Difference In Body Mass Index Z-score Research Articles

Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity.

Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity.

Differences in weight status among Australian children and adolescents from priority populations: a longitudinal study.

Australia has a high level of cultural and linguistic diversity, including Aboriginal and Torres Strait Islander peoples. Children from specific cultural and ethnic groups may be at greater risk of overweight and obesity and may bear the additional risk of socioeconomic disadvantage. Our aim was to identify differences in body-mass index z-score (zBMI) by: (1) Cultural and ethnic groups and; (2) Socioeconomic position (SEP), during childhood and adolescence. We used data from the Longitudinal Study of Australian children (n = 9417) aged 2-19 years with 50870 longitudinal measurements of zBMI. Children were classified into 9 cultural and ethnic groups, based on parent and child's country of birth and language spoken at home. These were: (1) English-speaking countries; (2) Middle East & North Africa; (3) East & South-East Asia; (4) South & Central Asia; (5) Europe; (6) Sub-Saharan Africa; (7) Americas; (8) Oceania. A further group (9) was defined as Aboriginal and Torres Strait Islander from self-reported demographic information. Longitudinal cohort analyses in which exposures were cultural and ethnic group and family socioeconomic position, and the outcome was zBMI estimated using multilevel mixed linear regression models. We stratified our analyses over three periods of child development: early childhood (2-5 years); middle childhood (6-11 years); and adolescence (12-19 years). Across all three periods of child development, children from the Middle East and North Africa, the Americas and Oceania were associated with higher zBMI and children from the two Asian groups were associated with lower zBMI, when compared to the referent group (English). zBMI was socioeconomically patterned, with increasingly higher zBMI associated with more socioeconomic disadvantage. Our findings identified key population groups at higher risk of overweight and obesity in childhood and adolescence. Prevention efforts should prioritize these groups to avoid exacerbating inequalities in healthy weight in childhood.

THU180 Evaluation Of Factors Affecting Changes In Body Mass Index In Childhood Brain Tumor Survivors

Abstract Disclosure: D. Chatila: None. L.A. DiMeglio: None. D. Runco: None. N.G. Haddad: None. Introduction Excessive weight gain in childhood brain tumor (CBT) survivors has been documented. We characterized changes in body mass index (BMI) in CBT survivors and studied possible risk factors for excessive weight gain. Objectives 1) Compare BMI z-score at CBT diagnosis to that at time of last clinical follow up, and 2) Correlate BMI and BMI z-score changes with age at diagnosis; tumor location; treatment including radiation therapy (RT), chemotherapy (CT), or both; presence of endocrinopathies. Methods Following IRB approval, we conducted a retrospective chart review of children with CBTs diagnosed between 2005 and 2017. We excluded children with craniopharyngiomas due to their known high risk of obesity. Results 311 patients (177 female) were identified (median age at diagnosis 6y [range 0-18 y], median follow-up duration 6y [range 1-15 y]. Gliomas were the most common CBT type (69%) then medulloblastomas (18%) and germinomas (6%). 77 (25%) of CBTs were suprasellar. 137 patients received RT, 167 had CT, 110 had both, 7 had only surgery. 95 (30%) of children were ultimately diagnosed with a concomitant endocrinopathy. Baseline BMI and BMI z-scores (18.6 ± 4.8; 0.45 ± 1.52) correlated with mean BMI and BMI z-scores at last follow up [22.5 ± 6.4 (r=0.15, p=0.005); 0.67 ± 1.26, (r=0.11, p=0.048)]. BMI z-scores increased significantly over time. Age at diagnosis was not correlated with change in BMI or BMI z-scores. There were no differences in BMI z-scores at last follow-up or change in BMI z-scores between patients who had suprasellar tumors vs those with other tumor locations (BMI z-scores 0.94 ± 1.53 vs 0.60 ± 1.17, p=0.06; change in BMI z-score 0.36 ± 1.95 vs 0.18 ± 1.84, p=0.47). However, patients with a suprasellar tumor location had a lower mean age at diagnosis (5.6 ± 4.2 years vs 7.2 ± 4.2 years p=0.01). There were no differences in BMI z-scores at last follow-up or change in BMI z-score by type of treatment (CT, RT, or surgery alone) nor were there differences in BMI z-scores at last follow-up or change in BMI z-score between patients who did and did not have endocrinopathies (BMI z-score 0.61 ± 1.29 vs 0.70 ± 1.25, p=0.57; change in BMI z-score 0.03 ± 1.95 vs -0.33 ± 1.817, p=0.11) although children with endocrinopathies were older at CBT diagnosis (8.1 ± 4.9 years vs 6.3 ± 4.5 years, p=0.002) and had a longer duration of follow up than patients without endocrinopathies (7.5 ± 3.4 vs 5.7± 3.0 years, p< 0.001). Conclusions In CBT survivors, BMI z-scores increased over time however this change did not correlate with age at diagnosis of CBT, tumor location, type of intervention received, or presence of endocrinopathies. Future studies are needed to evaluate additional risk factors underlying increases in BMI. Presentation: Thursday, June 15, 2023

Gestational age and trajectories of body mass index and height from birth through adolescence in the Danish National Birth Cohort

Preterm birth is associated with smaller body dimensions at birth. The impact on body size in later life, measured by body mass index (BMI) and height, remains unclear. A prospective register-based cohort study with 62,625 singletons from the Danish National Birth Cohort born 1996–2003 for whom information on gestational age (GA) at birth, length or weight at birth, and at least two growth measurements scheduled at the ages of 5 and 12 months, and 7, 11 and 18 years were available. Linear mixed effects with splines, stratified by sex, and adjusted for confounders were used to estimate standardised BMI and height. GA was positively associated with BMI in infancy, but differences between preterm and term children declined with age. By age 7, preterm children had slightly lower BMI than term children, whereas no difference was observed by adolescence (mean difference in BMI z-score − 0.28 to 0.15). GA was strongly associated with height in infancy, but mean differences between individuals born preterm and term declined during childhood. By adolescence, the most preterm individuals remained shorter than their term peers (mean difference in height z-score from − 1.00 to − 0.28). The lower BMI in preterm infants relative to term infants equalizes during childhood, such that by adolescence there is no clear difference. Height is strongly positively associated with GA in early childhood, whilst by end of adolescence individuals born preterm remain slightly shorter than term peers.

The Physical Behaviour Intensity Spectrum and Body Mass Index in School-Aged Youth: A Compositional Analysis of Pooled Individual Participant Data.

We examined the compositional associations between the intensity spectrum derived from incremental acceleration intensity bands and the body mass index (BMI) z-score in youth, and investigated the estimated differences in BMI z-score following time reallocations between intensity bands. School-aged youth from 63 schools wore wrist accelerometers, and data of 1453 participants (57.5% girls) were analysed. Nine acceleration intensity bands (range: 0–50 mg to ≥700 mg) were used to generate time-use compositions. Multivariate regression assessed the associations between intensity band compositions and BMI z-scores. Compositional isotemporal substitution estimated the differences in BMI z-score following time reallocations between intensity bands. The ≥700 mg intensity bandwas strongly and inversely associated with BMI z-score (p < 0.001). The estimated differences in BMI z-score when 5 min were reallocated to and from the ≥700 mg band and reallocated equally among the remaining bands were −0.28 and 0.44, respectively (boys), and −0.39 and 1.06, respectively (girls). The time in the ≥700 mg intensity band was significantly associated with BMI z-score, irrespective of sex. When even modest durations of time in this band were reallocated, the asymmetrical estimated differences in BMI z-score were clinically meaningful. The findings highlight the utility of the full physical activity intensity spectrum over a priori-determined absolute intensity cut-point approaches.

The impact of breastfeeding on childhood obesity in children that were large-for-gestational age: retrospective study from birth to 4 years

Our aim was to assess effects of breast-feeding (BF) in the association between large-for-gestational age (LGA) and body mass index (BMI) trajectories on childhood overweight from 1 to 4 years old. A total of 1649 healthcare records of mother–child pairs had detailed records of feeding practices and were included in this retrospective cohort study. Data were available in Medical Birth Registry of Xiamen between January 2011 and March 2018. Linear and logistic regression models were used to access the difference between BF and no-BF group. For offspring were LGA and BF was significantly associated with a lower BMI Z-score from 1 to 4 years old after adjustment confounders in Model 1 to 3 [difference in BMI Z-score in Model 1: estimated β: −0.07 [95%CI: −0.13 to −0.01]; Model 2: estimated β: −0.07 (−0.13 to −0.004); Model 3: estimated β: −0.06 (−0.12 to −0.001); P = 0.0221, 0.0371, 0.0471]. A significantly lower risk of childhood overweight was observed in Model 1 [odd ratio (OR): 0.85 (95%CI, 0.73 to 1.00)], P = 0.0475) with adjustment for maternal pre-pregnancy BMI. Furthermore, Model 2 and Model 3 showed LGA-BF infants had a lower risk for childhood overweight then LGA-no-BF infants [OR: 0.87 and 0.87 (95%CI, 0.73 to 1.03; 0.74 to 1.03)], however, there was no statistical significance (P = 0.1099, and 0.1125)]. BF is inversely related to BMI Z-score and risk for overweight in children were LGA from 1 to 4 years old. Adjustment for maternal pre-pregnancy BMI, the protective association between BF and childhood overweight was more significant.

Differences in sibling temperament are associated with differences in maternal use of food to soothe during infancy: A sibling analysis.

Firstborn children are more likely to have obesity than secondborns, which may partially be explained by differential use of food to soothe (FTS) infant distress, which has been inked to higher weight status. To test associations between the birth order and maternal FTS and whether differences in sibling temperament and body mass index (BMI) z-scores were associated differences in maternal FTS. Random effect models assessed associations between birth order and FTS. Linear regressions examined associations between differences in maternal FTS and sibling differences in temperament at 16 weeks and BMI z-scores at 1 year. Mothers (n=117) used contextual-based FTS more with firstborns than secondborns (2.70 vs. 2.38, p < 0.0001). Sibling differences in negative affect were associated with differences in maternal contextual-based (R2 =0.09, p=0.002) and emotion-based (R2 =0.09, p=0.001) FTS. Sibling differences in effortful control were associated with differences in maternal emotion-based FTS (R2 =0.04, p=0.04). Finally, differences in maternal emotion-based FTS were associated with sibling differences in BMI z-scores at age 1year (R2 =0.14, p=0.006). To promote healthy child weight, mothers should learn to respond to each child's temperament and use alternatives to FTS infant distress.

Early Risk Factors for Obesity in the First 1000 Days-Relationship with Body Fat and BMI at 2 Years.

(1) Background: Obesity is defined as an excessive accumulation of body fat. Several early developmental factors have been identified which are associated with an increased risk of childhood obesity and increased adiposity in childhood. The primary objective of the present study is to analyse the effect of various early risk factors on Body Mass Index (BMI) and body fat percentage at 2 years of age. (2) Methods: A prospective cohort study design was used, with the sample consisting of 109 mother-child pairs from whom data were collected between early pregnancy and 2 years old. Adiposity was determined based on skinfold measurements using the Brooks and Siri formulae. Mean comparison tests (Student’s t-test and ANOVAs) and multiple linear regression models were used to analyse the relationship between early programming factors and dependent variables. (3) Results: Maternal excess weight during early pregnancy (β = 0.203, p = 0.026), gestational smoking (β = 0.192, p = 0.036), and accelerated weight gain in the first 2 years (β = − 0.269, p = 0.004) were significantly associated with high body fat percentage. Pre-pregnancy BMI and accelerated weight gain in the first 2 years were associated with high BMI z-score (β = 0.174, p = 0.047 and β = 0.417, p = 0.000 respectively). The cumulative effect of these variables resulted in high values compared to the baseline zero-factor group, with significant differences in BMI z-score (F = 8.640, p = 0.000) and body fat percentage (F = 5.402, p = 0.002) when three factors were present. (4) Conclusions: The presence of several early risk factors related to obesity in infancy was significantly associated with higher BMI z-score and body fat percentage at 2 years of age. The presence of more than one of these variables was also associated with higher adiposity at 2 years of age. Early prevention strategies should address as many of these factors as possible.

The Relationship of Early Adiposity Rebound With Accelerated Bone Age and Breast Development in Girls: A Prospective Cohort Study

Abstract Introduction: Adiposity rebound (AR) refers to the increase in body mass index (BMI) that follows the BMI nadir in childhood. Earlier AR increases the likelihood of being overweight/obese and may lead to early pubertal advancement, especially in girls. We aimed to evaluate the longitudinal changes in anthropometrics, bone age (BA), and breast development in relation to AR timing in girls. Methods: This study included girls (n = 349) of the Environment and Development of Children (EDC) cohort, a prospective cohort of healthy children started in 2012 with biennial visits to study the effects of environmental exposures on physical and neurobehavioral development. The BMI trajectories of girls with 3 or more measurements between 2 and 8 years of age (n = 242) were visually inspected to determine AR timing. After excluding preterm and multiple births, 204 girls were included and categorized according to the age at AR: group 1 (&amp;lt;3.9 years; n = 34, 17%), group 2 (3.9-5.9 years; n = 55, 27%) and group 3 (≥6 years; n = 115, 56%). AR groups were compared for differences in anthropometric measures, BA progression, and breast development. The relationships between AR and outcomes were analyzed with adjustment for age, gestational age, birthweight, physical activity and diet. Results: At age 2, there were no differences in anthropometric measures. By age 4, group 1 showed higher mean BMI z-scores (0.87) than groups 2 (-0.19) and 3 (-0.45) (P &amp;lt;0.001). The differences in BMI z-scores were significant between all 3 groups at 6 and 8-years (P &amp;lt;0.001, for all). Height differences became significant at 8-years (P = 0.010), with greater mean height z-score in group 1 (0.80) compared to group 3 (0.30). BA progression differed significantly between groups 1, 2 and 3 at 6-years (BA 6.87 vs. 6.44 vs. 6.36 years respectively; P &amp;lt; 0.001) and at 8-years (BA 9.65 vs. 8.82 vs. 8.60 respectively; P &amp;lt; 0.001). The inverse relationship between AR timing and BA remained significant after adjusting for covariates at 6 years (B = -0.222, P = 0.040) and 8 years (B = -0.468, P &amp;lt;0.001). Breast development occurred in 49 girls (24%) by age 8 with increased occurrence in the earlier AR groups: group 1 (n = 16, 47%), group 2 (n = 17, 31%), and group 3 (n = 16, 14%) (P for trend &amp;lt;0.001). When compared to group 3, the earlier AR groups had significantly increased risk of breast development at age 8 (OR 5.1, 95%CI 2.1-12.4 for group 1 and OR 2.4, 95%CI 1.1-5.4 for group 2, P &amp;lt;0.001 for both), after adjusting for covariates (P &amp;lt;0.05, for both). Conclusions: Girls who had earlier AR showed greater BA progression starting at 6 years and continuing at 8 years along with greater height at 8 years. These girls are at risk for early breast development after adjustment for covariates. AR timing may be a predictor for BA progression and onset of breast development in girls.

Evaluation of a group family-based intervention programme for adolescent obesity: the LITE randomised controlled pilot trial.

This study aimed to evaluate the LITE (Lifestyle Intervention for TEenagers) group programme, a family-based behavioural lifestyle intervention for overweight and obese adolescents. We conducted a two-arm randomised controlled trial that recruited overweight and obese adolescents who attended a tertiary care weight management clinic. Participants were randomised to the LITE programme or usual care. The primary outcome assessed was body mass index (BMI) z-score. Secondary outcomes of anthropometric measurements, metabolic profile, parenting and adolescents' perception of family support were measured at baseline, three months and six months. Feasibility and acceptability of the LITE programme were also evaluated. 61 adolescents were enrolled, with 31 in the LITE programme and 30 in usual care. At three months, participants in the programme had a greater reduction in weight (-0.18 ± 2.40 kg vs. 1.48 ± 1.97 kg; p = 0.107), waist circumference (-1.0 ± 3.1 cm vs. 2.4 ± 2.7 cm; p = 0.016), waist-height ratio (-0.01 ± 0.02 vs. 0.01 ± 0.02; p = 0.040) and systolic blood pressure (-3.8 ± 13.7 vs. 5.7 ± 13.1; p = 0.119) compared to the usual care group. There was no significant difference in BMI z-score. At six months, there were significant improvements in adolescents' perception of family support for eating habits in the LITE group compared to the usual care group. The LITE programme had a good attendance rate of 67.7% and was well received. The LITE programme showed feasibility and short-term clinical effectiveness in improving some clinical outcomes and improved adolescents' perception of family support.

The Role of Children\u2019s Dietary Pattern and Physical Activity in the Association Between Breastfeeding and BMI at Age 5: The GECKO Drenthe Cohort

ObjectivesBreastfeeding is protective against childhood obesity, but the role of childhood lifestyle in this association is unclear. We investigated whether physical activity and dietary pattern at age 5 differed between breastfed and non-breastfed children, and how they relate to Body Mass Index (BMI) Z-scores.Methods1477 children of the Dutch GECKO Drenthe birth cohort were included. At one month, children were categorized as breastfed (receiving breast milk exclusively or in combination with formula milk) or non-breastfed (receiving formula milk exclusively). At age 5, height and weight were objectively measured, physical activity was measured by ActiGraph GT3x and dietary patterns were assessed with a parent-reported food pattern questionnaire, assessing the consumption frequency of selected food items at seven occasions over the day.ResultsNon-breastfed children had higher BMI Z-scores (0.36 ± 0.90 vs. 0.20 ± 0.80 SD, p = 0.002), more frequently consumed sugar-sweetened beverages (25.0 ± 10.5 vs. 22.5 ± 9.71 times per week, p < 0.001), and consumed relatively less whole-wheat or brown bread (p = 0.007). Differences in sugar-sweetened beverage consumption were most pronounced during main meals. Total fruit consumption, sedentary time and moderate-to-vigorous physical activity levels did not differ between the groups. Multivariable adjusted linear regression analyses showed that the differences in BMI-z score between non-breastfed and breastfed children were not explained by the differences in sugar-sweetened beverages or type of bread consumed.ConclusionsInfant breastfeeding itself is indicative of healthy dietary behaviors in early life, and is also more likely to be followed by a favorable dietary pattern at toddler age. However, the differences in dietary habits between breastfed and non-breastfed children did not explain the difference in BMI Z-score at the age of 5.

Rural-urban differences in body mass index and obesity-related behaviors among low-income preschoolers.

With one in eight preschoolers classified as obese in the USA, childhood obesity remains a significant public health issue. This study examined rural-urban differences in low-income preschoolers' body mass index z-scores (BMIz), eating behaviors, dietary quality, physical activity (PA) and screen time. Pre-intervention data from 572 preschooler-parent dyads participating in a randomized, controlled obesity prevention trial in the Midwest USA were analyzed. We examined the associations among living in rural versus urban areas, child BMIz and child obesity-related behaviors, including eating behaviors, dietary quality, PA and screen time. Rural children had higher BMIz, more emotional overeating behaviors and more time spent playing outdoors compared with urban children. We found no associations between children living in rural versus urban areas and dietary quality and screen time. The study found that rural-urban differences in BMIz may start as early as 3-4years of age, if not earlier. To reverse the weight-related health disparities between rural and urban low-income preschoolers, structural changes in rural locations and family supports around coping skills may be needed.

Sex-specific associations between prenatal antibiotics exposure and offspring's body mass index.

Animal studies and epidemiological studies have shown that there is potential sex-specific sensitivity to the intrauterine environment in relation to the developmental programming of obesity. The objective of this study was to assess the sex-specific association between prenatal antibiotics exposure and body mass index (BMI) in offspring from 1 to 4 years. A total of 10,163 mother-child pairs from the Medical Birth Registry in Xiamen, China, were included in this prospective cohort study. Data on prenatal antibiotics exposure were collected from the prescription database. A total of 4909 (48.3%) offspring had prenatal antibiotics exposure. The associations between prenatal antibiotics exposure and offspring's BMI were significantly different among female offspring and male offspring (P for interaction: 0.034 at 1 year of age; 0.033 at 2 years of age; 0.020 at 3 years of age; and 0.021 at 4 years of age). In female offspring, prenatal antibiotic use was significantly associated with a higher BMI Z-score from 1 to 4 years old (difference in BMI Z-score: 0.11 [95% CI: 0.05-0.17] at 1 years of age; 0.10 [95% CI: 0.05-0.16] at 2 years of age; 0.14 [95% CI: 0.09-0.21] at 3 years of age; and 0.13 [95% CI: 0.07-0.19] at 4 years of age) after adjustment for confounder. Prenatal antibiotics use was not associated with offspring BMI Z-score from 1 to 4 years in male offspring. The association of prenatal antibiotics exposure and BMI Z-score from 1 to 4 years old may differ by sex of offspring.

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

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

Maternal Gestational Diabetes Mellitus and Offspring Body Mass Index from 1 to 4 Years

Objective: Using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria to diagnose gestational diabetes mellitus (GDM), the association between GDM and offspring body mass index (BMI) gains in early childhood in China remains unclear. We aimed to assess the association between GDM diagnosed by the IADPSG criteria and BMI gain and the risk for overweight/obesity in offspring from 1 to 4 years. Methods: This prospective cohort study was based on the healthcare records data from the Medical Birth Registry in Xiamen, China. We included 10,412 mother-child pairs tested for GDM using IADPSG criteria. Results: A total of 1,786 (17.2%) offspring were exposed to GDM. The offspring exposed to GDM had higher mean BMI Z-score (difference, 0.07; 95% confidence interval [CI], 0.02 to 0.12) and risk for overweight/obesity (odds ratio [OR], 1.22; 95% CI, 1.06 to 1.40) compared to those unexposed to GDM from 1 to 4 years of age. However, after adjustment for maternal pre-pregnancy BMI (Model 2), these associations attenuated towards the null (difference in BMI Z-score, 0.02; 95% CI, -0.03 to 0.07; OR for overweight/obesity, 1.09; 95% CI, 0.95 to 1.25). Conclusion: The associations between GDM diagnosed using IADPSG criteria and BMI Z-score and the risk for overweight/obesity in offspring at the age of 1 to 4 years were largely explained by maternal pre-pregnancy BMI. Reducing the prevalence of childhood overweight and obesity in China should focus on maternal weight status before pregnancy, in addition to glycemia during pregnancy. Abbreviations: BMI = body mass index; CI = confidence interval; GDM = gestational diabetes mellitus; IADPSG = International Association of Diabetes and Pregnancy Study Groups; LGA = large for gestational age; MBRX = Medical Birth Registry in Xiamen; OGTT = oral glucose tolerance test; OR = odds ratio.

Effects of intergenerational exposure interventions on adolescent outcomes: An application of inverse probability weighting to longitudinal pre-birth cohort data.

There is great interest in understanding whether interventions on sugar-sweetened beverage (SSB) consumption through pregnancy and early childhood affect adolescent body mass index (BMI). Without data from randomised trials, unbiased estimation of such effects might be achieved with observational data given sufficient and appropriate adjustment for both baseline and time-varying confounders. To illustrate the use of inverse probability (IP) weighting of marginal structural models (MSM) for estimating the effects of SSB consumption through pregnancy and early childhood on the mean early adolescent BMI z-score. Our baseline sample consisted of 1584 pregnant women from a pre-birth cohort. We defined 6 intervention intervals: early pregnancy, late pregnancy, 3, 4, 5, and 6years. We fitted a MSM via a weighted linear regression with IP exposure and censoring weights to estimate the mean difference in BMI z-score under interventions: "maintain SSB consumption below (vs above) 0.5 servings/day in all intervals." The estimated difference in mean BMI z-score under interventions maintaining SSB consumption at or below (vs above) 0.5 servings/day from pregnancy to 6years was -0.94 (95% confidence interval [CI] -1.52, -0.08). The effect estimate in pregnancy, while fixing the exposure range in childhood, was -0.05 (95% CI -0.34, 0.23), and in early childhood, while fixing the range in pregnancy was -0.89 (95% CI -1.46, -0.11). The effect estimates were largely unchanged under sensitivity analyses to different implementation choices except for the choice of time interval length. Under assumptions that include no unmeasured confounding and selection bias, and no model misspecification, results of thisIP weighting application are in line with a lower mean BMI z-score in early adolescence under interventions ensuring lower, vs greater, SSB consumption in early life. This application provides a resource for researchers working with longitudinal birth cohort studies and interested in similar causal questions.

A cross-sectional study on the deprivation and sex differences in health-related fitness measures in school children

ABSTRACTThis study aimed to investigate deprivation and sex differences in selected health-relatedfitness measures in 9-12-year-old children. Data were captured on 3,407 children (49.3% boys; aged 10.5 ± 0.6 years). Cardiorespiratory fitness(20 m multistage shuttle run test; 20 m MSRT), muscular strength (handgrip strength) and body mass index (BMI) were measured. Welsh Index of Multiple Deprivation (WIMD) scores were used to make quintile groups. A two-way Analysis of Variance examined differences in BMI z-score by sex and WIMD quintiles. Two-wayAnalysis of Covariances investigated the effect of sex and WIMD quintiles on grip strength and shuttles achieved in 20 m MSRT, adjusting for BMI z-score and maturation, repectively. Independent of sex, children in the middle quintile had a significantly higher mean BMI z-score (p = 0.029) than their least deprived counterparts. There was a significant increase in grip strength (p = 0.005) and20 m MSRT (boys p < 0.001; girls p = 0.028) between most and least deprived quintiles. Significant differences in 20 m MSRT score were more apparent with decreases in deprivation in boys.Overall, inequalities exist in health-related fitness by sex and deprivation. These results can be used to inform focused services to improve current and future health.

Effects of the Girls on the Move randomized trial on adiposity and aerobic performance (secondary outcomes) in low-income adolescent girls.

Limited, mixed evidence exists regarding the effectiveness of physical activity interventions on adiposity and aerobic performance in adolescent underrepresented populations. To examine effects of Girls on the Move on body mass index z-scores (BMI-z), percent (%) body fat, and aerobic performance in fifth- to eighth-grade underrepresented girls. A group randomized trial, involving 12 intervention and 12 control schools in low-income areas, was conducted. Participants (n = 1519) were low-active girls. The 17-week intervention included (a) a physical activity club, (b) two motivational interviewing sessions, and (c) one Internet-based session. BMI-z was determined from measured height and weight; % body fat was assessed using bioelectric impedance. Aerobic performance was assessed using a shuttle run. Demographics, physical activity (accelerometer), and pubertal development were assessed. Linear mixed models, adjusting for baseline, were used to examine group differences in postintervention. No significant between-group differences in BMI-z existed at postintervention, but % body fat increased less among intervention than control group girls (Mchange = 0.43% vs 0.73%). Aerobic performance decreased less in intervention vs control (Mchange = -0.39 vs -0.57). Although the intervention positively impacted % body fat and aerobic performance in underrepresented girls, more research is necessary to determine optimal implementation for yielding greater effects.

Neonatal Adipocytokines and Longitudinal Patterns of Childhood Growth.

ObjectiveAdipocytokines are markers of fetal metabolism, but their association with childhood growth is unclear. This study examined associations of neonatal adipocytokines with longitudinal childhood adiposity measures in a prospective cohort of pregnant women and their children.MethodsWe measured leptin and adiponectin concentrations at delivery and children’s body mass index (BMI) z-scores between ages 4 weeks and 8 years. We estimated differences in BMI z-scores and rates of BMI z-score change by leptin (N = 257) and adiponectin (N = 271) terciles.ResultsChildren in the middle (mean difference: 0.2; 95% CI: −0.1, 0.4) and highest (0.4; 95% CI: 0.1, 0.6) leptin terciles had greater BMI z-scores than children in the lowest tercile. Associations were null after adjustment for birthweight z-score. Children in the lowest adiponectin tercile had greater gains in BMI z-score (change per year: 0.10; 95% CI: 0.08, 0.13) than children in the middle (0.07; 95% CI: 0.04, 0.09) and highest terciles (0.04; 95% CI: −0.01, 0.05) (adiponectin x age interaction P < 0.001).ConclusionsLower adiponectin levels were associated with increased rates of BMI gains in the first 8 years of life. While leptin was positively associated with BMI, this association may be confounded by birthweight.

Do differences in compositional time use explain ethnic variation in the prevalence of obesity in children? Analyses using 24-hour accelerometry.

Whether variation in sleep and physical activity explain marked ethnic and socioeconomic disparities in childhood obesity is unclear. As time spent in one behaviour influences time spent in other behaviours across the 24-hour day, compositional analyses are essential. The aims of this study were to determine how ethnicity and socioeconomic status influence compositional time use in children, and whether differences in compositional time use explain variation in body mass index (BMI) z-score and obesity prevalence across ethnic groups. In all, 690 children (58% European, 20% Māori, 13% Pacific, 9% Asian; 66% low-medium deprivation and 34% high deprivation) aged 6-10 years wore an ActiGraph accelerometer 24-hours a day for 5 days yielding data on sedentary time, sleep, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). Height and weight were measured using standard techniques and BMI z-scores calculated. Twenty-four hour movement data were transformed into isometric log-ratio co-ordinates for multivariable regression analysis and effect sizes were back-transformed. European children spent more time asleep (predicted difference in minutes, 95% CI: 16.1, 7.4-24.9) and in MVPA (6.6 min, 2.4-10.4), and less time sedentary (-10.2 min, -19.8 to -0.6) and in LPA (-12.2 min, -21.0 to -3.5) than non-European children. Overall, 10% more sleep was associated with a larger difference in BMI z-score (adjusted difference, 95% CI: -0.13, -0.25 to -0.01) than 10% more MVPA (-0.06, -0.09 to -0.03). Compositional time use explained 35% of the increased risk of obesity in Pacific compared with European children after adjustment for age, sex, deprivation and diet, but only 9% in Māori and 24% in Asian children. Ethnic differences in compositional time use explain a relatively small proportion of the ethnic differences in obesity prevalence that exist in children.