Child Body Mass Index Z-score Research Articles

Unlocking Health Literacy: investigating Parental Health Literacy and Child Weight Outcomes

Abstract Background While parental health literacy (HL) is widely recognized as crucial for child health, research on its impact on children’s weight-related outcomes remains limited. This study aims to fill this gap by investigating the associations between parental HL and children’s anthropometric measurements, with a focus on child BMI Z-score and waist-to-height ratio (WHtR). Methods As part of a cluster randomized trial in primary schools serving vulnerable populations, 735 children (51.7% boys, mean age 7.7 years) participated. Parental HL was assessed using the HLS-Q12 questionnaire, comprising 12 items. Health literacy levels, standardized from 0 to 100, were categorized into ‘inadequate,’ ‘problematic,’ ‘sufficient,’ and ‘excellent’ HL. General HL and three specific domains-health promotion, disease prevention, and healthcare-were computed. Children’s weight, height, and BMI were measured following standardized procedures. Regression analyses examined HL’s impact on BMI Z-scores and WHtR. Results Parents with higher HL in disease prevention and health promotion had children with significantly lower BMI Z-scores, even after adjusting for parental education and children’s sex sex [-0.010 (-0.18; -0.0001) and -0.10 (-0.019; 0.01). Similar associations were found for WHtR [-0.0004 (-0.001; -0.0001)]. Parents with excellent HL in general and health promotion had significantly lower WHtR [-0.027 (-0.046; -0.008)] and BMI Z-score [-0.74 (-1.2; -0.28)]. Conclusions This study highlights the significant role of parental health literacy in shaping children’s weight-related outcomes. Higher levels of parental HL in disease prevention and health promotion were linked to lower BMI Z-scores and WHtR in children, independent of parental education and children’s sex. Enhancing parental HL, alongside promoting healthy behaviors and environments for children, could lead to more effective approaches for addressing this public health issue. Key messages • Parental health literacy is associated with children’s weight outcomes, emphasizing the need for HL-focused interventions. • Higher parental HL is associated with lower child BMI Z-scores and waist-to-height ratios, highlighting potential HL’s role in combating childhood obesity.

Parenting Practices to Prevent Childhood Obesity Among Hispanic Families: A Systematic Literature Review.

Background: Childhood obesity disproportionately affects Hispanic families and remains an unresolved public health concern. Interventions to enhance health-related parenting practices may be a promising strategy to lower the risk for childhood obesity. However, there are scarce data on which parenting practices would be culturally relevant and contribute to lower the risk for childhood obesity among Hispanic families in the United States. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. An electronic database search of records was carried out in PubMed, CINAHL, PsycINFO, and Scopus to synthesize studies assessing associations or intervention effects of parenting practices on child BMI or other anthropometric measure among Hispanic parent-child dyads aged ≥18 and 2-12 years, respectively. Results: Of 1055 unique records identified, 17 studies were included. Most of these studies used a cross-sectional design (n = 10) and child BMI z-scores or BMI-for-age-sex percentiles as the outcome variable. Parenting practices to lower the risk for child overweight/obesity among Hispanic families included setting limits and providing routines (e.g., limited screentime), supporting a healthy lifestyle and physical activity (e.g., providing transportation to places for children's physical activities), and parenting feeding or diet-related practices (e.g., control the foods that children eat). Conclusion: Parenting practices that support healthy behaviors may be components of interventions to lower the risk for childhood obesity among Hispanic families.

Growth Parameters and Prevalence of Obesity in PKU Patients and Peers: Is This the Right Comparison?

One of the main objectives of Phenylketonuria (PKU) management is represented by optimising the growth trend under restricted protein diet regimen. The data on long-term growth in PKU children are limited and mostly based on earlier studies. The data for this twelve-year longitudinal study were collected from 34 PKU children and 37 healthy peers, whose auxological parameters were taken at 7 time-points over the follow-up. The weight-for-length ratio (WLR) z-score and body mass index (BMI) z-score were considered according to age. Prevalence of overweight/obesity was evaluated at last assessment. The median BMI z-score of PKU children was normal and not statistically different from that of controls on all the seven time-point assessments. Their distributions tended to be wider than those of peers, with the upper limit exceeding the normal range since 12 months old, with a peak specifically at 3 years of age. In controls, there was a tendency to approach the BMI z-score values of overweight in later childhood. The prevalence of overweight was comparable (29% vs. 25%, p: 0.78) between the two groups at last assessment, and obese subjects (3/37) were only detected in the control group. In this study, we report data from a long-term follow-up on growth, highlighting that the median BMI z-score of PKU children was normal and not statistically different from that of controls. Also, the prevalence of obesity at 12 years of age was overlapping. However, the high prevalence of overweight children in the general population may explain the lack of difference and does not reassure about patients' nutritional risk.

Feasibility of a culturally adapted technology-delivered, family-based childhood obesity intervention for Latino/Hispanic families in rural Nebraska: the Hispanic Family Connections study protocol

IntroductionAddressing childhood obesity risk factors like home environment, parental roles, excess weight, physical activity and healthy eating among Latino/Hispanic (L/H) families living in rural communities is an important priority. However,...

A growth curve model to estimate longitudinal effects of parental BMI on Indonesian children's growth patterns.

The global surge in childhood obesity is also evident in Indonesia. Parental body mass index (BMI) values were found to be one of the major determinants of the increasing prevalence of childhood obesity. It is uncertain if parental BMI during their offspring's childhood significantly affects their children's BMI trajectories into adulthood. We aimed to investigate the influence of parental BMI Z-scores on BMI trajectories of Indonesian school-aged children, with a focus on sex-specific effects. This study utilized data from the Indonesian Family Life Survey and tracked the same respondents over four time points, from wave 2 (1997-1998) to wave 5 (2014-2015). The sample of this study consisted of children aged 5-12 years in wave 2 for whom height and weight data were available. We utilized a two-level growth curve model to account for the hierarchical structure of the data, with time nested within individual children. Fathers' BMI Z-scores in wave 2 had a pronounced influence (β = 0.31) on female children's BMI Z-scores compared to the influence of mothers' BMI Z-scores (β = 0.17). Mothers' BMI Z-scores in wave 2 showed a stronger positive association with male children's BMI Z-scores (β = 0.22) than did the father's BMI Z-scores (β = 0.19). A significant interaction of fathers' BMI Z-scores and years of follow-up was found for male children. As male children's BMI Z-scores increased by year, this effect was stronger in those whose fathers' BMI Z-scores were at a higher level. In conclusion, we found that parental BMI values profoundly influenced their children's BMI trajectories.

Interventions for the prevention of weight gain during festive and holiday periods in children and adults: A systematic review.

Some periods during the year, such as festive and summer holiday periods, have been associated with weight gain. We aimed to assess the effect of interventions for the prevention of body weight gain during festive and holiday periods in children and adults. A systematic search was conducted in six databases and supplementary sources until January 4, 2023. We included randomized controlled trials (RCTs), cluster-RCTs, and non-RCTs. Our primary outcome measure was the change in body weight in adults or the change in BMI z-score or BMI percentile in children and adolescents. From 4216 records, 12 primary studies (from 22 reports) met the inclusion criteria-10 from the United States, one from the United Kingdom, and one from Chile. Two studies had a low risk of bias, two moderate, seven high, and one critical risk of bias. The meta-analysis in children included four of seven studies during the summer holidays (six interventions) and showed a mean difference in BMI z-score favoring the intervention group (-0.06 [95% CI -0.10, -0.01], p = 0.01, I2= 0%, very low certainty evidence). The meta-analysis in adults included five studies during festive periods with a mean difference in weight favoring the intervention group (-0.99 kg [95% CI -2.15, 0.18], p = 0.10, I2= 89%, very low certainty evidence). This review has highlighted potential interventions to prevent the increase in body weight during holiday periods. More work is needed to improve the quality of the evidence and to extend it to countries outside of the United States and United Kingdom and to the adolescent population.

Associations between Exposure to Perfluoroalkyl Substances at Preconception and BMI Z-Scores in Children from Singapore

Associations between Exposure to Perfluoroalkyl Substances at Preconception and BMI Z-Scores in Children from Singapore

Prenatal EDC exposure, DNA Methylation, and early childhood growth: A prospective birth cohort study

BackgroundExposure to endocrine-disrupting chemicals (EDCs) has been found to be associated with growth and developmental abnormalities in children. However, the potential mechanisms by which exposure to EDCs during pregnancy increases the risk of obesity in children remain unclear. ObjectiveWe aimed to explore associations between prenatal EDC exposure and the body mass index (BMI) of children at age two, and to further explore the potential impact of DNA methylation (DNAm). MethodThis study included 285 mother–child pairs from a birth cohort conducted in Wuhan, China. The BMI of each child was assessed at around 24 months of age. The concentrations of sixteen EDCs at the 1st, 2nd, and 3rd trimesters were measured using ultra-high performance liquid chromatography coupled to a triple quadrupole mass spectrometer. The research utilized general linear models, weighted quantile sum regression, and Bayesian Kernel Machine Regression to assess the association between prenatal EDC exposure and childhood BMI z-scores (BMIz). Cord blood DNAm was measured using the Human Methylation EPIC BeadChip array. An epigenome-wide DNAm association study related to BMIz was performed using robust linear models. Mediation analysis was then applied to explore potential mediators of DNAm. ResultsUrinary concentrations of seven EDCs were positively associated with BMIz in the 1st trimester, which remained significant in the WQS model. A total of 641 differential DNAm positions were associated with elevated BMIz. Twelve CpG positions (annotated to DUXA, TMEM132C, SEC13, ID4, GRM4, C2CD2, PRAC1&PRAC2, TSPAN6 and DNAH10) mediated the associations between urine BP-3/BPS/MEP/TCS and elevated BMIz (P < 0.05). ConclusionOur results revealed that prenatal exposure to EDCs was associated with a higher risk of childhood obesity, with specific DNAm acting as a partial mediator.

Maternal phthalate exposure and BMI trajectory in children-an 18-year birth cohort follow-up study.

Obesity is a major health concern worldwide. Previous studies have suggested that phthalate plasticizers are obesogens. However, the relationship between early-life phthalate exposure and long-term obesity development remains unknown. We investigated the association between prenatal phthalate exposure and children's body mass index (BMI) patterns in an 18-year birth cohort follow-up study in Taiwan. Our analytical lab quantified seven phthalate metabolites in maternal urine during pregnancy using quantitative liquid chromatography-tandem mass spectrometry. In addition, we calculated BMI z scores for participated children at each follow-up, utilized trajectory analysis to describe children's BMI z-score patterns at 2-18 years of age, and adopted generalized estimating equations (GEE) and multivariate logistic regression models to assess the association between prenatal phthalate exposure and BMI z scores in children. A total of 208 mother-child pairs were included in the analysis. Maternal urinary diethyl phthalate (DEP) metabolites were associated with the increase of BMI z scores in children aged 2-18 years in the GEE model. Doubled maternal urinary ∑mDEHP (3 mono hexyl-metabolites of di-ethyl-hexyl phthalate (DEHP) increased the risk of children being in the stable-high BMI trajectory group until the age of eighteen. We observed that BMI trajectories of children remained stable after the age of 5 years. During each follow-up, a higher frequency of overweight or obese was observed in children, ranging from 15.9% to 35.6% for girls and 15.2-32.0% for boys, respectively. Prenatal phthalate exposure was associated with increasing BMI z scores in children. Prenatal DEHP exposure was associated with a stable-high BMI trajectory in children up to the age of 18 years.

Maternal concern and perception about child overweight risk, maternal feeding practices, and child eating behaviors: A cross-sectional study.

Abundant efforts have been directed to understand the global obesity epidemic and related obesogenic behaviors. However, the relationships of maternal concern and perception about child weight with child eating behaviors in Saudi Arabia have not been investigated. Therefore, this study aimed to examine the associations of maternal concern and perception about child overweight risk with maternal feeding practices and child eating behaviors among mothers and their children in Saudi Arabia. Mothers of 115 children aged 3-5 years old were recruited from eight preschools. Child eating behaviors (enjoyment of food, responsiveness to foods, food fussiness, satiety responsiveness, and slowness in eating) and maternal feeding practices (restriction, monitoring, and using food as a reward), maternal concern about child weight, and maternal perception about child overweight risk were assessed using validated questionnaires. Multiple linear regression models, adjusted for maternal body mass index (BMI) and child's BMI-z score and sex, were tested to examine the independent associations of maternal concern and perception about child overweight risk with child eating behaviors and maternal feeding practices. Maternal concern about child weight was positively associated with food enjoyment in children (B = 0.14 [95% confidence intervals = 0.02,0.27]) and responsiveness to food (B = 0.16 [0.03,0.29]), whereas a negative association with child food fussiness was observed (B = -0.19 [-0.33, -0.04]). Maternal perception about child overweight risk and child slowness in eating were negatively associated (B = -0.72 [-0.16 to -0.28]). Maternal concern and perception about child overweight risk were not associated with maternal feeding practices. In conclusion, maternal concern and perception about child overweight risk were found to be associated with food approach eating behavior traits but not with maternal feeding practices. Mothers who are concerned about child weight or perceive their children as overweight may need guidance and support to promote healthy eating behaviors among their children. Future cross-cultural studies are needed to understand the underlying mechanisms for the influence of maternal concern and perception about child overweight risk on maternal feeding practices, child eating behaviors, and weight status of children.

P345 BMI (Z-scores) in children with cystic fibrosis improved despite comparable energy and nutritional intake following the introduction of elexacaftor/tezacaftor/ivacaftor therapy

P345 BMI (Z-scores) in children with cystic fibrosis improved despite comparable energy and nutritional intake following the introduction of elexacaftor/tezacaftor/ivacaftor therapy

Predicting higher child BMI z-score and obesity incidence in Malaysia: a longitudinal analysis of a dynamic cohort study.

To target public health obesity prevention, we need to predict who might become obese i.e. predictors of increasing Body Mass Index (BMI) or obesity incidence. Predictors of incidence may be distinct from more well-studied predictors of prevalence, therefore we explored parent, child and sociodemographic predictors of child/adolescent BMI z-score and obesity incidence over 5 years in Malaysia. The South East Asia Community Observatory in Segamat, Malaysia, provided longitudinal data on children and their parents (n = 1767). Children were aged 6-14 years at baseline (2013-14) and followed up 5 years later. Linear multilevel models estimated associations with child BMI z-score at follow-up, adjusting for baseline BMI z-score and potential confounders. Predictors included parent cardiometabolic health (overweight/obesity, central obesity, hypertension, hyperglycaemia), and socio-demographics (ethnicity, employment, education). Logistic multilevel models explored predictors of obesity incidence. Higher baseline BMI z-score predicted higher follow-up BMI z-score both in childhood to late adolescence (0.60; 95% CI: 0.55, 0.65) and early to late adolescence (0.76; 95% CI: 0.70, 0.82). There was inconsistent evidence of association between child BMI z-score at follow-up with parent cardiometabolic risk factors independent of baseline child BMI z-score. For example, maternal obesity, but not overweight, predicted a higher BMI z-score in childhood to early adolescence (overweight: 0.16; 95% CI: -0.03, 0.36, obesity: 0.41; 95% CI: 0.20, 0.61), and paternal overweight, but not obesity, predicted a higher BMI z-score in early to late adolescence (overweight: 0.22; 95% CI: 0.01, 0.43, obesity: 0.16; 95% CI: -0.10, 0.41). Parental obesity consistently predicted five-year obesity incidence in early to late adolescence, but not childhood to early adolescence. An adolescent without obesity at baseline with parents with obesity, had 3-4 times greater odds of developing obesity during follow-up (incidence OR = 3.38 (95% CI: 1.14-9.98, mother) and OR = 4.37 (95% CI 1.34-14.27, father) respectively). Having a higher BMI z-score at baseline was a stronger predictor of a higher BMI z-score at follow-up than any parental or sociodemographic factor. Targeting prevention efforts based on parent or sociodemographic factors is unwarranted but early childhood remains a key period for universal obesity prevention.

Postpartum Obesity Is Associated With Increases in Child Adiposity in Midchildhood in a Cohort of Black and Dominican Youth

BackgroundObesity disproportionately affects marginalized and low-income populations. Birth parent obesity from the prenatal period and childhood has been associated with child obesity. It is unknown whether prenatal or postnatal birth parent obesity has differential effects on subsequent changes in adiposity and metabolic health in children. ObjectivesWe evaluated how birth parent obesity 7 y after delivery was associated with child body composition changes and cardiometabolic health in midchildhood and further assessed the influence of the perinatal and postpartum period on associations. MethodsBlack and Dominican pregnant individuals were enrolled, and dyads (n = 319) were followed up at child age 7 and 9 y. Measures included, height, weight, waist circumference (WC), and percent body fat (BF%). Multiple linear regression was used to relate postpartum weight status with child outcomes accounting for attrition, and a series of secondary analyses were conducted with additional adjustment for perinatal weight status, gestational weight gain (GWG), and/or long-term weight retention to evaluate how these factors influenced associations. ResultsAlmost one-quarter (23%) of birth parents and 24.1% children were classified with obesity at child age 7 y, while at 9 y, 30% of children had obesity. Birth parent obesity at child age 7 y was associated with greater changes, from ages 7 to 9 y, in child BMI z-score (β: 0.13; 95% CI: 0.02, 0.24) and BF% (β: 1.15; 95% CI: 0.22, 2.09) but not obesity at age 9 y. All observed associations crossed the null after additional adjustment for prenatal factors. ConclusionsBirth parent obesity at 7-y postpartum is associated with greater gains in child BMI z-score and BF% in midchildhood. These associations diminish after accounting for prenatal size, suggesting a lasting impact of the perinatal environment and that interventions supporting families from the prenatal period through childhood are needed.

The Effect of an Obesity Prevention Intervention Among Specific Subpopulations: A Heterogeneity of Treatment Effect Analysis of the Greenlight Trial.

Background: Understanding how different populations respond to a childhood obesity intervention could help optimize personalized treatment strategies, especially with the goal to reduce disparities in obesity. Methods: We conducted a secondary analysis of the Greenlight Cluster Randomized Controlled Trial, a health communication focused pediatric obesity prevention trial, to evaluate for heterogeneity of treatment effect (HTE) by child biological sex, caregiver BMI, caregiver reported race and ethnicity, primary language, and health literacy. To examine HTE on BMI z-score from 2 to 24 months of age, we fit linear mixed effects models. Results: We analyzed 802 caregiver-child pairs, of which 52% of children were female, 58% of households reported annual family income of <$20,000, and 83% did not have a college degree. We observed evidence to suggest HTE by primary language (p = 0.047 for Spanish vs. English) and the combination of primary language and health literacy (p = 0.01). There was insufficient evidence to suggest that the Greenlight intervention effect differed by biological sex, caregiver BMI, or by race/ethnicity. Conclusions: This HTE analysis found that the Greenlight obesity prevention intervention had a more beneficial effect on child BMI z-score over 2 years for children of caregivers with limited health literacy and for caregivers for whom Spanish was the primary language.

Intrapartum antibiotic use is associated with higher child body mass index (BMI) z-score at 4 years of age

Early life antibiotic exposure may increase obesity risk. We investigated if prenatal, intrapartum, or childhood antibiotic use is associated with child zBMI score at 4 yrs of age. We included data from the Alberta Pregnancy Outcomes and Nutrition (APrON) study, a prospective cohort study, on maternal and child antibiotic exposure and clinic measures of height and weight at age 4 (n = 408). Prenatal and childhood antibiotic exposure was not associated with zBMI score. Maternal intrapartum antibiotic exposure was associated with a zBMI score increase of 0.12 (95 % CI; 0.04, 0.46) in children at 4 years of age compared to non-exposure intrapartum.

The cross-sectional association of parental psychosocial status with children's Body Mass Index z-score and the mediating role of children's energy balance behaviors - the ABCD Study.

Investigate the cross-sectional association between the psychosocial status of mothers and fathers and the BMI z-scores of their 10 to 12-year-old children. Explore whether this association is mediated by children's diet, physical activity, screen time and sleep. Analyze the moderating effect of the educational levels of both the mother and father on the association. In a cross-sectional study design, children's height and weight were measured following a standardized protocol. Parents completed the validated Depression Anxiety and Stress questionnaire, while diet quality, sports participation, time spent in bed and screen time were assessed through child-report using previously validated questions. The data for this study were obtained from the Amsterdam Born Children and their Development study, involving children aged 10 to 12 years and both of their parents (N = 1315). The majority, 80%, of the parents were highly educated and born in the Netherlands, and 68% of the children had a healthy BMI. Maternal or paternal psychosocial status was not significantly associated with children's BMI z-score (maternal β -0.0037; 95% CI: -0.008 to 0.0007, paternal β 0.0028; 95% CI: -0.007 to 0.002). Screen time mediated the association between paternal psychosocial status and children's BMI z-score (β = 0.010, 95% CI: 0.002; 0.020). Children's diet, physical activity, and sleep did not mediate the association between paternal psychosocial status and children's BMI z-score. Parental educational level was not a moderator. This research is unique in including four energy balance behaviors and including both mothers and fathers' psychosocial status. Children withfathers experiencing poorer psychosocial status engaged in more screen time which partly explained their higher BMI z-score.

Differences in maternal and paternal pressure to eat and perception of household responsibilities.

Controlling feeding practices, such as pressure to eat, are associated with a child's disinhibited eating and extremes in bodyweight. We aimed to explore which factors are associated with parent dyads' pressuring feeding practices, including how mothers and fathers perceive the sharing of household tasks such as mealtime and child feeding responsibilities. In this cross-sectional study, parent dyads (mother and father) of healthy preschool-aged children completed an identical questionnaire consisting of measures of picky eating (food fussiness subscale of Child Eating Behavior Questionnaire), parental concern for undereating, and pressure to eat (Child Feeding Questionnaire). We used separate multivariable linear regression models for mothers and fathers to assess correlates associated with pressure to eat subscale score, including slowness of eating and enjoyment of food, child BMI z-score and race/ethnicity, and household income. Separate unadjusted linear regression models for mothers and fathers were used to report the association of pressure to eat with household responsibilities. Parents (N = 88) had similar mean picky eating, concern for undereating, and pressure to eat scores; more fathers had high pressure to eat scores (36% vs 27%). Higher pressure to eat was significantly associated with lower income, non-Hispanic Black or Black race/ethnicity, slow eating, and lower enjoyment of food. Pressure was not associated with household responsibilities. While there were similar maternal and paternal perceptions of child eating behaviors, more fathers reported pressuring their child to eat. Identifying differences in parental feeding practices may assist in intervention development to improve feeding practices.

Sibship Composition and BMI Z-Score Among Saudi Preschoolers: A Cross-Sectional Study.

Background and objective The association between sibship composition and child body mass index (BMI) has not been investigated in any Arab/Middle Eastern populations. In light of this, this study aimed to examine the association of the number of siblings, number of older siblings, and number of younger siblings with child BMI z-score (BMIz) among preschoolers in the Kingdom of Saudi Arabia (KSA). Methods A total of 209 mothers and their children were recruited from preschools in Jeddah, KSA. Mothers reported their responses to the study questionnaire via telephone. Child anthropometry was objectively measured; BMIz was calculated based on age- and sex-specific World Health Organization (WHO) growth standards and reference data. We used hierarchical multiple linear regression to examine the association between sibship composition variables and child BMIz, independent of the effect of potential confounders, and to evaluate changes in model fit. Results The number of siblings was negatively associated with child BMIz [b = -0.18, 95% confidence interval (CI) = -0.35, -0.06, p<0.01, adjusted R2= 0.16]. There was a negative association between the number of older siblings and child BMIz (b = -0.23, 95% CI = -0.38, -0.11, p<0.01, adjusted R2= 0.21) as well as between the number of older sisters and child BMIz (b = -0.18, 95% CI = -0.52, -0.09, p<0.01, adjusted R2= 0.19). However, there were no significant associations between the number of older brothers or the number of younger siblings and child BMIz. Conclusions Based on our findings, sibship composition was found to be associated with BMIz among a sample of preschoolers in KSA. More research is needed to further establish this association and to understand the underlying mechanism of the association of the greater number of older siblings and older sisters with lower BMIz.

Abstract MP30: Sugar-Sweetened Beverages, Fruit Juices, and Whole Fruits Throughout Childhood and Adolescence and Glycemic Outcomes in Late Adolescence in Project Viva

Objective: To investigate sex-specific associations of sugar-sweetened beverages (SSBs), 100% fruit juices, and whole fruit intake throughout childhood and adolescence with insulin resistance and glycemic outcomes in late adolescence. Methods: We used data from Project Viva, an ongoing pre-birth cohort from eastern Massachusetts. We evaluated intake of SSBs, 100% fruit juices, and whole fruit at early childhood (median age: 3.1 yrs), mid-childhood (7.6 yrs) and early teen research visits (12.9 yrs) using food frequency questionnaires. We measured fasting blood glucose, insulin and glycated hemoglobin (HbA1c) levels in late adolescence (17.4 yrs). We estimated insulin resistance with the homeostasis model assessment for insulin resistance (HOMA-IR). We computed sex-specific linear regression models to estimate associations of average consumption of SSBs, fruit juice and whole fruit across the 3 childhood-early teen visits with late adolescence HOMA-IR, fasting glucose and HbA1c adjusting for demographics, socioeconomic status, mother BMI, child BMI z-score, and parental history of type 2 diabetes in early childhood (model 1), and additionally for lifestyle habits and diet quality in early childhood (model 2). Results: A total of 240 girls and 215 boys met eligibility criteria and had an outcome measure in late adolescence. Greater SSB intake throughout childhood and adolescence was associated with higher HOMA-IR, fasting glucose, and HbA1c in boys only (Figure). Also in boys, greater fruit juice intake was associated with higher HbA1c in late adolescence. Effect estimates in girls were of small magnitude and centered to the null, except for fruit juice and HbA1c with associations in the same direction as boys (Figure). We did not observe any association with respect to whole fruits for either sex. Conclusion: Findings suggest that SSBs and fruit juice consumption throughout childhood and adolescence are associated with less favorable glycemic traits in boys, suggesting greater risk of developing diabetes.

Impact of prenatal maternal dietary exclusion on childhood obesity and overweight risk.

Child birthweight is a measure of fetal nutrition that is primarily determined by prenatal maternal (PM) diet. Child birthweight and child obesity/overweight risk are well established to be linked. Nevertheless, no studies have investigated the impact of PM dietary exclusion on child obesity/overweight risk or body mass index z-score (BMIz). The study aimed to determine whether PM dietary exclusion affected the child's BMIz, obesity/overweight risk, whether child birthweight serves as a mediator of this, and whether PM use of dietary supplements can protect against this. Waves within the years 2004-2019 from the Longitudinal Study of Australian Children, a population-based cohort study, were analyzed. The participants were aged 0 to 15 years during these waves of the study. Analysis was conducted using logistic and linear models. A total of 5,107 participants were involved in the first wave of the study. The PM exclusion of fish was associated with a higher risk of being underweight at age 14 or 15 years and mild-to-moderate obesity at age 6 or 7 years. The PM exclusion of egg was associated with a higher risk of being overweight at age 14 or 15 years. The exclusion of dairy was associated with more mixed effects. Mediation effects did not reach statistical significance. Moderation effects involving PM dietary supplement use, when they did occur, were associated with higher child BMIz and usually a higher risk of obesity/overweight. Fish and eggs are likely important parts of PM diets for preventing childhood obesity and overweight. Further studies will be needed to determine reasons for this and the apparent adverse effects of dietary supplements on overweight/obesity risk.