Parental BMI Research Articles

Pre-pregnancy parental BMI and offspring blood pressure in infancy.

AimsA growing body of evidence suggests that a higher maternal pre-pregnancy body mass index results in higher offspring’s blood pressure, but there is inconsistency about the impact of father’s body mass index. Furthermore, evidence is limited with regard to low and middle income countries. We aimed to determine the association between parental pre-pregnancy body mass index and offspring’s blood pressure during the first year of life.MethodsIn 587 infants of the BReastfeeding Attitude and Volume Optimization (BRAVO) trial systolic and diastolic blood pressure were measured twice at the right leg in a supine position, using an automatic oscillometric device at day 7, month 1, 2, 4, 6, 9 and 12. Parental pre-pregnancy body mass index was based on self-reported weight and height. Linear mixed models were performed to investigate the associations between parental pre-pregnancy body mass index and offspring blood pressure patterns.ResultsEach unit increase in maternal body mass index was associated with 0.24 mmHg (95% confidence interval 0.05; 0.44) and 0.13 mmHg (0.01; 0.25) higher offspring’s mean systolic and diastolic blood pressure, respectively, during the first year of life. A higher offspring blood pressure with increased maternal pre-pregnancy body mass index was seen at birth and remained higher during the first year of life. The association with systolic blood pressure remained similar after including birth size and offspring’s weight and height over time. The association with diastolic blood pressure attenuated slightly to a non-significant result after including these variables. Paternal body mass index was not associated with offspring’s blood pressure.ConclusionHigher maternal pre-pregnancy body mass index, but not paternal pre-pregnancy body mass index, is associated with higher offspring blood pressure already from birth onwards.

Competency-Based Approaches to Community Health: A Randomized Controlled Trial to Reduce Childhood Obesity among Latino Preschool-Aged Children.

Background: Health behavior change interventions that target childhood obesity in minority populations have led to inconsistent and short-lived results. The purpose of this study was to test a novel intervention that was personalized and family-based in a Latino population to reduce childhood obesity. Methods: Competency-Based Approaches to Community Health (COACH) was a randomized controlled trial. Latino parent-child pairs were recruited from community settings in Nashville, TN. Child eligibility criteria included age 3-5 years and a BMI ≥50th percentile. The intervention included 15 weekly, 90-minute sessions followed by 3 months of twice-monthly health coaching calls. The control group was a twice-monthly school readiness curriculum for 3 months. Sessions were conducted by a health coach in local community centers, with groups of 8-11 parent-child pairs. The primary outcome was child BMI trajectory across 12 months, measured at four times. The intervention's effect was assessed by using a longitudinal, linear mixed-effects growth model, adjusting for child gender, baseline child and parent age, and baseline parent BMI and education. Results: Of the 305 parent-child pairs assessed for eligibility, 117 were randomized (59 intervention, 58 control). Child BMI was available for 91.5% at 1-year follow-up. Mean baseline child age was 4.2 [standard deviation (SD) = 0.8] years, and 53.8% of children were female. Mean baseline child BMI was 18.1 (SD = 2.6) kg/m2. After adjusting for covariates, the intervention's effect on linear child BMI growth was -0.41 kg/m2 per year (95% confidence interval -0.82 to 0.01; p = 0.05). Conclusions: Over 1-year follow-up, the intervention resulted in slower linear BMI growth for Latino preschool-aged children from poverty.

The shattered “Iron Rice Bowl”: Intergenerational effects of Chinese State-Owned Enterprise reform

Reform of the Chinese State-Owned Enterprise (SOE) sector in the late 1990s triggered massive layoffs (34 million employees) and marked the end of the “Iron Rice Bowl” guarantee of employment security for the remaining 67 million workers. An expanding international literature has documented the adverse health impacts of economic insecurity on adults, but has typically neglected children. This paper uses the natural experiment of SOE reform to explore the causal relationship between increased parental economic insecurity and children's BMI Z-score. Using province-year-level layoff rates and income loss from the layoffs, we estimate a generalised difference-in-differences model with child fixed effects and year fixed effects. For a medium-build 10-year-old boy, a median treatment effect implies a gain of 1.8 kg and a 2.2-percentage-point increase in the overweight rate due to the reform. Anxiety about potential losses causes weight gain for boys whose SOE parents kept their jobs. Unconditional quantile regressions suggest that boys who are heavier are more likely to gain weight. Girls are not significantly affected. Intergenerational effects therefore increase the estimated public health costs of greater economic insecurity

Parent BMI Increase 2 to 5 Years Post-study Related to Change in Age but Independent of Other Sociodemographics, Health Behavior, and Study Engagement (P16-001-19)

ObjectivesCharacterize parent (P) weight change 2–5 y post participation in Fuel for Fun (FFF) a controlled trial of a school and family intervention focused on culinary and physical activity experiences for 4th grade youth. MethodsP who had participated with their 4th grader in FFF were recruited via email to enroll in a follow-up (FFF-FU) assessment. FFF-FU survey set included measures from the original study and new items pertinent to P of adolescents. Physical activity was measured with the IPAQ; low income was denoted as using an income-based program or worry about money for food. Height, weight, age in FFF and FFF-FU were self-reported. Perimenopausal age included 47 y within BL and FFF-FU. Youth in FFF cohorts 1 and 4 were controls and cohorts 2 and 3 included the multi-component intervention. P were enrolled in 1 of 4 treatments varying in type and intensity. FFF and FFF-FU data were collected online using the Qualtrics platform. FFF P completed surveys at baseline (BL), post-intervention, and 4 months post-study. FFF-FU data were collected spring 2018, about 2 to 5 years years post-BL. Data were analyzed with repeated measures controlling for BL or FFF-FU sociodemographics, engagement, health behaviors. ResultsOf the 418 FFF P, 127 completed FFF-FU surveys (mean age 42.5 6.0 y) with 115 providing weight and height. FFF-FU sample was female (88%), white (84%), active (44% high activity), educated (69% college degree or higher), but had lower BMI and fewer with low income than FFF P. Of FFF-FU providing heights/weights at the 4 assessments, mean (SE) BMIs were 24.2 (0.5), 24.4 (0.5), 24.6 (0.6) and 25.7 (0.6) respectively. Change in BMI was significant after controlling for age, stress, ethnicity, sex, physical activity level, P treatment and engagement, but not when BL to FFU-FU change in age or perimenopausal age were controlled. The significantly greater increase in BMI for P of intervention youth than controls persisted when controlling for sociodemographic and health behavior findings, but not when BL to FFF-FU age change, perimenopausal age or activity level were controlled. ConclusionsSignificant weight gain by P of youth in a nutrition intervention 2 to 5 years post-study was unrelated to stress, ethnicity, activity level, income, but was related to the FFF-FU age change from BL and perimenopausal age. Funding SourcesNIFA.

The role of weight stigma in parental weight talk.

Many parents engage in "weight talk" with their child, such as encouraging their child to lose weight or making comments about their own weight or others' weight. What parents say to their children about weight can affect children's well-being, yet little is known about parental characteristics that may be at play regarding this common practice. This study examined the role of weight stigma in parental weight talk, and whether internalized weight bias mediates the relationship between parents' experiences of weight stigma and weight-based conversations and comments. A sample of 453 parents (Mage =35.07) with children 2 to 17years old (Mage =8.76) completed surveys measuring parental experiences with weight stigma, weight bias internalization, and frequency of different types of parental weight talk. Mediations were tested via the PROCESS macro. Independent of controls (parent BMI, child BMI percentile, parent and child sex, parent and child age, race, income, and education), experienced weight stigma was indirectly associated with greater frequency of weight-based conversations (β=.08) and comments about oneself (β=.08) and others (β=.04) via parents' internalized weight bias. These findings offer novel insights for understanding parental weight talk and can inform pediatric providers working with families on weight-related issues.

Can Parental Engagement in Social Media Enhance Outcomes of an Online Healthy Lifestyle Program for Preschool-Aged Children?

ABSTRACT This study explored parental engagement, child BMI and secondary outcomes from the social media component of an online healthy lifestyle program for parents of preschool-aged children. Intervention group participants received access to an online program and Facebook group. Data were collected at baseline and 3- and 6-months follow-up. Facebook usage data on comments and posts were used to determine total active engagement. There was a high level of Facebook group membership and most parents actively engaged at least once. Although there were varying levels of engagement between modules and cohorts, it was modest overall. User acceptability of the Facebook group was lower than expected. Children of parents in the intervention who engaged more in the Facebook group (by posting and commenting) demonstrated greater sleep duration over time (estimate 1.79, 95% CI 0.42 to 3.17, p = .01) Children of parents who engaged more in the Facebook group also participated in less moderate- to vigorous-intensity physical activity (estimate −0.14, 95% CI −0.26 to −0.01, p = .03). This study is one of the first parent-focussed healthy lifestyle interventions to include a social media component. Further research is recommended with larger sample sizes and longer duration to further explore the potential of social media in childhood obesity interventions.

Parental Education and Genetics of BMI from Infancy to Old Age: A Pooled Analysis of 29 Twin Cohorts.

Objective:To analyze how parental education modifies the genetic and environmental variances of body mass index (BMI) from infancy to old age in three geographic-cultural regions.Methods:A pooled sample of 29 cohorts including 143 499 twin individuals with information on parental education and BMI from 1 to 79 years (299 201 BMI measures) was analyzed by genetic twin modeling.Results:Until 4 years of age, parental education was not consistently associated with BMI. Thereafter, higher parental education was associated with lower BMI in males and females. Total and additive genetic variances of BMI were smaller in the offspring of highly educated parents than in those whose parents had low education. Especially in North American and Australian children, environmental factors shared by co-twins also contributed to the higher BMI variation in the low educational category. In Europe and East Asia, the associations of parental education with mean BMI and BMI variance were weaker than in North America and Australia.Conclusions:Lower parental education is associated with higher mean and larger genetic variance of BMI after early childhood, especially in the obesogenic macro-environment. The interplay between genetic predisposition, childhood social environment and macro-social context is important for socio-economic differences in BMI.

Parental child feeding practices and their relationship with children's dietary intake and weight status in Nepal.

Background: Small children have less control over their dietary intake and parents have a major role to play in it. The aim of our study was to determine parental child feeding practices and their association with the weight status and dietary intake of the child.Design and methods: A cross-sectional study was conducted among 138 parents and preschool children attending two private schools in Kathmandu Valley, Nepal using a structured questionnaire. Parents filled in a self-report questionnaire to assess child feeding practices, perceived activity level of the child, and dietary intake at home. Child’s height and weight was measured using a standard height scale and a digital weighing scale. A digital food scale was used for measuring dietary intake.Results: Eight percent of the children were overweight and another 8% were obese. On bivariate analysis, the BMI of parents had weak, positive, and significant correlation (r=0.206, p=0.016 for fathers; r=0.307, p≤0.001 for mothers) with child’s weight status. Similarly, concern about child’s overweight had a significant, positive correlation (r=0.232, p=0.006) with the weight status of the child. Furthermore, these three independent variables were found to be significant predictors of a child’s weight status on multivariate analysis. None of the studied independent variables was associated with dietary intake.Conclusion: The study concludes that parental BMI and parental concern about the child being overweight is significantly associated with the weight status of the child.

The Association between Parental Weight Status and Risk of Hypertension in Children Aged 6 to 12 Years: A Cross‐sectional Study in Shanghai, China

BackgroundParents may play important roles in the regulation of children's weight status and consequently risk of childhood HTN. However, data relating parental dietary/lifestyle characteristics to risk of HTN in their children is sparse.ObjectiveUsing parental weight status as a marker of their dietary and lifestyle habits, we aimed to examine the association between parental weight status and risk of hypertension (HTN) in their children.MethodsA total of 1,949 children aged 6 to 12 years (1,012 girls) and their parents were enrolled. Information on demographics, anthropometrics, lifestyle, diet, and medical history were obtained from the participants and their parents through self‐administered questionnaires. Multivariable‐adjusted odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) of prevalent HTN in children in relation to parental weight status are presented.ResultsThe HTN prevalence in children was 8.4%, with no significant gender difference (9.0% in boys vs. 7.8% in girls, P=0.36). After adjusting for potential confounders, parental overweight was significantly associated with risk of HTN in children. Compared with children who had both parents being normal weight, the risk of childhood HTN was increased by 94% (OR=1.94; 95% CI: 1.08, 3.50) for children with only father being overweight and 109% (OR=2.09; 95% CI: 1.26, 3.46) for children with both parents being overweight. The observed association was attenuated after further adjustment for children's body mass index.ConclusionsFindings from this cross‐sectional study suggest that parental BMI levels were associated with higher prevalence of HTN in their children through the mediation of children's BMI. Because parental weight status is a marker of the dietary and lifestyle choices in a family, actions focusing on improving health awareness and changing unhealthy habits among parents may exert critical influence on the risk of childhood HTN.Support or Funding InformationThis work was partially supported by a grant from the NIH (R01ES021735).This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Parental influences on screen time and weight status among preschool children from Brazil: a cross-sectional study

BackgroundLittle is known about the influence of parental attributes and parental screen time behaviours on pre-schooler’s screen time and weight status in low-to-middle income countries. The purpose of this study was to examine the relationships between parental screen time, parental self-efficacy to limit screen time, child screen time and child BMI in preschool-aged children in Brazil.MethodsThree hundred eighteen parent-child dyads from Caruaru, Brazil completed a survey measuring sociodemographic data, weekday and weekend screen time, and parental self-efficacy for limiting screen time. Height and weight were measured and used to derive BMI and BMI percentile. Observed variable path analysis was used to evaluate the relationships between the parental and child variables.ResultsAnalyses were conducted for screen time on weekdays and weekend days. Parental screen time was positively associated with child screen time, either directly (weekdays = β = 0.27, p < 0.001, weekends = β = 0.24, p < 0.001) or indirectly through reduced self-efficacy to limit child screen time (weekdays = β = − 0.15, p = 0.004, weekends = β = − 0.16, p = 0.004). After controlling for household income, parental occupation, and parental BMI, greater child screen time on weekends, not weekdays, was associated with higher child BMI percentile (β = 0.15, p = 0.006).ConclusionsParental screen time and self-efficacy to limit screen time are important influences on child screen time and weight status in pre-schoolers from Brazil. Reducing parental screen time and increasing parental confidence to limit screen time may be effective strategy to prevent overweight in Brazilian pre-schoolers.

An examination of children's eating behaviours as mediators of the relationship between parents' feeding practices and early childhood body mass index z-scores.

SummaryObjectiveParent's use of restrictive feeding practices is associated with child weight. Similarly, the literature shows that children's eating behaviours are also associated with child weight. Given this interrelationship between children's eating behaviours, restrictive feeding practices and child weight, examination of possible mediator relationships is warranted. This study aimed to examine the relationships between overt restriction and covert restriction with child body mass index z‐scores (BMIz) and determine if children's eating behaviours (satiety responsiveness and food responsiveness) act as mediators.MethodParents of Australian children (n = 977) 2.0–5.0 years of age (49.4% male) provided data in an online survey on child eating behaviours, parent's restrictive feeding practices and child anthropometrics (modified z‐scores were created to screen for biologically implausible values). Correlation analysis was used to determine variables to include in mediation models. Hayes' PROCESS macros in spss was used to examine mediation, controlling for covariates of child BMIz.ResultsOvert restriction was the only parent feeding practice related to child BMIz (B = 0.132, P = 0.04). Mediation analysis showed that the indirect effect of overt restriction on child BMIz (controlling for child age, gender, parent BMI and income) became non‐significant when controlling for food responsiveness, thus suggesting full mediation, explaining 5.75% of the relation.ConclusionOvert restriction and covert restriction have distinctly different relationships with children's eating behaviours. Food responsiveness appears an important intermediary in the relationship between overt restriction and child BMIz.

Evidence for gene-environment correlation in child feeding: Links between common genetic variation for BMI in children and parental feeding practices.

The parental feeding practices (PFPs) of excessive restriction of food intake (‘restriction’) and pressure to increase food consumption (‘pressure’) have been argued to causally influence child weight in opposite directions (high restriction causing overweight; high pressure causing underweight). However child weight could also ‘elicit’ PFPs. A novel approach is to investigate gene-environment correlation between child genetic influences on BMI and PFPs. Genome-wide polygenic scores (GPS) combining BMI-associated variants were created for 10,346 children (including 3,320 DZ twin pairs) from the Twins Early Development Study using results from an independent genome-wide association study meta-analysis. Parental ‘restriction’ and ‘pressure’ were assessed using the Child Feeding Questionnaire. Child BMI standard deviation scores (BMI-SDS) were calculated from children’s height and weight at age 10. Linear regression and fixed family effect models were used to test between- (n = 4,445 individuals) and within-family (n = 2,164 DZ pairs) associations between the GPS and PFPs. In addition, we performed multivariate twin analyses (n = 4,375 twin pairs) to estimate the heritabilities of PFPs and the genetic correlations between BMI-SDS and PFPs. The GPS was correlated with BMI-SDS (β = 0.20, p = 2.41x10-38). Consistent with the gene-environment correlation hypothesis, child BMI GPS was positively associated with ‘restriction’ (β = 0.05, p = 4.19x10-4), and negatively associated with ‘pressure’ (β = -0.08, p = 2.70x10-7). These results remained consistent after controlling for parental BMI, and after controlling for overall family contributions (within-family analyses). Heritabilities for ‘restriction’ (43% [40–47%]) and ‘pressure’ (54% [50–59%]) were moderate-to-high. Twin-based genetic correlations were moderate and positive between BMI-SDS and ‘restriction’ (rA = 0.28 [0.23–0.32]), and substantial and negative between BMI-SDS and ‘pressure’ (rA = -0.48 [-0.52 - -0.44]. Results suggest that the degree to which parents limit or encourage children’s food intake is partly influenced by children’s genetic predispositions to higher or lower BMI. These findings point to an evocative gene-environment correlation in which heritable characteristics in the child elicit parental feeding behaviour.

Parent Instrumentality for Adolescent Eating and Activity.

Parent-adolescent interactions have health implications for adolescents. Parents can be instrumental to healthy eating by purchasing fruits and vegetables or refraining from purchasing hedonic (low nutrient, high energy-dense) foods. Parents can be instrumental to healthy activity by modeling exercise behavior or discouraging sedentary activities. This research leverages theory on goal pursuit within relationships to investigate whether parents are instrumental to adolescents' eating and activity. Using a national sample of 1,556 parent-adolescent dyads, we conducted dyadic analyses to examine whether parent instrumentality (both parent-perceived and adolescent-perceived) for healthy behaviors was associated with adolescent engagement in those behaviors. We examined whether the link between parent instrumentality and adolescent BMI was mediated by parent instrumentality. We also explored whether parent instrumentality was associated with parent behaviors and parent BMI. Greater adolescent-perceived parent instrumentality was associated with greater fruit and vegetable consumption and physical activity, and lower sedentariness. Parent-perceived parent instrumentality was associated with greater adolescent fruit and vegetable consumption, less hedonic eating, and more activity. Mediation modeling suggests that adolescent BMI is partially attributable to parent instrumentality for activity. Instrumental parents also engage in healthier behaviors, some of which in turn are associated with lower parent BMI. Findings have implications for the promotion of healthy eating and activity patterns among adolescents. Parental instrumentality for behavior may be an important target for interventions to improve adolescent health, and interventions may be most successful in facilitating adolescent behavior change if they target both parent- and adolescent-perceived parent instrumentality.

Body composition and blood pressure in 6-year-old singletons born after pre-implantation genetic testing for monogenic and structural chromosomal aberrations: a matched cohort study.

STUDY QUESTIONDoes Day 3 embryo biopsy for pre-implantation genetic testing for monogenic (PGT-M) and structural chromosomal aberrations (PGT-SR) affect body composition and blood pressure readings of 6-year-old singletons?SUMMARY ANSWERThis study of 87 PGT-M and PGT-SR conceived singletons showed no differences in anthropometric measurements and blood pressure readings in comparison with a matched cohort of peers born after ICSI without embryo biopsy.WHAT IS KNOWN ALREADYWhile neonatal outcomes after PGT conception have been found comparable to those after ICSI without embryo biopsy, only a few studies have reported outcomes after PGT at older ages. Moreover, embryo biopsy is also applied in couples who opt for PGT-M and PGT-SR and hence are not necessarily infertile. Health parameters and in particular body composition data in this group of children are lacking.STUDY DESIGN, SIZE, DURATIONThis single-centre matched-pair cohort study evaluated body composition of 6-year-old children born after fresh blastocyst embryo transfer with or without embryo biopsy performed at Day 3 for the purpose of PGT-M and PGT-SR. For each child born after embryo biopsy, a singleton born after transfer of a fresh ICSI embryo at the blastocyst stage and reaching the age of 6 years between May 2011 and June 2017 was matched as closely as possible for gender, age, maternal educational level and birth order.PARTICIPANTS/MATERIALS, SETTING, METHODSAnthropometry (weight, height, BMI, skinfold thickness, waist and mid-upper arm circumference) and blood pressure readings in a longitudinally followed cohort of 87 singletons conceived by PGT-M and PGT-SR and a pairwise matched sample of 87 children conceived by ICSI are described. Results are adjusted for current, neonatal and parental characteristics.MAIN RESULTS AND THE ROLE OF CHANCEFrom the 124 eligible PGT-M and PGT-SR families, 110 could be reached of whom 23 refused and 87 (87/110 = 79%) participated. All anthropometric measurements, including z-scores of BMI, waist and mid-upper arm circumference, were comparable between the PGT-M and PGT-SR (−0.23; 0.27; 0.17, respectively) and ICSI (−0.29; 0.11; 0.11, respectively) groups (all P > 0.05). Furthermore, indices of peripheral (triceps) and central (subscapular) adiposity derived from skinfold thickness were comparable (PGT-M and PGT-SR: 14.7 mm; 11.6 mm and ICSI: 15.5 mm; 11.5 mm) as well as the percentage total body fat mass derived from these (PGT-M and PGT-SR: 13.7% and ICSI: 13.9%) (all P > 0.05). Z-scores for blood pressure were also comparable between the PGT and ICSI groups (all P > 0.05). Results did not change when adjusted for neonatal (birthweight, birth order), current (age) and parental (smoking during pregnancy, parental BMI) characteristics. Hospitalization rate and surgical intervention rate were not different for PGT-M and PGT-SR children compared to matched peers born after ICSI.LIMITATIONS, REASONS FOR CAUTIONAlthough our study describes the largest cohort of singletons born after embryo biopsy worldwide, we were only able to detect moderate differences in anthropometrics and blood pressure with our sample size.WIDER IMPLICATIONS OF THE FINDINGSAlthough Day 3 embryo biopsy followed by blastocyst transfer is not associated with adverse outcomes regarding anthropometry and blood pressure, future studies should focus on outcomes in children born after trophectoderm biopsy and/or transfer of warmed embryos after vitrification.STUDY FUNDING/COMPETING INTEREST(s)This study was supported by Methusalem grants and by grants from Wetenschappelijk Fonds Willy Gepts; all issued by the Vrije Universiteit Brussel (VUB). All co-authors, except M.B. declared no conflict of interest. M.B. has received consultancy fees from MSD, Serono Symposia and Merck. The Universitair Ziekenhuis Brussel (UZ Brussel) and the Centre for Medical Genetics have received several educational grants from IBSA, Ferring, Organon, Shering-Plough, Merck for establishing the database for follow-up research and organizing the data collection.

Risk factors for pre-diabetes and diabetes in adolescence and their variability by race and ethnicity

Adolescent risk factors for pre-diabetes and diabetes in young adulthood were examined in three minority groups and compared to those in non-Hispanic Whites.Retrospective cohort study with data on 8337 adolescent respondents from Add Health (1994–2008). Participants included 5131 non-Hispanic Whites, 1651 non-Hispanic Blacks, 1223 Hispanics, and 332 American Indians/Alaska Natives. Diabetes was defined as: hemoglobin A1C ≥ 6.5%, glucose > 125 mg/dl, self-reported diabetes, or self-reported diabetes medication use, in Wave 4 data. Pre-diabetes was defined as hemoglobin A1C ≥ 5.7%. Relative risk regression models were used to evaluate the association between risk factors and risk of diabetes and pre-diabetes, controlling for body mass index, sedentary and physical activity habits, fast food consumption, and parental education, parental diabetes status, and financial stability. 484 participants developed diabetes; 2878 developed pre-diabetes between 1994 and 2008. Pre-diabetes and diabetes were more prevalent in non-Hispanic Blacks (55% and 12%, respectively) than in American Indians/Alaska Natives (43% and 11%), Hispanics (37% and 6%), and non-Hispanic Whites (27% and 3%). In all races, higher body mass index and parental diabetes were associated with higher risk of pre-diabetes and diabetes, while female sex was associated with lower risk of pre-diabetes. Efforts to reduce the risk of pre-diabetes and diabetes in adolescents should emphasize parental diabetes and BMI in all races, independent of physical activity, sedentary behaviors, or fast food consumption. Future interventions might be interested in targeting households, rather than individuals, to prevent pre-diabetes and diabetes in adolescents and young adults.

Parents Matter: Associations of Parental BMI and Feeding Behaviors With Child BMI in Brazilian Preschool and School-Aged Children

Background: Brazil is undergoing nutritional transition and rates of obesity in preschool and school-aged children are increasing. Excess weight in the first years of life could predict excess weight in adulthood, making it essential to study risk factors in this population.Objective: Our goal was to investigate associations of parent feeding behaviors, as well as more distal familial influences including family SES and maternal and paternal weight, with BMI z-score in preschool and school-aged children in a Brazilian sample.Methods: Cross-sectional study. Data were collected in 14 Brazilian private schools. Parents of children aged 2–8 years (n = 1,071) completed a questionnaire assessing parent feeding behaviors, as well as sociodemographic and anthropometric information. Hierarchical linear regression models were fitted to investigate relationships between parent and child characteristics and child BMI z-score in preschool (2–5 years, n = 397) and school-aged (6–8 years, n = 618) children.Results: Final models indicated that higher maternal BMI and “restriction for weight control” were associated with higher child BMI z-score in both age groups (excessive weight, i.e., BMI ≥ +1 z-score, in preschoolers and school-aged children: 24.4 and 35.9%, respectively). In preschoolers only, “healthy eating guidance” and “pressure” were associated with lower child BMI z-score. For school-aged children, male sex, higher father BMI, and “restriction for health” were associated with higher child BMI z-score.Conclusions: Parent feeding behaviors and parent weight, as well as child sex, are associated with child BMI z-score, with evidence for differential relationships in preschool and school-aged children. Optimal obesity prevention and treatment strategies may differ by child age.

Snack cost and percentage of body fat in Chinese children and adolescents: a longitudinal study.

Only a few studies examined the relationship between snack cost and change in the percentage of body fat in children. We thus conducted a longitudinal study to investigate whether high snack cost is associated with fast increase in the percentage of body fat in Chinese children. The study included 2368 children (1126 girls and 1242 boys, aged 6-14years). Percentage of body fat was repeatedly assessed by bioelectrical impedance analysis in 2014 (baseline), 2015 and 2016. Snack cost in 2014 was estimated by self-report associated with purchasing snacks at school and classified into low, moderate, and high group. Association between snack cost and repeated percentage of body fat was analyzed with linear mixed models, adjusting for demographic factors, diet, physical activity, and parental BMI and education. High snack cost was significantly associated with a fast increase in the percentage of body fat over time (p trend = 0.04). Adjusted difference in annual increase rate in percentage of body fat between the high and low snack cost group was 0.31% [95% confident interval (CI) 0.04%, 0.58%], after adjusting for potential confounders. The impacts of snack cost on change in the percentage of body fat were more pronounced in boys, younger participants and those with higher BMI z-score at the baseline, relative to their counterparts (p interaction < 0.001 for all). High snack cost was associated with more gain of body fat in Chinese school-aged children.

P24 - Frequency of Eating Alone Among Adolescents was Associated with Parent Support, Dietary Intake and BMI: FLASHE Study Results

P24 - Frequency of Eating Alone Among Adolescents was Associated with Parent Support, Dietary Intake and BMI: FLASHE Study Results

High Performance Two-Step Model for Early Detection and Management of Type 2 Diabetes Risk in the Workplace

Background: Identification of T2D high risk individuals is key for early implementation of prevention interventions. Employers could be instrumental in reversing T2D risk for a majority of its population via improved predictive power risk detection tools. Objective: To test the feasibility of a two-step screening model, based on the combination of a risk test score and Hb1Ac, for early detection and management of risk in an employee population. Methodology: The model was tested in nondiabetic employees of a large employer in Mexico. As a first step, a T2D risk score was computed for each participant via a multivariate logistic regression model that integrates 16 T2D genetic variants, T2D parental history and BMI. Subjects with a risk score above certain cut points were considered medium and high-risk individuals. As a second step, medium and high-risk individuals identified in the first step were tested for levels of Hb1Ac. Subjects with Hb1Ac of ≥5.7% were recommended to join the employer’s diabetes prevention program. Results: 5,201 of 7,480 (69.5%) employees (46% women, 54% men) aged 18-60 years and free of diabetes agreed to participate in the screening program. 5,201 samples (buccal swabs) for genotyping and corresponding data (demographics, personal and family medical history) were collected on-site at 36 branch offices from 10/2017 to 12/2017 in Mexico City, Monterrey and Guadalajara. Participants risk scores stratified as low (52%), medium (34%) or high risk (14%). Of the medium and high-risk individuals, 31% showed elevated Hb1Ac (≥5.7%), and were suggested to join the employer’s diabetes prevention program. Conclusions: Our study initiates a data-driven discussion of how employers can radically support employee diabetes prevention and lower healthcare costs via improved predictive power tools. A two-step system, based on the combination of a risk test score and Hb1Ac, may be a useful tool for an effective identification of high risk individuals in a workplace setting. Disclosure M. Zulueta: Employee; Self; Patia, Patia.

Does Love Really Make Mothers Blind? A Large Transcontinental Study on Mothers' Awareness About Their Children's Weight.

The aim of this study was to assess maternal misperception rates (perception as normal or underweight of a child with overweight or obesity) and their role in affecting the chance of implementing actions to change children's weight. Obesogeneicity of Gadgets Marketed with Snacks (OBEY-AD) is an international study investigating factors promoting childhood overweight and obesity in 10 countries, in which 2,720 child-mother dyads have been enrolled. Mothers' perception of their children's weight was assessed using a projective test. Children's weight status was measured according to the anthropometric standards established by the World Health Organization. Mothers classified 89% of children with overweight and 52% of children with obesity as normal weight. The odds ratio of mothers' misperception was significantly higher for higher parental BMI, higher children's International Brand Awareness Inventory score, and high family socioeconomic status. Children with overweight and/or obesity who were perceived as normal weight by their mothers were less likely to be referred to specific health care services. Most children with overweight and/or obesity were perceived as normal weight by their mothers. Such lack of concern regarding a severe disease might interfere with the effectiveness of prevention programs. Considering the contextual factors that frame the etiological causes of a disease may help in finding effective and enduring solutions to target childhood obesity.