non-smokers in all models used. Total fat percentage was not significantly associated with maternal smoking when adjusted. Systolic and diastolic BP was not associated with maternal smoking. Results of this study strengthen the need for smoking cessation during pregnancy in order to possibly reduce the childhood obesity epidemic. Creating public health awareness of the potential risk of maternal-smoking on children's weight status later in life is warranted.
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Affiliation(s)
- Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 11855 Athens, Greece
| | - Paul Farajian
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 11855 Athens, Greece
| | | | - Grigoris Risvas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 11855 Athens, Greece
| | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 11855 Athens, Greece
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27
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Moore BF, Sauder KA, Starling AP, Ringham BM, Glueck DH, Dabelea D. Exposure to secondhand smoke, exclusive breastfeeding and infant adiposity at age 5 months in the Healthy Start study. Pediatr Obes 2017; 12 Suppl 1:111-119. [PMID: 28868814 PMCID: PMC5608262 DOI: 10.1111/ijpo.12233] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 06/03/2017] [Accepted: 06/22/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Infant adiposity may be influenced by several environmental risk factors, but few studies have explored these interactions. OBJECTIVE To examine the interaction between exposure to secondhand smoke and breastfeeding exclusivity on adiposity at age 5 months. METHODS We studied 813 mother-offspring pairs from the longitudinal Healthy Start study. Fat mass and fat-free mass were measured by air displacement plethysmography. Linear regression analyses were used to estimate the association between household smokers (none, any) with fat mass, fat-free mass, percent fat mass, weight-for-age z-score, weight-for-length z-score and BMI-for-age z-score as separate outcomes. Interaction terms between household smokers and breastfeeding exclusivity (<5 months, ≥5 months) were added to separate models. RESULTS The combination of exposure to secondhand smoke and a lack of exclusive breastfeeding was associated with increased adiposity at age 5 months. For example, within the not exclusively breastfed strata, exposure to secondhand smoke was associated with increased fat mass (0.1 kg; 95% CI: 0.0-0.2; P = 0.05). Conversely, within the exclusively breastfed strata, there was virtually no difference in fat mass between exposed and non-exposed infants (coefficient: -0.1; 95% CI: -0.3-0.1; P = 0.25). CONCLUSIONS Our findings may inform new public health strategies with potential relevance for both smoking cessation and obesity prevention.
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Affiliation(s)
- Brianna F Moore
- Department of Epidemiology, Colorado School of Public Health, Aurora CO, USA
| | - Katherine A Sauder
- Department of Pediatrics, University of Colorado School of Medicine, Aurora CO, USA
| | - Anne P Starling
- Department of Epidemiology, Colorado School of Public Health, Aurora CO, USA
| | - Brandy M Ringham
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora CO, USA
| | - Deborah H Glueck
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora CO, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, Aurora CO, USA,Department of Pediatrics, University of Colorado School of Medicine, Aurora CO, USA
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28
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Leonard SA, Petito LC, Rehkopf DH, Ritchie LD, Abrams B. Weight gain in pregnancy and child weight status from birth to adulthood in the United States. Pediatr Obes 2017; 12 Suppl 1:18-25. [PMID: 27350375 PMCID: PMC5404997 DOI: 10.1111/ijpo.12163] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 05/09/2016] [Accepted: 05/20/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND High weight gain in pregnancy has been associated with child adiposity, but few studies have assessed the relationship across childhood or in racially/ethnically diverse populations. OBJECTIVES The objectives of the study are to test if weight gain in pregnancy is associated with high birthweight and overweight/obesity in early, middle and late childhood and whether these associations differ by maternal race/ethnicity. METHODS Mother-child dyads (n = 7539) were included from the National Longitudinal Survey of Youth 1979, a nationally representative cohort study in the USA (1979-2012). Log-binomial regression models were used to analyse associations between weight gain and the outcomes: high birthweight (>4000 g) and overweight/obesity at ages 2-5, 6-11 and 12-19 years. RESULTS Excessive weight gain was positively associated, and inadequate weight gain was negatively associated with high birthweight after confounder adjustment (P < 0.05). Only excessive weight gain was associated with overweight in early, middle and late childhood. These associations were not significant in Hispanics or Blacks although racial/ethnic interaction was only significant ages 12-19 years (P = 0.03). CONCLUSIONS Helping pregnant women gain weight within national recommendations may aid in preventing overweight and obesity across childhood, particularly for non-Hispanic White mothers.
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Affiliation(s)
- Stephanie A. Leonard
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA
| | - Lucia C. Petito
- Division of Biostatistics, School of Public Health, University of California, Berkeley, CA
| | - David H. Rehkopf
- Division of General Medical Disciplines, Stanford University School of Medicine, Stanford, CA
| | - Lorrene D. Ritchie
- Nutrition Policy Institute, University of California, Division of Agriculture and Natural Resources, Oakland, CA
| | - Barbara Abrams
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA
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29
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Li L, Peters H, Gama A, Carvalhal MIM, Nogueira HGM, Rosado‐Marques V, Padez C. Maternal smoking in pregnancy association with childhood adiposity and blood pressure. Pediatr Obes 2016; 11:202-9. [PMID: 26178147 PMCID: PMC4949567 DOI: 10.1111/ijpo.12046] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 03/04/2015] [Accepted: 05/01/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Maternal smoking during pregnancy has been associated with increased risk of childhood overweight/obesity defined by body mass index (BMI). We examined its association with a range of adiposity measures and cardiovascular indicators in children aged 3-10 years. METHODS We used data from a cross-sectional study of schoolchildren across mainland Portuguese districts (2009-2010). We applied quantile regressions to examine maternal smoking associations with adiposity (n = 17 286), blood pressure (BP) and resting pulse rate (RPR) (n ≈ 2500) measures across the age range, adjusting for prenatal and early life factors. RESULTS Maternal smoking during pregnancy was associated with increases in offspring adiposity levels. The difference in median BMI between children of smokers and non-smokers was 0.39 kg m(-2) (95% confidence interval: 0.25, 0.53) in boys and 0.46 kg m(-2) (0.31, 0.62) in girls; 0.55 cm (0.24, 0.87) and 0.82 cm (0.45, 1.19), respectively, in median waist circumference; and 0.94 mm (0.49, 1.40) and 1.47 mm (0.87, 2.07) in median sum of (triceps, subscapular, suprailiac) skin-folds. The associations appeared to be stronger with increasing age. The differences in the 90th centile tended to be greater than those in median. There was no consistent association of maternal smoking with BP and RPR. CONCLUSIONS Children whose mother smoked during pregnancy had higher adiposity levels than children of non-smokers, across several measures, particularly among older children. Although there was no consistent association with cardiovascular indicators, maternal smoking association with childhood obesity may have implications for cardiovascular risk factors over the life course.
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Affiliation(s)
- L. Li
- Population, Policy, and Practice ProgrammeInstitute of Child HealthUniversity College LondonLondonUK
| | - H. Peters
- Population, Policy, and Practice ProgrammeInstitute of Child HealthUniversity College LondonLondonUK
| | - A. Gama
- Departamento de Biologia AnimalFaculdade de CiênciasUniversity of LisbonLisbonPortugal,Research Centre for Anthropology and HealthDepartment of Life SciencesUniversity of CoimbraCoimbraPortugal
| | | | - H. G. M. Nogueira
- Research Centre for Anthropology and HealthDepartment of Life SciencesUniversity of CoimbraCoimbraPortugal,Department of GeographyUniversity of CoimbraCoimbraPortugal
| | - V. Rosado‐Marques
- Research Centre for Anthropology and HealthDepartment of Life SciencesUniversity of CoimbraCoimbraPortugal,Tropical Research Institute of LisbonLisbonPortugal
| | - C. Padez
- Research Centre for Anthropology and HealthDepartment of Life SciencesUniversity of CoimbraCoimbraPortugal
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