Risk Of Overweight In Children Research Articles

Postnatal exposure to household disinfectants, infant gut microbiota and subsequent risk of overweight in children.

Emerging links between household cleaning products and childhood overweight may involve the gut microbiome. We determined mediating effects of infant gut microbiota on associations between home use of cleaning products and future overweight. From the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort, we tested associations between maternal report of cleaning product use and overweight at age 3, and whether associations were mediated by microbial profiles of fecal samples in 3- to 4-month-old infants. Among 757 infants, the abundance of specific gut microbiota was associated with household cleaning with disinfectants and eco-friendly products in a dose-dependent manner. With more frequent use of disinfectants, Lachnospiraceae increasingly became more abundant (highest v. lowest quintile of use: adjusted odds ratio [AOR] 1.93, 95% confidence interval [CI] 1.08 to 3.45) while genus Haemophilus declined in abundance (highest v. lowest quintile of use: AOR 0.36, 95% CI 0.20 to 0.65). Enterobacteriaceae were successively depleted with greater use of eco-friendly products (AOR 0.45, 95% CI 0.27 to 0.74). Lachnospiraceae abundance significantly mediated associations of the top 30th centile of household disinfectant use with higher body mass index (BMI) z score (p = 0.02) and with increased odds of overweight or obesity (p = 0.04) at age 3. Use of eco-friendly products was associated with decreased odds of overweight or obesity independently of Enterobacteriaceae abundance (AOR 0.44, 95% CI 0.22 to 0.86), with no significant mediation (p = 0.2). Exposure to household disinfectants was associated with higher BMI at age 3, mediated by gut microbial composition at age 3-4 months. Although child overweight was less common in households that cleaned with eco-friendly products, the lack of mediation by infant gut microbiota suggests another pathway for this association.

Gestational diabetes and offspring’s growth from birth to 6 years old

The objective of this study was to compare the children's body mass index (BMI) growth between offspring exposed to maternal gestational diabetes mellitus (GDM) and those not exposed, and assess the associations between maternal hyperglycemia and their offspring's overweight risk from 1 to 6 years of age. Using the healthcare records data from the Tianjin Maternal and Child Healthcare System, we conducted a population-based cohort study, which is composed of 27,155 mother-child pairs with all mothers undergoing GDM screening test in pregnancy. After adjustment for maternal and children's characteristics, children born to mothers with abnormal glucose (including GDM or abnormal glucose challenge test (GCT) but normal oral glucose tolerance test (OGTT) results) during pregnancy had higher mean values of Z-scores for BMI for age at 1, 2, 3, 5, and 6 years of age, in comparison with those born to mothers with normal glucose (all P values < 0.05). Moreover, maternal abnormal glucose was associated with a higher risk of childhood overweight with multivariate-adjusted hazard ratios of 1.07 (95% confidence interval (CI) 1.01-1.14), 1.09 (95% CI 1.04-1.15), 1.10 (95% CI 1.04-1.15), 1.08 (95% CI 1.03-1.14), 1.08 (95% 1.03-1.13), and 1.07 (95% 1.02-1.12) at 1-6 years of age compared with children of mothers with normal glucose. Abnormal maternal glucose tolerance during pregnancy was independently associated with children's higher BMI and overweight risk from 1 to 6 years of age. Women with positive GCT results but negative OGTT can be neglected by the health system. More attention should be paid to the health of these mothers and their offspring.

Association between household poverty dynamics and childhood overweight risk and health behaviours in the United States: a 8-year nationally representative longitudinal study of 16800 children.

No study has examined how the pattern of income dynamics influences both of children's body mass index (BMI) trajectory and health behaviours. To examine the association between household poverty dynamics and childhood overweight risk in the USA. Using the longitudinal data of 16800 children (from kindergarten to the 8th grade) in the nationally representative US cohort-Early Childhood Longitudinal Study, Kindergarten Class 1998-1999, we examined the differences in BMI trajectory, weight-related health behaviours and risk of overweight in association with household poverty dynamics during follow-up (never [no experience of poverty], transient [once], recurrent [≥2 times] and persistent poor [remained]) using mixed models with fractional polynomial functions and estimating equation models. Overall, children experiencing poverty were more likely to have adverse BMI growth trajectory and eating and sedentary behaviours compared with the never poor. The recurrently poor children (12.8%) had the fastest BMI trajectory, highest overweight/obesity prevalence from 5 to 16years old and highest proportion of excessive soda/fast food consumption and irregular exercise at 8th grade than did others (p<0.05). The persistently poor (8.4%) were the lowest in BMI growth trajectory but became the second highest in childhood obesity through a steady increase in BMI over time. Children in the recurrently poor group had a 1.5 times (95% CI=1.0-2.2) higher risk of overweight than those having never experienced poverty during follow-up. The experience of recurrent household poverty had a significant association with children's adverse eating behaviours and increased obesity risk subsequently.

Early Infant Feeding of Formula or Solid Foods and Risk of Childhood Overweight or Obesity in a Socioeconomically Disadvantaged Region of Australia: A Longitudinal Cohort Analysis.

In southwestern Sydney the timing of introduction of formula and solids may be associated with risk of childhood overweight or obesity, and this may vary by age at breastfeeding cessation during first year. We included 346 infants from southwestern Sydney using the longitudinal study for Australian children (LSAC), who at baseline were singleton, full term, and normal weight births. The outcome risk of overweight or obesity was measured at every two-year interval of children aged 0 or 1 year at baseline until they reached age 10 or 11, defined by body mass index (BMI) ≥ 85th percentile, using the Centre for Disease Control and Prevention growth charts. Age at introduction to formula or solids was dichotomized at four months. We used mixed effects logistic regression for performing all analyses with and without adjusting for mother’s BMI, age during pregnancy, and social disadvantage index. Missing data were estimated using multivariate normal imputation having 25 imputations. The odds of overweight or obesity were significantly higher among infants introduced to formula or solids at ≤4 months compared to those introduced at >4 months in both unadjusted (odds ratio = 2.3262, p = 0.023) and adjusted (odds ratio = 1.9543, p = 0.0475) analyses. The odds of overweight or obesity when age at formula or solids introduction was held fixed at ≤4 months, increased significantly (odds ratio = 2.0856, p = 0.0215) for children stopping breastfeeding at age ≤4 months compared to >4 months. Thus, increasing the prevalence of breast-feeding without any formula or solids to 4–6 months in southwest Sydney should be a worthwhile public health measure.

The Healthfulness of Food-at-Home Expenditures, the Local Food Environment, and Childhood Obesity.

Despite the growth of food-away-from-home expenditures, food-at-home (FAH) expenditures still constitute the majority of American families' food dollars. The FAH expenditures may have important impacts on children's diets and, consequently, their weight statuses. This study examined the association between the composition of FAH expenditures and childhood overweight or obesity. We compiled a longitudinal data set from the 2010 to 2012 IRI Consumer Panel and its associated MedProfiler surveys. This study took place in the United States. One thousand seven hundred thirty-one households across the United States, with 2645 children aged 2 to 17, were surveyed over 3 years (2010-2012). The binary outcome variable indicated whether a child was overweight or obese. The key predictor variable-composition of FAH expenditures-was an index reflecting households' adherence to expenditure shares for 24 food categories recommended by the United States Department of Agriculture (USDA) Thrifty Food Plans. The key control variables were FAH expenditure shares from different food stores. Data were analyzed by multilevel logistic regressions that controlled for a number of individual-level and household-level characteristics. Higher compliance with the USDA Thrifty Food Plans was associated with lower risk of childhood overweight or obesity. Channel expenditure shares were not significantly associated with the weight outcomes. To prevent childhood obesity, the USDA Thrifty Food Plans can provide potential guidelines for households to decide the composition of their FAH expenditures.

NP7 - Advancing and Expanding HomeStyles: Shaping Home Environments and Lifestyles to Prevent Childhood Obesity

Objective: This multi-disciplinary, multi-institutional, multi-state, integrated Research, Education, and Extension project will advance and expand the progress of HomeStyles toward reducing risk of childhood overweight and obesity. Description: HomeStyles, an in-home family intervention, enables and motivates English- and Spanish-speaking parents to shape home environments and weight-related lifestyle practices to prevent childhood obesity. Segment 1 of HomeStyles focused on families with preschoolers (ages 2–5). This project will conduct a dissemination feasibility study to determine how to effectively diffuse the innovations of the evidence-based HomeStyles-Segment 1 intervention to parents of children in preschools. This project will create a novel, culturally-competent HomeStyles-Segment 2 responsive to the developmentally unique needs of middle childhood (6–11 years) and deliver it online and in face-to-face SNAP-Ed sessions. Further, this project will build the expertise of the next generation of nutrition and health education professionals in creating effective childhood obesity prevention programs through formal coursework and hands-on practicums. Evaluation: The dissemination feasibility study for Segment 1 will include pre/post survey completed by a key informant at each participating preschool/daycare and brief parent surveys. The new, second segment (Segment 2) of HomeStyles tailored to families with children 6 to 11 years will be evaluated via a randomized controlled trial designed to determine whether this novel, age-appropriate, family intervention enables and motivates English- and Spanish-speaking parents to shape their home environments and weight-related lifestyle practices (diet, exercise, sleep) to reduce risk of obesity during middle childhood more than those in the control condition. Students enrolled in coursework and practicums will be evaluated using rubrics and satisfaction surveys. Conclusions and Implications: This intervention will apply community-based participatory research principles and be aligned with current obesity prevention recommendations and behavior change theories. This project will provide a sustainable model for confronting and combating obesity and safeguarding health that can be brought to scale nationwide. Funding: 2017-680001-26351. The following is the supplementary data to this article: Download .pdf (1.14 MB) Help with pdf files Poster

Maternal Gestational Diabetes and Childhood Obesity—A Large Observational Study

Previous studies found conflicting results about the associations between the exposure to maternal hyperglycemia in utero and the later risks of childhood overweight and obesity. The aim of the present study was to compare the children’s body mass index (BMI) growth between offspring exposed to maternal gestational diabetes mellitus (GDM) and those not exposed, and assess the associations between maternal GDM and their offspring’s overweight and obesity risk. We performed a large observational study in 1156 women and their offspring (578 GDM and 578 non-GDM mother-child pairs, matched by their offspring’s gender and age). The mean values of children were 5.86 years (range 3-9 years old). After adjustment for maternal and children’s characteristics, children born to mothers with GDM during pregnancy had higher mean values of Z scores for BMI-for-age, Z-scores for weight-for-age, waist circumferences, body fat, subscapular skinfold, and suprailiac skinfold, in comparison with their counterparts born to mothers with normal glucose (all P values &amp;lt;0.05). Moreover, maternal GDM was associated with a higher risk of childhood overweight and obesity with multivariate-adjusted odds ratios of 1.42 (95% confidence interval [CI]: 1.02-1.97) and 1.18 (95% CI: 1.11-1.24), respectively, compared with the children of mothers without GDM during pregnancy. Maternal GDM is an independent risk factor of childhood overweight and obesity, and it is associated with children’s faster growth of BMI. Disclosure J. Wang: None. L. Wang: None. S. Zhang: Employee; Self; American Diabetes Association. Advisory Panel; Self; Company/ABC. H. Liu: None. J. Leng: None. W. Li: None. T. Zhang: None. N. Li: None. W. Li: None. A. Baccarelli: None. L. Hou: None. G. Hu: None.

Prospective associations of age at complementary feeding and exclusive breastfeeding duration with body mass index at 5-6years within different risk groups.

SummaryBackgroundChildren with overweight or obesity are at risk for developing obesity in adulthood. Certain maternal characteristics, such as ethnicity, education, body mass index (BMI) or neighbourhood, are determinants for childhood overweight risk. There are large variations in how mothers differing in these characteristics feed their infants. Therefore, associations of age at complementary feeding, exclusive breast feeding duration with childhood overweight may differ in these groups. Understanding these associations would be essential to develop overweight prevention strategies.ObjectivesThe objective of this study is to study the associations of age at complementary feeding, exclusive breastfeeding duration with BMI‐standard deviation score (SDS) at 5–6 years within risk groups.MethodsUsing data from the Amsterdam Born Children and their Development study, a population‐based birth cohort (n = 4495), we formed groups of children at varying risk of overweight according to maternal characteristics of ethnicity, education, pre‐pregnancy BMI and neighbourhood. Linear and logistic regression analyses were conducted.ResultsComplementary feeding after 5 months of age was associated with lower BMI‐SDS in children of mothers of Dutch ethnicity (B: −0.12; 95% CI: −0.21, −0.04), medium‐level education (−0.19; −0.30, −0.08), normal BMI (−0.08; −0.16, −0.01) and high‐risk neighbourhood (−0.16; −0.29, −0.02). Compared with exclusive breastfeeding for <3 months, exclusive breastfeeding for ≥6 months was associated with lower BMI‐SDS in groups of medium‐level education (−0.28; 0.44, −0.11), normal BMI (−0.18; −0.29, −0.08) and medium‐risk (−0.18; −0.33, −0.04) and high‐risk (−0.22; −0.42, −0.02) neighbourhoods.ConclusionsAssociations between infant feeding practices and childhood BMI may differ between risk groups, implying that overweight prevention strategies should be group‐specific.

Breastfeeding and complementary feeding in relation to body mass index and overweight at ages 7 and 11 y: a path analysis within the Danish National Birth Cohort

Infant feeding may play an important role in the development of childhood overweight and obesity. The objective of this study was to examine whether duration of breastfeeding (BF), timing of introduction of complementary food, and protein intake at age 18 mo are associated with body mass index [BMI (measured in kg/m2)] and overweight at ages 7 and 11 y, independent of BMI during infancy. Children participating in the Danish National Birth Cohort were followed up at ages 7 and 11 y. Information on infant feeding, protein intake at age 18 mo, Ponderal Index at birth, child BMI (at ages 5 mo, 12 mo, 7 y, and 11 y), and several parental factors was available. Path analysis was used to assess the direct and indirect effects of infant feeding on BMI z scores (BMIz) at ages 7 (n=36,481) and 11 y (n=22,047). Logistic regression analyses were used to examine associations with overweight. Duration of BF was not associated with childhood BMIz at ages 7 and 11 y. Earlier introduction of complementary food (<4 mo old) was not associated with BMIz at age 7 y, but with a 0.069 (95% CI: 0.021, 0.117, P=0.005) higher BMIz at age 11 y and increased risk of overweight at age 11 y (OR 1.44; 95% CI: 1.04, 2.00; P=0.03). Protein intake from dairy products (per 5 g/d) was associated with higher BMIz only at age 7 y (OR: 0.012; 95% CI: 0.003, 0.021; P=0.007). Protein intake from meat and fish (per 2g/d) was associated with a 0.010 (95% CI: 0.004, 0.017; P=0.003) higher BMIz at age 7y, a 0.013 (95% CI: 0.005, 0.020; P=0.002) higher BMIz at age 11 y and increased odds of overweight at age 7y (OR: 1.07; 95% CI: 1.03, 1.10; P<0.001), but not at age 11 y. Intake of protein from meat and fish at age 18 mo was associated with higher BMIz and risk of overweight in childhood. However, the effect sizes were small. Early introduction of complementary food may be associated with child BMIz and child overweight. This study was registered at www.clinicaltrials.gov as NCT03334760.

Antibiotic exposure in early life and childhood overweight and obesity: A systematic review and meta-analysis.

We conducted a systematic review and meta-analysis of observational studies investigating the association between antibiotic exposure in infancy and risk of childhood overweight and obesity. Thirteen studies, including a total of 527 504 children, were included in the systematic review and 8 were included in meta-analyses. Exposure to antibiotics in infancy was associated with an increased odds ratio (OR) of childhood overweight and obesity (OR 1.11, 95% confidence interval [CI] 1.02-1.20). Whereas exposure to 1 treatment only and exposure between 6 and 24 months were not associated with increased risk of childhood overweight and obesity, exposure to >1 treatment was associated with an OR of 1.24 (95% CI 1.09-1.43) and exposure within the first 6 months of life was associated with an OR of 1.20 (95% CI 1.04-1.37). In conclusion, antibiotic exposure in infancy was associated with a slightly increased risk of childhood overweight and obesity, mainly if children were exposed to repeated treatments or treatment within the first 6 months of life. It is unclear whether this association is mediated via direct effects of antibiotics on the gut microbiota.

Childcare Environment and Japanese Children Who Are Overweight in Early Childhood.

Maternal employment may affect child care styles and contribute to the increasing prevalence of overweight children. We explored the potential risk factors for becoming overweight during early childhood, especially in the child care environment. We conducted a retrospective cohort study using data from health check-up services from 2007 to 2015 in Kobe, Japan. The main outcome was being overweight at age 3 years, which was defined by the International Obesity Task Force cutoffs. Environmental, maternal, and infantile factors were examined as possible risk factors for childhood overweight. Of 31,463 infants, 1315 (4.2%) were classified as overweight at age 3 years. Compared with children who were cared for by their mothers during the day at 4 and 18 months, the adjusted odds ratio (aOR) for becoming overweight for those who were not cared for by their mothers was 1.52: 95% confidence interval (CI), 1.16-1.99. Long sleep duration was associated with lower risk of childhood overweight: aOR, 0.79; 95% CI, 0.66-0.96. Less daytime care by mothers and shorter sleep duration were associated with increased risk of becoming overweight during childhood. Further studies are needed to determine on how the effect of those factors may be diminished with respect to childhood overweight.

Exclusive breastfeeding and partial breastfeeding reduce the risk of overweight in childhood: A nationwide longitudinal study in Korea

Breastfeeding is generally known to reduce the risk of childhood overweight and obesity. However, the results are controversial between countries, and nationwide data are rare. This study assessed the relationship between breastfeeding types and overweight incidence using nationwide longitudinal data in Korea. We analysed 774,764 infants who participated in the longitudinal nationwide data from the Korea National Children's Health Examination 2007-2013. Childhood overweight was defined by a Z-score≥1.64 (95th centile) for infants under 24 months and Z-scores≥1.04 (85th centile) for children over 24 months. Cox proportional hazard model was used to analyse the relationship between breastfeeding types and overweight incidence. Infants who were exclusively breastfed at 4-6 months of age had the multivariate-adjusted hazard ratio (HRs) for overweight of 0.78 (95% CI 0.77-0.79) and infants who were partially breastfed had the HRs for overweight of 0.96 (95% CI 0.94-0.98), which was lower compared to that of the exclusively formula fed group. Similar results were obtained for stratified analysis by boys and girls. Exclusive and partial breastfeeding have preventive effect on childhood overweight in Korea. Therefore, it is necessary to encourage breastfeeding to prevent childhood obesity and its consequences in developed Asian countries.

The role of fathers in overweight prevention: an analysis of a Caribbean cohort

Family-based strategies to reduce the risk of overweight in childhood are needed in the Caribbean. To investigate the associations between parental characteristics and risk of overweight and explore possible mechanisms. Data from a parenting intervention were analysed. Parental characteristics were obtained by questionnaire at enrolment. At 18 months, 501 infants (82.9% of cohort) had weight and length measured using standardized methods. The association of parents' characteristics with risk of infant overweight was assessed using random-effects logistic regression. Four focus groups among mothers in Jamaica were conducted to explore mechanisms. Overall, 20.6% of infants were 'at risk of overweight'. Fathers were present in 52% of households. Fathers' presence [OR (95% CI) 0.60 (0.37-0.96)] was associated with reduced risk of overweight independent of socioeconomic status. Mothers reported that fathers encouraged healthier practices. Fathers may be important agents of change in intervention strategies to prevent childhood overweight.

Bullying and Poverty are Associated with Increased Risk of Childhood Overweight and Obesity

Purpose: Obesity is a complex condition, but most interventions focus on diet and exercise and neglect socioeconomic factors. We examined whether social and economic factors are associated with obesity risk among adolescents.

Parenting practices and overweight status of junior high school students in China: A nationally representative study of 19,487 students from 112 schools

The study aimed to examine the level of parental responsiveness and demandingness for junior high students in China and its association with child weight status; assess if it differs by student socio-demographic characteristics; and to test the association between parenting and child physical activity.Nationally representative survey data collected from 19,487 students in 112 middle schools across China in 2013–2014 academic year were analyzed in 2016. Children's anthropometrics and perceptions of parenting practices were accessed by self-administered questionnaire. Multilevel logistic regression models were fit to test the association controlling for child age, sex, school region, and parental education.The majority of adolescents reported their parents were highly responsive in terms of emotional support and involvement (high: 64.1% vs. low: 9.2%), although more parents were not perceived as highly demanding (high: 21.4% vs. low: 35.5%). Children were more likely to be overweight or obese if their parents were highly responsive (OR=1.4 [95%CI: 1.2,1.6]) and demanding (OR=1.1 [95%CI: 1.0,1.3]) compared to those with medium parenting scores. Older children, boys, children with highly educated parents, or in urban schools had greater odds of being overweight or obese by receiving highly responsive parenting compared to their counterparts. Children with highly demanding or responsive parenting had longer physical activity duration and higher physical activity participation rates than their counterparts.High responsiveness and demandingness among Chinese parents were associated with the risk of child overweight and obesity. Further research is needed to examine the causal relationship between parenting practices and childhood obesity in China.

\u201cI would rather be told than not know\u201d - A qualitative study exploring parental views on identifying the future risk of childhood overweight and obesity during infancy

BackgroundRisk assessment tools provide an opportunity to prevent childhood overweight and obesity through early identification and intervention to influence infant feeding practices. Engaging parents of infants is paramount for success however; the literature suggests there is uncertainty surrounding the use of such tools with concerns about stigmatisation, labelling and expressions of parental guilt. This study explores parents’ views on identifying future risk of childhood overweight and obesity during infancy and communicating risk to parents.MethodsSemi-structured qualitative interviews were conducted with 23 parents and inductive, interpretive and thematic analysis performed.ResultsThree main themes emerged from the data: 1) Identification of infant overweight and obesity risk. Parents were hesitant about health professionals identifying infant overweight as believed they would recognise this for themselves, in addition parents feared judgement from health professionals. Identification of future obesity risk during infancy was viewed positively however the use of a non-judgemental communication style was viewed as imperative. 2) Consequences of infant overweight. Parents expressed immediate anxieties about the impact of excess weight on infant ability to start walking. Parents were aware of the progressive nature of childhood obesity however, did not view overweight as a significant problem until the infant could walk as viewed this as a point when any excess weight would be lost due to increased energy expenditure. 3) Parental attributions of causality, responsibility, and control. Parents articulated a high level of personal responsibility for preventing and controlling overweight during infancy, which translated into self-blame. Parents attributed infant overweight to overfeeding however articulated a reluctance to modify infant feeding practices prior to weaning.ConclusionThis is the first study to explore the use of obesity risk tools in clinical practice, the findings suggest that identification, and communication of future overweight and obesity risk is acceptable to parents of infants. Despite this positive response, findings suggest that parents’ acceptance to identification of risk and implementation of behaviour change is time specific. The apparent level of parental responsibility, fear of judgement and self-blame also highlights the importance of health professionals approach to personalised risk communication so feelings of self-blame are negated and stigmatisation avoided.

Modifiable risk factors in the first 1000 days for subsequent risk of childhood overweight in an Asian cohort: significance of parental overweight status.

Many studies have identified early-life risk factors for subsequent childhood overweight/obesity, but few have evaluated how they combine to influence risk of childhood overweight/obesity. We examined associations, individually and in combination, of potentially modifiable risk factors in the first 1000 days after conception with childhood adiposity and risk of overweight/obesity in an Asian cohort. Six risk factors were examined: maternal pre-pregnancy overweight/obesity (body mass index (BMI) ⩾25 kg m-2), paternal overweight/obesity at 24 months post delivery, maternal excessive gestational weight gain, raised maternal fasting glucose during pregnancy (⩾5.1 mmol l-1), breastfeeding duration <4 months and early introduction of solid foods (<4 months). Associations between number of risk factors and adiposity measures (BMI, waist-to-height ratio (WHtR), sum of skinfolds (SSFs), fat mass index (FMI) and overweight/obesity) at 48 months were assessed using multivariable regression models. Of 858 children followed up at 48 months, 172 (19%) had none, 274 (32%) had 1, 244 (29%) had 2, 126 (15%) had 3 and 42 (5%) had ⩾4 risk factors. Adjusting for confounders, significant graded positive associations were observed between number of risk factors and adiposity outcomes at 48 months. Compared with children with no risk factors, those with four or more risk factors had s.d. unit increases of 0.78 (95% confidence interval 0.41-1.15) for BMI, 0.79 (0.41-1.16) for WHtR, 0.46 (0.06-0.83) for SSF and 0.67 (0.07-1.27) for FMI. The adjusted relative risk of overweight/obesity in children with four or more risk factors was 11.1(2.5-49.1) compared with children with no risk factors. Children exposed to maternal pre-pregnancy (11.8(9.8-13.8)%) or paternal overweight status (10.6(9.6-11.6)%) had the largest individual predicted probability of child overweight/obesity. Early-life risk factors added cumulatively to increase childhood adiposity and risk of overweight/obesity. Early-life and preconception intervention programmes may be more effective in preventing overweight/obesity if they concurrently address these multiple modifiable risk factors.

Food environments in Malta: Associations with store size and area-level deprivation

Food environments are potential targets for interventions to reduce obesity prevalence, particularly in island settings that are typically dependent on food imports. This observational study aimed to characterise the availability, quality and price of foods and beverages in a nationally representative sample of grocery stores in Malta using the Nutrition Environment Measures Survey for Stores (NEMS-S) instrument, and to examine the association between area-level density of different types of food stores and the likelihood of children living in these areas being overweight or obese. Fieldwork was carried out between March and May 2014. There was a strong positive correlation between store size and NEMS-S score (p=<0.001), suggesting that smaller grocery stores generally offered a smaller range of products and fewer healthy food/beverage options than larger supermarkets. Across all stores, median prices of certain ‘healthier’ versions of foods were more expensive than their less healthy alternatives. A significant association between risk of childhood overweight, and density of confectionery stores in children’s locality of residence, was found (OR 1.19; 95% CI: 1.04, 1.37). These baseline findings highlight opportunities to improve the food environment in Malta to support more healthful eating, and may be of particular interest to public health practitioners in island settings.

Antibiotic Exposure in Early Life Increases Risk of Childhood Obesity: A Systematic Review and Meta-Analysis.

A number of studies have previously assessed the impact of antibiotic exposure in early life on the risk of childhood obesity, but no systematic assessment is currently available. A systematic review and meta-analysis was performed to comprehensively and quantitatively elucidate the risk of childhood obesity caused by antibiotic exposure in early life. Literature search was performed in PubMed, Embase, and Web of Science. Random-effect meta-analysis was used to pool the statistical estimates. Fifteen cohort studies involving 445,880 participants were finally included, and all those studies were performed in developed countries. Antibiotic exposure in early life significantly increased risk of childhood overweight [relative risk (RR) = 1.23, 95% confidence interval (CI) 1.13–1.35, P < 0.001] and childhood obesity (RR = 1.21, 95% CI 1.13–1.30, P < 0.001). Antibiotic exposure in early life also significantly increased the z-score of childhood body mass index (mean difference: 0.07, 95% CI 0.05–0.09, P < 0.00001). Importantly, there was an obvious dose–response relationship between antibiotic exposure in early life and childhood adiposity, with a 7% increment in the risk of overweight (RR = 1.07, 95% CI 1.01–1.15, P = 0.03) and a 6% increment in the risk of obesity (RR = 1.06, 95% CI 1.02–1.09, P < 0.001) for each additional course of antibiotic exposure. In conclusion, antibiotic exposure in early life significantly increases risk of childhood obesity. Moreover, current analyses are mainly taken from developed countries, and therefore the impact of antibiotic exposure on risk of childhood obesity in vulnerable populations or developing countries still needs to be evaluated in future studies.

Childhood overweight and obesity amongst primary school children in Hai Phong City, Vietnam.

Childhood obesity is a rising health concern in Vietnam, however, research in this area is not extensive. The aim of this study was to determine the prevalence of childhood overweight and obesity, and to study associations between weight status and selected lifestyle factors, such as diet and physical activity levels, among children aged 6-10 years in Hai Phong City, Vietnam. Two hundred and seventy-six children from an urban and a rural primary school participated in this cross-sectional study. Data on weight, height and waist circumference were used to calculate BMI, and waist-height ratio to determine the proportion of children who were overweight, obese and had high central adiposity. Information on diet, physical activity and socioeconomic status of families was collected using questionnaires. Prevalences of overweight, obesity and high abdominal adiposity were 11.2%, 10.1% and 19.9%, respectively. Children who completed >=60 minutes of physical activity daily were 50% and 80% less likely to be overweight and have high abdominal adiposity, respectively. Computer usage increased the odds of overweight and high abdominal adiposity by 4.5 and 3.9 times, respectively. Mothers with higher education and income levels increased the risk of their children being overweight (p<0.05). Physical inactivity and high maternal education and income levels increased the risk of childhood overweight and obesity in this cohort. Future interventions should target parents and their children by providing both with educational modules centred on healthy eating habits, parental feeding practices and strategies for increasing physical activity.