Rapid Weight Gain Research Articles

Sleep SAAF responsive parenting intervention improves mothers’ feeding practices: a randomized controlled trial among African American mother-infant dyads

Background/ObjectiveParents shape children’s early experiences with food, influencing what is served, children’s food choices, and how much children eat. Responsive parenting (RP) interventions such as INSIGHT have improved maternal infant feeding practices, but have only been tested among predominantly White families. This secondary analysis of data from the Sleep SAAF (Strong African American Families) RCT tests the effects of an RP intervention designed to prevent rapid infant weight gain on African American mothers’ infant feeding practices.MethodsPrimiparous African American mother-infant dyads (n = 194) were randomized to an RP or safety control intervention delivered by community research associates at infant age 3 and 8 weeks. At 16 weeks, mothers completed the Babies Need Feeding questionnaire, the Infant Feeding Styles Questionnaire, and the Babies Need Soothing questionnaire. Logistic regression and general linear models examined the effect of study group on infant feeding practices. Moderation analyses explored whether effects varied by feeding mode (any breast milk versus exclusive formula), maternal age (≥ 20 years versus < 20 years), and maternal pre-pregnancy BMI (with obesity versus not).ResultsRP mothers reported more responsive feeding (p = 0.005, partial η2 = 0.02), lower likelihood of using beverages other than breast milk/formula to soothe their infant (p = 0.01, OR = 0.42, 95% CI [0.2–0.8]), and less pressure with cereal than control mothers (p = 0.09, partial η2 = 0.02). RP mothers also reported less pressure to finish/soothe than controls (p = 0.007, partial η2 = 0.04); feeding mode (B = 0.74, p = 0.003) and maternal age (B = 0.53, p = 0.04) moderated this effect. There were no significant group differences in bottle-feeding practices (e.g., adding cereal to bottle, using an appropriate nipple/bottle size), or in context-based or emotion-based food to soothe.ConclusionsResponsive parenting education influenced some feeding practices of African American mothers. Mothers reported using less pressure, a control-based feeding practice, and more responsive feeding than controls.Trial registrationSleep SAAF: A Strong African American Families Study. www.clinicaltrials.gov NCT03505203. Registered 3 April 2018.

Growth pattern during early infancy, body mass index during childhood and childhood asthma.

There is a lack of longitudinal studies of associations between growth from infancy to childhood and asthma development. The objective of the study was to investigate the effects of weight change during infancy, body mass index (BMI) and the interaction of these factors on the risk of childhood asthma. We enrolled children born in 2008 and 2009 at full-term and with normal birth weight. The weight change in infancy was grouped into slow, on-track and rapid. BMI status in childhood was stratified into low, normal and high groups and used as a time-varying variable. The outcome was asthma, defined as two or more diagnoses of asthma separated by at least 1year after 2 years of age. The risk of asthma was assessed using Cox proportional hazard regression, with adjustment for sex, residence area at birth, economic status and feeding types in infancy. Of 917,707 children born in Korea in 2008 and 2009, 271,871 were eligible for analysis. The risk of asthma was greater in groups with low birth weight (aHR 1.06, 95% CI 1.04 to 1.08), rapid body weight change during early infancy (aHR 1.08, 95% CI 1.07 to 1.10) and high BMI during childhood (aHR 1.06, 95% CI 1.04-1.08). The interaction of weight change during early infancy with BMI during childhood was significant for asthma (p < .01). Rapid weight gain in infancy was associated with lower risk of asthma in those with low BMI during childhood; had no association with asthma in those with normal BMI during childhood; and was associated increased asthma risk in those with high BMI during childhood-aHR 1.26 (95% CI 1.19 to 1.33) and aHR 1.33 (95% CI 1.12 to 1.56) compared with on-track and slow infant weight gain, respectively. Low birth weight, high BMI during childhood and, in those with high childhood BMI, rapid weight gain during early infancy are associated with increased risk of childhood asthma.

High-throughput phenotyping by deep learning to include body shape in the breeding program of pacu (Piaractus mesopotamicus)

Deep learning (DL) is a cutting-edge technology that enables high-throughput phenotyping in aquaculture. The routine application of DL offers new opportunities for the genetic selection of appearance traits, especially those related to body shape. The criteria currently used for the trait selection of commercial interest, such as rapid growth and weight gain, can directly influence the animal's appearance, which is a criterion for sales and profit. Different morphotypes of the pacu Piaractus mesopotamicus (elliptical and rounded) have been described previously and may represent different commercial trends. Therefore, this study aimed to 1) develop a computer vision system (CVS) through deep learning that targets the prediction of morphometric measurements and body shape (morphotypes) in pacu, 2) analyze whether morphotypes vary according to the environment, sex, and/or age, and 3) estimate genetic parameters for body shape, using the condition factor (K) and ellipticity (E) as criteria. Data from 1380 individuals corresponding to 48 full-sib families were evaluated in two distinct environments (breeding nucleus: env1; commercial fish farm: env2). The animals were evaluated based on their weight and morphometric measurements at 15 and 28 months of age (growth stage). We used the mask R-CNN model as a deep-learning algorithm, which was optimized for a ResNet architecture with only 18 layers. This resulted in a faster training period (8GB NVIDIA 2060 RTX in less than a day), which requires less computational effort. The pacu CVS was effectively developed to account for the segmentation of several fish body regions (head, body, fins, and pelvis), as corroborated by the high correlations of measurements predicted manually and automatically. We detected K and E variation at different growth stages and environments, in which fish tend to have rounded shapes in env2 and at 28 months old. The body shape heritability indicates that this trait is under moderate genetic control and should respond to selection. In conclusion, this study established an efficient CVS for pacu that is resilient to field conditions, allowing high-throughput phenotyping for the routine assessment of body shape in breeding programs for this species.

The association between ambient temperature exposure during infancy and overweight at age two years

BACKGROUND AND AIM: Childhood overweight and obesity is increasing in prevalence globally and is a risk factor for metabolic disease in adulthood. We have previously described an association between exposure to higher ambient temperatures during infancy and rapid infant weight gain. We aimed to examine the association between ambient temperature exposure during the first year of life and overweight at age two years. METHODS: A population-based cohort study using data from the Israeli network of public maternal and child health clinics from 2011 to 2018. The study population was restricted to children born with birthweight &amp;#x2265;2500g (N=579,404). We assessed exposure to ambient temperature using a high-resolution spatio-temporal model and calculated the average annual exposure during the first year of life for each infant based on daily temperature at their address. Overweight at two years was defined as &amp;#x3e;85th percentile in World Health Organization age and sex-adjusted body mass index. We calculated relative risks using log-linear models and fitted general additive models with thin plate regression splines while adjusting for sub-district, neighbourhood socio-economic index, ethnicity, month and year of birth and average ambient temperature during pregnancy. RESULTS: We found a positive association between ambient temperature exposure and risk of overweight at age two years. Children exposed to the highest temperature quintile (&amp;#x2265;22.0&amp;#xb0;C) had an adjusted relative risk of 1.16 (95% CI 1.12, 1.19) compared to those exposed to the lowest quintile (&amp;#x3c;19.6&amp;#xb0;C). Modelling temperature as a continuous variable using general additive models showed an increase in risk with higher temperature exposure up to approximately 23&amp;#xb0;C when the risk levelled out. CONCLUSIONS: Exposure to higher ambient temperatures during infancy is associated with increased risk of overweight at age two years in Israel. Future studies should explore this association in other populations and examine possible biological mechanisms. KEYWORDS: temperature, child health, climate

Early rapid weight gain, parental body mass index and the association with an increased waist-to-height ratio at 5 years of age.

Background/ObjectivesObesity-related adverse health consequences are closely associated with abdominal obesity. Risk factors for overweight and obesity have been studied but there is a lack of information regarding risk factors for abdominal obesity, especially in the preschool population. The aim of the present study was to examine early life risk factors for an increased waist-to-height ratio (WHtR) in children at five years of age and, in addition, to investigate if these risk factors also were associated with overweight or obesity.Subjects/MethodsThe study population comprised 1,540 children from a population-based longitudinal birth cohort study that included 2,666 Swedish children. The children were included if they had complete growth data for the analyses used in this study. Children were classified as having WHtR standard deviation scores (SDS) ≥ 1 or < 1 at five years of age, according to Swedish reference values, and as having body mass index standard deviation scores (BMISDS) for overweight/obesity, or normal weight/underweight according to the International Obesity Task Force criteria. Associations between child-related, socioeconomic status-related, parental health-related and nutrition- and feeding practice-related factors during the first two years and a WHtRSDS ≥ 1 or a BMISDS for overweight/obesity at five years were investigated with logistic regression analyses.ResultsAt five years of age, 15% of the children had WHtRSDS ≥ 1 and 11% had overweight or obesity. In multivariable analyses, rapid weight gain (RWG) during 0–6 months (OR: 1.90, 95% CI: 1.23–2.95, p = 0.004), maternal pre-pregnancy BMI (1.06, 1.01–1.11, p = 0.019) and paternal BMI (1.11, 1.01–1.21, p = 0.028) were associated with WHtRSDS ≥ 1. RWG during 0–6 months (2.53, 1.53–4.20, p<0.001), 6–12 months (2.82, 1.37–5.79, p = 0.005), and maternal pre-pregnancy BMI (1.11, 1.06–1.17, p<0.001) were associated with overweight or obesity.ConclusionsEarly risk factors, including rapid weight gain, are associated with increased WHtRSDS and overweight or obesity at 5 years of age. Preventive interventions should target early RWG and parental overweight and obesity.

Ventromedial hypothalamic OGT drives adipose tissue lipolysis and curbs obesity.

The ventromedial hypothalamus (VMH) is known to regulate body weight and counterregulatory response. However, how VMH neurons regulate lipid metabolism and energy balance remains unknown. O-linked β-d-N-acetylglucosamine (O-GlcNAc) modification (O-GlcNAcylation), catalyzed by O-GlcNAc transferase (OGT), is considered a cellular sensor of nutrients and hormones. Here, we report that genetic ablation of OGT in VMH neurons inhibits neuronal excitability. Mice with VMH neuron-specific OGT deletion show rapid weight gain, increased adiposity, and reduced energy expenditure, without significant changes in food intake or physical activity. The obesity phenotype is associated with adipocyte hypertrophy and reduced lipolysis of white adipose tissues. In addition, OGT deletion in VMH neurons down-regulates the sympathetic activity and impairs the sympathetic innervation of white adipose tissues. These findings identify OGT in the VMH as a homeostatic set point that controls body weight and underscore the importance of the VMH in regulating lipid metabolism through white adipose tissue–specific innervation.

Influence Of Rapid Weight Gain On Outcomes In Professional Boxers And Mixed Martial Artists

PURPOSE: Professional combat sport athletes commonly practice rapid weight gain (RWG) following official weigh-in to gain a theoretical competitive advantage over their opponent. Recent literature highlights conflicting evidence on the associations between RWG and competitive success. The objective of this study was to evaluate the effect of RWG on competitive success in large cohorts of professional boxers and mixed martial artists. METHODS: Fighter demographic and event records from 2015-2019 for 1582 professional boxers and 752 mixed martial artists were collected from the California State Athletic Commission (CSAC). Official weigh-in weights, event weights, and bout outcomes were recorded. Independent t-tests were used to compare absolute and relative weight gain based on bout outcome for each sport. Logistic regression was used to assess the relationships between bout outcome and predictors including weight gain, competitive level, weight class and year of competition. RESULTS: For boxers, winners gained significantly more absolute and relative weight than losers (4.9 ± 0.1 vs. 4.3 ± 0.1 kg, p < 0.001) and (7.9 ± 0.1 vs. 6.9 ± 0.1 %, p < 0.001), respectively. Logistic regression revealed relative RWG significantly predicted winning outcome (OR = 1.11, 95% CI [1.07, 1.15]). Among mixed martial artists, winners gained significantly more absolute and relative weight than losers (5.9 ± 0.1 vs. 5.3 ± 0.1 kg, p < 0.001) and (8.7 ± 0.2 vs. 7.8 ± 0.2 %, p < 0.001), respectively. Logistic regression revealed relative RWG significantly predicted winning outcome (OR = 1.07, 95% CI [1.03, 1.12]). CONCLUSIONS: Despite previous studies with conflicting findings, this study contributes further evidence that RWG confers a competitive advantage in professional boxing and mixed martial arts.

Case Report: Considerations of nocturnal ventilator support in ROHHAD syndrome in chronic care of childhood central hypoventilation with hypothalamus dysfunction

Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) is a rare life-threatening disorder that can occur during childhood. All children with ROHHAD develop alveolar hypoventilation during wakefulness and sleep. The key treatment for these patients is the optimization of oxygenation and ventilation. Here, we report the case of a 5-year-old girl with suspected ROHHAD, with rapid weight gain, breathing cessation, decreased height, hypoventilation, central hypothyroidism, hyperprolactinemia, and absolute deficiency of growth hormone, and negative PHOX2B sequencing results. The presentation met the diagnostic criteria for ROHHAD syndrome. During the 5-year follow-up, she presented with progressive deterioration of the function of the hypothalamus and respiratory center, hypoxemia (PO2 < 60 mmHg), and hypercapnia [transcutaneous carbon dioxide (TcPCO2) > 70 mmHg] during the first two cycles of N3 sleep with a poor response to ventilatory support. Early diagnosis and application of non-invasive positive pressure ventilation during sleep can improve the quality of life and outcomes of patients with ROHHAD, and polysomnography and TcPCO2 should be repeated every 3–6 months to follow the progress and regulate ventilator support. Multidisciplinary care is crucial for the successful management of these patients.

Ecological interactions between Antarctic krill (Euphausia superba) and baleen whales in the South Sandwich Islands region – Exploring predator-prey biomass ratios

Following the cessation of whaling, the southwest Atlantic humpback whale (Megaptera novaeangliae) population is thought to be close to pre-exploitation size, reversing 20th century changes in abundance. Using a model-based approach applied to concurrently collected data on baleen whale abundance and Antarctic krill (Euphausia superba) biomass in the South Sandwich Islands (SSI) region, we explore ecological interactions between these taxa. Krill biomass and baleen whale density were highest to the north and northeast of the SSI, where the Antarctic Circumpolar Current (ACC) is deflected around the island chain. Humpback whale density was elevated at locations of krill biomass density >150 gm-2. Krill consumption by baleen whales was estimated at 19–29% of the available krill standing stock. We used historic whaling data to confirm the plausibility of these consumption rates and found evidence of rapid weight gain in humpback whales, such that blubber depleted during the breeding season could be restored in a much shorter period than previously assumed. Little is known about krill replenishment rates in the flow of the ACC, or about niche separation between recovering baleen whale populations; both factors may affect species carrying capacities and further monitoring will be required to inform the management of human activities in the region.

Association of gestational hypertension and preeclampsia with offspring adiposity: A systematic review and meta-analysis.

BackgroundThe association of gestational hypertension (GH) and preeclampsia (PE) with offspring adiposity outcomes had controversial results in different studies.ObjectiveWe conducted a systematic review and meta-analysis to evaluate the relationship between maternal GH/PE and offspring adiposity outcomes.Search strategyStudies were identified in PubMed, Embase, and Cochrane databases, with keywords including “gestational hypertension”, “preeclampsia”, “offspring”, “weight”, “cohort study”, etc., without year restriction. This study was registered with PROSPERO, CRD42022292084.Selection criteriaWe set the selection criteria for six aspects: population, outcome, time frame, study design, and availability. For the studies included in the meta-analysis, we required the potential confounders in these studies have been adjusted.Data collection and analysisTwo reviewers independently evaluated the data from the included studies. The meta-analyses included mean differences, regression coefficients, and corresponding 95% confidence intervals. Results were performed using RevMan software (version 5.4; Cochrane Collaboration). Heterogeneity among the included studies was assessed using the I2 statistic.Main resultsA total of 16 studies were included in our review, 15 of which were evaluated as high quality. In all offspring, during the early life (28 days-36 months), GH/PE exposure was found to be not or inversely associated with offspring obesity, then become positively associated at larger ages (3-19 years old). In offspring with adverse birth outcomes, the maternal GH/PE-exposed group had a lower weight in the short term (28 days to 18 months), but there was a trend of rapid weight gain as they grew older, compared with the non-exposed group. The meta-analysis showed that the BMI of the female offspring in the maternal PE-exposed group was significantly higher than that of the non-exposed offspring (MD=1.04, 95% CI: 0.67~1.42, P < 0.05).ConclusionsThe systematic review suggested that maternal exposure to de novo hypertension disorders of pregnancy (HDP) was associated with obesity in offspring, extending from early childhood to adolescence. The meta-analysis showed that PE was associated with higher BMI in female offspring. More studies are needed to conduct stratified analyses by PE/GH, the severity of HDP, or gender.Systematic review registrationPROSPERO, identifier CRD42022292084.

Monitoring and treating hypoglycemia during meal-based rapid nutritional rehabilitation in patients with extreme anorexia nervosa.

Hypoglycemia, a complication of prolonged starvation, can be life-threatening and is presumed to contribute to the high mortality of anorexia nervosa. Furthermore, early refeeding in severe anorexia nervosa can precipitate paradoxical post-prandial hypoglycemia. Few studies have analyzed the course of hypoglycemia during nutritional rehabilitation in patients with extremely low-weight anorexia nervosa. No standard practice guidelines exist and recommended strategies for managing hypoglycemia (i.e., nasogastric feeds, high-fat diets) have limitations. This cohort study assessed prevalence and correlates of hypoglycemia in 34 individuals with very low body mass index (BMI < 14.5kg/m2) anorexia nervosa treated in an intensive eating disorders program with an exclusively meal-based rapid weight gain nutritional protocol. Hypoglycemia was monitored with frequent point of care (POC) glucose testing and treated with oral snacks and continuous slow intravenous 5% dextrose in 0.45% saline (IV D5 1/2 NS) infusion. POC hypoglycemia was detected in 50% of patients with highest prevalence noted on the day of admission. Hypoglycemia resolved during the first week of hospitalization in most cases and was generally asymptomatic. Seven patients (20.6%) experienced at least one episode of severe hypoglycemia with POC glucose < 50mg/dl. Lower admission BMI was associated with higher likelihood of developing hypoglycemia and longer duration of hypoglycemia. Meal-based management of hypoglycemia supplemented by continuous IV D5 1/2 NS appears a viable alternative to alternate strategies such as enteral tube feeding. We discuss recommendations for hypoglycemia monitoring during nutritional rehabilitation and directions for future research. Level III, retrospective cohort study.

Energy balance in cancer survivors at risk of weight gain: a review.

The study of energy balance [i.e., energy intake (EI) and energy expenditure (EE)] is a powerful tool for understanding body weight regulation and may contribute to our understanding of rapid weight gain risk in certain cancer survivors post-diagnosis. The purpose of this review was to summarize studies that assessed longitudinal, prospective changes in components of energy balance from diagnosis/start of treatment to any duration of follow-up in cancer survivors with prior evidence of weight gain (breast, prostate, thyroid, gynecologic, testicular, and acute lymphoblastic leukemia) RESULTS: The available literature suggests that energy balance components may be altered in cancer survivors who have a heightened risk of weight gain post-diagnosis. The evidence for EI was overall inconsistent. Conversely, decreases in resting and physical activity EE during the active phases of treatment (e.g., chemotherapy, hypothyroid state) were commonly noted, which then slowly rebounded towards baseline levels at the end of treatment and during follow-up assessments. Much of this evidence is based on data collected from breast cancer survivors, which highlights a paucity of data currently available on other cancer types. While there is growing acknowledgement that weight management interventions in cancer survivors are needed, it is important to recognize that changes in both behavioral (EI, physical activity EE) and passive (resting EE, thermic effect of food) components of energy balance may occur post-diagnosis. This information can help to inform weight management interventions which often entail modifications in diet and/or physical activity.

Teaching Second-Year Medical Students How to Counsel Pediatric Patients With Unhealthy Body Mass Index.

Obesity affects the health and well-being of children globally. Despite recommendations to routinely screen children for obesity starting at age 6 years, physicians do not consistently address weight or provide effective weight-management counseling. We developed an interactive session for second-year medical students with foundational knowledge and practical communication skills around partnership and discussion of pediatric healthy weight management. Students were administered a pre-/post-Likert survey to self-assess knowledge, comfort, and confidence in counseling patients and caregivers about weight management. Students' related counseling skills were assessed during a standardized patient encounter of a teen with rapid weight gain. The session successfully increased students' self-assessed knowledge, comfort, and confidence, and resulted in successful application of weight management skills in a simulated patient encounter. Utilization of empathy skills requires continued coaching. We propose incorporation of similar sessions into medical school curricula to address the pediatric obesity epidemic.

The Role of Nutrition in Primary and Secondary Prevention of Cardiovascular Damage in Childhood Cancer Survivors.

Innovative therapeutic strategies in childhood cancer led to a significant reduction in cancer-related mortality. Cancer survivors are a growing fragile population, at risk of long-term side effects of cancer treatments, thus requiring customized clinical attention. Antineoplastic drugs have a wide toxicity profile that can limit their clinical usage and spoil patients’ life, even years after the end of treatment. The cardiovascular system is a well-known target of antineoplastic treatments, including anthracyclines, chest radiotherapy and new molecules, such as tyrosine kinase inhibitors. We investigated nutritional changes in children with cancer from the diagnosis to the end of treatment and dietary habits in cancer survivors. At diagnosis, children with cancer may present variable degrees of malnutrition, potentially affecting drug tolerability and prognosis. During cancer treatment, the usage of corticosteroids can lead to rapid weight gain, exposing children to overweight and obesity. Moreover, dietary habits and lifestyle often dramatically change in cancer survivors, who acquire sedentary behavior and weak adherence to dietary guidelines. Furthermore, we speculated on the role of nutrition in the primary prevention of cardiac damage, investigating the potential cardioprotective role of diet-derived compounds with antioxidative properties. Finally, we summarized practical advice to improve the dietary habits of cancer survivors and their families.

Perinatal exposure to environmental endocrine disruptor bisphenol A aggravates the onset of non-alcoholic fatty liver disease (NAFLD) in weanling F1 offspring of obese rats.

Bisphenol A (BPA) is a major environmental pollutant and food contaminant with endocrine-disrupting effects on human and animal health. Perinatal and developmental exposure to BPA has been known to cause hepatotoxicity in adulthood. However, its intergenerational effects in a metabolically challenged population have been scarcely investigated. Our study was designed to assess the intergenerational effect of an environmentally relevant dose of BPA and diet-induced parental obesity on the hepatic health outcome of F1 offspring. Wistar rats were given a high-fat diet to induce obesity, followed by chronic low dosages of BPA (10 ppm × 180 days) in drinking water. Post-treatment, rats were crossed within groups to obtain the F1 generation. Weanling pups were observed for weight gain, levels of hepatic antioxidants, liver function enzymes, cholesterol, C-reactive protein, and triglyceride in the serum. Histological changes in the liver tissue were also investigated. mRNA expression of energy homeostasis genes (FTO and MCR-4) in the liver was analyzed alongside blood biomarkers. We observed higher birth weight and rapid weight gain in the test group in comparison with controls, which was consistent with the changes in mRNA and protein expression ofFTO and MCR-4. BPA caused a significant, treatment-related change in the inflammatory marker C-reactive protein, lipid peroxidation, antioxidants, and lipid profile. These findings were accompanied by histological changes in the liver tissue characteristic of hepatic steatosis indicating the onset of the non-alcoholic fatty liver disease (NAFLD). Our study offers a link between exposure to BPA in parents and onset of NAFLD in their offspring.

MC4R Deficiency Causes Dysregulation of Postsynaptic Excitatory Synaptic Transmission as a Crucial Culprit for Obesity.

Melanocortin 4 receptor (MC4R) in the paraventricular nucleus of the hypothalamus (PVH) shows bidirectional characterization in modulating food intake and energy homeostasis. We demonstrate that MC4R knockdown (KD) in the PVH can attenuate AMPA receptor (AMPAR)-mediated postsynaptic responses by altering the phosphorylation of AMPAR GluA1 subunit through the protein kinase A (PKA)-dependent signaling cascade and simultaneously lead to rapid body weight gain. Furthermore, PKA KD in the PVH engendered similar electrophysiological and behavioral phenotypes as in MC4R KD mice. Importantly, we observed that the reduction of AMPAR GluA1 expression not only led to attenuated synaptic responses but also caused body weight gain, suggesting that the aberration of synaptic responses may be one of the crucial pathogeny of obesity. Our study provides the synaptic and molecular explanations of how body weight is regulated by MC4R in the PVH.

Early-life weight gain is associated with non-atopic asthma in childhood

BackgroundPrevious studies suggest the association between early-life weight gain and asthma. It remains unclear whether early-life weight gain is associated with atopic or non-atopic asthma. This study aimed to investigate whether early-life weight gain is associated with atopic or non-atopic asthma. MethodsIncluded in this study were 1343 singleton-birth children (761 boys, 57%) born between January 2010 and December 2011 participating in the Longitudinal Investigation of Global Health in Taiwanese Schoolchildren (LIGHTS) cohort were evaluated by a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and interviewed by pediatricians between July 1, 2016 and May 31, 2018 at the mean age of 6.4 years. Weight gain z-scores during the first 6, 12, and 18 months of life were classified into 4 groups: slow (below −0.67), on track (−0.67 to 0.67), rapid (0.67 to 1.28), and extremely rapid (above 1.28). The main outcomes were atopic and non-atopic asthma. Asthma was defined as having physician-diagnosed asthma and the presence of wheeze or asthma exacerbations in the last 12 months. Atopy was determined by Phadiatop Infant. ResultsThe extremely rapid weight gain group of children during the first 6, 12, and 18 months of life was significantly associated with an increased risk of non-atopic asthma (adjusted odd ratio [AOR], 2.14, 95% confidence interval [CI], 1.01–4.53 for the first 6 months; AOR, 2.86, 95% CI, 1.34–6.14 for the first 12 months; AOR, 3.26, 95% CI 1.49–7.15 for the first 18 months) compared with the on track group. No significant association was found in atopic asthma. A sex-stratified analysis revealed the association of early-life weight gain with non-atopic asthma was statistically significant only in boys (AOR, 4.24, 95% CI, 1.44–12.50). ConclusionExtremely rapid weight gain during the first 6–18 months of life was significantly associated with 2.1- to 3.3-fold increased risk of non-atopic asthma, with a more pronounced risk found in boys.

The promise of new anti-obesity therapies arising from knowledge of genetic obesity traits.

Obesity is a multifactorial and complex disease that often manifests in early childhood with a lifelong burden. Polygenic and monogenic obesity are driven by the interaction between genetic predisposition and environmental factors. Polygenic variants are frequent and confer small effect sizes. Rare monogenic obesity syndromes are caused by defined pathogenic variants in single genes with large effect sizes. Most of these genes are involved in the central nervous regulation of body weight; for example, genes of the leptin–melanocortin pathway. Clinically, patients with monogenic obesity present with impaired satiety, hyperphagia and pronounced food-seeking behaviour in early childhood, which leads to severe early-onset obesity. With the advent of novel pharmacological treatment options emerging for monogenic obesity syndromes that target the central melanocortin pathway, genetic testing is recommended for patients with rapid weight gain in infancy and additional clinical suggestive features. Likewise, patients with obesity associated with hypothalamic damage or other forms of syndromic obesity involving energy regulatory circuits could benefit from these novel pharmacological treatment options. Early identification of patients affected by syndromic obesity will lead to appropriate treatment, thereby preventing the development of obesity sequelae, avoiding failure of conservative treatment approaches and alleviating stigmatization of patients and their families.

Predicting of excess body fat in children.

Approximately 370 million children and adolescents worldwide showed overweight or obesity in 2016. The risk of developing severe comorbidities depends on the age of onset and the duration of obesity. This review discusses available methodologies to detect excess body fat in children as well as the early life factors that predict excess body fat and its development. Factors, such as parental nutritional status, maternal weight gain during pregnancy, maternal malnutrition, maternal smoking during pregnancy, low and high birth weight, rapid weight gain, and short infant sleep duration have been independently and positively associated with neonatal, infant, and children adiposity. Early detection of excess body fat in children through the use of various tools is the first step in preventing nutrition-related diseases in adulthood. The early detection of excess body fat and the implementation of efficient interventions to normalize the weight of children and adolescents at obesity risk are essential to prevent diseases in adult life.

Rapid weight loss among elite-level judo athletes: methods and nutrition in relation to competition performance.

ABSTRACTBackgroundRapid weight loss (RWL) followed by rapid weight gain (RWG) is a regular pre-competition routine in combat sports and weightlifting. With the prevalence of these sports exceeding 20% at the 2020 Tokyo Olympics, there are limited data on RWL and RWG practices and their impact on well-being and competitive success in elite-level athletes.MethodsA total of 138 elite-level female and male judokas, 7.7% of the athletes ranked as top 150 on the International Judo Federation Senior World Ranking List (WRL), completed a survey on RWL, RWG, and the consequences of these practices.ResultsOur findings showed that 96% of the respondents practice RWL. The average reduced body mass percentage was 5.8 ± 2.3%. Respondents who used either of the dehydration methods – fluid restriction, sauna suit, and/or sauna/hot bath – to reduce weight were 88%, 85%, and 76%, respectively. Furthermore, 91% of the respondents reported reduced energy as a negative consequence of RWL and 21% experienced a collapse episode during the RWL period. Respondents ranked 1–20 on the WRL experienced fewer negative consequences of RWL and RWG (p = 0.002) and had more dietitian and/or medical doctor support (p = 0.040) than lower-ranked respondents. Those who started with RWL practices before the age of 16 (38%) were ranked lower on the WRL (p = 0.004) and reported more negative consequences of RWL and RWG (p = 0.014).ConclusionsThis study is the first to provide insight into the RWL practices of worldwide elite-level judokas and provides valuable information for the combat sports society, especially coaches. Proper weight management and optimal timed initiation of RWL practices in a judoka’s career may contribute to success at the elite level.