Child Overweight Status Research Articles

Healthy Change Intervention: A Cluster RCT in Preschooler Mothers in Mexico and the United States.

To assess effects of Healthy Change intervention on maternal perception of her child's body weight (MPCW), maternal feeding style, and obesogenic home environment. A randomized control trial was conducted, consisting of two arms: the intervention group received the Healthy Change program, and the control group received the Hygiene and Accident Prevention program. A total of 356 mother-preschool child dyads participated, 182 in the intervention group and 174 in the control group, residing in Mexico and the United States. Data were collected at baseline and after the program through self-administered questionnaires completed by mothers and child anthropometric measurements. Although no significant between-group difference in pre- and post-intervention change of MPCW was found, sub-analyses revealed that a higher proportion of mothers in the intervention group accurately perceived their child's body weight at the study endpoint using categorical (67% vs. 57.1%, p < 0.005) and visual scales (48.9% vs. 41.8%, p < 0.015). Additionally, more mothers of overweight children in the intervention group accurately perceived their children's overweight and obese status compared to those in the control group (29.8% vs. 10.3%, X2 = 4.26, df = 1, p < 0.039). The intervention group also displayed a higher proportion of mothers with authoritative feeding style (26.4% vs. 16.5%, p < 0.036) and significantly higher family nutrition and physical activity scores (29.1 vs. 28.0, p < 0.000) at the study endpoint. Healthy Change Intervention led to improved accuracy of MPCW, a shift toward maternal authoritative feeding styles, and positive changes in obesogenic home environments.

Unmasking the Risk Factors Associated with Undiagnosed Diabetes and Prediabetes in Ghana: Insights from Cardiometabolic Risk (CarMeR) Study-APTI Project.

Undiagnosed diabetes poses significant public health challenges in Ghana. Numerous factors may influence the prevalence of undiagnosed diabetes among adults, and therefore, using a model that takes into account the intricate network of these relationships should be considered. Our goal was to evaluate fasting plasma levels, a critical indicator of diabetes, and the associated direct and indirect associated or protective factors. This research employed a cross-sectional survey to sample 1200 adults aged 25-70 years who perceived themselves as healthy and had not been previously diagnosed with diabetes from 13 indigenous communities within the Cape Coast Metropolis, Ghana. Diabetes was diagnosed based on the American Diabetes Association (ADA) criteria for fasting plasma glucose, and lipid profiles were determined using Mindray equipment (August 2022, China). A stepwise WHO questionnaire was used to collect data on sociodemographic and lifestyle variables. We analyzed the associations among the exogenous, mediating, and endogenous variables using a generalized structural equation model (GSEM). Overall, the prevalence of prediabetes and diabetes in the Cape Coast Metropolis was found to be 14.2% and 3.84%, respectively. In the sex domain, females had a higher prevalence of prediabetes (15.33%) and diabetes (5.15%) than males (12.62% and 1.24%, respectively). Rural areas had the highest prevalence, followed by peri-urban areas, whereas urban areas had the lowest prevalence. In the GSEM results, we found that body mass index (BMI), triglycerides (TG), systolic blood pressure (SBP), gamma-glutamyl transferase (GGT), and female sex were direct predictive factors for prediabetes and diabetes, based on fasting plasma glucose (FPG) levels. Indirect factors influencing diabetes and prediabetes through waist circumference (WC) included childhood overweight status, family history, age 35-55 and 56-70, and moderate and high socioeconomic status. High density lipoprotein (HDL) cholesterol, childhood overweight, low physical activity, female sex, moderate and high socioeconomic status, and market trading were also associated with high BMI, indirectly influencing prediabetes and diabetes. Total cholesterol, increased TG levels, WC, age, low physical activity, and rural dwellers were identified as indirectly associated factors with prediabetes and diabetes through SBP. Religion, male sex, and alcohol consumption were identified as predictive factors for GGT, indirectly influencing prediabetes and diabetes. Diabetes in indigenous communities is directly influenced by blood lipid, BMI, SBP, and alcohol levels. Childhood obesity, physical inactivity, sex, socioeconomic status, and family history could indirectly influence diabetes development. These findings offer valuable insights for policymakers and health-sector stakeholders, enabling them to understand the factors associated with diabetes development and implement necessary public health interventions and personalized care strategies for prevention and management in Ghana.

Caregiver self-efficacy providing nutritional support for pediatric patients undergoing hematopoietic stem cell transplant is associated with psychosocial factors.

Caregiver self-efficacy in providing nutritional support to pediatric hematopoietic stem cell transplantation (HSCT) patients has been little studied despite the increased risk of these children potentially being over- or under-nourished after HSCT, and nutritional status could possibly affect treatment outcomes. The current study aimed to describe caregiver dietary self-efficacy and its associated psychosocial factors and barriers to following dietary recommendations. Caregivers completed questionnaires pre-HSCT and 30 days, 100 days, and one year post-HSCT. A subset provided a 24-h recall of food intake. Results showed generally high caregiver confidence and low difficulty supporting their child nutritionally. However, lower confidence was associated with higher caregiver depression, anxiety, and stress 30 days post-HSCT. Further, higher difficulty at various time points was correlated with lower income, higher depression and anxiety, stress, and miscarried helping (i.e., negative caregiver-child interactions surrounding eating), as well as child overweight status and failure to meet protein intake guidelines. Nutritional criteria for protein, fiber, added sugar, and saturated fat were met by 65%, 0%, 75%, and 75%, respectively. Caregiver attitudes and child behavior were the most frequently reported barriers to healthy eating. Results suggest that directing resources to caregivers struggling emotionally, economically, or transactionally could support pediatric patients undergoing HSCT in maintaining optimal nutritional status.

Social patterning of childhood overweight in the French national ELFE cohort

An inverse social gradient in early childhood overweight has been consistently described in high-income countries; however, less is known about the role of migration status. We studied the social patterning of overweight in preschool children according to the mother’s socio-economic and migration background. For 9250 children of the French ELFE birth cohort with body mass index collected at age 3.5 years, we used nested logistic regression to investigate the association of overweight status in children with maternal educational level, occupation, household income and migration status. Overall, 8.3% (95%CI [7.7–9.0]) of children were classified as overweight. The odds of overweight was increased for children from immigrant mothers (OR 2.22 [95% CI 1.75–2.78]) and descendants of immigrant mothers (OR 1.35 [1.04–2.78]) versus non-immigrant mothers. The highest odds of overweight was also observed in children whose mothers had low education, were unemployed or students, or were from households in the lowest income quintile. Our findings confirm that socio-economic disadvantage and migration status are risk factors for childhood overweight. However, the social patterning of overweight did not apply uniformly to all variables. These new and comprehensive insights should inform future public health interventions aimed at tackling social inequalities in childhood overweight.

A Randomised Control Trial Investigating the Efficacy of the MapMe Intervention on Parental Ability to Correctly Categorise Overweight in Their Child and the Impact on Child BMI Z-Score Change at 1 Year.

Research suggests parental ability to recognise when their child has overweight is limited. It is hypothesised that recognition of child overweight/obesity is fundamental to its prevention, acting as a potential barrier to parental action to improve their child's health-related behaviours and/or help seeking. The purpose of this study was to investigate the efficacy of an intervention (MapMe) to improve parental ability to correctly categorise their child as having overweight one-month post-intervention, and reduce child body mass index (BMI) z-score 12 months post-intervention. MapMe consists of body image scales of known child BMI and information on the consequences of childhood overweight, associated health-related behaviours and sources of support. We conducted a three-arm (paper-based MapMe, web-based MapMe and control) randomised control trial in fifteen English local authority areas with parents/guardians of 4-5- and 10-11-year-old children. Parental categorisation of child weight status was assessed using the question 'How would you describe your child's weight at the moment?' Response options were: underweight, healthy weight, overweight, and very overweight. Child weight status and BMI z-scores were calculated using objectively measured height and weight data and UK90 clinical thresholds. There was no difference in the percentage of parents correctly categorising their child as having overweight/very overweight (n = 264: 41% control, 48% web-based, and 43% paper-based, p = 0.646). BMI z-scores were significantly reduced for the intervention group at 12 months post-intervention compared to controls (n = 338, mean difference in BMI z-score change -0.11 (95% CI -0.202 to -0.020, p = 0.017). MapMe was associated with a decrease in BMI z-score 12 months post-intervention, although there was no direct evidence of improved parental ability to correctly categorise child overweight status. Further work is needed to replicate these findings in a larger sample of children, investigate mechanisms of action, and determine the use of MapMe as a public health initiative.

Analysis of association between childhood overweight/obesity with screen time, sedentary life style and low levels of physical activity

The escalating prevalence of childhood obesity, affecting nearly 40 million children under five globally, has become a pressing public health concern. The high incidence of obesity in this population can be attributed to numerous factors, such as unhealthy eating habits, lack of physical activity, sedentary lifestyle, and increased screen time, which were exacerbated by worldwide lockdowns during the Covid-19 pandemic. These factors, together with obesity, can potentially predispose these children to non-communicable diseases such as coronary artery disease, type 2 diabetes, and cancer, thereby increasing morbidity and mortality rates. This capstone project aims to globally assess the prevalence of obesity or overweight status in children, establish a relationship between screen usage, physical activity levels, and sedentary behavior, and examine the impact of Covid-19 lockdowns on these parameters. The study methodology includes a comprehensive literature review and data collection from global studies on childhood obesity. Findings from this study could be instrumental in identifying risk factors and developing interventions to mitigate the rising rates of childhood obesity, ultimately supporting the WHO's goal of "no rise in childhood overweight by 2025". Additionally, the study would provide valuable recommendations to decrease sedentary behavior in children and increase physical activity levels, promoting healthier lifestyle choices in children.

Behavioral and Environmental Risk Factors Associated with Primary School Children's Overweight and Obesity in Urban Indonesia.

To aid the design of nutrition interventions in low- and middle-income countries undergoing a nutrition transition, this study examined behavioral and environmental risk factors associated with childhood overweight and obesity in urban Indonesia. Body height and weight of children were measured to determine BMI-for-age Z-scores and childhood overweight and obesity status. A self-administered parental survey measured socioeconomic background, children's diet, physical activity, screen time, and parental practices. Logistic and quantile regression models were used to assess the association between risk factors and the BMI-for-age Z-score distribution. Public primary schools in Central Jakarta, sampled at random. Children (n=1,674) aged 6-13 years from 18 public primary schools. Among the children, 31.0% were overweight or obese. The prevalence of obesity was higher in boys (21.0%) than in girls (12.0%). Male gender and height (aOR=1.67; 95% CI 1.30, 2.14 and aOR=1.16; 95% CI 1.14, 1.18, respectively) increased the odds of being overweight or obese, while the odds reduced with every year of age (aOR=0.43; 95% CI 0.37, 0.50). Maternal education was positively associated with children's BMI at the median of the Z-score distribution (P=0.026). Dietary and physical activity risk scores were not associated with children's BMI at any quantile. The obesogenic home food environment score was significantly and positively associated with the BMI-for-age Z-score at the 75th and 90th percentiles (P=0.022 and 0.023, respectively). This study illustrated the demographic, behavioral, and environmental risk factors for overweight and obesity among primary school children in a middle-income country. To foster healthy behaviors in primary school children, parents need to ensure a positive home food environment. Future gender-responsive interventions should involve both parents and children, promote healthy diets and physical activity and improve food environments in homes and schools.

Assessment of Food Intake and Nutritional Status of Children Attending Montessori School of Pokhara Valley

Introduction: Childhood is a time of critical growth in which proper nutrition is necessary. Children afflicted by sustained poor nutrition are at greater risk for obesity, mental and emotional health problems and a failure to thrive academically. The objective of this study was to assess the food intake of children attending the Montessori school.&#x0D; Methods: A cross sectional study was carried out among 235 children of 3-5 years from twenty Montessori schools. Data were collected using simple random sampling. A weighed food was recorded from the consumption of children during a day of their stay in the Montessori school along with the observation of food consumption.&#x0D; Results: More than every nine out of ten children (92.8%) didn’t meet calorie requirement. The mean food intake during their stay in Montessori was 368.81±111.89 grams. Mean calorie, fat, protein, retinol and beta carotene intake were 540±150.5 Kcal, 10.04±5.6 grams, 13.25±5.49 grams, 49.76±32.6 grams, 135.75±274.67 grams respectively. Dietary fat (OR=3.7, 95% CI; 1.8, 7.5) and protein consumption (OR=2.2, 95% CI; 1.1, 4.4) were significantly associated with overweight status of children.&#x0D; Conclusion: The amount of nutritive foods should be increased so that the children meet adequate amount of nutrient required for the proper growth and development of their body. Since the association between dietary fat and protein intake with overweight condition was observed the excess use of fat providing foods should be limited and protein rich foods should be provided as per the Recommended Dietary Allowance (RDA) of Montessori children.&#x0D; Keywords: Food intake, nutritional status, children, Nepal

Understanding the pathways between prenatal and postnatal factors and overweight outcomes in early childhood: a pooled analysis of seven cohorts

Background/objectivesChildhood overweight and obesity are influenced by a range of prenatal and postnatal factors. Few studies have explored the integrative pathways linking these factors and childhood overweight. This study aimed to elucidate the integrative pathways through which maternal pre-pregnancy body mass index (BMI), infant birth weight, breastfeeding duration, and rapid weight gain (RWG) during infancy are associated with overweight outcomes in early childhood from ages 3 to 5 years.Subjects/methodsPooled data from seven Australian and New Zealand cohorts were used (n = 3572). Generalized structural equation modelling was used to examine direct and indirect associations of maternal pre-pregnancy BMI, infant birth weight, breastfeeding duration, and RWG during infancy with child overweight outcomes (BMI z-score and overweight status).ResultsMaternal pre-pregnancy BMI was directly associated with infant birth weight (β 0.01, 95%CI 0.01, 0.02), breastfeeding duration ≥6 months (OR 0.92, 95%CI 0.90, 0.93), child BMI z-score (β 0.03, 95%CI 0.03, 0.04) and overweight status (OR 1.07, 95%CI 1.06, 1.09) at ages 3–5 years. The association between maternal pre-pregnancy BMI and child overweight outcomes was partially mediated by infant birth weight, but not RWG. RWG in infancy exhibited the strongest direct association with child overweight outcomes (BMI z-score: β 0.72, 95%CI 0.65, 0.79; overweight status: OR 4.49, 95%CI 3.61, 5.59). Infant birth weight was implicated in the indirect pathways of maternal pre-pregnancy BMI with RWG in infancy, breastfeeding duration, and child overweight outcomes. The associations between breastfeeding duration (≥6 months) and lower child overweight outcomes were fully mediated by RWG in infancy.ConclusionsMaternal pre-pregnancy BMI, infant birth weight, breastfeeding duration and RWG in infancy act in concert to influence early childhood overweight. Future overweight prevention interventions should target RWG in infancy, which showed the strongest association with childhood overweight; and maternal pre-pregnancy BMI, which was implicated in several pathways leading to childhood overweight.

Dietary patterns and child, parental, and societal factors associated with being overweight and obesity in Vietnamese children living in Ho Chi Minh city.

Childhood overweight and obesity are rapidly increasing in urban Vietnam. Dietary patterns are understudied for their association with obesity risk in these children, and it is unclear which parental and societal factors should be targeted in prevention efforts. The study assessed child characteristics, dietary patterns, parental and societal factors for associations with childhood overweight and obesity status in Ho Chi Minh City, Vietnam. A sample of 221 children aged 9-11 years was randomly selected from four Ho Chi Minh City primary schools. Weight, heightand waist circumference were measured using standardized methods. Three 24-hdietary recalls were collected from 124 children, which were used to assess dietary patterns using principal component analysis (PCA). Parents completed a questionnaire about child, parentaland societal factors. The overall prevalence of obesity was 31.7% and of combined overweight and obesity 59.3%. Three main dietary patterns from 10 food groups were identified by PCA: traditional (grains, vegetables, meat and meat alternatives), discretionary (snacks and sweetened beverages), and industrialized (fast food and processed meat). Children with higher discretionary diet scores had higher odds of being overweight. Being a boy, screen time over 2 h/day, parental underestimation of child weight status, father's obesity, and household income in the lowest quintile were positively associated with childhood obesity. Future intervention programmes in Vietnam need to consider targeting children's unhealthy diets and parental perceptions of child weight status, as well as focusing on upstream approaches that reduce inequities contributing to childhood obesity and concomitant dietary patterns.

Predicting childhood overweight status by accelerated weight gain from neonatal period to infancy.

The increased prevalence of obesity in early childhood is a public health problem. Childhood obesity may affect cardiorespiratory fitness and can induce obesity and its comorbidities in adulthood. We aimed to assess childhood overweight status by accelerated weight gain during infancy. This is a historical cohort that was conducted on 637 7-year-old students of Guilan province, north of Iran. Data were collected, including demographic characteristics, weight at 4, 6, 12, and 18 months, and clinical examination. The ROC curve was designated based on the standardized z-scores, and the most appropriate cutoff point by sensitivity and specificity was noted for predicting obesity at 7 years. Rapid weight gain (RWG) was also assessed. Among participants, 334 (53.3%) were female. In this study, the mean and standard deviation of RWG in 0-4 months, 0-6 months, 0-12 months, and 0-18 months were 3.50 ± 0.89, 4.64 ± 1.02, 6.54 ± 1.21, and 8.00 ± 1.46 kg, respectively. The highest AUC was dedicated to 0-18 months (0.7 ± 0.05) and the suitable cut-off for RWG in this interval was 8.55 kg with 65.5% and 72.0% sensitivity and specificity, respectively. Although in the previous investigations, the changes in the first 3 years of life had a significant role in further complications, regarding our results, it seems that even earlier consideration of excess weight gain may be necessary.

Caregiver Concern About Child Overweight/Obesity in Grandparent Versus Parent-Headed Households in the United States.

To examine the association of caregivers' concern about children's overweight and obesity status with family structure (grandparent versus parent-headed households). Caregivers reported their relation to the child aged 10 to 17 years and the child's weight and height (National Survey of Children's Health 2016-20). Overweight/obesity was calculated using Centers for Disease Control and Prevention growth charts. We estimated associations (prevalence odds ratio) of residing in a grandparent-headed household with lack of weight concern (responding "Yes, it's too low" or "No, not concerned" to "Are you concerned about this child's weight?") among propensity score-matched children with overweight and obesity. Covariates included child's sex, race, ethnicity, age, family poverty ratio, primary household language, highest level of education among reported adults, caregiver mental and emotional health, usual source of care and survey year. The prevalence of child overweight/obesity was higher in grandparent-headed households. Among children with overweight/obesity, 64.65 (SE=3.27)% of grandparents and 66.55 (SE=0.81)% of parents did not express concern about the child's weight status. Among children with obesity, it was 52.42 (SE=4.63)% and 49.04 (SE=1.28)%, respectively. Family structure was not associated with caregiver lack of weight concern in propensity score-matched samples. Appropriate caregiver concern about child's weight status was low in both grandparent and parent-headed households in the United States.

Investigating socioecological obesogenic factors in children with Autism Spectrum Disorder.

Obesity-related information in children with Autism Spectrum Disorder (ASD) is limited, and research findings are contradictory. Thus, this study aimed to use a nationwide non-clinical sample to examine the association of sociological factors with overweight status in children with ASD and reveal the degree of differences in the risk factors for overweight in children with and without ASD. The data for this cross-sectional study, based on the modified ecological system theory model, were obtained from the 2019 National Survey of Children's Health. The weighted logistic regressions were performed to determine the factors associated with overweight status in children with ASD, controlling for demographics, physical activity-related behaviors, and family and environmental conditions. A total of 529 children were identified (mean age 13.78 years, 83.21% boys). Two-parent households, less healthy parents and households, households with smokers, poor sleep quality, and greater participation in organized activities were associated with a higher likelihood of overweight in children with ASD (all P < 0.05). The determinants of obesity among children with ASD go beyond the individual level; family and community support are important. Therefore, greater attention should be directed toward the families of children with ASD and community-level administrative policies to improve quality of life by preventing or reducing obesity in children with ASD.

The Association Between Sedentary Screen Time, Non-screen-based Sedentary Time, and Overweight in Chinese Preschool Children: A Cross-Sectional Study.

Introduction: Less is known about the effects of the different domains of sedentary behaviors on healthy weight in young children. This cross-sectional study examined the association between sedentary screen time (SST), non-screen-based sedentary time (NSST), and overweight (and obesity) in Chinese preschoolers.Methods: Data were collected from the Physical Activity and Health in Tianjin Chinese Children study (PATH-CC), involving healthy children 3–6 years old and their families. Children's overweight status was classified according to the international (IOTF) childhood BMI cut-offs. SST and NSST were reported in minutes/day by parents using the leisure-time sedentary behaviors questionnaire. Logistic regression models adjusted by sex, age, socioeconomic status, outdoor play, and sleep duration were used.Results: In a total of 971 children (55.4% boys), 11.8% were overweight. Generally, children spent 1 h/day in SST and 1 h/day in NSST. Multiple models showed that children who spent more time in SST were more likely to be overweight [OR and 95% CI: 1.22 (1.03–1.45)]. No correlation between time spent on NSST and children with overweight was found (P > 0.05).Conclusions: This study indicated that children who spent more time in SST were more likely to be overweight, but a null correlation between NSST and overweight was found. Longitudinal studies designed to identify associations between exposures to screen media and changes in metabolic parameters during a child's early years are needed.

Examining the influence of positive childhood experiences on childhood overweight and obesity using a national sample

Positive childhood experiences (PCEs) promote healthy social development, improve overall wellness, and help to moderate and prevent exposure to adverse childhood experiences. There has been limited research examining the association between positive childhood experiences and overweight or obesity status in children. The purpose of this study was to examine whether experiencing positive childhood experiences are associated with lower rates of overweight or obesity status in children between 10 and 17 years of age, using cross-sectional data from the 2018–2019 National Survey of Children's Health (n = 28,771), a nationally representative mail and online survey. Frequencies, proportions, and unadjusted associations for each variable were calculated using descriptive statistics and bivariate analyses. To examine the association between overweight or obesity and PCEs, multivariable regression models were used. Compared to children who were underweight or had a healthy weight, children who were overweight or obese were less likely to: participate after school activities (78.1%, p < 0.0001), volunteer in their community, school, or church (45.6%, p < 0.0001), have a mentor they feel comfortable going to for guidance (87.0%, p = 0.02), live in a safe neighborhood (61.3%, p < 0.0001), live in a supportive neighborhood (50.4%, p < 0.0001), and to live with a resilient family (78.3%; p = 0.0099). In adjusted analysis, among children exposed to two or more ACEs, children residing in a supportive neighborhood were less likely to be overweight or obese (aOR 0.87; 0.77–0.98). Our findings suggest that certain PCEs may mitigate overweight and obesity when children have experienced at least some childhood trauma.

Underestimation of overweight weight status in children and adolescents aged 0-19 years: A systematic review and meta-analysis.

BackgroundPerceptions of children's weight status may be important in obesity prevention and treatment.AimsThis review identifies the prevalence of the underestimation of overweight status in children by parents/main carers, children, and healthcare professionals (HCP). The review critically synthesized both quantitative and qualitative evidence to explore the factors associated with this underestimation. The diverse methods used to assess this phenomenon are reported.MethodsPooled effect sizes were calculated using random‐effects model. Published studies, up to 2020, were accessed using the following search engines: CINAHL, EMBASE, PUBMED, and Psych‐Info and including the “Cited by” and “Related Articles” functions. Hand‐searching was used to retrieve further articles. Publication language and location had no bearing on the nature of the included studies.ResultsA total of 91 articles were included. In the quantitative studies, 55% (95% CI 49%–61%) of caregivers underestimated their child's level of overweight and obesity using a verbal scale and 47% (95% CI 36%–55%) using visual scales. Of the children studied, 34% (95% CI 25%–43%) underestimated their own level of overweight and obesity using both scales. In (n = 3) articles, HCPs reflected this misperception, but limited studies prevented meta‐analysis. Underestimation was associated with the child's age, gender, BMI and parental weight status, ethnicity and education. In the qualitative studies, parents/main carers of children with overweight and obesity described their child's weight in terms other than overweight, for example, “big boned,” “thick,” and “solid.”ConclusionThe results confirm the prevalence of underestimation of child overweight status across international studies. Understanding the factors which lead to this inaccuracy may help to improve communication within the therapeutic triad and facilitate the recognition and management of children's overweight status.

640 Regular bedtime routines and biological obesity risk among 9-year old children from the Fragile Families Child and Wellbeing Study

Abstract Introduction Obesity rates among Hispanic (26%) and Black (22%) children are considerably higher compared to their white counterparts (14%), which evidence suggests may be attributable to biological, behavioral, and psychosocial factors affecting the family unit. Bio-behavioral factors in the household may affect child health behaviors, including sleep, a known predictor for obesity. Hispanic and Black children report shorter sleep duration, later bedtimes, and are often lacking in bedtime routines, compared to white children. Evidence suggests that early childhood routines are highly predictive of overweight status in children. Herein, we investigate whether bedtime routines are associated with the genetic allele for obesity in a racially diverse sample of children. Methods Data for the present analysis emanated from wave 5 (Year 9--2007–2010) cohort of the Fragile Families Child and Wellbeing Study dataset. During home visits, interviews with children’s mother and father during home visits, around the target child’s ninth birthday collected data on home routines and other parent-child relationship and school connectedness topics. Saliva samples were also collected at Year 9 to assess telomere length and DNA methylation levels and changes. The independent variable was regular bedtime routine, and biological variable for fat mass and obesity (rs9939609) was the dependent variable. Adjusted covariates included child’s age and BMI, and parent household income. Results Analysis of the final sample of 466 children showed 52% of the children were male and were 9 years old, on average; 35% were White, 46% Black, 20% Hispanic, 4% Asian and 5% other. The median family income was $42,500. The child’s sleep measures captured was ‘children have a regular bedtime routine’ was associated with (β = -0.137, p = 0.01) decrease in the odds of having the genetic allele for obesity. Conclusion Regular bedtime routines among 9-year old Black and Hispanic children may be associated with genetic alleles related to fat mass and obesity. Regular bedtime routines could aid in promoting healthy weight in children. Support (if any) NIH (T32HL129953, K07AG052685, R01MD007716, R01HL142066, K01HL135452, R01HL152453.

Overweight and obesity status from the prenatal period to adolescence and its association with non-alcoholic fatty liver disease in young adults: cohort study.

To examine the associations of maternal and child overweight status across multiple time-points with liver fat content in the offspring during young adulthood. Cohort study. ELEMENT Cohort in Mexico City. Pregnant women with singleton births (n=97). We quantified hepatic triglyceride content (liver fat content) by proton magnetic resonance spectroscopy (1H MRS) and conventional T2-weighted MRIs (3T scanner) in 97 young adults from the ELEMENT birth cohort in Mexico City. Historical records of the cohort were used as a source of pregnancy, and childhood and adolescence anthropometric information, overweight and obesity (OWOB) were defined. Adjusted structural equation models were run to identify the association between OWOB in different life stages with liver fat content (log-transformed) in young adulthood. Maternal OWOB at the time of delivery was directly and indirectly associated with the liver fat content in the offspring at young adulthood. Seventeen percent of the participants were classified as having NAFLD. We found a strong association of OWOB between all periods assessed. Maternal OWOB at time of delivery (β=1.97, 95% CI 1.28-3.05), and OWOB status in the offspring at young adulthood (β=3.17, 95% CI 2.10-4.77) were directly associated with the liver fat content in the offspring. Also, maternal OWOB was indirectly associated with liver fat content through offspring OWOB status. We found that maternal OWOB status is related to fatty liver content in the offspring as young adults, even after taking into account OWOB status and lifestyle factors in the offspring. There was an association between pre-pregnancy overweight and the development of NAFLD in adult offspring.

Maternal psychological distress and child weight at 24 months: investigating indirect effects through breastfeeding in the All Our Families cohort.

Maternal psychological distress in pregnancy has been associated with both breastfeeding duration and child weight at 24months; however, the potential that breastfeeding duration partially mediates the risk of maternal mental health problems during pregnancy on child weight classification has not been examined. The current study investigated this proposed relationship. Data was taken from the All Our Families (AOF) cohort, an ongoing prospective pregnancy cohort located in Calgary, Canada. Psychological distress, defined as clinically significant symptoms of anxiety and depression, was assessed via self-report and measured between 34 and 36weeks of gestation. Breastfeeding duration was assessed in the postpartum by self-report. Child overweight classification was defined as a weight-for-length/height z-score at or above the 97th percentile as per World Health Organization's child growth guidelines. In this sample of 1582 mother-child pairs, there was no direct relationship between psychological distress and child overweight status. Both anxiety (B = - 5.40, p = 0.001) and depression (B = - 6.54, p = 0.008) were associated with decreased weeks breastfeeding. Breastfeeding duration mediated the association between maternal prenatal psychological distress and child overweight status at 24months, for both anxiety (B(SE) = 0.10(0.05), CI 0.03-0.21) and depression (B(SE) = 0.11(0.07), CI 0.01-0.27). Covariates included maternal age, education, ethnicity, income, pre-pregnancy BMI, gestational weight gain, and infant birth weight. The results of this longitudinal cohort analysis support an indirect relationship between maternal psychological distress in pregnancy and the childhood overweight/obesity at 24months old, mediated through breastfeeding duration.

Distribution of Tri-Ponderal Mass Index and its Relation to Body Mass Index in Children and Adolescents Aged 10 to 20 Years

ContextBody mass index percentiles are widely used to determine overweight and obesity status in children and adolescents. Their limitations in clinical settings can be addressed.ObjectiveReference ranges for the tri-ponderal mass index percentiles of Korean children and adolescents are presented for a comparison of their clinical variables with those of body mass index.DesignCross-sectional study.SettingKorea National Health and Nutrition Examination Survey, 2007–2016.PatientsKorean children and adolescents aged 10 to 20 years.Main Outcome MeasuresThe age- and sex-specific least mean square parameters (skewness, median, and coefficient of variation) for the tri-ponderal mass index of 9749 subjects aged 10 to 20 years.ResultsThe factors associated with metabolic syndrome, except diastolic blood pressure, were more likely to be worse in the subjects with tri-ponderal mass index values indicative of overweight status than in those with normal tri-ponderal mass index values. Body mass index tends to underestimate obesity-related comorbidities more than tri-ponderal mass index does.ConclusionThe tri-ponderal mass index standard deviation score may be advantageous when defining overweight and obesity in children and adolescents.