Risk Of Overweight In Children Research Articles

Physical Activity during Pregnancy and Childhood Obesity: Systematic Review and Meta-Analysis.

Background and Objectives: The repercussions of childhood overweight and obesity are multifaceted, extending beyond the realm of physiology and giving rise to psychological and emotional disturbances in affected children. The precise effects of gestational physical activity (PA) on parameters related to childhood overweight and obesity remain inadequately understood. The aim of this study (Registration CRD42022372490) was to evaluate the literature regarding the influence of PA during pregnancy on the risk of childhood overweight and obesity. Materials and Methods: Only randomized controlled trials (RCTs) were considered for inclusion. Determinant parameters of childhood obesity were analyzed. A total of 30 studies involving 16,137 pregnant women were examined. Five meta-analyses about the effects of PA during pregnancy on determinants of childhood overweight and obesity were conducted. Results: Although favorable trends were observed, Meta-Analyses showed no statistical differences in the effects of PA on weight at birth (Z = 0.03, p = 0.97), Ponderal Index at birth (Z = 0.64, p = 0.52), Macrosomia and Large for Gestational Age at birth (Z = 0.93, p = 0.35), children's BMI (Z = 0.78, p = 0.44), weight (Z = 0.50, p = 0.62), and skinfold thicknesses (Z = 0.45, p = 0.65). Conclusions: The engagement in physical activity during pregnancy exhibits a favorable trend in parameters associated with childhood overweight and obesity while presenting no adverse effects on such outcomes.

Abstract MP47: Fetal Life Exposure to GDM and Postnatal Breastfeeding and Beverage Intake in the First Year Are Associated With Severe Child Obesity at 6 to 11 Years: The SWIFT Study in Youth

Objective: To evaluate associations between fetal exposure to GDM and postnatal breastfeeding (BF) and sugary beverages in the first year with risk of child overweight and obesity severity at 6-11 y. Methods: The sample included 850 children exposed to maternal GDM with BF and infant diet assessed by monthly surveys from birth to 1 y and weight and length/height measurements up to ages 6-11 y from electronic health records. Maternal GDM severity was classified by diagnosis time (Early <24 wks or Standard ≥24 wks) and treatment type (Diet or Medication). Child BMI percentiles at 6-11 y were categorized as normal <85 th (referent), overweight 85 th to <95 th , moderate obesity 100 to <120% of 95 th and severe obesity ≥120% of 95 th . Multinomial logistic regression estimated adjusted odds ratios (aOR) and 95%CI of child BMI categories associated with fetal GDM exposure (diagnosis time & treatment) and postnatal diet; BF inadequate <6 months or adequate >6 months and sugary beverages (fruit juice or sugar added) adjusted for race/ethnicity, WIC recipient, pre-pregnancy BMI and gestational weight gain. Results: There were 480 (56.5%) children with normal weight, 150 (17.6%) with overweight, 155 (18.2%) with moderate obesity and 65 (7.6%) with severe obesity. Child average age (SD) at follow-up was 9.6 (1.4) y. Early GDM diagnosis was associated with aORs [95%CI] of severe obesity = 3.06 (1.33-7.04) with medication, and 2.61 (1.08-6.35) with diet and of moderate obesity = 1.93 (1.05-3.55) with diet vs. Standard diagnosis with diet. Inadequate BF with sugary beverage or fruit juice was associated with aOR [95%CI] of severe obesity = 3.06 (1.07-8.72) vs. adequate BF and no beverage. Conclusions: Earlier fetal exposure to maternal GDM and shorter BF combined with sugary beverages in the first postnatal year shows persistent higher risk of severe child obesity about 10 y later. These findings highlight pre-pregnancy screening to avert GDM and the importance of adequate BF and avoidance of sugary beverages and fruit juice among offspring exposed to GDM.

Maternal smoking during pregnancy increases the risk of gut microbiome-associated childhood overweight and obesity

ABSTRACT Childhood obesity is linked to maternal smoking during pregnancy. Gut microbiota may partially mediate this association and could be potential targets for intervention; however, its role is understudied. We included 1,592 infants from the Canadian Healthy Infants Longitudinal Development Cohort. Data on environmental exposure and lifestyle factors were collected prenatally and throughout the first three years. Weight outcomes were measured at one and three years of age. Stool samples collected at 3 and 12 months were analyzed by sequencing the V4 region of 16S rRNA to profile microbial compositions and magnetic resonance spectroscopy to quantify the metabolites. We showed that quitting smoking during pregnancy did not lower the risk of offspring being overweight. However, exclusive breastfeeding until the third month of age may alleviate these risks. We also reported that maternal smoking during pregnancy significantly increased Firmicutes abundance and diversity. We further revealed that Firmicutes diversity mediates the elevated risk of childhood overweight and obesity linked to maternal prenatal smoking. This effect possibly occurs through excessive microbial butyrate production. These findings add to the evidence that women should quit smoking before their pregnancies to prevent microbiome-mediated childhood overweight and obesity risk, and indicate the potential obesogenic role of excessive butyrate production in early life.

Adverse birth outcomes and childhood overweight at age of 3–8 years in a prospective cohort study in Tianjin, China

ObjectivesTo explore associations between adverse birth outcomes and childhood overweight at 3–8 years of age.DesignA prospective cohort study.SettingSix central urban districts of Tianjin, China.Participants1681 woman–child pairs.Methods1681 woman–child pairs were followed...

Pre-labor and post-labor cesarean delivery and early childhood adiposity in the Canadian Healthy Infant Longitudinal Development (CHILD) Cohort Study.

Delivery by cesarean section (CS) compared to vaginal delivery has been associated with increased risk of overweight in childhood. Our study examined if the presence or absence of labor events in CS delivery altered risk of overweight in early childhood (1-5 years) compared to vaginal delivery and if this association differed according to infant sex. The study included 3073 mother-infant pairs from the CHILD Cohort Study in Canada. Data from birth records were used to categorize infants as having been vaginally delivered, or delivered by CS, with or without labor events. Age and sex adjusted weight-for-length (WFL) and body mass index (BMI) z scores were calculated from height and weight data from clinic visits at 1, 3 and 5 years and used to classify children as overweight. Associations between delivery mode and child overweight at each timepoint were assessed using regression models, adjusting for relevant confounding factors including maternal pre-pregnancy BMI. Effect modification by infant sex was tested. One in four infants (24.6%) were born by CS delivery; 13.0% involved labor events and 11.6% did not. Infants born by CS without labor had an increased odds of being overweight at age 1 year compared to vaginally delivered infants after adjustment for maternal pre-pregnancy BMI, maternal diabetes, smoking, infant sex and birthweight-for-gestational age (aOR 1.68 [95% CI 1.05-2.67]). These effects did not persist to 3 or 5 years of age and, after stratification by sex, were only seen in boys (aOR at 1 year 2.21 [95% CI 1.26-3.88]). Our findings add to the body of evidence that CS, in particular CS without labor events, may be a risk factor for overweight in early life, and that this association may be sex-specific. These findings could help to identify children at higher risk for developing obesity.

O.3.3-6 Brazilian immigrant parents' preferences for content and intervention modalities for the design of a family-based intervention to promote their preschool-age children’s healthful energy balance-related behaviors

Abstract Purpose Childhood obesity is a complex public health problem disproportionally affecting racial/ethnic minority populations and children in immigrant families. Promoting healthful energy balance-related behaviors (EBRBs) in young children, a fundamental obesity preventative strategy, is critical for addressing health disparities in childhood obesity among ethnic minority and immigrant populations. Accumulating evidence indicates that unhealthful EBRBs, including poor eating behaviors (e.g., high consumption of unhealthy foods and sugar-sweetened beverages [SSBs]), inadequate physical activity (PA), excessive sedentary behavior/screen time, and short sleep duration, increase the risk of childhood overweight and obesity. Brazilians are a rapidly growing ethnic immigrant population in the United States (U.S.) and currently, there is a lack of childhood obesity prevention interventions addressing the needs of Brazilian preschool-age children. Methods Guided by the family ecological model, this formative cross-sectional study assessed the preferences (content, intervention modality, and language) of 52 individual Brazilian immigrant families (27 mothers, 25 fathers) for the development of a family-based intervention to promote healthful energy balance-related behaviors (EBRB). Results Overall, 85% or more of parents reported being interested or very interested in content related to five (increase fruits and vegetables, reduce unhealthy foods and sugar-sweetened beverages, increase physical activity, and reduce screen time) out of the seven assessed EBRBs. Group sessions delivered by community health workers (CHWs), email, and text messages were the preferred intervention modalities with most parents (71.2%) indicating a preference for content delivered in Portuguese. Interventions integrating multiple components such as workshops offered by CHWs, text messaging using SMS and WhatsApp, and printed materials should all be considered. Conclusions Future steps should include investigating different communication channels and their integration into a pilot test of a linguistic and cultural-sensitive family-based intervention to promote healthful EBRBs of preschool-age children in Brazilian families in the U.S.

Prediction of childhood overweight and obesity at age 10–11: findings from the Studying Lifecourse Obesity PrEdictors and the Born in Bradford cohorts

BackgroundIn England, 41% of children aged 10–11 years live with overweight or obesity. Identifying children at risk of developing overweight or obesity may help target early prevention interventions. We aimed to develop and externally validate prediction models of childhood overweight and obesity at age 10–11 years using routinely collected weight and height measurements at age 4–5 years and maternal and early-life health data.MethodsWe used an anonymised linked cohort of maternal pregnancy and birth health records in Hampshire, UK between 2003 and 2008 and child health records. Childhood body mass index (BMI), adjusted for age and sex, at 10–11 years was used to define the outcome of overweight and obesity (BMI ≥ 91st centile) in the models. Logistic regression models and multivariable fractional polynomials were used to select model predictors and to identify transformations of continuous predictors that best predict the outcome. Models were externally validated using data from the Born in Bradford birth cohort. Model performance was assessed using discrimination and calibration.ResultsChildhood BMI was available for 6566 children at 4–5 (14.6% overweight) and 10–11 years (26.1% overweight) with 10.8% overweight at both timepoints. The area under the curve (AUC) was 0.82 at development and 0.83 on external validation for the model only incorporating two predictors: BMI at 4–5 years and child sex. AUC increased to 0.84 on development and 0.85 on external validation on additionally incorporating maternal predictors in early pregnancy (BMI, smoking, age, educational attainment, ethnicity, parity, employment status). Models were well calibrated.ConclusionsThis prediction modelling can be applied at 4–5 years to identify the risk for childhood overweight at 10–11 years, with slightly improved prediction with the inclusion of maternal data. These prediction models demonstrate that routinely collected data can be used to target early preventive interventions to reduce the prevalence of childhood obesity.

Maternal vitamin D status and risk of childhood overweight at 5 years of age in two Nordic cohort studies.

Maternal vitamin D status during pregnancy has been suggested to have a role in childhood adiposity development, but results are conflicting. Our aims were to investigate [1] the relationships between maternal 25-hydroxyvitamin D (25OHD) during pregnancy and the child's body mass index (BMI) and risk of overweight at 5 years of age, and [2] maternal pre-pregnancy BMI as effect modifier for these associations. Data sources included a subsample from the Norwegian Mother, Father and Child Cohort Study (MoBa sub-cohort; N = 2,744) and the Swedish GraviD cohort study (N = 891). Maternal 25OHD was analyzed in gestational week 18 in the MoBa sub-cohort and week 10 in the GraviD cohort. In the MoBa sub-cohort, parents reported their child's documented measures of weight and length or height from the health card at routine check-up. In the GraviD cohort, this information was collected directly from medical records. Childhood overweight (including obesity) was identified using the International Obesity Task Force cut-offs. Linear and logistic regression models were used to investigate the association between maternal 25OHD and child's BMI and risk of overweight at 5 years of age in each cohort separately, and in a pooled dataset. In the pooled analysis, maternal 25OHD <30 nmol/L was associated with lower BMI in children at 5 years of age, but not with risk of overweight. Interaction analysis showed that the association was predominant among children of mothers with pre-pregnancy BMI ≥25 kg/m2. Low maternal vitamin D status, particularly in mothers with overweight or obesity, predicted lower BMI in their five-year-old children. However, there was no evidence of an effect on overweight in these children.

1089-P: Gestational Glucose Intolerance and Risk of Childhood Overweight and Obesity

Infants of individuals with gestational glucose intolerance (GGI, abnormal glucose loading test [GLT] without gestational diabetes [GDM]) have increased risk of large for gestational age birthweight, but an association between GGI and childhood adiposity has not been consistently observed. We studied the risk of overweight and obesity in 2-5-year-old children exposed to varying degrees of maternal glycemia in utero in a retrospective hospital-based cohort. We defined normal glucose tolerance (NGT) as a GLT &amp;lt;140 mg/dl, GGI as GLT ≥ 140 mg/dl and zero (GGI-0) or 1 (GGI-1) abnormal values on a 3-hour 100-gram oral glucose tolerance test (OGTT), and gestational diabetes (GDM) as ≥2 abnormal values. We used logistic regression to investigate the risk of obesity, defined as body mass index (BMI) &amp;gt; 95th percentile, in children born to individuals with GGI and GDM as compared to NGT. In model 1, we adjusted for maternal age, gestational weight gain, parity, insurance, race/ethnicity, marital status, gestational age at delivery and infant sex; in model 2, we further adjusted for maternal 1st trimester BMI. Of n=12728 children, 48.5% were female, the mean (SD) gestational age at delivery was 39.4 (1.7) weeks, and the mean birthweight was 3341 (519) grams. A total of 10567 children were exposed to NGT in utero, 1156 to GGI-0, 428 to GGI-1, and 577 to GDM. Obesity was present in 12.9% of children exposed to NGT, 12.5% exposed to GGI-0, 16.6% exposed to GGI-1, and 18.5% exposed to GDM, respectively. In model 1, there was an increased odds of obesity in those exposed to GGI-1 (1.37 [1.04, 1.78], P=0.02) and GDM (1.61 [1.28, 2.02] P&amp;lt;0.001). After maternal BMI adjustment, we did not find a significant increased risk of obesity in any group compared to NGT (GGI-1: 1.15 [0.86, 1.51] P=0.33; GDM 1.24 (0.97, 1.57), P=0.08). After accounting for maternal BMI, children exposed to GGI and GDM in utero have a similar risk of obesity in early childhood to those born to NGT pregnancies. Disclosure J.Maya: None. S.Hsu: None. C.C.M.Schulte: None. K.James: None. T.Thaweethai: None. M.Hivert: None. C.E.Powe: Consultant; Mediflix, Inc., Other Relationship; Wolters Kluwer Health. Funding National Institutes of Health (T32DK007028-47S1)

Impact of parental lifestyle patterns in the preconception and pregnancy periods on childhood obesity.

High prevalence of overweight and obesity already observed in preschool children suggests the involvement of early-life risk factors. Preconception period and pregnancy are crucial windows for the implementation of child obesity prevention interventions with parental lifestyle factors as relevant targets. So far, most studies have evaluated their role separately, with only a few having investigated their potential synergistic effect on childhood obesity. Our objective was to investigate parental lifestyle patterns in the preconception and pregnancy periods and their association with the risk of child overweight after 5 years. We harmonized and interpreted results from four European mother-offspring cohorts participating in the EndObesity Consortium [EDEN, France; Elfe, France; Lifeways, Ireland; and Generation R, Netherlands] with data available for 1,900, 18,000, 1,100, and 9,500 families, respectively. Lifestyle factors were collected using questionnaires and included parental smoking, body mass index (BMI), gestational weight gain, diet, physical activity, and sedentary behavior. We applied principal component analyses to identify parental lifestyle patterns in preconception and pregnancy. Their association with risk of overweight (including obesity; OW-OB) and BMI z-scores between 5 and 12 years were assessed using cohort-specific multivariable logistic and linear and regression models (adjusted for potential confounders including parental age, education level, employment status, geographic origin, parity, and household income). Among the various lifestyle patterns derived in all cohorts, the two explaining the most variance were characterized by (1) "high parental smoking, low maternal diet quality (and high maternal sedentary behavior in some cohorts)" and, (2) "high parental BMI and low gestational weight gain." Patterns characterized by high parental BMI, smoking, low diet quality or high sedentary lifestyle before or during pregnancy were associated with higher risk of OW-OB in children, and BMI z-score at any age, with consistent strengths of associations in the main cohorts, except for lifeways. This project provides insight into how combined parental lifestyle factors in the preconception and pregnancy periods are associated with the future risk of child obesity. These findings are valuable to inform family-based and multi-behavioural child obesity prevention strategies in early life.

Association between diet quality scores and risk of overweight and obesity in children and adolescents

BackgroundThis study examined the associations of diet quality assessed by Healthy Eating Index 2015 (HEI-2015), Alternative Healthy Eating Index 2010 (AHEI-2010), Mediterranean Diet (MedDiet) and overweight/obesity in children and adolescents.MethodsThis cross-sectional study used data of participants aged 2–19 years from National Health and Nutrition Examination Survey (NHANES) 2005–2018. The weighted logistic regression model was adopted to explore the association between diet quality scores and overweight, obesity in children and adolescents. Subgroup analysis was also performed based on sex.ResultsA total of 9,724 participants were included in children group (2–11 years old), and 5,934 were adolescent group (12–19 years old). All participants were divided into based on the BMI-for-age: underweight and normal, overweight and obesity groups. After adjusting for age, race, poverty-income ratio, maternal smoking during pregnancy and total energy, HEI-2015 and MedDiet scores were related to the risk of overweight in children, and only MedDiet scores remained associated with a decreased risk of obesity in children. MedDiet scores were associated with a decreased risk of overweight, obesity in adolescents, respectively, after adjusting age, sex, race, poverty-income ratio, cotinine, total energy and physical activity. The similar results in male participants were also found.ConclusionHigher MedDiet scores were associated with lower the risk of overweight and obesity, respectively, particularly for male children and adolescents. The higher HEI-2015 scores were also related to the risk of overweight in children.

Parental lifestyle patterns around pregnancy and risk of childhood obesity in four European birth cohort studies

BackgroundA high prevalence of excess weight in children younger than 5 years suggests the involvement of early-life risk factors. The preconception and pregnancy periods are crucial stages for the implementation of interventions to prevent childhood obesity. Most studies so far have evaluated the effects of early-life factors separately, with only a few investigating the combined effect of parental lifestyle factors. Our objective was to fill the literature gap regarding parental lifestyle factors in the preconception and pregnancy periods and to study their association with the risk of overweight in children after the age of 5 years. MethodsWe harmonised and interpreted data from four European mother–offspring cohorts (EDEN [comprising 1900 families], Elfe [comprising 18 000 families], Lifeways [comprising 1100 families], and Generation R [comprising 9500 families]). Written informed consent was obtained from parents of all involved children. Lifestyle factor data collected through questionnaires comprised parental smoking, BMI, gestational weight gain, diet, physical activity, and sedentary behaviour. We applied principal component analyses to identify multiple lifestyle patterns in preconception and pregnancy. Their association with child BMI z-score and risk of overweight (including obesity, overweight and obesity, as defined by the International Task Force reference) between the ages of 5 and 12 years were assessed using cohort-specific multivariable linear and logistic regression models (adjusted for confounders including parental age, education level, employment status, geographic origin, parity, and household income). FindingsAmong the various lifestyle patterns identified in all cohorts, the two that better explained variance were high parental smoking plus low maternal diet quality or high maternal sedentary behaviour, and high parental BMI plus low gestational weight gain. Overall, we observed that patterns characterised by high parental BMI, smoking, low-quality diet, or sedentary lifestyle before or during pregnancy were associated with higher BMI z-scores and risk of overweight and obesity in children aged 5–12 years. InterpretationOur data contribute to a better understanding of how parental lifestyle factors might be associated with the risk of childhood obesity. These findings are valuable to inform future family-based and multi-behavioural child obesity prevention strategies in early life. FundingEuropean Union's Horizon 2020 under the ERA-NET Cofund action (reference 727565) and European Joint Programming Initiative “A Healthy Diet for a Healthy Life” (JPI HDHL, EndObesity).

Assessment of health risks caused by overweight in children depending on the FTO gene rs9939609 polymorphism

In this study, we aimed to estimate the association between the rs9939609 FTO (fat mass and obesity associated) polymorphism and a risk of overweight in children living in the Baikal region. We performed a case – control study that included 113 schoolchildren living in industrial centers of the Baikal region (Irkutsk, Angarsk, and Ulan-Ude). Anthropometric parameters were measured and body mass index was calculated with its values being ranked in accordance with the WHO BMI curves depending on a sex and age. Genotyping of the rs9939609 FTO polymorphism was performed by allele-specific amplification with real-time results detection. To assess likelihood of an association between the FTO gene allele and overweight and obesity, relative risk (RR) and 95 % confidence interval (CI) were calculated. The assessment revealed the A allele of the rs9939609 FTO polymorphism to be by 1.29 times more frequent in the examined children with overweight and obesity (48.44 %) than in the children form the reference group (37.65 %). The FTO rs9939609 polymorphism was authentically associated with likelihood of elevated risks of overweight and obesity in children with the homozygous AA genotype (RR = 2.806, 95 % CI: 1.650–4.772; STD = 0.271). Our study confirms that the rs9939609 polymorphism of the FTO gene is a risk factor of overweight and obesity for children from the Baikal region who have the A allele of the homozygous AA genotype. Prevailing frequency of the TT genotype (29.2 %) as compared with the AA genotype (10.62) is likely due to influence of assimilation processes on urbanized territories in the Baikal region.

Оценка риска избыточной массы тела у детей в зависимости от полиморфизма rs9939609 генa FTO

In this study, we aimed to estimate the association between the rs9939609 FTO (fat mass and obesity associated) polymorphism and a risk of overweight in children living in the Baikal region. We performed a case – control study that included 113 schoolchildren living in industrial centers of the Baikal region (Irkutsk, Angarsk, and Ulan-Ude). Anthropometric parameters were measured and body mass index was calculated with its values being ranked in accordance with the WHO BMI curves depending on a sex and age. Genotyping of the rs9939609 FTO polymorphism was performed by allele-specific amplification with real-time results detection. To assess likelihood of an association between the FTO gene allele and overweight and obesity, relative risk (RR) and 95 % confidence interval (CI) were calculated. The assessment revealed the A allele of the rs9939609 FTO polymorphism to be by 1.29 times more frequent in the examined children with overweight and obesity (48.44 %) than in the children form the reference group (37.65 %). The FTO rs9939609 polymorphism was authentically associated with likelihood of elevated risks of overweight and obesity in children with the homozygous AA genotype (RR = 2.806, 95 % CI: 1.650–4.772; STD = 0.271). Our study confirms that the rs9939609 polymorphism of the FTO gene is a risk factor of overweight and obesity for children from the Baikal region who have the A allele of the homozygous AA genotype. Prevailing frequency of the TT genotype (29.2 %) as compared with the AA genotype (10.62) is likely due to influence of assimilation processes on urbanized territories in the Baikal region.

Maternal feeding styles and the risk of overweight in a cohort of Caribbean infants

AbstractIntroductionParental feeding styles in the first years of life may increase childhood overweight risk. There are few studies on this association in children under 2 years. The current study aimed to investigate the association between maternal feeding styles and Caribbean infants’ risk of overweight at 18 months and determine whether maternal depression is an important confounder in the association.MethodsIt is a prospective study of mother–child dyads that participated in a three‐island parenting trial. Maternal and infant characteristics were collected at infant age 6–10 weeks with maternal depression assessed using the Center for Epidemiologic Studies Depression (CES‐D) scale questionnaire. Feeding styles were measured using items from the Toddler Feeding Behaviour Questionnaire at 12 months. Infant weight and length were measured at 18 months, and infants at risk of overweight were defined as weight‐for‐length z‐scores (WLZ) &gt; 1. Factor analysis was used to identify feeding styles and associations with overweight risk assessed using multilevel logistic regression accounting for country and health clinic. Logistic regression models were adjusted for infant and maternal covariates, with a final model including depressive symptom scores.ResultsOf 366 infants assessed, 18.9% were affected by the risk of overweight. Five feeding styles were identified—uninvolved, indulgent, forceful, restrictive and responsive. Only restrictive feeding was associated with an increased risk of overweight (OR [95% CI], 1.61 [1.22, 2.13]). The association strengthened after adjusting for maternal depressive symptoms (OR [95% CI], 1.79 [1.30, 2.30]), representing an 11.18% increase in the risk of overweight odds.ConclusionInterventions that address restrictive feeding may be one strategy to reduce overweight risk among Caribbean maternal–infant dyads.

Maternal Gestational Diabetes Is Associated with High Risk of Childhood Overweight and Obesity: A Cross-Sectional Study in Pre-School Children Aged 2–5 Years

Background and Objectives: Childhood obesity is a global public health concern with long-term and serious health implications. An important factor for childhood obesity is maternal gestational diabetes mellitus (GDM), which in turn impacts maternal and offspring long-term health. This study aimed to investigate the associations between maternal GDM and childhood weight status and multiple anthropometric and sociodemographic factors and perinatal outcomes. Materials and Methods: A total of 5348 children aged 2-5 years old and their paired mothers took part in the study. Questionnaires were utilized to evaluate the sociodemographic factors and perinatal outcomes as well as smoking habits, educational level, economic status, age, and parity status. Children's anthropometric parameters were measured, and maternal medical history, preterm birth records, and anthropometric measures during pregnancy were retrieved by their medical records. Results: Overall, 16.4% of the children aged at 2-5 years were overweight, and 8.2% of them were affected by obesity, leading to a total 24.6% of children with overweight/obesity. Further, 5.5% of the enrolled mothers were diagnosed with gestational diabetes mellitus. GDM doubles the probability of childhood overweight/obesity at ages 2-5 years old independently of multiple confounding factors. Pre-pregnancy overweight and obesity, older maternal age, and smoking are risk factors for GDM, while GDM additionally increases the risk of preterm birth. Children of mothers that developed GDM were at greater risk of overweight or obesity, with the association between GDM and offspring's weight status being independent of confounding factors. Conclusions: GDM is a severe public health issue with prolonged complications for both the mother and their children. Public health approaches and programs need to promote the negative role of pre-pregnancy weight and smoking status as well as the significance of a good glycemic control throughout gestation in women of childbearing age.

Maternal tobacco smoking and childhood obesity in South Africa: A cohort study.

Tobacco use and obesity are major public health problems and part of the leading causes of preventable disease and death worldwide. The prevalence of overweight children has escalated over the years; making the weight gain in children a critical issue for health professionals and academics alike. This study examines the association between maternal tobacco use and body weight abnormalities among South African children. The study uses data from the National Income Dynamics Study (NIDS), conducted from 2008 to 2017. The survey is available in five waves which have been merged into a panel dataset of 211,718 children aged between 0 to 5 years old, drawn from a nationally representative sample of households followed across time. Thus, the subgroup of children aged between 6 and 15 years old was excluded from the analysis. The empirical investigation employs a logistic regression model to estimate the marginal effect of maternal smoking on childhood overweight prevalence measured by three anthropometric based proxies, namely risk of child overweight, child overweight and child obesity. This framework assumes unobserved child characteristics to be uncorrelated with independent variables (random effect assumption); hence allowing to control for time-invariant sociodemographic factors which are likely to affect child nutritional health. In addition to sociodemographic and health characteristics of mothers, empirical findings suggest that maternal smoking exhibits a significant odds and/ or probability of weight abnormalities in children. Notably, children of smoking mothers are likely to be obese, overweight, or at risk of becoming overweight with a possible coexistence of mother-child overweight. Similarly, weight irregularities in children are likely to increase with mother's age. Conversely, married mothers although associated with increased odds of children having high BMI, display a reduced probability of children being abnormally weighted. Finally, child support grant has the potential to improve children nutritional health as children whose mothers are recipient of such grant have a negative probability of having high BMI. Overall, maternal smoking contributes to child overweight and/or obesity in south Africa; suggesting that maternal healthy lifestyle could be an alternative strategic tool to fight against overweight in children. However, mothers' inability to remain and/or follow a healthy life style is plausible as age increases, with spillover effect on child care. Thus, policymakers should prioritize programs to reduce smoking, especially amongst pregnant women and caregivers, to minimise the risk of overweight in children. Promoting the consumption of healthy foods accompanied by physical activity may reduce mothers' stress levels and their incentive to self-medicate using tobacco substances. In addition, comprehensive action programs including child support grant and recommendations for treatment plans that address the problems of children who are already suffering from overweight, remain essential.

Association between maternal weight gain during pregnancy and child's body mass index at preschool age.

Recent studies reported that prepregnancy body mass index (BMI) and weight gain during pregnancy affect birth weight and contribute to childhood obesity. However, no such data are available in Korea. This study gathered data on weight gain during pregnancy and its impact on birth weight and childhood obesity in Korea. We reviewed 1,753 singleton full-term babies born at CHA Bundang Medical Center in 2014-2016. We first review each maternal and baby factor based on prepregnancy BMI (underweight, normal, overweight/obese) and then divided them into low, normal, and excess gestational weight gain (GWG) groups based on the American Institute of Medicine (IOM) guidelines. We reviewed the characteristics of each group and analyzed the association between maternal GWG based on IOM guidelines and child BMI after 6 years. The maternal prepregnancy BMI group showed a significant difference in birth weight and child BMI at 6 years. As the prepregnancy BMI increased, the birth weight and BMI at 6 years also increased (P<0.001). Mean birth weight and child BMI at 6 years differed significantly among the GWG groups. Furthermore, excess postpartum weight gain increased the risk of childhood overweight and obesity (odds ratio, 2.21; 95% confidence interval, 1.40-3.49). Excess weight gain during pregnancy should be avoided due to its short- and long-term association with childhood obesity. Owing to the high prevalence of excess GWG and childhood obesity, excess weight gain during pregnancy can have significant public health implications.

Early-life antibiotic exposure increases the risk of childhood overweight and obesity in relation to dysbiosis of gut microbiota: a birth cohort study

BackgroundEarly-life antibiotic exposure is associated with the development of later obesity through the disruption of gut microbiota in the animal models. However, the related epidemiological evidence is still conflicting.MethodsA birth cohort was consisted of 2140 mother-infant pairs in Chaoyang District Maternal and Child Health Care Hospital in this study. Here, their available antibiotic exposure during the first one year of life was ascertained using a open-ended questionnaire and related anthropometric parameters from the health screening program. The compositions of gut microbiota were comprehensively analyzed by16S rRNA high throughput sequencing. Then the spearman correlations were performed by the multiple covariance-adjusted regressions between the antibiotic exposure with anthropometric parameters and compositions of gut microbiota.ResultsAmong the 2140 subjects, the antibiotic exposure during the first one year of life was 53.04%, mainly by Cephalosporins (53.39%) and Erythromycins(27.67%) for the treatment of respiratory tract infection (79.56%), which were not significantly different among the subgroups. Compared to the control group, both childhood overweight and obesity at two and a half years were higher in the antibiotic exposed group, with higher percents of Faecalibacterium, Agathobacter and Klebsiella, and lower percentage of Bifidobacterium. Moreover, there were positively potential associations between early-life antibiotic exposure with the accelerated anthropometric parameters and disruption of Faecalibacterium, Agathobacter, Klebsiella and Bifidobacterium at two and a half years.ConclusionThese above results proved that early-life antibiotic exposure was positively associated with the accelerated childhood overweight and obesity from one year to two and a half years by impacting the disorders of Faecalibacterium, Agathobacter, Klebsiella and Bifidobacterium, which would propose the theoretical basis for rationalizing the personalized antibiotic exposure among the infants to truly reflect the fairness of public health.

Residential Proximity to Urban Play Spaces and Childhood Overweight and Obesity in Barcelona, Spain: A Population-Based Longitudinal Study.

Findings on the relationship between play spaces and childhood overweight and obesity are mixed and scarce. This study aimed to investigate the associations between residential proximity to play spaces and the risk of childhood overweight or obesity and potential effect modifiers. This longitudinal study included children living in the city of Barcelona identified in an electronic primary healthcare record database between 2011 and 2018 (N = 75,608). Overweight and obesity were defined according to the WHO standards and we used 300 m network buffers to assess residential proximity to play spaces. We calculated the risk of developing overweight or obesity using Cox proportional hazard models. A share of 29.4% of the study population developed overweight or obesity, but we did not find consistent associations between play space indicators and overweight or obesity. We did not find any consistent sign of effect modification by sex, and only some indications of the modifying role of area socioeconomic status and level of exposure. Although it is not possible to draw clear conclusions from our study, we call for cities to continue increasing and improving urban play spaces with an equitable, healthy, and child-friendly perspective.