Evidence for independent genetic influences on fat mass and body mass index in a pediatric twin sample

ANMCO (Italian Association of Hospital Cardiologists) scientific statement: obesity in adults-an approach for cardiologists

Obesity is a complex, chronic disease requiring a multidisciplinary approach to its management. In clinical practice, body mass index and waist-related measurements can be used for obesity screening. The estimated prevalence of obesity among adults worldwide is 12%. With the expected further increase in overall obesity prevalence, clinicians will increasingly be managing patients with obesity. Energy balance is regulated by a complex neurohumoral system that involves the central nervous system and circulating mediators, among which leptin is the most studied. The functioning of these systems is influenced by both genetic and environmental factors. Obesity generally occurs when a genetically predisposed individual lives in an obesogenic environment for a long period. Cardiologists are deeply involved in evaluating patients with obesity. Cardiovascular risk profile is one of the most important items to be quantified to understand the health risk due to obesity and the clinical benefit that a single patient can obtain with weight loss. At the individual level, appropriate patient involvement, the detection of potential obesity causes, and a multidisciplinary approach are tools that can improve clinical outcomes. In the near future, we will probably have new pharmacological tools at our disposal that will facilitate achieving and maintaining weight loss. However, pharmacological treatment alone cannot cure such a complex disease. The aim of this paper is to summarize some key points of this field, such as obesity definition and measurement tools, its epidemiology, the main mechanisms underlying energy homeostasis, health consequences of obesity with a focus on cardiovascular diseases and the obesity paradox.Level of evidence V: report of expert committees.

D3-creatine dilution for the noninvasive measurement of skeletal muscle mass in premature infants

BACKGROUND

The rate of accrual of muscle mass in neonates has not been assessed. We describe the D₃-creatine (D₃Cr) dilution method, a noninvasive assessment of muscle mass in neonates.

METHODS

A total of 76 neonates >26-week-old corrected gestational age were enrolled and measured at 2-week intervals while admitted to a neonatal intensive care unit (NICU). Additional measures at 6 and 12-20 months after initial measurement were obtained if available. An enteral dose of 2 mg D₃Cr in 0.5 mL 20% ²H₂O was used to determine muscle mass and total body water (TBW).

RESULTS

Muscle mass by the D₃Cr method was strongly associated with TBW and body weight (r = 0.9272, p < 0.0001 and r = 0.9435, p < 0.0001 for all time points and r = 0.6661, p < 0.0001 and r = 0.8634, p < 0.0001, respectively, while in the NICU). Change in muscle mass vs. change in body weight, TBW, and length were also strongly correlated.

CONCLUSIONS

The D₃Cr dilution method provides a noninvasive assessment of muscle mass accrual in neonates, which has not been previously possible and may be an important new tool for the evaluation of nutritional status and normal growth patterns.

IMPACT

We describe a noninvasive method for the measurement of skeletal muscle mass neonates. At the present time, there is no direct measurement of muscle mass in infants available. The D₃Cr dilution method is a direct and noninvasive measurement of muscle mass. Using a single enteral dose of D₃Cr in ²H₂O followed by urine and saliva samples, rapid and substantial accrual of muscle mass and TBW is assessed. Assessment of muscle mass accrual in premature infants may be a strong indicator of nutritional status. Change in muscle mass is strongly related to change in weight and TBW.

Nutritional genomics, inflammation and obesity

The Human Genome Project has significantly broadened our understanding of the molecular aspects regulating the homeostasis and the pathophysiology of different clinical conditions. Consequently, the field of nutrition has been strongly influenced by such improvements in knowledge - especially for determining how nutrients act at the molecular level in different conditions, such as obesity, type 2 diabetes, cardiovascular disease, and cancer. In this manner, characterizing how the genome influences the diet and vice-versa provides insights about the molecular mechanisms involved in chronic inflammation-related diseases. Therefore, the present review aims to discuss the potential application of Nutritional Genomics to modulate obesity-related inflammatory responses. Arch Endocrinol Metab. 2020;64(3):205-22.

Comparison of Genotypic and Phenotypic Correlations: Cheverud's Conjecture in Humans

Cheverud’s conjecture asserts that the use of phenotypic correlations as proxies for genetic correlations in situations where genetic data is not available is appropriate. Although empirical evidence for this has been found across...

Accurate estimation of genetic correlation requires large sample sizes and access to genetically informative data, which are not always available. Accordingly, phenotypic correlations are often assumed to reflect genotypic correlations in evolutionary biology. Cheverud’s conjecture asserts that the use of phenotypic correlations as proxies for genetic correlations is appropriate. Empirical evidence of the conjecture has been found across plant and animal species, with results suggesting that there is indeed a robust relationship between the two. Here, we investigate the conjecture in human populations, an analysis made possible by recent developments in availability of human genomic data and computing resources. A sample of 108,035 British European individuals from the UK Biobank was split equally into discovery and replication datasets. Seventeen traits were selected based on sample size, distribution, and heritability. Genetic correlations were calculated using linkage disequilibrium score regression applied to the genome-wide association summary statistics of pairs of traits, and compared within and across datasets. Strong and significant correlations were found for the between-dataset comparison, suggesting that the genetic correlations from one independent sample were able to predict the phenotypic correlations from another independent sample within the same population. Designating the selected traits as morphological or nonmorphological indicated little difference in correlation. The results of this study support the existence of a relationship between genetic and phenotypic correlations in humans. This finding is of specific interest in anthropological studies, which use measured phenotypic correlations to make inferences about the genetics of ancient human populations.

A population association study of PPAR δ gene rs2016520 and rs9794 polymorphisms and haplotypes with body mass index and waist circumference in a Chinese population

BACKGROUND

Peroxisome proliferator-activated receptor (PPAR) gene plays an important role in obesity and PPAR δ protein is a potent inhibitor; however, few previous studies have focused on this gene.

AIM

To investigate the association of haplotypes of PPAR δ gene rs2016520 and rs9794 with abnormal weight (BMI ≥ 24 kg/m(2)) and abdominal obesity (WC ≥ 90 cm for males and ≥ 80 cm for females) in a Chinese Han population.

SUBJECTS AND METHODS

In total, 820 subjects (270 men, 550 women) were randomly selected from the PMMJS cohort population and no individuals were related. rs2016520 and rs9794 were detected by TaqMan fluorescence probe. Hardy-Weinberg equilibrium (HWE) was used to detect genotype typing errors by Fisher's exact test. Linkage disequilibrium (LD) between polymorphisms was estimated by using SHEsis. Two PPAR δ SNPs (rs2016520 and rs9794) were analysed by using the logistic regression model.

RESULTS

After adjustment for covariates, the haplotype containing the rs1026520-C and rs9794-C alleles was associated with a statistically significant decreased risk of obesity (OR = 0.64; 95% CI = 0.48-0.84, p = 0.0015). Coincidentally, the haplotype containing the rs1026520-C and rs9794-C alleles was also associated with a statistically decreased risk of abdominal obesity after covariate adjustment (OR = 0.59, 95% CI = 0.45-0.77, p < 0.001).

CONCLUSION

C-C haplotype, constructed from rs2016520 and rs9794 alleles, showed a significant protective effect for both abnormal weight and abdominal obesity.

Association study of common polymorphisms in MSRA, TFAP2B, MC4R, NRXN3, PPARGC1A, TMEM18, SEC16B, HOXB5 and OLFM4 genes with obesity-related traits among Portuguese children

At least 52 genetic loci were associated with obesity-related traits. However, little is known about the genetic basis of obesity among children. This study aims to test whether 10 polymorphisms in obesity-related genes methionine sulfoxide reductase A (MSRA), transcription factor AP-2 beta (TFAP2B), melanocortin 4 receptor (MC4R), neurexin 3 (NRXN3), peroxisome proliferator-activated receptor gamma coactivator 1 alpha (PPARGC1A), transmembrane protein 18 (TMEM18), homolog of S. cerevisiae Sec16 (SEC16B), homeobox B5 (HOXB5) and olfactomedin 4 (OLFM4) are associated with the risk of obesity in Portuguese children. A total of 730 children aging from 6 to 12 years old, recruited randomly from public schools in Portugal, were analysed. Anthropometric measurements were obtained and children were classified into three phenotypic groups, normal weight (n=256), overweight (n=320) and obese (n=154), according to the International Obesity Task Force cutoffs. Polymorphisms were genotyped by allelic discrimination TaqMan assays. The MC4R rs12970134 polymorphism was nominally associated with body mass index (BMI) (P=0.035), BMI Z-score (P=0.043) and waist circumference (P=0.020), and borderline associated with weight (P=0.053). Near nominal associations were also found for the PPARGC1A rs8192678 polymorphism with weight (P=0.061), and for the MSRA rs545854 polymorphism with BMI (P=0.055) and BMI Z-score (P=0.056). Furthermore, logistic regression showed that MC4R rs12970134 and TFAP2B rs987237 were nominally, respectively, associated (P=0.029) and borderline associated (P=0.056) with the obese phenotype. This study highlighted the possible association of MC4R, PPARGC1A, MSRA and TFAP2B polymorphisms with several obesity-related traits in a sample of Portuguese children. The two significant associated TFAP2B rs987237 and MC4R rs12970134 polymorphisms showed an opposite direction of effect to that in the original reports.

Sex differences in genetic and environmental influences on percent body fatness and physical activity

BACKGROUND

Knowing the extent to which genetic and environmental factors influence percent body fatness (%Fat) and physical activity (PA) would be beneficial, since both are tightly correlated with future health outcomes. Thus, the purpose was to evaluate sex differences in genetic and environmental influences on %Fat and physical activity behavior in male and female adolescent twins.

METHODS

Subjects were adolescent (age range 8.3 to 16.6 yr) twins. %Fat (n = 518 twins) was assessed by bioelectrical impedance analysis (BIA) and PA (n = 296 twins) was measured using 3-Day PA Recall. Each activity was converted to total MET-minutes. Univariate twin models were used to examine sex differences in genetic and environmental factors influencing %Fat and PA.

RESULTS

%Fat was influenced by genetic effects in both boys and girls (88% and 90%, respectively), with slightly higher heritability estimates for girls. PA was influenced solely by environmental effects for both sexes with higher shared environmental influences in boys (66%) and higher nonshared effects in girls (67%).

CONCLUSIONS

When developing interventions to increase PA in adolescents, it is important to consider the environment in which it takes place as it is the primary contributor to PA levels.

Compliant eating of maternally prompted food predicts increased body mass index z-score gain in girls: results from a population-based sample

BACKGROUND

Poorer "division of responsibility" (DoR) feeding, characterized by high parental control and reduced child food choice, may promote pediatric obesity, although population-based prospective data are lacking. We tested whether poorer DoR feeding predicts childhood overweight/obesity onset and BMI z-score gain, over 10 years in the National Longitudinal Study of Youth.

METHODS

We studied 302 girls and 316 boys, with mean ages 52.24 and 52.35 months, respectively, in 1986, who were followed for 10 years. We excluded children who were initially overweight/obese. Mothers completed three DoR feeding questions in 1986: (1) child eating compliance of prompted foods; (2) child eating compliance of initially refused foods; and (3) mother-allotted child food choice. Child BMI (kg/m(2)) was calculated from measured weights and heights in 1986, 1988, 1992, 1994, and 1996.

RESULTS

Daughters who complied with maternal food prompts [odds ratio (OR), 2.01] and those who obeyed maternal prompts to consume initially rejected foods (OR, 2.29) "most of the time" were significantly more likely than daughters who complied less frequently to become overweight/obese after 8 years. Also, more frequent eating compliance (p<0.001) and more frequent compliance of initially rejected foods (p=0.003) predicted greater BMI z-score gain in girls. These associations were not found for boys. Maternal obesity consistently predicted overweight/obesity risk in girls (ORs, 2.48-8.63) and boys (ORs, 2.27- 4.03).

CONCLUSIONS

Teaching parents to avoid coercive feeding practices, while encouraging child self-selection of healthier foods, may help their daughters to achieve better energy balance.

Application of structural equation models for elucidating the ecological drivers of Anopheles sinensis in the three gorges reservoir

Objective

To identify the major ecological drivers for malaria vector density using the structural equation model (SEM) in the Three Gorges Reservoir.

Method

An 11-year longitudinal surveillance of malaria vector as well as its related ecological factors was carried out in the Three Gorges Reservoir. The Delphi method was used to identify associated ecological factors. The structural equation model was repeatedly corrected and improved by the corrected index, combined with the actual situation. The final model was defined by relative simplicity, best fitting as well as the practicality.

Result

The final model indicated that the direct effects of temperature, livestock, humidity, and breeding on the vector were 0.015, −0.228, 0.450, 0.516 respectively, their total effects on the vector were 0.359, −0.112, 0.850, and 0.043 through different pathways.

Conclusion

SEM was effective and convenient in elucidating the mechanism by which malaria vector dynamics operated in this study. It identified that the breeding had the highest direct effect on vector and played a key role for mediating effect of temperature and humidity.

Association of peroxisome proliferator-activated receptor α/δ/γ with obesity, and gene-gene interaction, in the Chinese Han population

BACKGROUND

We investigated the association of 10 single-nucleotide polymorphisms (SNPs) in the peroxisome proliferator-activated receptors (PPARs) with obesity and the additional role of gene-gene interaction.

METHODS

Participants were recruited within the framework of the Prevention of Multiple Metabolic Disorders and MS in Jiangsu Province cohort population survey of an urban community in China. In total, 820 subjects (513 nonobese adults, 307 obese adults) were randomly selected, and no individuals were consanguineous. Ten SNPs (rs135539, rs4253778, rs1800206, rs2016520, rs9794, rs10865710, rs1805192, rs709158, rs3856806, and rs4684847) were genotyped and analyzed.

RESULTS

After covariate adjustment, minor alleles of rs2016520 in PPARδ and rs10865170 in PPARγ were associated with lower BMI (P < 0.01 for all). Generalized multifactor dimensionality reduction analysis showed significant gene-gene interaction among rs2016520, rs9794, and rs10865170 in 3-dimensional models (P = 0.0010); prediction accuracy was 0.6011 and cross-validation consistency was 9/10. It also showed significant gene-gene interaction between rs2016520 and rs10865170 in all 2-dimensional models (P = 0.0010); prediction accuracy was 0.6072 and cross-validation consistency was 9/10.

CONCLUSIONS

rs2016520 and rs10865170 were associated with lower obesity risk. In addition, interaction was identified among rs2016520, rs9794, and rs10865170 in obesity.

Obesity and eating behaviour in children and adolescents: contribution of common gene polymorphisms

The prevalence of childhood obesity is increasing in many countries and confers risks for early type 2 diabetes, cardiovascular disease and metabolic syndrome. In the presence of potent 'obesogenic' environments not all children become obese, indicating the presence of susceptibility and resistance. Taking an energy balance approach, susceptibility could be mediated through a failure of appetite regulation leading to increased energy intake or via diminished energy expenditure. Evidence shows that heritability estimates for BMI and body fat are paralleled by similar coefficients for energy intake and preferences for dietary fat. Twin studies implicate weak satiety and enhanced food responsiveness as factors determining an increase in BMI. Single gene mutations, for example in the leptin receptor gene, that lead to extreme obesity appear to operate through appetite regulating mechanisms and the phenotypic response involves overconsumption and a failure to inhibit eating. Investigations of robustly characterized common gene variants of fat mass and obesity associated (FTO), peroxisome proliferator-activated receptor (PPARG) and melanocortin 4 receptor (MC4R) which contribute to variance in BMI also influence the variance in appetite factors such as measured energy intake, satiety responsiveness and the intake of palatable energy-dense food. A review of the evidence suggests that susceptibility to childhood obesity involving specific allelic variants of certain genes is mediated primarily through food consumption (appetite regulation) rather than through a decrease in activity-related energy expenditure. This conclusion has implications for early detection of susceptibility, and for prevention and management of childhood obesity.

Heritability of body mass index in pre-adolescence, young adulthood and late adulthood

Increased body mass index (BMI) is a worldwide health issue. Individual differences in the susceptibility to increased BMI could be related to genes or environment. We performed a systematic review of genetic studies on BMI in pre-adolescence, young adulthood and late adulthood. We searched PubMed and EMBASE with heritability, body mass index, BMI, weight, height, anthropometry and twins as search terms. Studies reporting intra-pair correlations of healthy twin pairs that were raised together were included. This resulted in the inclusion of 8,179 monozygotic (MZ) and 9,977 dizygotic (DZ) twin pairs from twelve published studies in addition to individual participant data for 629 MZ and 594 DZ pairs from four twin registries. Structural equation modelling with intra-pair twin correlations showed that the heritability of BMI remained high over all age categories ranging from 61% (95% CI 54-64%) to 80% (95% CI 76-81%) for male and female subjects combined, while unique environmental influences increased from 14% (95% CI 13-15%) to 40% (95% CI 37-43%) with increasing age. Heritability of BMI remains consistently high over different age categories. Environmental changes over time do not seem to have as big a relative impact on an individual's weight as previously reported, suggesting a mainly genetic influence on variation in BMI over the years.

Evaluating Parents and Adult Caregivers as “Agents of Change” for Treating Obese Children: Evidence for Parent Behavior Change Strategies and Research Gaps

This scientific statement addresses parents and adult caregivers (PACs) as “agents of change” for obese children, evaluating the strength of evidence that particular parenting strategies can leverage behavior change and reduce positive energy balance in obese youth. The statement has 3 specific aims. The first is to review core behavior change strategies for PACs as used in family-based treatment programs and to provide a resource list. The second is to evaluate the strength of evidence that greater parental “involvement” in treatment is associated with better reductions in child overweight. The third is to identify research gaps and new opportunities for the field. This review yielded limited and inconsistent evidence from randomized controlled clinical trials that greater PAC involvement necessarily is associated with better child outcomes. For example, only 17% of the intervention studies reported differential improvements in child overweight as a function of parental involvement in treatment. On the other hand, greater parental adherence with core behavior change strategies predicted better child weight outcomes after 2 and 5 years in some studies. Thus, the literature lacks conclusive evidence that one particular parenting strategy or approach causally is superior to others in which children have a greater focus in treatment. A number of research gaps were identified, including the assessment of refined parenting phenotypes, cultural tailoring of interventions, examination of family relationships, and incorporation of new technologies. A conceptual model is proposed to stimulate research identifying the determinants of PAC feeding and physical activity parenting practices, the results of which may inform new treatments. The statement addresses the need for innovative research to advance the scope and potency of PAC treatments for childhood obesity.

A twin study of self-regulatory eating in early childhood: estimates of genetic and environmental influence, and measurement considerations

OBJECTIVE

Children differ greatly in their ability to self-regulate food intake for reasons that are poorly understood. This laboratory-based twin study tested the genetic and environmental contributions to self-regulatory eating and body fat in early childhood.

METHODS

A total of 69 4-7 year-old same-sex twin pairs, including 40 monozygotic and 29 dizygotic pairs, were studied. Self-regulatory eating was operationalized as the percentage compensation index (COMPX%), assessed by a 'preload' challenge in which lunch intake was measured following a low- (3 kcal) or high-calorie (159 kcal) drink. Body fat indexes also were measured. The familial association for COMPX% was estimated by an intraclass correlation, and biometric analyses estimated heritability.

RESULTS

Children ate more at lunch following the low- compared with high-energy preload (P<0.001), although variability in COMPX% was considerable. Compensation was significantly poorer among African American and Hispanic compared with European American children, and among girls compared with boys. There was a familial association for self-regulatory eating (ρ = 0.23, P = 0.03) but no significant genetic component. In all, 22% of the variance in COMPX% was due to shared environmental 'household' factors, with the remaining variance attributable to child-specific 'unique' or 'random' environments. Poorer self-regulatory eating was associated with greater percent body fat (r = -0.21, P = 0.04).

CONCLUSIONS

Self-regulatory eating was influenced by environmental factors, especially those differing among siblings. The absence of a significant genetic effect may reflect the age of the sample or could be artifactual due to measurement issues that need to be considered in future studies.

Variability in the heritability of body mass index: a systematic review and meta-regression

Evidence for a major role of genetic factors in the determination of body mass index (BMI) comes from studies of related individuals. Despite consistent evidence for a heritable component of BMI, estimates of BMI heritability vary widely between studies and the reasons for this remain unclear. While some variation is natural due to differences between populations and settings, study design factors may also explain some of the heterogeneity. We performed a systematic review that identified 88 independent estimates of BMI heritability from twin studies (total 140,525 twins) and 27 estimates from family studies (42,968 family members). BMI heritability estimates from twin studies ranged from 0.47 to 0.90 (5th/50th/95th centiles: 0.58/0.75/0.87) and were generally higher than those from family studies (range: 0.24-0.81; 5th/50th/95th centiles: 0.25/0.46/0.68). Meta-regression of the results from twin studies showed that BMI heritability estimates were 0.07 (P = 0.001) higher in children than in adults; estimates increased with mean age among childhood studies (+0.012/year, P = 0.002), but decreased with mean age in adult studies (-0.002/year, P = 0.002). Heritability estimates derived from AE twin models (which assume no contribution of shared environment) were 0.12 higher than those from ACE models (P < 0.001), whilst lower estimates were associated with self reported versus DNA-based determination of zygosity (-0.04, P = 0.02), and with self reported versus measured BMI (-0.05, P = 0.03). Although the observed differences in heritability according to aspects of study design are relatively small, together, the above factors explained 47% of the heterogeneity in estimates of BMI heritability from twin studies. In summary, while some variation in BMI heritability is expected due to population-level differences, study design factors explained nearly half the heterogeneity reported in twin studies. The genetic contribution to BMI appears to vary with age and may have a greater influence during childhood than adult life.

Prepregnancy body mass index and gestational weight gain in relation to child body mass index among siblings

There is increasing evidence that in utero effects of excessive gestational weight gain may result in increased weight in children; however, studies have not controlled for shared genetic or environmental factors between mothers and children. Using 2,758 family groups from the Collaborative Perinatal Project, the authors examined the association of maternal prepregnancy body mass index (BMI) and gestational weight gain on child BMI at age 4 years using both conventional generalized estimating equations and fixed-effects models that account for shared familial factors. With generalized estimating equations, prepregnancy BMI and gestational weight gain had similar associations with the child BMI z score (β = 0.09 units, 95% confidence interval (CI): 0.08, 0.11; and β = 0.07 units, 95% CI: 0.04, 0.11, respectively. However, fixed effects resulted in null associations for both prepregnancy BMI (β = 0.03 units, 95% CI: -0.01, 0.07) and gestational weight gain (β = 0.03 units, 95% CI: -0.02, 0.08) with child BMI z score at age 4 years. The positive association between gestational weight gain and child BMI at age 4 years may be explained by shared family characteristics (e.g., genetic, behavioral, and environmental factors) rather than in utero programming. Future studies should continue to evaluate the relative roles of important familial and environmental factors that may influence BMI and obesity in children.

The genetic epidemiology of obesity: a case study

Obesity (OMIM #601665) is a disease where excessive stores of body fat impact negatively on health. The first law of thermodynamics dictates that energy cannot be created or destroyed so if energy is taken into the body, but not transformed to ATP for metabolic work or dissipated as heat, it will be stored as fat. Therefore, the ultimate cause of obesity is a long-term positive energy imbalance [energy intake (EI) exceeds energy expenditure (EE)]. Despite this simple explanation, there is no single reason why EI may exceed EE meaning that the proximate causes of obesity are multi-factorial in origin involving a complex interplay of genetic, behavioural, and environmental influences on metabolism, diet, and activity.

Early-life determinants of overweight and obesity: a review of systematic reviews

The aim of this paper was to review the evidence for early-life (from conception to 5 years of age) determinants of obesity. The design is review of published systematic reviews. Data sources included Medline, Embase, Web of Science, Cochrane Library, CINAHL, PsycINFO. Identification of 22 eligible reviews from a database of 12,021 independent publications. Quality of selected reviews assessed using the Assessment of Multiple Systematic Reviews score. Articles published after the reviews were used to confirm results. No review was classified as high quality, 11 as moderate and 11 as low. Factors associated with later overweight and obesity: maternal diabetes, maternal smoking, rapid infant growth, no or short breastfeeding, obesity in infancy, short sleep duration, <30 min of daily physical activity, consumption of sugar-sweetened beverages. Other factors were identified as potentially relevant, although the size of their effect is difficult to estimate. Maternal smoking, breastfeeding, infant size and growth, short sleep duration and television viewing are supported by better-quality reviews. It is difficult to establish a causal association between possible determinants and obesity, and the relative importance of each determinant. Future research should focus on early-life interventions to confirm the role of protective and risk factors and to tackle the high burden obesity represents for present and future generations.

Infant temperament and eating style predict change in standardized weight status and obesity risk at 6 years of age

OBJECTIVE

Little research has addressed the relationships among infant temperament, eating styles and obesity risk. To address this gap, we tested whether infant temperament and eating patterns at the age of 1 year are associated with a greater increase in standardized weight status, and greater obesity risk at 6 years of age.

DESIGN

A secondary, prospective analysis of the Colorado Adoption Study was conducted. The main predictor variables were infant temperament (that is, emotionality, activity, attention span-persistence, reaction to food and soothability) and eating domains (that is, reactivity to food, predictable appetite and distractability at mealtime) at the age of 1 year, along with the body mass index (BMI) of biological mothers. The outcome measures were child weight and height (length) assessed at ages 1 through 6 years, from which weight-for-length and BMI were computed along with the standardized indexes (z-scores) and percentiles. Overweight/obesity status was computed at each year as well.

PARTICIPANTS

A primarily White sample of 262 boys and 225 girls, assessed at ages 1 through 6 years, along with their mothers.

RESULTS

Among boys, greater attention span-persistence was associated with reduced standardized weight status gain (β=-0.15, P<0.05) and reduced obesity risk (odds ratio (OR)=0.46, P=0.06). Among girls, greater soothability and negative reaction to food were associated with greater standardized weight status gain (β=0.19, P<0.01; and β=0.16, P<0.05, respectively) and increased obesity risk (OR=3.72, P=0.03; and OR=2.81, P=0.08, respectively). Biological mothers' obesity status predicted obesity risk in boys (OR=3.07, P=0.01) and girls (OR=5.94, P=0.03).

CONCLUSIONS

Male infants with less attention span, and female infants with greater soothability or a more negative food reaction, showed greater increases in standardized weight and were more likely to be overweight/obese at the age of 6 years. The role of infant temperament in pediatric obesity onset warrants greater research.

Energy intake, parental control of children's eating, and physical activity in siblings discordant for adiposity

Studying siblings discordant for adiposity allows for identifying risk factors for obesity by testing whether there is low familiality or resemblance of energy balance behaviors and then whether sibling differences in these behaviors are associated with differences in their adiposity. Nineteen sibling pairs discordant for overweight were assessed for physical activity, laboratory-based food consumption (single food, variety of foods), and parental control of child feeding behaviors. There was virtually no familiality for physical activity and energy intake during a single food meal. Sibling differences in moderate-to-vigorous physical activity (MVPA) and energy intake independently predicted differences in their adiposity. There was high familiality for increased energy intake (responsivity) when presented with a meal composed of a variety of foods, and sibling differences in responsivity did not predict sibling differences in adiposity. Parent concern and monitoring of child eating had only slight familiality and were associated with sibling differences in adiposity. In conclusion, sibling differences in MVPA and energy intake and parent concern and monitoring of child eating may promote differences in adiposity. Increased responsivity to dietary variety by overweight siblings does not appear to promoting sibling discordance in overweight as normal weight and overweight siblings responded similarly to dietary variety.

Eating behaviors of children in the context of their family environment

Both a family history of obesity and early childhood obesity have been identified as strong predictors of adult obesity risk. The finding that parental obesity, maternal obesity in particular, increases a child's risk for developing obesity suggests that either shared genes, or environment, or likely a combination of both may promote overeating and excessive weight gain in children. Parents not only create food environments for children's early experiences with food and eating, but they also influence their children's eating by modeling their own eating behaviors, taste preferences, and food choices. Thus, it is important to identify intermediary behavioral eating traits which promote overeating and obesity in children and to determine the extent to which associations between eating traits and excessive weight gain in children may be influenced by genetic factors, environmental factors, or both. Behavioral genetic methods can be used to help partition genetic and environmental sources of variability in behavioral traits. The focus of this paper is to review and discuss findings from both short-term experimental and prospective cohort studies on eating behaviors of children at various stages in their lives. Select child eating traits and parent-child resemblances in eating will be further examined in the context of children's home environment and their familial predisposition to obesity. The paper represents an invited review by a symposium, award winner or keynote speaker at the Society for the Study of Ingestive Behavior [SSIB] Annual Meeting in Portland, July 2009.

Postprandial responses in hunger and satiety are associated with the rs9939609 single nucleotide polymorphism in FTO

BACKGROUND

The common rs9939609 single nucleotide polymorphism (SNP) in the fat mass and obesity-associated (FTO) gene is associated with adiposity, possibly by affecting satiety responsiveness.

OBJECTIVE

The objective was to determine whether postprandial responses in hunger and satiety are associated with rs9939609, taking interactions with other relevant candidate genes into account.

DESIGN

Sixty-two women and 41 men [age: 31 +/- 14 y; body mass index (in kg/m(2)): 25.0 +/- 3.1] were genotyped for 5 SNPs in FTO, DNMT1, DNMT3B, LEP, and LEPR. Individuals received fixed meals provided in energy balance. Hunger and satiety were determined pre- and postprandially by using visual analog scales.

RESULTS

A general association test showed a significant association between postprandial responses in hunger and satiety with rs9939609 (P = 0.036 and P = 0.050, respectively). Individuals with low postprandial responses in hunger and satiety were overrepresented among TA/AA carriers in rs9939609 (FTO) compared with TT carriers (dominant and additive model: P = 0.013 and P = 0.020, respectively). Moreover, multifactor dimensionality reduction showed significant epistatic interactions for the postprandial decrease in hunger involving rs9939609 (FTO), rs992472 (DNMT3B), and rs1137101 (LEPR). Individuals with a low postprandial decrease in hunger were overrepresented among TA/AA (dominant), CC/CA (recessive), and AG/GG (dominant) carriers in rs9939609 (FTO), rs992472 (DNMT3B), and rs1137101 (LEPR), respectively (n = 39), compared with TT, AA, and/or AA carriers in these SNPs, respectively (P = 0.00001). Each SNP had an additional effect.

CONCLUSIONS

Our results confirm a role for FTO in responsiveness to hunger and satiety cues in adults in an experimental setting. The epistatic interaction suggests that DNA methylation, an epigenetic process, affects appetite.

Heritability of childhood weight gain from birth and risk markers for adult metabolic disease in prepubertal twins

OBJECTIVE

Associations between size at birth, postnatal weight gain, and potential risk for adult disease have been variably explained by in utero exposures or genetic risk that could affect both outcomes. We utilized a twin model to explore these hypotheses.

METHODS

One hundred pairs of healthy twins aged 8.9 yr (range, 7.2-10.9 yr) had fasting blood samples collected, blood pressure (BP) measured, and anthropometry assessed. All measurements were converted to sd scores (SDS) to adjust for age and sex.

RESULTS

Mean birth weights in both monozygotic and dizygotic twins were -0.90 SDS lower than the UK reference. In postnatal life, 58% of monozygotic twins and 59% of dizygotic twins showed rapid weight gain (a change of more than +0.67 in weight SDS) from birth. Postnatal weight gain was positively associated with sum of skinfolds (r = 0.51; P < 0.0005), fasting insulin levels (r = 0.35; P < 0.0005), systolic BP (r = 0.30; P < 0.0005), and diastolic BP (r = 0.15; P < 0.05) at follow-up. Heritability estimates (additive genetic components) were calculated using variance components models for: birth weight, 44%; postnatal weight gain, 80%; childhood height, 89%; body mass index, 72%; sum of skinfolds, 89%; waist circumference, 74%; fasting insulin, 65%; systolic BP, 33%; and diastolic BP, 29%.

CONCLUSIONS

Postnatal weight gain from birth, rather than birth weight, was associated with childhood risk markers for adult metabolic disease. Childhood weight gain was highly heritable, and genetic factors associated with postnatal weight gain are likely to also contribute to risks for adult disease.

The genetic and environmental influences on childhood obesity: a systematic review of twin and adoption studies

In this systematic review, we aimed to collect together all previous twin and adoption studies on childhood and adolescent obesity up to the age of 18 years. Using several sources, we identified nine twin and five adoption studies; all of these studies had used relative weight as an indicator of obesity. Except the two twin studies from the Korean population, all studies represented Caucasian populations. In a meta-analysis of these twin studies, we found that genetic factors had a strong effect on the variation of body mass index (BMI) at all ages. The common environmental factors showed a substantial effect in mid-childhood, but this effect disappeared at adolescence. Adoption studies supported the role of family environment in childhood obesity as correlations were found between adoptees and adoptive parents; however, correlations were substantially stronger between parents and their biological offspring, further supporting the importance of genetic factors. In the future, more studies implementing genetic and environmental measures into twin models are needed as they allow estimation of the proportion of total genetic variation explained by candidate genes and analyses of gene-environment interactions. More studies of genetic architecture in non-Caucasian populations, of gene-environment interactions, and of body composition and body fat distribution are needed.

Gene-environment interactions and obesity--further aspects of genomewide association studies

Advances in genotyping technologies have facilitated the advent of the genomewide association studies in large study populations and thereby led to the identification of an impressive-and still increasing-number of genetic variants with significant impact on the risk of widespread lifestyle health problems such as obesity, diabetes, and cardiovascular disease. Yet, the scientific community is a long way from reaching a comprehensive picture of the heritable components of these diseases and advancing from plain statistical significance into a biological understanding where the true contribution to a trait is recognized. Increasingly large study populations, denser single-nucleotide polymorphism mapping, deep sequencing, and raised awareness of the importance of structural variants may add to the known genetic variance underlying common complex disorders; however, genetic variance alone probably cannot account for disease susceptibility without the addition of pre- and postnatal environmental and/or behavioral factors. Moreover, an interaction between genetic and environmental factors may hinder the detection of genetic effects if not accounted for, e.g., in genomewide association studies, and prospective cohort studies have hence been proposed to surpass the classic case-control design. With a focus on obesity we describe some of the recently reported gene-environment interactions for polymorphisms identified in the FTO and INSIG2 genes. Ultimately, a thorough understanding of the gene-environment interactions underlying a common complex condition such as obesity may suggest novel treatment or intervention strategies to complement the harmful effect of detrimental genetic variation and thus may assist in improving the quality of life for affected individuals.

A consultation with genetic information about obesity decreases self-blame about eating and leads to realistic weight loss goals in obese individuals

OBJECTIVE

This study tested the effects of a consultation using genetic information about obesity on attitudes relating to weight loss goals, self-blame about eating, and weight-related coping in obese individuals. Furthermore, the study sought to explore possible predictors for weight gain/loss.

METHOD

A total of 411 obese individuals were randomly assigned to two standardized consultations, with and without genetic information about obesity, and a control group without any intervention. After a 6-month follow-up, 253 obese individuals of the intervention groups and 98 individuals of the control group had a complete dataset. Data were analyzed regarding the independent variables assessment time, treatment group, and the familial predisposition (at least one obese parent or sibling). As dependent measures, attitudes about weight loss goals, weight-related self-blame, coping, and body shame were assessed via questionnaire or interview.

RESULTS

Individuals with and without a familial predisposition profited in different ways from a consultation using genetic information about obesity: at follow-up, individuals with a familial predisposition reported mainly a relieving effect (less self-blame about eating). Both groups reported an adjustment to more realistic weight loss goals and a greater satisfaction with a 5% weight loss. Furthermore, the more negative obese individuals felt about their current weight at baseline, the higher the risk that these individuals had gained weight at follow-up.

CONCLUSION

A consultation focusing on genetic factors might be helpful for obese individuals regardless of their familial predisposition, but only predisposed individuals showed a decrease in self-blame about eating. Negative thoughts and feelings about current weight might predict future weight gain.

Associations between sleep duration patterns and overweight/obesity at age 6

OBJECTIVE

To investigate whether longitudinal sleep duration patterns during early childhood is a risk factor of overweight or obesity at school entry while controlling for a variety of obesogenic environmental factors.

DESIGN, SETTING, AND PARTICIPANTS

This is a prospective cohort study (March-December 1998 to December 2004) of a representative sample of infants born in 1997-1998 in the Canadian province of Quebec. Body mass index (BMI) was measured at ages 2.5 and 6 years. Sleep duration was reported yearly from 2.5 to 6 years of age by their mothers. Prenatal, postnatal (5 and 29 months), and lifestyle (6 y) potentially confounding factors for excess weight were assessed by interviews, questionnaires and hospital records. A group-based semiparametric mixture model was used to estimate developmental patterns of sleep duration. The relationship between sleep duration patterns and BMI was tested using multivariate logistic regression models to control for potentially confounding factors on 1138 children.

RESULTS

Four sleep duration patterns were identified: short persistent (5.2%), short increasing (4.7%), 10-hour persistent (50.7%), and 11-hour persistent (39.4%). After controlling for potentially confounding factors, the risk for overweight or obesity was almost 4.2 times higher for short persistent sleepers (odds ratio [OR], 4.2; 95% confidence interval [CI], 1.6 to 11.1; P = 0.003) than for 11-hour persistent sleepers.

CONCLUSIONS

Persistently short sleep duration (<10 h) during early childhood significantly increases the risk of excess weight or obesity in childhood, and appears to be independent of other obesogenic factors.

Considerations regarding the genetics of obesity

The genetics of human body fat content (obesity) are clearly complex. Genetic and physiological analysis of rodents have helped enormously in pointing to critical molecules and cells in central nervous system and "peripheral" pathways mediating the requisite fine control over the defense of body fat. Human and animal studies are consistent with inferences from evolutionary considerations that the strengths of defenses against fat loss are greater than those against gain. Many of the genes participating in these pathways have reciprocal effects on both energy intake and expenditure, though different genes may have primary roles in respective responses to weight gain or loss. Such distinctions have important consequences for both research and treatment strategies. The body mass index (BMI) is a useful gross indicator of adiposity, but more refined measurements of body composition and energy homeostasis will be required to understand the functional consequences of allelic variation in genes of interest. Phenotypes related to energy intake and expenditure-which clearly are the major determinants of net adipose tissue storage-are not salient when individuals are in energy balance (weight stable); measurements obtained during weight perturbation studies are likely to provide more revealing phenotypes for genetic analysis. The advent of high-density genome-wide scans in large numbers of human subjects for association analysis will revolutionize the study of the genetics of complex traits such as obesity by generating substantial numbers of powerful linkage signals from smaller genetic intervals. Many of the genes implicated will not have been previously related to energy homeostasis (e.g., recent experience with FTO/FTM as described below), and will have relatively small effects on the associated phenotype(s). The mouse will again prove useful in determining the relevant physiology of these new genes. New analytic tools will have to be developed to permit the necessary analysis of the gene x gene interactions that must ultimately convey aggregate genetic effects on adiposity.

Genetic and shared environmental influences on children's 24-h food and beverage intake: sex differences at age 7 y

BACKGROUND

The genetics of habitual food and beverage intake in early childhood is poorly understood.

OBJECTIVE

The objective was to test the magnitude of genetic and environmental influences on 24-h food and beverage intake in 7-y-old children. The association between intake of specific food-beverage categories and child body mass index (BMI; in kg/m(2)) was also tested.

DESIGN

A classic twin design was conducted, using the MacArthur Longitudinal Study of Twins. There were 792 children, including 396 boys from 102 monozygotic and 96 dizygotic twin pairs and 396 girls from 112 monozygotic and 86 dizygotic twin pairs; Children's 24-h dietary intake was estimated by parental recall, from which 9 composite food-beverage categories were derived. Height and weight were converted to BMI. Biometrical analyses of children's daily intake of food-beverage categories and BMI were conducted.

RESULTS

There was consistent evidence of genetic influences on children's 24-h intake of food and beverages (servings/d), especially among boys. Seven categories showed significant heritability estimates among boys, ranging from 12% (fish and lemon) to 79% (peanut butter and jelly). Only 3 categories showed significant heritability estimates among girls, ranging from 20% (bread and butter) to 56% (fish and lemon). BMI showed a genetic correlation only with bread and butter intake in girls.

CONCLUSION

The magnitude of genetic and environmental influences on children's 24-h food and beverage intake differed for boys and girls, which suggests sex differences in the development of eating patterns. Heritability estimates were generally large, although other eating phenotypes may be necessary for identifying genetic correlations with adiposity.

Genome-wide scan revealed genetic loci for energy metabolism in Hispanic children and adolescents

OBJECTIVE

Genome-wide scans were conducted in search for genetic locations linked to energy expenditure and substrate oxidation in children.

DESIGN

Pedigreed data of 1030 Hispanic children and adolescents were from the Viva La Familia Study which was designed to investigate genetic and environmental risk factors for the development of obesity in Hispanic families. A respiratory calorimeter was used to measure 24-h total energy expenditure (TEE), basal metabolic rate (BMR), sleep metabolic rate (SMR), 24-h respiratory quotient (24RQ), basal metabolic respiratory quotient (BMRQ) and sleep respiratory quotient (SRQ). Protein, fat and carbohydrate oxidation (PROOX, FATOX and CHOOX, respectively) were also estimated. All participants were genotyped for 384 single tandem repeat markers spaced an average of 10 cM apart. Computer program SOLAR was used to perform the genetic linkage analyses.

RESULTS

Significant linkage for TEE was detected on chromosome 1 near marker D1S2841, with a logarithm of the odds (LOD) score of 4.0. SMR, BMRQ and PROOX were associated with loci on chromosome 18, 17 and 9, respectively, with LOD scores of 4.88, 3.17 and 4.55, respectively. A genome-wide scan of SMR per kg fat-free mass (SpFFM) peaked in the same region as SMR on chromosome 18 (LOD, 5.24). Suggestive linkage was observed for CHOOX and FATOX. Several candidate genes were found in the above chromosomal regions including leptin receptor (LEPR).

CONCLUSION

Regions on chromosomes 1, 9, 17 and 18 harbor genes affecting variation in energy expenditure and substrate oxidation in Hispanic children and adolescents.

Pediatric obesity: the unique issues in Latino-American male youth

Pediatric obesity in the United States has been steadily rising over the past few decades, and it is a clear risk factor for adult obesity and obesity-related morbidity and mortality. A review of the literature from three major national databases reveals that the prevalence rates of obesity within Latino male children and adolescents is, in general, higher than other major gender-ethnic groups. Additionally, obese Latino male youth seem to be especially prone to a variety of obesity-related morbidities. Given the rising percentage of Latinos among our nation's youth, there is an urgency to develop and implement clinical and community research strategies to prevent and treat obesity within this high-risk gender-ethnic group. This article reviews the prevalence of pediatric obesity within the three largest databases in the U.S. with Latino representation. The paper then discusses unique issues in the etiology and ramifications of obesity within young Latino-American boys, reviews the few intervention studies that focus on Latino youth, and discusses potential strategies for further research.

Genetic and environmental factors in relative weight from birth to age 18: the Swedish young male twins study

OBJECTIVES

To investigate the contributions of genetic and environmental factors to the development of relative weight during the growth period.

DESIGN

Longitudinal twin study.

SUBJECTS

Two-hundred and thirty-one monozygotic and 144 dizygotic complete male twin pairs born between 1973 and 1979 were measured annually from birth to 18 years of age.

RESULTS

Body mass index (BMI, kg/m(2)) at age 18 correlated with BMI at age 1 (r=0.32, 95% confidence intervals (CI) 0.21-0.42), and this correlation increased steadily up to age 17 (r=0.91, 95% CI 0.89-0.93). Major part (81-95%) of these trait correlations was attributable to correlate additive genetic factors, but also unique environmental correlations were present during the whole-growth period. The correlation between ponderal index (kg/m(3)) at birth and BMI at age 18 was small (r=0.09, 95% CI 0.02-0.15) and totally because of correlated unique environmental factors.

CONCLUSIONS

Our results suggest persistent genetic regulation of BMI from age 1 to 18. However, environmental factors, not shared by siblings, also affected the correlations of BMI. A small specific environmental correlation was found between ponderal index at birth and BMI at age 18, which may reflect the effect of neonatal environmental factors on adult BMI. A challenge to the future research is to identify chromosome regions and specific genes regulating the development of BMI as well as environmental factors affecting BMI through the growth period independently or interacting with genetic factors.

Genetic study of the melanin-concentrating hormone receptor 2 in childhood and adulthood severe obesity

CONTEXT

The melanin-concentrating hormone receptor 2 (MCHR2) is a G protein-coupled receptor for melanin-concentrating hormone, a neuropeptide that plays an important role in feeding behaviors. MCHR2 maps on chromosome 6q16.3, in a susceptibility locus for childhood obesity.

OBJECTIVE

The aim of this study was to investigate the association between MCHR2 variation and human obesity.

DESIGN

Case control and family-based studies were performed.

PARTICIPANTS

A total of 141 obese children and 24 nonobese adult subjects was sequenced, and case-control analyses were conducted using 628 severely obese children and 1,401 controls.

RESULTS

There were 11 single nucleotide polymorphisms (SNPs) identified. We showed nominal association among -38,245 ATG A/G SNP (P = 0.03; 95% confidence interval 1.02-1.34; odds ratio 1.17), A76A T/C SNP (P = 0.03; 95% confidence interval 0.58-0.97; odds ratio 0.75), and childhood obesity. Analysis of 645 trios with childhood obesity supported further the A76A T/C association, showing an overtransmission to obese children of the at risk T allele (59.0%; P = 0.01), especially in children with most severe forms of obesity (Z score of body mass index > 4) (67.0%; P = 0.003). The A76A at risk T allele was also associated with overeating during meals (P = 0.02) in an additional group of 102 nonobese children. None of the MCHR2 variants, including the A76A SNP, showed association with adult severe obesity, although a trend for association of the T allele of this variant with food disinhibition (P = 0.06) and higher hunger (P = 0.09) was found. This variant was not associated with childhood obesity in an independent case-control study, including 1,573 subjects (P = 0.98). Moreover, the A76A SNP did not explain the linkage on the 6q locus.

CONCLUSION

Our results altogether suggest that MCHR2 is not a major contributor to polygenic obesity and support a modest effect of the A76A SNP on food intake abnormalities in childhood.

Maternal size in pregnancy and body composition in children

CONTEXT

Evidence suggests that babies' fat mass at birth is greater if their mothers were themselves fatter during pregnancy, but it is unclear whether this association persists into childhood.

OBJECTIVE

Our objective was to examine the relation between maternal size in pregnancy, early growth and body composition in children.

DESIGN AND SETTING

We conducted a prospective cohort study in Southampton, United Kingdom.

PARTICIPANTS

Participants included 216 9-yr-old children whose mothers had participated in a study of nutrition during pregnancy.

MAIN OUTCOME MEASURES

Fat mass and lean mass were measured by dual-energy x-ray absorptiometry and adjusted for height (fat mass index and lean mass index).

RESULTS

Fat mass index at age 9 yr was greater in children whose mothers had a larger mid-upper arm circumference in late pregnancy or a higher prepregnant body mass index. For 1 sd increase in maternal mid-upper arm circumference in late pregnancy, fat mass index rose by 0.26 [95% confidence interval (CI) 0.06-0.46] sd in boys and by 0.44 (95% CI 0.31-0.57) sd in girls. For 1 sd increase in maternal prepregnant BMI, fat mass index rose by 0.26 (95% CI 0.04-0.48) sd in boys and by 0.42 (95% CI 0.29-0.56) sd in girls.

CONCLUSIONS

Mothers with a higher prepregnant body mass index or a larger mid-upper arm circumference during pregnancy tend to have children with greater adiposity at age 9. The extent to which this is attributable to genetic factors, the influence of maternal lifestyle on that of her child, or maternal adiposity acting specifically during pregnancy on the child's fat mass cannot be determined in this study.

Genetic and environmental influences on body size in early childhood: a twin birth-cohort study

Genetic and environmental contributions to body size from birth to 5 years in a population-based twin cohort were studied. Sex differences in gene-environment etiology were also explored. Analyses used data from the Quebec Newborn Twin Study (QNTS), a population-based birth cohort of 672 twin pairs. The final sample consisted of 177 complete twin pairs. Heritability of weight was moderate at birth while common environmental factors accounted for almost half of the variance. Influence of family environment disappeared by 5 months and genetic effects were high (approximately 90%) for both sexes at 5 months and 5 years. Adjustment of weight for height yielded similar results as for weight alone. Slight but significant sex-limitation of genetic effects was observed at 5 months. Overall, genetic factors accounted for 40% of birthweight variance, with intrauterine environment influences explaining almost half. However, genetic factors accounted for most of the variance in weight. These results do not imply a lack of environmental effects on body weight, but rather a lack of: (1) environmental effects that are independent from genetic liability, and/or (2) a lack of significant environmental variation in the population (e.g., uniform nutritional habits) that leaves genetic differences between children to generate most of the variance in weight.

Genetic regulation of growth in height and weight from 3 to 12 years of age: a longitudinal study of Dutch twin children

Human growth is a complex and poorly understood process. We studied the effect of genetic and environmental factors on height and body mass index (BMI, kg/m(2)) based on maternal reports at 3, 4, 5, 7, 10 and 12 years of age in a large longitudinal cohort of Dutch twins (7755 complete twin pairs at age 3). Several multivariate variance component models for twins were fitted to the data using the Mx statistical package. The first-born twin was taller until age 10 and heavier until age 12 than the second-born co-twin. Heritability estimates were high for height (a(2) = .58-.91) and BMI (a(2) = .31-.82), but common and unshared environmental factors were also important. The phenotypic correlations across the ages for height and BMI were mainly explained by correlated additive genetic factors (r(a) = .77-.96 for height and .43-.92 for BMI), but common (r(c) = .40-.84 and .09-.78, respectively) and specific environmental correlations (r(e) = .50-.81 and .42-.80, respectively) were also significant. Additive genetic factors decreased with increasing age difference for both height and BMI. However, the full Cholesky model, which does not make any assumptions regarding the underlying genetic structure, had the best fit. High genetic correlations across the ages, especially for height, may help further molecular genetic studies of human growth. Environmental factors affecting height and BMI during growth period are also important, and further studies are needed to identify these factors and test whether they interact with genetic factors.

Gene-diet interactions in childhood obesity: paucity of evidence as the epidemic of childhood obesity continues to rise

Childhood obesity is growing rapidly worldwide. Although there have been enormous advances in the genetic underpinnings of obesity in recent years, the pathways that lead to obesity are still not completely understood. One of the ongoing challenges is the lack of a comprehensive definition of the obese phenotype that encompasses intermediary phenotypic expressions of biological and behavioral nature. Interactions between genetic and environmental factors, including nutrient exposures and dietary behaviors, can influence the development of the obese phenotype. Specifically, genes play a decisive role in the etiology of childhood obesity under the permissive circumstances of an obesogenic environment (increase in energy intake with a decrease in physical activity). Like many diseases, the causes of obesity are complex and their investigation requires novel approaches. Given the many contributors to obesity (weight gain, weight loss, weight maintenance, variability in body composition), as well as the dynamic nature of this issue, genomic tools must continue to be employed to evaluate all dimensions of the obesity phenotype, such as biochemical characteristics, susceptibility markers, nutrient intake, feeding practices and gene-environment interactions. Fundamental knowledge of the types of genes involved and available gene-diet interaction studies in children's obesity are reviewed. Although there is a paucity of existing literature in this specific domain of childhood obesity, ongoing investigations utilizing large cohorts have potential for providing the knowledge needed for targeted interventions in the future.

Child eating patterns and weight regulation: a developmental behaviour genetics framework

There is relatively limited knowledge about the development of child eating patterns and how they may contribute to excess weight gain in early life. Particularly scarce are genetically informative studies that addressed environmental and genetic influences which can be challenging to disentangle. A review of this literature can help identify ongoing themes in the field and may stimulate new ideas for future research. The purpose of this paper is to provide an overview about how select environmental factors (e.g. the portion size of foods) and parental feeding practices (e.g. dietary restriction) can affect children's eating behaviour and weight status. The second part of the review explains in more detail the types of studies that can be employed to assess genetic influences (e.g. heritability estimates) on child food intake and body weight and composition. The review closes with suggestions for future research emphasizing the importance of collaborations among investigators from different disciplines to further elucidate gene-environment interactions in the domains of child eating behaviour and obesity.

Evidence for Higher Heritability of Somatotype Compared to Body Mass Index in Female Twins

The influence of genetics on human physique and obesity has been addressed by the literature. Evidence for heritability of anthropometric characteristics has been previously described, mainly for the body mass index (BMI). However, few studies have investigated the influence of genetics on the Heath-Carter somatotype. The aim of the present study was to assess the heritability of BMI and somatotype (endomorphy, mesomorphy, and ectomorphy) in a group of female monozygotic and dizygotic twins from childhood to early adulthood. A total of 28 females aged from 7 to 19 years old were studied. The group included 5 monozygotic and 9 dizygotic pairs of twins. The heritability was assessed by the twin method (h(2)). The anthropometric measures and somatotype were assessed using standard validated procedures. Significant differences between monozygotic and dizygotic pairs of twins were found for height, endomorphy, ectomorphy, and mesomorphy, and the heritability for these measures was high (h(2) between 0.88 and 0.97). No significant differences were found between monozygotic and dizygotic twins for weight, and the BMI and the heritability indexes were lower for these measures (respectively 0.42 and 0.52). The results of the present study have indicated that the somatotype may be more sensible to genetic influences than the BMI in females.

Viva la Familia Study: genetic and environmental contributions to childhood obesity and its comorbidities in the Hispanic population

BACKGROUND

Genetic and environmental contributions to childhood obesity are poorly delineated.

OBJECTIVE

The Viva la Familia Study was designed to genetically map childhood obesity and its comorbidities in the Hispanic population. The objectives of this report were to describe the study design and to summarize genetic and environmental contributions to the phenotypic variation in obesity and risk factors for metabolic diseases in Hispanic children.

DESIGN

The Viva la Familia cohort consisted of 1030 children from 319 families selected based on an overweight proband between the ages of 4 and 19 y. In-depth phenotyping to characterize the overweight children and their siblings included anthropometric and body-composition traits by dual-energy X-ray absorptiometry and assessments of diet by 24-h recalls, physical activity by accelerometry, and risk factors for metabolic diseases by standard biochemical methods. Univariate quantitative genetic analysis was used to partition phenotypic variance into additive genetic and environmental components by using the computer program SOLAR.

RESULTS

Sex, age, and environmental covariates explained 1-91% of the phenotypic variance. Heritabilities of anthropometric indexes ranged from 0.24 to 0.75. Heritability coefficients for the body-composition traits ranged from 0.18 to 0.35. Diet and physical activity presented heritabilities of 0.32 to 0.69. Risk factors for metabolic diseases were heritable with coefficients ranging from 0.25 to 0.73. Significant genetic correlations between obesity traits and risk factors for metabolic diseases substantiated pleiotropy between traits.

CONCLUSION

The Viva la Familia Study provides evidence of a strong genetic contribution to the high prevalence of obesity and its comorbidities in Hispanic children.

Effects of open-loop feedback on physical activity and television viewing in overweight and obese children: a randomized, controlled trial

OBJECTIVES

Television viewing and physical inactivity increase the risk of obesity in youth. Thus, identifying new interventions that increase physical activity and reduce television viewing would be helpful in the prevention and treatment of pediatric obesity. This study evaluated the effects of open-loop feedback plus reinforcement versus open-loop feedback alone on physical activity, targeted sedentary behavior, body composition, and energy intake in youth.

METHODS

Thirty overweight or obese 8- to 12-year-old children were randomly assigned to an intervention (n = 14) or control group (n = 16). Participants wore accelerometers every day for 8 weeks and attended biweekly meetings to download the activity monitors. For children in the open-loop feedback plus reinforcement (intervention) group, accumulating 400 counts of physical activity on pedometers earned 1 hour of television/VCR/DVD time, which was controlled by a Token TV electronic device. Open-loop feedback control subjects wore activity monitors but had free access to targeted sedentary behavior.

RESULTS

Compared with controls, the open-loop feedback plus reinforcement group demonstrated significantly greater increases in daily physical activity counts (+65% vs +16%) and minutes per day of moderate-to-vigorous physical activity (+9.4 vs +0.3) and greater reductions in minutes per day spent in television viewing (-116.1 vs +14.3). The intervention group also showed more favorable changes in body composition, dietary fat intake, and energy intake from snacks compared with controls. Reductions in sedentary behavior were directly related to reductions in BMI, fat intake, snack intake, and snack intake while watching television.

CONCLUSIONS

Providing feedback of physical activity in combination with reinforcing physical activity with sedentary behavior is a simple method of modifying the home environment that may play an important role in treating and preventing child obesity.

Co-twin control designs for testing behavioral economic theories of child nutrition: methodological note

OBJECTIVE

To illustrate the use and potential efficiency of the co-twin control design for testing behavioral economic theories of child nutrition.

DESIGN

Co-twin control design, in which participating twins ate an ad libitum lunch on two laboratory visits. At visit 1, child food choices were not reinforced. On visit 2, twins were randomized to conditions such that one twin was reinforced for each fruit and vegetable serving consumed during lunch ('contingent') while his co-twin was reinforced irrespective of food intake ('non-contingent').

SUBJECTS

Six male twins, 5 years old, from three monozygotic twin pairs.

MEASUREMENTS

Ad libitum intake of total energy (kcals), fat (kcals), and fruits and vegetables (servings) from the protocol test meals on the two visits.

RESULTS

Compared to twins receiving non-contingent reinforcement, twins receiving contingent reinforcement increased fruit and vegetable intake by 2.0 servings, reduced fat intake 106.3 kcals, and reduced total energy intake by 112.7 kcals. The relative efficiency of the co-twin control design compared to a conventional between-groups design of unrelated children was most powerful for detecting 'substitution effects' (i.e., reduced total energy and fat intake) more so than for detecting increased fruit and vegetable intake.

CONCLUSION

Genetically informative studies, including the co-twin control design, can provide conceptually elegant and efficient strategies for testing environmental theories of child nutrition and obesity.

Energy balance and food intake: the role of PPARgamma gene polymorphisms

Mechanisms regulating energy balance involve complex interactions between genetic, environmental and behavioural (learnt and intrinsic) factors. Genotype may drive the partitioning of energy metabolism and predispose to site-specific adiposity, culminating in a state of energy imbalance. One candidate gene with a direct link to adiposity is the peroxisome proliferator-activated receptor gamma (PPARG) gene. PPARG is a cell nuclear receptor expressed almost exclusively in adipose tissue that regulates adipocyte differentiation, lipid metabolism and insulin sensitivity. PPARgamma appears to be a key regulator of energy balance, with polymorphisms on the PPARG gene linked to obesity and effects on body composition. Our research has confirmed an association between the pro12ala allele and reduced incidence of obesity in pre-pubertal children and there are strong associations between genetic variation at the PPARG locus and percentage body fat. Moreover, our evidence suggests that PPARG C-681G and pro12ala polymorphisms display opposing effects in terms of growth phenotype, with pro12Ala associated with deficient energy utilisation, leading to reduced growth and the G-681 variant associated with accelerated growth compared with wildtypes. Common differences in this gene have also been associated with variations in body weight in response to dietary macronutrients. Preliminary evidence suggests that PPARG variants may even be involved in the control of short term energy compensation. Taken together these data suggest that the role of PPARG is varied and complex, influencing fat deposition and growth velocity early in life, with potential impact in the control of energy intake and appetite regulation, and could provide a key target for future research and anti-obesity agents.

Childhood obesity and the metabolic syndrome

The current epidemic of obesity reflects environmental changes that have an impact on a genetically susceptible population. The scope of obesity and its associated comorbidities warrants its position among the most crucial global public health problems faced today. Society has gained better appreciation for the significance of this problem yet still has much to learn regarding how best to address the obesity crisis. Although strategies for treating individuals who have weight problems successfully continue to evolve, the most profound impacts ultimately will arise from societal changes dictating that all individuals strive to adopt a healthy lifestyle.

Habitual physical activity in children: the role of genes and the environment

BACKGROUND

Understanding the factors that contribute to physical inactivity in children is important because sedentary behavior strongly relates to metabolic disorders such as obesity and diabetes.

OBJECTIVE

We aimed to quantify the genetic and environmental influences on physical activity energy expenditure (PAEE) in 100 sex-concordant dizygotic (n = 38) and monozygotic (n = 62) twin pairs aged 4-10 y.

DESIGN

Resting metabolic rate (RMR) was assessed by using respiratory gas exchange, total energy expenditure (TEE) by using doubly labeled water, and body composition by using dual-energy X-ray absorptiometry. Structural equation modeling was used to partition the phenotypic variance into additive genetic (a2) and common (c2) and unshared (e2) environmental components.

RESULTS

Because PAEE [TEE - (RMR + 0.1 x TEE)] depends on body weight, which is highly heritable, we tested several models: 1) after adjustment for age, sex, ethnicity, study date, season, and weight, a2 explained none of the phenotypic variance in PAEE (95% CI: 0%, 38%), whereas c2 and e2 accounted for 69% (33%, 77%; P = 0.001) and 31% (23%, 39%; P < 0.001) of the variance, respectively; 2) after adjustment for the cofactors in model 1, a2 explained 19% of the phenotypic variance in TEE (0%, 60%; P = 0.13), whereas c2 and e2 accounted for 59% (16%, 79%; P = 0.007) and 23% (17%, 31%; P < 0.0001) of the variance, respectively; 3) in models adjusted as above (excluding weight), a2 explained no variance in physical activity level (TEE/RMR) (0%, 32%; P = 0.50), whereas c2 and e2 explained 65% (34%, 60%; P = 0.001) and 35% (28%, 45%; P < 0.0001) of the variance, respectively.

CONCLUSIONS

Our data suggest that the familial resemblance in physical activity in these children is explained predominantly by shared environmental factors and not by genetic variability.

Heritability of body composition measured by DXA in the diabetes heart study

OBJECTIVE

The purpose of this study was to investigate the heritability of body composition measured by DXA in the Diabetes Heart Study (DHS).

RESEARCH METHODS AND PROCEDURES

Participants were 292 women and 262 men (age, 38 to 86 years; BMI, 17 to 57 kg/m(2)) from 244 families. There were 492 white and 49 African-American sibling pairs. DXA measurements of percentage fat mass (FM), whole body FM, and lean mass (LM), as well as regional measurements of trunk fat mass (TFM) and appendicular lean mass (ALM), were obtained. Heritability of FM, LM, and BMI were estimated using Sequential Oligogenic Linkage Analysis Routines.

RESULTS

After adjusting for age, gender, ethnicity, and height, the heritability estimates of various compositional attributes were %FM = 0.64, whole body FM = 0.71, TFM = 0.63, whole body LM = 0.60, ALM = 0.66, and BMI = 0.64 (all p < 0.0001). Additional adjustment for diabetes status, smoking, dietary intake, and physical activity resulted in only minor changes in the heritability estimates (h(2) = 0.63 to 0.72, all p < 0.0001). Furthermore, heritability of TFM after additional adjustment for whole body FM was significant (h(2) = 0.55, p < 0.0001), and heritability of ALM after additional adjustment for whole body LM was also significant (h(2) = 0.51, p < 0.0001).

DISCUSSION

These data suggest that FM and LM measured by DXA are highly heritable and can be effectively used in designing linkage studies to locate genes governing body composition. In addition, regional distribution of FM and LM may be genetically determined.

Strategies for Healthy Weight Loss: From Vitamin C to the Glycemic Response

America is experiencing a major obesity epidemic. The ramifications of this epidemic are immense since obesity is associated with chronic metabolic abnormalities such as insulin resistance, dyslipidemia, and heart disease. Reduced physical activity and/or increased energy intakes are important factors in this epidemic. Additionally, a genetic susceptibility to obesity is associated with gene polymorphisms affecting biochemical pathways that regulate fat oxidation, energy expenditure, or energy intake. However, these pathways are also impacted by specific foods and nutrients. Vitamin C status is inversely related to body mass. Individuals with adequate vitamin C status oxidize 30% more fat during a moderate exercise bout than individuals with low vitamin C status; thus, vitamin C depleted individuals may be more resistant to fat mass loss. Food choices can impact post-meal satiety and hunger. High-protein foods promote postprandial thermogenesis and greater satiety as compared to high-carbohydrate, low-fat foods; thus, diet regimens high in protein foods may improve diet compliance and diet effectiveness. Vinegar and peanut ingestion can reduce the glycemic effect of a meal, a phenomenon that has been related to satiety and reduced food consumption. Thus, the effectiveness of regular exercise and a prudent diet for weight loss may be enhanced by attention to specific diet details.