Adolescent Weight Status Research Articles

Adiposity rebound may be a predictive index of body size for adolescents—Based on retrospective cohort data in a Japanese rural area

BackgroundWe aimed to examine whether the timing of adiposity rebound (AR) could be a predictive index of body size in Japanese adolescents. MethodsThe longitudinal individual data of 1438 Japanese children, including 714 boys and 724 girls born between 2001 and 2007, were obtained from child health check-ups conducted at ages 1.5, 2, 3, and 5 years, and then yearly after the age of 6 years. We examined whether the timing of AR could be used to estimate the body size at 14 years of age. ResultsThe AR had a normal distribution with a mean occurrence at age 6–7 years. The odds ratio of having obesity at age 14 were 8.32 for boys and 4.81 for girls, whereas boys and girls with later AR at the same age had a relative risk of thinness of 6.27 and 8.14, respectively. The probability that children with an early AR (i.e., <6 years old) would be obese was nearly 40%. Similar to obesity, the probability of thinness at 14 years remained approximately 8% for both sexes. ConclusionsThe findings suggest that early AR could raise the risk of obesity, and AR could later raise the risk of thinness. However, both probabilities of AR timing as predictors of adolescent weight status may only be about 10%–20%. This study cannot clearly determine whether the results were influenced by other factors after controlling for the timing of AR. Future studies that also consider lifestyle and genetic factors are warranted.

Degree of Accuracy of the BMI Z-Score to Determine Excess Fat Mass Using DXA in Children and Adolescents.

Obesity is caused by fat accumulation. BMI Z-score is used to classify the different degrees of weight status in children and adolescents. However, this parameter does not always express the true percentage of body fat. Our objective was to determine the degree of agreement between the fat mass percentage measured by DXA and the stratification of weight according to BMI Z-score in the pediatric age group. We designed a descriptive cross-sectional study. The patients were classified as underweight/normal weight with Z-scores between −2 and +0.99, overweight from 1 to 1.99, obese from 2 to 2.99, and very obese ≥3. We included 551 patients (47% girls), with a mean age of 11.5 ± 2.8 years (3.7–18 years). Higher BMI Z-scores were associated with a higher percentage of total fat (p < 0.001). However, there were important overlaps between both parameters, such that the BMI Z-score classified patients with the same percentage of total fat mass as having a different nutritional status classification. In conclusion, the stratification of weight status according to BMI Z-score revealed that 46.7% of patients had a fat percentage that did not correspond to their classification. For a more accurate weight assessment in clinical practice, we recommend combining anthropometric indices with diagnostic tools that better correlate with DXA, such as electrical bioimpedance.

Dairy intake and long-term body weight status in German children and adolescents: results from the DONALD study

PurposeTo analyse the association between intake of total dairy (TD) and types of dairy [liquid dairy (LD), solid dairy (SD), low-fat dairy (LFD), high-fat dairy (HFD), high sugar dairy (HSD), low-sugar dairy (LSD), not fermented dairy (NFD), as well as fermented dairy (FD)] and long-term changes in body weight status and composition among children and adolescents in Germany.MethodsIn total, 9999 3-day dietary records collected between 1985 and 2019 by 1126 participants (3.5–18.5 years; boys: 50.8%) of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study were analysed. Polynomial mixed-effects regression models were used to examine whether changes (median follow-up: 9 years) in the intake of TD and dairy types (in 100 g/1000 kcal total energy intake) were associated with changes in body-mass-index-standard-deviation-score (BMI-SDS); fat mass index (FMI); fat-free mass index (FFMI) over time.ResultsAn individual increase in TD intake was slightly but significantly associated with an increase in BMI-SDS (β = 0.0092; p = 0.0371), FMI (β = 0.022; p = 0.0162), and FFMI (β = 0.0156; p = 0.0417) after adjustment for potential confounder. Analyses for LD (BMI-SDS: β = 0.0139; p = 0.0052; FMI: β = 0.0258; p = 0.0125; FFMI: β = 0.0239; p = 0.0052) and LSD intake (BMI-SDS: β = 0.0132; p = 0.0041, FMI: β = 0.02; p = 0.0316, FFMI: β = 0.0183; p = 0.0189) showed similar results to TD. Both processing method and fat content showed no association with body composition in our analyses.ConclusionIncreases in TD, LD, and LSD intake showed small but significant increases in BMI and concomitant increases in fat mass and lean mass. However, the observed changes were too small to expect biological or physiological meaningful effects. Overall, our results showed that policies to promote dairy intake in childhood are to be welcomed, as no negative effects on body composition are expected, while the intake of important nutrients for growth is ensured. The type of dairy does not seem to matter.

Obesogenic Clusters Associated with Weight Status in Brazilian Adolescents of the Movimente School-Base Intervention.

Background: the relationship between behavior clusters and weight status, mainly in low- and middle-income countries, remains unclear. This study aimed to examine the association between profiles of physical activity (PA), diet and sedentary behavior (SB) with weight status in adolescents from a southern Brazilian city, according to sex. Methods: data from the Movimente Intervention study were analyzed (n = 812 / mean age 13.0 years (sd 1.04). Data on SB hours per day, PA minutes per week and weekly consumption frequencies of fruits, vegetables, salty snacks, candies and soda were self-reported on the validated Movimente questionnaire. Classes of healthy and unhealthy behaviors were derived by latent class analysis. Logistic regression analysis was used to estimate the associations between adolescents’ weight status and classes. Results: two classes were identified for the whole sample and for boys and girls. All classes had high probabilities of engaging high time in SB. Male adolescents in the unhealthy class had low probabilities of being active and high probability of consuming a low-quality diet. In contrast, girls’ healthiest profile presented lower probabilities of being active compared to boys’ healthiest profiles. No association was found between weight status and classes. Conclusion: All classes had at least one unhealthy behavior, for both the whole sample, and for girls and boys. Girls’ profiles were unhealthier compared to boys’ profiles. Hence, it is recommended that intervention strategies to change behaviors need to be distinct according to sex, targeting more than one obesogenic behavior at the same time.

Relationship between Weight Status and Health-Related Quality of Life in a Sample of Early Adolescents from Central and Northern Italy: A Cross-Sectional Study of the AVATAR Project Participants.

Among the various factors that could influence health-related quality of life (HRQoL) in adolescence, body mass index (BMI) seems to play a key role as a main anthropometric parameter. The aim of this cross-sectional study was to determine, in a sample of Italian adolescents, whether HRQoL is associated with the different weight status categories (underweight, normal weight, overweight, obese), according to BMI cut-off points for children, even considering sex differences. Data were collected from 1707 adolescents (n = 828 males) in seven schools. HRQoL was analyzed using the Italian version of KIDSCREEN-52. Males were more overweight and obese than females (13% vs. 10% and 4% vs. 2%, p < 0.05, respectively). In females, BMI categories are associated with physical well-being (p < 0.05), emotion/mood (p < 0.05), self-perception (p < 0.001), financial resources (p < 0.05), and bullying behavior (p < 0.05). In males, weight status is linked to physical well-being dimension (p < 0.001) and perception of self (p < 0.05). Our results may suggest that there is an association between weight status categories and HRQoL, more pronounced in females than in males. Interestingly, the weight status correlated more with the psychological dimension mainly in females, whereas in males, a stronger association between weight and physical status was observed, suggesting that given the complex, multifaceted, and dynamic nature of relationship between health-related quality of life and weight status in adolescents, multiple factors must be considered.

Is store density associated with sugar-sweetened beverages consumption and overweight or obesity in Mexican adolescents?

The consumption of sugar-sweetened beverages (SSBs) is a risk factor for obesity. In Mexico, SSBs are widely available and consumed daily by adolescents. The purpose of this study was to estimate the indirect association between store density (including grocery, convenience, non-alcoholic beverage stores and supermarkets) and overweight or obesity (OW/O) among Mexican adolescents, using SSB consumption as a mediator. We used cross-sectional data on adolescent SSB consumption, weight status (body mass index for age [BMI for age]), physical activity, screen time and sociodemographic factors from the 2016 Mexican Midway National Health and Nutrition Survey (ENSANUT MC 2016). The National Statistical Directory of Economic Units provided information on stores selling SSBs. We estimated structural equations models to test associations between store density and OW/O, using SSB consumption as a mediator. We found a direct positive association between store density and SSB intake in adolescents (β =1.229), including density of supermarkets (β=132.07), grocery stores (β=1.170) and non-alcoholic beverage stores (β=1.537). No significant association was observed for convenience stores. Direct association between store density and OW/O was strongest for supermarket density (β=0.426). In addition, SSB intake was significantly associated with OW/O (p=0.033). No significant indirect association between density of any store and OW/O was found. Store density was directly associated with SSB consumption but not indirectly associated with OW/O mediated by SSB. Further research on food environment is required in order to design evidence-based strategies aimed at reducing SSB intake and OW/O in adolescents.

Independent associations of sleep timing, duration and quality with adiposity and weight status in a national sample of adolescents: The UK Millennium Cohort Study.

Short sleep appears to elevate obesity risk in youth; however, sleep is a multidimensional construct, and few studies have investigated parameters beyond duration. The objective of this study was to investigate if sleep onset time, duration, latency and night waking frequency are independently associated with adiposity and weight status in UK adolescents. This was a cross-sectional observational study of 10,619, 13-15years olds. Adjusted linear and logistic regressions were used to investigate associations of self-reported sleep characteristics with adiposity markers (body mass index z-score and percent body fat) and weight status. Compared with a sleep onset before 10pm, later sleep timing was associated with higher adiposity and higher likelihood of overweight and obesity in boys (after midnight, odds ratio [95% confidence interval]: 1.76 [1.19-2.60]) and girls (between 11pm and 11:59pm: 1.36 [1.17-1.65]). Sleeping ≤ 8hr, compared with > 9-10hr, was associated with higher odds of overweight and obesity in both sexes (boys: 1.80 [1.38-2.35]; girls: 1.38 [1.06-1.79]), and so too was sleeping > 10hr in girls (1.31 [1.06-1.62]), indicating evidence for a U-shaped association. Also in girls, compared to a sleep latency of 16-30 min, sleep latencies ≥ 46min were associated with higher adiposity (46-60min, beta coefficient [95% confidence interval], percent body fat: 1.47 [0.57-2.36]) and higher likelihood of overweight and obesity (46-60min: 1.39 [1.05-1.83]), and often as opposed to never waking in the night was associated with higher adiposity (body mass index z-score: 0.24 [0.08-0.41]; percent body fat: 1.44 [0.44-2.44]). Sleep duration and timing in both sexes, and sleep quality in girls, appear to be independently associated with adiposity and weight status in adolescence, and may be important targets for obesity prevention.

Important gender differences in psychosomatic and school-related complaints in relation to adolescent weight status

Underweight or overweight in adolescence is linked to several adverse health outcomes. Less evidence exists about the association between weight status and school-related psychosocial characteristics in high income countries. We sought to investigate the relationship between weight status and psychosomatic and school-related complaints with a focus on gender differences. The study is a cohort of 18,462 adolescents (12–19 years; 51% girls) conducted in Sweden. The associations between weight status and psychosomatic and school-related complaints were estimated by binary logistic regression adjusted for several potential confounders. After correction for multiple testing, being underweight or overweight/obese was adversely associated with several psychosomatic and school-related complaints with significant differences between boys and girls. Specifically, underweight boys had higher odds to have psychosomatic complaints than normal-weight boys, while no such associations were observed among underweight girls. Overweight/obese (vs. normal-weight) boys had higher odds to complain about headache, pain in the back/hips, and feeling low. Overweight/obese (vs. normal-weight) girls were more likely to complain about feeling low, anxious/worried and having difficulty in falling asleep (P ≤ 0.01). In relation to school-related complaints (e.g., being bullied at school and academic failure), greater associations were observed for overweight/obese girls and boys than for underweight adolescents compared with normal-weight peers.

Weight Status and Body Composition Dynamics in Children and Adolescents During the COVID-19 Pandemic.

Introduction: The preventive measures taken in attempt to prevent COVID-19 spread lead to closure of schools and leisure time activities. The impact of the pandemic on pediatric weight status is unclear, reports from around the world predict grave consequences with increasing obesity. We aimed to examine the change in body composition parameters of children and adolescents during the pandemic.Materials and Methods: An observational study of 220 pediatric subjects (109 boys; mean current age 11.8 ± 3.3 years; 37 with underweight, 123 with normal weight, and 60 with overweight/obesity) who underwent height and body composition measurements by bioelectrical impedance analysis, Tanita MC-780MA, GMON Professional Software before and during the pandemic. Height, body mass index (BMI) and muscle-to-fat ratio (MFR) z-scores were calculated. Data collected from the participants' medical files included home address for socioeconomic position calculation, pubertal stage, and self-reported sleep duration and physical activity performance.Results: The vast majority of the cohort (81.8%) had stable or improved MFR z-scores during the pandemic. MFR z-scores significantly increased in subjects with underweight (p = 0.05) and normal weight (p = 0.008), but not in subjects with overweight/obesity (p = 0.169). There were significant associations in BMI z-scores (r = 0.961, p < 0.001) and MFR z-scores (r = 0.854, p < 0.001) before and during the pandemic. A multivariate linear regression model identified socioeconomic position, pre-pandemic BMI z-scores, pre-pandemic MFR z-scores, and physical activity levels during the pandemic as predictors for delta MFR z-scores (F = 12.267, p < 0.001). Age, sex, pre-pandemic physical activity, and the time that had elapsed between initiation of the first nationwide lockdown and the BIA assessment during the pandemic did not emerge as predictors for delta MFR z-score.Conclusions: Our encouraging findings demonstrate improvement in body composition parameters of subjects with underweight and normal weight and stability in subjects with overweight/obesity. Engagement in physical activity during the pandemic predicted improvement, while lower socioeconomic position predicted deterioration.

P71 Barriers to Attendance in a Father-focused Adolescent Obesity Prevention Program: Padres Preparados, Jóvenes Saludables

<h3>Background</h3> Latino family-centered, community-based intervention studies to prevent childhood obesity have primarily involved mothers; therefore, little information about father participation is available. A Latino father-focused program to prevent adolescent obesity was conducted with low participation from some fathers. <h3>Objective</h3> The study aim was to determine factors associated with fathers' attendance in an adolescent obesity prevention program. <h3>Study Design, Settings, Participants</h3> Data were from 147 fathers participating in the Padres Preparados, Jóvenes Saludables program, a randomized controlled trial to prevent Latino adolescent (10-14 years) obesity. Eight weekly (2-hour) sessions were conducted in the Minneapolis/St. Paul metropolitan area (2017-2020). Participants were randomly assigned to intervention or waitlist control groups after baseline data collection. <h3>Measurable Outcome/Analysis</h3> The program facilitator recorded father presence or absence at each session. Attendance data were used in cluster analysis to identify attendance patterns. Predictor variables were measured at baseline with surveys and via anthropometric measures, including demographics, socioeconomic status, adolescent weight status, adolescent weight concerns, food-related activities with adolescents, family meal frequency, food assistance program participation, family stress, number of children, neighborhood safety, assigned group, site, and session season. Multinomial logistic regression analyses were used to examine associations between attendance patterns and predictor variables after assessing appropriateness for inclusion in regression models. <h3>Results</h3> Three attendance patterns were identified for all fathers: consistently high attendance (52%), declining attendance (18%), and non-attendance (30%). Compared to fathers with a consistently high attendance pattern, fathers with a non-attendance pattern were more likely to be assigned to the waitlisted control group (OR: 7.9 [95% CI: 2.6-23.9]; <i>P</i> < 0.01) and have lower household income (OR: 2.8 [95% CI: 1.0-7.8]; <i>P</i> = 0.04). No predictors were associated with declining attendance compared to consistently high attendance. <h3>Conclusion</h3> Maintaining contact with control families during waiting periods and providing online sessions to increase flexibility for low-income families could address Latino father non-attendance.

Associations of Health-Related Conversations and Mealtime Media Device Use Among Parent-Adolescent Dyads

Abstract Objectives To determine how health-related conversations between parents and their adolescent children is associated with mealtime media device use by adolescents. Methods A sample of primarily Hispanic parents (n = 347; 43 ± 6.5 years; 89.3% female) of 6th, 7th or 8th grade adolescents enrolled in a parenting intervention focusing on the promotion of healthy nutrition and substance use prevention. Parents completed baseline surveys to self-report the frequency with which they had health-related conversations with their adolescent child (healthy eating, being physically active, adolescent's weight, adolescent weighing too much, eating differently to lose weight, exercising to lose weight), and the frequency with which the adolescent used media devices during mealtimes (television and movie watching, cellphone use or texting, handheld gaming devices, listening to music with headphones). Spearman's rank correlations were used to assess the associations between health-related communication and mealtime media device use. Results Reported conversations about healthy eating, being physically active, and general weight of the adolescent were not associated with reported use of media devices by adolescents during mealtimes. Having conversations related to the adolescent weighing too much was positively and significantly correlated with television/movie watching (r = 0.219; P &amp;lt; 0.0001), talking on a cellphone (r = 0.130; P &amp;lt; 0.05), using gaming devices (r = 0.140; P &amp;lt; 0.05), and listening to music with headphones (r = 0.136; P &amp;lt; 0.05). Having conversations about exercising to lose weight was also significantly correlated with television/movie watching during mealtimes (r = 0.137; P &amp;lt; 0.05). Conclusions Findings suggest that higher frequency of weight-related conversation is associated with higher usage of media devices during mealtimes. Whether parenting practices, parental concerns about their children's weight, and the home mealtime environment play a role on adolescent weight status in Hispanic households warrants further investigation. Funding Sources National Institute on Minority Health and Health Disparities and Health Resources and Services Administration of the U.S. Department of Health and Human Services as part of a Maternal Child Health Bureau Nutrition Training Grant.

An examination of the association between risk of depression and academic performance according to weight status in adolescents: DADOS study

BackgroundThe early identification of emotional and psychological problems during adolescence seems helpful to improve academic performance (AP). However, the association between risk of depression and AP, as well as the role of health-related factors in this association remain to be elucidated. Therefore, the aims of this study were to analyze the association between risk of depression and AP in adolescents; to examine this association according to weight status; and to test the mediating role of weight status in this association. MethodsA sample of 265 adolescents (125 girls) aged 13.9 ± 0.3 years old from the DADOS (Deporte, ADOlescencia y Salud) study was included in the analyses. Risk of depression was self-reported through the Behavior Assessment System for Children and Adolescents. AP was assessed through academic grades and the Spanish version of the Science Research Associates Test of Educational Ability. Weight status was assessed by body mass index (BMI) (kg/m2) and dichotomized according to the international age- and sex-specific BMI cut-offs (non-overweight vs. overweight). ResultsLinear regression analyses showed an inverse association between risk of depression and academic grades (all p<0.05). Further linear regressions analyzing risk of depression and AP (dependent variable) stratified by weight status showed stronger associations among overweight adolescents. Additionally, mediation analyses revealed that weight status acted as a mediator of this association. LimitationsThe cross-sectional design prevents from interfering causal relationships. ConclusionsEducational institutions should promote the early identification of depression as well as the promotion of healthy weight status as strategies to enhance AP in adolescents.

Can adolescents with eating disorders be treated in primary care? A retrospective clinical cohort study

BackgroundFamily-Based Treatment (FBT) is considered the first-line intervention for adolescent anorexia nervosa. However, access to this treatment is limited. Treatment programs for other pediatric mental health conditions have successfully overcome barriers to accessing evidence-based intervention by integrating mental health services into primary care. This study evaluated the proof-of-concept of a novel modification of FBT, Family-Based Treatment for Primary Care (FBT-PC) for adolescent restrictive eating disorders designed for delivery by primary care providers in their practices.MethodsThis retrospective clinical cohort study evaluated 15 adolescents with restrictive eating disorders receiving FBT-PC and 15 adolescents receiving standard FBT. We examined improvement in BMI percentile, reduction in weight suppression, and clinical benchmarks of eating disorder recovery including weight restoration to > 95% of expected body weight (EBW) and resolution of DSM-5 criteria for eating disorders.ResultsIn both groups, effect sizes for increased BMI percentile exceeded Cohen’s convention for a large effect (FBT-PC: d = .94; standard FBT: d = 1.15) as did effect sizes for reduction in weight suppression (FBT-PC: d = 1.83; standard FBT: d = 1.21). At the end of treatment, 80% of the FBT-PC cohort and 87% in the standard FBT group achieved > 95%EBW and 67% in the FBT-PC group and 60% in the standard FBT group no longer met DSM-5 criteria for an eating disorder. There were no cohort differences in the number of treatment drop-outs or referrals to a more intensive level of eating disorder treatment.ConclusionsFindings suggest that primary care providers have potential to improve weight and clinical status in adolescents with restrictive eating disorders. Based on these results, more rigorous testing of the FBT-PC model is warranted.

Low Muscular Strength, Weight Status, and Metabolic Syndrome in Adolescents: National Health and Nutrition Examination Survey 2011-2014.

To investigate the association between muscular strength and metabolic syndrome (MetS), with a specific focus on the role of weight status, using a nationally representative sample of US youth. The analysis included 409 boys and 415 girls from the 2011 to 2014 National Health and Nutrition Examination Survey between 12 and 18years of age. The prevalence of MetS was defined using age- and sex-specific criteria for abdominal obesity, elevated triglycerides, blood pressure, fasting glucose, and low high-density lipoprotein (HDL) cholesterol. Strength was assessed via handgrip dynamometer and expressed as age- and sex-specific z scores of relative strength. Low strength was defined as a relative strength below the 25th percentile. Analyses controlled for age, sex, race/ethnicity, physical activity, and weight status. The sample prevalence of MetS was approximately 5.3%. However, MetS prevalence was 18.5% in overweight/obese youth with low strength. The adjusted odds of MetS were 3.1 (95% confidence interval, 1.5-6.3, P < .001) times higher for overweight/obese youth with low strength versus sufficient strength. Muscular strength is predictive of adolescent MetS, specifically in those with unhealthy weight status. Approximately one in 5 overweight/obese youth with low strength had MetS. These findings highlight the relevance of muscular strength in youth cardiometabolic morbidities.

Emotional Eating and Weight Status in Adolescents: A Systematic Review.

Background: Despite evidence that emotional eating is associated with weight gain in adults, less is known about this association in adolescents. The purpose of the current study was to conduct a systematic review to assess the association between emotional eating and weight status in adolescents. This study also sought to describe existing measures of emotional eating in adolescents and explore weight-loss interventions that assessed emotional eating in relation to weight status in this population. Methods: Two independent reviewers searched the database PubMed for published or in press peer-reviewed studies that assessed the association between emotional eating and weight status in adolescents aged 12 to 19 years. Studies were excluded from this review if they were not written in the English language, did not include a measure of emotional eating, or were a dissertation study. Results: A total of 13 studies met full inclusion criteria and were included in the systematic review. Of the six longitudinal studies in the review, only one found a prospective association between emotional eating and weight status. The Dutch Eating Behavior Questionnaire was the most widely used measure of emotional eating in the systematic review (n = 6; 46.2%). The one intervention study included in this review found that baseline emotional eating was not associated with weight outcomes 2 years following gastric bypass surgery in obese Swedish adolescents (13–18 years). Conclusions: While there were some inconsistent findings across the studies included in this review, taken as a whole, the results largely do not support an association between emotional eating and elevated weight status or reduced weight loss in adolescents.

Relative contributions of health behaviours versus social factors on perceived and objective weight status in Canadian adolescents.

Public health interventions for adolescent "obesity prevention" have focused predominantly on individualistic health behaviours (e.g., diet and physical activity) at the expense of recognizing body weight diversity and the array of social factors (e.g., stigma and discrimination of marginalized identities) that may be linked to weight status. Research is needed to examine the extent to which individualistic health behaviours versus social factors contribute to weight status in adolescents. As such, the aim of this study was to investigate the relative contribution of individualistic health behaviours versus social factors to objective and perceptual indices of weight status. Cross-sectional survey data were collected as part of the Toronto Public Health Student Survey and comprised students 12 to 19years of age (N = 5515). Measures included perceived and objective weight status, social and demographic factors (e.g., gender, sexual orientation, school connectedness), and health behaviours (e.g., physical activity, nutritious consumption). Findings from latent variable regression models partially supported hypotheses, whereby social factors (i.e., age, sex, socio-economic access, sexual minority status) contribute similar amounts of variance, or relatively more variance in weight indices, compared to health behaviours (e.g., physical activity, nutritious consumption). Contrary to traditional views of adolescent weight status, physical activity (i.e., school-based, individual, active transport) and nutritious consumption (i.e., fruits, vegetables, milk) were not associated with weight status, when considering social factors. These findings challenge the utility of public health approaches that target individualistic behaviours as critical risk factors in "obesity prevention" efforts in adolescence.

Longitudinal associations of modifiable risk factors in the first 1000 days with weight status and metabolic risk in early adolescence

Many studies have identified early-life risk factors for childhood overweight/obesity (OwOb), but few have evaluated how they combine to influence later cardiometabolic health. We aimed to examine the association of risk factors in the first 1000 d with adiposity and cardiometabolic risk in early adolescence. We studied 1038 mother-child pairs in Project Viva. We chose 6 modifiable early-life risk factors previously associated with child adiposity or metabolic health in the cohort: smoking during pregnancy (yes compared with no); gestational weight gain (excessive compared with nonexcessive); sugar-sweetened beverage consumption during pregnancy (≥0.5 compared with <0.5 servings/d); breastfeeding duration (<12 compared with ≥12 mo); timing of complementary food introduction (<4 compared with ≥4 mo); and infant sleep duration (<12 compared with ≥12 h/d). We computed risk factor scores by calculating the cumulative number of risk factors for each child. In early adolescence (median: 13.1 y) we measured indicators of adiposity [BMI, fat mass index (FMI), trunk fat mass index (TFMI)]. We also calculated OwOb prevalence and metabolic syndrome (MetS) risk z score of adolescents. Among 1038 adolescents, 71% had >1 early-life risk factor. In covariate-adjusted models, we observed positive monotonic increases in BMI, FMI, TFMI, and MetS z scores with increasing risk factor score. Children with 5‒6 risk factors (compared with 0-1 risk factors) had the highest risk of OwOb [risk ratio (RR): 2.53; 95% CI: 1.63, 3.91] and being in the highest MetS quartile (RR: 2.46; 95% CI: 1.43, 4.21). The predicted probability of OwOb in adolescence varied from 9.4% (favorable levels for all factors) to 63.6% (adverse levels for all factors), and for being in the highest MetS quartile from 9.6% to 56.6%. Early-life risk factors in the first 1000 d cumulatively predicted higher adiposity and cardiometabolic risk in early adolescence. Intervention strategies to prevent later obesity and cardiometabolic risk may be more effective if they concurrently target multiple modifiable factors.

Emotional Eating in Adolescence: Effects of Emotion Regulation, Weight Status and Negative Body Image.

Emotional eating is associated with an increased risk of binge eating, eating in the absence of hunger and obesity risk. While previous studies with children and adolescents suggest that emotion regulation may be a key predictor of this dysregulated eating behavior, little is known about what other factors may be influencing the link between emotional regulation and emotional eating in adolescence. This multi-method longitudinal study (n = 138) utilized linear regression models to examine associations between childhood emotion regulation, adolescent weight status and negative body image, and emotional eating at age 17. Emotion regulation predicted adolescent emotional eating and this link was moderated by weight status (β = 1.19, p < 0.01) and negative body image (β = −0.34, p < 0.01). Higher engagement in emotional eating was predicted by lower emotional regulation scores among normal-weight teens (β = −0.46, p < 0.001) but not among overweight/obese teens (β = 0.32, p > 0.10). Higher scores on emotion regulation were significantly associated with lower emotional eating at high (β = −1.59, p < 0.001) and low (β = −1.00, p < 0.01) levels of negative body image. Engagement in emotional eating was predicted by higher negative body image among overweight/obese teens only (β = 0.70, p < 0.001). Our findings show that while better childhood emotion regulation skills are associated with lower emotional eating, weight status and negative body image influence this link and should be considered as important foci in future interventions that aim to reduce emotional eating in adolescence.

Levels of Physical Fitness and Weight Status in Children and Adolescents: A Comparison between China and Japan.

This study compared the physical fitness level and weight status of children and adolescents in China and Japan. Children and adolescents aged 7–18 years were recruited (China: n = 5660; Japan: n = 5660). Physical fitness was assessed using seven core items—grip strength, 30-s sit-ups, standing long jump, sit-and-reach, 20-s repeated straddling, 20-m shuttle run test, and 50-m dash. A physical fitness index (PFI) was calculated by adding all items’ Z-scores. We conducted comparisons of PFI and its distribution, each physical fitness item, and weight status for individuals from China and Japan across all ages. The PFI was lower in China than in Japan for all age groups, with an especially large difference at age 18 years for boys (a difference of 9.05) and girls (a difference of 9.10) (p < 0.001). The same result was seen for the seven items. The PFI distribution for children and adolescents was more disperse among those in Japan than among those in China. Obesity prevalence was 2.84 times higher in China than in Japan. An inverted U-shaped relationship was observed between physical fitness and nutritional status. Children and adolescents showed markedly lower physical fitness and higher obesity prevalence in China than in Japan.

Lifetime antimicrobial use is associated with weight status in early adolescence-A register-based cohort study.

SummaryBackgroundAntimicrobial agents (AMs) are the most prescribed drugs to children. Early and repeated exposure to AMs in infancy is associated with increased risk of childhood overweight and obesity.AimsWe extended the investigation of AMs use, from birth to early adolescence, and evaluated their association with weight status.Materials & MethodsA total of 10093 children from Finnish Health in Teens cohort (Fin‐HIT) with register‐based data on AMs purchases and measured weight status at the mean age of 11.2 y (SD 0.82) were included in the study. The key exposures were the number AM purchases at a given age or the sum of these during the entire follow‐up time to describe lifetime exposure / use. Outcome was weight status in early adolescence defined with International Obesity Task Force cut‐offs for the age‐ and sex‐specific body mass index. Odds Ratio (OR) and 95% confidence intervals (CI) were estimated using Multinomial Logistic Regression.ResultsOf children, 73.7% were normal weight, 11.1% thin and 15.2% overweight/obese. AMs use was highest during the second year of life, when 65% of all children used AMs, but thereafter decreased with age. The highest mean purchases and prevalence at any given age along with the highest lifetime use were consistently seen among overweight children. Each episode of AMs use throughout life increased the risk of being overweight in adolescence [OR = 1.02 (1.02–1.03)]. However, there was an inverse association between AMs use and thinness [OR = 0.98 (0.97–0.99)].DiscussionDespite a high prevalence of AMs use during the early years, lifetime‐use was associated with weight status in early adolescence in a dose response manner.ConclusionFuture studies should address mechanisms underlying the relationship between AM use and weight.