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Beckhaus J, Eveslage M, Bison B, Friedrich C, Müller HL. Impact of parental body mass index at diagnosis on obesity in survivors of pediatric craniopharyngioma. Endocr Connect 2024; 13:e240126. [PMID: 38904467 PMCID: PMC11301543 DOI: 10.1530/ec-24-0126] [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: 03/26/2024] [Accepted: 06/21/2024] [Indexed: 06/22/2024]
Abstract
Objective It is well known that both genetic background and lifestyle influence the development of 'general' obesity. However, the role of parental body mass index (BMI) on the development of obesity in long-term survivors of childhood-onset craniopharyngioma (CP) is not well understood. This study analyzed the correlation of patients' BMI at diagnosis and last visit and parental BMI at CP diagnosis and further explored potential risk factors for obesity in CP patients. Design This is a registry-based retrospective cohort study. Methods In total,291 CP patients and their parents recruited in the German KRANIOPHARYNGEOM studies were included. Correlations between patient's BMI SDS at CP diagnosis and last visit and parental BMI at CP diagnosis were analyzed. The associations between hypothalamic damage, maternal/paternal BMI and CP patients' obesity at last visit were analyzed by multivariable logistic regression. Results At follow-up, 52% of CP patients developed obesity (BMI > 3SDS). Patient's BMI SDS at last visit was moderately correlated with BMI-SDS at CP diagnosis (r = 0.48, 95% CI: 0.38-0.58, P < 0.001), and also with maternal BMI at diagnosis (r = 0.28, 95% CI: 0.17-0.38, P < 0.001) and paternal BMI at diagnosis (r = 0.3, 95% CI: 0.19-0.41, P < 0.001). However, the contributing role of parental BMI to the pathogenesis of obesity was small compared to the impact of hypothalamic damage. Conclusion We conclude that besides hypothalamic damage, parental disposition for obesity is associated with the development of obesity in patients after CP. Our results indicate that also the family situation could have an influence on the development of obesity after CP and might be a therapeutic target. Significance statement Survivors of childhood-onset craniopharyngioma are at risk of developing morbid obesity. So far, patients with posterior hypothalamic involvement and lesion were identified as a high risk group. With this study, the influence of parental body mass index on the risk of obesity was investigated. Patient's body-mass-index at last visit was correlated with maternal and paternal body mass index at diagnosis. With increasing maternal or paternal body mass index, the likelihood of obesity in individuals with CP increased. Nevertheless, the parents' weight had only a small effect on the development of patients' obesity compared to hypothalamic damage.
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Affiliation(s)
- Julia Beckhaus
- Department of Pediatrics and Pediatric Hematology/Oncology, University Children’s Hospital, Carl von Ossietzky Universität, Klinikum Oldenburg AöR, Oldenburg, Germany
- Division of Epidemiology and Biometry, Carl von Ossietzky Universität, Oldenburg, Germany
| | - Maria Eveslage
- Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany
| | - Brigitte Bison
- Diagnostic and Interventional Neuroradiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Carsten Friedrich
- Department of Pediatrics and Pediatric Hematology/Oncology, University Children’s Hospital, Carl von Ossietzky Universität, Klinikum Oldenburg AöR, Oldenburg, Germany
| | - Hermann L Müller
- Department of Pediatrics and Pediatric Hematology/Oncology, University Children’s Hospital, Carl von Ossietzky Universität, Klinikum Oldenburg AöR, Oldenburg, Germany
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Gutmann D, Dressler M, Eickmeier O, Herrmann E, Kirwil M, Schubert R, Zielen S, Zissler UM. Proinflammatory pattern in the lower airways of non-asthmatic obese adolescents. Cytokine 2024; 173:156452. [PMID: 38039695 DOI: 10.1016/j.cyto.2023.156452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/06/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Obesity is known to be a pro-inflammatory condition affecting multiple organs. Obesity as a systemic pro-inflammatory state, might be associated with bronchial inflammation in non-smoking adolescents with a BMI ≥ 30 kg/m2 without evidence of concomitant chronic diseases. MATERIALS AND METHODS We studied non-asthmatic obese patients (n = 20; median age 15.8 years; BMI 35.0 kg/m2) compared to age matched healthy control subjects (n = 20; median age 17.5 years; BMI 21.5 kg/m2). Induced sputum differential cell counts and sputum mRNA levels were assessed for all study subjects. Serum levels of CRP, IL-6, and IL-8 were measured. Further, IL-5, IL-6, IL-8, IL-13, IL-17, TNF-α, IFN-γ, and IP-10 protein levels were analyzed in induced sputum was. RESULTS Serum CRP levels, sputum inflammatory cell load and sputum eosinophils differed significantly between obese and non-obese subjects, for sputum neutrophils, a correlation was shown with BMI ≥ 30 kg/m2. Differences were also observed for sputum mRNA expression of IL6, IL8, IL13, IL17, IL23, and IFN-γ, as well as the transcription factors T-bet, GATA3, and FoxP3. CONCLUSIONS Increased bronchial inflammation, triggered by systemic or local inflammatory effects of obesity itself, may account for the higher rates of airway disease in obese adolescents.
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Affiliation(s)
- Desiree Gutmann
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University, Frankfurt
| | - Melanie Dressler
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University, Frankfurt
| | - Olaf Eickmeier
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University, Frankfurt
| | - Eva Herrmann
- Institute of Biostatistics and Mathematical Modeling, Goethe-University, Frankfurt, Germany
| | - Marta Kirwil
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University, Frankfurt
| | - Ralf Schubert
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University, Frankfurt
| | - Stefan Zielen
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University, Frankfurt
| | - Ulrich M Zissler
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Center for Environmental Health (HMGU), Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany.
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3
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Ulloa E, Saure C, Giudici V, Armeno M. Causes of possible excessive weight gain in exclusively breastfed infants in the first six months of life. Minerva Pediatr (Torino) 2023; 75:844-851. [PMID: 32731728 DOI: 10.23736/s2724-5276.20.05735-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
BACKGROUND The aim of this study was to describe factors related to the infant, mother, and breastmilk composition that may be associated with excessive weight gain in a cohort of exclusively breastfed infants younger than 6 months of life with excessive weight gain, and to compare these findings with data from a group of normal-weight exclusively breastfed infants. METHODS Thirty-six exclusively breastfed infants younger than 6 months of life seen at two health-care centers between July 2016 and 2017 were enrolled in the study. The clinical features of the infants, their mothers, and the macronutrient composition of the breast milk were evaluated. We classified infants according to weight gain velocity between birth and 6 months of life into an excessive weight gain (EWG) and an adequate weight gain (AWG) group. RESULTS Mean age at protocol entry was 3.8 months. Thirteen patients were classified as EWG and 23 patients as AWG. Co-sleeping was more often observed in EWG than in AWG infants. Mothers in the EWG group were younger and more often had gained more than 18 kg during pregnancy than those in the AWG group. No significant differences were found in the macronutrient content of the breast milk between both groups. CONCLUSIONS Greater weight gain in infants under 6 months of age may be related to greater weight gain of the mother during pregnancy, younger age of the mother, and co-sleeping of the mother and child.
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Affiliation(s)
- Eugenia Ulloa
- Department of Clinical Nutrition, J. P. Garrahan National Pediatrics Hospital, Buenos Aires, Argentina
| | - Carola Saure
- Department of Clinical Nutrition, J. P. Garrahan National Pediatrics Hospital, Buenos Aires, Argentina -
| | - Vanesa Giudici
- Laboratory for Physical-chemical Food Analysis, Department of Food Sciences, National University of Entre Ríos, Entre Ríos, Argentina
| | - Marisa Armeno
- Department of Clinical Nutrition, J. P. Garrahan National Pediatrics Hospital, Buenos Aires, Argentina
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Mainieri F, La Bella S, Rinaldi M, Chiarelli F. Rare genetic forms of obesity in childhood and adolescence, a comprehensive review of their molecular mechanisms and diagnostic approach. Eur J Pediatr 2023; 182:4781-4793. [PMID: 37607976 DOI: 10.1007/s00431-023-05159-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/24/2023]
Abstract
Obesity represents a major health problem in the pediatric population with an increasing prevalence worldwide, associated with cardiovascular and metabolic disorders, and due to both genetic and environmental factors. Rare forms of obesity are mostly monogenic, and less frequently due to polygenic influence. Polygenic form of obesity is usually the common obesity with single gene variations exerting smaller impact on weight and is commonly non-syndromic.Non-syndromic monogenic obesity is associated with variants in single genes typically related to the hypothalamic leptin-melanocortin signalling pathway, which plays a key role in hunger and satiety regulation, thus body weight control. Patients with these genetic defects usually present with hyperphagia and early-onset severe obesity. Significant progress in genetic diagnostic testing has recently made for early identification of patients with genetic obesity, which guarantees prompt intervention in terms of therapeutic management of the disease. What is Known: • Obesity represents a major health problem among children and adolescents, with an increasing prevalence worldwide, associated with cardiovascular disease and metabolic abnormalities, and it can be due to both genetic and environmental factors. • Non-syndromic monogenic obesity is linked to modifications in single genes usually involved in the hypothalamic leptin-melanocortin signalling pathway, which plays a key role in hunger and satiety regulation. What is New: • The increasing understanding of rare forms of monogenic obesity has provided significant insights into the genetic causes of pediatric obesity, and our current knowledge of the various genes associated with childhood obesity is rapidly expanding. • A useful diagnostic algorithm for early identification of genetic obesity has been proposed, which can ensure a prompt intervention in terms of therapeutic management of the disease and an early prevention of the development of associated metabolic conditions.
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Affiliation(s)
| | | | - Marta Rinaldi
- Paediatric Department, Stoke Mandeville Hospital, Thames Valley Deanery, Oxford, UK
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Scorrano G, La Bella S, Matricardi S, Chiarelli F, Giannini C. Neuroendocrine Effects on the Risk of Metabolic Syndrome in Children. Metabolites 2023; 13:810. [PMID: 37512517 PMCID: PMC10383317 DOI: 10.3390/metabo13070810] [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: 05/22/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023] Open
Abstract
The endocrine and nervous systems reciprocally interact to manage physiological individual functions and homeostasis. The nervous system modulates hormone release through the hypothalamus, the main cerebrally specialized structure of the neuroendocrine system. The hypothalamus is involved in various metabolic processes, administering hormone and neuropeptide release at different levels. This complex activity is affected by the neurons of various cerebral areas, environmental factors, peripheral organs, and mediators through feedback mechanisms. Therefore, neuroendocrine pathways play a key role in metabolic homeostasis control, and their abnormalities are associated with the development of metabolic syndrome (MetS) in children. The impaired functioning of the genes, hormones, and neuropeptides of various neuroendocrine pathways involved in several metabolic processes is related to an increased risk of dyslipidaemia, visceral obesity, insulin resistance, type 2 diabetes mellitus, and hypertension. This review examines the neuroendocrine effects on the risk of MetS in children, identifying and underlying several conditions associated with neuroendocrine pathway disruption. Neuroendocrine systems should be considered in the complex pathophysiology of MetS, and, when genetic or epigenetic mutations in "hot" pathways occur, they could be studied for new potential target therapies in severe and drug-resistant paediatric forms of MetS.
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Affiliation(s)
- Giovanna Scorrano
- Department of Pediatrics, University of Chieti-Pescara, Via Dei Vestini, 66100 Chieti, Italy
| | - Saverio La Bella
- Department of Pediatrics, University of Chieti-Pescara, Via Dei Vestini, 66100 Chieti, Italy
| | - Sara Matricardi
- Department of Pediatrics, University of Chieti-Pescara, Via Dei Vestini, 66100 Chieti, Italy
| | - Francesco Chiarelli
- Department of Pediatrics, University of Chieti-Pescara, Via Dei Vestini, 66100 Chieti, Italy
| | - Cosimo Giannini
- Department of Pediatrics, University of Chieti-Pescara, Via Dei Vestini, 66100 Chieti, Italy
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Khoshakhlagh AH, Al Sulaie S, Yazdanirad S, Orr RM, Dehdarirad H, Milajerdi A. Global prevalence and associated factors of sleep disorders and poor sleep quality among firefighters: A systematic review and meta-analysis. Heliyon 2023; 9:e13250. [PMID: 36798763 PMCID: PMC9925976 DOI: 10.1016/j.heliyon.2023.e13250] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/13/2023] [Accepted: 01/24/2023] [Indexed: 01/30/2023] Open
Abstract
Lack of sleep can affect the health and performance of firefighters. This systematic review and meta-analysis estimated the global prevalence of sleep disorders and poor sleep quality among firefighters and reported associated factors. Four academic databases (Scopus, PubMed, Web of Science, and Embase) were systematically searched from January 1, 2000 to January 24, 2022. These databases were selected as they are known to index studies in this field. The search algorithm included two groups of keywords and all possible combinations of these words. The first group included keywords related to sleep and the second group keywords related to the firefighting profession. The relevant Joanna Briggs Institute checklist was used to evaluate study quality. Data from eligible studies were included in a meta-analysis. In total, 47 articles informed this review. The pooled prevalence of sleep disorders and poor sleep quality in firefighters were determined as 30.49% (95% CI [25.90, 35.06]) and 51.43% (95% CI [42.76, 60.10]), respectively. The results of a subgroup analysis showed that individuals in low- and middle-income countries (LMICs) had a higher prevalence of sleep disorders than those in high-income countries (HICs) but HICs had a higher prevalence of poor sleep quality than LMICs. Various factors, including shift work, mental health, injuries and pain, and body mass index were associated with sleep health. The findings of this review highlight the need for sleep health promotion programs in firefighters.
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Affiliation(s)
- Amir Hossein Khoshakhlagh
- Department of Occupational Health, School of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Saleh Al Sulaie
- Department of Industrial Engineering, College of Engineering in Al-Qunfudah, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Saeid Yazdanirad
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran,School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran,Corresponding author. Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Robin Marc Orr
- Tactical Research Unit, Bond University, Gold Coast, Australia
| | - Hossein Dehdarirad
- Medical Library & Information Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Milajerdi
- Research Center of Biochemistry and Nutrition in Metabolic Diseases, Institude for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
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7
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Hinney A, Körner A, Fischer-Posovszky P. The promise of new anti-obesity therapies arising from knowledge of genetic obesity traits. Nat Rev Endocrinol 2022; 18:623-637. [PMID: 35902734 PMCID: PMC9330928 DOI: 10.1038/s41574-022-00716-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 02/07/2023]
Abstract
Obesity is a multifactorial and complex disease that often manifests in early childhood with a lifelong burden. Polygenic and monogenic obesity are driven by the interaction between genetic predisposition and environmental factors. Polygenic variants are frequent and confer small effect sizes. Rare monogenic obesity syndromes are caused by defined pathogenic variants in single genes with large effect sizes. Most of these genes are involved in the central nervous regulation of body weight; for example, genes of the leptin-melanocortin pathway. Clinically, patients with monogenic obesity present with impaired satiety, hyperphagia and pronounced food-seeking behaviour in early childhood, which leads to severe early-onset obesity. With the advent of novel pharmacological treatment options emerging for monogenic obesity syndromes that target the central melanocortin pathway, genetic testing is recommended for patients with rapid weight gain in infancy and additional clinical suggestive features. Likewise, patients with obesity associated with hypothalamic damage or other forms of syndromic obesity involving energy regulatory circuits could benefit from these novel pharmacological treatment options. Early identification of patients affected by syndromic obesity will lead to appropriate treatment, thereby preventing the development of obesity sequelae, avoiding failure of conservative treatment approaches and alleviating stigmatization of patients and their families.
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Affiliation(s)
- Anke Hinney
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy and University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
- Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
| | - Antje Körner
- Leipzig University, Medical Faculty, Hospital for Children and Adolescents, Centre of Paediatric Research (CPL), Leipzig, Germany
- LIFE Child, Leipzig Research Centre for Civilization Diseases, Leipzig, Germany
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
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8
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Tudor C. The Nexus between Pollution and Obesity and the Magnifying Role of Media Consumption: International Evidence from GMM Systems Estimates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10260. [PMID: 36011894 PMCID: PMC9407853 DOI: 10.3390/ijerph191610260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
The aim of this paper is to uncover the associations between air pollution, media consumption, and the prevalence of obesity. Based on data availability, this study draws on an unbalanced panel of 28 countries and develops and extracts relationships through robust System-General Method of Moments (Sys-GMM) estimators that account for the dynamic nature and high persistence of the variables of interest. In light of previous findings, economic development, trade openness, and government consumption are included as controls in the dynamic panel models. The estimation results consistently indicate that pollution is a strong determinant of obesity, a link that remains robust through the alternative proxies for pollution (i.e., total greenhouse gas emissions (GHG) and carbon (CO2) intensity of energy generation). However, CO2 intensity shows the strongest association with obesity. Furthermore, the findings indicate that media consumption is an independent and significant driver of obesity, whilst its inclusion among regressors further magnifies the impact and significance of the pollution factor. Moreover, the combined effect of media consumption and pollution significantly contributes to spurring obesity in all model specifications. Thus, a vicious cycle emerges between air pollution, media consumption, and obesity, with synergistic detrimental health effects. The current findings highlight the importance of continuing and consistent efforts to mitigate pollution and reach related low-carbon policy targets. Moreover, for the sustainable reduction and prevention of obesity, these efforts should be complemented by policy interventions and public campaigns aimed at "healthy" media consumption, such as encouraging regular physical exercise and healthy nutrition.
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Affiliation(s)
- Cristiana Tudor
- International Business and Economics Department, The Bucharest University of Economic Studies, 010374 Bucharest, Romania
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9
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Family socioeconomic status and childhood adiposity in Europe - A scoping review. Prev Med 2022; 160:107095. [PMID: 35594926 DOI: 10.1016/j.ypmed.2022.107095] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/28/2022] [Accepted: 05/13/2022] [Indexed: 11/23/2022]
Abstract
Childhood obesity is a considerable public health problem worldwide. In Europe, lower parental socioeconomic status (SES) relates to higher childhood adiposity. This scoping review strives to discover, which SES indicators are the most commonly used and meaningful determinants of childhood adiposity (greater level of continuous adiposity indicator, e.g. body mass index z-score, or overweight or obesity categorized by established definitions). The review focused on studies about European general populations from the 21st century (January 2000-April 2021) considering children and adolescents aged 0-17 years. PubMed and reference lists of articles were searched in February-April 2021. Total of 53 studies with 121 association analyses between different SES indicators and adiposity indicators, were identified and reviewed. Different SES indicators were grouped to 25 indicators and further to six indicator groups. The most used indicator was mother's education (n of association analyses = 24) and the most used indicator group was parental education (n of association analyses = 51). Of all association analyses, 55% were inverse, 36% were non-significant, and 8% were positive. Composite SES (80%), parental education (69%) and parental occupation (64%) indicators showed most frequently inverse associations with obesity measures (i.e. lower parental SES associating with higher adiposity), while parental income (50% inverse; 50% non-significant) and property and affluence (42% inverse; 50% nonsignificant) indicators showed approximately even number of inverse and non-significant associations. Instead, majority of parental employment (60%) indicators, showed non-significant associations and 33% showed positive associations (i.e. higher parental SES associating with higher adiposity). Despite some variation in percentages, majority of the associations were inverse in each age group and with different outcome categorizations. In girls and in boys, non-significant associations predominated. It seems that children with parents of higher SES have lower likelihood of adiposity in Europe. Parents' employment appears to differ from other SES indicators, so that having an employed parent(s) does not associate with lower likelihood of adiposity. Positive associations seem to occur more frequently in poorer countries. Criteria for uniform childhood SES and adiposity measures should be established and used in studies in order to be able to produce comparable results across countries.
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10
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Alrouh H, van Bergen E, de Zeeuw E, Dolan C, Boomsma DI. Intergenerational transmission of body mass index and associations with educational attainment. BMC Public Health 2022; 22:890. [PMID: 35509009 PMCID: PMC9069759 DOI: 10.1186/s12889-022-13270-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/28/2022] [Indexed: 11/29/2022] Open
Abstract
Background Individual differences in educational attainment (EA) and physical health, as indexed by body mass index (BMI), are correlated within persons and across generations. The present aim was to assess these associations while controlling for parental transmission. Methods We analyzed BMI and EA obtained for 8,866 families from the Netherlands. Data were available for 19,132 persons, including 6,901 parents (mean age 54) and 12,234 of their adult offspring (mean age 32). We employed structural equation modeling to simultaneously model the direct and indirect transmission of BMI and EA from parents to offspring, spousal correlations, and the residual within-person BMI-EA association and tested for gender differences in the transmission parameters. Results We found moderate intergeneration transmission for BMI (standardized beta ~ .20) and EA (~ .22), and substantial spousal correlations for BMI (.23) and EA (.51). Cross-trait parent to offspring transmission was weak. The strength of transmission was largely independent of parent or offspring gender. Negative within person EA-BMI correlations were observed for all family members (fathers, -0.102; mothers, -0.147; sons, -0.154; daughters, -0.173). About 60% of the EA-BMI correlation in offspring persisted after taking into account the intergeneration transmission. Conclusions The intergenerational transmission for BMI and EA is mainly predictive within traits. Significant spousal and within person correlations in the parental generation are responsible for the effect of parental EA on offspring BMI. Offspring EA and BMI are further correlated beyond parental influences. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13270-1.
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Affiliation(s)
- Hekmat Alrouh
- Department of Biological Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7-9, Room MF-H557, 1081 BT, Amsterdam, The Netherlands. .,Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Elsje van Bergen
- Department of Biological Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7-9, Room MF-H557, 1081 BT, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Research Institute LEARN!, VrijeUniversiteit Amsterdam, Amsterdam, Netherlands
| | - Eveline de Zeeuw
- Department of Biological Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7-9, Room MF-H557, 1081 BT, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Conor Dolan
- Department of Biological Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7-9, Room MF-H557, 1081 BT, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Dorret I Boomsma
- Department of Biological Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7-9, Room MF-H557, 1081 BT, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Amsterdam Reproduction & Development Research Institute, Amsterdam, Netherlands
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11
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Nikooyeh B, Ghodsi D, Amini M, Rasekhi H, Rabiei S, Doustmohammadian A, Al-Jawaldeh A, Neyestani TR. The Analysis of Trends of Preschool Child Stunting, Wasting and Overweight in the Eastern Mediterranean Region: Still More Effort Needed to Reach Global Targets 2025. J Trop Pediatr 2022; 68:6565201. [PMID: 35393613 DOI: 10.1093/tropej/fmac028] [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] [Indexed: 11/12/2022]
Abstract
BACKGROUND This study was undertaken to analyze and compare Eastern Mediterranean (EM) countries in achievement of WHO nutrition global targets for children growth indicators by 2025. METHODS A total of 108 national surveys from 20 countries in EM region were analyzed to estimate the prevalence of stunting and wasting and 93 surveys to estimate the prevalence of overweight/obesity in children. These data were obtained from national surveys included in the WHO Global Database on Child Growth and Malnutrition. RESULTS In EM region, the prevalence of childhood stunting was estimated to have a 38% decline from 2000 (34.7%) to 2025 (21.2%). Only three countries in EM region (Iran and Jordan, Saudi Arabia) were anticipated to achieve the expected WHO target by 2025. From 2000 to 2020, the prevalence of wasting decreased from 6.9 to 5.3. Six countries were presumed to achieve the expected WHO target by 2025. Nine countries will presumably have overweight rates >5% (Djibouti, Egypt, Iraq, Kuwait, Lebanon, Libya, Morocco, Syrian Arab Republic and Tunisia) in 2025 whereas five countries will have overweight rates above 10% (Egypt, Libya, Morocco, Syrian Arab Republic and Tunisia). CONCLUSION Despite descending trends of child stunting and wasting and a secular trend of child obesity in EM region, it is expected that WHO targets will not be achieved by 2025. A diverse socio-economic condition in EM countries necessitates different action plans. International determination, political commitment and, above all, involvement of the families are needed to achieve 2025 targets for child stunting, wasting and overweight/obesity.
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Affiliation(s)
- Bahareh Nikooyeh
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Delaram Ghodsi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Amini
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Rasekhi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samira Rabiei
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo 7608, Egypt
| | - Tirang R Neyestani
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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12
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Kang E, Kim S, Yun YH. Comparison of eating habits and inappropriate weight control efforts of secondary school students enrolled in a weight control program. Nutr Res Pract 2021; 15:628-638. [PMID: 34603610 PMCID: PMC8446692 DOI: 10.4162/nrp.2021.15.5.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/22/2020] [Accepted: 12/18/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND/OBJECTIVES Numerous school-based weight control programs have been initiated for weight loss among adolescents. However, the relationship between these programs and inappropriate weight control efforts, dietary habits and behavior of students, have not been investigated sufficiently. This study was undertaken to investigate the association between body mass index (BMI) of adolescents, and their health status and inappropriate weight-control efforts. We further examined the relationship between attendance to school-based weight-control programs and attempting inappropriate weight-control efforts, dietary habits, and behavior. SUBJECTS/METHODS A survey of 1,742 students was conducted in Korea. Logistic regression was used to assess differences in the health status (grouped by BMI and improper weight control) and dietary habits, based on attendance to the weight-control programs. RESULTS Obese students were significantly more dissatisfied with physical, mental and spiritual health. Students who attended weight-control programs were likely to be underweight (P < 0.001), whereas those who did not attend weight-control programs were likely to attempt weight control improperly (P < 0.001). Students who participated in the program also had relatively healthy dietary habits (P < 0.001-0.027), and students who did not attend had comparatively unhealthy dietary habits (P < 0.001-0.008). Students who attended weight-control programs were likely to be underweight (P < 0.001) with relatively healthy dietary habits (P < 0.001-0.027), whereas students who did not attend the programs were likely to attempt weight control improperly (P < 0.001) and had comparatively unhealthy dietary habits (P < 0.001-0.008). CONCLUSIONS Attending school-based weight-control programs was significantly associated with not attempting inappropriate weight-control efforts, as well as following healthy dietary habits. Our data indicates that offering school-based weight-control programs is valuable to student health, and is anticipated to reducing the public health burden.
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Affiliation(s)
- EunKyo Kang
- Public Healthcare Center, Seoul National University Hospital, Seoul 03080, Korea
- Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea
| | - Soojeong Kim
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Young Ho Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul 03080, Korea
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Ober P, Sobek C, Stein N, Spielau U, Abel S, Kiess W, Meigen C, Poulain T, Igel U, Lipek T, Vogel M. And yet Again: Having Breakfast Is Positively Associated with Lower BMI and Healthier General Eating Behavior in Schoolchildren. Nutrients 2021; 13:1351. [PMID: 33919560 PMCID: PMC8072724 DOI: 10.3390/nu13041351] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 12/18/2022] Open
Abstract
Given the high prevalence of childhood overweight, school-based programs aiming at nutritional behavior may be a good starting point for community-based interventions. Therefore, we investigated associations between school-related meal patterns and weight status in 1215 schoolchildren. Anthropometry was performed on-site in schools. Children reported their meal habits, and parents provided family-related information via questionnaires. Associations between nutritional behavior and weight status were estimated using hierarchical linear and logistic regression. Analyses were adjusted for age, socio-economic status, school type, migration background, and parental weight status. Having breakfast was associated with a lower BMI-SDS (βadj = -0.51, p = 0.004) and a lower risk of being overweight (ORadj = 0.30, p = 0.009), while having two breakfasts resulting in stronger associations (BMI-SDS: βadj = -0.66, p < 0.001; risk of overweight: ORadj = 0.22, p = 0.001). Likewise, children who regularly skipped breakfast on school days showed stronger associations (BMI-SDS: β = 0.49, p < 0.001; risk of overweight: OR = 3.29, p < 0.001) than children who skipped breakfast only occasionally (BMI-SDS: β = 0.43, p < 0.001; risk of overweight: OR = 2.72, p = 0.032). The associations persisted after controlling for parental SES and weight status. Therefore, our data confirm the school setting as a suitable starting point for community-based interventions and may underline the necessity of national programs providing free breakfast and lunch to children.
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Affiliation(s)
- Peggy Ober
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
- Integrated Research and Treatment Center Adiposity Diseases, Medical Faculty, Leipzig University, Ph.-Rosenthal-Str. 27, 04103 Leipzig, Germany;
| | - Carolin Sobek
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
| | - Nancy Stein
- Integrated Research and Treatment Center Adiposity Diseases, Medical Faculty, Leipzig University, Ph.-Rosenthal-Str. 27, 04103 Leipzig, Germany;
| | - Ulrike Spielau
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
- Integrated Research and Treatment Center Adiposity Diseases, Medical Faculty, Leipzig University, Ph.-Rosenthal-Str. 27, 04103 Leipzig, Germany;
| | - Sarah Abel
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
- Integrated Research and Treatment Center Adiposity Diseases, Medical Faculty, Leipzig University, Ph.-Rosenthal-Str. 27, 04103 Leipzig, Germany;
| | - Wieland Kiess
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
| | - Christof Meigen
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
| | - Tanja Poulain
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
| | - Ulrike Igel
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
- Department of Social Work, University of Applied Science, Altonaer Str. 25, 99085 Erfurt, Germany
| | - Tobias Lipek
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
- Integrated Research and Treatment Center Adiposity Diseases, Medical Faculty, Leipzig University, Ph.-Rosenthal-Str. 27, 04103 Leipzig, Germany;
| | - Mandy Vogel
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
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Bohn C, Vogel M, Poulain T, Spielau U, Hilbert C, Kiess W, Körner A. Birth weight increases with birth order despite decreasing maternal pregnancy weight gain. Acta Paediatr 2021; 110:1218-1224. [PMID: 32981144 DOI: 10.1111/apa.15598] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/22/2020] [Indexed: 12/11/2022]
Abstract
AIM We investigated whether birth order is an influencing factor for birth weight independent from maternal factors. METHODS Data were obtained from the longitudinal cohort study LIFE Child and included 1864 children, of which 526 were only children. The 1338 siblings were ranked into first-borns (n = 570), second-borns (n = 606) and third-or-later-borns (n = 162). Children born prematurely, suffering from chronic or syndromic diseases, were excluded. We performed intra-family comparisons to reduce bias and assessed the impact of perinatal parameters, such as birth order on birth weight, using mixed models. RESULTS Birth weight increased with birth order. In univariate analyses, birth order had a significant effect on birth weight-SDS with second-borns having 0.29 SDS (app. 130 g) and third-borns 0.40 SDS (app. 180 g) higher values than first-borns (P < .001). Maternal pregnancy weight gain was associated with higher birth weight-SDS (P < .01) in univariate analysis, though maternal pregnancy weight gain was lower for higher birth orders. Multivariate analyses revealed that being a second or third-or-later-born child had a stronger impact on birth weight than all maternal factors. CONCLUSION Birth order must be considered a potential risk factor for higher birth weight. Maternal pregnancy weight gain is not the driving factor for higher birth weight in siblings.
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Affiliation(s)
- Claudia Bohn
- Medical Faculty LIFE Child (Leipzig Research Centre for Civilization Diseases) University of Leipzig Leipzig Germany
| | - Mandy Vogel
- Medical Faculty LIFE Child (Leipzig Research Centre for Civilization Diseases) University of Leipzig Leipzig Germany
| | - Tanja Poulain
- Medical Faculty LIFE Child (Leipzig Research Centre for Civilization Diseases) University of Leipzig Leipzig Germany
| | - Ulrike Spielau
- Department of Women and Child Health Medical Faculty Hospital for Children and Adolescents and Centre for Paediatric Research (CPL) University of Leipzig Leipzig Germany
| | - Cornelia Hilbert
- Medical Faculty LIFE Child (Leipzig Research Centre for Civilization Diseases) University of Leipzig Leipzig Germany
| | - Wieland Kiess
- Medical Faculty LIFE Child (Leipzig Research Centre for Civilization Diseases) University of Leipzig Leipzig Germany
- Department of Women and Child Health Medical Faculty Hospital for Children and Adolescents and Centre for Paediatric Research (CPL) University of Leipzig Leipzig Germany
| | - Antje Körner
- Medical Faculty LIFE Child (Leipzig Research Centre for Civilization Diseases) University of Leipzig Leipzig Germany
- Department of Women and Child Health Medical Faculty Hospital for Children and Adolescents and Centre for Paediatric Research (CPL) University of Leipzig Leipzig Germany
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15
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Ziser K, Decker S, Stuber F, Herschbach A, Giel KE, Zipfel S, Ehehalt S, Junne F. Barriers to Behavior Change in Parents With Overweight or Obese Children: A Qualitative Interview Study. Front Psychol 2021; 12:631678. [PMID: 33841261 PMCID: PMC8034266 DOI: 10.3389/fpsyg.2021.631678] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/24/2021] [Indexed: 12/20/2022] Open
Abstract
Overweight and obesity among children and adolescents are global problems of our time. Due to their authority and role modeling, parents play an essential part in the efficacy of prevention and intervention programs. This study assessed the barriers that parents of overweight/obese children face in preventive and interventional health care utilization. Sixteen parents were qualitatively interviewed. A content analysis was performed, and barriers to change were allocated to their stage of change according to the transtheoretical model. Among the main barriers is the underestimation of health risks caused by overweight/obesity in association with diminished problem awareness. Parents seem not necessarily in need of theoretical knowledge for prevention and interventions. They do however need support in evaluating the weight status of their child and the knowledge of whom to turn to for help as well as specific and hands-on possibilities for change. The results extend past studies by adding specific barriers to change that parents commonly experience. Possibilities to address these barriers, e.g., through trainings at the pediatric practice or adoption of conversation techniques, are discussed. Future studies might identify subgroups experiencing specific barriers and thus be able to address these in an individualized way.
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Affiliation(s)
- Katrin Ziser
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Stefanie Decker
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Felicitas Stuber
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Anne Herschbach
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Stefan Ehehalt
- Public Health Department of Stuttgart, Stuttgart, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Paduano S, Borsari L, Salvia C, Arletti S, Tripodi A, Pinca J, Borella P. Risk Factors for Overweight and Obesity in Children Attending the First Year of Primary Schools in Modena, Italy. J Community Health 2021; 45:301-309. [PMID: 31522302 DOI: 10.1007/s10900-019-00741-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Over the last four decades, childhood overweight/obesity has dramatically increased, becoming a significant public health concern. The main aims of this study were to investigate the prevalence of overweight/obesity among first-year primary schools children in Modena and to identify the associated risk factors. Data were collected on the socio-demographic characteristics of family and weight, height, dietary habits and sedentary behaviours of the children, and on the parents' perception of their child's weight status, through an anonymous questionnaire administered to parents. The questionnaires were delivered by 660 out of 890 (74.2%) families, and after excluding those without anthropometric data, 588 children were included in the study. The prevalence of overweight/obesity among the children was 25.2%, significantly lower in children born to parents with a high education, and higher among children born to foreign parents and overweight/obese mothers. The multivariable analysis showed that the children most likely to become overweight/obese were those who skipped breakfast (OR 2.3, 95%CI 1.3-4.2) and/or mid-morning snacks (OR 3.2, 95%CI 1.5-6.5). Breakfast consumption was positively associated with higher parental education levels, whereas skipping mid-morning snacks is more frequent among children born to foreign parents and overweight/obese mothers. Moreover, 84.7% of the parents of overweight/obese children underestimated their child's weight status. One in four 6-7 year-old children is already overweight or obese. Childhood overweight/obesity is significantly associated with unhealthy lifestyles and family lifestyle. It is therefore essential to implement public health intervention programs aimed at both parents and children, in order to promote healthy lifestyles in early childhood.
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Affiliation(s)
- Stefania Paduano
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy.
| | - Lucia Borsari
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - Chiara Salvia
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Alberto Tripodi
- Department of Public Health, Food Hygiene and Nutrition Service, AUSL Modena, Modena, Italy
| | - Jenny Pinca
- Department of Public Health, Food Hygiene and Nutrition Service, AUSL Modena, Modena, Italy
| | - Paola Borella
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
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Gätjens I, Hasler M, di Giuseppe R, Bosy-Westphal A, Plachta-Danielzik S. Family and Lifestyle Factors Mediate the Relationship between Socioeconomic Status and Fat Mass in Children and Adolescents. Obes Facts 2020; 13:596-607. [PMID: 33321513 PMCID: PMC7802469 DOI: 10.1159/000511927] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 09/24/2020] [Indexed: 12/19/2022] Open
Abstract
Socioeconomic status (SES) is strongly associated with childhood overweight. The underlying mechanism and the role of family and lifestyle factors as potential mediators of this relationship remain, however, unclear. Cross-sectional data of 4,772 girls and boys aged 5-16 years from the Kiel Obesity Prevention Study were considered in mediation analyses. Fat mass (FM) was assessed by bioelectrical impedance analysis and converted into a percent FM SD score (FM%-SDS). SES was defined by the parental educational level, classified as low, middle, or high. Characteristics of family and lifestyle factors were obtained via validated questionnaires and considered as mediators. In 3 different age groups, the product-of-coefficients method was used to examine age-specific mediator effects on the relationship between SES and FM%-SDS (c = total effects) and their ratio to total effects, adjusted for age, sex, puberty, and nationality. The prevalence of overweight was 6.9%. In all age groups, SES was inversely associated with FM%-SDS as follows: 5-7 years, c1 = -0.11 (95% CI -0.19 to -0.03); 9-11 years, c2 = -0.21 (95% CI -0.27 to -0.14); and 13-16 years, c3 = -0.23 (95% CI -0.28 to -0.17). The relationship between SES and FM%-SDS was fully (5-7 and 9-11 years) and partly (13-16 years) mediated by similar and age-specific mediators, including parental BMI, parental smoking habits, media consumption, physical activity, and shared meals. Overall, these variables resulted in a total mediating effect of 77.8% (5-7 years), 82.4% (9-11 years), and 70.6% (13-16 years). Consistent for both sexes, the relationship between SES and FM%-SDS was therefore mediated by parental weight status, risk-related behavior within families, and children's and adolescents' lifestyle factors. Strategies for obesity prevention, which are predominantly targeted at socially disadvantaged groups, should therefore address the family environment and lifestyle factors.
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Affiliation(s)
- Isabel Gätjens
- Human Nutrition, Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | - Mario Hasler
- Applied Statistic, Agricultural and Food Economics Faculty, Christian-Albrechts University, Kiel, Germany
| | | | - Anja Bosy-Westphal
- Human Nutrition, Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | - Sandra Plachta-Danielzik
- Human Nutrition, Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany,
- Kompetenznetz Darmerkrankungen e.V., Kiel, Germany,
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18
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Overweight and obesity in Eastern Morocco: Prevalence and associated risk factors among high school students. Rev Epidemiol Sante Publique 2020; 68:295-301. [PMID: 32896444 DOI: 10.1016/j.respe.2020.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 05/28/2020] [Accepted: 06/19/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Overweight and obesity in children and adolescents have become a major public health problem affecting most countries worldwide. The purpose of the study was to assess the prevalence and risk factors of overweight and obesity among public high school students in Eastern Morocco. METHODS A cross-sectional survey was conducted between February and May 2014 among a sample of 2271 students (1086 girls and 1185 boys). References from the International Obesity Task Force (IOTF) were used to determine the prevalence of overweight and obesity. RESULTS The prevalence of overweight and obesity reached 12.2% (14.2% in girls vs 10.4% in boys, P<0.01) and 3.0% (3.1% in girls vs 2.8% in boys), respectively. Risk factors associated with overweight and obesity were urban residence (OR=1.76; [1.18-2.63]; P<0.01), father's income≥5000MAD (OR=1.32; [1.02-1.70]; P<0.05), father's overweight (including obesity) (OR=1.87; [1.38-2.54]; P<0.001) and female sex (OR=1.31; [1.02-1.68]; P<0.05). CONCLUSION The prevalence of overweight/obesity has reached an alarming rate among high school students in the Eastern region of Morocco. The findings of the present study suggest an urgent need to set up a strategy to prevent and combat this epidemic.
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Vitamin D during pregnancy and its association with birth outcomes: a Brazilian cohort study. Eur J Clin Nutr 2020; 75:489-500. [PMID: 32879447 DOI: 10.1038/s41430-020-00733-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 07/14/2020] [Accepted: 08/19/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND/OBJECTIVES Evidence is lacking on how variation in vitamin D concentrations during gestation affects perinatal outcomes. Therefore, we evaluated the association between vitamin D serum concentrations during pregnancy and neonatal outcomes. METHODS A prospective cohort of 180 healthy Brazilian pregnant women was followed and plasma 25-hydroxyvitamin [25(OH)D, nmol/L] was measured at 5-13 (baseline), 20-26 and 30-36 gestational weeks. Birth weight (BW), birth length (BL), BW z-scores, BL z-scores, first minute Apgar, small for gestational age (SGA), large for gestational age (LGA) and preterm birth were the outcomes. Multiple linear and Poisson regression models were estimated. Best linear unbiased prediction of random coefficients model was used to determine the association between the mean rate of change in vitamin D during pregnancy concentrations and neonatal outcomes. RESULTS Mean (SD) BW was 3300 (600) g, BW z-score 0.34 (1.11), BL 49.3 (3.3) cm, BL z-score 0.44 (1.5), and first minute Apgar score 8.2 (1.4). Prevalence of SGA, LGA and preterm birth were 6%, 18% and 13%, respectively. 25(OH)D was directly associated with the risk of preterm birth at all trimesters. Incidence-rate ratios were 1.02, 1.05 and 1.04 for the 1st, 2nd and 3rd trimester, respectively. Mean rate of change during pregnancy in 25(OH)D was directly associated with BW z-score (β: 0.36, 95% CI 0.07; 0.65), LGA risk (IRR: 1.97, 95% CI 1.07; 3.63) and preterm birth (IRR: 7.35, 95% CI 2.99; 18.07). CONCLUSIONS Mean 25(OH)D rate of change during pregnancy was directly associated with BW z-scores, and increased LGA and preterm birth risk.
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Lehmann F, Varnaccia G, Zeiher J, Lange C, Jordan S. Influencing factors of obesity in school-age children and adolescents - A systematic review of the literature in the context of obesity monitoring. JOURNAL OF HEALTH MONITORING 2020; 5:2-23. [PMID: 35146282 PMCID: PMC8734193 DOI: 10.25646/6729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 03/17/2020] [Indexed: 12/03/2022]
Abstract
Around 15% of children and adolescents in Germany are overweight or obese. To support the planning, implementation and evaluation of preventive activities, the Robert Koch Institute (RKI) has developed a population-wide monitoring of influencing factors relevant to the development of obesity during childhood (AdiMon). AdiMon is a web-based indicator system providing population-wide meaningful and regularly updated data on factors that influence obesity in kindergarten-age girls and boys (0- to 6-years-old). Towards the end of 2020, the RKI will expand the indicator system to also cover the 7- to 17-year-old age group. To this end, a systematic review of the literature was conducted, a process which served to identify over 80 relevant factors that influence the development of obesity. These factors have been attributed to the categories behaviour, environment, biology, pre- and postnatal, psychosocial factors and context. Compared to a previous literature review for kindergarten-age children, around one tenth of the influencing factors now identified are new, including 'peer group influences' and 'bullying'. As the results highlight, an array of influencing factors must be considered when expanding the monitoring system, ranging from individual health behaviour to the social framework conditions and environmental factors.
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Affiliation(s)
- Franziska Lehmann
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Gianni Varnaccia
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Johannes Zeiher
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Cornelia Lange
- Formerly Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Susanne Jordan
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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21
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Abstract
Zusammenfassung
Hintergrund
Übergewicht und Bewegungsmangel stellen bei Kindern ein Risiko für kardiovaskuläre Erkrankungen dar. Das Ziel der Studie war, den kardiovaskulären Gesundheitsstatus und die Fitness deutscher Grund- und Gesamtschülerinnen und -schüler sowie mögliche Einflussfaktoren zu erfassen.
Methodik
In einer prospektiven Querschnittsstudie wurden 357 Kinder (9,6 ± 1,7 Jahre) auf kardiovaskuläre Risikofaktoren untersucht. Die Pulswellengeschwindigkeit (PWV) als Maß für die arterielle Gefäßelastizität sowie die Fahrradergometrie zur Einschätzung der Fitness wurden bestimmt.
Ergebnisse
24 % der Kinder waren übergewichtig (Body-Mass-Index, BMI >90. Perzentile) oder adipös (BMI >97. Perzentile). Nahezu alle diese Kinder litten an einer viszeralen Adipositas (99 %). Bei Kindern mit Übergewicht/Adipositas war häufiger eine geringere Gefäßelastizität nachweisbar (PWV „standard deviation score“, SDS 0,8 ± 1,0 vs. 0,2 ± 0,9 bei Kindern ohne Übergewicht, p < 0,001; PWV-Werte >95. Perzentile 24 % vs. 3 %). Das Vorliegen von Übergewicht/Adipositas, Grundschulalter, höherer Blutdruck und niedrigeres „High Density Lipoprotein“(HDL)-Cholesterin waren unabhängige Prädiktoren für geringere Gefäßelastizität. Zudem zeigten Kinder mit Übergewicht/Adipositas einen höheren systolischen Blutdruck, ein nachteiligeres Fettstoffwechselprofil, höhere Harnsäure- und Glutamat-Pyruvat-Transaminase(GPT)-Werte sowie schlechtere körperliche Fitness und einen höheren Medienkonsum. Es bestand eine signifikante Assoziation von BMI und glomerulärer Filtrationsrate.
Diskussion
Das mit erhöhtem BMI und reduzierter Fitness einhergehende kardiovaskuläre Risiko wird durch weitere Risikofaktoren für die Entwicklung eines metabolischen Syndroms verstärkt. Zusätzlich finden sich Hinweise, dass bereits strukturelle Veränderungen an den Gefäßen vorliegen. Unsere Daten legen eine umfassende Beurteilung des individuellen kardiovaskulären Risikos bei Kindern mit Übergewicht nahe und unterstreichen die Notwendigkeit, Präventionsmaßnahmen früh in den Alltag von Kindern zu implementieren, um die kardiovaskuläre Morbidität im Erwachsenenalter zu verringern.
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Vinciguerra F, Tumminia A, Roppolo F, Romeo LC, La Spina N, Baratta R, Parrino C, Sciacca L, Vigneri R, Frittitta L. Impact of unhealthy childhood and unfavorable parents' characteristics on adiposity in schoolchildren. Diabetes Metab Res Rev 2019; 35:e3199. [PMID: 31257680 DOI: 10.1002/dmrr.3199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 06/06/2019] [Accepted: 06/20/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND Childhood obesity is encouraged by low physical activity (PA), time spent using screens (screen time, ST), and by sugar-sweetened beverage consumption (SSBc). It is also influenced by unfavorable parents' characteristics, such as a high body mass index (BMI) and low education level (EL). Our aim was to evaluate the overall and specific influence of these factors on childhood adiposity. MATERIAL AND METHODS Anthropometric parameters including BMI z-score, waist circumference (WC), waist to height ratio (WtHR), and fat mass were measured in a cohort of 1702 schoolchildren (6.0-14.5 years, mean 10.7 ± 1.8) and questionnaires concerning children's PA, ST, and SSBc, and parent's BMI and EL were administered to parents. RESULTS Overweight/obesity prevalence was higher (P < .0001) in males (57%) than in females (43%). Less physically active children (28.9%) had a higher prevalence of overweight/obesity and higher BMI z-score, WC, WtHR, and fat mass relative to more physically active children (P < .05). PA was negatively associated with the BMI z-score (r = 0.18, P < .0001) and fat mass percentage (r = 0.18, P < .0001). Children with more ST had higher WC and WtHR than non-ST viewers (P < .05) but not BMI. Moreover, SSBc did not influence the anthropometric parameters. At multivariate analysis, male gender, less PA, and parental risk factors (parent's overweight/obesity and low/medium EL) were independently associated with overweight and obesity among childhood with a progressively increasing odds ratio (1.65, 1.40, and 1.80, respectively). CONCLUSIONS Male gender, behavioral risk factors (particularly low PA), and parent's characteristics are important correlates of obesity in children.
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Affiliation(s)
- Federica Vinciguerra
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Andrea Tumminia
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Francesca Roppolo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Luana Catena Romeo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Nadia La Spina
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Cristina Parrino
- Endocrinology and Diabetology Unit, I.R.C.C.S, Policlinico San Donato University Hospital, Milan, Italy
| | - Laura Sciacca
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Unit of Endocrinology, Garibaldi Hospital, Catania, Italy
| | | | - Lucia Frittitta
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Unit of Endocrinology, Garibaldi Hospital, Catania, Italy
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23
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Mitra DK, Mistry SK, Afsana K, Rahman M. Demographic, Socio-economic and Lifestyle Determinants of Under- and Over-nutrition among Bangladeshi Adult Population: Results from a Large Cross-Sectional Study. J Epidemiol Glob Health 2019; 8:134-142. [PMID: 30864754 PMCID: PMC7377563 DOI: 10.2991/j.jegh.2018.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/31/2018] [Indexed: 12/31/2022] Open
Abstract
Bangladesh is currently going through a nutritional transition with rapid increase in overnutrition while undernutrition is still remaining prevalent. Nevertheless, population-based data on demographic, socio-economic and lifestyle factors associated with underweight and overweight among adult population is scarce. Employing a nationwide cross-sectional survey, we collected anthropometric, demographic, socio-economic, lifestyle and dietary information from 12,180 adults aged ≥35 years. Body Mass Index (BMI) was calculated using standard formula and categorized into underweight (<18.50), normal weight (18.50–22.99), and overweight (≥23.00). Multivariable multinomial logistic regression was performed to identify factors associated with underweight and overweight. Overall, prevalence of underweight and overweight was 18.1% (95% CI: 17.5–18.8) and 33.7% (95% CI: 32.9–34.6), respectively. All the demographic, socio-economic, dietary and lifestyle factors showed significant association with nutritional status in bivariate analysis. In adjusted analysis, factors showing significant positive association with underweight included female gender (ARRR-1.38, 95% CI: 1.11–1.71), older age [compared to 35–39 years age group, ARRR (95% CI) for ≥ 70 years is 2.32 (1.89–2.86), for 60–69 years is 1.62 (1.36–1.93), for 50–59 years 1.34 (1.13–1.58) and for 40–49 years 1.05 (0.87–1.15)] and smoking habit (ARRR-1.32, 95% CI: 1.14–1.52) while factors showing significant inverse association with underweight included higher household wealth [compared to lowest wealth quintile, ARRR (95% CI) for highest quintile is 0.68 (0.55–0.84), for second highest quintile 0.77 (0.65–0.91), for middle quintile 0.81 (0.69–0.94) and for second lowest quintile 0.89 (0.77–1.03)], urban residence (ARRR-0.66, 95% CI: 0.66–0.90), and more frequent meat/fish and fruits consumption (ARRR-0.76, 95% CI: 0.65–0.90). On the other hand, factors significantly associated with increased risk of overweight included female gender (ARRR-1.35, 95% CI: 1.12–1.63), higher household wealth [compared to lowest wealth quintile, ARRR (95% CI) for highest quintile is 2.27 (1.93–2.68), for second highest quintile 1.67 (1.44–1.94), for middle quintile 1.26 (1.10–1.46) and for second lowest quintile 1.07 (0.93–1.24), excess food availability [compared to food shortage, ARRR (95% CI) for excess food in the household is 1.29 (1.12–1.47) and for no shortage/no excess is 1.23 (1.09–1.38) and more frequent fruits consumption [compared to no fruits, ARRR (95% CI) for 5–7 days per week consumption is 1.61 (1.41–1.83) and for 3–4 days per week is 1.28 (1.16–1.41) and factors significantly associated with decreased risk of overweight included older age [compared to 35–39 years age group, ARRR (95% CI) for ≥ 70 years is 0.77 (0.64–0.93), for 60–69 years is 0.82 (0.71–0.94), for 50–59 years 0.91 (0.80–1.04) and for 40–49 years 1.01 (0.89–1.15)] and smoking (ARRR-0.76, 95% CI: 0.68–0.86). Both underweight and overweight are prevalent in Bangladeshi adult population. Several demographic, socio-economic, dietary and lifestyle factors are associated with underweight and overweight in Bangladesh. Population level impact of these factors should be examined to design suitable public health and nutrition interventions to address this dual challenge.
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Affiliation(s)
- Dipak K Mitra
- School of Public Health, North South University, Bangladesh
| | - Sabuj Kanti Mistry
- Research and Evaluation Division, BRAC, BRAC Centre, 75 Mohakhali, Dhaka 1212, Bangladesh
| | - Kaosar Afsana
- Health Nutrition and Population Programme, BRAC, BRAC Centre, 75 Mohakhali, Dhaka 1212, Bangladesh
| | - Mahfuzar Rahman
- Research and Evaluation Division, BRAC, BRAC Centre, 75 Mohakhali, Dhaka 1212, Bangladesh
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24
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UĞRAŞ DİKMEN A, KONŞUK ÜNLÜ H, ÖZCEBE LH. Evaluation of being overweight/obese and related sociodemographic factors in 0-5 year age group in Turkey: Turkey Demographic Health Survey 2013 advanced analysis. Turk J Med Sci 2019; 49:879-887. [PMID: 31203589 PMCID: PMC7018246 DOI: 10.3906/sag-1808-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background/aim To determine risk factors of overweightness/obesity in children aged 0-5 years in the Turkish population. Materials and methods We made advanced analysis using the Turkey Demographic Health Survey (TDHS) 2013 female database, in which data from children aged under five years and their mothers are included. Analyses were performed using weight for height index data. The children were divided into two groups by age as 0–23 months and 24–59 months. Results The analysis comprised 2196 children aged under 5 years. Several factors were associated with an increase in overweightness/obesity of children aged under 5 years. Overweight/obesity in children aged 0-23 months was associated with several factors such as age (12–23 months) (OR: 2.89 CI: 1.62-5.13), high birth weight (OR: 2.36 CI: 1.26-4.44), maternal obesity (OR: 2.09 CI: 1.33-3.27), and maternal smoking (OR: 2.07, CI: 1.28-3.33). Overweightness/obesity in children aged 24–59 months was associated with several factors such as education level of the mother (OR: 2.27, CI: 1.08-4.75), consanguineous marriage (OR: 2.86, CI: 1.83-4.47), and which region of Turkey the family lives in (OR: 2.79, CI: 1.53-5.08). Conclusion Our results from the TDHS 2013 showed several risk factors of children overweight/obesity. Determining obesity risk factors, monitoring obese children/adults, and providing a multidisciplinary approach to the treatment and prevention of obesity will be useful for the future.
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Affiliation(s)
- Asiye UĞRAŞ DİKMEN
- Public Health Department, Gazi University Medicine Faculty, AnkaraTurkey
- Public Health Department, Hacettepe University Medicine Faculty, AnkaraTurkey
| | - Hande KONŞUK ÜNLÜ
- Public Health Department, Hacettepe University Medicine Faculty, AnkaraTurkey
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25
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Reimers AK, Brzoska P, Niessner C, Schmidt SCE, Worth A, Woll A. Are there disparities in different domains of physical activity between school-aged migrant and non-migrant children and adolescents? Insights from Germany. PLoS One 2019; 14:e0214022. [PMID: 30883609 PMCID: PMC6422267 DOI: 10.1371/journal.pone.0214022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/05/2019] [Indexed: 12/29/2022] Open
Abstract
Background Large proportions of the populations in many European countries, including Germany, are migrants. Migrant children and adolescents tend to be less physically active than their non-migrant peers. However, current research is limited as it does not sufficiently consider different domains of physical activity. Using a representative dataset, the present study examines the patterns of sports participation and other domains of physical activity among migrant and non-migrant children and adolescents residing in Germany. Methods Nationwide data from the Motorik-Modul (MoMo) Study is used. Five different domains of physical activity participation (sports clubs, outside of sports clubs, extra-curricular physical activity, physical activity, outdoor play and active commuting to school) were compared between children and adolescents with no, one-sided and two-sided migration background using logistic regression adjusted for demographic factors. Interaction terms were included in order to examine whether difference between the three groups differ by age and gender. Results Information on n = 3,323 children and adolescents was available. As compared to non-migrants, children and adolescents with a two-sided migration background had a 40% (adjusted odds ratio [aOR] = 0.60, 95%-CI: 0.44–0.81), those with a one-sided migration background a 26% (aOR = 0.74, 95%-CI: 0.55-<1.00) lower chance of participating in sport club activities. In contrast, children and adolescents with a two-sided migration background were at 65% higher chance of participating in extra-curricular physical activity than non-migrants (OR = 1.65, 95%-CI: 1.15–2.36). Conclusion The study shows that differences in levels of physical activity between migrant and non-migrant children and adolescents are less pronounced than previous research has suggested. In particular, it reveals that migrants are only disadvantaged regarding participation in sports clubs whereas they fare better with respect to extra-curricular physical activity. Interventions should therefore address barriers migrant children and adolescents encounter in the access to sport clubs while maintaining their high level of extra-curricular physical activity.
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Affiliation(s)
- Anne K. Reimers
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Technical University of Chemnitz, Chemnitz, Germany
- * E-mail:
| | - Patrick Brzoska
- Health Services Research Unit, Faculty of Health/School of Medicine, Witten/Herdecke University, Witten/Herdecke, Germany
| | - Claudia Niessner
- Institute of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Steffen C. E. Schmidt
- Institute of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Annette Worth
- Institute for Movement and Sports, University of Education Karlsruhe, Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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26
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Geserick M, Vogel M, Gausche R, Lipek T, Spielau U, Keller E, Pfäffle R, Kiess W, Körner A. Acceleration of BMI in Early Childhood and Risk of Sustained Obesity. N Engl J Med 2018; 379:1303-1312. [PMID: 30281992 DOI: 10.1056/nejmoa1803527] [Citation(s) in RCA: 456] [Impact Index Per Article: 76.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The dynamics of body-mass index (BMI) in children from birth to adolescence are unclear, and whether susceptibility for the development of sustained obesity occurs at a specific age in children is important to determine. METHODS To assess the age at onset of obesity, we performed prospective and retrospective analyses of the course of BMI over time in a population-based sample of 51,505 children for whom sequential anthropometric data were available during childhood (0 to 14 years of age) and adolescence (15 to 18 years of age). In addition, we assessed the dynamics of annual BMI increments, defined as the change in BMI standard-deviation score per year, during childhood in 34,196 children. RESULTS In retrospective analyses, we found that most of the adolescents with normal weight had always had a normal weight throughout childhood. Approximately half (53%) of the obese adolescents had been overweight or obese from 5 years of age onward, and the BMI standard-deviation score further increased with age. In prospective analyses, we found that almost 90% of the children who were obese at 3 years of age were overweight or obese in adolescence. Among the adolescents who were obese, the greatest acceleration in annual BMI increments had occurred between 2 and 6 years of age, with a further rise in BMI percentile thereafter. High acceleration in annual BMI increments during the preschool years (but not during the school years) was associated with a risk of overweight or obesity in adolescence that was 1.4 times as high as the risk among children who had had stable BMI. The rate of overweight or obesity in adolescence was higher among children who had been large for gestational age at birth (43.7%) than among those who had been at an appropriate weight for gestational age (28.4%) or small for gestational age (27.2%), which corresponded to a risk of adolescent obesity that was 1.55 times as high among those who had been large for gestational age as among the other groups. CONCLUSIONS Among obese adolescents, the most rapid weight gain had occurred between 2 and 6 years of age; most children who were obese at that age were obese in adolescence. (Funded by the German Research Council for the Clinical Research Center "Obesity Mechanisms" and others; ClinicalTrials.gov number, NCT03072537 .).
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Affiliation(s)
- Mandy Geserick
- From the Center for Pediatric Research, University Hospital for Children and Adolescents (M.G., T.L., U.S., R.P., W.K., A.K.), Leipzig Research Center for Civilization Diseases (LIFE Child) (M.G., M.V., W.K., A.K.), CrescNet, Medical Faculty (R.G., E.K., R.P.), and Integrated Research and Treatment Center (IFB), Adiposity Diseases, University Medical Center (T.L., U.S., A.K.), University of Leipzig, Leipzig, Germany
| | - Mandy Vogel
- From the Center for Pediatric Research, University Hospital for Children and Adolescents (M.G., T.L., U.S., R.P., W.K., A.K.), Leipzig Research Center for Civilization Diseases (LIFE Child) (M.G., M.V., W.K., A.K.), CrescNet, Medical Faculty (R.G., E.K., R.P.), and Integrated Research and Treatment Center (IFB), Adiposity Diseases, University Medical Center (T.L., U.S., A.K.), University of Leipzig, Leipzig, Germany
| | - Ruth Gausche
- From the Center for Pediatric Research, University Hospital for Children and Adolescents (M.G., T.L., U.S., R.P., W.K., A.K.), Leipzig Research Center for Civilization Diseases (LIFE Child) (M.G., M.V., W.K., A.K.), CrescNet, Medical Faculty (R.G., E.K., R.P.), and Integrated Research and Treatment Center (IFB), Adiposity Diseases, University Medical Center (T.L., U.S., A.K.), University of Leipzig, Leipzig, Germany
| | - Tobias Lipek
- From the Center for Pediatric Research, University Hospital for Children and Adolescents (M.G., T.L., U.S., R.P., W.K., A.K.), Leipzig Research Center for Civilization Diseases (LIFE Child) (M.G., M.V., W.K., A.K.), CrescNet, Medical Faculty (R.G., E.K., R.P.), and Integrated Research and Treatment Center (IFB), Adiposity Diseases, University Medical Center (T.L., U.S., A.K.), University of Leipzig, Leipzig, Germany
| | - Ulrike Spielau
- From the Center for Pediatric Research, University Hospital for Children and Adolescents (M.G., T.L., U.S., R.P., W.K., A.K.), Leipzig Research Center for Civilization Diseases (LIFE Child) (M.G., M.V., W.K., A.K.), CrescNet, Medical Faculty (R.G., E.K., R.P.), and Integrated Research and Treatment Center (IFB), Adiposity Diseases, University Medical Center (T.L., U.S., A.K.), University of Leipzig, Leipzig, Germany
| | - Eberhard Keller
- From the Center for Pediatric Research, University Hospital for Children and Adolescents (M.G., T.L., U.S., R.P., W.K., A.K.), Leipzig Research Center for Civilization Diseases (LIFE Child) (M.G., M.V., W.K., A.K.), CrescNet, Medical Faculty (R.G., E.K., R.P.), and Integrated Research and Treatment Center (IFB), Adiposity Diseases, University Medical Center (T.L., U.S., A.K.), University of Leipzig, Leipzig, Germany
| | - Roland Pfäffle
- From the Center for Pediatric Research, University Hospital for Children and Adolescents (M.G., T.L., U.S., R.P., W.K., A.K.), Leipzig Research Center for Civilization Diseases (LIFE Child) (M.G., M.V., W.K., A.K.), CrescNet, Medical Faculty (R.G., E.K., R.P.), and Integrated Research and Treatment Center (IFB), Adiposity Diseases, University Medical Center (T.L., U.S., A.K.), University of Leipzig, Leipzig, Germany
| | - Wieland Kiess
- From the Center for Pediatric Research, University Hospital for Children and Adolescents (M.G., T.L., U.S., R.P., W.K., A.K.), Leipzig Research Center for Civilization Diseases (LIFE Child) (M.G., M.V., W.K., A.K.), CrescNet, Medical Faculty (R.G., E.K., R.P.), and Integrated Research and Treatment Center (IFB), Adiposity Diseases, University Medical Center (T.L., U.S., A.K.), University of Leipzig, Leipzig, Germany
| | - Antje Körner
- From the Center for Pediatric Research, University Hospital for Children and Adolescents (M.G., T.L., U.S., R.P., W.K., A.K.), Leipzig Research Center for Civilization Diseases (LIFE Child) (M.G., M.V., W.K., A.K.), CrescNet, Medical Faculty (R.G., E.K., R.P.), and Integrated Research and Treatment Center (IFB), Adiposity Diseases, University Medical Center (T.L., U.S., A.K.), University of Leipzig, Leipzig, Germany
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27
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Gong QH, Li SX, Li H, Cui J, Xu GZ. Insufficient Sleep Duration and Overweight/Obesity among Adolescents in a Chinese Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050997. [PMID: 29762538 PMCID: PMC5982036 DOI: 10.3390/ijerph15050997] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 05/11/2018] [Accepted: 05/12/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The objective of this study was to investigate the relationship between sleep duration and overweight/obesity among Chinese adolescents. METHODS A school-based cross-sectional study was conducted among Chinese adolescents in 2016. In total, 2795 school-aged Chinese children aged 12 to 13 years participated in this study. Participants were asked to complete self-administered surveys during a 45-min class period in their classroom. Details of the questionnaire about health-related behaviors included sleep habits, physical activity, screen time, cigarette use, and alcohol use. Height, weight, waist circumference and hip circumference were directly measured. RESULTS The mean sleep duration was 8.7 h/day. In total, 43.0% of the participants had a sleep duration of less than 9 h/day. Sleep duration was significantly inversely related to BMI, waist circumference, hip circumference and WHtR in multiple linear regression analyses in both genders. Logistic regression models showed that insufficient sleep (<9 h/day) was associated with high odds of overweight/obesity among both young boys and girls. CONCLUSIONS Insufficient sleep duration was associated with overweight/obesity in Chinese adolescents, and short sleep duration was probably associated with central adiposity, especially among boys.
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Affiliation(s)
- Qing-Hai Gong
- Ningbo Center for Disease Control and Prevention, Ningbo 315010, China.
| | - Si-Xuan Li
- Ningbo Center for Disease Control and Prevention, Ningbo 315010, China.
| | - Hui Li
- Ningbo Center for Disease Control and Prevention, Ningbo 315010, China.
| | - Jun Cui
- Ningbo Center for Disease Control and Prevention, Ningbo 315010, China.
| | - Guo-Zhang Xu
- Ningbo Center for Disease Control and Prevention, Ningbo 315010, China.
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28
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Albers L, Sobotzki C, Kuß O, Ajslev T, Batista RF, Bettiol H, Brabin B, Buka SL, Cardoso VC, Clifton VL, Devereux G, Gilman SE, Grzeskowiak LE, Heinrich J, Hummel S, Jacobsen GW, Jones G, Koshy G, Morgen CS, Oken E, Paus T, Pausova Z, Rifas-Shiman SL, Sharma AJ, da Silva AA, Sørensen TI, Thiering E, Turner S, Vik T, von Kries R. Maternal smoking during pregnancy and offspring overweight: is there a dose-response relationship? An individual patient data meta-analysis. Int J Obes (Lond) 2018; 42:1249-1264. [PMID: 29717267 DOI: 10.1038/s41366-018-0050-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/13/2017] [Accepted: 12/27/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND/OBJECTIVES A number of meta-analyses suggest an association between any maternal smoking in pregnancy and offspring overweight obesity. Whether there is a dose-response relationship across number of cigarettes and whether this differs by sex remains unclear. SUBJECT/METHODS Studies reporting number of cigarettes smoked during pregnancy and offspring BMI published up to May 2015 were searched. An individual patient data meta-analysis of association between the number of cigarettes smoked during pregnancy and offspring overweight (defined according to the International Obesity Task Force reference) was computed using a generalized additive mixed model with non-linear effects and adjustment for confounders (maternal weight status, breastfeeding, and maternal education) and stratification for sex. RESULTS Of 26 identified studies, 16 authors provided data on a total of 238,340 mother-child-pairs. A linear positive association was observed between the number of cigarettes smoked and offspring overweight for up to 15 cigarettes per day with an OR increase per cigarette of 1.03, 95% CI = [1.02-1.03]. The OR flattened with higher cigarette use. Associations were similar in males and females. Sensitivity analyses supported these results. CONCLUSIONS A linear dose-response relationship of maternal smoking was observed in the range of 1-15 cigarettes per day equally in boys and girls with no further risk increase for doses above 15 cigarettes.
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Affiliation(s)
- Lucia Albers
- Division of Epidemiology, Institute of Social Paediatrics and Adolescents Medicine, Ludwig-Maximilians-University Munich, Munich, Germany.
| | - Christina Sobotzki
- Division of Epidemiology, Institute of Social Paediatrics and Adolescents Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Oliver Kuß
- German Diabetes Center, Institute of Biometrics and Epidemiology, Düsseldorf, 40225, Germany
| | - Teresa Ajslev
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Bispebjerg and Frederiksberg Hospitals, The Capital Region, Denmark
| | - Rosangela Fl Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - Heloisa Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Bernard Brabin
- Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK.,Department of Community Child Health,Royal Liverpool Children's Hospital, NHS Trust Alder Hey, Liverpool, UK.,Emma Kinderziekenhuis, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Stephen L Buka
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Viviane C Cardoso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Vicki L Clifton
- Adelaide Medical School, The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | | | - Stephen E Gilman
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.,Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Luke E Grzeskowiak
- Adelaide Medical School, The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Joachim Heinrich
- Institute of Occupational, Social, and Environmental Medicine, University Hospital, Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Occupational, Social, and Environmental Medicine, University Hospital, Neuherberg, Germany
| | - Sandra Hummel
- Forschergruppe Diabetes der Technischen Universität München, Munich, Germany.,Institut für Diabetesforschung der Forschergruppe Diabetes e.V. am Helmholtz Zentrum München, Munich, Germany
| | - Geir W Jacobsen
- Department of Public Health and General Practice, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Gibby Koshy
- Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Camilla Schmidt Morgen
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Bispebjerg and Frederiksberg Hospitals, The Capital Region, Denmark
| | - Emily Oken
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Tomas Paus
- Rotman Research Institute and Departments of Psychology and Psychiatry, University of Toronto, Toronto, Canada
| | - Zdenka Pausova
- Hospital for Sick Children and Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, Canada
| | - Sheryl L Rifas-Shiman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | | | - Antônio Am da Silva
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - Thorkild Ia Sørensen
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Bispebjerg and Frederiksberg Hospitals, The Capital Region, Denmark.,Novo Nordisk Foundation Centre for Basic Metabolic Research, and Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth Thiering
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany
| | | | - Torstein Vik
- Department of Laboratory Medicine, Children and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Rüdiger von Kries
- Division of Epidemiology, Institute of Social Paediatrics and Adolescents Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
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Seyednasrollah F, Mäkelä J, Pitkänen N, Juonala M, Hutri-Kähönen N, Lehtimäki T, Viikari J, Kelly T, Li C, Bazzano L, Elo LL, Raitakari OT. Prediction of Adulthood Obesity Using Genetic and Childhood Clinical Risk Factors in the Cardiovascular Risk in Young Finns Study. ACTA ACUST UNITED AC 2018; 10:CIRCGENETICS.116.001554. [PMID: 28620069 DOI: 10.1161/circgenetics.116.001554] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 12/06/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Obesity is a known risk factor for cardiovascular disease. Early prediction of obesity is essential for prevention. The aim of this study is to assess the use of childhood clinical factors and the genetic risk factors in predicting adulthood obesity using machine learning methods. METHODS AND RESULTS A total of 2262 participants from the Cardiovascular Risk in YFS (Young Finns Study) were followed up from childhood (age 3-18 years) to adulthood for 31 years. The data were divided into training (n=1625) and validation (n=637) set. The effect of known genetic risk factors (97 single-nucleotide polymorphisms) was investigated as a weighted genetic risk score of all 97 single-nucleotide polymorphisms (WGRS97) or a subset of 19 most significant single-nucleotide polymorphisms (WGRS19) using boosting machine learning technique. WGRS97 and WGRS19 were validated using external data (n=369) from BHS (Bogalusa Heart Study). WGRS19 improved the accuracy of predicting adulthood obesity in training (area under the curve [AUC=0.787 versus AUC=0.744, P<0.0001) and validation data (AUC=0.769 versus AUC=0.747, P=0.026). WGRS97 improved the accuracy in training (AUC=0.782 versus AUC=0.744, P<0.0001) but not in validation data (AUC=0.749 versus AUC=0.747, P=0.785). Higher WGRS19 associated with higher body mass index at 9 years and WGRS97 at 6 years. Replication in BHS confirmed our findings that WGRS19 and WGRS97 are associated with body mass index. CONCLUSIONS WGRS19 improves prediction of adulthood obesity. Predictive accuracy is highest among young children (3-6 years), whereas among older children (9-18 years) the risk can be identified using childhood clinical factors. The model is helpful in screening children with high risk of developing obesity.
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Affiliation(s)
- Fatemeh Seyednasrollah
- From the Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Finland (F.S., J.M., L.L.E.); Department of Mathematics and Statistics (F.S.), Research Centre of Applied and Preventive Cardiovascular Medicine (N.P., O.T.R.), and Department of Medicine (M.J., J.V.), University of Turku, Finland; Division of Medicine (M.J., J.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Finland; Department of Pediatrics (N.H.-K.) and School of Medicine (T.L.), University of Tampere, Finland; Tampere University Hospital, Finland (N.H.-K.); Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland (T.L.); Tulane University Health Sciences Center, New Orleans, LA (T.K., L.B.); and Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens (C.L.)
| | - Johanna Mäkelä
- From the Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Finland (F.S., J.M., L.L.E.); Department of Mathematics and Statistics (F.S.), Research Centre of Applied and Preventive Cardiovascular Medicine (N.P., O.T.R.), and Department of Medicine (M.J., J.V.), University of Turku, Finland; Division of Medicine (M.J., J.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Finland; Department of Pediatrics (N.H.-K.) and School of Medicine (T.L.), University of Tampere, Finland; Tampere University Hospital, Finland (N.H.-K.); Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland (T.L.); Tulane University Health Sciences Center, New Orleans, LA (T.K., L.B.); and Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens (C.L.).
| | - Niina Pitkänen
- From the Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Finland (F.S., J.M., L.L.E.); Department of Mathematics and Statistics (F.S.), Research Centre of Applied and Preventive Cardiovascular Medicine (N.P., O.T.R.), and Department of Medicine (M.J., J.V.), University of Turku, Finland; Division of Medicine (M.J., J.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Finland; Department of Pediatrics (N.H.-K.) and School of Medicine (T.L.), University of Tampere, Finland; Tampere University Hospital, Finland (N.H.-K.); Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland (T.L.); Tulane University Health Sciences Center, New Orleans, LA (T.K., L.B.); and Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens (C.L.)
| | - Markus Juonala
- From the Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Finland (F.S., J.M., L.L.E.); Department of Mathematics and Statistics (F.S.), Research Centre of Applied and Preventive Cardiovascular Medicine (N.P., O.T.R.), and Department of Medicine (M.J., J.V.), University of Turku, Finland; Division of Medicine (M.J., J.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Finland; Department of Pediatrics (N.H.-K.) and School of Medicine (T.L.), University of Tampere, Finland; Tampere University Hospital, Finland (N.H.-K.); Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland (T.L.); Tulane University Health Sciences Center, New Orleans, LA (T.K., L.B.); and Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens (C.L.)
| | - Nina Hutri-Kähönen
- From the Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Finland (F.S., J.M., L.L.E.); Department of Mathematics and Statistics (F.S.), Research Centre of Applied and Preventive Cardiovascular Medicine (N.P., O.T.R.), and Department of Medicine (M.J., J.V.), University of Turku, Finland; Division of Medicine (M.J., J.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Finland; Department of Pediatrics (N.H.-K.) and School of Medicine (T.L.), University of Tampere, Finland; Tampere University Hospital, Finland (N.H.-K.); Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland (T.L.); Tulane University Health Sciences Center, New Orleans, LA (T.K., L.B.); and Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens (C.L.)
| | - Terho Lehtimäki
- From the Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Finland (F.S., J.M., L.L.E.); Department of Mathematics and Statistics (F.S.), Research Centre of Applied and Preventive Cardiovascular Medicine (N.P., O.T.R.), and Department of Medicine (M.J., J.V.), University of Turku, Finland; Division of Medicine (M.J., J.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Finland; Department of Pediatrics (N.H.-K.) and School of Medicine (T.L.), University of Tampere, Finland; Tampere University Hospital, Finland (N.H.-K.); Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland (T.L.); Tulane University Health Sciences Center, New Orleans, LA (T.K., L.B.); and Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens (C.L.)
| | - Jorma Viikari
- From the Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Finland (F.S., J.M., L.L.E.); Department of Mathematics and Statistics (F.S.), Research Centre of Applied and Preventive Cardiovascular Medicine (N.P., O.T.R.), and Department of Medicine (M.J., J.V.), University of Turku, Finland; Division of Medicine (M.J., J.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Finland; Department of Pediatrics (N.H.-K.) and School of Medicine (T.L.), University of Tampere, Finland; Tampere University Hospital, Finland (N.H.-K.); Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland (T.L.); Tulane University Health Sciences Center, New Orleans, LA (T.K., L.B.); and Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens (C.L.)
| | - Tanika Kelly
- From the Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Finland (F.S., J.M., L.L.E.); Department of Mathematics and Statistics (F.S.), Research Centre of Applied and Preventive Cardiovascular Medicine (N.P., O.T.R.), and Department of Medicine (M.J., J.V.), University of Turku, Finland; Division of Medicine (M.J., J.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Finland; Department of Pediatrics (N.H.-K.) and School of Medicine (T.L.), University of Tampere, Finland; Tampere University Hospital, Finland (N.H.-K.); Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland (T.L.); Tulane University Health Sciences Center, New Orleans, LA (T.K., L.B.); and Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens (C.L.)
| | - Changwei Li
- From the Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Finland (F.S., J.M., L.L.E.); Department of Mathematics and Statistics (F.S.), Research Centre of Applied and Preventive Cardiovascular Medicine (N.P., O.T.R.), and Department of Medicine (M.J., J.V.), University of Turku, Finland; Division of Medicine (M.J., J.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Finland; Department of Pediatrics (N.H.-K.) and School of Medicine (T.L.), University of Tampere, Finland; Tampere University Hospital, Finland (N.H.-K.); Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland (T.L.); Tulane University Health Sciences Center, New Orleans, LA (T.K., L.B.); and Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens (C.L.)
| | - Lydia Bazzano
- From the Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Finland (F.S., J.M., L.L.E.); Department of Mathematics and Statistics (F.S.), Research Centre of Applied and Preventive Cardiovascular Medicine (N.P., O.T.R.), and Department of Medicine (M.J., J.V.), University of Turku, Finland; Division of Medicine (M.J., J.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Finland; Department of Pediatrics (N.H.-K.) and School of Medicine (T.L.), University of Tampere, Finland; Tampere University Hospital, Finland (N.H.-K.); Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland (T.L.); Tulane University Health Sciences Center, New Orleans, LA (T.K., L.B.); and Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens (C.L.)
| | - Laura L Elo
- From the Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Finland (F.S., J.M., L.L.E.); Department of Mathematics and Statistics (F.S.), Research Centre of Applied and Preventive Cardiovascular Medicine (N.P., O.T.R.), and Department of Medicine (M.J., J.V.), University of Turku, Finland; Division of Medicine (M.J., J.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Finland; Department of Pediatrics (N.H.-K.) and School of Medicine (T.L.), University of Tampere, Finland; Tampere University Hospital, Finland (N.H.-K.); Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland (T.L.); Tulane University Health Sciences Center, New Orleans, LA (T.K., L.B.); and Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens (C.L.)
| | - Olli T Raitakari
- From the Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Finland (F.S., J.M., L.L.E.); Department of Mathematics and Statistics (F.S.), Research Centre of Applied and Preventive Cardiovascular Medicine (N.P., O.T.R.), and Department of Medicine (M.J., J.V.), University of Turku, Finland; Division of Medicine (M.J., J.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Finland; Department of Pediatrics (N.H.-K.) and School of Medicine (T.L.), University of Tampere, Finland; Tampere University Hospital, Finland (N.H.-K.); Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland (T.L.); Tulane University Health Sciences Center, New Orleans, LA (T.K., L.B.); and Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens (C.L.)
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Tönnies T, Stahl-Pehe A, Baechle C, Castillo K, Kuss O, Yossa R, Lindner LME, Holl RW, Rosenbauer J. Risk of Microvascular Complications and Macrovascular Risk Factors in Early-Onset Type 1 Diabetes after at Least 10 Years Duration: An Analysis of Three Population-Based Cross-Sectional Surveys in Germany between 2009 and 2016. Int J Endocrinol 2018; 2018:7806980. [PMID: 29808091 PMCID: PMC5901480 DOI: 10.1155/2018/7806980] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 02/15/2018] [Indexed: 02/04/2023] Open
Abstract
AIMS To estimate the risk of microvascular complications and macrovascular risk factors among persons with early-onset (diagnosed at ages 0 to <5 years) and long-duration type 1 diabetes and determine temporal trends and associations with potential predictors. METHODS We conducted three population-based cross-sectional surveys in Germany (N = 1789) to obtain information on exposures and five outcomes (retinopathy, nephropathy, dyslipidemia, hypertension, and a composite endpoint combining all four outcomes). For each outcome, log-binomial spline regression was applied to estimate the risk and dose-response relationship with diabetes duration and exposures. RESULTS The risk for microvascular complications increased after 14 years since diabetes diagnosis whereas dyslipidemia and hypertension were already prevalent at 10 years. The 15-year risk (95% confidence interval) of the composite endpoint for female and male patients was 22.9% (18.8%-27.9%) and 19.2% (15.5%-23.8%), respectively. Temporal trends suggested a decreasing risk between 2009 and 2016. Glycemic control, lifestyle-related factors, and SES, but not health care-related factors, were associated with the risk of the composite endpoint. CONCLUSIONS In early-onset type 1 diabetes, there exists a considerable risk of complications and comorbidities already in young ages. Future research should focus on prevention of diabetic complications in young patients and clarification of pathways of the associations found.
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Affiliation(s)
- Thaddäus Tönnies
- Institute for Biometrics and Epidemiology, German Diabetes Centre (DDZ), Leibniz Centre for Diabetes Research, Heinrich Heine University, Auf'm Hennekamp 65, 40225 Duesseldorf, Germany
- German Centre for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Anna Stahl-Pehe
- Institute for Biometrics and Epidemiology, German Diabetes Centre (DDZ), Leibniz Centre for Diabetes Research, Heinrich Heine University, Auf'm Hennekamp 65, 40225 Duesseldorf, Germany
- German Centre for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Christina Baechle
- Institute for Biometrics and Epidemiology, German Diabetes Centre (DDZ), Leibniz Centre for Diabetes Research, Heinrich Heine University, Auf'm Hennekamp 65, 40225 Duesseldorf, Germany
- German Centre for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Katty Castillo
- Institute for Biometrics and Epidemiology, German Diabetes Centre (DDZ), Leibniz Centre for Diabetes Research, Heinrich Heine University, Auf'm Hennekamp 65, 40225 Duesseldorf, Germany
- German Centre for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Oliver Kuss
- Institute for Biometrics and Epidemiology, German Diabetes Centre (DDZ), Leibniz Centre for Diabetes Research, Heinrich Heine University, Auf'm Hennekamp 65, 40225 Duesseldorf, Germany
- German Centre for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Rhuphine Yossa
- Institute for Biometrics and Epidemiology, German Diabetes Centre (DDZ), Leibniz Centre for Diabetes Research, Heinrich Heine University, Auf'm Hennekamp 65, 40225 Duesseldorf, Germany
- German Centre for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Lena M. E. Lindner
- Institute for Biometrics and Epidemiology, German Diabetes Centre (DDZ), Leibniz Centre for Diabetes Research, Heinrich Heine University, Auf'm Hennekamp 65, 40225 Duesseldorf, Germany
- German Centre for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Reinhard W. Holl
- German Centre for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
- Institute of Epidemiology and Medical Biometry, University of Ulm, Albert-Einstein-Allee 41, 89069 Ulm, Germany
| | - Joachim Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Centre (DDZ), Leibniz Centre for Diabetes Research, Heinrich Heine University, Auf'm Hennekamp 65, 40225 Duesseldorf, Germany
- German Centre for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
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Lichtveld K, Thomas K, Tulve NS. Chemical and non-chemical stressors affecting childhood obesity: a systematic scoping review. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2018; 28:1-12. [PMID: 28952603 PMCID: PMC6097845 DOI: 10.1038/jes.2017.18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 07/03/2017] [Indexed: 05/02/2023]
Abstract
Childhood obesity in the United States has doubled over the last three decades and currently affects 17% of children and adolescents. While much research has focused on individual behaviors impacting obesity, little research has emphasized the complex interactions of numerous chemical and non-chemical stressors found in a child's environment and how these interactions affect a child's health and well-being. The objectives of this systematic scoping review were to (1) identify potential chemical stressors in the context of non-chemical stressors that impact childhood obesity; and, (2) summarize our observations for chemical and non-chemical stressors in regards to child-specific environments within a community setting. A review was conducted to identify chemical and non-chemical stressors related to childhood obesity for the childhood life stages ranging from prenatal to adolescence. Stressors were identified and grouped into domains: individual behaviors, family/household behaviors, community stressors, and chemical exposures. Stressors were related to the child and the child's everyday environments and used to characterize child health and well-being. This review suggests that the interactions of chemical and non-chemical stressors are important for understanding a child's overall health and well-being. By considering these relationships, the exposure science research community can better design and implement strategies to reduce childhood obesity.
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Affiliation(s)
- Kim Lichtveld
- ORISE Post-Doctoral Participant, U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, Research Triangle Park, NC, USA
- Current Affiliation: Assistant Professor, The University of Findlay, Department of Environmental, Safety and Occupational Health, Findlay, OH
| | - Kent Thomas
- U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, Research Triangle Park, NC, USA
| | - Nicolle S. Tulve
- U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, Research Triangle Park, NC, USA
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Faizi N, Shah MS, Ahmad A, Ansari MA, Amir A, Khalique N. Adverse eating behavior and its association with obesity in Indian adolescents: Evidence from a nonmetropolitan city in India. J Family Med Prim Care 2018; 7:198-204. [PMID: 29915759 PMCID: PMC5958568 DOI: 10.4103/jfmpc.jfmpc_139_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION With the so-called modernization, the epidemiological and sociocultural context of adolescents in developing countries is rapidly changing and is affecting their eating behavior and dietary choices. The objective of our study is twofold. First, our study seeks to find whether there is a prevalence of the adverse eating behaviors among the adolescents. Second, our study seeks to examine whether the prevalence of the adverse eating behavior is related to obesity and quantifies their association of with body mass index (BMI) status. MATERIALS AND METHODS A cross-sectional school-based study was conducted in 13-15-year-old adolescents from schools of Aligarh, India, with prevalidated study tools and standardized anthropometric measures. The Z-scores were found by the WHO recommended AnthroPlus. RESULTS The results indicate a high prevalence of different adverse eating behaviors. The dietary behavior was found to be poor in 19.3%, fair in 54.4%, and good in only 26.3% of the study population. The mean BMI for age Z-score was found to be 0.87 and 0.02 in poor and fair dietary behavior. The odds of being overweight and obese were high (1.82 [1.20-2.78]) in those with poor dietary behavior. CONCLUSIONS Our findings suggest that more research and timely intervention in adverse eating behaviors are much needed in India before this widely neglected problem acquires even more alarming and gigantic proportions.
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Affiliation(s)
- Nafis Faizi
- Department of Community Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Mohammad Salman Shah
- Department of Community Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Anees Ahmad
- Department of Community Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Mohammad Athar Ansari
- Department of Community Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Ali Amir
- Department of Community Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Najam Khalique
- Department of Community Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Demographic, Socio-economic and Lifestyle Determinants of Under- and Over-nutrition among Bangladeshi Adult Population: Results from a Large Cross-Sectional Study. J Epidemiol Glob Health 2018. [DOI: 10.1016/j.jegh.2018.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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34
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Schürmann S, Kersting M, Alexy U. Vegetarian diets in children: a systematic review. Eur J Nutr 2017; 56:1797-1817. [PMID: 28299420 DOI: 10.1007/s00394-017-1416-0] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 02/19/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE While the prevalence of children on vegetarian diets is assumed to be on the rise in industrialized countries, there are hardly any representative data available. In general, vegetarian diets are presumed to be healthy; nevertheless, there are concerns as to whether the dietary specifications required during infancy, childhood, and adolescence can be met. Therefore, the objective of this systematic review was to evaluate studies on the dietary intake and the nutritional or health status of vegetarian infants, children, and adolescents. METHODS The database MEDLINE was used for literature search. In addition, references of reviews and expert opinions were considered. Inclusion criteria were (1) sufficient dietary information to define vegetarian type diet and (2) characteristics of nutritional or health status. Case reports and studies from non-industrialized countries were excluded. RESULTS 24 publications from 16 studies published from 1988 to 2013 met our criteria. Study samples covered the age range from 0 to 18 years, and median sample size was 35. Five studies did not include a control group. With regard to biomarkers, anthropometry, and dietary or nutritional intake, the outcomes were diverse. Growth and body weight were generally found within the lower reference range. The intakes of folate, vitamin C, and dietary fiber were relatively high compared to reference values and/or control groups. Low status of vitamin B12 was reported in one study and low status of vitamin D in two studies. CONCLUSIONS Due to the study heterogeneity, the small samples, the bias towards upper social classes, and the scarcity of recent studies, the existing data do not allow us to draw firm conclusions on health benefits or risks of present-day vegetarian type diets on the nutritional or health status of children and adolescents in industrialized countries.
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Affiliation(s)
- S Schürmann
- Research Institute of Child Nutrition, Pediatric University Clinic Bochum, Alexandrinenstraße 5, 44791, Bochum, Germany
| | - M Kersting
- Research Institute of Child Nutrition, Pediatric University Clinic Bochum, Alexandrinenstraße 5, 44791, Bochum, Germany
| | - U Alexy
- IEL-Nutritional Epidemiology, DONALD Study, University of Bonn, Heinstück 11, 44225, Dortmund, Germany.
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Bagordo F, De Donno A, Grassi T, Guido M, Devoti G, Ceretti E, Zani C, Feretti D, Villarini M, Moretti M, Salvatori T, Carducci A, Verani M, Casini B, Bonetta S, Carraro E, Schilirò T, Bonizzoni S, Bonetti A, Gelatti U. Lifestyles and socio-cultural factors among children aged 6-8 years from five Italian towns: the MAPEC_LIFE study cohort. BMC Public Health 2017; 17:233. [PMID: 28264671 PMCID: PMC5339991 DOI: 10.1186/s12889-017-4142-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 02/23/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lifestyles profoundly determine the quality of an individual's health and life since his childhood. Many diseases in adulthood are avoidable if health-risk behaviors are identified and improved at an early stage of life. The aim of the present research was to characterize a cohort of children aged 6-8 years selected in order to perform an epidemiological molecular study (the MAPEC_LIFE study), investigate lifestyles of the children that could have effect on their health status, and assess possible association between lifestyles and socio-cultural factors. METHODS A questionnaire composed of 148 questions was administered in two different seasons to parents of children attending 18 primary schools in five Italian cities (Torino, Brescia, Pisa, Perugia and Lecce) to obtain information regarding the criteria for exclusion from the study, demographic, anthropometric and health information on the children, as well as some aspects on their lifestyles and parental characteristics. The results were analyzed in order to assess the frequency of specific conditions among the different seasons and cities and the association between lifestyles and socio-economic factors. RESULTS The final cohort was composed of 1,164 children (50.9 boys, 95.4% born in Italy). Frequency of some factors appeared different in terms of the survey season (physical activity in the open air, the ways of cooking certain foods) and among the various cities (parents' level of education and rate of employment, sport, traffic near the home, type of heating, exposure to passive smoking, ways of cooking certain foods). Exposure to passive smoking and cooking fumes, obesity, residence in areas with heavy traffic, frequency of outdoor play and consumption of barbecued and fried foods were higher among children living in families with low educational and/or occupational level while children doing sports and consuming toasted bread were more frequent in families with high socio-economic level. CONCLUSIONS The socio-economic level seems to affect the lifestyles of children enrolled in the study including those that could cause health effects. Many factors are linked to the geographical area and may depend on environmental, cultural and social aspects of the city of residence.
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Affiliation(s)
- Francesco Bagordo
- Department of Biological and Environmental Science and Technology, University of Salento, Via Prov.le Lecce-Monteroni, 73100, Lecce, Italy
| | - Antonella De Donno
- Department of Biological and Environmental Science and Technology, University of Salento, Via Prov.le Lecce-Monteroni, 73100, Lecce, Italy.
| | - Tiziana Grassi
- Department of Biological and Environmental Science and Technology, University of Salento, Via Prov.le Lecce-Monteroni, 73100, Lecce, Italy
| | - Marcello Guido
- Department of Biological and Environmental Science and Technology, University of Salento, Via Prov.le Lecce-Monteroni, 73100, Lecce, Italy
| | - Gabriele Devoti
- Department of Biological and Environmental Science and Technology, University of Salento, Via Prov.le Lecce-Monteroni, 73100, Lecce, Italy
| | - Elisabetta Ceretti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Claudia Zani
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Donatella Feretti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Milena Villarini
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - Massimo Moretti
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - Tania Salvatori
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | | | - Marco Verani
- Department of Biology, University of Pisa, Pisa, Italy
| | - Beatrice Casini
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - Sara Bonetta
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - Elisabetta Carraro
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - Tiziana Schilirò
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | | | - Alberto Bonetti
- Centro Servizi Multisettoriale e Tecnologico - CSMT Gestione S.c.a.r.l., Brescia, Italy
| | - Umberto Gelatti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
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Design, Implementation, and Study Protocol of a Kindergarten-Based Health Promotion Intervention. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4347675. [PMID: 28303253 PMCID: PMC5338306 DOI: 10.1155/2017/4347675] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 01/12/2017] [Accepted: 01/31/2017] [Indexed: 12/28/2022]
Abstract
Inactivity and an unhealthy diet amongst others have led to an increased prevalence of overweight and obesity even in young children. Since most health behaviours develop during childhood health promotion has to start early. The setting kindergarten has been shown as ideal for such interventions. “Join the Healthy Boat” is a kindergarten-based health promotion programme with a cluster-randomised study focussing on increased physical activity, reduced screen media use, and sugar-sweetened beverages, as well as a higher fruit and vegetable intake. Intervention and materials were developed using Bartholomew's Intervention Mapping approach considering Bandura's social-cognitive theory and Bronfenbrenner's ecological framework for human development. The programme is distributed using a train-the-trainer approach and currently implemented in 618 kindergartens. The effectiveness of this one-year intervention with an intervention and a control group will be examined in 62 kindergartens using standardised protocols, materials, and tools for outcome and process evaluation. A sample of 1021 children and their parents provided consent and participated in the intervention. Results of this study are awaited to give a better understanding of health behaviours in early childhood and to identify strategies for effective health promotion. The current paper describes development and design of the intervention and its implementation and planned evaluation. Trial Registration. The study is registered at the German Clinical Trials Register (DRKS), Freiburg University, Germany, ID: DRKS00010089.
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Antelo M, Magdalena P, Reboredo JC. Obesity: A major problem for Spanish minors. ECONOMICS AND HUMAN BIOLOGY 2017; 24:61-73. [PMID: 27889634 DOI: 10.1016/j.ehb.2016.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 11/03/2016] [Accepted: 11/11/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Manel Antelo
- Departamento de Fundamentos da Análise Económica, Universidade de Santiago de Compostela, Campus Norte s/n, 15782 Santiago de Compostela, Spain.
| | | | - Juan C Reboredo
- Departamento de Fundamentos da Análise Económica, Universidade de Santiago de Compostela, Campus Norte s/n, 15782 Santiago de Compostela, Spain.
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Hilpert M, Brockmeier K, Dordel S, Koch B, Weiß V, Ferrari N, Tokarski W, Graf C. Sociocultural Influence on Obesity and Lifestyle in Children: A Study of Daily Activities, Leisure Time Behavior, Motor Skills, and Weight Status. Obes Facts 2017; 10:168-178. [PMID: 28528341 PMCID: PMC5644947 DOI: 10.1159/000464105] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 02/09/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Juvenile overweight is increasing, and effective preventive measures are needed. After years of arbitrarily assigning these measures disregarding socioeconomic and/or cultural differences, it has become necessary to tailor interventions more specific to these target groups. Providing data for such an intervention is the objective of this study. METHODS Influencing variables on children's weight status, motor skills and lifestyle have been analyzed among 997 first graders (53.2% male) involved in the Children's Health InterventionaL Trial (CHILT). RESULTS Median age was 6.9 years; 7.3% were obese, 8.8% were overweight. Children with low socioeconomic status (SES) were more likely to be obese (p = 0.029). Low SES (p ˂ 0.001), migration background (p = 0.001) and low sports activity levels (p = 0.007) contributed most to an increased consumption of television. Migration background (p = 0.003) and male gender (p < 0.001) were the strongest factors in predicting a greater consumption of computer/video games. Children with higher SES (p = 0.02), lower BMI (p = 0.035), and males (p = 0.001) performed better in motor tests. CONCLUSION Children with a low SES and migration background were more likely to exhibit unfavorable health behavior patterns, higher BMI scores, and poorer motor skills. Interventions should integrate motivational and targeting strategies and consider cultural and educational differences to address these vulnerable groups.
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Affiliation(s)
- Martin Hilpert
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - Konrad Brockmeier
- Pediatric Cardiology, Heart Center, University Hospital of Cologne, Cologne, Germany
- Cologne Center of Prevention in Childhood and Adolescence, Heart Center, University Hospital of Cologne, Cologne, Germany
| | - Sigrid Dordel
- Institute of School Sports and School Development, German Sport University, Cologne, Germany
| | - Benjamin Koch
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
- Bremen-City Center for Obesity Therapy (ZABS), Bremen, Germany
| | - Verena Weiß
- Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
| | - Nina Ferrari
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
- Cologne Center of Prevention in Childhood and Adolescence, Heart Center, University Hospital of Cologne, Cologne, Germany
| | - Walter Tokarski
- Institute of European Sport Development and Leisure Studies, German Sport University, Cologne, Germany
| | - Christine Graf
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
- Cologne Center of Prevention in Childhood and Adolescence, Heart Center, University Hospital of Cologne, Cologne, Germany
- *Prof. Dr. Dr. Christine Graf, Institute of Movement and Neurosciences, German Sport University, Cologne, Am Sportpark Müngersdorf 6, 50933 Köln, Germany,
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Mizuta A, Fujiwara T, Ojima T. Association between economic status and body mass index among adolescents: a community-based cross-sectional study in Japan. BMC OBESITY 2016; 3:47. [PMID: 27843560 PMCID: PMC5103506 DOI: 10.1186/s40608-016-0127-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 10/29/2016] [Indexed: 12/05/2022]
Abstract
BACKGROUND Childhood overweight and obesity is a growing health challenge in Japan and might be associated with childhood poverty. We aimed to investigate the association between low economic status and body mass index (BMI) and to reveal the mediators of this association among junior high school students in Japan. METHODS Junior high school students (N = 2968) from two cities in Shizuoka, Japan, were surveyed. Questionnaires assessed subjective economic status, weight, and height. Economic status was categorized into low and non-low, and BMI z-scores were calculated using the WHO Growth Reference. Multivariate regression analyses were conducted to determine the association between economic status and BMI z-scores, adjusted for covariates and stratified by gender. RESULTS Among girls, low economic status was significantly positively associated with BMI z-scores in the crude model (coefficient: 0.35; p = 0.001). In a model adjusted for breakfast skipping, the coefficient of economic status decreased by 28.57 % but remained significant (coefficient: 0.25; p = 0.017). In the final model adjusted for other possible covariates, low economic status remained significantly positively associated with BMI z-score (coefficient: 0.22; p = 0.044). The same association was not found for boys. CONCLUSIONS Low economic status was positively associated with higher BMI among girls in junior high school in Japan, but this was not true for boys. Childhood poverty might be associated with overweight and obesity among adolescent girls in Japan. Health policies at junior high schools to discourage breakfast skipping might be effective for countering the association between childhood poverty and overweight in adolescent girls.
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Affiliation(s)
- Akiko Mizuta
- Department of Community Health Nursing, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka 431-3192 Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519 Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka 431-3192 Japan
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Grassi T, De Donno A, Bagordo F, Serio F, Piscitelli P, Ceretti E, Zani C, Viola GCV, Villarini M, Moretti M, Levorato S, Carducci A, Verani M, Donzelli G, Bonetta S, Bonetta S, Carraro E, Bonizzoni S, Bonetti A, Gelatti U. Socio-Economic and Environmental Factors Associated with Overweight and Obesity in Children Aged 6-8 Years Living in Five Italian Cities (the MAPEC_LIFE Cohort). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13101002. [PMID: 27727193 PMCID: PMC5086741 DOI: 10.3390/ijerph13101002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 09/15/2016] [Accepted: 09/29/2016] [Indexed: 01/06/2023]
Abstract
The prevalence of obesity among Italian children has reached such alarming levels as to require detailed studies of the causes of the phenomenon. A cross-sectional study was carried out in order to assess the weight status of 1164 Italian children aged 6–8 years (the Monitoring Air Pollution Effects on Children for Supporting Public Health Policy (MAPEC_LIFE) cohort) and to identify any associations between selected socio-economic and environmental factors and overweight/obesity. The data were obtained by means of a questionnaire given to parents, and any associations were examined by binomial logistic regression analyses. Overweight was found to be positively associated with male gender, parents of non-Italian origin, and parents who smoke, and negatively associated with the parents’ level of education and employment. In addition, the frequency of overweight varied in relation to the geographical area of residence, with a greater prevalence of overweight children in the cities of central-southern Italy. This study highlights the need to implement appropriate obesity prevention programs in Italy, which should include educational measures concerning lifestyle for parents from the earliest stages of their child’s life.
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Affiliation(s)
- Tiziana Grassi
- Department of Biological and Environmental Science and Technology, University of Salento, Via Prov.le Lecce-Monteroni, Lecce 73100, Italy.
| | - Antonella De Donno
- Department of Biological and Environmental Science and Technology, University of Salento, Via Prov.le Lecce-Monteroni, Lecce 73100, Italy.
| | - Francesco Bagordo
- Department of Biological and Environmental Science and Technology, University of Salento, Via Prov.le Lecce-Monteroni, Lecce 73100, Italy.
| | - Francesca Serio
- Department of Biological and Environmental Science and Technology, University of Salento, Via Prov.le Lecce-Monteroni, Lecce 73100, Italy.
| | - Prisco Piscitelli
- Euro Mediterranean Scientific Biomedical Institute, Via Reali di Bulgaria, Mesagne (BR) 72023, Italy.
| | - Elisabetta Ceretti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 11, Brescia 25123, Italy.
| | - Claudia Zani
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 11, Brescia 25123, Italy.
| | - Gaia C V Viola
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 11, Brescia 25123, Italy.
| | - Milena Villarini
- Department of Pharmaceutical Sciences, University of Perugia, Via del Giochetto, Perugia 06122, Italy.
| | - Massimo Moretti
- Department of Pharmaceutical Sciences, University of Perugia, Via del Giochetto, Perugia 06122, Italy.
| | - Sara Levorato
- Department of Pharmaceutical Sciences, University of Perugia, Via del Giochetto, Perugia 06122, Italy.
| | - Annalaura Carducci
- Department of Biology, University of Pisa, Via Ghini 13, Pisa 56126, Italy.
| | - Marco Verani
- Department of Biology, University of Pisa, Via Ghini 13, Pisa 56126, Italy.
| | - Gabriele Donzelli
- Department of Biology, University of Pisa, Via Ghini 13, Pisa 56126, Italy.
| | - Sara Bonetta
- Department of Public Health and Pediatrics, University of Torino, Piazza Polonia 94, Torino 10126, Italy.
| | - Silvia Bonetta
- Department of Public Health and Pediatrics, University of Torino, Piazza Polonia 94, Torino 10126, Italy.
| | - Elisabetta Carraro
- Department of Public Health and Pediatrics, University of Torino, Piazza Polonia 94, Torino 10126, Italy.
| | | | - Alberto Bonetti
- Centro Servizi Multisettoriale e Tecnologico-CSMT Gestione S.c.a.r.l., via Branze, 45, Brescia 25123, Italy.
| | - Umberto Gelatti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 11, Brescia 25123, Italy.
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Schüle SA, Fromme H, Bolte G. Built and socioeconomic neighbourhood environments and overweight in preschool aged children. A multilevel study to disentangle individual and contextual relationships. ENVIRONMENTAL RESEARCH 2016; 150:328-336. [PMID: 27340813 DOI: 10.1016/j.envres.2016.06.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 05/18/2016] [Accepted: 06/14/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Structural factors of neighbourhood environments in which children live have attracted increasing attention in epidemiological research. This study investigated whether neighbourhood socioeconomic position (SEP), public playground and park space, and perceived environmental exposures were independently associated with overweight in preschool aged children while simultaneously considering individual child and family factors. METHODS Body-Mass-Index (BMI) data from 3499 children (53% boys and 47% girls) from three surveys between 2004 and 2007 from 18 school enrolment zones in the city of Munich, Germany, were analysed with hierarchical logistic regression models. An index of neighbourhood SEP was calculated with principal component analysis. Individual socioeconomic data, parental BMI, birth weight, housing characteristics, and perceived annoyance due to exposures to noise, air pollution, lack of greenspace, and traffic were collected with parental questionnaires. Measures of age-specific playground space and availability of park space derived from Geographic Information System were additionally weighted with age-specific population data. RESULTS In bivariate analysis perceived annoyance due to exposures to noise or lack of greenspace, high frequency of lorries, traffic jam, living in a multiple dwelling or next to a main road, low neighbourhood SEP, and low playground space were significantly associated with overweight. However, in multivariate analysis only living in a multiple dwelling was independently associated with overweight. From the considered individual child and family factors low parental education, parental overweight or obesity, and a high birthweight showed an independent relation to overweight. CONCLUSIONS Our study identified individual child and parental factors, and living in a multiple dwelling as the strongest predictors for overweight in preschool aged children. However, perceived annoyance to built environmental exposures additionally explained overweight variance between neighbourhoods. Based on our findings interventions and policies addressing overweight prevention in young children should focus on parental behaviours and the immediate home environment.
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Affiliation(s)
- Steffen Andreas Schüle
- Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany.
| | - Hermann Fromme
- Bavarian Health and Food Safety Authority, Munich, Germany
| | - Gabriele Bolte
- Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany
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Mbakwa CA, Scheres L, Penders J, Mommers M, Thijs C, Arts ICW. Early Life Antibiotic Exposure and Weight Development in Children. J Pediatr 2016; 176:105-113.e2. [PMID: 27402330 DOI: 10.1016/j.jpeds.2016.06.015] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 03/31/2016] [Accepted: 06/03/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To examine the timing, frequency, and type of antibiotic exposure during the first 10 years of life in association with (over)weight across this period in a cohort of 979 children. STUDY DESIGN Within the Child, Parents and Health: Lifestyle and Genetic Constitution Birth Cohort Study, antibiotic exposure record was obtained from general practitioners. Anthropometric outcomes (age- and sex-standardized body mass index, weight and height z-scores, and overweight) were measured repeatedly at 7 time points during the first 10 years of life. Generalized estimating equations method was used for statistical analysis. RESULTS After adjusting for confounding factors, children exposed to one course of antibiotics compared with none in the first 6 months of life had increased weight- (adjusted generalized estimating equations estimates [adjβ] 0.24; 95% CI 0.03-0.44) and height (adjβ 0.23; 95% CI 0.0002-0.46) z-scores; exposure to ≥2 courses during the second year of life was associated with both increased weight (adjβ 0.34; 95% CI 0.07-0.60), and height z-scores (adjβ 0.29; 95% CI -0.003 to 0.59). Exposure later in life was not associated with anthropometric outcomes. Associations with weight z-scores were mainly driven by exposure to broad- (≥2 courses: adjβ 0.11; 95% CI 0.003-0.22) and narrow-spectrum β-lactams (1 course: adjβ 0.18; 95% CI 0.005-0.35) during the follow-up period. Specific antibiotic used was not associated with body mass index z-scores and overweight. CONCLUSIONS Repeated exposure to antibiotics early in life, especially β-lactam agents, is associated with increased weight and height. If causality of obesity can be established in future studies, this further highlights the need for restrictive antibiotic use and avoidance of prescriptions when there is minimal clinical benefit.
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Affiliation(s)
- Catherine A Mbakwa
- Top Institute Food and Nutrition, Wageningen, The Netherlands; Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands.
| | - Lotte Scheres
- Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands
| | - John Penders
- Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands; Department of Medical Microbiology, Maastricht University Medical Center, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht and CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands
| | - Monique Mommers
- Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands
| | - Carel Thijs
- Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands
| | - Ilja C W Arts
- Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands; CARIM School for Cardiovascular Diseases, and Maastricht Center for Systems Biology (MaCSBio), Maastricht, The Netherlands
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Rayfield S, Plugge E. Systematic review and meta-analysis of the association between maternal smoking in pregnancy and childhood overweight and obesity. J Epidemiol Community Health 2016; 71:162-173. [PMID: 27480843 DOI: 10.1136/jech-2016-207376] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Revised: 07/10/2016] [Accepted: 07/11/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND By 2020, it is predicted that 60 million children worldwide will be overweight. Maternal smoking in pregnancy has been suggested as a contributing factor. Our objective was to systematically review studies on this, thereby expanding the evidence base for this association. METHODS Systematic review with meta-analysis, Prospero Registration number CRD42012002859. We searched PubMed, Embase, Global Health, Web of Science and the Grey literature. We included prevalence, cohort and cross-sectional studies involving full-term, singleton pregnancies. Published and unpublished studies through to 1 January 2015 in all languages, demonstrating an objective overweight outcome up until 18 years of age and data presented as an OR, were included. Quality assessment was undertaken using an adaption of the Newcastle-Ottawa scale. Statistical analysis was performed using Review Manager V.5.3. FINDINGS The meta-analysis included 39 studies of 236 687 children from Europe, Australia, North America and South America and Asia. Maternal smoking in pregnancy ranged from 5.5% to 38.7%, with the prevalence of overweight from 6.3% to 32.1% and obesity from 2.6% to 17%. Pooled adjusted ORs demonstrated an elevated odds of maternal smoking in pregnancy for childhood overweight (OR 1.37, 95% CI 1.28 to 1.46, I2 45%) and childhood obesity (OR 1.55, 95% CI 1.40 to 1.73, I2 24%). INTERPRETATION Our results demonstrate an association between maternal prenatal smoking and childhood overweight. This contributes to the growing evidence for the aetiology of childhood overweight, providing important information for policymakers and health professionals alike in planning cessation programmes or antismoking interventions for pregnant female smokers.
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Affiliation(s)
- Sarah Rayfield
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, Oxford, UK
| | - Emma Plugge
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, Oxford, UK
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Nawab T, Khan Z, Khan IM, Ansari MA. Is small town India falling into the nutritional trap of metro cities? A study in school-going adolescents. J Family Med Prim Care 2016; 5:581-586. [PMID: 28217587 PMCID: PMC5290764 DOI: 10.4103/2249-4863.197296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION There has been an increasing secular trend in the prevalence of overweight and obesity in developing countries. The prevalence reported among children and adolescents of some metro cities in India are comparable to that in some developed countries. Westernization of culture, rapid mushrooming of fast food joints, lack of physical activity, and increasing sedentary pursuits in the metro cities are some of the reasons implicated for this. The nutritional changes in small town school children might be following the same pattern of larger cities. AIMS AND OBJECTIVES To study the prevalence of overweight and obesity among school-going adolescents of Aligarh and to study the sociodemographic and behavioral correlates of the same. MATERIALS AND METHODS A cross-sectional study done in two affluent and two nonaffluent schools in Aligarh, taking 330 adolescents from each group (total-660). Study tools included a predesigned and pretested questionnaire, Global Physical Activity Questionnaire, and anthropometric measurement. Overweight and obesity were defined based on World Health Organization 2007 Growth Reference. Chi-square test and multiple logistic regression analysis were done. RESULTS Prevalence of overweight and obesity was 9.8% and 4.8% among school-going adolescents. The difference in prevalence of overweight and obesity among affluent schools (14.8% and 8.2%) and nonaffluent schools (4.8% and 1.5%) was significant. Risk factors for overweight and obesity were affluence, higher maternal education, parental history of obesity, frequent fast food intake, and television (TV) viewing more than 2 h/day. CONCLUSION Overweight and obesity among school-going adolescents is a crisis facing even smaller cities in India. Behavior change communication should be focused to adolescents, especially of the affluent section, toward restricting fast food intake, and TV viewing.
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Affiliation(s)
- Tabassum Nawab
- Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Zulfia Khan
- Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Iqbal Mohammed Khan
- Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Mohammed Athar Ansari
- Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Schlüter N, Schmidt R, Kittel R, Tetzlaff A, Hilbert A. Loss of control eating in adolescents from the community. Int J Eat Disord 2016; 49:413-20. [PMID: 26711325 DOI: 10.1002/eat.22488] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 11/10/2015] [Accepted: 11/11/2015] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Loss of control (LOC) eating is a salient indicator of eating disorder psychopathology in adolescents and is associated with marked distress. While research has focused on the relevance of episode size, clinical significance of LOC eating frequency has rarely been explored. Therefore, this study aimed at identifying LOC eating prevalence with respect to its recurrence and associated variables in a community-based sample. METHOD Participants were 1,643 adolescents, aged 12-20 years (62.4% female). Based on EDE-Q self-report, participants were categorized as those reporting recurrent (N = 156; 9.5%), nonrecurrent (N = 226; 13.8%), and no LOC eating (N = 1261; 76.7%). RESULTS Adolescents with recurrent LOC eating reported clinically relevant and significantly greater eating disorder psychopathology, functional impairment, and distress because of LOC eating, and a significantly higher body mass index (BMI, kg/m(2) ) than adolescents with nonrecurrent and those without LOC eating. DISCUSSION These results underline that LOC eating is a common eating behavior among adolescents in the community associated with clinical characteristics of eating disorders, and could therefore be a risk factor for developing full- or partial-syndrome eating disorders. Further research on the classification of eating disorders in adolescents with LOC eating and severity indicators is warranted.
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Affiliation(s)
- Nora Schlüter
- Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, 04103, Leipzig, Germany
| | - Ricarda Schmidt
- Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, 04103, Leipzig, Germany
| | - Rebekka Kittel
- Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, 04103, Leipzig, Germany
| | - Anne Tetzlaff
- Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, 04103, Leipzig, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, 04103, Leipzig, Germany
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Abstract
The prevalence of obesity has increased dramatically over the past decade. Although an imbalance between caloric intake and physical activity is considered a key factor responsible for the increase, there is emerging evidence suggesting that other factors may be important contributors to weight gain, including inadequate sleep. Overall research evidence suggests that inadequate sleep is associated with obesity. Importantly, the strength and trajectory of the association seem to be influenced by multiple factors including age. Although limited, the emerging evidence suggests young adults might be at the center of a "perfect health storm," exposing them to the highest risk for obesity and inadequate sleep. Unfortunately, the methods necessary for elucidating the complex relationship between sleep and obesity are lacking. Uncovering the underlying factors and trajectories between inadequate sleep and weight gain in different populations may help to identify the windows of susceptibility and to design targeted interventions to prevent the negative impact of obesity and related diseases.
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Affiliation(s)
- Perla A Vargas
- New College of Liberal Arts and Sciences, School of Social and Behavioral Sciences, Arizona State University, 4701 W Thunderbird Rd, MC 3051, Glendale, AZ, 85306, USA.
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Little M, Humphries S, Patel K, Dewey C. Factors associated with BMI, underweight, overweight, and obesity among adults in a population of rural south India: a cross-sectional study. BMC OBESITY 2016; 3:12. [PMID: 26904203 PMCID: PMC4761187 DOI: 10.1186/s40608-016-0091-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 02/08/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Overweight, obesity, and related chronic diseases are becoming serious public health concerns in rural areas of India. Compounded with the existing issue of underweight, such concerns expose the double burden of disease and may put stress on rural healthcare. The purpose of this article was to present the prevalence and factors associated with underweight, overweight, and obesity in an area of rural south India. METHODS During 2013 and 2014, a random sample of adults aged 20-80 years were selected for participation in a cross-sectional study that collected information on diet (using a food frequency questionnaire), physical activity (using the Global Physical Activity Questionnaire), socioeconomic position (using a wealth index), rurality (using the MSU rurality index), education, and a variety of descriptive factors. BMI was measured using standard techniques. Using a multivariate linear regression analysis and multivariate logistic regression analyses, we examined associations between BMI, overweight, obesity, and underweight, and all potential risk factors included in the survey. RESULTS Age and sex-adjusted prevalence of overweight, obesity class I, and obesity class II were 14.9, 16.1, and 3.3 % respectively. Prevalence of underweight was 22.7 %. The following variables were associated with higher BMI and/or increased odds of overweight, obesity class I, and/or obesity class II: Low physical activity, high wealth index, no livestock, low animal fat consumption, high n-6 polyunsaturated fat consumption, television ownership, time spent watching television, low rurality index, and high caste. The following variables were associated with increased odds of underweight: low wealth index, high rurality index, and low intake of n-6 PUFAs. CONCLUSION Underweight, overweight, and obesity are prevalent in rural regions of southern India, indicating a village-level dual burden. A variety of variables are associated with these conditions, including physical activity, socioeconomic position, rurality, television use, and diet. To address the both underweight and obesity, policymakers must simultaneously focus on encouraging positive behaviour through education and addressing society-level risk factors that inhibit individuals from achieving optimal health.
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Affiliation(s)
- Matthew Little
- />Department of Population Medicine, University of Guelph, Guelph, ON Canada
| | - Sally Humphries
- />Department of Sociology and Anthropology, University of Guelph, Guelph, ON Canada
| | - Kirit Patel
- />Department of International Development Studies, Menno Simons College, University of Winnipeg, Winnipeg, MB Canada
| | - Cate Dewey
- />Department of Population Medicine, University of Guelph, Guelph, ON Canada
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Salama M, Drapeau V, Tremblay A, Pérusse-Lachance É. The impact of a mental work on food preferences, eating behavior traits and satiety efficiency. Physiol Behav 2016; 154:191-5. [DOI: 10.1016/j.physbeh.2015.11.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 10/29/2015] [Accepted: 11/18/2015] [Indexed: 10/22/2022]
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Pacce S, Saure C, Mazza CS, Garcia S, Tomzig RG, Lopez AP, Ribarola L, Krochick GA. Impact of maternal nutritional status before and during pregnancy on neonatal body composition: A cross-sectional study. Diabetes Metab Syndr 2016; 10:S7-S12. [PMID: 26431950 DOI: 10.1016/j.dsx.2015.08.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The existence of early factors which, acting during critical periods of intrauterine or immediate postnatal development, determine long-term health has become increasingly recognized. Both high and low birth weight have been associated with cardiovascular risk factors in adulthood. Therefore, body composition at birth rather than birth weight may be a marker to predict future diseases. Maternal weight previous to and gained during pregnancy is associated with intrauterine fetal growth. OBJECTIVE To evaluate the correlation between maternal nutritional status before and during pregnancy and neonatal body composition. MATERIAL AND METHODS We studied consecutive mother-child pairs at delivery at an Argentinean public hospital during 5 months period, evaluating maternal and neonatal anthropometry before 24h of life as well as the history of the mother before and during pregnancy. Neonatal body composition was calculated according to a mathematical formula based on skinfold thickness measurement validated in newborns. RESULTS Mothers of newborns with high body fat mass were more frequently obese (72.7% versus 35.1%, p 0.005), and more frequently showed weight gain above 18kg during pregnancy (76.4% versus 31%, p 0.03). CONCLUSIONS Our findings confirm the hypothesis that maternal obesity before pregnancy is highly correlated with neonatal fat mass in the first hours of life.
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Affiliation(s)
- Sol Pacce
- Department of Diabetes and Clinical Nutrition, Hospital J.P. Garrahan, Buenos Aires, Argentina
| | - Carola Saure
- Department of Diabetes and Clinical Nutrition, Hospital J.P. Garrahan, Buenos Aires, Argentina.
| | - Carmen S Mazza
- Department of Diabetes and Clinical Nutrition, Hospital J.P. Garrahan, Buenos Aires, Argentina
| | - Silvia Garcia
- Department of Neonatology, Hospital Posadas, Buenos Aires, Argentina
| | - Rita G Tomzig
- Department of Neonatology, Hospital Posadas, Buenos Aires, Argentina
| | - Ana P Lopez
- Department of Obstetrics, Hospital Posadas, Buenos Aires, Argentina
| | - Lucio Ribarola
- Department of Obstetrics, Hospital Posadas, Buenos Aires, Argentina
| | - Gabriela A Krochick
- Department of Diabetes and Clinical Nutrition, Hospital J.P. Garrahan, Buenos Aires, Argentina
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Braithwaite I, Stewart AW, Hancox RJ, Beasley R, Murphy R, Mitchell EA. Maternal post-natal tobacco use and current parental tobacco use is associated with higher body mass index in children and adolescents: an international cross-sectional study. BMC Pediatr 2015; 15:220. [PMID: 26699863 PMCID: PMC4690230 DOI: 10.1186/s12887-015-0538-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 12/16/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We investigated whether maternal smoking in the first year of life or any current parental smoking is associated with childhood or adolescent body mass index (BMI). METHODS Secondary analysis of data from a multi-centre, multi-country, cross-sectional study (ISAAC Phase Three). Parents/guardians of children aged 6-7 years completed questionnaires about their children's current height and weight, whether their mother smoked in the first year of the child's life and current smoking habits of both parents. Adolescents aged 13-14 years completed questionnaires about their height, weight and current parental smoking habits. A general linear mixed model was used to determine the association between BMI and parental smoking. RESULTS 77,192 children (18 countries) and 194 727 adolescents (35 countries) were included. The BMI of children exposed to maternal smoking during their first year of life was 0.11 kg/m(2) greater than those who were not (P = 0.0033). The BMI of children of currently smoking parents was greater than those with non-smoking parents (maternal smoking: +0.08 kg/m(2) (P = 0.0131), paternal smoking: +0.10 kg/m(2) (P < 0.0001)). The BMI of female adolescents exposed to maternal or paternal smoking was 0.23 kg/m(2) and 0.09 kg/m(2) greater respectively than those who were not exposed (P < 0.0001). The BMI of male adolescents was greater with maternal smoking exposure, but not paternal smoking (0.19 kg/m(2), P < 0.0001 and 0.03 kg/m(2), P = 0.14 respectively). CONCLUSION Parental smoking is associated with higher BMI values in children and adolescents. Whether this is due to a direct effect of parental smoking or to confounding cannot be established from this observational study.
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Affiliation(s)
- Irene Braithwaite
- Medical Research Institute of New Zealand, Private Bag 7902, Newtown, Wellington, 6242, New Zealand.
| | - Alistair W Stewart
- School of Population Health, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| | - Robert J Hancox
- Department of Preventive & Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, 9016, New Zealand.
| | - Richard Beasley
- Medical Research Institute of New Zealand, Private Bag 7902, Newtown, Wellington, 6242, New Zealand.
| | - Rinki Murphy
- Department of Medicine, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand.
| | - Edwin A Mitchell
- Department of Paediatrics: Child and Youth Health, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand.
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