Body Mass Index Z-score Research Articles

Associations of prenatal and concurrent exposure to phenols mixture with anthropometric measures and blood pressure during childhood: A time-varying mixture approach

BackgroundEnvironmental phenols were recognized as endocrine disrupting chemicals (EDCs). However, their impact on childhood anthropometric measures and blood pressure (BP) is still inconclusive. Limited studies have simultaneously considered prenatal and childhood exposures in analyzing mixtures of phenols. ObjectiveWe investigated the relationships between combined prenatal and childhood exposures (two periodic exposures) to phenol mixtures and anthropometric measure and BP, to further identify the vulnerable periods of phenol exposure and to explore the important individual contribution of each phenol. MethodsWe analyzed 434 mother-child dyads from the Sheyang Mini Birth Cohort Study (SMBCS). The urinary concentrations of 11 phenolic compounds were measured using gas chromatography tandem mass spectrometry. Generalized linear regression models (GLMs) and hierarchical Bayesian Kernel Machine Regression (hBKMR) were used to examine the effects of individual phenolic compounds at each period and of two periodic exposures. ResultsIn the single-chemical analysis, prenatal or childhood exposure to specific phenols, especially Benzopheone-3 (BP3), 4-tert-Octylphenol (4-tOP), and Benzyl paraben (BePB) were associated with BMI z-scores (BAZ), Waist-to-height ratio (WHtR), and BP. In the hBKMR models, two periodic exposures to phenol mixtures had a U-shaped association with WHtR, primarily driven by childhood BePB exposure. Moreover, among the phenol mixtures analysis, childhood 4-tOP exposure was identified as the primary contributor to the positive association with diastolic BP. Concurrent exposure to phenol mixtures resulted in greater susceptibility. ConclusionsWe found that prenatal and childhood exposure to phenol mixtures might influence childhood obesity and elevate blood pressure levels. Concurrent exposure to 4-tOP may be the primary driver of the positive associations with BP.

Social Jetlag on Obesity-Related Outcomes in Spanish Adolescents: Cross-Sectional Evidence from the EHDLA Study.

This study aimed to investigate the association between social jetlag (SJL) and obesity-related outcomes among adolescents from Valle de Ricote (Region of Murcia, Spain). We explored the relationship between SJL and body mass index (BMI) z-score, waist circumference, and body fat percentage, as well as the odds of having excess weight, obesity, and abdominal obesity in a sample of Spanish adolescents. A cross-sectional study was conducted using data from the Eating Healthy and Daily Life Activities (EHDLA) project, which included 847 Spanish adolescents aged 12-17 years. SJL was assessed based on the differences in sleep patterns between weekdays and weekends. Obesity-related indicators such as BMI z-score, waist circumference, body fat percentage, excess weight, obesity, and abdominal obesity were measured. Generalized linear models with a Gaussian or binomial distribution were used to analyze the associations between SJL and obesity-related outcomes, adjusting for potential confounders. The analysis revealed significant associations between SJL and BMI z-score (unstandardized beta coefficient [B] = 0.15, 95% CI: 0.05 to 0.25, p = 0.003), waist circumference (B = 1.03, 95% CI: 0.39 to 1.67, p = 0.002), and body fat percentage (B = 0.83, 95% CI: 0.31 to 1.43, p = 0.008). Additionally, the odds ratios (ORs) for excess weight (OR = 1.35, 95% CI: 1.16 to 1.57; p < 0.001), obesity (OR = 1.59, 95% CI: 1.26 to 2.00; p < 0.001), and abdominal obesity (OR = 1.46, 95% CI: 1.23 to 1.72; p < 0.001) increased significantly with each 60 min increment in SJL. This study pointed out that the misalignment of sleeping times during weekdays and weekends (SJL) is significantly associated with higher BMI z-scores, waist circumference, body fat percentage, and higher odds of excess weight, obesity, and abdominal obesity among adolescents, being more significant in boys than in girls. These findings highlight the importance of addressing circadian misalignment in the prevention and management of obesity and its related metabolic disorders in this population.

BMI z-score as a prognostic factor for height velocity in children treated with recombinant human growth hormone due to idiopathic growth hormone deficiency

PurposeGrowth hormone deficiency (GHD) causes growth disturbances during childhood. The most recommended treatment of GHD is the administration of recombinant human growth hormone (rhGH). Recent studies have proved that well-nourished GHD children respond better to rhGH therapy compared to undernourished individuals. The aim of this study was to analyze nutritional status along with height velocity in GHD children during the first two years of rhGH therapy, and to estimate the optimal BMI z-score range in which these children achieve the best growth results.MethodsThis retrospective analysis included 80 prepubertal idiopathic GHD children treated with rhGH. Anthropometric data were obtained from medical records made at an initial visit and then follow-up visits after 12 and 24 months of treatment. The body mass index (BMI) was calculated and standardized into z-score, basing on Cole’s LMS method. Then, the BMI z-score was analyzed in relation to the parameters of growth response.ResultsThe higher the BMI z-score at treatment entry, the greater the increase in height during the first twelve months of rhGH therapy. BMI z-score ≥0 noted at the beginning of each year of the treatment are associated with significantly better growth increments throughout the first and the second years of the therapy.ConclusionPrepubertal idiopathic GHD children with BMI z-score below 0 would probably benefit from the improvement of their nutritional status prior to the rhGH treatment beginning. It seems that increasing BMI z-score to obtain values between 0 and 1 would be optimal for the growth process.

Urinary concentrations of phthalate/DINCH metabolites and body mass index among European children and adolescents in the HBM4EU Aligned Studies: A cross-sectional multi-country study

BackgroundPhthalates are ubiquitous in the environment. Despite short half-lives, chronic exposure can lead to endocrine disruption. The safety of phthalate substitute DINCH is unclear. ObjectiveTo evaluate associations between urinary concentrations of phthalate/DINCH metabolites and body mass index (BMI) z-score among children and adolescents. MethodWe used Human Biomonitoring for Europe Aligned Studies data from 2876 children (12 studies, 6–12 years, 2014–2021) and 2499 adolescents (10 studies, 12–18 years, 2014–2021) with up to 14 phthalate/DINCH urinary metabolites. We used multilevel linear regression to assess associations between phthalate/DINCH concentrations and BMI z-scores, testing effect modification by sex. In a subset, Bayesian kernel machine regression (BKMR) and quantile-based g-computation assessed important predictors and mixture effects. ResultsIn children, we found few associations in single pollutant models and no interactions by sex (p-interaction > 0.1). BKMR detected no relevant exposures (posterior inclusion probabilities, PIPs < 0.25), nor joint mixture effect. In adolescent single pollutant analysis, mono-ethyl phthalate (MEP) concentrations were associated with higher BMI z-score in males (β = 0.08, 95 % CI: 0.001,0.15, per interquartile range increase in ln-transformed concentrations, p-interaction = 0.06). Conversely, mono-isobutyl phthalate (MiBP) was associated with a lower BMI z-score in both sexes (β = -0.13, 95 % CI: −0.19, −0.07, p-interaction = 0.74), as was sum of di(2-ethylhexyl) phthalate (∑DEHP) metabolites in females only (β = -0.08, 95 % CI: −0.14, −0.02, p-interaction = 0.01). In BKMR, higher BMI z-scores were predicted by MEP (PIP=0.90) and MBzP (PIP=0.84) in males. Lower BMI z-scores were predicted by MiBP (PIP=0.999), OH-MIDP (PIP=0.88) and OH-MINCH (PIP=0.72) in both sexes, less robustly by DEHP (PIP=0.61) in females. In quantile g-computation, the overall mixture effect was null for males, and trended negative for females (β = -0.11, 95 % CI: −0.25, 0.03, per joint exposure quantile). ConclusionIn this large Europe-wide study, we found age/sex-specific differences between phthalate metabolites and BMI z-score, stronger in adolescents. Longitudinal studies with repeated phthalate measurements are needed.

Premature pubarche in Prader-Willi syndrome: Risk factors and consequences.

Children with Prader-Willi Syndrome (PWS) may develop premature pubarche (PP). We investigated the frequency of PP, and its potential precursors and sequelae, in PWS. A chart review of children with PWS treated at our institution between 1990 and 2021 was performed. PP was defined as Tanner stage 2 (TS2) pubic hair in girls <8 and boys <9 years old. Demographic, anthropometric, and laboratory data were collected to assess predisposing factors and consequences of PP in comparison to patients with PWS who had normal pubarche (NP). Analysis included 43 children with PWS, 23 (53.5%) with PP and 20 (46.5%) with NP. Median age at pubarche was 7.0 years in PP group and 10.0 years in NP group. Age at pubarche was not correlated with age of recombinant human growth hormone (rhGH) initiation, body mass index (BMI) z-score, or homeostasis model assessment of insulin resistance (HOMA-IR) at pubarche. BMI z-score at pubarche was modestly correlated with degree of pubarchal BA advancement (p = 0.033). Those with PP were more likely to have a lower high-density lipoprotein (HDL) (1.05 mmol/L vs. 1.41 mmol/L in the NP group, p = 0.041). The difference between target and final height did not differ between groups (p = 0.507). PP is common in PWS but does not compromise final height in comparison to the NP group. Obesity and insulin resistance were not associated with PP in children with PWS, contrary to what has been seen in obese children without PWS.

Body composition trajectories during childhood predict skeletal maturation at puberty: A longitudinal study

Nutritional status significantly impacts linear bone growth. We aimed to determine the relationship between the trajectories of four body composition indicators and pubertal advanced bone age. Trajectories of body mass index z-score (BMI z-score), visceral fat area z-score (VFA z-score), fat mass index z-score (FMI z-score), and fat-free mass index z-score (FFMI z-score) were identified based on three body composition measurements conducted from October 2018 to April 2023 within a pediatric cohort (the PROC study). We assessed pubertal bone age using the Tanner-Whitehouse 3-Chinese Radius-Ulna-Short (TW3-C RUS) method among 1402 primary school children. Children with a trajectory of higher BMI z-score, VFA z-score, FMI z-score, and FFMI z-score since childhood were more likely to have advanced bone age. The risk of advanced bone age was higher in children who were consistently in the high VFA z-score group (odds ratio [OR] = 6.73) or consistently in the high BMI z-score group (OR = 5.57), as compared to those in the low VFA z-score and low BMI z-score groups. Regular monitoring and maintenance of normal VFA during childhood may reduce the risk of advanced bone age at puberty. Furthermore, BMI monitoring is optional, especially in cases where specialized body composition equipment is not available.

Is Polycystic Ovary Syndrome Associated With Night Eating Syndrome and Sleep Complaints in Adolescence?

To evaluate the relationship between polycystic ovary syndrome (PCOS), night eating syndrome (NES), and sleep problems in the adolescent population. PCOS patients (n = 43) and healthy controls (n = 62) aged between 15 and 19 years were recruited from the clinics of Adolescent Medicine and Adolescent Gynecology. The Night Eating Questionnaire (NEQ), Pittsburg Sleep Quality Index (PSQI), and Pediatric Sleep Questionnaire-Short Form (PSQ-SF) were completed by the participants. The PSQI (P = .175), PSQ-SF (P = .320), and NEQ (P = .493) scores were not statistically different between the PCOS and control groups. The NEQ scores were positively correlated with illness duration (r = 0.348, P = .024) in the PCOS group. There was no significant correlation between the NEQ scores and body mass index Z-score, total testosterone and dehydroepiandrosterone sulfate levels, or modified Ferriman-Gallwey Score. The NEQ scores were positively correlated with both the PSQI (r = 0.532, P < .001) and PSQ-SF scores (r = 0.204, P = .037) in the PCOS group. The ratio of adolescents at risk for NES (having an NEQ score ≥25) did not differ significantly between the PCOS and control groups (P = .601). Adolescents with PCOS have NES scores similar to those of healthy controls. This result may change as the duration of exposure to the disease increases. When screening adolescents with PCOS for eating, psychiatric, and sleep problems, they should also be screened for NES due to the high comorbidity rates and symptom overlap of these health conditions.

Evaluation of Family-Based Interventions as a Therapeutic Tool in the Modulation of Childhood Obesity: A Systematic Review.

Childhood obesity is a major public health burden. The prevalence of weight excess for children and the adolescent population (8 to 16 years) is 34.9%. During childhood, lifestyles are acquired, which are developed in adulthood. In this context, the role of parents is crucial, since they are the model to imitate. We aimed to evaluate the current evidence on the effects of family-based interventions as a tool in the treatment of childhood obesity. We reviewed studies indexed in several databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Original articles published from 1 January 2014 to 30 May 2024 with a controlled trial design were considered, in which family-based interventions were carried out compared to a control group or to data before the intervention. Although 148 records were identified in the search, 6 studies met inclusion criteria. Overall, studies reported beneficial effects of family-based interventions on improving anthropometric parameters: BMI z-score, BMI, waist circumference, and body fat percentage. Regarding nutritional and physical activity guidelines, general recommendations must consider increased consumption of fruits and vegetables, reducing sugary drinks, controlled screen time, and 30-60 min of physical activity/day. Thus, family-based interventions could be an effective non-pharmacological strategy for modulating childhood obesity, allowing families to modify their lifestyles.

How do maternal socioeconomic and behavioral patterns affect oral health in early childhood?

A prospective longitudinal observational cohort study. The data analyzed were derived from a comprehensive observational study on BRISA prenatal cohort conducted in São Luís City, Brazil, between 2010 and 2013. A convenience sample included pregnant women recruited from both public and private prenatal health services in the city. To participate in the study, women needed to have undergone an obstetric ultrasound before the 20th week of pregnancy to estimate gestational age. Multiple pregnancies were excluded. Initially, the pregnant women were interviewed and assessed for oral health indicators between the 22nd and 25th weeks of pregnancy. A follow-up interview was conducted within 48 h after delivery. In the child's second year, the mothers were re-interviewed, and the children were examined for the second follow-up. The study received approval from the local ethics committee, and written informed consent was obtained from all participants. The research followed the STROBE guidelines for reporting observational studies. At baseline, a structured questionnaire was used to gather sociodemographic and lifestyle information like maternal age, family income, education level, occupation of the family head, pre-gestational BMI, alcohol and soft drink consumption, and smoking status during pregnancy. Dental examinations were conducted by 6 trained and calibrated dentists who assessed DMFT index and periodontal health indicators. In the second follow-up, children's oral health was evaluated using visible plaque index (VPI), gingival bleeding, and the modified dmft index. Children's weight and height were measured by a digital scale, and BMI z-scores were calculated based on WHO standards. Sugar-sweetened beverage intake was categorized by terciles based on the percentage of total daily energy from these beverages. Structural equation modeling (SEM) was used to analyze multiple pathways among a set of latent and observed variables. Three latent variables were proposed and measured: Socioeconomic Status and Periodontal Maternal Status in the mothers, and Chronic Oral Disease Burden (CODB) in the children. CODB was inferred from 3 observed indicators: VPI, gingival bleeding, and tooth decay. Total, direct, and indirect effects were calculated for variables from the gestational period and the child's second year of life. In total, 1141 mother-child dyads were included. Periodontal Maternal Status correlated with more decayed teeth in pregnant women (standardized coefficient (SC) = 0.089; p = 0.008). Addictive risk behaviors were highly correlated, with SCs of 0.679 (p < 0.001) for alcohol and smoking, and 0.262 (p < 0.001) for soft drink and alcohol consumption. Obesity (SC = 0.081; p = 0.048) and added sugar consumption (SC = 0.142; p = 0.040) were interconnected across generations from pregnant women to their offspring. Children's consumption of sugar was strongly associated with CODB (SC = 0.357; p = 0.005). Caries and periodontitis were correlated in pregnant women. Obesity and sugar consumption have intergenerational impacts. Early sugar intake relates to CODB in early childhood. Intergenerational behavioral risks affect oral health in the first 1000 days of life, influencing long-term health outcomes.

Real-world impact of ivacaftor in people with cystic fibrosis and select ivacaftor-responsive mutations

BackgroundIvacaftor approval was extended to people with cystic fibrosis (CF) with ≥1 of 28 additional ivacaftor-responsive mutations in the USA in 2017 based on preclinical in vitro data. This retrospective,...

Results of the eating habits program for children from 3 to 12 years based on Nutriplato®

poor dietary habits and lack of physical activity are associated with non-communicable diseases. A healthy diet during childhood is important for the prevention of these diseases in the short and long term. improve eating habits, promote the Mediterranean diet (MD) and prevent and/or reverse overweight and obesity in children aged 3 to 12 years. the program includes 3 to 5 visits with dietitian-nutritionists, 1 telephone control and 1 practical workshop, with a follow-up of 1 year. Anthropometric, body composition and eating habits data are collected, and nutritional education is provided. the program included 1018 participants (51.5 % children; median age 8.5 ± 2.7 years). At baseline, 31 % were overweight or obese and 33.9 % had optimal MD. 696 participants completed the 12-month follow-up, and an increase in the percentage of participants following optimal MD was observed (38.1 % vs. 53.4 %; p < 0.001). Statistically significant improvements were also observed in relation to the consumption of fruits (except for 3 servings/day), vegetables, legumes, nuts and wholegrains cereals. In participants who were overweight or obese, a slight decrease in the mean BMI z-score was observed at the 12-month follow-up (p = 0.039). the results highlight the need for nutritional education in children and show that the Nutriplato® Program is effective in improving eating habits.

Role of dietary intake and physical activity in reducing weight social inequalities among adolescents: an application of G-formula to PRALIMAP-INÈS trial.

Interventions aiming to reduce social inequalities of weight status in adolescents usually focus on lifestyle behaviours, but their effectiveness is limited. This study analysed the effect of achieving levels of dietary intake (DI) and/or physical activity (PA) guidelines on reducing social inequalities in weight status among adolescents. We included adolescents from the PRomotion de l'ALIMentation et de l'Activité Physique - INÉgalité de Santé (PRALIMAP-INÈS) trial with weight status data available at baseline and 1-year follow-up (n 1130). PA and DI were measured using the International Physical Activity Questionnaire and a validated FFQ, respectively. We estimated the likelihood of a 1-year reduction in BMI z-score (BMIz) and population risk difference (PRD) under hypothetical DI and PA levels and socio-economic status using the parametric G-formula. When advantaged and less advantaged adolescents maintained their baseline DI and PA, we found social inequalities in weight status, with a PRD of a 1-year reduction in BMIz of -1·6 % (-3·0 %, -0·5 %). These inequalities were not observed when less advantaged adolescents increased their proportion of achieving DI guidelines by 30 % (PRD = 2·2 % (-0·5 %, 5·0 %)) unlike the same increase in PA (PRD = -3·9 % (-6·8 %, -1·3 %)). Finally, social inequalities of weight status were not observed when levels of achievement of both PA and DI guidelines increased by 30 % (PRD = 2·2 % (-0·5 %, 4·0 %)). Enhancing DI rather than PA could be effective in reducing social inequalities in weight status among adolescents. Future interventions aiming to reduce these inequalities should mostly target DI to be effective.

Regional Disparities in Growth Patterns of Children with Cerebral Palsy: A Comparative Analysis of Saudi Arabian, UK, and US Data.

In order to understand the global variations in the growth trajectories of cerebral palsy patients, this study aimed to compare the growth patterns of cerebral palsy patients in Saudi Arabi with United States and United Kingdom counterparts. Anthropometric data from 107 participants with cerebral palsy in Saudi Arabia were collected, including age, gender, cerebral palsy type, Gross Motor Function Classification System level, birth weight, weight at assessment, height at assessment, body mass index, and head circumference at assessment. This study found discrepancies between the growth patterns of Saudi Arabian children with cerebral palsy and United Kingdom and the United States growth charts, particularly among those with severe cerebral palsy. Significant differences were observed in weight, height, and body mass index z-scores when comparing Saudi Arabian data with the United kingdom and United States reference data. These findings emphasize the importance of validating growth charts across different populations to ensure accurate monitoring and clinical management of children with cerebral palsy. Additionally, this study highlights the need for region-specific growth references to better address the diverse needs of individuals with cerebral palsy worldwide.

Association between Dietary Practices and Growth Trajectories in Preschool Children.

To estimate the association of dietary practices with early life weight among children born in 2001 in the U.S. The Early Childhood Longitudinal Study (ECLS-B) is a population-based cohort followed from 9 months to Kindergarten entry (n~5000). We employed an auto-regressive cross-lagged model to assess the impacts of dietary practices on weight stability over time. We calculated age- and sex-standardized BMI z-scores using WHO growth curves. BMI z-scores had a stable increase over time. Later age of solid food introduction was associated with lower BMI z-score at age 2y [-0.03(-0.05,-0.004)]; having dinners more times per week with family at age 2y was associated with higher BMI z-score at 4y [0.03(0.01,0.05)]. These changes, of <0.05 BMI z-score, are small. Children with higher birthweight were introduced to solid foods at younger ages [-0.39 months(-0.45,-0.32)] and were breast fed longer [0.13 months(0.04,0.22)]. For girls, having dinner at a regular time at ages 2y and 4y was associated with lower BMI at ages 4y and 5y. Dietary practices in early childhood affect weight trajectories. However, these effects are small and are largely overshadowed by prior weight. Children's weight in infancy is associated with subsequent dietary practices but also small effects.

Long-term effects of the COVID-19 lockdown on weight status, eating habits, and lifestyle changes related to school-aged children in Bandar Abbas, Iran

BackgroundDespite the end of the COVID-19 lockdown and reopening of schools, the long-term effects of quarantine on the weight status, eating habits, and lifestyle of children and adolescents remain unknown. This study aimed to determine the long-term effects of the lockdown on the weight status, eating habits, and lifestyle changes of children and adolescents in Iran.MethodThis descriptive cross-sectional study was conducted from April to May 2022. The target population comprised one hundred students aged between 10 and 16 years old. Our study obtained students’ weight and height data from records maintained by school principals or physical education instructors before and after the quarantine period. The BMI z-score (zBMI) was calculated for each time point. The researchers also provided a questionnaire to collect the students’ demographic and lifestyle status changes during school closures.ResultsWe found that the zBMI increased significantly from − 0.02 ± 1.64 to 0.36 ± 1.12, and the number of individuals with overweight and obesity increased by 3% during quarantine (P ≤ 0.05). These changes were more pronounced in males and students aged 14–16 years old. We also found that eating habits, sleeping time, sleeping patterns, screen time (time spent on social media per day), and physical activity had significant negative changes during quarantine, and a significant increase in zBMI was observed among students who experienced negative eating behaviors, altered sleeping patterns, and decreased physical activity during school closures.ConclusionAs prolonged school closures due to the COVID-19 lockdown aggravated students’ health and lifestyle status, our findings can aid in proper planning to establish an appropriate framework for the diet, physical activity, and sleeping quality of students during extended school closures.

Exploring the Influence of Concurrent Nutritional Therapy on Children with Spinal Muscular Atrophy Receiving Nusinersen Treatment.

Background This study examines spinal muscular atrophy (SMA), a neuromuscular disease associated with malnutrition. Our goals are to assess how effectively screening tools can detect malnutrition and evaluate the impact of nutritional interventions on neurological outcomes, particularly motor functions. Methods Thirty-seven genetically diagnosed SMA patients (types 1, 2, and 3) under nusinersen therapy were included in the study. The nutritional status of these patients was assessed by using anthropometric measurements, including height for age (HFA), weight for height (WFH), and body mass index (BMI) before and after the study. Additionally, the risk of malnutrition was determined using screening tools, namely the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP). Nutritional counseling followed the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines and considered the patients' dietary history, including content and administration method. Motor functions were assessed by validated tests: the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP-INTEND) and the Hammersmith Functional Motor Scale-Expanded (HFMSE). Result The study showed an improvement in HFA, by a change from -0.95 to -0.65 (p = 0.015). Conversely, BMI scores decreased from 0.08 to -0.54 (p = 0.015), while WFH and MUAC showed no significant alterations (p = 0.135, p = 0.307). Following nutritional interventions, HFMSE demonstrated a median increase from 29.5 to 30.5 (p = 0.023). Patients identified as being at high risk for malnutrition based on PYMS and STAMP belonged to the moderate-to-severe malnutrition group (BMI Z-score ≤ -2, p = 0.001). Conclusions Use of screening tools in SMA patients is highly beneficial for the early detection of malnutrition. Future research should highlight the importance of combining nutritional management with nusinersen therapy to potentially alter the disease trajectory, especially in motor and neurological functions.

Psychometric Properties of the Dimensional Yale Food Addiction Scale for Children 2.0 among Portuguese Adolescents.

The dimensional Yale Food Addiction Scale for Children 2.0 (dYFAS-C 2.0) was developed to provide a reliable psychometric measure for assessing food addiction in adolescents, in accordance with the updated addiction criteria proposed in the fifth edition of the Diagnostic and Statistical Manual (DSM-5). The present study aimed to evaluate the psychometric properties of the dYFAS-C 2.0 among Portuguese adolescents and pre-adolescents and to explore the relationship between food addiction and other eating behaviors such as grazing and intuitive eating. The participants were 131 Portuguese adolescents and pre-adolescents (53.4% female and 46.6% male) aged between 10 and 15 years (Mage = 11.8) and with a BMI between 11.3 and 35.3 (MBMI z-score = 0.42). Confirmatory Factor Analysis demonstrated an adequate fit for the original one-factor model (χ2 (104) = 182; p < 0.001; CFI = 0.97; TLI = 0.97; NFI = 0.94; SRMR = 0.101; RMSEA = 0.074; 95% CI [0.056; 0.091]). Food addiction was positively correlated with higher grazing (r = 0.69, p < 0.001) and negatively correlated with lower reliance on hunger/satiety cues (r = -0.22, p = 0.015). No significant association was found between food addiction and BMI z-score, or between food addiction and age. The results support the use of dYFAS-C 2.0 as a valid and reliable measure for assessing food addiction in Portuguese adolescents and pre-adolescents. Furthermore, the findings highlight that food addiction may be part of a spectrum of disordered eating behaviors associated with control impairment. Future research with a larger sample size could further elucidate the associations between food addiction and other variables, such as psychological distress and multi-impulsive spectrum behaviors.

Effects of New Complementary Feeding Guidelines on Eating Behaviour, Food Consumption and Growth in Colombian Children: 6-Year Follow-Up of a Randomised Controlled Trial.

Complementary feeding (CF) may influence later eating behaviour and growth. Our previous Randomised Control Trial (RCT) reported that new CF guidelines (NCFGs) implemented in 6-12-month-old infants in Bogota, Colombia, had positive short-term effects on red meat, vegetable and fruit consumption. Here, we assessed the effects of the NCFGs on food consumption, eating behaviour and growth at 6 years of age. Weight and height were measured using 50 children (58.8%) from the cohort. Feeding behaviour was measured using the Child Eating Behaviour Questionnaire (CEBQ) and maternal and child food consumption was measured using a semi-quantitative food frequency questionnaire. The control group (CG) had a significantly higher weekly consumption of chocolate milk drinks (p = 0.05). The mean food responsiveness (FR) score was significantly higher in the CG (p < 0.001). Although HAZ (height for age Z-score) at 6 years of age was significantly higher in the CG (p < 0.02), there was no significant difference between groups in the change in HAZ from 6 months and 12 months to 6 years of age. BMIZ (body mass index Z-score) and % overweight (CG 18.5% versus NCFG 13%) or obese (3.7% versus 0%) were not significantly different between groups. BMIZ was positively predicted by FR (β 0.293; p = 0.014) and negatively predicted by weekly red meat consumption episodes per week at 12 months (β -0.169; p = 0.020). Although there was no direct effect of an intervention on BMIZ at 6 years of age, the results were consistent with an indirect effect via intervention effects on meat consumption at an age of 12 months and FR at 6 years of age. However, further longitudinal studies with a larger sample size are needed.

Ambulatory isolated diastolic hypertension and risk of left ventricular hypertrophy in children with primary and secondary hypertension

BackgroundPediatric blood pressure (BP) assessment and management is increasingly important. Uncontrolled systolic and combined hypertension leads to hypertension-mediated organ damage. The impact of isolated diastolic hypertension is less clearly understood.MethodsWe analyzed the prevalence of ambulatory isolated diastolic hypertension (IDH) in primary (PH) and secondary (SH) hypertension, and associations with BMI Z-score (BMIz) and left ventricular mass index adjusted to the 95th percentile (aLVMI) in a large, multicenter cohort of hypertensive children. Hypertensive children were divided and analyzed in three ambulatory hypertension subgroups: 24-h, daytime, and nighttime. Specifically, we sought to determine the prevalence of ambulatory 24-h, daytime, or nighttime IDH.ResultsPrevalence of IDH varied based on ambulatory phenotypes, ranging from 6 to 12%, and was highest in children with SH. Children with IDH tended to be more likely female and, in some cases, were leaner than those with isolated systolic hypertension (ISH). Despite previous pediatric studies suggesting no strong association between diastolic blood pressure and left ventricular hypertrophy (LVH), we observed that children with IDH were equally likely to have LVH and had comparable aLVMI to those with ISH and combined systolic-diastolic hypertension.ConclusionsIn summary, ambulatory IDH appears to be a unique phenotype with a female sex, and younger age predilection, but equal risk for LVH in children with either PH or SH.Graphical abstractA higher-resolution version of the Graphical abstract is available as Supplementary information

Preventative dental practices and cardiometabolic health in adolescents.

The aim of this study was to identify the relationship between preventative dental practices and cardiometabolic health in adolescents. Analysis included children aged 13-17 years enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2011-2018 who completed an Oral Health Examination and Questionnaire. Deferred dental care was defined as not having a dental visit in the past year. Financial barriers to seeking dental care (vs. no financial barriers) were assessed among those with deferred dental care in the past year. Primary cardiometabolic outcomes included obesity, elevated blood pressure and hypertensive blood pressure. Secondary outcomes included dyslipidemia, glucose intolerance, uric acid, glomerular hyperfiltration, and albuminuria. Regression models adjusted for age, sex, ethnicity, household income, food insecurity, health insurance status, household education, and body mass index z-score examined associations using complex survey design procedures. Of 2,861 adolescents, 17.6% (SE 0.9%) did not receive dental care in the past year and 20.2% (SE 1.9%) had a financial barrier to accessing dental care. In adjusted regression models, adolescents with deferred dental care had higher odds of dyslipidemia (OR= 1.51, 95% CI 1.07, 2.11 p = 0.020). Having a financial barrier was associated with a lower odd of dyslipidemia (OR=0.35, 95% CI 0.14, 0.89 p = 0.03). Financial barriers were associated with lower non-HDL (b=-7.95, 95% CI -14.87, -1.05 p=0.03) and higher HDL (b=3.06, 95% CI 0.37, 5.75 p=0.03) in adjusted models. Deferred dental care and financial barriers were not associated with any other cardiometabolic parameters. In this nationally representative cohort of adolescents, there was an association between lack of preventative dental care and the cardiometabolic health marker of dyslipidemia. However, financial barriers to dental care were surprisingly associated with higher HDL levels and lower odds of dyslipidemia.