Risk Factors For Childhood Obesity Research Articles

Exploring Associations Between Household Chaos With Sedentary Behavior And Screen Time In Rural Children

Household chaos is perceived home disorganization caused by noise, crowding, and traffic patterns. It has been shown to be linked to weight-related behaviors such as sleep and nutritional behaviors (i.e., family meals). However, the relationship between sedentary behavior and household chaos has not been explored. Examining this association could allow us to better understand how family milieu contributes to behavioral risk factors for childhood obesity. PURPOSE: To examine associations between household chaos with sedentary behavior and screen time in rural children. METHODS: Participants (n=105 parent/child dyads) were enrolled in the NU-HOME study, a family-based, obesity prevention RCT in rural Minnesota. Parents reported baseline data on sociodemographics, household chaos, and child screen time. Household chaos was measured with a 15-item scale about home disorganization (α=0.83; higher scores indicate more chaos). Children’s sedentary behavior was assessed via accelerometry. Regression analyses using SAS 9.4 were performed to assess associations between household chaos and sedentary behavior and screen time, controlling for child-parent ratio, economic assistance, child BMI z-score and age. Normality of screen time was not met, so a transformed variable was used in analyses. RESULTS: Child mean age was 8.95±1.05 years; 59% were female; mean BMI z-score=0.92±0.94. Mean daily sedentary time and screen time were 8.33±77.5 and 2.06±1.42 hours, respectively. Household chaos scores had a mean of 5.04±3.6, which is comparable to other studies. Household chaos scores were not significantly associated with child sedentary behavior but were positively associated with child screen time (p=0.002). CONCLUSIONS: In other studies, household chaos has been associated with negative health behaviors, which aligns with our current findings. The association between screen time and household chaos may be explained by parents using electronics to entertain children in chaotic environments. Parents in chaotic homes may also have more difficulty managing a child’s screen time than those in less chaotic homes. The relationship between household chaos and sedentary behavior should be further explored to increase our understanding of how the home environment may affect health-related behaviors.

HOW TO OPTIMIZE INFANT FEEDING PRACTICES

Introduction. Obesity is one of the most important non-communicable epidemics of the 21st century. Rapid weight gain during first year of life is considered as a risk factor for childhood and adolescence obesity. Pediatricians play a central role in shaping healthy diets and combating the childhood obesity epidemic. It is necessary to optimize the teaching of child nutrition in the undergraduate and postgraduate studies, first and foremost, this concerns breastfeeding.Purpose of the study: optimization of infant feeding practices by updating the content of continuing medical education for physicians to improve their parental counseling skills.Materials and methods of research. A voluntary, anonymous survey of 40 primary care physicians on their infant feeding recommendations was conducted by random sampling. With the help of Google Forms, doctors were asked to answer 20 online survey questions. The prevalence of self-reported physician recommendations has been compared with current Guidelines for Infants and Young Toddler (2017) and parental self-reported responses, which reflects existing infant feeding practices.Results of the study and their discussion. It has been found that physicians spend an average of 15-20 minutes on counseling about breastfeeding, complementary foods or assessment and correction of feeding in the second part of the first year of life. Only 27.5% of doctors did not have difficulties in counseling parents. According to doctors, enhancement of counseling algorithms (42.5%) and printed material for parents (55%) could help to improve parental counseling practices. The main recommendations of doctors on breastfeeding, the timing of complementary feeding and the general list of supplementary foods are modern and have a significant impact on the practice of breastfeeding. In doing so, evidence-based recommendations provided by Feeding Guidelines for Infants and Young Toddler (2017) regarding iron-rich foods, potential high-allergenic foods, non-recommended foods, and responsive feeding have proven to be new to some physicians.Conclusion. In order to optimize the practice of breastfeeding, it is necessary to improve the training of pediatricians and family doctors during undergraduate studies and continuing postgraduate education. In the undergraduate program, greater emphasis should be placed on developing such competencies as effective communication of physicians with parents, and the elements of breastfeeding counseling and responsive breastfeeding may be included in the list of objective structured clinical exam skills. Continuing postgraduate physician education provides for continuous updating of knowledge as updated evidence-based recommendations emerge. The Feeding Guidelines for Infants and Young Toddler (2017) can now be offered as a prototype for national infant and toddler feeding guidelines, and the information contained therein is being disseminated.

Association between rs1421085 and rs9939609 Polymorphisms of Fat Mass and Obesity-Associated Gene with High-Density Lipoprotein Cholesterol and Triglyceride in Obese Turkish Children and Adolescents.

Several studies have shown that rs9939609 and rs1421085 in fat mass and obesity-associated ( FTO ) gene rs17782313 and rs12970134 in melanocortin-4 receptor ( MC4R ) gene influence obesity. In the present study, we aimed to determine association between rs9939609, rs1421085, rs17782313, and rs12970134 polymorphism, and their relation with body mass index (BMI), glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and lipid values in obese children. We included 100 newly diagnosed obese children and 100 healthy children. The rs1421085 (CC/CT) ( p = 0.019) and rs9939609 (AA/AT) ( p = 0.002) polymorphism regions were higher in the obese group. Additionally, we found that both the rs1421085 (CC/CT) and rs9939609 (AA/AT) polymorphism associated with high-density lipoprotein cholesterol ( p = 0.011 and p = 0.003) and triglycerides ( p = 0.01 and p = 0.004) level, respectively. Further, the rs9939609 and rs1421085 variants of FTO gene associated with HDL-cholesterol and triglycerides levels in obese children; however, updated studies with a large sample size are required to establish strong links with genetic variants and risk factors in childhood obesity.

A Prospective Study of the Relationship of Infant Adiposity with Maternal Prenatal and Postnatal Diet Quality

Abstract Objectives This study examines relationships of maternal prenatal and postnatal diet quality with infant birth size and growth, which are known risk factors for child obesity. Methods Women completed six 24-hour diet recalls (1 per pregnancy trimester and at 6 weeks, 6 months, and 12 months postpartum); infant anthropometrics were obtained at birth (n = 331 mother-child dyads), 6 weeks, 6 months and 12 months of age. Prenatal and postnatal Healthy Eating Index 2015 total (HEI), adequacy (HEI-adq) and moderation (HEI-mod) scores were calculated by combining recalls across pregnancy and across postpartum. Linear mixed models estimated associations of infant weight-for-length z-scores (WFLz) with prenatal and postnatal diet quality. Logistic regressions estimated odds of small-for-gestational age (SGA, <10th percentile) and large-for-gestational age (LGA, >90th percentile) associated with maternal prenatal diet quality. Covariates included maternal height, demographics, delivery mode, child sex, and gestational age at delivery. Sensitivity analyses examined whether associations were robust to inclusion of maternal total energy intake or early pregnancy BMI. Results WFLz was inversely associated with prenatal HEI (β±SE = −0.02 ± 0.005, P = 0.004) and HEI-mod (β ± SE = −0.04 ± 0.01, P < 0.001), and with postnatal HEI (β ± SE = −0.01 ± 0.005, P = 0.01) and HEI-adq (β ± SE = −0.02 ± 0.007, P = 0.005). SGA and LGA occurred for 92 (7%) and 172 (12%) babies, respectively. LGA was inversely associated with prenatal HEI (OR = 0.94, 95% CI: 0.90–0.98), HEI-mod (OR = 0.83, 95% CI: 0.74–0.83) and HEI-adq (OR = 0.95, 95% CI: 0.90–1.01). SGA was not associated with prenatal diet quality. Associations were not changed when adjusted for energy intake but were modestly attenuated when adjusted for BMI. Conclusions Higher maternal prenatal and postnatal diet quality were associated with more favorable indicators of infant adiposity from birth through 12 months of age. Interventions are needed to determine whether targeting both prenatal and postnatal diet may lead to improved infant adiposity development. Funding Sources This research was supported by the NICHD Intramural Research Program.

Access to bike lanes and childhood obesity: A systematic review and meta-analysis.

SummaryThe lack of bike lane access has been a proven risk factor for childhood obesity due to its role in discouraging healthy lifestyles. However, there has not been a systematic review of this important association in the existing literature. This study aims to fill this gap. A literature search was conducted in the Cochrane Library, PubMed, Embase, and Web of Science for studies published from 1 January 2019 onwards that examined the association between bike lane access and weight‐related behaviours and outcomes among children aged <18 years. A total of 21 studies were included in this systematic review. Among them, most of the studies showed that bike lane access was significantly associated with children and adolescents' physical activity (PA), whereas only two studies showed a negative association. Meta‐analysis also supported these findings and showed that bike lane access was significantly associated with children and adolescents' PA (odds ratio [OR] = 1.57, 95% confidence interval [CI]: 1.37–1.81). Additionally, we reviewed how bike lane characteristics and microenvironment variables such as children and adolescents' choice of bicycle travel mode, the degree of separation of cycle path, cycle path unevenness, and street maintenance were associated with adolescents' preferences and intention to cycle. This systematic review and meta‐analysis strongly suggests that bike lane access is associated with children and adolescents' PA. Nonetheless, it was difficult to draw a conclusion on the association between bike lane access and weight‐related outcomes.

Obesity in Primary Schools Children in Baquba City

Background: Obesity is an abnormal or increased fat accumulation in the body. Body mass index (BMI) defined as a person weight in kilograms divided by the square of his height in meters (kg/m2). It is a very simple index that more commonly used to identify overweight and obesity in adults. For childhood, the amount of body fat differs from that an adult because it differs according to the age and to the sex, so the BMI age- and sex- specific percentiles are used. Obesity in children is a real health problem worldwide especially in developed countries, as well as, it increases in developing countries. Childhood obesity predispose to type 2 diabetics, hypertension, liver and renal disease, cardiovascular diseases and adult obesity. Objective: To detect the prevalence and possible risk factors for childhood obesity in primary schools in Baqubah city from age 6 to 12 years. Patients and Methods: The study was cross-sectional study conducted on a random sample of 6 primary schools from different localities in Baqubah city, followed by a systematic random sample of 308 children aged from 6 to12 years of both sexes. A questionnaire sent to the parents to get information on socio-demographic characteristics, dietary habits, physical activity, family history of obesity and parents education and job. Children's height (cm), weight (Kg), and BMI-for-age were measured. Child's weight status was categorized based on WHO 2007 Growth Reference. This study was included 308 child, the mean age was 9.32±1.9year, 51.9% of the children were males, and 49.1% were female the mean BMI was 18.36±4. Only 2.5% of the studied sample were underweight, while 73.4%, 14.3% and 9.4% were of normal, overweight or obese respectively. Results: About 48% of children in this study eat sweets, 48.5% do regular sports, 48.7% watch TV or mobile for more than 2 hours daily. It was found that 34.7% of children got positive family history of obesity, regarding educational level of parents 39% of mothers and 42.9% of fathers got primary level of education and 33.1% of mothers, 31.2% of fathers got higher than secondary level. Conclusion: The prevalence of overweight and obesity was 23.7% in primary schoolchildren in Baqubah city. The study supports the multi factorial etiology of obesity It showed that sedentary life style, positive family history and eating un healthy foods are risk factors.

Quantity versus quality of objectively measured sleep in relation to body mass index in children: cross-sectional and longitudinal analyses.

Although sleep duration is well established as a risk factor for child obesity, how measures of sleep quality relate to body size is less certain. The aim of this study was to determine how objectively measured sleep duration, sleep timing, and sleep quality were related to body mass index (BMI) cross-sectionally and longitudinally in school-aged children. All measures were obtained at baseline, 12 and 24 months in 823 children (51% female, 53% European, 18% Māori, 12% Pacific, 9% Asian) aged 6-10 years at baseline. Sleep duration, timing, and quality were measured using actigraphy over 7 days, height and weight were measured using standard techniques, and parents completed questionnaires on demographics (baseline only), dietary intake, and television usage. Data were analysed using imputation; mixed models, with random effects for person and age, estimated both a cross-sectional effect and a longitudinal effect on BMI z-score, adjusted for multiple confounders. The estimate of the effect on BMI z-score for each additional hour of sleep was -0.22 (95% CI: -0.33, -0.11) in cross-sectional analyses and -0.05 (-0.10, -0.004) in longitudinal analyses. A greater effect was observed for weekday sleep duration than weekend sleep duration but variability in duration was not related to BMI z-score. While sleep timing (onset or midpoint of sleep) was not related to BMI, children who were awake in the night more frequently (0.19; 0.06, 0.32) or for longer periods (0.18; 0.06, 0.36) had significantly higher BMI z-scores cross-sectionally, but only the estimates for total time awake (minutes) were significant longitudinally (increase in BMI z-score of 0.04 for each additional hour awake). The beneficial effect of a longer sleep duration on BMI was consistent in children, whereas evidence for markers of sleep quality and timing were more variable.

Fetal growth does not modify the relationship of infant weight gain with childhood adiposity and blood pressure in the Southampton women’s survey

Background: Rapid infant weight gain is a risk factor for childhood obesity. This relationship may depend on whether infant weight gain is preceded by in-utero growth restriction.Aim: Examine whether fetal growth modifies the relationship between infant weight gain and childhood adiposity and blood pressure.Subjects and methods: 786 children in the Southampton Women’s Survey. We related infant weight gain (weight at 2 years-birth weight) to body mass index (BMI), %body fat, trunk fat (kg), systolic (SBP) and diastolic blood pressure (DBP) at age 6–7 years. Mean estimated fetal weight (EFW) between 19–34 weeks and change in EFW (19–34 weeks) were added to models as effect modifiers.Results: Infant weight gain was positively associated with all childhood outcomes. We found no evidence that these effects were modified by fetal growth (p > .1 for all interaction terms). For example, a 1 standard deviation (SD) increase in infant weight gain was associated with an increase in BMI z-score of 0.51 (95% CI 0.37;0.64) when EFW-change was set at -2 SD-scores compared with an increase of 0.41 (95% CI 0.27;0.54, p(interaction)=.48) when set at 2 SD-scores.Conclusion: The documented adverse consequences of rapid infant weight gain may occur regardless of whether growth was constrained in-utero.

Access to public transport and childhood obesity: A systematic review.

SummaryThe lack of access to public transport is generally considered to be a risk factor for childhood obesity by discouraging active transport and thus physical activity. To explore the association between access to public transport and childhood obesity, we have conducted a systematic literature search in the Cochrane Library, PubMed, and Web of Science for studies published before January 1, 2019. A total of 25 cross‐sectional and two longitudinal studies conducted in 10 countries were identified. Inconsistent findings were identified arising from a great variety of sample characteristics, definitions of exposure (ie, access to public transport), and outcome variables (eg, obesity), and analysis methods. While over half of the studies showed null associations between access to public transport and childhood obesity, we have observed more positive than negative associations among the rest of the studies. These observations suggest that an increased level of access to public transport may have a health‐promoting effect and hence prevent the development of childhood obesity. However, this conclusion needs to be further corroborated in future research on the basis of large‐sample health surveys, in situ observations, and comparative analyses among different study areas.

Best compromise nutritional menus for childhood obesity

Childhood obesity is an undeniable reality that has rapidly increased in many countries. Obesity at an early age not only increases the risks of chronic diseases but also produces a problem for the whole healthcare system. One way to alleviate this problem is to provide each patient with an appropriate menu that is defined by a mathematical model. Existing mathematical models only partially address the objective and constraints of childhood obesity; therefore, the solutions provided are insufficient for health specialists to prepare nutritional menus for individual patients. This manuscript proposes a multiobjective mathematical programming model to aid in healthy nutritional menu planning that may prevent childhood obesity. This model provides a plan for combinations and amounts of food across different schedules and daily meals. This approach minimizes the major risk factors of childhood obesity (i.e., glycemic load and cholesterol intake). In addition, this approach considers the minimization of nutritional mismatch and total cost. The model is solved using a deterministic method and two metaheuristic methods. Test instances associated with children aged 4–18 years were created with the support of health professionals to complete this numerical study. The quality of the solutions generated using the three methods was similar, but the metaheuristic methods provided solutions in a shorter computational time. These results are submitted to statistical hypothesis tests to be validated. The numerical results indicate proper guidelines for personalized plans for individual children.

Measuring attentional bias to food cues in young children using a visual search task: An eye-tracking study

ObjectiveAttentional bias to food cues may be a risk factor for childhood obesity, yet there are few paradigms to measure such biases in young children. Therefore, the present work introduces an eye-tracking visual search task to measure attentional bias in young children. Methods: Fifty-one 3-6-year-olds played a game to find a target cartoon character among food (experimental condition) or toy (control condition) distractors. Children completed the experimental and toy conditions on two separate visits in randomized order. Behavioral (response latencies) and eye-tracking measures (time to first fixation, initial gaze duration duration, cumulative gaze duration ) of attention to food and toy cues were computed. Regressions were used to test for attentional bias to food versus toy cues, and whether attentional bias to food cues was related to current BMI z-score. Results: Children spent more cumulative time looking at food versus toy distractors and took longer to locate the target when searching through food versus toy distractors. The faster children fixated on their first food versus toy distractor was associated with higher BMI z-scores. Conclusions: Using a game-based paradigm employing eye-tracking, we found a behavioral attentional bias to food vs. toy distractors in young children. Further, attentional bias to food cues was associated with current BMI z-score.

Metabolic disturbances and cardiovascular risk factors in obese children with vitamin D deficiency

ObjectivesThe prevalence of obesity among children and adolescents has been rapidly increasing in recent years. Obese individuals are at risk of vitamin D deficiency. The aim of this study was to investigate the relationship between vitamin D deficiency and anthropometric measurements, cardiovascular risk factors, and glucose homeostasis in obese children. MethodsBetween June 2011 and January 2012, 40 obese and 30 non-obese children (between 7 and 14 years of age) were evaluated at Tepecik Training and Research Hospital. The following characteristics were recorded: height; weight; body mass index (BMI); total body fat content; fasting glucose, insulin, and lipid levels; basic biochemical parameters; complete blood count; bilateral carotid intima media thickness; liver ultrasound results; and left ventricular wall thickness were recorded. 25-hydroxy (OH) vitamin D levels were measured from serum. ResultsThe serum 25(OH) vitamin D level was low in 45 children (64.3%). The 24-h ambulatory blood pressure measurements, carotid intima-media thickness, and the prevalence of 25(OH) vitamin D deficiency were different between obese and non-obese children (P<0.05). The incidence of dyslipidemia was not statistically different between obese and non-obese children (P>0.05). Plasma 25(OH) vitamin D concentrations were negatively correlated with age, BMI, total body fat content, 24-h ambulatory blood pressure, and carotid intima-media thickness (P<0.05). Plasma 25(OH) vitamin D levels were not correlated with fasting plasma glucose, HOMA-IR, triglycerides, total cholesterol, low-density cholesterol, and high-density cholesterol (P>0.05). ConclusionVitamin D deficiency is more prevalent in obese children. Serum 25(OH)vitamin D was significantly associated with several cardiometabolic risk factors. There was no relationship between abnormal glucose homeostasis and dyslipidemia with vitamin D deficiency in obese children.

Access to fruit and vegetable markets and childhood obesity: A systematic review.

SummaryThe lack of access to fruit/vegetable markets (FVMs) is thought to be a risk factor for childhood obesity by discouraging healthy dietary behaviours while encouraging access to venues that offer more unhealthy food (and thus the compensatory intake of those options). However, findings remain mixed, and there has not been a review of the association between FVM access and childhood obesity. A comprehensive and systematic understanding of this epidemiologic relationship is important to the design and implementation of relevant public health policies. In this study, a literature search was conducted in the Cochrane Library, PubMed, and Web of Science for articles published before 1 January 2019 that focused on the association between neighbourhood FVM access and weight‐related behaviours and outcomes among children and adolescents. Eight cross‐sectional studies, two longitudinal studies, and one ecological study conducted in five countries were identified. The median sample size was 2142 ± 1371. Weight‐related behaviours and outcomes were used as the outcome variable in two and eight studies, respectively, with one study using both weight‐related behaviours and outcomes as outcome variables. We still found a negative association between access to FVMs in children's residential and school neighbourhoods and weight‐related behaviours and an inconclusive association between FVM access and overweight or obesity. This conclusion should be regarded as provisional because of a limited amount of relevant evidence and may not be a strong guide for policymaking. Nonetheless, it points to an important research gap that needs to be filled if successful public health interventions are to be undertaken.

Variability in sociodemographic factors and obesity in Korean children: a cross-sectional analysis of Korea National Health and Nutrition Examination survey data (2007–2015)

PurposeSociodemographic factors are well-known risk factors for childhood obesity, even though the relationship between sociodemographic factors and obesity varies among countries. The objective of this study was to evaluate the relationship between sociodemographic factors and obesity in Korean children. MethodsThis study is an analysis of cross-sectional data from the 2007–2009, 2010–2012, and 2013–2015 Korea National Health and Nutrition Examination Surveys. The sample included 14,482 children aged between 2 and 18 years (7652 boys and 6830 girls) and their parents. Sociodemographic factors were measured as a combination of demographic, economic, and sociological factors, including sex, age, residential area, family income, parent education level, and parent employment status. ResultsIn 2013–2015, obesity among Korean children was associated with current maternal smoking (P < .001). Obesity categorized according to age group was positively associated with paternal education level/high school graduation (P = .026 for ages 7–12 years), maternal smoking (P = .003 for ages 7–12 years), maternal body mass index (all age groups), paternal body mass index (all age groups), and low monthly family income (P = .017 for ages 2–6 years). ConclusionsCurrent maternal smoking habits, paternal education, and low family income are potential risk factors for obesity in Korean children.

The Effect of Upgrades to Childcare Outdoor Spaces on Preschoolers' Physical Activity: Findings from a Natural Experiment.

Physical inactivity is a significant risk factor for childhood obesity. Preventing obesity in the early years reduces the risk of developing chronic health conditions later. Early childhood education and care (ECEC) services are important settings to establish good preschooler physical activity behaviors. This natural experiment investigated the influence of ECEC outdoor physical environment upgrade on preschoolers’ physical activity (aged 2–5 years). Centers implemented upgrades without researcher input. Physical activity was measured by 7-day accelerometry for intervention (n = 159; 6 centers) and control (n = 138; 5 centers) groups. ECEC outdoor space was assessed using a modified Environment and Policy Assessment and Observation (EPAO) Instrument. Key outcomes were measured at baseline and 6–12 months follow-up. Fixed sandboxes, balls, portable slides, portable floor play equipment (e.g., tumbling mats), and natural grassed areas were positively associated with activity levels; fixed tunnels and twirling equipment were negatively associated with activity levels (all p < 0.05). Post-upgrade portable play equipment (balls, twirling equipment, slides, floor play equipment) increased intervention preschoolers’ moderate-vigorous physical activity (MVPA) levels compared to control (p < 0.05). Intervention preschoolers were more active than control at follow-up (58.09 vs. 42.13 min/day increase in total physical activity; 30.46 vs. 19.16 min/day increase in MVPA (all p < 0.001)). Since few preschoolers meet daily activity recommendations while at ECEC, the findings may help ECEC providers to optimize outdoor physical environments and encourage more active play among preschoolers.

Association of cord blood methylation with neonatal leptin: An epigenome wide association study.

BackgroundNeonatal adiposity is a risk factor for childhood obesity. Investigating contributors to neonatal adiposity is important for understanding early life obesity risk. Epigenetic changes of metabolic genes in cord blood may contribute to excessive neonatal adiposity and subsequent childhood obesity. This study aims to evaluate the association of cord blood DNA methylation patterns with anthropometric measures and cord blood leptin, a biomarker of neonatal adiposity.MethodsA cross-sectional study was performed on a multiethnic cohort of 114 full term neonates born to mothers without gestational diabetes at a university hospital. Cord blood was assayed for leptin and for epigenome-wide DNA methylation profiles via the Illumina 450K platform. Neonatal body composition was measured by air displacement plethysmography. Multivariable linear regression was used to analyze associations between individual CpG sites as well as differentially methylated regions in cord blood DNA with measures of newborn adiposity including anthropometrics (birth weight, fat mass and percent body fat) and cord blood leptin. False discovery rate was estimated to account for multiple comparisons.Results247 CpG sites as well as 18 differentially methylated gene regions were associated with cord blood leptin but no epigenetic changes were associated with birth weight, fat mass or percent body fat. Genes of interest identified in this study are DNAJA4, TFR2, SMAD3, PLAG1, FGF1, and HNF4A.ConclusionEpigenetic changes in cord blood DNA are associated with cord blood leptin levels, a measure of neonatal adiposity.

Cord Leptin, C-Peptide and Insulin Levels in Large for Gestational Age Newborns in Sri Lanka

Background Large for gestational age (LGA) infants are more prone to be obese and are at a higher risk of metabolic complications later in life. It is established that Asians have lower skeletal muscle mass and excess body fat for a given body mass index. Thus, objective of this study was to determine the relationship between leptin, insulin, C-peptide in cord blood on the birth weight of newborns and to determine whether these parameters are deviated from data already published from other populations. Methods Umbilical cord blood was collected from 90 newborns (male 50, gestational age 38–42 weeks) which comprise of 43 LGA and 47 appropriate for gestational age (AGA) newborns. Serum leptin, insulin and C-peptide levels were measured and anthropometric parameters of the newborn and maternal characteristics were recorded. Results Significantly higher (P < 0.001) concentrations of leptin, insulin and C-peptide levels (12.670 ± 2.345 ng/mL, 18.725 ± 0.644 µIU/mL, 9.318 ± 0.772 ng/mL) were observed in the LGA group compared to AGA group (7.108 ± 0.906 ng/mL, 13.081 ± 0.428 µIU/mL, 5.439 ± 0.192 ng/mL) and all three parameters showed positive and significant correlations with anthropometric parameters of the newborn and maternal characteristics. Conclusion Although increased leptin, insulin and C-peptide levels may be involved in insulin resistance, increased adiposity and macrosomia, they were not significantly deviated from published data from other populations. Other factors may contribute to higher fat mass found in Asian populations and finding this relationship during neonatal period is useful to predict risk factors for childhood obesity.

Childhood obesity: an overview of laboratory medicine, exercise and microbiome.

In the last few years, a significant increase of childhood obesity incidence unequally distributed within countries and population groups has been observed, thus representing an important public health problem associated with several health and social consequences. Obese children have more than a 50% probability of becoming obese adults, and to develop pathologies typical of obese adults, that include type 2-diabetes, dyslipidemia and hypertension. Also environmental factors, such as reduced physical activity and increased sedentary activities, may also result in increased caloric intake and/or decreased caloric expenditure. In the present review, we aimed to identify and describe a specific panel of parameters in order to evaluate and characterize the childhood obesity status useful in setting up a preventive diagnostic approach directed at improving health-related behaviors and identifying predisposing risk factors. An early identification of risk factors for childhood obesity could definitely help in setting up adequate and specific clinical treatments.

Factors influencing sweet drink consumption among preschool-age children: A qualitative analysis.

Consumption of high sugar foods and drinks are key risk factors for childhood obesity and dental decay. Sweet drinks are the single greatest contributor to the free sugars consumed by Australian children. Little is known about the factors influencing consumption of sweet drinks, particularly among preschool-age children. Focus groups and semi-structured interviews conducted with parents and grandparents (n=25) residing in different socio-economic areas across metropolitan and regional Victoria, Australia. Thematic analysis identified the factors influencing sweet drink consumption, which were then aligned with the socio-ecological model. At an individual level, health knowledge, health beliefs, and parenting skills and confidence influenced drink choices. At the social level, peer and family influence, and social and cultural norms emerged as influential. At the environmental level, sweet drink availability, targeted marketing, drink prices and settings-based policies influenced drink choices. Strategies identified by participants to support healthier drink choices included health education at the individual level; positive role modelling at the social level; and restricting unhealthy marketing, improved access to water, decreased availability of sweet drinks and price modification at the environmental level. Sweet drink consumption among preschool-age children is influenced by multiple factors across all domains of the socio-ecological model. Parents and grandparents are calling for education, healthy environments and supportive policies. SO WHAT?: In contrast to common rhetoric, children's sweet drink consumption is often influenced by factors beyond parental control. A multi-component strategy is required to support parents and grandparents in their efforts to make healthy choices for their children.

The Obesity Susceptibility Gene &lt;i&gt;TMEM18&lt;/i&gt; Promotes Healthy Adipogenesis from Adipose-Derived Stem Cells Through Direct Activation of &lt;i&gt;PPARG&lt;/i&gt;

TMEM18 is the strongest risk factor for childhood obesity identified from GWAS. We here investigated the functional relevance of TMEM18 for adipose tissue development and obesity. We demonstrate that adipocyte TMEM18 expression is down-regulated in obese children. Functionally, such a down-regulation of TMEM18 impairs adipocyte formation in zebrafish and in human preadipocytes indicating that TMEM18 is important for adipose-derived stem cell differentiation in vivo and in vitro. On the molecular level, TMEM18 activates PPARG through direct interaction with the PPARG promoter and this activation is repressed by inflammatory stimuli in human and mouse adipocyte models. The relationship between TMEM18 and PPARG is also evident in adipocytes of children and is clinically associated with obesity and related adipocyte hypertrophy, inflammation and insulin resistance. Our findings indicate a role of TMEM18 as a direct activator of PPARG signaling driving healthy adipogenesis which is dysregulated with adipose tissue dysfunction and obesity.