Pediatric Obesity最新文献

Objective: This study examined cross-level interaction between parental education and neighbourhood SES in predicting overweight including obesity among school-aged children.

Methods: This analysis used data from 19 984 children aged 5-6 years participating in the school-entry examination of the years 2015 to 2019 in the Aachen city region in Germany. We employed multilevel logistic regression models to predict overweight based on parental education and neighbourhood SES, along with their cross-level interaction, while controlling for several characteristics of the child.

Results: Children from families with intermediate (OR: 1.99; 95% CI, 1.65-2.40) and low parental education (OR: 2.55; 95% CI, 1.92-3.39) and from neighbourhoods with intermediate (OR: 1.25; 95% CI, 1.02-1.53) and low SES (OR: 1.61; 95% CI, 1.29-2.02) were at significantly higher odds for overweight. There was an indication of a cross-level interaction effect (p-value <0.10) to the disadvantage of children with higher parental education, suggesting that inequalities in overweight decrease in more deprived neighbourhoods. The predicted probability of overweight for children with high parental education increased from 6.4% in high SES neighbourhoods to 7.8% in intermediate and 9.9% in low SES neighbourhoods. Sensitivity analyses for obesity and a higher context level of spatial SES confirmed the results.

Conclusions: The results highlight the crucial role of both individual and contextual socioeconomic conditions in predicting childhood overweight. They also suggest that the impact of neighbourhood socioeconomic status on childhood overweight varies by parental education, particularly disadvantaging children with higher parental education, indicating a social contagion of overweight through spatial disadvantage.

Background: Breastfeeding is a protective measure against childhood overweight and obesity. However, many children are not breastfed the recommended duration, with those from disadvantaged backgrounds more likely to cease breastfeeding early.

Objectives: Investigate the association between duration of any breastfeeding and body mass index (BMI) and estimate the health, economic and equity impacts of increasing breastfeeding duration to at least 6 months.

Methods: We modelled the association between any breastfeeding duration and BMI at age 6/7 years, using a nationally representative cohort of 3935 Australian children (survey weighted to 221 103 children). We then used a simulation model to predict the impact of increasing breastfeeding duration to at least 6 months in all children on prevalence of overweight (including obesity) and associated healthcare costs to age 16/17 years.

Results: Achieving breastfeeding duration of at least 6 months could prevent 2933 cases of overweight at age 16/17 years, translating to healthcare cost-savings of AUD $4.29 million. Although most cases (68%) would come from low socio-economic backgrounds this would make only a minor difference in reducing inequalities.

Conclusion: Efforts to support increased breastfeeding duration could result in reduced prevalence of overweight and obesity and save healthcare costs, however, additional action would be required to improve equity.

Background: Weight-related conversations are common between adolescents and parents. However, there is limited understanding of how these conversations vary across sociodemographic groups, such as sex, sexual orientation, race/ethnicity, or parents' level of education. This study assessed the prevalence of weight-related communication among adolescents and parents across sociodemographic characteristics, and identified adolescents' preferred sources for these discussions.

Methods: Quantitative data were collected through online surveys from two independent U.S.

Samples: adolescents aged 10-17 years of age (N = 2032), and parents of children aged 10-17 years of age (N = 1936). Frequency and sources of weight-related communication were assessed. Sociodemographic factors were analysed for their associations with these communication patterns.

Results: While few differences emerged based on race/ethnicity or grade level, significant variation was observed for sex, sexual orientation, and parental education. Girls, sexual minority youth, high school students, and those with college-educated parents were more likely to communicate about their own weight, whereas boys were more likely to comment on others' weight. Most adolescents preferred healthcare professionals (71%) and parents (69%) for these conversations, although sexual minority youth preferred mental health professionals considerably more than parents. Among parents, 77% discussed their child's weight, with fathers and Latinx parents engaging more frequently in these conversations, and Black parents engaging least frequently.

Conclusion: Weight-related communication is prevalent among adolescents and parents, with variation across sociodemographic characteristics. As healthcare professionals and parents were identified as the preferred sources for weight-related communication by adolescents across sociodemographic groups, it is important that paediatricians and parents are equipped to engage in these conversations without imparting stigma.

Objective: This study aimed to examine associations between prenatal neighbourhood socioeconomic deprivation (NSD) with early offspring weight status and to assess potential modification by race and ethnicity.

Methods: We used data from the Newborn Epigenetics STudy (NEST) cohort. Gestational NSD was assessed as neighbourhood deprivation index (NDI) tertiles. Offspring height and weight were assessed at 6 months (N = 1023), 1 year (N = 1268), 2 years (N = 1033) and 3 years (N = 1038). Multilevel logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for the relationship of NDI with overweight or obesity and rapid infant weight gain, adjusting for gestational parent age, race/ethnicity, marital status and educational attainment. Models were estimated in the total sample and also stratified by race and ethnicity.

Results: Children exposed to NDI in the highest (compared to the lowest) tertile had increased odds of having overweight/obesity at 1 year (OR = 1.53, 95%CI = 1.09-2.15). In stratified models, children of NH Black gestational parents residing in the highest tertile of NDI (compared to the lowest) had increased odds of having overweight/obesity at 1 year (OR = 1.67, 95%CI = 1.00-2.77).

Conclusions: This findings suggest that higher gestational exposure to NSD may play a role in early childhood weight status, which has important implications for later development and health.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly common in the pediatric population and may increase risk for developing cardiovascular disease (CVD) in people with MASLD. Oxidized high-density lipoprotein (oxHDL) and oxidized low-density lipoprotein (oxLDL) are modified, pro-atherosclerotic lipoproteins that are increased in adults with MASLD and CVD but have not been reported in adolescents with MASLD.

Purpose: To determine if oxLDL and oxHDL are increased in adolescents with MASLD.

Methods: Fasting oxHDL and oxLDL were measured in adolescents (11-20 years) with obesity and biopsy-confirmed MASLD (n = 47), and peers without MASLD but with obesity (Ob; n = 28), or normal weight (NW; n = 29).

Results: oxHDL was 27% higher (p < 0.05) in the MASLD group (mean ± SD: 11.9 ± 4.7 ng/mL) compared to the Ob group (9.3 ± 3.7 ng/mL, p < 0.05) but only 7% higher than the NW group (11.1 ± 3.8 ng/mL, p > 0.05). However, HDL-C was 19% and 32% lower in the MASLD group than in the Ob and NW groups, respectively. Thus, oxHDL/HDL-C ratio was 55% and 66% higher in MASLD compared to the Ob group (p < 0.004) and the NW group (p < 0.001), respectively. oxLDL (52.4 ± 16.0, 46.7 ± 10.1 and 47.1 ± 15.2 U/L for MASLD, Ob and NW, respectively), LDL-C and the oxLDL/LDL-C ratio did not differ among groups.

Conclusions: The elevated oxHDL and oxHDL/HDL-C in adolescents with MASLD compared to peers with Ob or NW suggests that there is some oxidative stress in MASLD independent of obesity and potential for increased CVD risk in the future.

Background: During the coronavirus disease 2019 (COVID-19) pandemic, the Australian state of Victoria (in particular, its capital, Melbourne) experienced some of the longest lockdowns in the world.

Objective: This repeated cross-sectional study examined changes between March to June 2019 (pre-pandemic) and April to August 2022 (6 to 11 months following pandemic-related lockdowns) in overweight and obesity prevalence, physical activity, sedentary behaviour, sleep, diet quality, and health-related quality of life (HRQoL) among primary school children in north-east Victoria, Australia.

Methods: Height and weight were measured for Grade 2, 4, and 6 students in 2019 (3889 children) and 2022 (1816 children). Grade 4 and 6 students self-reported on their movement behaviours, diet quality, and HRQoL.

Results: Participation declined among schools (2019:56%, 2022:34%) and students (2019:87%, 2022:75%). Compared to children in 2019, children in 2022 had a higher prevalence of overweight and obesity; were less likely to have met guidelines for moderate-to-vigorous physical activity, recreational screen time, and vegetable consumption; had higher intakes of takeaway food, energy-dense nutrient-poor snacks, and sugar-sweetened beverages; and had lower HRQoL.

Conclusion: Children's health-related behaviours and outcomes seemed not to have returned to pre-pandemic levels 6 to 11 months after the final lockdowns lifted for their communities. Continued monitoring and interventions targeting the drivers of childhood obesity are urgently needed.

Background: Studies on how birth body mass index (BMI) affects health outcomes in preterm infants are relatively limited.

Aim: To analyze the association between BMI at birth and neonatal health outcomes in extremely low and very low birth weight preterm infants in China.

Methods: Used data from the Chinese Premature Infant Informatization Platform (2022-2023). Preterm infants were categorized based on their birth BMI z-scores into three groups: low BMI group (< -2), normal BMI group (-2 to 2) and high BMI group (>2). The relationship between BMI and neonatal health outcomes was then analyzed.

Results: The final analysis included 1662 extremely low and very low birth weight preterm infants. The results indicated that low BMI was significantly associated with an increased risk of respiratory distress syndrome (RDS) (AOR 1.61, 95% CI 1.31-2.30), bronchopulmonary dysplasia (BPD) (AOR 1.34, 95% CI 1.00-1.80) and necrotizing enterocolitis (NEC) (AOR 1.57, 95% CI 1.01-2.42). High BMI was significantly associated with an increased risk of RDS (AOR 1.60, 95% CI 1.05-2.45).

Conclusions: BMI at birth is significantly associated with the risks of RDS, BPD and NEC in ELBW and VLBW, highlighting the importance of monitoring BMI as an additional risk predictor in a population of neonates already at high risk for adverse outcomes.

Background: Previous research observed links between prenatal air pollution and risk of childhood obesity but the timing of the exposure is understudied.

Aim: We examined prenatal particulate matter (PM₁₀, PM_2.5) exposure and child anthropometry.

Materials & methods: Children's body mass index z-scores (zBMI) at 0-3 (N = 4370) and 7-9 (n = 1191) years were derived from reported anthropometry at paediatric visits. We ran linear mixed models for six windows, adjusting for maternal, child, and neighbourhood factors.

Results: PM₁₀ exposure across pregnancy and at multiple windows was associated with higher zBMI in both early and middle childhood. For instance, one interquartile range increase in PM₁₀ exposure during the first 2 weeks of pregnancy was associated with higher zBMI at 0-3 (0.05, 95% CI: 0.01, 0.10) and 7-9 (0.14, 95% CI: 0.02, 0.23). PM_2.5 exposure during the final 2 weeks of gestation was associated with higher zBMI at 7-9 years (B: 0.12, 95% CI: 0.04, 0.22).

Conclusion: Even at low levels of air pollution, prenatal PM₁₀ exposure was associated with higher zBMI in childhood.

Objective: To examine associations between parent and adolescent weight change within two parent approaches to adolescent obesity treatment.

Methods: Adolescent (M_age = 13.7 ± 1.2 years; M_BMI = 34.9 ± 7.0 kg/m²) and parent (M_BMI = 36.4 ± 7.3 kg/m²) dyads (N = 82) were randomized to TEENS+Parents as Coaches (PAC) or TEENS+parent weight loss (PWL). Anthropometrics were assessed at baseline (0-month), 4 months (post) and 7 months (after 3-month maintenance period). Regression analyses examined associations between parent and adolescent ΔBMI_0-4m and ΔBMI_4-7m, with parent group as a moderator.

Results: Post-treatment, parent and adolescent ∆BMI_0-4m were positively related (β = 0.68, p < 0.001), with no group interaction. Parent and adolescent ΔBMI_4-7m were related (β = 0.48, p = 0.012) during maintenance, moderated by parent group (β = -0.49, p = 0.010): positive relationships persisted in PAC (β = 0.39, p = 0.011), but not PWL (β = -0.19, p = 0.211).

Discussion: Parent and adolescent weight changes were positively related during treatment in both parent groups. During maintenance, weight change associations persisted only in PAC. These patterns prompt further exploration of parent factors driving weight change relationships.

Background: Varying obesogenic inherited predisposition in early to later life may differentially impact colorectal cancer (CRC) development. Previous Mendelian randomization (MR) studies, conducted in populations of European genetic similarity, have not observed any significant associations between early life body weight with CRC risk. However, it remains unclear whether body mass index (BMI) at different early lifetime points is causally related with CRC risk in both Europeans and East Asian populations.

Objectives: We conducted a two-sample MR study to investigate potential causal relationships between genetically predicted BMI during early life (birth to 8 years old) and at specific periods (birth, transient, early rise and late rise) and CRC risk.

Methods: Summary data were obtained from genome-wide association study (GWAS) of BMI in 28 681 children from the Norwegian Mother, Father and Child Cohort Study (MoBa) study and applied to CRC GWAS data from European and East Asian descent populations (102 893 cases and 485 083 non-cases).

Results: There were no significant associations observed between early life BMI and CRC risk in European or East Asian populations. The effect estimates were similar in European studies (odds ratio [OR] per a 1-standard deviation [SD] increase: 1.01, 95% confidence interval [CI]: 0.95, 1.07) and in East Asians (OR per a 1-SD increase: 1.02, 95% CI: 0.91, 1.14). Similar nonsignificant associations were found between time of BMI measurement during childhood and cancer-site-specific analyses.

Conclusions: We found little evidence of any associations between early life adiposity on later life CRC risk.