Early Childhood Overweight Research Articles

The association between father involvement in caregiving and early childhood overweight or obesity.

Despite the increasing trend of paternal engagement in caregiving, fathers remain underrepresented in studies on parenting and childhood obesity. This study examined the association between father involvement in caregiving and child's weight status within a longitudinal dataset from Japan. The data were obtained from a population-based cohort study in Japan (N = 29 584). The association between father's involvement in child caregiving (age 18 months) on the weight status of the same children at age 3.5 years was examined by logistic regression and linear regression analysis. Furthermore, we checked the interaction between maternal employment & father involvement by creating four mutually exclusive groups of families. Children whose fathers were highly involved in caregiving were less likely to be overweight (OR = 0.90, 95% CI, 0.85-0.96). Employed mothers with high paternal involvement in caregiving were 30% less likely to have children with overweight or obesity compared to those with low paternal involvement (95% CI, 0.55-0.90). Father involvement in caregiving is associated with the development of overweight or obesity in early childhood, and may also modify the association between maternal employment and child's weight status. Social policies to support shared child-rearing such as expanding paid parental leave could help families to raise children with healthy weight.

Predicting the development of overweight and obesity in children between 2.5 and 8 years of age: The prospective ABIS study.

SummaryBackgroundA relationship between overweight and obesity early in life and adolescence has been reported. The aim of this study was to track changes in overweight/obesity in children and to assess risk factors related to the persistence of overweight/obesity between 2.5 and 8 years.Study designChildren who participated in all three follow‐ups at 2.5, 5 and 8 years in the prospective cohort All Children in Southeast Sweden (ABIS) (N = 2245, 52.1% boys and 47.9% girls) were classified as underweight, normal, overweight or with obesity, and changes within categories with age were related to risk factors for development of obesity in a multivariate analysis.ResultsThe prevalence of overweight and obesity between 2.5 and 8 years was 11%–12% and 2%–3%, respectively. Children with normal weight remained in the same category over the years, 86% between 2.5 to 5 years and 87% between 5 and 8 years. Overweight and obesity at 5 and 8 years were positively related to each other (p < 0.0001 for both). High level of TV watching at 8 years and high maternal body mass index (BMI) when the child was 5 years were related to lower probability to a normalized ISO‐BMI between 5 and 8 years of age (p < 0.05 for both).ConclusionChildren with ISO‐BMI 18.5 to 24.9 remain in that range during the first 8 years of life. Children with overweight early in life gain weight and develop obesity, and children with obesity tend to remain with obesity up to 8 years of age. TV watching and high maternal BMI were related to lower probability to weight normalization between 5 and 8 years of age. A multidisciplinary approach to promote dietary and physical activity changes in the entire family should be used for the treatment and prevention of overweight and obesity in early childhood.

Maternal postload 1-hour glucose level during pregnancy and offspring’s overweight/obesity status in preschool age

BackgroundChildhood obesity is associated with adverse outcomes such as metabolic syndrome, diabetes, and cardiovascular diseases in adulthood. Identifying risk factors related to excessive adiposity in early childhood is of great...

Double Burden of Nutrition and some Eating Habits Characteristics of Preschool Children in Nam Hong Commune, Dong Anh district, Hanoi, 2018

Double Burden of Nutrition and some Eating Habits Characteristics of Preschool Children in Nam Hong Commune, Dong Anh district, Hanoi, 2018

Parental perception of child health status and quality of life associated with overweight and obesity in early childhood.

The aim was to assess perceived health status and health-related quality of life (HRQL) according to persistence of and variation in weight status among children from the age of 4 to 6years. Longitudinal study of 1883 participants in the ELOIN cohort (Madrid Region, Spain), with physical examination at ages 4 and 6years. Perceived health status and HRQL were assessed using parent-reported Kidscreen-10 scores, with excess weight being defined on the basis of body mass index (BMI) using the WHO reference tables (z-BMI > 1 standard deviation), and abdominal obesity being defined on the basis of waist circumference (percentile ≥ 90) using the tables proposed by Fernández et al. Variation in these two parameters at age 6years was associated with incident cases of suboptimal health by logistic regression, and with HRQL by linear regression. Compared to children without excess weight or abdominal obesity in both periods, incident cases of excess weight or abdominal obesity had odds ratios (ORs) of suboptimal health of 2.41 (95% CI 1.21 to 4.80) and 2.99 (95% CI 1.31 to 6.84) respectively. In terms of HRQL, children with remission of excess weight had a higher Kidscreen-10 score: β coefficient = 2.02 (95% CI 0.36 to 3.68), whereas new cases of abdominal obesity had a lower Kidscreen-10 score: β = - 2.22 (95% CI - 4.40 to - 0.03). Incident cases of excess weight and abdominal obesity had a higher risk of suboptimal health. Incident cases of abdominal obesity were also associated with worse HRQL.

Sex-specific effects of bisphenol A exposure on adiposity in early childhood

TPS 632: Health effects of flame retardants and plasticizers, Johan Friso Foyer, Floor 1, August 27, 2019, 3:00 PM - 4:30 PM Background/Aim: Exposure to bisphenol A (BPA) may affect obesity development in exposed individuals and/or offspring. Data on the sex-specific effects of BPA on adiposity remain controversial. Objectives: We aimed to investigate the overall and sex-specific associations between prenatal and postnatal exposure to BPA and children’s adiposity in a prospective cohort study. In addition, we conducted a meta-analysis of the sex-specific effects of BPA on adiposity. Methods: We recruited midterm pregnant women between 2008 and 2011. In 2012-2017, we measured their children’s BPA levels at ages 2, 4, and 6 years, and assessed their body mass index (BMI) and its Z-scores, as well as the prevalence of overweight. We assessed the association between prenatal mid-term and postnatal exposure to BPA, and anthropometric measurements at each age. The results were also compared to those of previous studies in a meta-analysis. Results: The overall associations of prenatal and postnatal BPA concentrations with the adiposity measurements at each age were not statistically significant after controlling for covariates. In a sex-stratified analysis, we observed increasing patterns of BMI and its Z-score at 4 and 6 years of age associated with increases in prenatal exposure to BPA among boys; however, the direction of the association was opposite among girls. The meta-analysis also showed similar results, in that increases in maternal BPA concentrations were associated with increases in the BMI Z-scores among boys [0.12 (95% confidence interval (CI), 0.06, 0.18)] and decreases in the same among girls [-0.08 (95% CI, -0.15, -0.01)]. Conclusion: The study supports the sex-dimorphic transgenerational effects of BPA on childhood adiposity.

Antibiotic use during pregnancy and childhood overweight: A population-based nationwide cohort study

Studies in mice suggest that early life represents a critical time window, where antibiotics may exert profound and lasting effects on the gut microbiota and metabolism. We aimed to test the hypothesis that prenatal antibiotic exposure is associated with increased risk of childhood overweight in a population-based cohort study. We linked 43,365 mother-child dyads from a nationwide cohort of pregnant women and their offspring to the Danish National Prescription Registry. Linear and logistic regression models were used to examine associations between prenatal exposure to antibiotics and BMI z-score and overweight (including obesity) at age seven and 11 years. Prenatal antibiotic exposure and childhood overweight were both associated with high pre-pregnancy BMI, maternal diabetes, multi-parity, smoking, low socioeconomic status, high paternal BMI, and short duration of breastfeeding. After adjustment for confounders, no associations were observed between prenatal antibiotic exposure and odds of overweight at age seven and 11 years. Whereas no association was observed between broad-spectrum antibiotics and overweight at age 11 years, exposure to broad-spectrum antibiotics was associated with higher odds of overweight at age seven years with an odds ratio of 1.27 (95% CI, 1.05–1.53) for ampicillin and an odds ratio of 1.56 (95% CI, 1.23–1.97) for amoxicillin. As we did not account for underlying infections, the observed associations with early childhood overweight could be explained by confounding by indication. In conclusion, our population-based study suggests that prenatal exposure to narrow-spectrum antibiotics is not associated with overweight in offspring. Exposure to some broad-spectrum antibiotics may increase the odds of overweight in early childhood, but the association does not persist in later childhood.

Association between television viewing and early childhood overweight and obesity: a pair-matched case-control study in China

BackgroundTelevision (TV) viewing may affect children’s obesity status. In the present study the association between TV viewing and early childhood overweight/obese status was investigated as well as the association based on age difference.MethodsThe present study included 933 children 1–5 years of age that were individually matched on a 1:2 (cases: controls) ratio based on age and community. Cochran-Mantel-Haenszel test was used to evaluate the association between TV viewing time and the related unhealthy behaviors. Conditional logistic regression models were used to quantify the association between TV viewing and children overweight/obese status in two age groups. The effects of TV viewing-related behaviors on the associations were further investigated.ResultsTV viewing time > 1 h was positively associated with the prevalence of TV viewing-related unhealthy behaviors (P < 0.05). After controlling for these behaviors, the association between TV viewing and childhood overweight/obese status was significant among 4- to 5-year-old children (odds ratio, OR = 1.72, 95% confidence interval, CI: 1.16––2.54), but not significant among 1- to 3-year-old children.ConclusionsChildhood overweight/obese status was positively associated with longer TV viewing time only among 4- to 5-year-old children. The results from the present study may help in identifying the population susceptible for overweight and obesity caused by TV viewing.

Associations between anthropometric indicators in early life and low-grade inflammation, insulin resistance and lipid profile in adolescence

Background and aimsThe long-term relations between excessive adiposity in early childhood and unfavourable cardiometabolic profiles in later ages are not yet completely understood. We aimed to assess the associations between birth weight (BW) and BMI from 6 months to 6 years of age, with biomarkers indicative of low-grade inflammation, insulin resistance and lipid profiles in adolescence. Methods and resultsRetrospective school-based study with 415 Portuguese adolescents (220 girls), mean age of 14.08 ± 1.6 years old. Anthropometric data from birth to 6 years old was extracted from individual child health book records. Actual weight and height were measured and BMI calculated. Participants were classified at each time point as normal weight or overweight according to WHO reference values. Biomarkers were obtained from venous blood samples. Linear regressions were used to explore the associations between the biomarkers and early life anthropometric indicators. From 2 years onwards, BMI associated positively with the inflammatory score and HOMA-IR in adolescence. Children who were overweight/obese from 2 to 6 years of age presented significantly higher inflammatory score and HOMA-IR later in adolescence. TC/HDL ratio was also positively associated with BMI from the age of 5 years onwards. The associations between BMI and cardiometabolic outcomes remained positive in adolescence, with overweight adolescents presenting a higher inflammatory score, HOMA-IR and TC/HDL than normal weight adolescents. ConclusionA high BMI from an early age was consistently associated with worse inflammatory and lipid profiles and insulin resistance in adolescence. No associations were found between BW and the same studied outcomes.

Association between gestational urinary bisphenol a concentrations and adiposity in young children: The MIREC study

BackgroundBisphenol A (BPA) is a high production volume chemical and because of its use in many consumer products, exposure is ubiquitous. Gestational BPA exposure has been associated with excess adiposity in rodent studies, but not consistently in human studies. We investigated the relation between gestational BPA exposure and early childhood adiposity in a prospective cohort study of 719 mother-child pairs. MethodsWe used data from the MIREC Study, a prospective Pan-Canadian pregnancy and birth cohort study. We measured BPA in urine samples collected at an average of 12.1 weeks (range: 6.3–15 weeks) gestation and measured children's weight, height, waist/hip circumference, and subscapular/triceps skinfold thickness at an average age of 3.5 years (range: 1.9–6.2). We estimated covariate-adjusted associations of log2-transformed BPA concentrations with child adiposity measures and examined whether these associations differed in boys and girls. ResultsMedian BPA concentrations were 0.8 ng/mL (IQR: 0.5–1.4). Among both boys and girls, each 2-fold increase in BPA concentrations was associated with higher waist-to-hip ratio (β: 0.003; 95% CI: 0.001, 0.005). The association of BPA with waist circumference and subscapular skinfold thickness was modified by sex (sex x BPA interaction p-values<0.2). In girls, each 2-fold increase in BPA concentrations was associated with a 0.2 cm (95% CI: 0.0, 0.5) and 0.15 mm (95% CI: 0.01, 0.30) increase in waist circumference and subscapular skinfolds, respectively. Associations were generally null or slightly inverse in boys. ConclusionsIn this cohort, gestational urinary BPA concentrations were associated with subtle increases in girl's central adiposity during early childhood.

Obesity trends in children, adolescents, and young adults with congenital heart disease.

To determine the prevalence, age of onset, and risk factors for overweight and obesity in children with congenital heart disease (CHD). Children with CHD who were seen at our institution from 1996 to 2017 were studied. Patients were full-time residents of the United States and were receiving all cardiac care at our institution. Patients were categorized by age and CHD diagnosis. The date of last normal weight for age and the date of first recorded weight in the range of overweight and obese were documented. Nine hundred sixty-eight patients with CHD were included. The prevalence of overweight and obesity was 31.5% and 16.4%, respectively. For patients who became overweight or obese, the last recorded normal weight was between 6 and 10 years of age. Electrophysiologic disease and older age were risk factors for obesity. Children with CHD have an increasing risk of becoming overweight and obese in early childhood. This study provides important information and identifies critical period to implement preventative measures and counsel families about the risk of obesity in CHD.

Association of Elective and Emergency Cesarean Delivery With Early Childhood Overweight at 12 Months of Age

Global cesarean delivery (CD) rates have more than doubled over the past 2 decades, with an increasing contribution from elective CDs. Cesarean delivery has been linked to early childhood overweight and obesity, but limited studies have examined elective and emergency CDs separately. To investigate whether elective or emergency CD was associated with risk of early childhood overweight. Data were drawn from the Growing Up in Singapore Toward Healthy Outcomes (GUSTO) study, an ongoing prospective mother-child birth cohort study. Participants were pregnant women aged 18 years or older with homogeneous parental ethnic background in their first trimester recruited between June 2009 and September 2010 (n = 1237) at 2 major public hospitals in Singapore. Those with type 1 diabetes or undergoing chemotherapy or psychotropic drug treatment were excluded. Data analysis commenced in October 2017. Delivery mode obtained from clinical records. Elective and emergency CD examined separately against vaginal delivery as reference. Body mass index-for-age z scores at age 12 months calculated based on 2006 World Health Organization Child Growth Standards from infant weight and recumbent crown-heel length measurements taken between December 2010 and April 2012. High body mass index status at risk of overweight was defined as a z score of more than 1 SD and less than or equal to 2 SDs. Overweight was defined as a z score of more than 2 SDs. Among 727 infants analyzed (51.2% [372] male), 30.5% (222) were born via CD, of which 33.3% (74) were elective. Prevalence of at risk of overweight and overweight at age 12 months was 12.2% (89) and 2.3% (17), respectively. Elective CD was significantly associated with at risk of overweight or overweight at age 12 months after adjusting for maternal ethnicity, age, education, parity, body mass index, antenatal smoking, hypertensive disorders of pregnancy, gestational diabetes, and sex-adjusted birth weight-for-gestational age (odds ratio, 2.05; 95% CI, 1.08-3.90; P = .03). The association persisted after further adjustment for intrapartum antibiotics and first 6 months infant feeding, 2 potential mediators of early childhood overweight and obesity (odds ratio, 2.02; 95% CI, 1.05-3.89; P = .04). No significant associations were found for emergency CD. Analysis with multiple imputation for missing covariates yielded similar results. Choice of delivery mode may influence risk of early childhood overweight. Clinicians are encouraged to discuss potential long-term implications of elective CD on child metabolic outcomes with patients who intend to have children.

Eating behavior and body composition across childhood: a prospective cohort study

BackgroundAlthough many cross-sectional studies reported that children with overweight or obesity show more food approaching and less food avoidant eating behaviors, there is a lack of replication in longitudinal studies. Therefore, the question remains whether healthcare professionals should target eating behaviors in childhood obesity interventions and prevention. We aimed to examine the longitudinal and possible bi-directional associations between eating behavior and body composition across childhood.MethodsData was included from 3331 children participating in the Generation R Study. At 4 and 10 years, mothers reported on the Child Eating Behavior Questionnaire including the subscales Food Responsiveness, Enjoyment of Food, Emotional Overeating and Satiety Responsiveness, and children’s BMI was measured. Body composition, consisting of Fat Mass Index and Fat Free Mass Index was measured at 6 and 10 years with Dual-energy-X-ray-Absorptiometry scans.ResultsCross-lagged models including both directions of the BMI – eating behavior association showed that a higher BMI at the age of 4 years predicted more food responsiveness and enjoyment of food and less satiety responsiveness at 10 years (e.g. satiety responsiveness:β = − 0.10, 95% CI = − 0.14, − 0.07), but no associations were found in the opposite direction. For emotional overeating, however, a bi-directional association was found with BMI predicting more emotional eating and vice versa. Multivariable linear regression analyses showed that associations were stronger for Fat Mass Index than for Fat Free Mass Index.ConclusionsResults showed that a higher BMI, and particularly higher fat mass, at pre-school age predicted more food approaching and less food avoidant eating behaviors at the age of 10 years, rather than the hypothesized reverse direction. This suggests that increased adiposity in early childhood might upregulate appetite and related eating behaviors.

Gestational Urinary Bpa Concentrations and Child Adiposity at Age 3 Years: The MIREC Study

Background: Bisphenol A (BPA) is a high production volume chemical, and because of its use in numerous consumer products, exposure is ubiquitous. Prenatal BPA exposure has been associated with excess adiposity in rodent studies, but not consistently in human studies.Objectives: We investigated the relation between prenatal BPA exposure and early childhood adiposity in a prospective cohort study of 686 mother-child pairs.Methods: We used data from the Maternal Infant Research on Environmental Chemicals (MIREC) Study, a prospective pan-Canadian pregnancy and birth cohort study. We measured BPA in urine samples collected at an average of 13 weeks gestation. In six of the cities, we measured children&amp;#8217;s weight, height, waist/hip circumference, and subscapular/triceps skinfold at an average of age 3.4 years. Using linear regression, we estimated covariate-adjusted associations between log2-transformed urinary BPA concentrations and adiposity measures.Results: Median urinary BPA concentrations were 0.8 ng/mL (IQR: 0.5-1.4). Among all children, there was no association between BPA and child adiposity. However, the association of BPA with waist circumference and subscapular skinfold thickness was modified by child sex (sex x BPA interaction p-values&amp;lt;0.2). Among girls, each 2-fold increase in urinary BPA concentrations was associated with a 0.3 cm (95% CI: 0, 0.5) and 0.2 mm (95% CI: 0, 0.3) increase in waist circumference and subscapular skinfold thickness, respectively. Among boys, BPA was weakly inversely associated with subscapular skinfold thickness (b: -0.1; 95% CI: -0.3, 0.1), but was not associated with waist circumference (b: 0.03; 95% CI: -0.19, 0.25).Conclusions: In this cohort, prenatal urinary BPA concentrations were associated with subtle increases in measures of central adiposity during early childhood among girls, but not boys. Future studies should confirm these associations and determine if they persist into later childhood.

Maternal insulin resistance, triglycerides and cord blood insulin are not determinants of offspring growth and adiposity up to 5 years: a follow-up study.

Metabolic dysregulation in utero may influence fetal metabolism and early growth. We previously investigated relationships between maternal indices of glucose homeostasis and triglycerides as well as cord blood insulin with offspring anthropometry up to 2years. The aim of this analysis was to follow these relationships up to the age of 5 years. Associations between maternal metabolic variables of glucose and lipid metabolism measured at 32 weeks' gestation and cord blood insulin with growth and body composition of 162 offspring aged 3-5 years were explored. Both indirect (i.e. body weight, BMI percentiles, sum of four skinfold thicknesses) and direct (i.e. ultrasonography, magnetic resonance imaging in a subgroup) measurement techniques were employed. Maternal metabolic indices were largely unrelated to child body composition. Cord blood insulin was negatively associated with fat mass and lean body mass at 3years in unadjusted analyses, and the sum of four skinfold thicknesses and body fat percentage in adjusted analyses, whereas the association with lean body mass was no longer observed. An inverse relationship between cord blood insulin and weight gain up to 5years was observed in girls only with small effect sizes. Results from this follow-up do not provide convincing evidence that these markers are independently related to offspring growth and adiposity in early childhood. Although cord blood insulin was weakly inversely related to weight gain in girls at 5years, we cannot conclude that the observed changes in outcomes are clinically meaningful. (Clinical Trials Registry No: NCT00362089).

Overweight and Obesity in Early Childhood A Systematic Review of Individual, Family, and Peer Risk Factors

Purpose: The prevalence of children who are overweight or obese has been increasing worldwide. While a variety of biological as well as sociodemographic correlates have been identified and reviewed, a systematic review of psychosocial factors, particularly among preschool aged children, is lacking. This systematic review synthesizes the research on individual, family and peer risk factors for overweight and obesity in preschool aged children. Method: A systematic review of the recent literature on psychosocial factors and overweight or rather obesity in the early stages of childhood was conducted. Results: A total of 27 studies from 2011-2016 were identified that examined individual, family and social risk factors for obesity in children. Results indicate the importance of eating regulation as well as family factors in understanding early childhood risk for obesity. There was mixed support for associations between behavioral and emotional symptoms and obesity among this age group. For other risk factors examined, too few studies exist to be able to make strong conclusions about their relevance for understanding preschool obesity risk. Conclusions: Psychosocial factors are associated with overweight and obesity among preschool aged children. However, this review also highlights the dearth of research on several potentially important risk factors for childhood obesity in this age group (such as family violence, parental and peer relationships). Longitudinal studies, which examine multiple risk factors simultaneously over this important developmental period, are sorely needed.

Epidemiology of overweight and obesity in early childhood in the Gulf Cooperation Council countries: a systematic review and meta-analysis protocol

IntroductionThere has been a notable increase in the prevalence of overweight and obesity in school-aged children in many industrialised regions. The worldwide prevalence of childhood overweight and obesity increased from...

Patterns of early life body mass index and childhood overweight and obesity status at eight years of age

BackgroundExcess weight gain in infancy and childhood is associated with increased risk of subsequent obesity. Identifying patterns of infancy and childhood weight gain associated with subsequent obesity or overweight status could help identify children at highest risk. Thus, we examined patterns of infancy and early childhood BMI in relation to mid-childhood overweight and obesity status.MethodsIn a prospective cohort of 215 children from Cincinnati, OH (born: 2003–2006), we measured weight and length or height at ages 4 weeks and 1, 2, 3, 4, 5, and 8 years. We calculated BMI z-scores using World Health Organization references. Using linear fixed effect models, we estimated mean BMI at each age and rates of change in BMI between ages 4 weeks and 5 years by children’s overweight and obesity status at age 8 years, assessed with BMI z-scores or bioelectric impedance analysis (BIA).ResultsChildren who became overweight (BMI, n = 51 and BIA, n = 37) or obese (BMI, n = 22 and BIA, n = 29) at age 8 years had greater BMI at all ages compared to normal weightchildren. Children who were overweight had similar rates of change in BMI as children who were lean. Children who were obese had greater gains in BMI between age 4 weeks and 5 years, with the most rapid gains in the first 2 years.ConclusionsResults from this study of modest sample size, suggest that adiposity patterns in the first 5 years of life are related to subsequent childhood overweight and obesity risk.

Resignation, goal orientation or cultural essentialism? Health care practitioners’ approaches to interventions on childhood obesity

ABSTRACTThis qualitative study investigates health care practitioners’ approaches to early childhood obesity in Denmark and their view on their own ability to initiate processes of change in affected families, and it asks the overall question of whether perceived barriers become real through practitioners’ reluctance to intervene in families labelled as ´problematic’. The paper identifies three approaches in the practitioners’ narratives: the socially oriented, the individually oriented, and the mixed. The individually oriented approach was based on a logic resembling individualistic explanatory models of behaviour change, and was related to a positive perspective on their own ability to move families towards healthier habits by health care practitioners. The socially oriented approach borrowed elements from a sociological perspective, which seemed to lead to resigned pessimism in the face of the complexity of the problem of childhood overweight and a reluctance to address early childhood overweight in some families. In practitioners of all three types, widespread cultural essentialism was found. Non-western, ethnic minority background was seen as determining family habits and making preventive action especially difficult. Based on this, the current paper discusses whether individual actions and choices are being ascribed too much explanatory power, and the health system's biased perceptions too little.

1.11-P15Sleep duration and adiposity in early childhood: evidence for bidirectional associations from the Born in Bradford Study

1.11-P15Sleep duration and adiposity in early childhood: evidence for bidirectional associations from the Born in Bradford Study