Body Weight In Children Research Articles

Early-life exposure to antibiotics and excess body weight in childhood and adolescence: A systematic review and meta-analysis

BackgroundThe association between early-life exposure to antibiotics and overweight/obesity is unclear. We conducted a systematic review and meta-analysis to address this issue. MethodsWe searched PubMed, Web of Science, Scopus, and grey literature from inception to August 10, 2022, for cohort studies investigating the association between early-life exposure to antibiotics and weight outcomes. Two independent reviewers screened studies for eligibility, extracted data, assessed risk of bias, and examined the certainty of the evidence. Random-effects meta-analyses was used for pooling the data. The review was registered in PROSPERO, CRD42021265417. ResultsWe included 42 studies and data from 28 of them were pooled in the quantitative synthesis. Overall antenatal (OR 1.10, 95% CI 1.04–1.16; 518,095 children, very low certainty) and second trimester (OR 1.11, 95% CI 1.08–1.14, 248,469 children, low certainty) exposure to antibiotics were associated with increased risk of overweight/obesity in childhood/adolescence. Overall early postnatal antibiotic exposure was also associated with increased likelihood of overweight/obesity in childhood/adolescence (OR 1.09, 95% CI 1.05–1.12, 1,488,316 children, very low certainty). The magnitude of the association increased from exposure to one (OR 1.07, 95% CI 1.00–1.15, 512,954 children) to four or more courses of antibiotics (OR 1.31, 95% CI 1.17–1.46, 543,627 children). ConclusionAntenatal and early postnatal exposure to antibiotics is associated increased likelihood of overweight/obesity, although the findings are limited by the very low certainty of evidence. We highlight the need for homogeneous prospective studies addressing potential confounding factors to further explore the link between exposure to antibiotics and the risk of excess body weight.

Study of the relationship between nutrition, physical activity, and overweight/obesity in children in a school context

Aim: This study aimed to describe the behavior, eating habits, and lifestyle of schoolchildren from different regions of Bejaia, and to evaluate their food consumption on the one hand and their Physical Activity Level (PAL) on the other hand. Methods: This study involved children (n = 240, B/G = 120/120), aged from 6 to 12, that are enrolled in different institutions (primary schools, colleges) in different regions of Bejaia. The children's body weight and height were measured (BMI), and their eating habits and level of physical activity were assessed using adapted questionnaires. Food consumption was estimated by the 24-hour recall method. Results: Results showed observable BMI rise including drastic changes in BMI Z-score as a function of age, height and mainly weight, BMI Z-score values were between 0 and +2 in overweight for obese girls and boys and less than +1 for normal-weight girls and boys. The PAL evaluation was low in overweight and obese children compared to normal-weight children. The correlation test showed a positive correlation between BMI and PAL in both sexes. According to the results of the dietary habits, the frequency of consumption of the different food groups distributed according to the fourth daily intakes (breakfast, lunch, dinner and snacking between meals) was very rich in carbohydrates and fats in overweight and obese children, compared to normal-weight children and according to the recommended threshold. Conclusion: This study shows that there is an increase in BMI values, high BMI Z-scores in overweight and obese children compared to normal-weight children. Children have bad eating habits (snacking between meals, consumption of fast food and sugary drinks). These habits may act as obesity promoting factors when associated with sedentary activities. Keywords: Children, overweight-obesity, normal-weight, BMI, Physical Activity Level, food habits, food consumption.

Association between being Overweight in Young Childhood and during School Age and Puberty.

To examine whether body type at birth, body weight, and obesity in early childhood are associated with overweight/obesity during school age and puberty. Data from maternal and child health handbooks, baby health checkup information, and school physical examination information of participants at birth and three-generation cohort studies were linked. Association between body type and body weight at different time intervals (at birth and at 1.5, 3.5, 6, 11, and 14 years of age) were comprehensively analyzed using a multivariate regression model adjusted for gender, maternal age at childbirth, maternal parity, and maternal body mass index, and drinking and smoking statuses at pregnancy confirmation. Children who are overweight in young childhood had a greater risk of being overweight. Particularly, overweight at one year of age during checkup was associated with overweight at 3.5 years (adjusted odds ratio (aOR), 13.42; 95% confidence interval (CI), 4.46-45.42), 6 years (aOR, 6.94; 95% CI, 1.64-33.46), and 11 years (aOR, 5.22; 95% CI, 1.25-24.79) of age. Therefore, being overweight in young childhood could increase the risk of being overweight and obese during school age and puberty. Early intervention in young childhood may be warranted to prevent obesity during school age and puberty.

Child bodyweight, cognitive abilities, and well-being: evidence from West Bank schools

ABSTRACT The present study investigates the effect of obesity and overweight on children’s cognitive abilities and well-being using survey data from West Bank schools. The results show the significant adverse impact of obesity on a child's well-being by raising externalizing (behavioral) problems and increasing the probability of classifying a child with abnormal mental health difficulties, according to the Strength and Difficulties Questionnaire (SDQ), while no such impact was founded on the cognitive test results. The analysis further exposes that teachers’ negative attitude toward obese students is an important factor that contributes to the association between obesity/overweight and higher SDQ scores.

Macrosomia is associated with overweight in childhood: a follow-back of a cohort established in the early years of the obesity epidemic

Objective: Interventions currently recommended to control and prevent obesity have not been successful. Recent research has shifted toward the transgenerational cycle of obesity. We assessed the association between fetal macrosomia and early childhood body weight. Methods: We conducted a follow-back study to link birth certificate data to the Third National Health and Nutrition Examination Survey (1988–1994) of 2621 United States-born singletons aged 2–6 years. Birth weight and gestational age data were collected from birth certificates. Fetal macrosomia was defined as ≥90th percentile of gestational age-race-sex-parity specific body weight distribution in 1989 vital statistics. Results: With 12.7% (standard error = 0.85%) of participants born macrosomic, the prevalence of obesity and overweight (BMI percentiles ≥85th in the CDC growth chart) among children was 17.8% (1.17%). When the body weight was measured against age-sex-specific height (BMI percentiles), macrosomia was significantly associated with overweight and obesity (odds ratio [OR] = 1.64, 95% confidence interval = 1.07–2.50) adjusted for family income, maternal age and marital status, race, maternal smoking during pregnancy, and breastfeeding. The association became insignificant after adjusting for postnatal lifestyle and parental body mass index (OR = 1.38 [0.84-2.26]]. When body weight was measured against age, children who were too heavy for their age were more likely to be born macrosomically (OR = 2.64 [1.66-4.22]) than their peers with healthy age-specific body weight. Conclusion: Fetal macrosomia was significantly associated with a doubled risk of heavy body weight in children aged 2–6 years.

Trajectories of cardiorespiratory fitness from childhood to adolescence: Findings from the QUALITY cohort

ABSTRACT Estimate the shape and number of cardiorespiratory fitness (CRF) trajectories from childhood to adolescence; and verify whether CRF trajectory membership can be predicted by sex, biological maturation, body weight, body composition and physical activity (PA) in childhood. Data from QUALITY were used. Participants attended baseline (8–10 y old, n = 630) and follow-ups 2 years (n = 564) and 7 years (n = 359) after baseline. Group-based trajectory analysis for relative peak oxygen consumption (VO2peak, ml·kg−1·min−1) was performed. A multinomial logistic regression model was used to estimate the associations between baseline predictors and trajectory membership. Mean age of the 454 participants was 9.7 ± 0.9 years at baseline. Three distinct VO2peak trajectories were identified and all tended to decrease. They were labelled according to the starting point and slope. High-Decreasers were mostly boys, had lower body weight and fat-free mass index and higher PA levels at baseline (p < 0.05). Female sex and higher weight were associated with higher odds of being classified in the Low-Decreaser trajectory (OR = 74.03, 95%CI = 27.06–202.54; OR = 1.48, 95%CI = 1.36–1.60). Those with higher PA were less likely to be Low-Decreasers (OR = 0.96, 95%CI = 0.94–0.97). Sex, body weight and PA in childhood are important influencing factors of VO2peak (ml·kg−1·min−1) trajectories across adolescence.

Nutritional Status, Anemia and Eating Behavior among Children with Elevated Blood Lead Levels in a Primary Health Care of Peru

Aim: Malnutrition, anemia, and lead exposure are important public health problems. Introduction: To assess nutritional status, anemia, and eating habits and their relationship to elevated blood lead levels in children. Materials and Methods: Descriptive study conducted with data from children evaluated in a district of Callao, Peru. The variables studied were: nutritional status, based on anthropometric measurements; anemia, determined by blood hemoglobin concentration; dietary habits, evaluated by the 24-hour dietary recall method and food consumption frequency; and blood lead, determined by LeadCare II analyzer. Results and Discussion: A total of 425 children participated, with a median age of 6 years (IQR=5; Q3=9, Q1=4), 52.2% (n=222) were female and 71.3% (n=303) had blood lead level (BLL) ≥5μg/dL. Among children with BLL ≥5 μg/dL, 11.6% (n=35) presented poor nutritional status, 9.9% (n=30) had anemia, and 63% (n=191) had inadequate eating habits. Of the children with inadequate eating habits, 17.4% (n=47) had poor nutritional status and 15.9% (n=43) had anemia, compared to children with adequate eating habits (p&lt;0.001). In children with BLL ≥5 μg/dL, the children's median hemoglobin, body weight, and height were 12.2 g/dL, 21.6 Kg, and 114.8 cm, respectively; while in those with Pb levels &lt;5 μg/dL it was 12.5 g/dL, 29 Kg and 126.55 cm, respectively (p&lt;0.05). Conclusion: Nutritional status, anemia, and eating habits did not differ according to BLL; however, lower median hemoglobin, weight, and height were found in children with elevated lead levels. Children with subnormal nutritional status and children with anemia presented a shorter time to reach elevated blood lead levels.

Assessment of the Impact of Increased Physical Activity on Body Mass and Adipose Tissue Reduction in Overweight and Obese Children.

(1) Background: Within the last 30 years, growing rates of child overweight and obesity have been observed as a very concerning phenomenon in most countries worldwide. The research aim was to assess what effect increased physical activity has on reducing body mass and adipose tissue in children between 10 and 11 years of age as well as to answer the question of whether physical activity could be considered as a factor in preventing child overweight and obesity when maintaining their existing diet and lifestyle. (2) Material and methods: There were 419 sports class primary school pupils in the experimental group who, in addition to four obligatory weekly physical education hours, attended six training hours. The control group comprised 485 children from parallel non-sports classes. In all pupils, height and weight measurements as well as physical fitness measurements were taken twice, at the beginning and end of the school year. Cole's method was used to assess the children's normal body weight. With the help of this method, children with excessive body weight were selected from the entire study group (N = 904), who additionally had skinfolds and adipose tissue measured using the BIA electrical bioimpedance method. The obtained results were interpreted using the variance analysis for repeated measurements and LSD test. (3) Results: The number of children with excessive body mass after 10 months of increased physical activity decreased (in the case of overweight: p = 0.0014, obesity: p = 0.0022), as did their skinfolds (p ≤ 0.001) and body fat (p ≤ 0.001), while their physical fitness considerably improved compared to the control group. (4) Conclusions: The introduction of increased physical activity in the experimental group children when maintaining their existing diet and lifestyle contributed to reducing their obesity and overweight and, at the same time, proved to be an effective factor in the process of decreasing their excessive body mass.

Віддалені наслідки пілороміотомії в дітей

Hypertrophic pylorostenosis is one of the most frequent causes of vomiting in newborns requiring surgical intervention. While the intraoperative complications and immediate results of pyloromyotomy are widely reported in the literature, the remote consequences of this intervention, especially depending on the method of correction, are not well understood and contain contradictory results. Purpose - to study the remote consequences of pyloromyotomy depending on the method of surgical correction - open (OMPT) or laparoscopic pyloromyotomy (LMPT). Materials and methods. The primary assessment of long-term outcomes was performed by analysing the answers to the questions of the Diagnostic Questionnaire for Paediatric Functional Gastrointestinal Disorders, which was sent to 246 patients and their parents; responses were received from 169 (68.7%) respondents, who were included in the study. Re-hospitalisation was required in 57 (33.7%) children who underwent X-ray examination, fibrogastroscopy and ultrasonography. Statistical processing of the study results was performed using the software StatPlus: mac, AnalystSoft Inc. (version v8). Results. The average age of patients involved in the study was 8.5±0.3 years (range of fluctuations - from 2 to 18 years old). Among the respondents, 132 (78.1%) children underwent OPMT, and 37 (21.9%) children underwent LPMT. No complaints were expressed by 102 (60.4%) children, including 81 (61.4%) children after OPMT and 21 (56.8%) after LPMT (p=0.6152). The main complaint in children after pyloromyotomy, which required re-hospitalisation, was chronic abdominal pain, as indicated by 38 (22.5%) of the respondents. There was no correlation between the occurrence of chronic abdominal pain and the age at which hypertrophic pylorostenosis was diagnosed (R=0.183, p=0.2588), the duration of the disease (R=0.079, p=0.6275) and the child's body weight at the time of the intervention (R=0.048, p=0.768). Functional disorders of the digestive tract were diagnosed in 15 (8.9%) children. In 24 (14.2%) children, a slowdown in barium passage through the intestine was detected, which, in combination with periodic pain, indicated chronic adhesive disease. Fibrogastroscopy revealed duodenogastric reflux in 18 (10.7%) children, which in 5 (2.96%) patients was combined with pylorus insufficiency and in 12 (7.1%) with gastritis, and in 17 (10.1%) children gastroesophageal reflux was diagnosed. Conclusions. Thus, in the long term after pyloromyotomy, 33.7% of children required re-hospitalisation due to various pathologies of the gastrointestinal tract. Duodenogastric and gastroesophageal reflux and chronic adhesive disease were most often detected in the long term after pyloromyotomy, and the frequency of their occurrence did not depend on the method of surgical intervention. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the paper. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Presence of Parabens in Different Children Biological Matrices and Its Relationship with Body Mass Index.

Parabens have been accepted almost worldwide as preservatives by the cosmetic, food, and pharmaceutical industries. Since epidemiological evidence of the obesogenic activity of parabens is weak, the aim of this study was to investigate the association between parabens exposure and childhood obesity. Four parabens (methylparaben/MetPB, ethylparaben/EthPB, propylparaben/PropPB, and butylparaben/ButPB) were measured in 160 children's bodies between 6 and 12 years of age. Parabens measurements were performed with ultrahigh-performance liquid chromatography coupled with tandem mass spectrometry (UHPLC-MS/MS). Logistic regression was used to evaluate risk factors for elevated body weight associated with paraben exposure. No significant relation was detected between children's body weight and the presence of parabens in the samples. This study confirmed the omnipresence of parabens in children's bodies. Our results could be a basis for future research about the effect of parabens on childhood body weight using nails as a biomarker due to the ease of its collection and its non-invasive character.

A new method to estimate children's weight accurately in emergency settings using foot length and mid-upper arm circumference

BackgroundIn emergency settings, medication dosages are primarily determined based on the child's weight; however, the healthcare personnel sometimes may have to make the first intervention without knowing the patient's weight, which may result in an underdose or overdose of the medication. We aimed to find a reliable method to estimate children's bodyweight, including the obese and malnourished. MethodsWe conducted the study with children between the ages of 3 and 17 years. We measured the children's bodyweight, right foot length, and mid-upper arm circumference in centimeters during their examination. We created a concise formula through regression analysis to estimate the patients' weight based on the right foot length and mid-upper arm circumference. Finally, we compared this formula to other conventional formulae. ResultsThe study included 741 patients whose average age was 8.4±3.9 (3–17) years. A high correlation was found between the patients' foot length, arm circumference, and bodyweight (R: 0.866, p<0.001 and R: 0.910, p<0.001, respectively). A single formula was created by regression analysis based on foot length and the mid-upper arm circumference without including sex and age in the calculation to make a more straightforward and faster calculation in emergency cases. ConclusionThe formula created may be advantageous for reliably and easily estimating the weight of children aged 3–17 of any sex and body habitus in emergency settings without special equipment. This newly developed formula may enable a low-cost optimal level of weight estimation without the need for special equipment.

Risk of body weight changes among Danish children and adolescents during the COVID-19 pandemic.

Knowledge of COVID-19 and the pandemic's effects on Danish children's body weight is limited. Objectives were to investigate (I) risk of weight changes among Danish children with and without SARS-CoV-2, (II) associations between weight changes, psychological symptoms, and long COVID symptoms, and (III) weight distribution pre- and post-pandemic. A national survey was administered to all Danish children aged 0-18 years, with prior COVID-19 (cases) and matched references including questions on weight, weight changes during the pandemic and long COVID-related symptoms. Descriptive statistics and logistic regression were used. Weight distribution was compared with a pre-pandemic database. In all, 17 627 cases and 54 656 references were included. The 4-18-year-old cases had lower odds of unintended weight gain. The 2-3-year-old cases had higher odds and the 15-18-year-old cases lower odds of weight loss compared to references. Regardless of COVID-19 status, any reported long COVID-related symptom was associated with a change in body weight. No sign of increasing obesity rates was found among Danish children post-pandemic. COVID-19 was associated with higher odds of weight loss in 2-3-year-olds and lower odds of unintended weight gain in 4-18-year-olds. Any long COVID-related symptom was associated with higher odds of weight changes regardless of COVID-19 status.

Exploring the understanding of how parenting influences the children's nutritional status, physical activity, and BMI.

Parental behaviors and the home environment are two of the most effective ways to adopt healthy eating and active lifestyles. For this reason, it is crucial to understand children's nutritional habits, analyze the dynamics related to parental factors, diagnose and treat childhood obesity in the early period, and prevent adulthood obesity. This study aimed to explore how parenting influences children's nutritional status, physical activity, and BMI. The study involved 596 children with their parents. The data were collected through face-to-face interviews using the survey method. The survey consists of descriptive information (age, gender, educational status), anthropometric measurements, nutritional habits, Family Nutrition and Physical Activity Scale (FNPA), International Physical Activity Questionnaire, and 24-h dietary recall. The Mean Adequacy Ratio (MAR) was applied to assess dietary adequacy. Most mothers and fathers were overweight or obese (61.6 and 68.7%, respectively). 38.6% of boys and 23.1% of girls were overweight or obese. The FNPA score was positively correlated with MAR (p < 0.05). Multiple linear regression analysis revealed that children's BMI was negatively correlated with FNPA score, while maternal BMI and father's BMI were positively correlated (p < 0.05). Furthermore, dietary energy was not associated with the child's BMI but with dietary adequacy (p < 0.05). There was no evidence that family impacted children's physical activity. This study supports that parenting influences children's dietary intake and BMI. Adequate and balanced nutrition, regardless of dietary energy, may affect children's body weight. Family plays a significant role in influencing and forming children's lifestyle-related behaviors. Children's healthy eating and physical exercise habits can be encouraged through school-based programs involving families.

Changes in Lifestyle and Body Weight in Children and Adolescents during the COVID-19 Pandemic: A Representative Survey of Parents in Germany

Introduction: The public restrictions taken during the COVID-19 pandemic have substantially affected lifestyle and health behavior of children and adolescents. In Germany, little is known how these changes influenced daily life in families with children and adolescents. Methods: A cross-sectional survey was performed in April/May 2022 across Germany, similar to a survey performed in 2020. Parents (N = 1,004, 20–65 years) with at least one child aged 3–17 years filled in an online questionnaire released by the Forsa Institute for Social Research and Statistical Analysis. Fifteen questions related to eating habits, dietary patterns, physical activity, media consumption, fitness, mental health, and body weight were included, and standard socioeconomic parameters were assessed. Results: Parents’ answers indicated that there was a parental self-reported weight gain in every sixth child since the beginning of the COVID-19 pandemic. This was most obvious in children from families with lower household income and preexisting overweight. Parents also reported that lifestyle patterns had worsened: 70% reported an increase of media consumption during leisure time, 44% a decrease in daily physical activity, and 16% the worsening of dietary habits (e.g., 27% stated to eat more cake and sweets). Children aged 10–12 years were most severely affected. Conclusion: Negative health effects related to the COVID-19 pandemic are predominantly observed in children 10–12 years of age and in children from families with low household income, suggesting a worsening social disparity. Political action is urgently needed to tackle the adverse consequences of the COVID-19 pandemic on childhood lifestyle and health.

Effect of migrant parents' bodyweight perception on children's body bodyweight: A longitudinal analysis of population cohort study

Children of migrants in Australia are disproportionally affected by overweight/obesity. Their parents, however, are likely to put little effort into lifestyle changes if unable to recognise their children's suboptimal bodyweight. We examined the potential impact of migrant parents' bodyweight perception on their children's bodyweight over time and whether the region-of-birth of parents and acculturation to the host nation's way of life moderated the relationship, as very little is known about these in the Australian context. We analysed a sample of 2046 children of migrant parents drawn from 8 waves of population-based cohort data, the Longitudinal Study of Australian Children, capturing their lived experience from ages 2 to 17. After controlling for child, parent, family, and neighbourhood factors influencing children's bodyweight, multilevel models showed higher children's bodyweight in subsequent waves if their parents perceived children's bodyweight as lower than their actual bodyweight (i.e., underestimation). However, the rate of increase in children's bodyweight attenuated over time. The effect of migrant parents' underestimation on children's subsequent bodyweight differed by region-of-birth, with higher children's bodyweight in successive waves if their parents were from the Americas, compared to migrant parents from North/West Europe. Parents' acculturation, however, did not have a discernible effect. Although migrant parents' bodyweight perception of their children's bodyweight status influenced children's bodyweight in subsequent waves, this factor was not enough to explain the extent of disparities in children's bodyweight observed in the Australian migrant population. Further research is needed to assess the effects of other types of perception (such as perceptions of healthy weight and physical exercise) on bodyweight disparities in children of migrants.

Determinants of mechanical efficiency trajectories from childhood to adolescence: Findings from the QUALITY cohort

PurposeTo estimate the shape and number of mechanical efficiency (ME) trajectories from childhood to adolescence; and verify whether ME trajectory membership can be predicted by sex, biological maturation, body weight, body composition and physical activity (PA) in childhood. MethodsData from QUALITY, an ongoing cohort study on the natural history of obesity, were used. Participants attended a baseline visit (8–10 years, n = 630) and follow-up visits two years (n = 564), and seven years (n = 377) later. ME was assessed by an incremental cycling test at 50w (ME50w, %) and at VO2peak (MEVO2peak, %). Group-based trajectory analysis for ME and a logistic regression were performed. ResultsMean age of the 454 participants (boys = 54%) was 9.7 ± 0.9 years at baseline. Two distinct ME50w trajectories were identified and all tended to decrease. No distinct trajectories emerged for MEVO2peak; average MEVO2peak increased over time. Thus, the difference between MEVO2peak (∆) at baseline and follow-up was calculated for correlation analysis. Trajectory groups were labeled “Low-Decreaser” and “High-Decreaser” (Reference) for ME50w, describing the starting point and slope. High-Decreasers were mostly prepubertal girls, had lower body weight and fat free mass index, lower PA and lower VO2peak at baseline (χ2or t-test, p < 0.05). Girls were less likely to be Low-Decreasers (OR = 0.56, 95%CI = 0.42–0.74), while having overweight/obesity predicted a greater likelihood of classification in the Low-Decreaser trajectory (OR = 2.38, 95%CI = 1.16–4.88). Those with higher PA were more likely to be Low-Decreasers (OR = 1.02, 95%CI = 1.01–1.04). Finally, concerning MEVO2peak, sex, biological maturation, body weight, zBMI, fat free mass index, PA and VO2peak were positively correlated with ∆ MEVO2peak. ConclusionsWe found evidence that excess weight at baseline predicts low levels of ME in childhood and adolescence. Additionally, higher PA at baseline is not related to higher ME50w levels. More research is needed to identify different approaches to explore this measure in transition to adulthood.

Outcomes, dosing, and predictors of vedolizumab treatment in children with inflammatory bowel disease (VEDOKIDS): a prospective, multicentre cohort study

Scarce data are available on the use of vedolizumab in children with inflammatory bowel disease (IBD). We aimed to evaluate the safety, effectiveness, and dosing of vedolizumab to induce remission of IBD. VEDOKIDS was a paediatric, multicentre, prospective cohort study done in 17 centres in six countries. We report the 14-week outcomes as the first analyses of the planned 3-year follow-up of the VEDOKIDS cohort. Children (aged 0-18 years) with IBD who had commenced vedolizumab were followed up at baseline and at 2, 6, and 14 weeks. Children were managed according to local prescribing practices without standardisation of dosing or criteria for escalation, but the study protocol suggested dosing of 177 mg/m2 body surface area (up to 300 mg maximum). The primary outcome was steroid-free and exclusive enteral nutrition-free remission at 14 weeks, analysed according to the intention-to-treat principle. Serum samples were taken for analysis of drug concentration and faecal calprotectin at baseline, and at 2, 6, and 14 weeks. Adverse events were recorded in real time and classified as severe or non-severe and related or unrelated to vedolizumab. This study is registered with ClinicalTrials.gov, NCT02862132. Between May 19, 2016, and April 1, 2022, 142 children (76 [54%] girls and 66 [46%] boys; mean age 13·6 years [SD 3·6]) were enrolled. 65 (46%) children had Crohn's disease, 68 (48%) had ulcerative colitis, and nine (6%) had unclassified IBD (those with unclassified IBD were analysed with the ulcerative colitis group). 32 (42% [95% CI 30-54]) of 77 children with ulcerative colitis and 21 (32% [23-45]) of 65 children with Crohn's disease were in steroid-free and exclusive enteral nutrition-free remission at 14 weeks. Median drug concentrations at week 14 were higher in children with ulcerative colitis than in those with Crohn's disease (11·5 μg/mL [IQR 5·5-18·1] vs 5·9 μg/mL [3·0-12·7]; p=0·006). In children who weighed less than 30 kg, the optimal drug concentration associated with steroid-free and exclusive enteral nutrition-free clinical remission was 7 μg/mL at week 14 (area under the curve 0·69 [95% CI 0·41-0·98]), corresponding to a dose of 200 mg/m2 body surface area or 10 mg/kg. 32 (23%) of 142 children reported at least one adverse event, the most common were headache (five [4%]), myalgia (four [3%]), and fever (three [2%]). None of the adverse events were classified as severe, and only two (1%) patients discontinued treatment due to adverse events. Vedolizumab showed good safety and effectiveness at inducing remission in children with IBD at 14 weeks, especially those with ulcerative colitis. Vedolizumab should be considered in children when other approved drug interventions for IBD are unsuccessful. In children who weigh less than 30 kg, vedolizumab should be dosed by the child's body surface area (200 mg/m2) or weight (10 mg/kg). The European Crohn's and Colitis Organization, the European Society for Paediatric Gastroenterology Hepatology and Nutrition, and Takeda.

Effect of maternal hypertensive disorders during pregnancy on offspring's early childhood body weight: A population-based cohort study

ObjectiveThe prevalence of hypertensive disorder during pregnancy (HDP) and childhood obesity is increasing worldwide. HDP or obesity in mothers can increase the risk of overweight/obesity (OWOB) in their children. Few longitudinal studies have examined the associations of maternal body weight with the growth and risk factors for overweight in infants born to mothers with HDP. This study examined the risk factors for childhood OWOB through the age of 66 months in children born to mothers with HDP. Materials and methodsIn total, 24,200 pairs of mothers and their children were selected from the Taiwan Birth Cohort Study. The children's body weights were classified and analyzed to determine infant growth at birth and at the ages of 12, 24, 36, and 66 months. Multiple logistic regression analyses with different model settings were performed to identify the factors affecting growth and childhood OWOB in the children of mothers with HDP. ResultsThe average birth weight of children was lower in the HDP group than in the non-HDP group. The catch-up phenomenon began at the age of 18 months. The incidence of OWOB was higher in the children in the HDP group than in those in the non-HDP group from the age of 24 months and increased with the children's age. At every age point, maternal overweight before pregnancy was the main risk factor for childhood OWOB, and this effect increased with the children's age (odds ratio [OR]: 1.83 at 66 months). The effect of excessive maternal gestational weight gain on childhood OWOB was significant (OR: 1.26–1.44 for various age points). ConclusionMaternal overweight is the main risk factor for OWOB in children born to mothers with HDP. After adjusting for related confounders, we determined that HDP did not exert a significant effect on the risk of childhood OWOB.

Longitudinal Study of Growth Variation and Its Determinants in Body Weight of Children Aged 1 - 15 Years in Ethiopia

Background: Child growth assessment serves as a tool for assessing children's health and nutritional condition. Longitudinal studies have statistical power in inspecting growth changes. Objectives: This study aimed to examine the longitudinal growth differences and determinants of children's body weight in Ethiopia. Methods: Longitudinal data were obtained from the Young Lives cohort study conducted in Ethiopia from 2002 to 2016. The study involved 1,665 Ethiopian children who were followed from age 1 to 15 years. The obtained data were analyzed using a fractional polynomial mixed-effect model. Results: Children's weight gain followed non-linear trajectories. There were considerable differences in children's body weight across different regions of Ethiopia. Children in Addis Ababa, Oromiya, and SNNPR had much faster weight growth than Tigray children. There was no substantial difference in the children's rate of weight gain between Tigray and the Amhara region. Boys had a faster rate of change in weight gain than girls. Conclusions: Controlling for other factors, gender, residence, region, parental education, household size, wealth, and mother's age had significant influences on the longitudinal weight growth of children. However, safe drinking water, sleeping time, and father's age were not related to the weight trajectory over time.

Body Weight at Age Four Years and Readiness to Start School: A Prospective Cohort Study.

Background: Adolescents with obesity have lower academic performance, but little is known about the association between body weight in early childhood and school readiness. The objective was to examine the association between age- and sex-standardized body mass index (zBMI) and body weight status and school readiness in young children. Methods: A prospective cohort study in Toronto, Canada, was conducted in young children enrolled in TARGet Kids!. Children's weight and height were measured before the start of kindergarten. Children's school readiness was measured by the Early Development Instrument (EDI), a validated teacher-completed instrument that assesses children's skills and behaviors in five developmental domains in kindergarten. Generalized estimating equations, adjusted for relevant confounders, were used in the analysis. Results: The study included 1015 children (1217 observations): 52% were male and mean age at zBMI was 4.2 years [50 months (SD 12.1)] and school readiness was 5.2 years [62.7 months (SD 6.9)]. There was no evidence found that zBMI was associated with school readiness. However, in a post hoc analysis, being classified as overweight or with obesity in kindergarten was associated with twofold higher odds of vulnerability in school readiness and a lower social competence score compared with their normal weight peers. Conclusions: Being classified as overweight or with obesity was associated with poor school readiness in year 2 of kindergarten. Early interventions to promote healthy growth before school entry may help promote development and school readiness in young children. www.clinicaltrials.gov (NCT01869530).