Weight Development In Children Research Articles

Effect of a higher protein diet and lifestyle camp intervention on childhood obesity (The COPE study): results from a nonrandomized controlled trail with 52-weeks follow-up

Abstract Purpose In adults, diets rich in protein seem beneficial in relation to satiety, weight loss, and weight management; however, studies investigating dietary protein and weight development in children are scarce and inconsistent. This nonrandomized controlled trial aimed to investigate the effect of a higher protein diet during lifestyle intervention on anthropometry and metabolic biomarkers in children with overweight and obesity. Methods Children (n:208) were recruited from two multicomponent lifestyle camps. One camp was assigned as the intervention group. In the intervention group, carbohydrates-rich foods at breakfast and two in-between-meals were replaced with protein-containing foods to increase the amount of protein from ~ 10–15 energy percent (E%) per day to ~ 25E% per day. Other components were similar between groups. Anthropometry and biochemical measurements were collected at baseline, 10 weeks (after camp) and 52 weeks. Results The intervention group had a non-significant improvement in BMI-SDS (− 0.07 SD (− 0.19; 0.05), p = 0.24) compared to the control group, but in general, there was no effect of a higher protein diet on anthropometry and metabolic biomarkers. Overall, 10 weeks at camp resulted in a more favorable body composition [− 6.50 kg (p < 0.00), − 0.58 BMI-SDS (p < 0.00), and − 5.92% body fat (p < 0.00)], and improved metabolic health, with most changes maintained at 52 weeks. Conclusion A higher protein diet had no significant effect on body composition and metabolic health; however, these lifestyle camps are an efficiatious treatment strategy for childhood obesity. Clinical trial registration: clinicaltrials.gov with ID: NCT04522921. Preregistered August 21st 2020.

Associations between gestational weight gain and weight development of the offspring: Differences depending on maternal pre-pregnancy BMI.

Obesity rates are rising, and the gestational weight gain (GWG) of most women does not comply with current guidelines. This study assesses the association of pre-pregnancy BMI (ppBMI) and GWG with the child's weight development and investigates whether associations with GWG differ depending on ppBMI. Data were obtained from the cohort study LIFE Child (Germany), comprising 691 mother-child pairs. Children's weight was followed until age five. Associations between maternal ppBMI, GWG, and children's weight were evaluated using regression analyses. The association between GWG and birth weight (BW) was significantly positive in normal and underweight (n/u) women (βGWG = 0.05, p < 0.01, 95% confidence interval (CI) 0.03-0.07), but not in women with overweight or obesity (o/o) (βGWG = 0.0002, p = 0.99, 95% CI -0.03 to 0.03). The risk of giving birth to an infant who was large for gestational age (LGA) increased with rising GWG in n/u women (OR = 1.6, p < 0.01, 95% CI 1.23-2.25). Women with o/o were at increased risk for a LGA baby regardless of GWG (OR = 3, p < 0.01, 95% CI 1.34-6.97). This trend persisted in the child's weight development during the first 5years of life. Women with o/o might increase their offspring's risk for higher weight at birth and in early childhood. In n/u women, GWG might be the more influential factor. Women should strive for normal weight before conception and should be more attentive to GWG.

Parents' Experiences of Communication With School Nurses About Their Child's Weight Development in Sweden.

This study aimed to describe parents' experiences of communication with school nurses concerning the growth data and weight development of their children aged 8 and 10 years old in Sweden. Eighteen interviews with parents were conducted and analyzed through qualitative content analysis. The result showed a need for improved dialogue where the parents viewed the health visit's purpose as unclear and lacked feedback. The parents desired access to their child's growth data and described the need for an improved channel for receiving information. The parents moreover experienced the lack of a child-centered perspective, described the child's context as not in focus, and desired collaboration around their child. This study shows the need for the development of evidence-based methods for communicating growth data and weight development between School Health Service (SHS) and parents, as well as the need for a reformed SHS perspective towards parents and children.

COVID-19 pandemic-related weight gain in the pediatric population declined after restrictions ended, except among obese patients.

Childhood obesity has become an important topic, not only of increasing relevance during the COVID-19 pandemic but specifically enhanced by it. Restrictions implemented to mitigate further outbreaks led to major constraints on daily physical activity, leading to a severe increase in body weight among children. This study highlights changes in BMI and weight development in children during and (in particular) after the COVID-19 restrictions in Austria, focusing on various socioeconomic factors. Weight development throughout the pandemic and socioeconomic factors were evaluated by anonymous cross-sectional surveys filled out by parents at a pediatric practice. This study included 388 children. The rate of obesity increased by 88.5%, from 6.4 to 12.1%, throughout the pandemic, reaching a maximum of 15.2% during the restrictions. Overall, age-adapted BMI z-scores increased significantly by 0.22 during the restrictions and remained increased by 0.19 compared to pre-pandemic levels. With the exception of obese children, all children in the study population experienced significant weight loss after the restrictions were lifted. Obese children continued to gain weight without any sign of the onset of normalization. Socioeconomic factors, such as participation in regular activity in the form of organized sport or the availability of an outdoor area, were associated with relevant differences before the pandemic but had no protective effect against intra-pandemic weight gain. A higher level of parental education was the only factor associated with less weight gain in children during the early phase of the pandemic. Austrian COVID-19 restrictions have had concerning effects on pediatric BMI, with very little effect of socioeconomic background. After restrictions were loosened, measurable weight loss occurred, but the significant increase in children's BMI percentiles persisted. No weight loss was observed among children who were obese prior to the pandemic. There is a need for broad projects tackling childhood obesity, as obese children are the most vulnerable group with the strongest and most severe long-term effects.

The Effects of the Jump-In Whole-School Intervention on the Weight Development of Children in Amsterdam, the Netherlands.

This study assessed the effects of the "Jump-in" whole-school intervention in Amsterdam, the Netherlands, on children's weight development by comparing children exposed to the intervention and controls from 3 other large Dutch cities. Jump-in is a comprehensive intervention that aims to stimulate healthy nutrition and physical activity in children at primary schools in Amsterdam. In addition, the relationship between the intervention's implementation degree and its effectiveness was studied. Demographic and anthropometric data, collected by youth health care professionals via routine health checks at T0 (2014) and T1 (2019), were used to analyze possible intervention effects by comparing the weight development of children exposed to the Jump-in intervention versus unexposed controls. Implementation logs from health promotion professionals were used to determine intervention effects per implementation degree. Multilevel regression analyses were used for all analyses. In total, 4299 children were included mean age ± 5.5 years (T0), 10.6 years (T1), and ≈50% boys/girls at both times. Receiving the fully implemented intervention resulted in a decline in standardized body-mass index (zBMI) compared to the controls (-0.23, confidence interval [CI] -0.33, -0.13). It also led to higher odds to move into a healthier weight category over time (odds ratio [OR] 1.36, CI 1.06, 1.74), yet no statistically significant shift towards a healthy weight was found. Relative to the controls, children exposed to the intervention showed positive zBMI developments, with stronger effects when the implementation degree was higher. Despite positive results, creating more impact might require the further integration of school-based programs into whole-systems approaches that include other energy-balance behaviors.

Household food insecurity and obesity risk in preschool-aged children: A three-year prospective study

BackgroundHousehold food insecurity (FI) is a pressing social, economic and public health issue. However, little is known regarding the effect of FI exposure during the first few years of life, the most active postnatal time for neurobiological and physiological development, on patterns of weight gain during early childhood. It is also unknown whether dietary quality would serve as a pathway through which FI affects children's weight development. MethodThis was a secondary data analysis from a three-year randomized clinical trial with five hundred and thirty-four parent/child dyads. Household FI in the past year was reported by parents at baseline when children were 2–4 years of age using the USDA Household Food Security Survey Module-Six Item Short Form. Children's dietary quality at baseline was measured by the US Department of Agriculture Healthy Eating Index (HEI). Child body mass index (BMI) was measured following standardized protocols at baseline and 12-, 24-, and 36-month follow-up. A latent growth curve model was used to examine 1) the association between baseline FI and sex-and-age-adjusted BMI z-scores in children and 2) the HEI pathway between the FI- BMI association. ResultsFI early in life was associated with higher baseline BMI z-scores. Children who had higher BMI at baseline maintained their higher BMI status over the next three years. Children's dietary intake quality did not explain the association between baseline FI and BMI z-scores. ConclusionEarly exposure to FI was associated with higher BMI in children as early as two years of age, setting them up for an increased likelihood of persistently high BMI-for-age in later childhood. These data suggest that the first few years may be a critical time for developing obesity risk, calling for policy and practices designed for early intervention of food insecurity.

Weight development in children and adolescents with obesity during the COVID-19 pandemic

Weight development in children and adolescents with obesity during the COVID-19 pandemic

Characterization of the genetic architecture of infant and early childhood body mass index.

Early childhood obesity is a growing global concern; however, the role of common genetic variation on infant and child weight development is unclear. Here, we identify 46 loci associated with early childhood body mass index at specific ages, matching different child growth phases, and representing four major trajectory patterns. We perform genome-wide association studies across 12 time points from birth to 8 years in 28,681 children and their parents (27,088 mothers and 26,239 fathers) in the Norwegian Mother, Father and Child Cohort Study. Monogenic obesity genes are overrepresented near identified loci, and several complex association signals near LEPR, GLP1R, PCSK1 and KLF14 point towards a major influence for common variation affecting the leptin-melanocortin system in early life, providing a link to putative treatment strategies. We also demonstrate how different polygenic risk scores transition from birth to adult profiles through early child growth. In conclusion, our results offer a fine-grained characterization of a changing genetic landscape sustaining early childhood growth.

Sedentary activity bout length was associated with BMI and waist circumference in Swedish children aged 5-7years.

This study examined the pattern of sedentary behaviour during the week and on weekends and associations with health outcomes among children aged 5-7years in Sweden. This cross-sectional study used data from 342 children, many of whom had at least one parent born outside the Nordic region. Physical activity and sedentary time were measured by accelerometry. A sedentary bout was defined as 1-4 and 5-9min. Diet, time in front of television or computer screen, sleep and physical activity behaviour were measured via parental reports, and anthropometric data by research staff. The number of sedentary bouts was higher on weekends than on weekdays. Compared to girls, boys had more 1-4min bouts on both weekdays and weekend days, and more 5-9min bouts on weekends. A higher number of 5-9min bouts was associated with a higher body mass index and waist circumference. This study showed an association between sedentary activity and weight status in children as young as 5-7years. Reducing time, especially longer bouts, spent in sedentary activities may encourage healthy weight development in children.

Weight Development in Children After Gastric Bypass Surgery

Objective: More and more young obese women get pregnant after undergoing gastric bypass surgery (GBP) but little is known about weight development in their offspring. The first aim of this study was to investigate weight development of children whose mothers have undergone GBP before pregnancy and compare them to age specific reference values in Sweden. Second aim was to study the frequency of small for gestational age (SGA) in this population. Materials and methods: Weight of offspring (38 male and 28 female) where the mother had undergone GBP before pregnancy were studied from birth up to 18 months of age and compared to age-specific reference values in Sweden. Results: The boys to mothers who had undergone GBP before pregnancy weighed more than Swedish reference values at 6 months, 8.44 ± 1.18 kilogram (kg) (n = 35) vs. 7.98 ± 0.81 kg (n = 1388; p = 0.001), and less at 18 months, 11.54 ± 0.93 kg (n = 19) vs. 12.27 ± 1.19 kg (n = 862; p < 0.001). The girls to mothers who had undergone GBP before pregnancy weighed more than Swedish reference values at 6 months, 7.84 ± 1.00 kg (n = 28) vs. 7.50 ± 0.77 kg (n = 1375; p = 0.020). Frequency of SGA was 3.0%. Conclusion: No clear pattern was found concerning the short-term weight development of the children. However, studies with larger material and more follow up time must be performed.

Weight development between age 5 and 10 years and its associations with dietary patterns at age 5 in the ABCD cohort

BackgroundSocial inequalities in bodyweight start early in life and track into adulthood. Dietary patterns are an important determinant of weight development in children, towards both overweight and underweight. Therefore, we aimed to examine weight development between age 5 and 10 years by ethnicity, SES and thereafter by BMI category at age 5, to explore its association with dietary patterns at age 5.MethodsParticipants were 1765 children from the Amsterdam Born Children and their Development (ABCD) cohort that had valid data on BMI at age 5 and 10 and diet at age 5. Linear mixed model analysis was used to examine weight development between age 5 and 10 years and to assess if four previously identified dietary patterns at age 5 (snacking, full-fat, meat and healthy) were associated with weight development. Analyses were adjusted for relevant confounders, stratified by ethnicity and SES and thereafter stratified per BMI category at age 5.ResultsOverall, weight decreased in Dutch and high SES children and increased in non-Dutch and low/middle SES children. Across the range of bodyweight categories at age 5, we observed a conversion to normal weight, which was stronger in Dutch and high SES children but less pronounced in non-Dutch and low/middle SES children. Overall, the observed associations between weight development and dietary patterns were mixed with some unexpected findings: a healthy dietary pattern was positively associated with weight development in most groups, regardless of ethnicity and SES (e.g. Dutch B 0.084, 95% CI 0.038;0.130 and high SES B 0.096, 95% CI 0.047;0.143) whereas the full-fat pattern was negatively associated with weight development (e.g. Dutch B -0.069, 95% CI -0.114;-0.024 and high SES B -0.072, 95% CI -0.119;-0.026).ConclusionsWe observed differential weight development per ethnic and SES group. Our results indicate that each ethnic and SES group follows its own path of weight development. Associations between dietary patterns and weight development showed some unexpected findings; follow-up research is needed to understand the association between dietary patterns and weight development.

PEMBANGUNAN SISTEM INFORMASI POSYANDU DI KECAMATAN SINDANG KABUPATEN INDRAMAYU (Studi Kasus : Posyandu Mawar Desa Panyindangan Wetan)

Posyandu Mawar is a health service unit that is tasked with carrying out maternal and child health services (KIA) in the RW 02 Panyindangan Wetan Village, Sindang District, Indramayu Regency. At present, the data management process in Mawar Posyandu is still done manually by recording data into seven (7) register formats. This method is considered inefficient because it causes difficulties in the Posyandu Mawar data management process. To overcome these problems, the authors intend to develop a web-based posyandu information system using PHP as a programming language and MySQL as a database management system. Data collection is done by observation and interview. The system development method used is a structured method. The tools used in system analysis and design are Flow Of Diagrams (FOD), Data Flow Diagrams, Data Dictionaries, Entity Relationship Diagrams (ERD) so as to produce an integrated application. The results of this study are posyandu data processing applications that can help Posyandu Mawar in reporting service activities to infants and pregnant women. In subsequent developments, it is expected that the posyandu information system is equipped with KMS ribbon chart features to monitor the child's weight development.

Cool executive functioning predicts not only mean levels but also individual 3-year growth trajectories of zBMI in elementary-school children

Executive functions (EFs) may help children to regulate their food-intake in an “obesogenic” environment, where energy-dense food is easily available. There is mounting evidence that overweight is associated with diminished hot and cool EFs, and several longitudinal studies found evidence for a predictive effect of hot EFs on children’s bodyweight, but longitudinal research examining the effect of cool EF on weight development in children is still scarce. The current 3-year longitudinal study examined the effect of a latent cool EF factor, which was based on three behavioral EF tasks, on subsequent mean levels and 3-year growth trajectories of body-mass-index z-scores (zBMI). Data from a large sample of children, with zBMI ranging from normal weight to obesity (n = 1474, aged 6–11 years at T1, 52% girls) was analyzed using structural-equation modeling and linear latent growth-curve modeling. Cool EF at the first wave (T1) negatively predicted subsequent zBMI and zBMI development throughout the 3-year period in middle childhood such that children with better EF had a lower zBMI and less steep zBMI growth. These effects were not moderated by the children’s age or gender. In conclusion, as early as in middle childhood, cool EFs seem to support the self-regulation of food-intake and consequently may play a causal role in the multifactorial etiology of overweight.

Methylphenidate and Reduced Overweight in Children With ADHD

Objective: The objective of this study was to investigate odds ratios of overweight/obesity in children with ADHD and to compare the change in body mass index (BMI) after initiation of methylphenidate treatment in normal versus overweight/obese children. Method: This population-based study included 724 children (<18 years), of whom 197 were girls. Odds ratios for overweight and obesity were calculated, comparing the study group with a reference group from the same area. After initiation of methylphenidate treatment, changes in BMI were assessed for up to 3 years. Results: Children with ADHD had an odds ratio of 1.87 (95% confidence interval [CI]: [1.60, 2.19]) for overweight/obesity. A decrease in BMI standard deviation score was identified 1 to 3 years into treatment. The decrease was beneficially greater in overweight/obese as compared with normal weight children-mean (SD) −0.64 (0.80) versus −0.39 (0.68); p = .001-and greater in girls. Conclusion: Medication with methylphenidate may facilitate favorable weight development in children with ADHD and overweight/obesity.

Early Life Antibiotic Exposure and Weight Development in Children

To examine the timing, frequency, and type of antibiotic exposure during the first 10years of life in association with (over)weight across this period in a cohort of 979 children. Within the Child, Parents and Health: Lifestyle and Genetic Constitution Birth Cohort Study, antibiotic exposure record was obtained from general practitioners. Anthropometric outcomes (age- and sex-standardized body mass index, weight and height z-scores, and overweight) were measured repeatedly at 7 time points during the first 10years of life. Generalized estimating equations method was used for statistical analysis. After adjusting for confounding factors, children exposed to one course of antibiotics compared with none in the first 6months of life had increased weight- (adjusted generalized estimating equations estimates [adjβ] 0.24; 95% CI 0.03-0.44) and height (adjβ 0.23; 95% CI 0.0002-0.46) z-scores; exposure to ≥2 courses during the second year of life was associated with both increased weight (adjβ 0.34; 95% CI 0.07-0.60), and height z-scores (adjβ 0.29; 95% CI -0.003 to 0.59). Exposure later in life was not associated with anthropometric outcomes. Associations with weight z-scores were mainly driven by exposure to broad- (≥2 courses: adjβ 0.11; 95% CI 0.003-0.22) and narrow-spectrum β-lactams (1 course: adjβ 0.18; 95% CI 0.005-0.35) during the follow-up period. Specific antibiotic used was not associated with body mass index z-scores and overweight. Repeated exposure to antibiotics early in life, especially β-lactam agents, is associated with increased weight and height. If causality of obesity can be established in future studies, this further highlights the need for restrictive antibiotic use and avoidance of prescriptions when there is minimal clinical benefit.

Lifestyle intervention to prevent excessive maternal weight gain: mother and infant follow-up at 12 months postpartum.

BackgroundExcessive gestational weight gain (GWG) is associated with elevated weight retention in mothers and might be related to adiposity of their offspring. Little is known if lifestyle intervention during pregnancy has beneficial effects for mothers and children beyond gestation.MethodsA cluster-randomized controlled intervention trial was performed with 250 pregnant women in 8 gynaecological practices. Lifestyle intervention was carried out twice with individual counselling sessions on nutrition, physical activity and weight monitoring. Participants in the control group received routine prenatal care and an information leaflet. Follow-up data of women and their offspring were collected one year postpartum (pp) by phone call and/or via e-mail using a structured questionnaire. Maternal weight retention at 12 months pp and weight development of the children in their first year of life was compared between groups using linear regression. The association between energy and macronutrient intake during pregnancy with maternal weight retention and children weight development was also assessed.ResultsThe intervention resulted in a trend towards lower mean weight retention 12 months pp (0.2 vs. 0.8 kg), but was not statistically significant (p = 0.321). Among women receiving lifestyle counselling, only 8 % retained more than 5 kg weight while 17 % in the control group retained >5 kg (OR: 0.40 (95 % CI: 0.16, 0.97)). For the whole study cohort, an association between higher GWG and increased 12 month weight retention was found (0.4 kg weight retention per 1 kg increase in GWG, p < 0.001). Weight development of the infants did not differ between groups in the first months after birth. At the 10th–12th month weight measurement, infants born to mothers in the intervention group tended towards lower body weights. Both energy intake and macronutrient composition of the diet during pregnancy did not affect maternal weight retention and weight development of the infants.ConclusionsLifestyle counselling during pregnancy to avoid GWG had a rather modest effect on maternal pp weight retention and weight development of the infants. However, larger intervention studies and longer follow-up are required to be able to draw definite conclusions.Trial registrationGerman Clinical Trials Register DRKS00003801.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-015-0701-2) contains supplementary material, which is available to authorized users.

Executive function and weight status in children: A one-year longitudinal perspective

There is considerable evidence for an association between obesity and impaired executive function (EF) in adolescents and adults. However, little research has examined EF in overweight or obese children. Furthermore, data on EF in underweight individuals is lacking. In addition, there is no consensus on the directionality of the relationship between Body Mass Index (BMI) and EF, and longitudinal studies are rare. Thus, the present study examined whether children differ in their performance on a battery of EF tasks depending on their weight status (underweight, normal-weight, overweight), and investigated the longitudinal cross-lagged associations between EF and BMI. Hot EF (delay of gratification, affective decision-making), cool EF (attention shifting, inhibition, working memory [WM] updating), and BMI were assessed in 1,657 German elementary-school children at two time points, approximately one year apart. Overweight children exhibited slightly poorer attention shifting, WM updating, and affective decision-making abilities as compared to normal-weight children. Unexpectedly, they did not show any deficits in inhibition or delay of gratification. EF levels of underweight children did not differ significantly from those of normal-weight children. Furthermore, poor attention shifting and enhanced affective decision-making predicted a slightly higher BMI one year later, and a higher BMI also predicted poorer attention shifting and WM updating one year later. The latter association between BMI and subsequent EF scores, however, diminished when controlling for socioeconomic status. Results indicate that hot and cool EF plays a role in the weight development of children, and might be a promising factor to address in preventive interventions.

The intestinal microbiota composition and weight development in children: the KOALA Birth Cohort Study.

To investigate whether the intestinal microbiota composition in early infancy is associated with subsequent weight development in children. Analyses were conducted within the KOALA Birth Cohort Study (n = 2834). This cohort originates from two recruitments groups: pregnant women with a conventional lifestyle (no selection based on lifestyle) and pregnant women recruited through alternative channels (organic shops, anthroposophic clinicians/midwives, Steiner schools and relevant magazines). From 909 one-month-old infants, fecal samples were collected and analyzed by quantitative PCR targeting bifidobacteria, Bacteroides fragilis group, Clostridium difficile, Escherichia coli, Lactobacilli and total bacteria counts. Between the ages of 1 and 10 years, parent-reported weight and height was collected at 7 time points. Age- and gender-standardized body mass index (BMI) z-scores were calculated. Data were analyzed using generalized estimating equation. Colonization with B. fragilis group was borderline significantly associated with a higher BMI z-score of 0.15 (95% confidence interval (CI): -0.02 to 0.31), in the conventional subcohort. After stratification for fiber intake (P(forinteraction) = 0.003), colonization with B. fragilis group was associated with a 0.34 higher BMI z-score among children with a low-fiber intake in this subcohort (95% CI: 0.17-0.53). Higher counts among colonized children were positively associated with BMI z-score only in children within the conventional subcohort and a high-fiber diet (BMI z-score 0.08; 95% CI: 0.01-0.14), but inversely associated in children with a low-fiber diet (BMI z-score -0.05; 95% CI: -0.10 to 0.00), and in children recruited through alternative channels (BMI z-score -0.10; 95% CI: -0.17 to -0.03). The other bacteria were not associated with BMI z-scores, regardless of subcohort. Using a targeted approach, we conclude that the intestinal microbiota, particularly the B. fragilis group, is associated with childhood weight development. To identify the potential impact of additional bacterial taxa, further prospective studies applying an unconstrained in-depth characterization of the microbiota are needed.

Epidemiological investigation of physique situation for birth high-risk children aged 9-15 years in Chengdu, Southwest China

Background: As the intrauterine environment can effect children's growth and development, this study aimed to explore the relationship between birth high-risk and physique situation of 9 to 15-year-old children by cross-sectional investigation, and to provide clues for the monitoring, prevention, and treatment of growth deviation in children. Materials and Methods: This study recruited 7,194 students aged 9 to 15 years in primary and junior schools. Their parents were asked to complete the birth situation questionnaire. Measurements included height, weight, and body mass index (BMI). Birth high-risk infant was defined according to the gestational age and birth weight. Growth deviation was classified as underweight, short stature, overweight, and obesity. Results: The prevalence of all kinds of growth deviations in preterm, full-term, and post-term birth groups were similar, the same as the physique situation at school age among both sexes. The incidence of small for gestational age (SGA) was 6.23%, when at school age, part of SGA had catch-up growth. However, the prevalence of underweight and short stature for SGA was highest in three groups. The weight and height at school age in SGA group was less than that in appropriate for gestational age (AGA) and large for gestational age (LGA) groups. The prevalence of overweight and obesity for LGA and macrosomia were highest in three groups. At school age, the weight in macrosomia and LGA groups was higher than that in the other groups. Conclusions: Longitudinal height and weight development and growth of children with birth high-risk are different from normal children. In order to improve healthy situation, more attention should be paid to height and weight development of those children with birth high-risk at school age, even in pre-school age. Prevention may already begin during pregnancy.

Children and adolescents with type 1 diabetes in Germany are more overweight than healthy controls: results comparing DPV database and CrescNet database

To describe the development of weight in children and adolescents with type 1 diabetes in Germany. We analyzed the body mass index (BMI) of the most recent treatment year of each patient with diabetes in the Pediatric Quality Initiative (DPV) database. BMI SD score (SDS) was calculated based on pooled historical German normative data (AGA) and based on healthy children from the CrescNet database. Thus, 25,762 children and adolescents with diabetes were compared with more than 75,000 healthy controls. BMI-SDS was 0.49±0.88 and 0.26±0.79 when children and adolescents, respectively, with diabetes were compared with AGA reference or with CrescNet controls from the same year. In both analyses, female patients (0.57±0.89 and 0.30±0.79) had significantly higher BMI-SDS than male patients (0.41±0.86 and 0.22±0.78; p<0.0001). Analysis of different age groups showed highest BMI-SDS in patients below 6 years (0.61 and 0.56, respectively). After adjustment for metabolic control, center, and insulin treatment, BMI-SDS was significantly influenced by diabetes duration, age, and female gender. BMI of children and adolescents with type 1 diabetes is higher compared with healthy children measured in the same year. Especially, very young children and adolescent girls are at risk for overweight independent of annual trends.