Measures Of Adiposity In Children Research Articles

Dietary sodium intake and overweight and obesity in children and adults: a protocol for a systematic review and meta-analysis

BackgroundOverweight and obesity in children and adults is a major public health concern. Emerging evidence suggests dietary sodium intake may be associated with obesity. This systematic review and meta-analysis will aim to (i) assess the relation between dietary sodium intake and measures of adiposity in children and adults and (ii) examine the relation between sodium intake and sugar-sweetened beverage (SSB) consumption, which is a known risk factor for obesity.Methods/designAn electronic search will be conducted using Medline Complete, CINAHL, Scopus, Embase and Cochrane central register of controlled trials (CENTRAL). The search strategy will identify published peer-reviewed articles that report on dietary sodium and either a marker of adiposity or SSB consumption. Only human studies (ages >1 year) in English will be included, and no limits will be placed on publication date. No restrictions will be placed on the method of sodium intake assessment. Cross-sectional, prospective studies, and randomised controlled trials with a duration of ≥3 months will be included. Studies with participants with renal disease, cancer, type 1 diabetes or heart failure or who are pregnant will be excluded. To assess the quality of studies, the Cochrane’s Collaboration tool for assessing risk of bias in randomised trials will be used for randomised controlled trials (RCTs), and the modified Newcastle-Ottawa Scale will be used for cross-sectional and prospective studies. Meta-analysis will be used to assess the relation of sodium intake with two primary outcomes: (i) BMI and body weight in adults and BMI z-score in children and (ii) weight category (i.e. healthy weight vs. overweight/obese). For any outcomes in which meta-analysis is not possible, we will present data as a systematic review. Findings will be grouped and reported separately for children and adolescents (ages 1–17 years) and adults (ages >18 years).DiscussionThis review and meta-analysis will provide insight into the relation between dietary sodium intake and overweight and obesity. This information can be used to inform public health policies which target population sodium consumption.Systematic review registrationProspero CRD42015016440Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-015-0175-3) contains supplementary material, which is available to authorized users.

Cross-sectional population associations between detailed adiposity measures and C-reactive protein levels at age 6 years: the Generation R Study.

High body mass index is associated with increased C-reactive protein levels in childhood and adulthood. Little is known about the associations of detailed adiposity measures with C-reactive protein levels in childhood. We examined the associations of general and abdominal adiposity measures with C-reactive protein levels at school age. To gain insight into the direction of causality, we used genetic risk scores based on known genetic variants in adults as proxies for child adiposity measures and C-reactive protein levels. Within a population-based cohort study among 4338 children at the median age of 6.2 years, we measured body mass index, fat mass percentage, android/gynoid fat mass ratio and preperitoneal abdominal fat mass. We also measured C-reactive protein blood levels and defined increased levels as ⩾3.0 mg l(-1). Single-nucleotide polymorphisms (SNPs) for the weighted genetic risk scores were extracted from large genome-wide association studies on adult body mass index, waist-hip ratio and C-reactive protein levels. All fat mass measures were associated with increased C-reactive protein levels, even after adjusting for multiple confounders. Fat mass percentage was most strongly associated with increased C-reactive protein levels (odds ratio 1.46 (95% confidence interval 1.30-1.65) per increase standard deviation scores in fat mass percentage). The association was independent of body mass index. The genetic risk score based on adult body mass index SNPs, but not adult waist-hip ratio SNPs, tended to be associated with increased C-reactive protein levels at school age. The genetic risk score based on adult C-reactive protein level SNPs was not associated with adiposity measures at school age. Our results suggest that higher general and abdominal fat mass may lead to increased C-reactive protein levels at school age. Further studies are needed to replicate these results and explore the causality and long-term consequences.

Ingestão de cálcio, níveis séricos de vitamina D e obesidade infantil: existe associação?

ObjectiveTo evaluate the association between calcium intake and serum vitamin D levels and childhood obesity by an integrative review. Data sourceThe research was conducted in the databases PubMed/medLine, Science Direct and SciELO with 2001 to 2014 publications. We used the combined terms in English: “children” and “calcium” or “children” and “vitamin D” associated with the descriptors: “obesity”, “adiposity” or “body fat” for all bases. Cross‐sectional and cohort studies, as well as clinical trials, were included. Review articles or those that that have not addressed the association of interest were excluded. Data synthesisEight articles were part of this review, five of which were related to calcium and three to vitamin D. Most studies had a longitudinal design. The analyzed studies found an association between calcium intake and obesity, especially when age and sex were considered. Inverse relationship between serum vitamin D and measures of adiposity in children has been observed and this association was influenced by the sex of the patient and by the seasons of the year. ConclusionsThe studies reviewed showed an association between calcium and vitamin D with childhood obesity. Considering the possible protective effect of these micronutrients in relation to childhood obesity, preventive public health actions should be designed, with emphasis on nutritional education.

Area-level deprivation and adiposity in children: is the relationship linear?

It has been suggested that childhood obesity is inversely associated with deprivation, such that the prevalence is higher in more deprived groups. However, comparatively few studies actually use an area-level measure of deprivation, limiting the scope to assess trends in the association with obesity for this indicator. Furthermore, most assume a linear relationship. Therefore, the aim of this study was to investigate associations between area-level deprivation and three measures of adiposity in children: body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR). This is a cross-sectional study in which data were collected on three occasions a year apart (2005-2007). Data were available for 13,333 children, typically aged 11-12 years, from 37 schools and 542 lower super-output areas (LSOAs). Stature, mass and WC. Obesity was defined as a BMI and WC exceeding the 95th centile according to British reference data. WHtR exceeding 0.5 defined obesity. The Index of Multiple Deprivation affecting children (IDACI) was used to determine area-level deprivation. Considerable differences in the prevalence of obesity exist between the three different measures. However, for all measures of adiposity the highest probability of being classified as obese is in the middle of the IDACI range. This relationship is more marked in girls, such that the probability of being obese for girls living in areas at the two extremes of deprivation is around half that at the peak, occurring in the middle. These data confirm the high prevalence of obesity in children and suggest that the relationship between obesity and residential area-level deprivation is not linear. This is contrary to the 'deprivation theory' and questions the current understanding and interpretation of the relationship between obesity and deprivation in children. These results could help make informed decisions at the local level.

Creation of an adiposity index for children aged 6-8 years: the Gateshead Millennium Study.

Objective. A number of measures of childhood adiposity are in use, but all are relatively imprecise and prone to bias. We constructed an adiposity index (AI) using a number of different measures. Methods. Detailed body composition data on 460 of the Gateshead Millennium Study cohort at the age of 6–8 years were analysed. The AI was calculated using factor analysis on age plus thirteen measures of adiposity and/or size. Correlations between these variables, the AI, and more traditional measures of adiposity in children were investigated. Results. Based on the factor loading sizes, the first component, taken to be the AI, consisted mainly of measures of fat-mass (the skinfold measurements, fat mass score, and waist circumference). The second comprised variables measuring frame size, while the third consisted mainly of age. The AI had a high correlation with body mass index (BMI) (rho = 0.81). Conclusions. While BMI is practical for assessing adiposity in children, the AI combines a wider range of data related to adiposity than BMI alone and appears both valid and valuable as a research tool for studies of childhood adiposity. Further research is necessary to investigate the utility of AI for research in other samples of children and also in adults.

APOE Genotype and Cardio-Respiratory Fitness Interact to Determine Adiposity in 8-Year-Old Children from the Tasmanian Infant Health Survey

APOE plays a well established role in lipid metabolism. Animal model evidence suggests APOE may also be associated with adiposity, but this has not been thoroughly investigated in humans. We measured adiposity (BMI, truncal fat mass, waist circumference), physical activity (PA), cardiorespiratory fitness and APOE genotype (E2, E3, E4) in 292 8-year-old children from the Tasmanian Infant Health Survey (TIHS), an Australian population-based prospective birth cohort. Our aims were to examine the association of APOE with child adiposity, and to examine the interplay between this association and other measured factors. We found that APOE was associated with child lipid profiles. APOE was also associated with child adiposity measures. The association was E4 allele-specific, with adiposity lower in the E4-containing group (BMI: Mean difference -0.90 kg/m2; 95% confidence intervals (CI) -1.51, -0.28; p = 0.004). The association of APOE4 with lower BMI differed by fitness status (difference in effect p = 0.002), and was more evident among the less fit (mean difference -1.78 kg/m2; 95% CI -2.74, -0.83; p<0.001). Additionally, associations between BMI and lipids were only apparent in those of lower fitness who did not carry APOE4. Similar overall findings were observed when truncal fat mass and waist circumference were used as alternative adiposity measures. APOE4 and cardiorespitatory fitness could interact to influence child adiposity. In studies addressing the genetic determinants of childhood obesity, the context of child fitness should also be taken into account.

Serum Brain-Derived Neurotrophic Factor Concentrations in Lean and Overweight Children and Adolescents

Brain-derived neurotrophic factor (BDNF) and its receptor appear to be important components of the leptin-signaling cascade involved in energy homeostasis, and mice with BDNF or TrkB gene haploinsufficiency have excessive adiposity. Little is known about the relationship between adiposity and BDNF, particularly in children. The objective of the study was to study the association of serum BDNF with measures of adiposity in children. BDNF was determined by a sandwich-type ELISA after an overnight fast in convenience sample of 328 subjects, aged 3-19 yr enriched for extreme obesity. In 43, BDNF was also measured before, and again 1 h after, consuming a high-energy content (787 kcal) milkshake. Measures included associations between BDNF and measures of adiposity. There were no significant univariate associations between log BDNF and adiposity measured by body mass index (BMI), BMI-Z score, or fat mass. However, in an analysis of covariance accounting for age, sex, race, pubertal status, and platelet count, BDNF was lower in overweight children (mean +/- sd, 39.8 +/- 24.8 vs. 47.0 +/- 25.4 ng/dl, P = 0.03); in multiple regression analyses with log BDNF as the dependent variable, BMI (P = 0.03), BMI-Z (P = 0.01), and body fat (P < 0.02) were all negatively associated with BDNF once age, pubertal status, and platelet count were included in the model. Ingestion of a meal did not significantly alter serum BDNF 1 h later (P = 0.26). Serum BDNF is lower in extremely overweight children and adolescents than those of normal weight. It remains to be determined whether obese individuals with low serum BDNF for age and platelet count have mutations that alter BDNF function.

Breastfeeding, introduction of complementary foods, and adiposity at 5 y of age

Although dual-energy X-ray absorptiometry (DXA) is considered the most accurate measure of adiposity in children, it has rarely been used to examine the relation between infant feeding and adiposity during childhood. The objective was to ascertain whether adiposity at age 5 y was related to breastfeeding, to the timing of the introduction of complementary foods during infancy, or to both. Body composition was measured in 313 children at age 5 y by using DXA. Data on breastfeeding, formula feeding, and the timing of the introduction of complementary foods were obtained from the mothers when the children were 3 y old. Regression analysis was used to examine the relation between infant feeding and fat mass after adjustment for lean body mass, sex, birth weight, maternal obesity, race, and other sociodemographic variables. Fifty-three percent of the children were boys, 80% were white, and 20% were black. There was no significant difference in adjusted fat mass between those ever breastfed and those never breastfed (x +/- SE: 4.48 +/- 0.09 and 4.76 +/- 0.17 kg, respectively; P = 0.17). Children who were breastfed for a longer duration and those who were breastfed without concurrent formula feeding did not have significantly lower fat mass than did those children who were never breastfed. Children did not differ significantly in fat mass if they were introduced to complementary foods before or after 4 mo of age (4.49 +/- 0.12 and 4.63 +/- 0.12 kg, respectively; P = 0.42). Neither breastfeeding nor the timing of the introduction of complementary foods was associated with adiposity at age 5 y.

Early body mass index and other anthropometric relationships between parents and children.

To assess longitudinally the relationship between measures of adiposity in children over the first 8 y of life with that of their parents and to explore the role of parental adiposity in the development of childhood adiposity. Longitudinal study of measures of adiposity in children. A community sample from three health service systems including 114 children followed annually from infancy to age 8 and their 228 biological parents. Measurements were assessed at baseline for parents (6 months post-partum for mothers) and at regular intervals for children beginning at age 2 months. Measurements included weight, height, triceps skinfold, subscapular skinfold, midarm circumference, waist and hip. The major findings were: (1) significant correlations between parental body mass index (BMI), both maternal and paternal, and their biological offspring first emerged at age 7; (2) children with two overweight parents had consistently elevated BMI compared to children with either no overweight parents or one overweight parent. These differences became significant beginning at age 7. This study supports the hypothesis that familial factors (biological and/or environmental) affecting the development of adiposity emerge at specific ages and are related to the adiposity of both parents.

Body Mass Index as a Measure of Adiposity in Children and Adolescents: Relationship to Adiposity by Dual Energy X-Ray Absorptiometry and to Cardiovascular Risk Factors

Body mass index is widely used as a measure of adiposity in adults, but its use in children and adolescents is controversial. We assessed body mass index as a measure of adiposity in children and adolescents between the ages of 5 and 20 yr examined as part of the NIH survey of health in the Pima Indian population. Body mass index (measured in 985 subjects and analyzed in 3 age groups: 5–9, 10–14, and 15–19 yr, in both sexes) was compared cross-sectionally to percent fat and fat mass derived from dual energy x-ray absorptiometry and to fasting and 2-h plasma glucose, systolic and diastolic blood pressures, cholesterol, high density lipoprotein cholesterol, fasting insulin, and triglycerides. Body mass index was strongly correlated in all age groups to both percent fat (r = 0.83–0.94; for each group, P< 0.0001) and fat mass (r = 0.96–0.98; P < 0.0001). The relationship of body mass index to percent fat was different in males and females; differences were more marked in older age groups. Body mass index, percent fat, and fat mass showed similar degrees of correlation to metabolic measures in childhood. Body mass index is strongly associated with measures of adiposity derived from dual energy x-ray absorptiometry. Both measures show similar associations with cardiovascular risk factors in Pima Indian children.

Evaluation of waist circumference, waist-to-hip ratio, and the conicity index as screening tools for high trunk fat mass, as measured by dual-energy X-ray absorptiometry, in children aged 3–19 y

A central fat pattern has adverse health implications in both children and adults. Because adiposity tracks from childhood into adulthood, the ability of simple anthropometric techniques to correctly measure truncal adiposity in childhood needs to be assessed. We sought to assess the validity of waist circumference, waist-to-hip ratio (WHR), and the conicity index as indicators of trunk fat mass in children and adolescents. Trunk fat mass (kg) was measured with dual-energy X-ray absorptiometry in 278 girls and 302 boys aged 3-19 y. Receiver operating characteristic (ROC) curves and areas under the curves (AUCs) for the ROCs were calculated to compare the relative abilities of the anthropometric measures to correctly identify children with high trunk fat mass (z score for our study population of > or =1). The 80th percentile for waist circumference correctly identified 89% of girls and 87% of boys with high trunk fat mass (sensitivity) and 94% of girls and 92% of boys with low trunk fat mass (specificity). Waist circumference performed significantly better as an index of trunk fat mass than did WHR or the conicity index, as shown by the AUCs in girls and boys, respectively: waist circumference AUCs = 0.97 and 0.97, conicity index AUCs = 0.80 and 0.81, and WHR AUCs = 0.73 and 0.71. Our cutoffs for high trunk fat mass and high waist circumference are provided for both sexes for each year of age. Waist circumference provides a simple yet effective measure of truncal adiposity in children and adolescents.

Carotenoid levels in normal children and in children with cystic fibrosis

The carotenoids are potent antioxidants with the ability to quench singlet oxygen and other toxic oxygen species. We studied 17 patients with cystic fibrosis (CF) and 10 normal children to assess plasma levels of four carotenoids, beta-carotene, alpha-carotene, lutein, and lycopene, by high-performance liquid chromatography. We found significantly lower plasma levels of specific carotenoids in children with CF than in normal control subjects. The standardization of carotenoid levels for total cholesterol did not significantly attenuate these differences. No differences in total carotene intake were apparent between the groups. Carotenoid levels did not correlate with fat absorption or measures of adiposity in children with CF. Additionally, levels of selected carotenoids correlated negatively with serum IgG levels, an indirect measure of inflammation. The differences in plasma carotenoid levels between children with CF and normal children may be due to rapid turnover of carotenoids, perhaps through quenching of toxic oxygen species in inflammatory states of CF. Studies assessing supplementation of these antioxidants should be considered.

Weight-for-height indices as measures of adiposity in children

This study examines the weight-for-height index q = w h λ where the parameter λ is chosen to maximize the correlation of q with triceps skinfold thickness, and thus provide an indirect measure of adiposity. Using a sample of 1668 children ages 5–12 years, we estimate λ by an iterative procedure in each age/sex category. We find that λ does not vary simply across the age/sex categories, and that the correlation of q and skinfold thickness is never more than marginally greater than that of the Quetelet index w h 2 . We indicate that almost identical properties will be evidenced by the more general two-parameter index w α h β Our conclusion is that there is no weight-for-height index generally useful as an indirect measure of adiposity in children.