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Fair FJ, Soltani H. Association of child weight with attendance at a healthy lifestyle service among women with obesity during pregnancy. MATERNAL & CHILD NUTRITION 2024; 20:e13629. [PMID: 38311775 PMCID: PMC10981489 DOI: 10.1111/mcn.13629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/13/2023] [Accepted: 01/08/2024] [Indexed: 02/06/2024]
Abstract
Women with obesity during pregnancy are at increased risk of excessive gestational weight gain (GWG) and other maternal and infant adverse outcomes, which all potentially increase childhood obesity. This study explored infant weight outcomes for women with a body mass index (BMI) ≥ 35 kg/m² who were offered an antenatal healthy lifestyle service. A retrospective cohort study, including linking data from two separate health care Trusts, was undertaken. Data were collected from maternity records for women with a BMI ≥ 35 kg/m2 referred to an antenatal healthy lifestyle service from 2009 to 2015. The respective child's weight outcome data was additionally collected from health and National Child Measurement Programme records. Univariate logistic regression determined the odds of childhood overweight, obesity and severe obesity according to attendance at the antenatal healthy lifestyle service, GWG and sociodemographic characteristics. Factors significant (p < 0.05) within the univariate analysis were entered into multiple logistic regression models. Among women with a BMI ≥ 35 kg/m², 30.4% of their children were obese at school entry and 13.3% severely obese. Healthy lifestyle service attendance was not associated with childhood overweight or obesity at any point within the univariate analysis. At school age multiple regression analysis showed the odds of overweight and obesity increased with excessive GWG and the odds of obesity decreased with a parent in a professional occupation, additionally having a mother who smoked in pregnancy increased severe obesity. Women should be supported to optimise their BMI before pregnancy. Additionally, rather than exclusively focusing on changing an individual's behaviour, future interventions should consider external influences such as the woman's family, friends and sociodemographic background.
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Affiliation(s)
- Frankie J. Fair
- College of Health, Wellbeing and Life SciencesSheffield Hallam UniversitySheffieldUK
| | - Hora Soltani
- College of Health, Wellbeing and Life SciencesSheffield Hallam UniversitySheffieldUK
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2
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Ong YY, Rifas-Shiman SL, Perng W, Belfort MB, Law E, Hivert MF, Oken E, Tiemeier H, Aris IM. Growth Velocities Across Distinct Early Life Windows and Child Cognition: Insights from a Contemporary US Cohort. J Pediatr 2023; 263:113653. [PMID: 37541424 PMCID: PMC10837309 DOI: 10.1016/j.jpeds.2023.113653] [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: 05/17/2023] [Revised: 07/06/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE To evaluate the relative importance of overall and period-specific postnatal growth and their interaction with fetal growth on cognition in a generally well-nourished population. STUDY DESIGN We included 1052 children from Project Viva, a prospective cohort in Boston, Massachusetts. Using linear spline mixed-effects models, we modeled length/height and body mass index (BMI) trajectories from birth to 7 years and estimated standardized overall (0-7 years) and period-specific growth velocities ie, early infancy (0-4 months), late infancy (4-15 months), toddlerhood (15-37 months), and early childhood (37-84 months). We investigated associations of growth velocities as well as their interactions with birthweight-for-gestational age on mid-childhood (mean age: 7.9 years) IQ, visual memory and learning, and visual motor ability. RESULTS Greater overall height velocity was associated with modestly higher design memory score, (adjusted β [95% CI] 0.19 [-0.01,0.38] P = .057])points per SD increase but lower verbal IQ (-0.88 [-1.76,0.00] P = .051). Greater early infancy height velocity was associated with higher visual motor score (1.92 [0.67,3.18]). Greater overall BMI velocity was associated with lower verbal IQ (-0.71 [-1.52,0.11] P = .090). Greater late infancy BMI velocity was associated with lower verbal IQ (-1.21 [-2.07,-0.34]), design memory score (-0.22 [-0.42,-0.03)], but higher picture memory score (0.22 [0.01,0.43]). Greater early infancy height velocity (-1.5 SD vs 1.5 SD) was associated with higher nonverbal IQ (margins [95% CI] 102.6 [98.9106.3] vs 108.2 [104.9111.6]) among small-for-gestational age infants (P-interaction = 0.04). CONCLUSIONS Among generally well-nourished children, there might not be clear cognitive gains with faster linear growth except for those with lower birthweight-for-gestational age, revealing the potential importance of early infancy compensatory growth.
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Affiliation(s)
- Yi Ying Ong
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA
| | - Wei Perng
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Mandy B Belfort
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Evelyn Law
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA; Diabetes Unit, Massachusetts General Hospital, Boston, MA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA
| | - Henning Tiemeier
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA
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Kong KL, Lee JK, Shisler S, Thanos PK, Huestis MA, Hawk L, Eiden RD. Prenatal tobacco and cannabis co-exposure and offspring obesity development from birth to mid-childhood. Pediatr Obes 2023; 18:e13010. [PMID: 36734672 PMCID: PMC10288513 DOI: 10.1111/ijpo.13010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/04/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although the association between prenatal tobacco exposure and child obesity risk is well-established, less is known about co-exposure to tobacco and cannabis. OBJECTIVE Determine the relation between prenatal substance co-exposure and obesity risk. METHODS In a diverse sample of pregnant women, we examined the association between prenatal substance exposure (tobacco-only and co-exposure) and child BMI (kg/m2 ) trajectories from birth to mid-childhood (n = 262), overweight/obese status based on BMI percentiles from toddlerhood (24 months) to mid-childhood (9-12 years), and adiposity outcomes at mid-childhood (fat mass [kg], fat mass [%] and fat free mass [kg]; n = 128). Given that the major goal of this study was to examine the associations between prenatal substance exposure and child outcomes, we oversampled pregnant women for substance use (with tobacco as the primary focus). RESULTS Multilevel models demonstrated that children in both exposure groups had a steeper increase in BMI trajectory from birth to mid-childhood and among co-exposed children, girls had a steeper increase than boys. Odds ratio of having obesity by mid-childhood was 12 times higher among those co-exposed than non-exposed. Co-exposure led to significantly greater fat mass and fat mass % compared with no exposure, but exposure to only tobacco was no different than no exposure. CONCLUSIONS Results highlight potentiating effects of cannabis exposure in the context of maternal tobacco use in pregnancy on obesity risk and the importance of multi-method assessments of obesity.
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Affiliation(s)
- Kai Ling Kong
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children’s Mercy Research Institute, Children’s Mercy Hospital, Kansas City, MO, USA
- Department of Pediatrics, University of Missouri- Kansas City, Kansas City, MO, USA
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jin-kyung Lee
- Department of Psychology and The Social Science Research Institute, The Pennsylvania State University, University Park, PA 16801, USA
| | - Shannon Shisler
- Department of Psychology, University at Buffalo, State University of New York, Buffalo, NY, 14203, USA
| | - Panayotis K. Thanos
- Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY 14203, USA
| | - Marilyn A. Huestis
- Institute on Emerging Health Professions, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Larry Hawk
- Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY 14203, USA
| | - Rina D. Eiden
- Department of Psychology and The Social Science Research Institute, The Pennsylvania State University, University Park, PA 16801, USA
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Maternal Pre-Pregnancy Nutritional Status and Infant Birth Weight in Relation to 0-2 Year-Growth Trajectory and Adiposity in Term Chinese Newborns with Appropriate Birth Weight-for-Gestational Age. Nutrients 2023; 15:nu15051125. [PMID: 36904121 PMCID: PMC10005412 DOI: 10.3390/nu15051125] [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: 12/13/2022] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 02/25/2023] Open
Abstract
Being born with appropriate weight-for-gestational age (AGA, ~80% of newborns) is often considered as low risk for future obesity. This study examined differential growth trajectories in the first two years by considering pre- and peri-natal factors among term-born AGA infants. We prospectively investigated 647 AGA infants and their mothers enrolled during 2012-2013 in Shanghai, China, and obtained repeated anthropometric measures at ages 42 days, 3, 6, 9, and 18 months from postnatal care records, and onsite measurements at age 1 and 2 years (skinfold thickness, mid-upper arm circumference (MUAC)). Birthweight was classified into sex-and gestational age-specific tertiles. Among mothers, 16.3% were overweight/obese (OWO), and 46.2% had excessive gestational weight gain (GWG). The combination of maternal prepregnancy OWO and high birthweight tertile identified a subset of AGA infants with 4.1 mm higher skinfold thickness (95% CI 2.2-5.9), 1.3 cm higher MUAC (0.8-1.7), and 0.89 units higher weight-for-length z-score (0.54, 1.24) at 2 years of age with adjustment for covariates. Excessive GWG was associated with higher child adiposity measures at 2 years of age. AGA infants manifested differential growth trajectories by the combination of maternal OWO and higher birthweight, suggesting that additional attention is needed for those "at increased risk" of OWO in early intervention.
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The Associations of Birthweight for Gestational Age Status with Its Differential 0-2 Year Growth Trajectory and Blood Pressure at Two Years of Age in Chinese Boys and Girls. Nutrients 2023; 15:nu15040979. [PMID: 36839337 PMCID: PMC9959466 DOI: 10.3390/nu15040979] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
The first 1000 days of life represents a critical period for lifelong metabolic health. This study prospectively examined the contrasts between the growth trajectories of large, small, and appropriate sizes for gestational age (LGA, SGA, and AGA) term-born infants in their first two years, and their blood pressure at two years. In 2012-2013, 806 Chinese mother-newborn dyads were enrolled in the Shanghai Obesity and Allergy Birth Cohort Study. Repeated anthropometric measures were obtained at age 42 days, and at 3, 6, 9, 12, 18 and 24 months. Systolic and diastolic blood pressure (SBP, DBP) were measured at two years of age. Linear random effect models were employed to evaluate growth trajectory differences between LGA, SGA, and AGA infants. Of the study infants, 12.4% were LGA and 4.0% SGA. Length, weight, and weight-for-length z-score (ZWFL) were all consistently higher in LGA infants and lower in SGA infants than AGA infants. SGA infants had a higher ZWFL (0.11 unit/month; 95% CI: 0.04, 0.19) and a higher BMI (0.19; 95% CI: 0.09, 0.28 kg/m2 per month) growth velocity at age 0-6 months, relative to AGA infants. SGA was associated with 6.4 (0.4-12.4) mmHg higher SBP, and LGA was associated with 2.9 (95% CI -5.2, -0.5) mmHg lower DBP at two years of age in boys, however, not in girls. In conclusion, in this prospective birth cohort with repeated anthropometric measures and BP at two years of age, LGA, SGA, and AGA term-born infants manifested differential patterns of weight growth trajectory and BP, providing new insight into developmental origins of cardiometabolic health.
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Descarpentrie A, Bernard JY, Vandentorren S, Melchior M, Galéra C, Chia A, Chong MFF, Charles MA, Heude B, Lioret S. Prospective associations of lifestyle patterns in early childhood with socio-emotional and behavioural development and BMI: An outcome-wide analysis of the EDEN mother-child cohort. Paediatr Perinat Epidemiol 2023; 37:69-80. [PMID: 36146899 DOI: 10.1111/ppe.12926] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/29/2022] [Accepted: 09/07/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Children's energy balance-related behaviours (EBRB), comprising diet, screen time, physical activity, and sleep, combine into "lifestyle patterns", which may exert a synergistic effect on health. To date, studies investigating this synergy have primarily focused on obesity risk, without addressing other facets of health. OBJECTIVES To examine the prospective associations of preschoolers' lifestyle patterns with socio-emotional, behavioural, and body mass index (BMI) outcomes at 8 years. METHODS Participants were 876 children from the EDEN mother-child cohort. Three lifestyle patterns (unhealthy, healthy, and mixed) were previously identified at age 5, separately in boys and girls. At age 8, height and weight measures generated BMI z-scores while social-emotional and behavioural development was assessed by parents using the Strengths and Difficulties Questionnaire (SDQ). Drawing from the outcome-wide approach, sex- and outcome-specific adjusted linear regressions were fitted. RESULTS Boys' adherence to a healthy lifestyle pattern (combining a nutrient-dense diet and limited screen time) at 5 years was positively associated with prosocial behaviours (β = 0.14; 95% confidence interval [CI] 0.01, 0.26) and inversely related to hyperactivity-inattention symptoms (β = -0.12; 95% CI -0.23, -0.01) at 8 years. Girls' mixed lifestyle pattern (sugar or artificially sweetened beverages, high screen, physical activity and low sleep times) was associated with prosocial behaviours (β = 0.12; 95% CI 0.01, 0.23). There was no evidence of associations between lifestyle patterns and BMI z-scores. CONCLUSIONS Findings suggest synergistic benefits of engaging in a combination of optimal EBRBs, especially in boys, and support intervention efforts at preschool age to enhance some dimensions of their later socio-emotional and behavioural development.
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Affiliation(s)
- Alexandra Descarpentrie
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Jonathan Y Bernard
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Stephanie Vandentorren
- Université Bordeaux, Inserm, UMR1219, Vintage Team, Bordeaux, France.,Santé publique France, French national public health agency, Saint-Maurice, France
| | - Maria Melchior
- Sorbonne Université, Inserm, IPLESP, ERES UMRS 1136, Paris, France
| | - Cédric Galéra
- Bordeaux Population Health Research Centre, INSERM U 1219, Bordeaux, France.,Université de Bordeaux, Bordeaux, France.,Department of Child and Adolescent Psychiatry, Centre Hospitalier Charles Perrens, Bordeaux, France
| | - Airu Chia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Mary F-F Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Marie-Aline Charles
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Barbara Heude
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Sandrine Lioret
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
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Yamashita M, Yorifuji T, Matsumoto N, Kubo T, Tsukahara H. Early childhood exposure to maternal smoking and obesity: A nationwide longitudinal survey in Japan. Clin Obes 2022; 13:e12572. [PMID: 36504321 DOI: 10.1111/cob.12572] [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: 07/01/2022] [Revised: 11/08/2022] [Accepted: 11/12/2022] [Indexed: 12/14/2022]
Abstract
Involuntary exposure to tobacco smoke is suspected to be one of the risks factors that are associated with obesity in children. The purpose of this study was to examine the relationship between early childhood exposure to tobacco smoke and the risk of obesity and overweight in Japan. This study utilized a nationwide, population-based longitudinal survey. The participants were restricted to 32 081 children who had available information on maternal smoking history as well as childhood height and weight. We conducted a binomial log-linear regression analysis with children of non-smoking mothers as the reference group. The children with mothers who were smokers had a higher risk of developing obesity or being overweight compared to the children with mothers who were nonsmokers. The risk ratios were 1.20 (95% confidence interval [CI]: 1.09-1.32) for overweight and 1.17 (95% CI: 0.95-1.44) for obesity. Early exposure to maternal smoking increases the risk of being overweight and having obesity during childhood. The increased risk is more pronounced among children with mothers, smoked heavily, or parents, who were smokers.
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Affiliation(s)
- Miho Yamashita
- Department of Foods and Human Nutrition Faculty of Human Life Sciences, Notre Dame Seishin University, Okayama, Japan
| | - Takashi Yorifuji
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Naomi Matsumoto
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Toshihide Kubo
- Department of Pediatrics, National Hospital Organization, Okayama Medical Center, Okayama, Japan
| | - Hirokazu Tsukahara
- Department of Pediatrics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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Caut C, Schoenaker D, McIntyre E, Vilcins D, Gavine A, Steel A. Relationships between Women's and Men's Modifiable Preconception Risks and Health Behaviors and Maternal and Offspring Health Outcomes: An Umbrella Review. Semin Reprod Med 2022; 40:170-183. [PMID: 35830867 DOI: 10.1055/s-0042-1744257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Parental health before conception effects maternal and offspring health outcomes. Preconception care provides healthcare to prospective parents addressing modifiable preconception risks and health behaviors. This umbrella review aimed to consolidate evidence on women's and men's modifiable preconception risks or health behaviors associated with maternal and offspring health outcomes. MEDLINE, EMBASE, Maternity and Infant Care, CINAHL, and PsycINFO were searched from March 4, 2010, to March 4, 2020. Eligible studies were systematic reviews or meta-analyses of observational studies examining associations between modifiable preconception risks or health behaviors and maternal and offspring health outcomes. Screening, data extraction, and methodological quality assessment (AMSTAR 2) occurred independently by two reviewers. Degree of overlap was examined. Findings were summarized for evidence synthesis. Twenty-seven systematic reviews were included. Modifiable preconception risks and health behaviors were identified across categories: body composition (e.g., overweight, obesity), lifestyle behaviors (e.g., caffeine, smoking), nutrition (e.g., micronutrients), environmental exposures (e.g., radiation), and birth spacing (e.g., short interpregnancy intervals). Outcomes associated with exposures affected embryo (e.g., embryonic growth), maternal (e.g., gestational diabetes mellitus), fetal/neonate (e.g., preterm birth), and child (e.g., neurocognitive disorders) health. For real-world practice and policy relevance, evidence-based indicators for preconception care should include body composition, lifestyle, nutrition, environmental, and birth spacing.
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Affiliation(s)
| | - Danielle Schoenaker
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Erica McIntyre
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.,Institute for Sustainable Futures, University of Technology Sydney, Sydney, Australia
| | - Dwan Vilcins
- Children's Health Environmental Program (CHEP), Child Health Research Centre, University of Queensland, South Brisbane, Australia
| | - Anna Gavine
- School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Gomes D, Le L, Perschbacher S, Haas NA, Netz H, Hasbargen U, Delius M, Lange K, Nennstiel U, Roscher AA, Mansmann U, Ensenauer R. Predicting the earliest deviation in weight gain in the course towards manifest overweight in offspring exposed to obesity in pregnancy: a longitudinal cohort study. BMC Med 2022; 20:156. [PMID: 35418073 PMCID: PMC9008920 DOI: 10.1186/s12916-022-02318-z] [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: 08/22/2021] [Accepted: 02/28/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Obesity in pregnancy and related early-life factors place the offspring at the highest risk of being overweight. Despite convincing evidence on these associations, there is an unmet public health need to identify "high-risk" offspring by predicting very early deviations in weight gain patterns as a subclinical stage towards overweight. However, data and methods for individual risk prediction are lacking. We aimed to identify those infants exposed to obesity in pregnancy at ages 3 months, 1 year, and 2 years who likely will follow a higher-than-normal body mass index (BMI) growth trajectory towards manifest overweight by developing an early-risk quantification system. METHODS This study uses data from the prospective mother-child cohort study Programming of Enhanced Adiposity Risk in CHildhood-Early Screening (PEACHES) comprising 1671 mothers with pre-conception obesity and without (controls) and their offspring. Exposures were pre- and postnatal risks documented in patient-held maternal and child health records. The main outcome was a "higher-than-normal BMI growth pattern" preceding overweight, defined as BMI z-score >1 SD (i.e., World Health Organization [WHO] cut-off "at risk of overweight") at least twice during consecutive offspring growth periods between age 6 months and 5 years. The independent cohort PErinatal Prevention of Obesity (PEPO) comprising 11,730 mother-child pairs recruited close to school entry (around age 6 years) was available for data validation. Cluster analysis and sequential prediction modelling were performed. RESULTS Data of 1557 PEACHES mother-child pairs and the validation cohort were analyzed comprising more than 50,000 offspring BMI measurements. More than 1-in-5 offspring exposed to obesity in pregnancy belonged to an upper BMI z-score cluster as a distinct pattern of BMI development (above the cut-off of 1 SD) from the first months of life onwards resulting in preschool overweight/obesity (age 5 years: odds ratio [OR] 16.13; 95% confidence interval [CI] 9.98-26.05). Contributing early-life factors including excessive weight gain (OR 2.08; 95% CI 1.25-3.45) and smoking (OR 1.94; 95% CI 1.27-2.95) in pregnancy were instrumental in predicting a "higher-than-normal BMI growth pattern" at age 3 months and re-evaluating the risk at ages 1 year and 2 years (area under the receiver operating characteristic [AUROC] 0.69-0.79, sensitivity 70.7-76.0%, specificity 64.7-78.1%). External validation of prediction models demonstrated adequate predictive performances. CONCLUSIONS We devised a novel sequential strategy of individual prediction and re-evaluation of a higher-than-normal weight gain in "high-risk" infants well before developing overweight to guide decision-making. The strategy holds promise to elaborate interventions in an early preventive manner for integration in systems of well-child care.
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Affiliation(s)
- Delphina Gomes
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Lien Le
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Sarah Perschbacher
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Nikolaus A Haas
- Division of Pediatric Cardiology and Intensive Care, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Heinrich Netz
- Division of Pediatric Cardiology and Intensive Care, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Uwe Hasbargen
- Department of Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Maria Delius
- Department of Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Kristin Lange
- Department of General Pediatrics, Neonatology, and Pediatric Cardiology, University Children's Hospital, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Uta Nennstiel
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Adelbert A Roscher
- Department of Pediatrics, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Ulrich Mansmann
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Regina Ensenauer
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany. .,Institute of Child Nutrition, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany.
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10
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Solans M, Barceló MA, Morales-Suárez-Varela M, Moya A, Saez M. Prenatal exposure to antibiotics and risk of childhood overweight or obesity: A systematic review and meta-analysis. Obes Rev 2022; 23 Suppl 1:e13382. [PMID: 34859947 DOI: 10.1111/obr.13382] [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: 10/08/2021] [Accepted: 10/08/2021] [Indexed: 10/19/2022]
Abstract
Infant antibiotic use has been modestly associated with childhood overweight, while evidence on prenatal exposures remains less clear. A systematic review and meta-analysis were conducted to examine associations between maternal antibiotic exposure and subsequent risk of childhood overweight/obesity. Publications were retrieved from PubMed and Web of Science databases up to December 2019. A random effects model was used to summarize risk estimates, overall, and by period and frequency of exposure. Ten observational studies were included in the narrative synthesis. We did not observe a clear pattern of association between prenatal antibiotic use and childhood overweight/obesity. There were suggestive associations for repeated exposures (≥3 courses) and those taking place during the second trimester of gestation, which were also pointed out in our meta-analysis (relative risk, RR2T = 1.15 (95% CI 1.04; 1.28, I2 = 18%), and RR3courses = 1.31 (95% CI 1.03; 1.67, I2 = 65%), respectively). In most studies, however, confounding by underlying infections cannot be ruled out. Overall, current data do not conclusively support the hypothesis that prenatal exposure to antibiotics is a risk factor for childhood obesity/overweight. Further studies, controlling for underlying infections and exploring the association according to frequency, period (both prenatal and intrapartum) and type of antibiotic, are needed to clarify this association.
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Affiliation(s)
- Marta Solans
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Girona, Spain.,Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
| | - Maria A Barceló
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Girona, Spain.,Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
| | - Maria Morales-Suárez-Varela
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Girona, Spain.,Department of Preventive Medicine and Public Health, Food Sciences, Toxicology, and Legal Medicine, School of Pharmacy, University of Valencia, Valencia, Spain
| | - Andrés Moya
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Girona, Spain.,Instituto de Biología Integrativa de Sistemas, Universitat de València and Spanish Research Council (CSIC), Valencia, Spain.,Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO), Valencia, Spain
| | - Marc Saez
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Girona, Spain.,Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
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11
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Krukowski R, Johnson B, Kim H, Sen S, Homsi R. A Pragmatic Intervention Using Financial Incentives for Pregnancy Weight Management: Feasibility Randomized Controlled Trial. JMIR Form Res 2021; 5:e30578. [PMID: 34951594 PMCID: PMC8742213 DOI: 10.2196/30578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/29/2021] [Accepted: 11/17/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Excessive gestational weight gain (GWG) is common and can result in maternal and child health complications. Pragmatic behavioral interventions that can be incorporated into standard obstetric care are needed, and financial incentives are a promising approach. OBJECTIVE The aim of this study is to evaluate the feasibility of recruitment, randomization, and retention, as well as treatment engagement and intervention satisfaction, in a behavioral program. The program provided small incentives for meeting behavioral goals of self-weighing and physical activity as well as larger outcome incentives for meeting GWG goals. METHODS We recruited 40 adult women in their first trimester of pregnancy from February 2019 to September 2019 at an obstetric clinic. Participants were randomized to 3 intervention components using a 2×2×2 factorial design: daily incentives for self-weighing (lottery vs certain loss), incentives for adhering to the Institute of Medicine's GWG guidelines based on BMI category (monthly vs overall), and incentives for reaching physical activity goals (yes vs no). Participants were asked to complete daily weigh-ins using the Withings Body wireless scale provided by the study, as well as wear a physical activity tracker (Fitbit Flex 2). Feasibility outcomes of recruitment, randomization, and retention, as well as treatment engagement and intervention satisfaction, were assessed. Weight assessments were conducted at baseline, 32-week gestation, and 36-week gestation. RESULTS Participants were enrolled at, on average, 9.6 (SD 1.8) weeks' gestation. Of the 39 participants who were oriented to their condition and received the intervention, 24 (62%) were Black or African American, 30 (77%) were not married, and 29 (74%) had an annual household income of less than US $50,000. Of the 39 participants, 35 (90%) completed the follow-up data collection visit. Participants were generally quite positive about the intervention components, with a particular emphasis on the helpfulness of, and the enjoyment of using, the e-scale in both the quantitative and qualitative feedback. Participants who received the loss incentive, on average, had 2.86 times as many days of self-weighing as those who received the lottery incentive. Participants had a relatively low level of activity, with no difference between those who received a physical activity incentive and those who did not. CONCLUSIONS A financial incentive-based pragmatic intervention was feasible and acceptable for pregnant women for promoting self-weighing, physical activity, and healthy GWG. Participants were successfully recruited early in their first trimester of pregnancy and retained for follow-up data collection in the third trimester. Participants demonstrated promising engagement in self-weighing, particularly with loss-based incentives, and reported finding the self-weighing especially helpful. This study supports further investigation of pragmatic, clinic-based financial incentive-based interventions for healthy GWG behaviors. TRIAL REGISTRATION ClinicalTrials.gov NCT03834194; https://clinicaltrials.gov/ct2/show/NCT03834194.
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Affiliation(s)
- Rebecca Krukowski
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States.,Department of Public Health Science, University of Virginia, Charlottesville, VA, United States
| | - Brandi Johnson
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Hyeonju Kim
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Saunak Sen
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Riad Homsi
- Just For Women Obstetric Clinic, Memphis, TN, United States
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12
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Laforest ME, Ward S, Landry LA, Mobetty F. The Relationship Between Paternal Preconception Obesity and Health Behaviors and Childhood Obesity: Protocol for a Systematic Review. JMIR Res Protoc 2021; 10:e31254. [PMID: 34860672 PMCID: PMC8686461 DOI: 10.2196/31254] [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: 06/17/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background Childhood obesity is a global public health concern and is a priority for researchers and policy makers. To overcome the epidemic of obesity, influencing factors throughout the life span need to be addressed, including those in the preconception period. A better understanding of the association between paternal preconception factors and childhood obesity is important for public health interventions. Objective This systematic review will examine the relationship between paternal preconception obesity and health behaviors and their offspring’s overweight or obesity. Methods Peer-reviewed quantitative studies and grey literature that report associations between paternal preconception obesity and health behaviors—such as smoking, exercise, and eating habits—and childhood overweight and obesity will be identified through a computerized literature search in 7 databases. The quality of each study will be assessed using the Quality Assessment Tool for Quantitative Studies. Characteristics of the included studies will be reported, and relevant findings from each paternal preconception exposure will be narratively synthesized. This review will follow the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) 2020 guidelines. Results This systematic review is anticipated to begin in December 2021 and be completed by the end of August 2022. Conclusions This systematic review will contribute to a better understanding of the relationship between preconception paternal exposures and their offspring’s overweight or obesity. Findings will help support health professionals working with prospective parents to educate fathers on the benefits of improving their weight and health behaviors during the preconception period. International Registered Report Identifier (IRRID) PRR1-10.2196/31254
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Affiliation(s)
- Marie-Eve Laforest
- École de Science Infirmière, Faculté des Sciences de la Santé et des Services Communautaires, Université de Moncton, Moncton, NB, Canada
| | - Stephanie Ward
- École des Sciences des Aliments, de Nutrition et d'Etudes Familiales, Faculté des Sciences de la Santé et des Services Communautaires, Université de Moncton, Moncton, NB, Canada
| | - Liette-Andrée Landry
- École de Science Infirmière, Faculté des Sciences de la Santé et des Services Communautaires, Université de Moncton, Campus de Shippagan, Shippagan, NB, Canada
| | - Fabrice Mobetty
- Département de Nutrition, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
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13
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Robatsch J, Voitl P, Diesner-Treiber SC. A cross-sectional, exploratory survey on health-relevant free-time activities and body mass index in preschool children in urban and rural settings of Austria. BMC Pediatr 2021; 21:495. [PMID: 34742276 PMCID: PMC8571826 DOI: 10.1186/s12887-021-02972-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/25/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The increasing prevalence of obesity is among the most relevant healthcare issues in Europe. The number of overweight people rises due to lifestyle changes, increased sitting activities, and less physical activity. Prevention in early childhood is paramount to stop this alarming trend. AIM This study primarily aimed to evaluate the average time children (3-5 years) from rural and urban Austrian regions spent engaging in physical activity and sedentary behaviors in their free-time. Additionally, we investigated the potential correlation between duration and habits of free-time activity or place of residence and age- and sex-specific body mass index (BMI). The potential impact of socio-economic factors on BMI was examined. METHODS Urban (Vienna) and rural (Carinthia) regions of Austria were chosen for this observational cross-sectional study. Preschool children (n=130) attending nurseries in these regions were included. Weight and height were measured and BMI calculated. Free-time activity and socio-economic data were asked using a self-administered questionnaire. Data on sedentary behavior time (sedentary activity and media consumption) and physical activity time (defined as organized or spontaneous exercise) were analyzed using non-parametric tests. RESULTS Preschool children spent approximately as many hours of their free-time engaged in physical activity as in sedentary behaviors. Time trend in media consumption amounts to one-third of the cumulative time spent engaging in sedentary behaviors. Preschoolers from the urban area spent fewer hours practicing organized exercise and more in sedentary behaviors than peers in the rural area. In the selected areas, 7 % of preschoolers were overweight, 3.9 % were obese. BMI was not associated with free-time activities but showed a trendwise negative correlation with organized exercise. A positive correlation of age and organized exercise was observed but not with physical activity per se. CONCLUSIONS Our results confirm the necessity of preventive interventions among Austrian preschoolers and lead to a better understanding of their free-time activities. Further investigations with larger study populations are needed to promote effective childhood obesity prevention and examine the differences regarding obesity prevalence and leisure-time activity between rural and urban areas.
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Affiliation(s)
- J. Robatsch
- First Vienna Pediatric Medical Center, Donau-City Strasse 1, 1220 Vienna, Austria
| | - P. Voitl
- First Vienna Pediatric Medical Center, Donau-City Strasse 1, 1220 Vienna, Austria
- Sigmund Freud University Vienna, Donau-City Strasse 1, 1220 Vienna, Austria
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14
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Maguire RL, House JS, Lloyd DT, Skinner HG, Allen TK, Raffi AM, Skaar DA, Park SS, McCullough LE, Kollins SH, Bilbo SD, Collier DN, Murphy SK, Fuemmeler BF, Gowdy KM, Hoyo C. Associations between maternal obesity, gestational cytokine levels and child obesity in the NEST cohort. Pediatr Obes 2021; 16:e12763. [PMID: 33381912 PMCID: PMC8178180 DOI: 10.1111/ijpo.12763] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 11/25/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Although maternal systemic inflammation is hypothesized to link maternal pre-pregnancy obesity to offspring metabolic dysfunction, patient empirical data are limited. OBJECTIVES In this study, we hypothesized that pre-pregnancy obesity alters systemic chemo/cytokines concentrations in pregnancy, and this alteration contributes to obesity in children. METHODS In a multi-ethnic cohort of 361 mother-child pairs, we measured prenatal concentrations of plasma TNF-α, IL-6, IL-8, IL-1β, IL-4, IFN-γ, IL-12 p70 subunit, and IL-17A using a multiplex ELISA and examined associations of pre-pregnancy obesity on maternal chemo/cytokine levels, and associations of these cytokine levels with offspring body mass index z score (BMI-z) at age 2-6 years using linear regression. RESULTS After adjusting for maternal smoking, ethnicity, age, and education, pre-pregnancy obesity was associated with increased concentrations of TNF-α (P = .026) and IFN-γ (P = .06). While we found no evidence for associations between TNF-α concentrations and offspring BMI-z, increased IFN-γ concentrations were associated with decreased BMI-z (P = .0002), primarily in Whites (P = .0011). In addition, increased maternal IL-17A concentrations were associated with increased BMI-z in offspring (P = .0005) with stronger associations in African Americans (P = .0042) than Whites (P = .24). CONCLUSIONS Data from this study are consistent with maternal obesity-related inflammation during pregnancy, increasing the risk of childhood obesity in an ethnic-specific manner.
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Affiliation(s)
- Rachel L. Maguire
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA,Department of Obstetrics and Gynecology, Duke University, Durham, NC, USA
| | - John S. House
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA,Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA,Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, 27709, USA
| | - Dillon T. Lloyd
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Harlyn G. Skinner
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA,Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | | | - Asifa Mohamed Raffi
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - David A. Skaar
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA,Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | - Sarah S. Park
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | | | - Scott H. Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Staci D. Bilbo
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - David N. Collier
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA,Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, NC, USA,East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, NC, USA
| | - Susan K. Murphy
- Department of Obstetrics and Gynecology, Duke University, Durham, NC, USA
| | - Bernard F. Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Kymberly M. Gowdy
- Pulmonary, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, Davis Heart and Lung Research Institute, Columbus, Ohio, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA,Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
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15
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Rossiter C, Cheng H, Appleton J, Campbell KJ, Denney-Wilson E. Addressing obesity in the first 1000 days in high risk infants: Systematic review. MATERNAL AND CHILD NUTRITION 2021; 17:e13178. [PMID: 33780128 PMCID: PMC8189222 DOI: 10.1111/mcn.13178] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 12/11/2022]
Abstract
Early intervention is critical for addressing the challenge of childhood obesity. Yet many preventive interventions do not target infants most at risk of future overweight or obesity. This systematic review examines interventions delivered before 2 years that aim to ameliorate excess weight gain among infants at high risk of overweight or obesity, due to sociodemographic characteristics, parental weight or health status, infant feeding or health behaviours. We searched six databases for interventions: (a) delivered before age two, (b) specifically aimed at infants at high risk of childhood obesity and (c) that reported outcomes by weight status beyond 28 days. The search identified over 27,000 titles, and 49 papers from 38 studies met inclusion criteria: 10 antenatal interventions, 16 postnatal and 12 conducted both before and after birth. Nearly all targeted infant and/or maternal nutrition. Studies varied widely in design, obesity risk factors, outcomes and quality. Overall, nine interventions of varying quality reported some evidence of significantly improved child weight trajectory, although effects tended to diminish over time. Interventions that improved weight outcomes tended to engage parents for a longer period, and most offered health professional input and support. Two studies of limited quality reported significantly worse weight outcomes in the intervention group.
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Affiliation(s)
- Chris Rossiter
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Heilok Cheng
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jessica Appleton
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Institute for Women, Children and their Families, Sydney, New South Wales, Australia.,Tresillian Family Care Centres, Belmore, New South Wales, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Victoria, Australia
| | - Elizabeth Denney-Wilson
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Institute for Women, Children and their Families, Sydney, New South Wales, Australia
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16
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Prenatal Exposure to Mixtures of Phthalates, Parabens, and Other Phenols and Obesity in Five-Year-Olds in the CHAMACOS Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041796. [PMID: 33673219 PMCID: PMC7918439 DOI: 10.3390/ijerph18041796] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 02/06/2023]
Abstract
Exposures to phthalates, parabens, and other phenols are often correlated due to their ubiquitous use in personal care products and plastics. Examining these compounds as a complex mixture may clarify inconsistent relationships between individual chemicals and childhood adiposity. Using data from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study, a longitudinal cohort of children in Salinas Valley, California (n = 309), we examined biomarkers of 11 phthalate metabolites and 9 phenols, including several parabens and bisphenol A, measured in maternal urine at two time points during pregnancy. We measured child height and weight at age five to calculate the body mass index (BMI) z-scores and overweight/obesity status. The association between prenatal urinary concentrations of biomarkers with the childhood BMI z-score and overweight/obesity status was analyzed using single-pollutant models and two mixture methods: Bayesian hierarchical modeling (BMH) and Bayesian kernel machine regression (BKMR). Urinary concentrations of monoethyl phthalate, monocarboxy-isononly phthalate (metabolites of diethyl phthalate and di-isodecyl phthalate, respectively), and propylparaben were consistently associated with an increased BMI z-score and overweight/obesity status across all modeling approaches. Higher prenatal exposures to the cumulative biomarker mixture also trended with greater childhood adiposity. These results, robust across two methods that control for co-pollutant confounding, suggest that prenatal exposure to certain phthalates and parabens may increase the risk for obesity in early childhood.
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17
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Naseri R, Navabi SJ, Samimi Z, Mishra AP, Nigam M, Chandra H, Olatunde A, Tijjani H, Morais-Urano RP, Farzaei MH. Targeting Glycoproteins as a therapeutic strategy for diabetes mellitus and its complications. Daru 2020; 28:333-358. [PMID: 32006343 PMCID: PMC7095136 DOI: 10.1007/s40199-020-00327-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/10/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Glycoproteins are organic compounds formed from proteins and carbohydrates, which are found in many parts of the living systems including the cell membranes. Furthermore, impaired metabolism of glycoprotein components plays the main role in the pathogenesis of diabetes mellitus. The aim of this study is to investigate the influence of glycoprotein levels in the treatment of diabetes mellitus. METHODS All relevant papers in the English language were compiled by searching electronic databases, including Scopus, PubMed and Cochrane library. The keywords of glycoprotein, diabetes mellitus, glycan, glycosylation, and inhibitor were searched until January 2019. RESULTS Glycoproteins are pivotal elements in the regulation of cell proliferation, growth, maturation and signaling pathways. Moreover, they are involved in drug binding, drug transportation, efflux of chemicals and stability of therapeutic proteins. These functions, structure, composition, linkages, biosynthesis, significance and biological effects are discussed as related to their use as a therapeutic strategy for the treatment of diabetes mellitus and its complications. CONCLUSIONS The findings revealed several chemical and natural compounds have significant beneficial effects on glycoprotein metabolism. The comprehension of glycoprotein structure and functions are very essential and inevitable to enhance the knowledge of glycoengineering for glycoprotein-based therapeutics as may be required for the treatment of diabetes mellitus and its associated complications. Graphical abstract.
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Affiliation(s)
- Rozita Naseri
- Internal Medicine Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Jafar Navabi
- Internal Medicine Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zeinab Samimi
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Abhay Prakash Mishra
- Department of Pharmaceutical Chemistry, Hemwati Nandan Bahuguna Garhwal (A Central) University, Srinagar Garhwal, Uttarakhand, 246174, India.
| | - Manisha Nigam
- Department of Biochemistry, Hemwati Nandan Bahuguna Garhwal University, Srinagar Garhwal, Uttarakhand, 246174, India
| | - Harish Chandra
- Department of Microbiology, Gurukul Kangri Vishwavidhyalya, Haridwar, Uttarakhand, 249404, India
| | - Ahmed Olatunde
- Department of Biochemistry, Abubakar Tafawa Balewa University, Bauchi, Nigeria
| | - Habibu Tijjani
- Natural Product Research Laboratory, Department of Biochemistry, Bauchi State University, Gadau, Nigeria
| | - Raquel P Morais-Urano
- Instituto de Química de São Carlos, Universidade de São Paulo, 13560-970, São Carlos, SP, Brasil
| | - Mohammad Hosein Farzaei
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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18
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Tang X, Andres A, West DS, Lou X, Krukowski RA. Eating behavior and weight gain during pregnancy. Eat Behav 2020; 36:101364. [PMID: 32032810 DOI: 10.1016/j.eatbeh.2020.101364] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 01/02/2020] [Accepted: 01/13/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Little is known about the relationship between eating behavior and weight gain during pregnancy. PURPOSE Our objective was to assess the relationship among self-reported cognitive restraint, disinhibition, and hunger, and excessive gestational weight gain (GWG) as defined by the Institute of Medicine's (IOM) 2009 guidelines. Based on previous research examining eating behaviors and weight gain in non-pregnant women, we hypothesized that excessive GWG would be related to higher cognitive restraint, higher disinhibition, and higher perception of hunger. METHODS 190 pregnant women from the Glowing study completed the Three-Factor Eating Questionnaire (TFEQ) at the enrollment visit, which included subscales assessing restraint, disinhibition, and hunger. Participants' height and weight from <10 weeks through 36 weeks gestation were measured, allowing classification within or in excess of the IOM guidelines adjusted for the week of the final measurement. RESULTS The odds that a participant would gain weight above IOM recommendations was 1.2 times higher (OR = 1.17, 95% CI = 1.05-1.29) for each one-unit increase in the disinhibition subscale in the unadjusted logistic regression. However, after controlling for sociodemographic characteristics and baseline BMI categories, participants' TFEQ scores were not associated with the likelihood of having GWG above IOM guidelines. Eating behaviors subscales were modestly correlated with baseline BMI categories (all rs < 0.50 with p-values ranging from <0.001 to 0.619). CONCLUSIONS Although disinhibition scores had a significant relationship with excessive GWG, the significance of this relationship was not sustained after adjusting for sociodemographic characteristics and baseline BMI categories.
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Affiliation(s)
- Xuyang Tang
- Department of Preventive Medicine, University of Tennessee Health Science Center, United States of America
| | - Aline Andres
- Department of Pediatrics, University of Arkansas for Medical Sciences, United States of America
| | - Delia S West
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, United States of America
| | - Xiangyang Lou
- Department of Biostatistics, University of Florida, United States of America
| | - Rebecca A Krukowski
- Department of Preventive Medicine, University of Tennessee Health Science Center, United States of America.
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19
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Keaulana S, Antonio M, Schoch H, Banna J. A Literature Review of the Role of Mindfulness Practices in Nutrition for Mothers and Their Children. Am J Lifestyle Med 2019; 13:533-536. [PMID: 31662715 DOI: 10.1177/1559827619866815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Nutrition-related problems have been increasingly prevalent among children and adults nationally and globally. Pregnant women and children are particularly susceptible to nutrition-related concerns. Mindfulness-based programs have demonstrated favorable outcomes for lifestyles and behaviors and may, therefore, assist in nutrition-related concerns. This column focuses on existing literature that focuses on the way mindfulness practices improve eating and nutrition outcomes for mothers. The synthesized findings of this review provide support for the effectiveness of mindfulness practices of mothers affecting improved nutrition for their children.
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Affiliation(s)
| | | | | | - Jinan Banna
- University of Hawai'i at Mānoa, Honolulu, Hawai'i
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20
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Navarro P, Shivappa N, Hébert JR, Mehegan J, Murrin CM, Kelleher CC, Phillips CM. Predictors of the dietary inflammatory index in children and associations with childhood weight status: A longitudinal analysis in the Lifeways Cross-Generation Cohort Study. Clin Nutr 2019; 39:2169-2179. [PMID: 31606243 DOI: 10.1016/j.clnu.2019.09.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/13/2019] [Accepted: 09/11/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS The family environment can influence offspring diet and weight status. Obesity is a pro-inflammatory state, which is associated with the dietary inflammatory index (DII®). Predictors of the DII in children (C-DII™) and its associations with childhood obesity are relatively unknown. We evaluated the intergenerational relationships between the energy-adjusted DII (E-DII) scores in adults, predictors of C-DII and associations with childhood weight status. METHODS The study comprises 551 children and index-child's mothers, fathers and grandparents in the Lifeways Cross-Generation Cohort Study. E-DII scores were generated at baseline for expectant mothers, fathers, and grandparents, and at 5-year follow-up for the mothers and children, using a validated food frequency questionnaire. Body mass index (BMI) and waist circumference were determined at age 5 and 9 years. Associations were assessed by logistic regression and mediation analysis. RESULTS Higher C-DII scores indicating a more pro-inflammatory diet among children, were associated with greater risk of childhood obesity at age 5 (OR:1.09; 95%CI:1.00-1.37; P = 0.02) and overweight/obese status at 5 and 9 years (OR:1.06; 95%CI:1.01-1.09; P = 0.01 and OR:1.12; 95%CI:1.07-1.18; P = 0.01, respectively). Maternal and paternal smoking during pregnancy (OR:1.98; 95%CI:1.19-3.03; P = 0.001 and OR:1.64; 95%CI:1.12-2.49; P = 0.006, respectively) increased likelihood of higher C-DII at age 5. Child BMI, TV watching and all meals given by the childcare provider were associated with a more pro-inflammatory diet (P < 0.05), whereas breastfeeding and family meals at home were associated with a more anti-inflammatory diet (P < 0.04). Higher maternal, but not paternal, E-DII scores during pregnancy (P < 0.001) and at 5-year follow-up (P = 0.008) were associated with more pro-inflammatory diet at age 5. Results from the mediation analysis suggest that maternal grandmothers E-DII scores may influence C-DII indirectly via the mothers E-DII scores. CONCLUSIONS A more pro-inflammatory dietary score was associated with childhood overweight and obesity. Parental, familial and personal factors independently influenced the C-DII score.
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Affiliation(s)
- Pilar Navarro
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - John Mehegan
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Celine M Murrin
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Cecily C Kelleher
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Catherine M Phillips
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland.
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A Community Bundle to Lower School-Aged Obesity Rates in a Small Midwestern City. REPORTS 2019. [DOI: 10.3390/reports2030020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Multi-component interventions in large communities such as Philadelphia can effectively lower childhood obesity rates. It is less clear whether this type of intervention can be successful in smaller communities with more limited resources. Norwood, Ohio is a small Midwestern city with a population of 19,207. In 2010, Ohio passed a school health law requiring Body Mass Index (BMI) screening of students in kindergarten and grades 3, 5 and 9 along with restrictions on competitive foods and vending machine products and a physical education requirement of 30 min per day. In 2014, Norwood implemented a multi-component childhood obesity prevention and treatment bundle of interventions. Our objective was to describe the effects if this bundle on childhood overweight/obesity (OW/OB) rates. We hypothesized that implementation of the bundle would lower the prevalence of OW/OB in Norwood school children. Methods: In 2012, the Healthy Kids Ohio Act was fully implemented in the Norwood City School District (NCSD). In 2014 a comprehensive bundle was implemented that included: 1. A student gardening program; 2. Supplementation of fresh produce to a local food pantry and a family shelter; 3. A farmers market; 4. A health newsletter; 5. Incentives in the school cafeterias to promote healthy food selection; 6. A 100-mile walking club; 7. “Cook for America” (a “cooked from scratch” intervention for school cafeterias); 8. A school-based obesity treatment clinic; Results: The OW/OB rate in the NCSD was 43% at the time of the Bundle implementation in 2014 and 37% in 2016 (p = 0.029). Conclusions: A childhood OW/OB prevention bundle can be implemented in a small city and is associated with a favorable change in BMI.
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