Average Body Mass Index Z-score Research Articles

Nutrition assessment and MASH severity in children using the Healthy Eating Index.

Pediatric metabolic-associated fatty liver disease (MAFLD) is a global health problem, with lifestyle modification as its major therapeutic strategy. Rigorous characterization of dietary content on MAFLD in children is lacking. We hypothesized an objectively measured healthier diet would positively modulate MAFLD. Diet was assessed using the Nutrition Data System for Research in children enrolled from 10 tertiary clinical centers to determine the Healthy Eating Index (HEI, 0-100) and individual food components. In all, 119 children were included (13.3 ± 2.7y), 80 (67%) male, 67 (18%) White, and 90 (76%) Hispanic, with an average body mass index Z-score of 2.2 ± 0.5. Diet was classified as low HEI < 47.94 (n = 39), mid HEI ≥ 47.94 and < 58.89 (n = 41), or high HEI ≥ 58.89 (n=39). Children with high HEI (healthier diet) had lower body weight (p = 0.005) and more favorable lipids. Mean serum triglycerides for low, mid, and high HEI were 163, 148, and 120mg/dL, respectively; p = 0.04 mid versus high, p = 0.01 low versus high. Mean HDL was 38, 41 and 43mg/dL; p = 0.02 low vs high. Less severe steatosis was noted with added sugar ≤ 10% of calories (p = 0.03). Higher lobular inflammation is associated with a higher percentage of calories from fat (OR (95% CI) = 0.95 (0.91-1.00), p = 0.04). In children with MAFLD, high HEI is associated with lower body weight and more favorable lipids, while added sugar and fat intake has individual histologic features. Differential consumption of major dietary components may modify both metabolic risk factors and histologic liver injury, highlighting the importance of objective diet assessments in children with MAFLD.

Methylation of RUNX3 Promoter 2 in the Whole Blood of Children with Ulcerative Colitis.

Ulcerative colitis (UC) results from a complex interplay between the environment, gut microbiota, host genetics, and immunity. Runt-related transcription factor 3 (RUNX3) regulates Th1/Th2 balance and, thus, the synthesis of cytokines and inflammation. We aimed to analyze the dependence of RUNX3 promoter 2 (P2) methylation level on: age, sex, body mass index (BMI), C-reactive protein (CRP), serum albumin, disease duration, Pediatric Ulcerative Colitis Activity Index (PUCAI), the Paris classification, and exposure to medications. This multicenter, cross-sectional study recruited hospitalized children with UC. Methylation of RUNX3 P2 was measured with methylation-sensitive restriction enzymes in the whole blood DNA. Sixty-four children were enrolled, with a mean age of 14.5 ± 2.8 years. Half of them were female (51.6%), and the average BMI Z-score was −0.44 ± 1.14. The mean methylation of RUNX3 P2 was 54.1 ± 13.3%. The methylation level of RUNX3 P2 did not correlate with age, sex, nutritional status, CRP, albumin, PUCAI, or the extent of colitis (Paris E1–E4). RUNX3 P2 methylation did not differ between patients recruited within two and a half months of diagnosis and children who had UC for at least a year. Current or past exposure to biologics, immunosuppressants, or steroids was not associated with RUNX3 P2 methylation. Methylation of RUNX3 promoter 2 in whole blood DNA does not seem to be associated with the characteristics of UC in children.

Metabolic Effects of Recombinant Human Growth Hormone Replacement Therapy on Juvenile Patients after Craniopharyngioma Resection.

Objective: To investigate the effect of short-term recombinant human growth hormone (rhGH) replacement therapy on metabolic parameters in juvenile patients following craniopharyngioma (CP) resection. Methods. This retrospective study included 42 cases of juvenile patients that had undergone CP resection in the Department of Endocrinology at the Peking Union Medical College Hospital, from April 2013 to August 2020. According to whether they received growth hormone replacement therapy, the patients were divided into either the growth hormone replacement therapy (GHRT) group (30 cases) or the control group (12 cases). Changes in body mass index (BMI), BMI z-score, transaminase activity, fasting blood glucose (FBG) levels, blood lipid profile, and high-sensitivity C-reactive protein (hsCRP) levels were evaluated after one year of GHRT treatment. Results. The average age of the GHRT group was 13.00 (8.00–14.00) years old and these patients had undergone a CP operation an average of 2.00 (1.62–3.15) years earlier. Prior to receiving GHRT treatment, they received appropriate doses of adrenocortical hormone and thyroid hormone replacement therapy. After one year of GHRT treatment, the average BMI z-score decreased from 1.60 ± 1.76 to 1.13 ± 1.73 (P=0.005). Alanine aminotransferase (ALT) activity decreased from 26.50 (17.00∼98.00) U/L to 18.00 (13.00∼26.48) U/L (P ≤ 0.001), and similar changes were observed with regard to aspartate aminotransferase (AST) and glutamyl transferase (GGT) activity in the GHRT treatment group. The average total cholesterol (TC) decreased from 4.67 (4.10–6.14) mmol/L to 4.32 ± 0.85 mmol/L (P=0.002), and low-density lipoprotein (LDL) levels decreased from 3.05 ± 0.95 mmol/L to 2.56 ± 0.65 mmol/L (P=0.001) in the GHRT treatment group. The average blood urea nitrogen level decreased from 4.53 ± 1.09 mmol/L to 3.92 ± 0.82 mmol/L (P=0.016) and the average serum creatinine (SCr) level decreased from 55.59 ± 12.54 µmol/L to 51.15 ± 10.51 µmol/L (P=0.005) in the GHRT treatment group. The average hsCRP level decreased from 3.23 (1.79∼4.34) mg/L to 0.92 (0.42∼1.21) mg/L in the GHRT treatment group. In the control group, the average ALT activity increased from 26.58 ± 8.75 U/L to 42.58 ± 24.59 U/L (P=0.039), GGT activity increased from 19.0 (13.25–29.25) U/L to 25.00 (14.75–34.75) U/L (P=0.026), and LDL levels increased from 2.27 ± 0.76 mmol/L to 3.43 ± 1.28 mmol/L (P=0.04). Conclusion. GHRT treatment improves the metabolic parameters of juvenile patients that have undergone craniopharyngioma resection by reducing BMI z-scores, low-density lipoprotein, and hsCRP levels and improving liver function.

Progression of Obstructive Sleep Apnea Syndrome in Pediatric Patients with Prader-Willi Syndrome.

Obstructive sleep apnea syndrome (OSAS) is one of the most common comorbidities in patients with Prader–Willi syndrome (PWS) and causes significant consequences. This observational study was conducted to investigate the progression of OSAS in pediatric patients with PWS, who had not undergone upper airway surgery, through a longitudinal follow-up of their annual polysomnography results. Annual body mass index (BMI), BMI z-score, sleep efficiency and stages, central apnea index (CAI), obstructive apnea–hypopnea index (OAHI), and oxygen saturation nadir values were longitudinally analyzed. At enrollment, of 22 patients (10 boys and 12 girls) aged 11.7 ± 3.9 years, 20 had OSAS. During the 4-year follow-up, only two patients had a spontaneous resolution of OSAS. The average BMI and BMI z-score increased gradually, but CAI and OAHI showed no significant differences. After statistical adjustment for sex, age, genotype, growth hormone use, and BMI z-score, OAHI was associated with the BMI z-score and deletion genotype. In conclusion, OSAS is common in patients with PWS, and rarely resolved spontaneously. Watchful waiting may not be the best OSAS management strategy. Weight maintenance and careful selection of surgical candidates are important for OSAS treatment in patients with PWS.

Exploring the effect of socioeconomic development on child growth in posttransitional Croatia: a cross-sectional study.

To determine the relationship between socioeconomic development (SD) of local administrative units (LAU) and the height and body mass index (BMI) of second- and third-grade children in Croatia. We analyzed average height-for-age and BMI-for-age z-scores of 99 LAUs, based on the measurement of 5662 children participating in the Childhood Obesity Surveillance Initiative Croatia. SD was defined according to the governmental Development index. Pearson's correlations between average height and BMI z-scores and SD were calculated. We used ANOVA to test differences in average height and BMI z-scores among LAUs from different SD quartiles and multiple linear regression to investigate the association between average height-for-age z-scores and SD. Height-for-age was significantly correlated with SD. We found a difference in average height-for-age between the least and more developed LAUs. A multiple linear regression model showed significant association between Development index and the average height-for-age z-score (F = 13.085, p < 0.001, R2 = 0.119). This finding is important for creators of policies worldwide as socioeconomic inequalities in children's height may exist in other countries that, like Croatia, have recently gone through the transition process.

Caesarean delivery is associated with higher risk of overweight in the offspring: within-family analysis in the SUN cohort

BackgroundMost studies assessing the association between caesarean delivery (CD) and childhood overweight/obesity have failed to account for important confounders, such as maternal prepregnancy body mass index (BMI) or the indication...

Baseline characteristics of gender dysphoric youth.

Background Limited information is available regarding baseline characteristics of children and adolescents with gender dysphoria (GD). The purpose of this retrospective study was to describe baseline characteristics of pediatric patients referred for GD. Methods A retrospective chart review of pediatric patients with GD referred to the pediatric endocrine clinic between 2002 and 2017 was conducted. Body mass index (BMI) percentiles and z-scores were calculated based on height and weight at the initial visit. Results Seventy-eight patients aged 14.9±2.37 years were identified. Of these, affirmed gender was more often male than female (63% vs. 37%, p=0.024). Although no difference was seen in average BMI z-scores between female to male (FTM) and male to female (MTF) patients, approximately 50% were overweight or obese. A higher incidence of anxiety was present in FTM compared with MTF youth (p=0.05). Fifty-six patients were referred in January 2014 or later, of whom 27% had a history of early expression of GD compared with 55% of those seen prior to 2014 (p=0.061). Conclusions The high prevalence of overweight in TG youth at baseline represents a potential risk for adverse health consequences. There appears to be a change in the age of first manifestation of GD over time.

How Healthy Is Homeschool? An Analysis of Body Composition and Cardiovascular Disease Risk.

Public school children regularly participate in school-based physical activity, physical education, and fitness testing. However, almost 2million American children are homeschooled. The purpose of this research was to assess the body composition of elementary school-aged homeschool children and their corresponding cardiovascular disease (CVD) risk. This research explored the body composition and CVD risk of 145 homeschool children aged 5-11 years using body mass index (BMI), percent body fat, and waist circumference. Chi-square and Mann-Whitney U tests examined differences in CVD risk within the homeschool population. Overall, homeschool children had average BMI z-scores (SD [range]) with a mean of -0.11 (0.97 [-3.47 to 2.53]). Unhealthy classifications were seen in 11.2% of the sample by BMI, 19.6% by percent body fat, and 49.7% by waist circumference. Statistical analysis revealed no difference in CVD risk between sexes (χ2 (1) = 0.062, p = .804) or ethnicities (χ2 (1) = 0.927, p = .336) but increased prevalence in children aged 5-9 years (U = 1427, z = -4.559, p < .001). Almost half of elementary school-aged homeschool children showed increased risk for CVD and need regular assessment of central adiposity.

Compliance with the Australian 24-hour movement guidelines for the early years: associations with weight status

BackgroundFor effective public health and surveillance it is important to document the proportion of young children who meet the new Australian Integrated 24 h Movement Guidelines for the Early Years and how these associate with health outcomes. We aimed to (i) assess compliance with the new Integrated 24 h Movement Guidelines for the Early Years in a sample of Australian toddlers; and (ii) ascertain whether compliance with the guidelines associates with weight status.MethodsThe sample comprised 202 toddlers (104 girls) aged 19.74 ± 4.07 months from the GET UP! Study. Participants wore accelerometers (Actigraph GT3X+) for 24 h over 7 consecutive days to assess physical activity, sedentary time and sleep. Parents reported participants’ screen time. Weight and height were measured and body mass index (BMI) z-scores by age and sex were calculated. Analysis of Covariance (ANCOVA) was performed to test differences in BMI z-scores between participants complying with (i) none or any individual guideline, (ii) any combination of meeting two guidelines, and (iii) those who met all three guidelines, adjusting for child age, gender and socioeconomic status.ResultsOnly 8.9% of the sample met the overall 24 h movement guidelines. Most of the sample met the physical activity (96.5%) and sleep (79.7%) guidelines but only 11.4% met the sedentary behavior guideline. Average BMI Z-scores did not significantly differ between children who complied with none or any individual guideline, any combination of meeting two guidelines, and those who met all three guidelines (p > 0.05). Although the lack of significant differences, participants who accomplished any combination of two guidelines or all three guidelines appear to have had a lower BMI Z-score than those complying with one of the guidelines or none.ConclusionsJust under 9% of our sample met the overall Australian 24 h Movement Guidelines for the Early Years. BMI was not associated with the accomplishment of any of the 24-h Movement Guidelines. Strategies to promote adherence to the 24-h movement guidelines in toddlers, particularly for screen time, are necessary, as promoting health-related behaviors in early childhood has the potential to provide children a strong foundation for lifelong physical and mental health.

Gene-by-environment interactions of the CLOCK, PEMT, and GHRELIN loci with average sleep duration in relation to obesity traits using a cohort of 643 New Zealand European children

ObjectivesModern technology may have desensitised the ‘biological clock’ to environmental cues, disrupting the appropriate co-ordination of metabolic processes. Susceptibility to misalignment of circadian rhythms may be partly genetically influenced and effects on sleep quality and duration could predispose to poorer health outcomes. Shorter sleep duration is associated with obesity traits, which are brought on by an increased opportunity to eat and/or a shift of hormonal profile promoting hunger. We hypothesised that increased sleep duration will offset susceptible genetic effects, resulting in reduced obesity risk. MethodsWe recruited 643 (male: 338; female: 305) European children born to participants in the New Zealand centre of the International Screening for Pregnancy Endpoints sleep study. Ten genes directly involved in the circadian rhythm machinery and a further 20 genes hypothesised to be driven by cyclic oscillations were evaluated by Sequenom assay. Multivariable regression was performed to test the interaction between gene variants and average sleep length (derived from actigraphy), in relation to obesity traits (body mass index (BMI) z-scores and percentage body fat (PBF)). ResultsNo association was found between average sleep length and BMI z-scores (p = 0.056) or PBF (p = 0.609). Uncorrected genotype associations were detected between STAT-rs8069645 (p = 0.0052) and ADIPOQ-rs266729 (p = 0.019) with differences in average sleep duration. Evidence for uncorrected gene-by-sleep interactions of the CLOCK-rs4864548 (p = 0.0039), PEMT-936108 (p = 0.016) and GHRELIN-rs696217 (p = 0.046) were found in relation to BMI z-scores but not for PBF. ConclusionOur results indicate that children may have different genetic susceptibility to the effects of sleep duration on obesity. Further confirmatory studies are required in other population cohorts of different age groups.

Validity of a simplified screening instrument for assessing overweight children in a dental setting: a cross sectional study

BackgroundObesity, with its rising prevalence among Canadians and its estimated cost of $2 billion annually in Canada, is no longer considered a cosmetic issue, but a major health issue that imposes a great burden on the healthcare system and economy. This cross sectional study aims to evaluate the feasibility of identifying the weight status of 6 to 11 year-old children in a university dental clinic using a simplified overweight screening instrument.MethodsOne hundred sixty eight healthy children were enrolled. Weight and height were measured and overweight/obesity status was assessed using two techniques: 1) the 2007 World Health Organization Body Mass Index (BMI)-for-age reference Tables, 2) simplified overweight screening instrument without BMI calculation. Measures of overall, positive, and negative percent agreement between the two approaches were computed.ResultsThe children’s average weight, height, BMI and BMI z-score were respectively 32.6 ± 9.5 kg, 133.8 ± 10.7 cm, 17.8 ± 3.2, and 0.4 ± 1.0. The overall, positive, and negative percent agreement between the two screening approaches were respectively, 89%, 100%, and 83%.ConclusionThis study demonstrated the feasibility and parental acceptance of weight, height and BMI measurement in a dental setting and evidence that supports the validity of a new simplified approach to assess children’s weight status without having to compute BMI.Trial registrationNCT02637752. Registered 18 December 2015.

Outcome Evaluation of a Policy-Mandated Lifestyle and Environmental Modification Program in a National Job Training Center.

Excess weight gain is common when adolescents become young adults, but there are no obesity prevention or weight management interventions that have been tested for emerging adults who follow non-traditional post-secondary paths, such as enrolling in job training programs. We evaluated Healthy Eating & Active Lifestyles (HEALs), a policy-mandated lifestyle education/environmental modification program, at a job training center for low-income 16-24year olds. We examined average change in body mass index (BMI) z-score from baseline to 6months for emerging adults (aged 16-24years) in pre-HEALs implementation (n = 125) and post-HEALs implementation (n = 126) cohorts living at the job training center, by baseline weight status. In both cohorts, average BMI z-score significantly increased from baseline to 6months for students with BMI < 25. Average BMI z-score significantly decreased for the overweight (BMI 25 to <30; -0.11, p = .03) and obese (BMI ≥ 30; -0.11, p = .001) students only within the post-HEALs cohort; changes within the pre-HEALs cohort and between cohorts were not significant. HEALs may promote positive weight-related trends for overweight/obese students, but prevention efforts for non-overweight/obese students need to be improved.

Pediatric Idiopathic Intracranial Hypertension: Age, Gender, and Anthropometric Features at Diagnosis in a Large, Retrospective, Multisite Cohort

To examine anthropometric and maturational characteristics at diagnosis in pediatric idiopathic intracranial hypertension (IIH). Retrospective, international, multisite study. Pediatric patients (2-18 years of age at diagnosis) with IIH. Body mass index (BMI), height, and weight Z-scores; sexual maturation. Cases of IIH were identified retrospectively based on diagnostic code, pediatric neuro-ophthalmologist databases, or both and updated diagnostic criteria (2013) were applied to confirm definite IIH. Anthropometric measurements were converted into age- and gender-specific height, weight, and BMI Z-scores CDC 2000 growth charts. When available, sexual maturation was noted. Two hundred thirty-three cases of definite IIH were identified across 8 sites. In boys, a moderate association between age and BMI Z-scores was noted (Pearson's correlation coefficient, 0.50; 95% confidence interval [CI], 0.30-0.66; P < 0.001; n= 72), and in girls, a weak association was noted (Pearson's correlation coefficient, 0.34; 95% CI, 0.20-0.47; P < 0.001; n= 161). The average patient was more likely to be overweight at diagnosis at age 6.7 years in girls and 8.7 years in boys, and obese at diagnosis at age 12.5 years in girls and 12.4 years in boys. Compared with age- and gender-matched reference values, early adolescent patients were taller for age (P= 0.002 in girls and P= 0.02 in boys). Data on Tanner staging, menarchal status, or both were available in 25% of cases (n= 57/233). Prepubertal participants (n= 12) had lower average BMI Z-scores (0.95±1.98) compared with pubertal participants (n= 45; 1.92±0.60), but this result did not reach statistical significance (P=0.09). With updated diagnostic criteria and pediatric-specific assessments, the present study identifies 3 subgroups of pediatric IIH: a young group that is not overweight, an early adolescent group that is either overweight or obese, and a late adolescent group that is mostly obese. Data also suggest that the early adolescent group with IIH may be taller than age- and gender-matched reference values. Understanding these features of pediatric IIH may help to illuminate the complex pathogenesis of this condition.

Associations Between Adolescents' Weight and Maladjustment Differ With Deviation From Weight Norms in Social Contexts.

In line with the reflected self-appraisal hypothesis, previous research finds associations between weight and maladjustment are strongest when there is a mismatch between individuals' weight and the weight norm of their social contexts. However, research has not considered associations in more proximal social contexts. We examined differences in associations between weight and maladjustment for 2 proximal social contexts: grade-level peers and friendship groups. We used sixth-graders (N = 565; Mage = 12 years) self-reported height and weight (used to calculate body mass index (BMI) z-score), experiences of peer victimization, and depressive symptoms. Deviation from the normative weight was calculated as the students' BMI z-score minus the average BMI z-score for the context (grade-level peers or friendship group). Considering deviations from grade-level peers, greater BMI z-scores were associated with more self-reported peer victimization only for students above the weight norm. For the friendship group, greater weight was associated with more self-reported depressive symptoms only for those who were above the normative weight. Being heavier during adolescence may be especially problematic for students who differ from the norm in their proximal social contexts. Intervention efforts focused on weight and maladjustment may want to consider the contexts involved in adolescents' self-appraisals.

(1138) - Nutritional Status of Children Undergoing Heart Transplantation at the Heart Institute of São Paulo (Incor) between 2013-2015

Congestive heart failure in children presents as an increased risk for malnutrition, due to cardiac cachexia and increased metabolic demand. The effect of malnutrition on adults undergoing heart transplantation (HTx) has been well-studied; however there are few data on pediatric population. The goal of our study was to analyse the nutritional status of children undergoing HTx at the Heart Institute of Sao Paulo (Incor), Brazil. We conducted a retrospective analysis of the medical records of all pediatric patients who underwent HTx between 2013 and 2015. Fifty-five patients were submitted to heart transplantation (28 girls and 27 boys), with an average age of 10 years. The average height was 127 cm ( median 131 cm, standard deviation (stdev) 32 cm), and the average Z-score according to world health organization (WHO) growth charts was -1,12 (median -0,97; stdev 2,01). The average body mass index Z-score according to world health organization (WHO) growth charts was -1,75 (median -0,8; stdev 1,7). We used the WHO definition for thinness, which is BMI Zscore<-2. There were 15 patients (27%) with diagnosis of thinness, of whom 7 had severe thinness (BMI Zscore<-3). There were no obese patients. Wasting was present in 18% of patients with congenital heart disease and 35% of patients with cardiomyopathy. There were 6 boys whose BMI Zscore was below -2, and 9 girls were under the same condition. Among the patients who died after heart transplantation, 31% were thin or severely thin before the procedure, while among those who survived heart transplantation, 28% were thin or severely thin. The data shows a tendency towards malnutrition at the time of HTx, which may impact on the outcome of the procedure.

The Recession is Associated with Increased Risk of Overweight and Obesity Among Children in California

BackgroundCalifornians experienced a significant decrease in economic resources during the Recession, however, the effect of the Recession on children's weight status is virtually unexplored.ObjectiveTo assess the effect of the Recession on body mass index (BMI) z‐score and risk for child overweight (BMI 蠅85th percentile) and obesity (BMI 蠅95th percentile).MethodsWe used longitudinal anthropometric measurements from fitness testing of children aged 7‐18 years in California, between 2008 and 2012. The Recession was assessed using the combined value of county‐level annual unemployment rates and foreclosure rates (unemployment rate + foreclosure rate). Individual fixed‐effects regression models with clustered standard errors tested the association of county‐level recession indicators with BMI z‐score and overweight and obesity risk. All models included child age and allowed the association between the Recession and weight status to vary by baseline socioeconomic status (SES).ResultsChildren (N= 6,112,953) had an average BMI z‐score (standard deviation) of 0.53 (1.16), and overweight/obesity prevalence of 36.2%. Average unemployment (11.0%) and foreclosure (6.7%) were considerable. The Recession was associated with an increased BMI z‐score (β= 0.073; 95% CI: 0.066, 0.080) and increased risk of overweight (β = 0.012; 95% CI: 0.011, 0.013) and obesity (β = 0.008; 95% CI: 0.007, 0.009). Larger increases in BMI z‐score and overweight and obesity were seen among children in counties with higher baseline SES.ConclusionsComparing children to themselves over time, increasing county‐level Recession indicators were associated with greater gains in BMI z‐score and increased risk of overweight and obesity.

What Can Providers Learn From Childhood Body Mass Index Trajectories: A Study of a Large, Safety-Net Clinical Population

ObjectiveTo describe childhood weight gain using body mass index (BMI) z-score trajectories in a low-income urban safety-net population and identify among gender- and race/ethnicity-specific groups any trends for increased risk. MethodsA retrospective cohort study was conducted among 2- to 12-year-old patients (2006–2013) visiting a safety-net provider. BMI z-score trajectories were calculated overall, for gender- and race/ethnicity-specific groups, and for peak BMI percentile subgroups to describe weight gain longitudinally. ResultsFrom 2006 to 2013, a total of 26,234 eligible children were followed for an average of 3.7 years. At baseline (mean age, 4.2 years), 74% of patients were at a normal weight compared to 65% at most recent observation (mean age, 7.8 years). All gender and race/ethnicity subgroups showed increasing average BMI z-scores during childhood. Children consistently under the 50th percentile and those of white race had the most stable BMI z-score trajectories. BMI z-score increased with increasing age in all subgroups. Hispanic boys and black girls had the most significant increase in BMI z-score during this observation period. Children observed in early childhood and whose BMI exceeded the 95th percentile at any time were often already overweight (20%) or obese (36%) by 3 years of age. ConclusionsThe entire population demonstrated an upward trend in BMI z-score trajectory. This trend was most notable among black girls and Hispanic boys. Many obese children were already overweight by age 3, and persistence of obesity after 3 years of age was high, suggesting that intervention before age 3 may be essential to curbing unhealthy weight trajectories.

Children consuming milk cereal drink are at increased risk for overweight: The IDEFICS Sweden study, on behalf of the IDEFICS Consortium.

The aims of this study were to characterize milk cereal drink (MCD) consumption among Swedish children and to investigate the association between MCD and overweight in a longitudinally followed cohort of children over 2 years of age. In the Swedish cohort from IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) we examined early feeding practices and weight status when children were aged 2-9 years (2007/2008) and at 2-year follow-up. Weight and height were measured at both time points in 1077 children. Characteristics of MCD consumers were explored with logistic regression. Body mass index (BMI) z-scores at both time points and weight status at follow-up were regressed on explanatory factors using mixed linear and logistic regression, respectively. Nearly 69% of children had consumed MCD. The MCD consumers were more likely than never-consumers to have two native Swedish parents, parents with less than 2 years of post-secondary education, and a shorter period of breastfeeding. MCD consumers had a higher BMI z-score at follow-up compared with baseline (difference in BMI z-score=0.12, 95% confidence interval (CI)=0.07, 0.17), while the average BMI z-score in non-consumers remained stable over time (0.00, 95% CI= -0.07, 0.07). MCD consumers were nearly five times more likely than non-consumers to become overweight during the follow-up (odds ratio (OR)=4.78, 95% CI=1.68, 13.59), independent of breastfeeding. MCD was consumed by the majority of children in this study. MCD consumption is associated with an increased risk for overweight and less exposure to breastfeeding. Our findings motivate future research aimed at investigating how MCD should be recommended.

In Utero DDT Exposure and Obesity and Metabolic Syndrome in Children of Farmworkers

Background: In utero exposure to endocrine disrupting compounds including dichlorodiphenyltrichloroethane (DDT) has been hypothesized to increase risk of obesity later in life. Aims: The Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study is a longitudinal birth cohort of low-income Latinas living in a California agricultural community. We examined the relation of in utero DDT exposure to obesity and metabolic syndrome at 9 years. Methods: We included 261 children with p,p’-DDT and p,p’-DDE concentrations measured in maternal serum collected during pregnancy (ng/g lipid) and complete 9-year follow-up data. Age- and sex-specific body mass index (BMI) Z-scores were calculated from WHO Child Growth Standards. Overweight/obese was defined as BMI Z-score ?85th percentile for age and sex. Metabolic syndrome was defined by the International Diabetes Federation criteria for children &lt;10 years, waist circumference ?90th percentile for age and sex. Results: At 9 years, average BMI Z-score was 1.10 (±1.08), 56.3% of children were overweight or obese, and 42.2% had metabolic syndrome. In boys, a 10-fold increase in maternal serum p,p’-DDT was associated with BMI Z-score (adj-?=0.27, 95% CI 0.08, 0.46) and overweight/ obese status (adj-OR=2.3, 95% CI 1.1, 4.6), but not metabolic syndrome (adj-OR=1.7, 95% CI 0.98, 2.8). Also among boys, a 10-fold increase in maternal serum p,p’-DDE was associated with overweight/obese status (adj-OR=2.1, 95% CI 1.0, 4.3), but not with BMI Z-score (adj-?=0.22, 95% CI -0.03, 0.48) or metabolic syndrome (adj-OR=1.5, 95% CI 0.7, 2.9). Neither DDT nor DDE were related to any of the outcomes in girls. Conclusion: We found a significant positive relation between in utero DDT exposure and BMI Z-score and overweight/obese status of 9-year-old CHAMACOS boys. Continued follow-up through puberty will be informative.

Qui sont les adolescents consultant pour demande de prise en charge d’une obésité dans une Maison des adolescents ? Phénotypes d’une cohorte de 200 patients

Common obesity is a frequent reason for outpatient visits to adolescent clinics. Its high risk of persistence or progression into adulthood is well known. This article is a study of 200 clinical charts of obese adolescents that visited our clinic. The physical, metabolic, psychological, and social characteristics of these patients when they first started their follow-up are described. Body image disturbance and the everyday psychosocial impact of obesity were the most frequent reasons for the first visit. Two-thirds of the adolescent girls had already had unsuccessful follow-ups by other teams or doctors. The average age was 14.5 years and the average body mass index z-score was above 7.4. They suffered from musculoskeletal or respiratory disorders but had few metabolic complications at that stage. Various personal or family psychological and social characteristics were frequently observed as well as certain types of eating disorders. This data may be useful in establishing different profiles that could be used to adapt obese patient care for adolescents.